PHARMACOLOGY-I

Unit- I

1. General Pharmacology

a. Introduction to Pharmacology

b. Pharmacokinetics

Q1: What is pharmacology?
A) The study of human anatomy and physiology
B) The study of drugs and their effects on biological systems
C) The study of microorganisms and their effects on the body
D) The study of surgical procedures and their outcomes

Answer: B) The study of drugs and their effects on biological systems

Q2: Which of the following best defines a drug?
A) Any substance that affects biological functions
B) A chemical used only to cure diseases
C) Any synthetic compound used in food
D) A substance used only for pain relief

Answer: A) Any substance that affects biological functions

Historical Landmarks in Pharmacology

Q3: Who is considered the “Father of Modern Pharmacology”?
A) Claude Bernard
B) Oswald Schmiedeberg
C) Paul Ehrlich
D) William Withering

Answer: B) Oswald Schmiedeberg

Q4: The first vaccine was developed by Edward Jenner for which disease?
A) Polio
B) Rabies
C) Smallpox
D) Tuberculosis

Answer: C) Smallpox

Q5: Who discovered penicillin, the first widely used antibiotic?
A) Louis Pasteur
B) Alexander Fleming
C) Robert Koch
D) Joseph Lister

Answer: B) Alexander Fleming

Q6: The concept of “magic bullet” in pharmacology, referring to selective drug action, was introduced by:
A) Paul Ehrlich
B) John Langley
C) Claude Bernard
D) James Black

Answer: A) Paul Ehrlich

Scope of Pharmacology

Q7: Which branch of pharmacology studies the absorption, distribution, metabolism, and excretion of drugs?
A) Pharmacodynamics
B) Pharmacokinetics
C) Clinical pharmacology
D) Toxicology

Answer: B) Pharmacokinetics

Q8: The study of drug actions at the molecular and cellular level is called:
A) Pharmacokinetics
B) Pharmacodynamics
C) Toxicology
D) Pharmacognosy

Answer: B) Pharmacodynamics

Q9: The study of harmful effects of drugs and other chemicals on the body is known as:
A) Pharmacogenetics
B) Toxicology
C) Pharmacognosy
D) Chemotherapy

Answer: B) Toxicology

Q10: Clinical pharmacology primarily focuses on:
A) The effects of drugs on laboratory animals
B) Drug interactions in plants
C) The effects of drugs in human subjects
D) The chemistry of drug molecules

Answer: C) The effects of drugs in human subjects

1. Nature of Drugs

Q1: What is a drug?
A) Any substance that alters physiological functions
B) Only synthetic chemicals used in medicine
C) A substance used only for pain relief
D) A compound used to enhance food flavor

Answer: A) Any substance that alters physiological functions

Q2: Which of the following is NOT a property of an ideal drug?
A) High efficacy
B) Selectivity
C) Toxicity
D) Stability

Answer: C) Toxicity

Q3: Drugs that mimic the action of natural body substances are called:
A) Agonists
B) Antagonists
C) Inhibitors
D) Placebos

Answer: A) Agonists

Q4: Drugs that block the effects of endogenous substances are called:
A) Agonists
B) Antagonists
C) Prodrugs
D) Excipients

Answer: B) Antagonists

Q5: A drug that is inactive until it is metabolized into an active form is called:
A) Enzyme inhibitor
B) Prodrug
C) Competitive antagonist
D) Chelating agent

Answer: B) Prodrug

2. Sources of Drugs

Q6: Morphine, a well-known analgesic, is obtained from which natural source?
A) Bacteria
B) Opium poppy plant
C) Seaweed
D) Fungi

Answer: B) Opium poppy plant

Q7: Which of the following drugs is obtained from microbial sources?
A) Penicillin
B) Atropine
C) Digitalis
D) Morphine

Answer: A) Penicillin

Q8: Which of the following is an example of a synthetic drug?
A) Insulin
B) Aspirin
C) Quinine
D) Morphine

Answer: B) Aspirin

Q9: Which of the following is an example of a semi-synthetic drug?
A) Penicillin G
B) Ampicillin
C) Atropine
D) Digitalis

Answer: B) Ampicillin

Q10: The drug quinine, used to treat malaria, is derived from:
A) Fungi
B) Bacteria
C) Cinchona bark
D) Mineral sources

Answer: C) Cinchona bark

3. Essential Drugs Concept

Q11: The concept of Essential Drugs was introduced by which organization?
A) FDA
B) WHO
C) UNESCO
D) ICMR

Answer: B) WHO

Q12: The Essential Medicines List (EML) is updated every:
A) 2 years
B) 5 years
C) 10 years
D) 15 years

Answer: A) 2 years

Q13: Essential drugs are selected based on:
A) Their affordability and high cost
B) Their safety, efficacy, and public health importance
C) Their ability to treat rare diseases only
D) Their complex manufacturing process

Answer: B) Their safety, efficacy, and public health importance

Q14: Which of the following is NOT a criterion for a drug to be considered “essential”?
A) Availability
B) Cost-effectiveness
C) Required for treating rare diseases only
D) Safety and efficacy

Answer: C) Required for treating rare diseases only

Q15: The first WHO Model List of Essential Medicines was published in:
A) 1948
B) 1952
C) 1977
D) 1990

Answer: C) 1977

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Routes of Drug Administration

Which of the following routes of drug administration has the fastest absorption?
a) Intramuscular
b) Oral
c) Intravenous
d) Subcutaneous
Answer: c) Intravenous
Which of the following is NOT a factor affecting drug absorption?
a) Blood flow to the site of absorption
b) Drug solubility
c) Drug color
d) Surface area of absorption
Answer: c) Drug color
The main site of drug absorption in the gastrointestinal tract is:
a) Stomach
b) Small intestine
c) Colon
d) Esophagus
Answer: b) Small intestine
Which of the following mechanisms is used for the absorption of most lipid-soluble drugs?
a) Passive diffusion
b) Active transport
c) Facilitated diffusion
d) Endocytosis
Answer: a) Passive diffusion
Which factor increases drug absorption in the intestine?
a) Increased gastric emptying
b) Low blood flow to the intestines
c) Presence of food
d) High first-pass metabolism
Answer: a) Increased gastric emptying

Physiological and Pharmaceutical Factors Affecting Absorption

The presence of food in the stomach generally:
a) Increases drug absorption
b) Decreases drug absorption
c) Has no effect
d) Always enhances bioavailability
Answer: b) Decreases drug absorption
Which of the following formulations enhances drug absorption the most?
a) Tablets
b) Capsules
c) Aqueous solutions
d) Suspensions
Answer: c) Aqueous solutions
Gastrointestinal pH affects the absorption of drugs because:
a) It changes the drug’s lipid solubility
b) It modifies plasma protein binding
c) It alters the size of the drug molecule
d) It increases drug elimination
Answer: a) It changes the drug’s lipid solubility
Which factor does NOT affect passive diffusion of drugs?
a) Drug concentration gradient
b) Lipid solubility
c) Surface area of absorption
d) ATP energy requirement
Answer: d) ATP energy requirement
The pH partition hypothesis states that:
a) Ionized drugs are absorbed more easily
b) Non-ionized drugs are absorbed more easily
c) Drug absorption is independent of pH
d) Acidic drugs are best absorbed in the intestines
Answer: b) Non-ionized drugs are absorbed more easily

Factors Affecting Drug Solubility and Permeability

Lipophilic drugs are best absorbed by:
a) Active transport
b) Passive diffusion
c) Endocytosis
d) Carrier-mediated transport
Answer: b) Passive diffusion
Which of the following factors enhances drug dissolution?
a) Large particle size
b) Poor aqueous solubility
c) High surface area
d) High crystallinity
Answer: c) High surface area
Which class of drugs is best absorbed in an acidic environment?
a) Weak acids
b) Weak bases
c) Neutral drugs
d) Protein-bound drugs
Answer: a) Weak acids
A drug with poor water solubility will have:
a) Fast absorption
b) Poor dissolution
c) High bioavailability
d) Rapid metabolism
Answer: b) Poor dissolution
The Henderson-Hasselbalch equation is useful in determining:
a) Drug solubility in lipid membranes
b) The pH of gastric acid
c) The ionization state of a drug
d) The excretion rate of drugs
Answer: c) The ionization state of a drug

Transport Mechanisms in Drug Absorption

Which transport mechanism requires ATP?
a) Passive diffusion
b) Active transport
c) Facilitated diffusion
d) Filtration
Answer: b) Active transport
Which of the following drugs is absorbed by active transport?
a) Glucose
b) Lipophilic drugs
c) Aminoglycosides
d) Peptide drugs
Answer: d) Peptide drugs
Which of the following statements is TRUE regarding facilitated diffusion?
a) It requires ATP
b) It follows a concentration gradient
c) It transports large molecules only
d) It is slower than passive diffusion
Answer: b) It follows a concentration gradient
Which transport mechanism is most common for polar drugs?
a) Passive diffusion
b) Active transport
c) Endocytosis
d) Facilitated diffusion
Answer: d) Facilitated diffusion
Endocytosis is the major absorption mechanism for:
a) Lipophilic drugs
b) Hydrophilic drugs
c) Large molecules such as proteins
d) Small ions
Answer: c) Large molecules such as proteins

Special Cases and Clinical Considerations

Which of the following routes bypasses the first-pass effect?
a) Oral
b) Sublingual
c) Rectal
d) Both b and c
Answer: d) Both b and c
Which of the following conditions will decrease drug absorption?
a) Increased gastric emptying
b) Decreased intestinal motility
c) Low blood flow to the intestines
d) Large surface area for absorption
Answer: c) Low blood flow to the intestines
Which of the following drugs shows poor oral absorption?
a) Morphine
b) Insulin
c) Paracetamol
d) Diazepam
Answer: b) Insulin
The term “bioavailability” refers to:
a) The rate and extent of drug absorption
b) The drug’s potency
c) The drug’s half-life
d) The drug’s metabolism rate
Answer: a) The rate and extent of drug absorption
Which of the following dosage forms has the highest bioavailability?
a) Oral tablet
b) Enteric-coated tablet
c) Intravenous injection
d) Extended-release capsule
Answer: c) Intravenous injection

Miscellaneous

Which organ plays the most significant role in drug absorption?
a) Stomach
b) Liver
c) Small intestine
d) Kidney
Answer: c) Small intestine
Which process is essential for the absorption of fat-soluble vitamins?
a) Passive diffusion
b) Active transport
c) Micelle formation
d) Ionization
Answer: c) Micelle formation
Gastric pH is lowest in:
a) Neonates
b) Adults
c) Elderly
d) Pregnant women
Answer: a) Neonates
Which of the following is a major barrier to drug absorption?
a) Blood-brain barrier
b) Hepatic portal vein
c) Lymphatic system
d) Kidneys
Answer: a) Blood-brain barrier
Which method enhances the absorption of poorly soluble drugs?
a) Nanotechnology
b) Large particle size
c) Crystalline formulation
d) Low surface area
Answer: a) Nanotechnology

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Which of the following factors primarily affects drug distribution?
a) Drug solubility
b) Plasma protein binding
c) Blood flow to tissues
d) All of the above
Answer: d) All of the above
Which plasma protein primarily binds acidic drugs?
a) Albumin
b) Globulin
c) Transferrin
d) Fibrinogen
Answer: a) Albumin
The volume of distribution (Vd) of a drug indicates:
a) The extent of drug distribution in body compartments
b) The drug’s elimination rate
c) The drug’s absorption rate
d) The drug’s half-life
Answer: a) The extent of drug distribution in body compartments
A drug with a high volume of distribution (Vd) is likely to:
a) Remain in the plasma
b) Distribute extensively into tissues
c) Be eliminated rapidly
d) Have a short half-life
Answer: b) Distribute extensively into tissues
Which of the following drugs is likely to have a low volume of distribution (Vd)?
a) Lipophilic drugs
b) Highly protein-bound drugs
c) Small, uncharged molecules
d) Weak bases
Answer: b) Highly protein-bound drugs

Plasma Protein Binding

Drugs that are highly bound to plasma proteins have:
a) Short half-lives
b) Low free drug concentration
c) Increased clearance
d) High bioavailability
Answer: b) Low free drug concentration
Displacement of a highly protein-bound drug by another drug can lead to:
a) Increased free drug concentration
b) Decreased drug activity
c) Increased drug metabolism
d) Increased drug excretion
Answer: a) Increased free drug concentration
Which of the following drugs is highly bound to plasma proteins?
a) Warfarin
b) Paracetamol
c) Penicillin
d) Metformin
Answer: a) Warfarin
Which condition can decrease plasma protein binding of drugs?
a) Liver disease
b) Kidney disease
c) Malnutrition
d) All of the above
Answer: d) All of the above
Hypoalbuminemia can lead to:
a) Increased drug metabolism
b) Increased free drug concentration
c) Decreased drug elimination
d) Increased drug absorption
Answer: b) Increased free drug concentration

Blood Flow and Tissue Distribution

Which organ receives the highest blood flow, influencing drug distribution?
a) Liver
b) Brain
c) Kidneys
d) Muscles
Answer: c) Kidneys
Which tissue is a poor site for drug distribution due to low blood flow?
a) Adipose tissue
b) Liver
c) Heart
d) Brain
Answer: a) Adipose tissue
The blood-brain barrier (BBB) is most permeable to:
a) Lipophilic drugs
b) Hydrophilic drugs
c) Ionized drugs
d) Protein-bound drugs
Answer: a) Lipophilic drugs
Which of the following drugs crosses the blood-brain barrier easily?
a) Morphine
b) Penicillin
c) Heparin
d) Aminoglycosides
Answer: a) Morphine
The placental barrier primarily protects the fetus by:
a) Blocking the entry of all drugs
b) Allowing only ionized drugs to pass
c) Selectively permitting lipophilic drugs
d) Enhancing drug metabolism
Answer: c) Selectively permitting lipophilic drugs

Drug Redistribution

Drug redistribution occurs when a drug initially distributes to:
a) High blood flow organs and later to fat/muscle
b) Plasma proteins only
c) The kidneys for elimination
d) The lungs for metabolism
Answer: a) High blood flow organs and later to fat/muscle
Which of the following drugs undergoes redistribution?
a) Thiopental
b) Penicillin
c) Atenolol
d) Metformin
Answer: a) Thiopental
The redistribution of thiopental leads to:
a) Short duration of action
b) Increased half-life
c) Enhanced metabolism
d) Decreased potency
Answer: a) Short duration of action
Which factor affects the rate of drug redistribution?
a) Blood flow to tissues
b) Plasma protein binding
c) Route of administration
d) Drug metabolism
Answer: a) Blood flow to tissues
Lipophilic drugs tend to accumulate in which tissue?
a) Brain
b) Adipose tissue
c) Liver
d) Kidneys
Answer: b) Adipose tissue

Volume of Distribution (Vd) and Clinical Considerations

A drug with a small volume of distribution (Vd) is primarily located in:
a) Plasma
b) Fat tissue
c) Muscle tissue
d) Brain tissue
Answer: a) Plasma
Which drug is likely to have a large volume of distribution (Vd)?
a) Digoxin
b) Warfarin
c) Heparin
d) Aminoglycosides
Answer: a) Digoxin
A large Vd indicates that the drug is:
a) Confined to plasma
b) Extensively bound to plasma proteins
c) Distributed into tissues
d) Poorly absorbed
Answer: c) Distributed into tissues
If a drug is highly bound to tissue proteins, it will have:
a) Low Vd
b) High Vd
c) No effect on Vd
d) Rapid elimination
Answer: b) High Vd
Which condition increases the volume of distribution of a drug?
a) Dehydration
b) Increased adipose tissue
c) Low plasma protein levels
d) Both b and c
Answer: d) Both b and c

Special Considerations

Which factor affects drug distribution in neonates?
a) Lower plasma protein levels
b) Increased body water content
c) Immature blood-brain barrier
d) All of the above
Answer: d) All of the above
Which of the following diseases can alter drug distribution?
a) Liver disease
b) Kidney disease
c) Cardiac failure
d) All of the above
Answer: d) All of the above
A drug with high plasma protein binding will have:
a) A longer duration of action
b) Faster elimination
c) Higher free drug concentration
d) Decreased bioavailability
Answer: a) A longer duration of action
Which drug is highly distributed in fat tissues?
a) Diazepam
b) Metformin
c) Heparin
d) Atenolol
Answer: a) Diazepam
Which factor does NOT influence drug distribution?
a) Blood flow
b) Plasma protein binding
c) Drug metabolism
d) Tissue permeability
Answer: c) Drug metabolism

Drug Metabolism (Biotransformation)

The primary site of drug metabolism is:
a) Kidney
b) Liver
c) Lungs
d) Intestines
Answer: b) Liver
Phase I metabolism mainly involves:
a) Conjugation reactions
b) Oxidation, reduction, and hydrolysis
c) Glucuronidation
d) Sulfation
Answer: b) Oxidation, reduction, and hydrolysis
Which enzyme system is primarily responsible for Phase I metabolism?
a) Cytochrome P450 (CYP450)
b) UDP-glucuronosyltransferase
c) Glutathione-S-transferase
d) Acetyltransferase
Answer: a) Cytochrome P450 (CYP450)
Phase II metabolism usually results in:
a) Increased drug lipophilicity
b) Drug activation
c) Increased drug hydrophilicity
d) Decreased drug elimination
Answer: c) Increased drug hydrophilicity
Which of the following is NOT a Phase II reaction?
a) Glucuronidation
b) Acetylation
c) Oxidation
d) Sulfation
Answer: c) Oxidation

Cytochrome P450 (CYP) Enzymes

CYP3A4 is responsible for metabolizing approximately what percentage of drugs?
a) 10%
b) 25%
c) 50%
d) 75%
Answer: c) 50%
Which of the following drugs is a CYP enzyme inducer?
a) Rifampin
b) Cimetidine
c) Ketoconazole
d) Erythromycin
Answer: a) Rifampin
Which drug is a CYP enzyme inhibitor?
a) Phenobarbital
b) Carbamazepine
c) Grapefruit juice
d) Phenytoin
Answer: c) Grapefruit juice
Genetic polymorphism affects which Phase I metabolic reaction the most?
a) Glucuronidation
b) Sulfation
c) Acetylation
d) Oxidation
Answer: d) Oxidation
The “first-pass effect” refers to:
a) Drug elimination via the kidney
b) Drug metabolism before reaching systemic circulation
c) Drug reabsorption in the intestines
d) Drug excretion via bile
Answer: b) Drug metabolism before reaching systemic circulation

Factors Affecting Drug Metabolism

Which factor decreases drug metabolism?
a) Enzyme induction
b) Liver disease
c) High first-pass effect
d) Increased renal clearance
Answer: b) Liver disease
Which phase of metabolism is most affected in neonates?
a) Phase I
b) Phase II
c) Both Phase I and Phase II
d) Neither Phase I nor Phase II
Answer: b) Phase II
Which metabolic reaction is deficient in slow acetylators?
a) Oxidation
b) Acetylation
c) Sulfation
d) Glucuronidation
Answer: b) Acetylation
Elderly patients usually have:
a) Increased drug metabolism
b) Reduced Phase I metabolism
c) Increased renal clearance
d) Higher plasma protein levels
Answer: b) Reduced Phase I metabolism
Which of the following conditions increases drug metabolism?
a) Liver cirrhosis
b) Smoking
c) Renal failure
d) Neonatal age
Answer: b) Smoking

Drug Excretion

The primary organ responsible for drug excretion is:
a) Liver
b) Kidney
c) Lungs
d) Skin
Answer: b) Kidney
Which of the following drugs is excreted mainly through bile?
a) Digoxin
b) Morphine
c) Warfarin
d) Aspirin
Answer: b) Morphine
Renal drug excretion involves all of the following EXCEPT:
a) Glomerular filtration
b) Passive reabsorption
c) Active tubular secretion
d) First-pass metabolism
Answer: d) First-pass metabolism
Which factor enhances renal drug excretion?
a) Increased tubular reabsorption
b) Increased urine pH
c) High lipid solubility
d) Protein binding
Answer: b) Increased urine pH
Weak acidic drugs are better excreted in:
a) Acidic urine
b) Alkaline urine
c) Plasma
d) Bile
Answer: b) Alkaline urine

Special Cases in Drug Excretion

Which of the following drugs is excreted mainly by the lungs?
a) Alcohol
b) Morphine
c) Diazepam
d) Lidocaine
Answer: a) Alcohol
Which process decreases drug excretion?
a) Increased renal blood flow
b) Increased active tubular secretion
c) Increased protein binding
d) Alkalinization of urine for acidic drugs
Answer: c) Increased protein binding
Which drug is excreted unchanged in urine?
a) Penicillin
b) Diazepam
c) Propranolol
d) Warfarin
Answer: a) Penicillin
Which of the following increases the elimination of weak bases?
a) Acidification of urine
b) Alkalinization of urine
c) Increased plasma protein binding
d) Decreased urine flow rate
Answer: a) Acidification of urine
Drugs with high renal clearance are:
a) Highly protein-bound
b) Highly filtered and secreted
c) Extensively reabsorbed
d) Lipophilic
Answer: b) Highly filtered and secreted

Miscellaneous

Which of the following is a prodrug that is activated by metabolism?
a) L-Dopa
b) Warfarin
c) Digoxin
d) Heparin
Answer: a) L-Dopa
Which of the following is an example of enterohepatic circulation?
a) Morphine
b) Warfarin
c) Aspirin
d) Paracetamol
Answer: a) Morphine
Which type of metabolism converts an inactive drug into an active metabolite?
a) First-pass metabolism
b) Phase I metabolism
c) Prodrug activation
d) Conjugation
Answer: c) Prodrug activation
Which of the following can alter drug metabolism?
a) Liver disease
b) Age
c) Genetic factors
d) All of the above
Answer: d) All of the above
Which factor does NOT affect renal drug excretion?
a) pH of urine
b) Plasma protein binding
c) Hepatic metabolism
d) Renal blood flow
Answer: c) Hepatic metabolism

Enzyme Induction

Enzyme induction results in:
a) Increased drug metabolism
b) Decreased drug metabolism
c) No effect on metabolism
d) Increased drug toxicity
Answer: a) Increased drug metabolism
Which enzyme system is primarily involved in enzyme induction?
a) Cytochrome P450 (CYP)
b) Glutathione-S-transferase
c) UDP-glucuronosyltransferase
d) Monoamine oxidase
Answer: a) Cytochrome P450 (CYP)
Which of the following drugs is a CYP enzyme inducer?
a) Rifampin
b) Cimetidine
c) Ketoconazole
d) Erythromycin
Answer: a) Rifampin
Enzyme induction leads to which of the following effects?
a) Increased plasma drug levels
b) Decreased therapeutic effect of the drug
c) Increased drug toxicity
d) Prolonged drug action
Answer: b) Decreased therapeutic effect of the drug
Which of the following drugs induces its own metabolism?
a) Carbamazepine
b) Warfarin
c) Diazepam
d) Digoxin
Answer: a) Carbamazepine
Chronic alcohol consumption leads to:
a) Enzyme inhibition
b) Enzyme induction
c) No effect on metabolism
d) Increased drug half-life
Answer: b) Enzyme induction
Which condition can increase enzyme induction?
a) Liver failure
b) Chronic exposure to certain drugs
c) Neonatal age
d) Renal disease
Answer: b) Chronic exposure to certain drugs
Which of the following effects may be observed with enzyme induction?
a) Decreased drug bioavailability
b) Increased drug toxicity
c) Reduced drug clearance
d) Prolonged drug effect
Answer: a) Decreased drug bioavailability
Which of the following drugs is NOT an enzyme inducer?
a) Phenytoin
b) Phenobarbital
c) Erythromycin
d) Rifampin
Answer: c) Erythromycin
Enzyme induction may require how many days to reach full effect?
a) Few minutes
b) Few hours
c) 5-7 days
d) Immediately after the first dose
Answer: c) 5-7 days

Enzyme Inhibition

Enzyme inhibition results in:
a) Increased drug metabolism
b) Decreased drug metabolism
c) No change in drug metabolism
d) Increased drug excretion
Answer: b) Decreased drug metabolism
Which of the following drugs is a CYP enzyme inhibitor?
a) Cimetidine
b) Rifampin
c) Carbamazepine
d) Phenytoin
Answer: a) Cimetidine
Which of the following statements is true regarding enzyme inhibition?
a) It increases drug metabolism
b) It prolongs drug action
c) It decreases plasma drug levels
d) It enhances prodrug activation
Answer: b) It prolongs drug action
Which of the following is a competitive enzyme inhibitor?
a) Warfarin
b) Ketoconazole
c) Diazepam
d) Phenytoin
Answer: b) Ketoconazole
Enzyme inhibition typically results in:
a) Faster drug clearance
b) Increased plasma drug concentration
c) Decreased drug potency
d) Increased drug metabolism
Answer: b) Increased plasma drug concentration
Acute alcohol consumption leads to:
a) Enzyme inhibition
b) Enzyme induction
c) Increased renal clearance
d) Increased drug absorption
Answer: a) Enzyme inhibition
Grapefruit juice is known to:
a) Induce CYP enzymes
b) Inhibit CYP enzymes
c) Enhance drug excretion
d) Reduce drug absorption
Answer: b) Inhibit CYP enzymes
Which type of enzyme inhibition is reversible?
a) Competitive inhibition
b) Non-competitive inhibition
c) Irreversible inhibition
d) Suicide inhibition
Answer: a) Competitive inhibition
Which enzyme inhibitor increases warfarin toxicity?
a) Rifampin
b) Cimetidine
c) Phenytoin
d) Phenobarbital
Answer: b) Cimetidine
Enzyme inhibition effects are usually observed:
a) After prolonged drug therapy
b) Immediately after administration
c) After 2-3 weeks
d) Only in neonates
Answer: b) Immediately after administration

Kinetics of Drug Elimination

The rate of drug elimination is directly proportional to drug concentration in:
a) First-order kinetics
b) Zero-order kinetics
c) Michaelis-Menten kinetics
d) Non-linear kinetics
Answer: a) First-order kinetics
Which of the following follows zero-order kinetics?
a) Phenytoin
b) Aspirin
c) Ethanol
d) All of the above
Answer: d) All of the above
In first-order kinetics, drug elimination:
a) Is constant per unit time
b) Increases as drug concentration increases
c) Is independent of drug concentration
d) Is always rapid
Answer: b) Increases as drug concentration increases
Zero-order elimination means:
a) Constant fraction of drug is eliminated per unit time
b) Constant amount of drug is eliminated per unit time
c) Drug elimination follows saturation kinetics
d) Drug metabolism is independent of enzyme availability
Answer: b) Constant amount of drug is eliminated per unit time
Which of the following drugs follows mixed-order (dose-dependent) kinetics?
a) Phenytoin
b) Theophylline
c) Warfarin
d) All of the above
Answer: d) All of the above
In first-order elimination, the drug half-life is:
a) Constant
b) Variable
c) Shorter at higher drug concentrations
d) Unpredictable
Answer: a) Constant
The drug with the longest half-life is:
a) Diazepam
b) Phenytoin
c) Amiodarone
d) Heparin
Answer: c) Amiodarone
Drugs eliminated by zero-order kinetics:
a) Show a linear elimination curve
b) Have a constant elimination rate
c) Saturate elimination mechanisms at high doses
d) All of the above
Answer: d) All of the above
Which drug is eliminated primarily by renal excretion?
a) Penicillin
b) Diazepam
c) Warfarin
d) Phenytoin
Answer: a) Penicillin
A drug with a short half-life will have:
a) A longer duration of action
b) A higher elimination rate
c) A lower clearance rate
d) A lower loading dose requirement
Answer: b) A higher elimination rate

Agonists and Antagonists

An agonist is a drug that:
a) Blocks a receptor
b) Activates a receptor
c) Competes with an antagonist
d) Decreases receptor activity
Answer: b) Activates a receptor
Which of the following is an example of a full agonist?
a) Naloxone
b) Morphine
c) Atropine
d) Propranolol
Answer: b) Morphine
A partial agonist:
a) Produces the same maximal effect as a full agonist
b) Acts as an antagonist in presence of a full agonist
c) Has no effect on the receptor
d) Is always inactive
Answer: b) Acts as an antagonist in presence of a full agonist
A competitive antagonist:
a) Binds irreversibly to the receptor
b) Increases the maximal response of an agonist
c) Can be overcome by increasing agonist concentration
d) Blocks receptor permanently
Answer: c) Can be overcome by increasing agonist concentration
Non-competitive antagonists:
a) Bind to the same site as the agonist
b) Irreversibly inhibit receptor function
c) Shift the dose-response curve to the right
d) Can be displaced by increasing agonist concentration
Answer: b) Irreversibly inhibit receptor function
Which of the following is a non-competitive antagonist?
a) Atropine
b) Phenoxybenzamine
c) Naloxone
d) Propranolol
Answer: b) Phenoxybenzamine
The potency of an agonist is reduced in the presence of:
a) Non-competitive antagonist
b) Competitive antagonist
c) Spare receptor activation
d) Allosteric activator
Answer: b) Competitive antagonist
Which of the following is an irreversible antagonist?
a) Prazosin
b) Phenoxybenzamine
c) Naloxone
d) Losartan
Answer: b) Phenoxybenzamine
Which drug acts as a partial agonist at opioid receptors?
a) Morphine
b) Buprenorphine
c) Naloxone
d) Codeine
Answer: b) Buprenorphine
In the presence of a competitive antagonist, the dose-response curve of an agonist shifts:
a) Downward
b) To the left
c) To the right
d) Does not change
Answer: c) To the right

Spare Receptors

Spare receptors are:
a) More than the number needed to produce a maximal response
b) Non-functional receptors
c) Less than the number needed to produce a response
d) Receptors that are permanently occupied
Answer: a) More than the number needed to produce a maximal response
Spare receptors increase:
a) Potency of the drug
b) Affinity of the drug
c) Clearance of the drug
d) None of the above
Answer: a) Potency of the drug
The presence of spare receptors means:
a) A lower concentration of drug can produce a maximal effect
b) All receptors must be occupied for an effect
c) The drug must be given in higher doses
d) The drug effect is always decreased
Answer: a) A lower concentration of drug can produce a maximal effect

Addiction, Tolerance, Dependence

Addiction is characterized by:
a) Physical dependence
b) Psychological dependence
c) Both physical and psychological dependence
d) No dependence
Answer: c) Both physical and psychological dependence
Which of the following drugs causes addiction?
a) Morphine
b) Aspirin
c) Paracetamol
d) Ibuprofen
Answer: a) Morphine
Drug tolerance means:
a) Decreased response to the same dose
b) Increased response to the same dose
c) The drug is ineffective
d) The drug causes an allergic reaction
Answer: a) Decreased response to the same dose
Which of the following develops the fastest tolerance?
a) Morphine
b) Diazepam
c) Alcohol
d) LSD
Answer: d) LSD
Dependence on a drug occurs when:
a) The drug is only taken once
b) The drug is stopped suddenly and withdrawal symptoms occur
c) The drug has no effect
d) There is no craving
Answer: b) The drug is stopped suddenly and withdrawal symptoms occur

Tachyphylaxis, Idiosyncrasy, and Allergy

Tachyphylaxis is:
a) Rapid tolerance to a drug
b) A drug allergy
c) A genetic defect
d) Increased drug response
Answer: a) Rapid tolerance to a drug
Which of the following is an example of tachyphylaxis?
a) Repeated use of ephedrine
b) Morphine addiction
c) Diazepam tolerance
d) Warfarin resistance
Answer: a) Repeated use of ephedrine
Idiosyncrasy is:
a) A predictable drug reaction
b) An unexpected, unusual reaction
c) An allergic reaction
d) A competitive antagonism
Answer: b) An unexpected, unusual reaction
An example of an idiosyncratic reaction is:
a) Penicillin-induced anaphylaxis
b) Severe hemolysis with primaquine in G6PD deficiency
c) Morphine tolerance
d) Naloxone antagonism
Answer: b) Severe hemolysis with primaquine in G6PD deficiency
Allergic reactions to drugs are mediated by:
a) Histamine release
b) Direct receptor activation
c) Enzyme inhibition
d) Genetic polymorphism
Answer: a) Histamine release
Which immunoglobulin mediates anaphylactic drug reactions?
a) IgG
b) IgA
c) IgE
d) IgM
Answer: c) IgE
Which of the following is NOT an allergic reaction?
a) Anaphylaxis
b) Serum sickness
c) Tachyphylaxis
d) Drug-induced rash
Answer: c) Tachyphylaxis
Which of the following drugs commonly causes anaphylaxis?
a) Penicillin
b) Paracetamol
c) Metformin
d) Propranolol
Answer: a) Penicillin

—————————————————————————————————————————–

Unit-II

1. Basic Principles of Pharmacodynamics

2. Adverse drug reactions.

3. Drug interactions

4. Drugdiscoveryand clinical evaluation of new drugs

Pharmacodynamics refers to
a) The movement of drugs within the body
b) The effect of the drug on the body
c) The metabolism of drugs
d) The excretion of drugs
Answer: b) The effect of the drug on the body
Which of the following is NOT a mechanism of drug action?
a) Enzyme inhibition
b) Receptor activation
c) Protein synthesis
d) Gene mutation
Answer: d) Gene mutation
A drug that binds to a receptor and activates it is called:
a) Antagonist
b) Agonist
c) Inhibitor
d) Modulator
Answer: b) Agonist
A drug that blocks the action of an endogenous molecule is called:
a) Agonist
b) Antagonist
c) Allosteric activator
d) Inhibitor
Answer: b) Antagonist
Which of the following drug-receptor interactions is reversible?
a) Covalent binding
b) Ionic bonding
c) Hydrogen bonding
d) Both b and c
Answer: d) Both b and c

Receptor Theory and Drug Action

According to the occupancy theory, drug response is proportional to:

a) Drug solubility
b) Number of receptors occupied
c) Drug metabolism
d) Drug excretion
Answer: b) Number of receptors occupied

Which of the following is an example of a ligand-gated ion channel?
a) GABA-A receptor
b) Insulin receptor
c) β-Adrenergic receptor
d) Estrogen receptor
Answer: a) GABA-A receptor
G-protein-coupled receptors (GPCRs) mediate drug action through:
a) Enzyme activation
b) Ion channels
c) Second messengers
d) Direct DNA binding
Answer: c) Second messengers
Which of the following is a second messenger?
a) cAMP
b) ATP
c) Na+
d) GTP
Answer: a) cAMP
Which receptor type is the fastest in action?
a) Ion channel receptors
b) GPCRs
c) Enzyme-linked receptors
d) Nuclear receptors
Answer: a) Ion channel receptors

Dose-Response Relationship

EC50 refers to:
a) The dose that produces 50% of the maximum response
b) The lethal dose in 50% of subjects
c) The amount of drug excreted in 50% of subjects
d) The highest possible dose of a drug
Answer: a) The dose that produces 50% of the maximum response
The maximal effect a drug can produce is called:
a) Potency
b) Efficacy
c) Affinity
d) Selectivity
Answer: b) Efficacy
Which parameter defines the strength of drug-receptor binding?
a) Potency
b) Efficacy
c) Affinity
d) Clearance
Answer: c) Affinity
Which of the following is NOT a type of dose-response relationship?
a) Graded dose-response
b) Quantal dose-response
c) Linear dose-response
d) None of the above
Answer: c) Linear dose-response
A more potent drug requires:
a) A lower dose to achieve the same effect
b) A higher dose to achieve the same effect
c) More time for action
d) A higher EC50 value
Answer: a) A lower dose to achieve the same effect

Types of Drug Actions

A drug that binds to a different site than the agonist and still blocks its action is called a:
a) Competitive antagonist
b) Non-competitive antagonist
c) Inverse agonist
d) Allosteric agonist
Answer: b) Non-competitive antagonist
Which of the following follows allosteric modulation?
a) Benzodiazepines
b) Atropine
c) Morphine
d) Naloxone
Answer: a) Benzodiazepines
Inverse agonists:
a) Activate the receptor fully
b) Decrease receptor activity below basal levels
c) Block receptor activation
d) Have no effect
Answer: b) Decrease receptor activity below basal levels
Which of the following is a second messenger system for GPCRs?
a) cAMP
b) ATP
c) GABA
d) Sodium ions
Answer: a) cAMP
Which of the following drugs acts through nuclear receptors?
a) Insulin
b) Cortisol
c) Epinephrine
d) Acetylcholine
Answer: b) Cortisol

Tolerance, Tachyphylaxis, and Drug Interactions

Drug tolerance develops due to:
a) Enzyme inhibition
b) Receptor desensitization
c) Drug excretion
d) Drug solubility
Answer: b) Receptor desensitization
Tachyphylaxis is characterized by:
a) Rapid tolerance development
b) Delayed response
c) Prolonged drug effect
d) No effect on response
Answer: a) Rapid tolerance development
An example of tachyphylaxis is:
a) Repeated use of nitroglycerin
b) Morphine tolerance
c) Antidepressant tolerance
d) Warfarin resistance
Answer: a) Repeated use of nitroglycerin
Synergism between two drugs means:
a) The effect is greater than the sum of both drugs
b) The effect is the same as a single drug
c) The drugs cancel each other’s effect
d) No interaction occurs
Answer: a) The effect is greater than the sum of both drugs
Which of the following is an example of a pharmacodynamic drug interaction?
a) Naloxone reversing morphine effects
b) Probenecid reducing renal excretion of penicillin
c) Antacids affecting drug absorption
d) Warfarin interacting with vitamin K
Answer: a) Naloxone reversing morphine effects

Receptor Theories

The term ‘receptor’ in pharmacology refers to:
a) A drug molecule
b) A specific cellular target where drugs bind
c) An enzyme that metabolizes drugs
d) A protein that transports drugs
Answer: b) A specific cellular target where drugs bind
The receptor occupancy theory states that:
a) Drug response is independent of receptor binding
b) Drug response is proportional to the number of receptors occupied
c) All drugs act through enzymes, not receptors
d) Drugs do not require receptors to act
Answer: b) Drug response is proportional to the number of receptors occupied
Which receptor theory suggests that the drug-receptor complex must undergo a conformational change to elicit a response?
a) Occupancy theory
b) Rate theory
c) Induced fit theory
d) Allosteric theory
Answer: c) Induced fit theory
The rate theory of drug action suggests that:
a) The response is proportional to receptor occupancy
b) The response depends on the frequency of receptor activation
c) A single binding event produces a maximal effect
d) All drugs follow first-order kinetics
Answer: b) The response depends on the frequency of receptor activation
The two-state receptor model suggests that receptors exist in:
a) Active and inactive states
b) Bound and unbound states only
c) A single conformational state
d) Non-functional and functional states
Answer: a) Active and inactive states

Classification of Receptors

Which of the following is NOT a major type of receptor?
a) Ion channel-linked receptors
b) G-protein-coupled receptors
c) Enzyme-linked receptors
d) Lipid receptors
Answer: d) Lipid receptors
Which of the following is an example of a ligand-gated ion channel?
a) GABA-A receptor
b) Beta-adrenergic receptor
c) Insulin receptor
d) Thyroid hormone receptor
Answer: a) GABA-A receptor
G-protein-coupled receptors (GPCRs) are also known as:
a) Ionotropic receptors
b) Metabotropic receptors
c) Cytoplasmic receptors
d) Nuclear receptors
Answer: b) Metabotropic receptors
Which of the following is a second messenger in GPCR signaling?
a) cAMP
b) ATP
c) Na+ ions
d) Insulin
Answer: a) cAMP
Which receptor type directly affects gene transcription?
a) Ion channel receptor
b) GPCR
c) Nuclear receptor
d) Enzyme-linked receptor
Answer: c) Nuclear receptor

Ion Channel-Linked Receptors

Which receptor is a ligand-gated ion channel?
a) Nicotinic acetylcholine receptor
b) Beta-adrenergic receptor
c) Estrogen receptor
d) Insulin receptor
Answer: a) Nicotinic acetylcholine receptor
Which ions pass through the nicotinic acetylcholine receptor when activated?
a) Potassium
b) Sodium
c) Calcium
d) Chloride
Answer: b) Sodium

G-Protein-Coupled Receptors (GPCRs)

GPCRs have how many transmembrane domains?
a) 4
b) 5
c) 7
d) 8
Answer: c) 7
Which of the following is a GPCR?
a) GABA-A receptor
b) Insulin receptor
c) Beta-adrenergic receptor
d) Estrogen receptor
Answer: c) Beta-adrenergic receptor
GPCRs activate which enzyme to increase cAMP?
a) Adenylyl cyclase
b) Phospholipase C
c) Tyrosine kinase
d) Cyclooxygenase
Answer: a) Adenylyl cyclase

Enzyme-Linked Receptors

Which of the following is an enzyme-linked receptor?
a) Nicotinic receptor
b) Beta-adrenergic receptor
c) Insulin receptor
d) GABA receptor
Answer: c) Insulin receptor
Which intracellular enzyme is activated by enzyme-linked receptors?
a) Kinase
b) Cyclooxygenase
c) Phospholipase A2
d) Lipoxygenase
Answer: a) Kinase

Nuclear Receptors

Which receptor type has the slowest response time?
a) GPCRs
b) Ion channels
c) Enzyme-linked receptors
d) Nuclear receptors
Answer: d) Nuclear receptors
Which of the following hormones acts via a nuclear receptor?
a) Epinephrine
b) Insulin
c) Cortisol
d) Acetylcholine
Answer: c) Cortisol
Where are nuclear receptors located?
a) Plasma membrane
b) Cytoplasm and nucleus
c) Synaptic cleft
d) Mitochondria
Answer: b) Cytoplasm and nucleus

Regulation of Receptors

Downregulation of receptors occurs due to:
a) Continuous stimulation by an agonist
b) Intermittent drug dosing
c) Competitive antagonism
d) Drug excretion
Answer: a) Continuous stimulation by an agonist
Upregulation of receptors occurs due to:
a) Chronic receptor blockade
b) Excessive agonist exposure
c) Enzyme induction
d) First-pass metabolism
Answer: a) Chronic receptor blockade
Which of the following is an example of receptor downregulation?
a) Prolonged use of beta-agonists reducing receptor sensitivity
b) Morphine withdrawal syndrome
c) Increased GABA receptor expression
d) Enzyme inhibition
Answer: a) Prolonged use of beta-agonists reducing receptor sensitivity
Desensitization of receptors leads to:
a) Increased drug response
b) Decreased drug response
c) Increased receptor number
d) Irreversible inhibition
Answer: b) Decreased drug response
Which of the following is an irreversible mechanism of receptor regulation?
a) Competitive antagonism
b) Covalent receptor modification
c) Allosteric inhibition
d) Drug metabolism
Answer: b) Covalent receptor modification

Drug-Receptor Interactions

A receptor is defined as:
a) A substance that inactivates drugs
b) A protein that binds to a ligand to produce a biological response
c) An enzyme that metabolizes drugs
d) A chemical that inhibits drug activity
Answer: b) A protein that binds to a ligand to produce a biological response
Which of the following statements is TRUE about drug-receptor interactions?
a) Only irreversible binding leads to drug action
b) All drugs act through receptors
c) Drug-receptor interactions follow the law of mass action
d) Drugs permanently modify receptors
Answer: c) Drug-receptor interactions follow the law of mass action
The strength of a drug binding to a receptor is known as:
a) Potency
b) Efficacy
c) Affinity
d) Selectivity
Answer: c) Affinity
The ability of a drug to produce a maximum biological response is called:
a) Potency
b) Efficacy
c) Affinity
d) Specificity
Answer: b) Efficacy
Competitive antagonists:
a) Bind to the same site as the agonist and inhibit its action
b) Bind to a different site and inhibit the agonist’s action
c) Activate receptors to produce a response
d) Irreversibly bind to receptors
Answer: a) Bind to the same site as the agonist and inhibit its action
Non-competitive antagonists:
a) Bind irreversibly to the receptor
b) Decrease the maximum response of the agonist
c) Bind to a site different from the agonist
d) All of the above
Answer: d) All of the above
Which of the following is an example of an irreversible antagonist?
a) Naloxone
b) Phenoxybenzamine
c) Atropine
d) Propranolol
Answer: b) Phenoxybenzamine
Which type of drug binds to a receptor but does NOT produce a full response?
a) Agonist
b) Partial agonist
c) Antagonist
d) Inverse agonist
Answer: b) Partial agonist
Spare receptors are associated with:
a) Competitive antagonism
b) Maximal response even when all receptors are not occupied
c) Slow drug action
d) Drug metabolism
Answer: b) Maximal response even when all receptors are not occupied
An inverse agonist:
a) Activates the receptor
b) Produces a response opposite to the agonist
c) Blocks the receptor without any intrinsic activity
d) Enhances the agonist’s effect
Answer: b) Produces a response opposite to the agonist

Signal Transduction Mechanisms

Which of the following is NOT a type of signal transduction mechanism?
a) Ion channel-linked receptors
b) G-protein-coupled receptors (GPCRs)
c) Enzyme-linked receptors
d) Drug metabolism pathways
Answer: d) Drug metabolism pathways
Ligand-gated ion channels mediate:
a) Fast synaptic transmission
b) Slow intracellular responses
c) Gene transcription
d) Enzyme activation
Answer: a) Fast synaptic transmission
Which of the following receptors is an ion channel?
a) Nicotinic acetylcholine receptor
b) Beta-adrenergic receptor
c) Insulin receptor
d) Estrogen receptor
Answer: a) Nicotinic acetylcholine receptor
GPCRs have how many transmembrane domains?
a) 4
b) 5
c) 7
d) 9
Answer: c) 7
Which of the following is a second messenger in GPCR signaling?
a) cAMP
b) Na+ ions
c) Insulin
d) GABA
Answer: a) cAMP
The G-protein subunit responsible for activating adenylyl cyclase is:
a) Gs
b) Gi
c) Go
d) Gq
Answer: a) Gs
Which enzyme degrades cAMP to AMP?
a) Phospholipase C
b) Adenylyl cyclase
c) Phosphodiesterase
d) Tyrosine kinase
Answer: c) Phosphodiesterase
Which second messenger is associated with the phospholipase C (PLC) pathway?
a) cAMP
b) Inositol triphosphate (IP3)
c) ATP
d) Dopamine
Answer: b) Inositol triphosphate (IP3)
Which ion is released from the endoplasmic reticulum in response to IP3 activation?
a) Sodium
b) Potassium
c) Calcium
d) Magnesium
Answer: c) Calcium
Which of the following is a function of kinase-linked receptors?
a) Gene transcription
b) Rapid synaptic transmission
c) Direct ion transport
d) Activation of nuclear receptors
Answer: a) Gene transcription
Which of the following receptors functions as a nuclear receptor?
a) Beta-adrenergic receptor
b) Insulin receptor
c) Estrogen receptor
d) Nicotinic acetylcholine receptor
Answer: c) Estrogen receptor
Which of the following is a slow-acting receptor type?
a) Ion channel receptor
b) GPCR
c) Enzyme-linked receptor
d) Nuclear receptor
Answer: d) Nuclear receptor
What is the role of Jak-STAT signaling?
a) G-protein activation
b) Ion channel opening
c) Gene expression regulation
d) Enzyme inhibition
Answer: c) Gene expression regulation
Epidermal growth factor (EGF) receptor is an example of:
a) GPCR
b) Enzyme-linked receptor
c) Ionotropic receptor
d) Nuclear receptor
Answer: b) Enzyme-linked receptor
Which pathway is activated by tyrosine kinase receptors?
a) cAMP pathway
b) MAP kinase pathway
c) GABA pathway
d) Sodium-potassium pump
Answer: b) MAP kinase pathway

G-Protein–Coupled Receptors (GPCRs)

G-protein-coupled receptors (GPCRs) are also known as:
a) Ionotropic receptors
b) Metabotropic receptors
c) Ligand-gated ion channels
d) Enzyme-linked receptors
Answer: b) Metabotropic receptors
GPCRs have how many transmembrane domains?
a) 4
b) 5
c) 7
d) 9
Answer: c) 7
Which of the following is NOT a characteristic of GPCRs?
a) They are integral membrane proteins
b) They activate second messenger systems
c) They directly transport ions across membranes
d) They contain extracellular ligand-binding sites
Answer: c) They directly transport ions across membranes
Which of the following is a GPCR?
a) Nicotinic acetylcholine receptor
b) Beta-adrenergic receptor
c) Insulin receptor
d) Estrogen receptor
Answer: b) Beta-adrenergic receptor
Which G-protein subunit is responsible for activating adenylyl cyclase?
a) Gs
b) Gi
c) Gq
d) Go
Answer: a) Gs
Which second messenger is activated by the Gq protein pathway?
a) cAMP
b) cGMP
c) Inositol triphosphate (IP3)
d) ATP
Answer: c) Inositol triphosphate (IP3)
What is the function of phospholipase C (PLC) in GPCR signaling?
a) It degrades cAMP
b) It converts ATP to cAMP
c) It hydrolyzes phosphatidylinositol-4,5-bisphosphate (PIP2) into IP3 and DAG
d) It inactivates GPCRs
Answer: c) It hydrolyzes phosphatidylinositol-4,5-bisphosphate (PIP2) into IP3 and DAG
Which enzyme is activated by the Gs subunit of GPCR?
a) Phospholipase C
b) Adenylyl cyclase
c) Guanylyl cyclase
d) Tyrosine kinase
Answer: b) Adenylyl cyclase
What happens when the Gi protein is activated?
a) Increases cAMP levels
b) Decreases cAMP levels
c) Increases intracellular calcium
d) Activates sodium channels
Answer: b) Decreases cAMP levels
Which second messenger is associated with the phospholipase C (PLC) pathway?
a) cAMP
b) IP3 and DAG
c) ATP
d) Dopamine
Answer: b) IP3 and DAG
Which ion is released from the endoplasmic reticulum upon IP3 activation?
a) Sodium
b) Potassium
c) Calcium
d) Magnesium
Answer: c) Calcium
What is the role of DAG in GPCR signaling?
a) Activates protein kinase A (PKA)
b) Inhibits phospholipase C
c) Activates protein kinase C (PKC)
d) Degrades cAMP
Answer: c) Activates protein kinase C (PKC)
Which of the following neurotransmitters acts via GPCRs?
a) Acetylcholine (Nicotinic receptors)
b) Glutamate (NMDA receptors)
c) Dopamine (D1, D2 receptors)
d) GABA-A
Answer: c) Dopamine (D1, D2 receptors)
Which of the following is an inhibitory G-protein?
a) Gs
b) Gi
c) Gq
d) G12
Answer: b) Gi
Which of the following receptors is NOT a GPCR?
a) Beta-adrenergic receptor
b) Dopamine D2 receptor
c) Insulin receptor
d) Serotonin 5-HT1 receptor
Answer: c) Insulin receptor

Ion Channel Receptors

Ion channel receptors are also known as:
a) Metabotropic receptors
b) Ligand-gated ion channels
c) Nuclear receptors
d) Enzyme-linked receptors
Answer: b) Ligand-gated ion channels
Which of the following is an example of a ligand-gated ion channel?
a) Beta-adrenergic receptor
b) Nicotinic acetylcholine receptor
c) Insulin receptor
d) Dopamine receptor
Answer: b) Nicotinic acetylcholine receptor
Which neurotransmitter activates the nicotinic receptor?
a) Dopamine
b) Acetylcholine
c) GABA
d) Serotonin
Answer: b) Acetylcholine
Which ion primarily passes through the nicotinic acetylcholine receptor?
a) Sodium (Na⁺)
b) Calcium (Ca²⁺)
c) Chloride (Cl⁻)
d) Magnesium (Mg²⁺)
Answer: a) Sodium (Na⁺)
The GABA-A receptor is a:
a) GPCR
b) Ligand-gated chloride ion channel
c) Tyrosine kinase receptor
d) Nuclear receptor
Answer: b) Ligand-gated chloride ion channel
Which ion flows through the GABA-A receptor upon activation?
a) Sodium
b) Potassium
c) Calcium
d) Chloride
Answer: d) Chloride
Which receptor is responsible for fast excitatory synaptic transmission?
a) NMDA receptor
b) Dopamine D2 receptor
c) Estrogen receptor
d) Beta-adrenergic receptor
Answer: a) NMDA receptor
Which of the following drugs is a GABA-A receptor agonist?
a) Diazepam
b) Propranolol
c) Atropine
d) Epinephrine
Answer: a) Diazepam
What happens when the NMDA receptor is activated?
a) Sodium and calcium ions enter the neuron
b) Potassium ions enter the neuron
c) G-proteins are activated
d) cAMP production increases
Answer: a) Sodium and calcium ions enter the neuron
Which of the following receptors is involved in pain perception?
a) Nicotinic receptor
b) NMDA receptor
c) Insulin receptor
d) Beta-adrenergic receptor
Answer: b) NMDA receptor

Transmembrane Enzyme-Linked Receptors

Enzyme-linked receptors typically mediate responses to:
a) Neurotransmitters
b) Growth factors, cytokines, and hormones
c) Ion channel blockers
d) Second messengers
Answer: b) Growth factors, cytokines, and hormones
The main structural feature of enzyme-linked receptors is:
a) Seven transmembrane domains
b) Single transmembrane α-helix
c) Ligand-gated ion channel
d) Multiple intracellular loops
Answer: b) Single transmembrane α-helix
The insulin receptor is an example of which type of receptor?
a) G-protein-coupled receptor (GPCR)
b) Ligand-gated ion channel
c) Tyrosine kinase receptor
d) Nuclear receptor
Answer: c) Tyrosine kinase receptor
Which of the following is NOT an example of an enzyme-linked receptor?
a) Epidermal growth factor (EGF) receptor
b) Insulin receptor
c) Beta-adrenergic receptor
d) Vascular endothelial growth factor (VEGF) receptor
Answer: c) Beta-adrenergic receptor
Which of the following is a key feature of tyrosine kinase receptors?
a) They are linked to G-proteins
b) They activate intracellular signaling cascades through phosphorylation
c) They directly open ion channels
d) They act through nuclear transcription factors only
Answer: b) They activate intracellular signaling cascades through phosphorylation
Which enzyme is primarily responsible for adding phosphate groups to tyrosine residues in receptor tyrosine kinases?
a) Phosphatase
b) Kinase
c) Adenylyl cyclase
d) Guanylyl cyclase
Answer: b) Kinase
Which of the following signaling pathways is commonly activated by receptor tyrosine kinases?
a) cAMP pathway
b) MAP kinase (MAPK) pathway
c) Sodium-potassium pump pathway
d) GABAergic pathway
Answer: b) MAP kinase (MAPK) pathway
Which of the following drugs targets tyrosine kinase receptors?
a) Imatinib
b) Propranolol
c) Atropine
d) Diazepam
Answer: a) Imatinib
Dysfunction in tyrosine kinase receptors is commonly associated with:
a) Neurodegenerative diseases
b) Cardiovascular disorders
c) Cancer and metabolic diseases
d) Bacterial infections
Answer: c) Cancer and metabolic diseases
Which of the following receptors has intrinsic serine/threonine kinase activity?
a) Transforming growth factor-beta (TGF-β) receptor
b) Beta-adrenergic receptor
c) GABA-A receptor
d) Nicotinic acetylcholine receptor
Answer: a) Transforming growth factor-beta (TGF-β) receptor

JAK-STAT Binding Receptors

JAK-STAT signaling is primarily used by which type of receptors?
a) G-protein-coupled receptors
b) Cytokine receptors
c) Ion channel receptors
d) Steroid hormone receptors
Answer: b) Cytokine receptors
What does JAK stand for in JAK-STAT signaling?
a) Just Another Kinase
b) Janus Kinase
c) Jump-Activated Kinase
d) Joint-Action Kinase
Answer: b) Janus Kinase
Which of the following is NOT a cytokine that activates the JAK-STAT pathway?
a) Interferons
b) Interleukins
c) Epidermal growth factor
d) Growth hormone
Answer: c) Epidermal growth factor
STAT proteins, once activated, function as:
a) Second messengers
b) Transcription factors
c) Membrane receptors
d) Enzyme inhibitors
Answer: b) Transcription factors
Which step is the final event in JAK-STAT signaling?
a) Binding of the ligand to the receptor
b) Phosphorylation of STAT proteins
c) Dimerization and nuclear translocation of STAT proteins
d) Activation of G-proteins
Answer: c) Dimerization and nuclear translocation of STAT proteins
JAK-STAT signaling is mainly associated with:
a) Inflammatory and immune responses
b) Ion transport
c) Synaptic transmission
d) DNA replication
Answer: a) Inflammatory and immune responses
Dysregulation of JAK-STAT signaling is implicated in:
a) Diabetes
b) Autoimmune diseases and cancer
c) Alzheimer’s disease
d) Bacterial infections
Answer: b) Autoimmune diseases and cancer
Which of the following drugs is a JAK inhibitor?
a) Ruxolitinib
b) Insulin
c) Propranolol
d) Omeprazole
Answer: a) Ruxolitinib

Receptors That Regulate Transcription Factors

Which type of receptors regulate gene transcription?
a) Ligand-gated ion channels
b) Nuclear receptors
c) G-protein-coupled receptors
d) Tyrosine kinase receptors
Answer: b) Nuclear receptors
Which of the following is a nuclear receptor?
a) Beta-adrenergic receptor
b) Estrogen receptor
c) Nicotinic acetylcholine receptor
d) GABA-A receptor
Answer: b) Estrogen receptor
Nuclear receptors bind to:
a) Cytoplasmic G-proteins
b) DNA response elements
c) Membrane lipids
d) Ion channels
Answer: b) DNA response elements
Which of the following hormones acts through a nuclear receptor?
a) Insulin
b) Thyroid hormone
c) Epinephrine
d) Dopamine
Answer: b) Thyroid hormone
Which receptor type typically has a delayed onset but long-lasting effects?
a) Ionotropic receptors
b) GPCRs
c) Nuclear receptors
d) Enzyme-linked receptors
Answer: c) Nuclear receptors
Steroid hormones act by:
a) Binding to membrane-bound receptors
b) Activating nuclear receptors to regulate gene expression
c) Opening ion channels
d) Stimulating G-proteins
Answer: b) Activating nuclear receptors to regulate gene expression
Retinoic acid receptor (RAR) is involved in:
a) Calcium homeostasis
b) Vision and skin development
c) Neurotransmission
d) Blood clotting
Answer: b) Vision and skin development

Dose-Response Relationship

The dose-response curve is used to determine the:
a) Potency and efficacy of a drug
b) Route of drug administration
c) Chemical structure of a drug
d) Side effects of a drug
Answer: a) Potency and efficacy of a drug
In a dose-response curve, the x-axis represents:
a) Drug response
b) Log dose of the drug
c) Time
d) Enzyme activity
Answer: b) Log dose of the drug
What is EC50?
a) The dose required to produce 100% of the maximal response
b) The dose required to produce 50% of the maximal response
c) The effective dose for 50% of the population
d) The toxic dose for 50% of the population
Answer: b) The dose required to produce 50% of the maximal response
A drug with a lower EC50 is considered:
a) Less potent
b) More potent
c) Less effective
d) A partial agonist
Answer: b) More potent
Which of the following best defines Emax?
a) The dose at which 50% of the population responds
b) The maximum response a drug can produce
c) The dose at which 50% of the drug is eliminated
d) The toxic dose for 50% of the population
Answer: b) The maximum response a drug can produce

Therapeutic Index (TI)

Therapeutic index (TI) is calculated as:
a) TD50 / ED50
b) ED50 / TD50
c) LD50 / EC50
d) EC50 / LD50
Answer: a) TD50 / ED50
A drug with a high therapeutic index (TI) is considered:
a) Less potent
b) Safer
c) More toxic
d) Less effective
Answer: b) Safer
Which of the following drugs has a narrow therapeutic index?
a) Penicillin
b) Warfarin
c) Paracetamol
d) Ibuprofen
Answer: b) Warfarin
If a drug has a TI of 1, it means:
a) The drug is very safe
b) The drug has equal effective and toxic doses
c) The drug is ineffective
d) The drug has no toxicity
Answer: b) The drug has equal effective and toxic doses
Drugs with a narrow therapeutic index require:
a) No monitoring
b) Less frequent dosing
c) Therapeutic drug monitoring
d) Higher doses for efficacy
Answer: c) Therapeutic drug monitoring

Combined Effects of Drugs

When two drugs produce a combined effect equal to the sum of their individual effects, it is called:
a) Synergism
b) Potentiation
c) Additive effect
d) Antagonism
Answer: c) Additive effect
Which of the following is an example of an additive effect?
a) Aspirin + Clopidogrel
b) Alcohol + Benzodiazepines
c) Naloxone + Morphine
d) Tetracycline + Penicillin
Answer: a) Aspirin + Clopidogrel
When one drug enhances the effect of another drug without having its own effect, it is called:
a) Additive effect
b) Synergism
c) Potentiation
d) Antagonism
Answer: c) Potentiation
An example of potentiation is:
a) Clavulanic acid + Amoxicillin
b) Paracetamol + Ibuprofen
c) Propranolol + Atenolol
d) Diazepam + Alcohol
Answer: a) Clavulanic acid + Amoxicillin
When two drugs have opposite effects and reduce each other’s action, it is called:
a) Synergism
b) Antagonism
c) Additive effect
d) Potentiation
Answer: b) Antagonism
An example of competitive antagonism is:
a) Atropine vs. Acetylcholine
b) Naloxone vs. Morphine
c) Flumazenil vs. Diazepam
d) All of the above
Answer: d) All of the above
Non-competitive antagonism occurs when:
a) The antagonist binds to the same site as the agonist
b) The antagonist binds to a different site and changes receptor function
c) The antagonist competes with the agonist for binding
d) The drug produces an additive effect
Answer: b) The antagonist binds to a different site and changes receptor function

Factors Modifying Drug Action

Which of the following factors can modify drug action?
a) Age
b) Sex
c) Genetics
d) All of the above
Answer: d) All of the above
In neonates, drug metabolism is usually:
a) Faster than adults
b) Slower than adults
c) The same as adults
d) Irrelevant
Answer: b) Slower than adults
Which of the following conditions can decrease drug metabolism?
a) Liver disease
b) Hyperthyroidism
c) Fever
d) Exercise
Answer: a) Liver disease
Which of the following drugs shows genetic variation in metabolism?
a) Isoniazid
b) Warfarin
c) Codeine
d) All of the above
Answer: d) All of the above
The effect of a drug can be increased in elderly patients due to:
a) Increased renal clearance
b) Decreased hepatic metabolism
c) Increased metabolism
d) Higher enzyme activity
Answer: b) Decreased hepatic metabolism
Grapefruit juice can:
a) Inhibit cytochrome P450 enzymes
b) Increase drug clearance
c) Have no effect on drug metabolism
d) Reduce drug absorption
Answer: a) Inhibit cytochrome P450 enzymes
Which of the following conditions can increase drug metabolism?
a) Hypothyroidism
b) Liver cirrhosis
c) Hyperthyroidism
d) Kidney failure
Answer: c) Hyperthyroidism
A drug that induces its own metabolism is called:
a) A prodrug
b) An auto-inducer
c) An antagonist
d) A competitive inhibitor
Answer: b) An auto-inducer

Adverse Drug Reactions (ADRs)

Adverse drug reactions (ADRs) are defined as:
a) Side effects of a drug that are always mild
b) Any unintended and harmful response to a drug at normal doses
c) Toxic effects caused by drug overdose
d) Drug withdrawal symptoms
Answer: b) Any unintended and harmful response to a drug at normal doses
Which of the following is NOT a type of ADR?
a) Type A (Augmented)
b) Type B (Bizarre)
c) Type C (Chronic)
d) Type D (Delayed)
e) Type E (Effective)
Answer: e) Type E (Effective)
Type A ADRs are:
a) Dose-dependent and predictable
b) Dose-independent and unpredictable
c) Delayed and rare
d) Related to genetic predisposition
Answer: a) Dose-dependent and predictable
Which of the following is an example of a Type A ADR?
a) Sedation caused by antihistamines
b) Anaphylaxis due to penicillin
c) Carcinogenic effects of chemotherapy
d) Tardive dyskinesia due to antipsychotics
Answer: a) Sedation caused by antihistamines
Type B ADRs are also known as:
a) Augmented reactions
b) Bizarre reactions
c) Beneficial effects
d) Biochemical interactions
Answer: b) Bizarre reactions
Which of the following is an example of a Type B ADR?
a) Hypoglycemia due to insulin overdose
b) Anaphylaxis from a penicillin injection
c) Bradycardia due to beta-blockers
d) Nausea caused by chemotherapy
Answer: b) Anaphylaxis from a penicillin injection
A Type C ADR refers to:
a) Acute allergic reactions
b) Chronic effects due to long-term drug use
c) Immediate toxic reactions
d) Genetic-based adverse reactions
Answer: b) Chronic effects due to long-term drug use
Which of the following is an example of a Type C ADR?
a) Hepatotoxicity due to long-term methotrexate use
b) Rash from an antibiotic
c) Dry mouth from antihistamines
d) Bronchospasm from beta-blockers
Answer: a) Hepatotoxicity due to long-term methotrexate use
A Type D ADR is characterized by:
a) Delayed effects appearing long after drug exposure
b) Dose-related toxicity
c) Genetic predisposition
d) Hypersensitivity reactions
Answer: a) Delayed effects appearing long after drug exposure
Which of the following is an example of a Type D ADR?
a) Cancer due to chemotherapy
b) Drowsiness due to benzodiazepines
c) Constipation due to opioids
d) Hypoglycemia from insulin
Answer: a) Cancer due to chemotherapy
Teratogenicity (fetal malformations due to drug exposure) is an example of which ADR type?
a) Type A
b) Type B
c) Type D
d) Type E
Answer: c) Type D
Which of the following drugs is a known teratogen?
a) Thalidomide
b) Paracetamol
c) Ranitidine
d) Metformin
Answer: a) Thalidomide
Type E ADRs occur:
a) Immediately after drug administration
b) Due to prolonged drug therapy withdrawal
c) Only in elderly patients
d) Only due to genetic mutations
Answer: b) Due to prolonged drug therapy withdrawal
Which of the following is an example of a Type E ADR?
a) Opioid withdrawal symptoms
b) Liver failure from paracetamol overdose
c) Allergic reaction from penicillin
d) Hypotension from diuretics
Answer: a) Opioid withdrawal symptoms
Which drug class is commonly associated with withdrawal (Type E ADRs)?
a) Beta-blockers
b) Benzodiazepines
c) Opioids
d) All of the above
Answer: d) All of the above
Which type of ADR is influenced by genetic factors?
a) Type A
b) Type B
c) Type F
d) Type C
Answer: b) Type B
Which of the following drugs is most commonly associated with hypersensitivity reactions?
a) Penicillin
b) Metformin
c) Atorvastatin
d) Propranolol
Answer: a) Penicillin
The “Black Box Warning” issued by regulatory agencies indicates:
a) Mild side effects of a drug
b) Severe ADRs requiring caution
c) That the drug is completely safe
d) That the drug should not be used in children
Answer: b) Severe ADRs requiring caution
Which organ is most commonly affected by ADRs?
a) Heart
b) Liver
c) Lungs
d) Spleen
Answer: b) Liver
Which of the following drugs is a major cause of hepatotoxicity?
a) Paracetamol (Acetaminophen)
b) Aspirin
c) Ibuprofen
d) Metformin
Answer: a) Paracetamol (Acetaminophen)
Which of the following is NOT a method to prevent ADRs?
a) Dose adjustment in renal failure
b) Avoiding drug interactions
c) Increasing the drug dose
d) Monitoring drug levels in high-risk patients
Answer: c) Increasing the drug dose
Pharmacovigilance is concerned with:
a) Drug synthesis
b) Monitoring, detecting, and preventing ADRs
c) Drug pricing policies
d) Hospital administration
Answer: b) Monitoring, detecting, and preventing ADRs
The WHO ADR reporting system is called:
a) Yellow Card Scheme
b) MedWatch
c) VigiBase
d) FDA Alert System
Answer: c) VigiBase
Which country first introduced the “Yellow Card” system for ADR reporting?
a) USA
b) UK
c) India
d) Canada
Answer: b) UK
The National Pharmacovigilance Program of India (PvPI) is coordinated by:
a) Central Drugs Standard Control Organization (CDSCO)
b) Indian Council of Medical Research (ICMR)
c) Pharmacy Council of India (PCI)
d) Drug Controller General of India (DCGI)
Answer: a) Central Drugs Standard Control Organization (CDSCO)

Pharmacokinetic Drug Interactions

Pharmacokinetic drug interactions occur at which level?
a) Drug-receptor binding
b) Absorption, distribution, metabolism, and excretion (ADME)
c) Signal transduction pathways
d) Pharmacological effects of drugs
Answer: b) Absorption, distribution, metabolism, and excretion (ADME)
Which of the following can decrease drug absorption?
a) Antacids reducing stomach acidity
b) Enzyme induction
c) Protein binding displacement
d) All of the above
Answer: a) Antacids reducing stomach acidity
Tetracycline absorption is reduced when taken with:
a) Milk
b) Coffee
c) Orange juice
d) Water
Answer: a) Milk
Which enzyme system is most commonly involved in drug metabolism interactions?
a) Monoamine oxidase
b) Cytochrome P450 (CYP)
c) Acetylcholinesterase
d) Glutathione transferase
Answer: b) Cytochrome P450 (CYP)
Which of the following is a CYP3A4 inhibitor?
a) Rifampin
b) Grapefruit juice
c) Phenytoin
d) Carbamazepine
Answer: b) Grapefruit juice
Which drug is a potent enzyme inducer?
a) Cimetidine
b) Ketoconazole
c) Rifampin
d) Erythromycin
Answer: c) Rifampin
What is the effect of enzyme induction on drug metabolism?
a) Increases drug metabolism
b) Decreases drug metabolism
c) Has no effect
d) Enhances drug absorption
Answer: a) Increases drug metabolism
Which of the following is an example of enzyme inhibition?
a) Rifampin increasing warfarin metabolism
b) Cimetidine decreasing the metabolism of warfarin
c) Carbamazepine decreasing phenytoin levels
d) Smoking increasing drug metabolism
Answer: b) Cimetidine decreasing the metabolism of warfarin
What happens when a drug is displaced from plasma protein binding sites?
a) Increased free (active) drug concentration
b) Decreased drug clearance
c) Increased drug half-life
d) All of the above
Answer: a) Increased free (active) drug concentration
Which of the following drugs is highly protein-bound and can cause displacement interactions?
a) Warfarin
b) Amoxicillin
c) Metformin
d) Paracetamol
Answer: a) Warfarin
Which of the following drugs undergoes enterohepatic circulation, leading to prolonged drug effects?
a) Digoxin
b) Warfarin
c) Morphine
d) Paracetamol
Answer: c) Morphine
Which drug interaction affects renal excretion?
a) Probenecid inhibiting penicillin excretion
b) Rifampin inducing liver enzymes
c) Warfarin displacing albumin-bound drugs
d) Metoclopramide increasing gastric motility
Answer: a) Probenecid inhibiting penicillin excretion

Pharmacodynamic Drug Interactions

Pharmacodynamic interactions occur at the level of:
a) Drug metabolism
b) Drug action and effect
c) Drug absorption
d) Drug elimination
Answer: b) Drug action and effect
When two drugs with similar effects are combined and produce a greater effect, this is called:
a) Antagonism
b) Synergism
c) Enzyme induction
d) Displacement
Answer: b) Synergism
Which of the following is an example of drug synergism?
a) Aspirin + Clopidogrel
b) Naloxone + Morphine
c) Warfarin + Vitamin K
d) Atropine + Acetylcholine
Answer: a) Aspirin + Clopidogrel
Which of the following is an example of pharmacodynamic antagonism?
a) Beta-blockers and beta-agonists
b) Warfarin and rifampin
c) Carbamazepine and phenytoin
d) ACE inhibitors and NSAIDs
Answer: a) Beta-blockers and beta-agonists
Which of the following is an example of a functional antagonism?
a) Adrenaline reversing histamine-induced bronchoconstriction
b) Naloxone blocking opioid receptors
c) Warfarin inhibiting vitamin K
d) Digoxin and furosemide
Answer: a) Adrenaline reversing histamine-induced bronchoconstriction
Which of the following drugs interact to cause severe serotonin syndrome?
a) SSRI + MAO inhibitors
b) Warfarin + Vitamin K
c) Propranolol + Salbutamol
d) NSAIDs + Antacids
Answer: a) SSRI + MAO inhibitors
Which of the following drug combinations can result in excessive bleeding risk?
a) Warfarin + NSAIDs
b) Propranolol + Aspirin
c) Antacids + Omeprazole
d) Rifampin + Paracetamol
Answer: a) Warfarin + NSAIDs
Which of the following increases the risk of hyperkalemia?
a) ACE inhibitors + Potassium-sparing diuretics
b) Beta-blockers + Insulin
c) Warfarin + Vitamin K
d) Aspirin + Clopidogrel
Answer: a) ACE inhibitors + Potassium-sparing diuretics
Which of the following drugs, when combined, can cause severe CNS depression?
a) Benzodiazepines + Alcohol
b) Beta-blockers + Salbutamol
c) Warfarin + Vitamin K
d) NSAIDs + Omeprazole
Answer: a) Benzodiazepines + Alcohol
Which of the following is an example of a drug-disease interaction?
a) NSAIDs worsening peptic ulcer disease
b) Warfarin interacting with Vitamin K
c) Phenytoin interacting with Carbamazepine
d) Furosemide interacting with Digoxin
Answer: a) NSAIDs worsening peptic ulcer disease
Which drug combination is potentially fatal due to QT prolongation?
a) Macrolides + Fluoroquinolones
b) Warfarin + Aspirin
c) Omeprazole + Antacids
d) Paracetamol + Ibuprofen
Answer: a) Macrolides + Fluoroquinolones
Which of the following is NOT a pharmacodynamic interaction?
a) Beta-blockers and beta-agonists
b) Warfarin and rifampin
c) Opioids and benzodiazepines
d) Aspirin and Clopidogrel
Answer: b) Warfarin and rifampin
Which of the following interactions leads to increased risk of lithium toxicity?
a) NSAIDs + Lithium
b) Rifampin + Warfarin
c) Aspirin + Heparin
d) Metformin + Insulin
Answer: a) NSAIDs + Lithium

General Drug Interactions

Drug interactions occur when:
a) Two or more drugs are taken together, altering each other’s effects
b) A drug is taken on an empty stomach
c) A drug is stored improperly
d) The dose of a drug is increased
Answer: a) Two or more drugs are taken together, altering each other’s effects
Which of the following is NOT a type of drug interaction?
a) Pharmacokinetic interaction
b) Pharmacodynamic interaction
c) Pharmaceutical interaction
d) Physiological interaction
Answer: d) Physiological interaction
A pharmacokinetic drug interaction affects:
a) Drug absorption, distribution, metabolism, and excretion
b) Drug-receptor binding
c) Pharmacological effects of the drug
d) Drug formulation stability
Answer: a) Drug absorption, distribution, metabolism, and excretion
A pharmacodynamic drug interaction occurs at the level of:
a) Absorption
b) Drug action and response
c) Metabolism
d) Excretion
Answer: b) Drug action and response
Which of the following is an example of a pharmacodynamic drug interaction?
a) Warfarin and rifampin (enzyme induction)
b) Aspirin and clopidogrel (synergistic effect)
c) Tetracycline and antacids (decreased absorption)
d) Probenecid and penicillin (renal excretion inhibition)
Answer: b) Aspirin and clopidogrel (synergistic effect)

Pharmacokinetic Drug Interactions

Which of the following drugs decreases the absorption of tetracycline?
a) Antacids
b) Proton pump inhibitors
c) NSAIDs
d) Beta-blockers
Answer: a) Antacids
Which enzyme system is most commonly involved in drug metabolism interactions?
a) Cytochrome P450 (CYP)
b) Monoamine oxidase
c) Acetylcholinesterase
d) Glutathione transferase
Answer: a) Cytochrome P450 (CYP)
Which of the following is a CYP3A4 enzyme inhibitor?
a) Rifampin
b) Grapefruit juice
c) Carbamazepine
d) Phenytoin
Answer: b) Grapefruit juice
Which of the following is a CYP enzyme inducer?
a) Ketoconazole
b) Cimetidine
c) Rifampin
d) Erythromycin
Answer: c) Rifampin
Which of the following occurs when a drug is displaced from plasma protein binding sites?
a) Increased free drug concentration
b) Decreased free drug concentration
c) Increased protein-bound drug
d) No effect on drug levels
Answer: a) Increased free drug concentration
Which of the following drugs is highly protein-bound and can cause displacement interactions?
a) Warfarin
b) Paracetamol
c) Metformin
d) Amoxicillin
Answer: a) Warfarin
Which drug undergoes enterohepatic circulation, leading to prolonged effects?
a) Digoxin
b) Morphine
c) Warfarin
d) Paracetamol
Answer: b) Morphine
Which drug interaction affects renal excretion?
a) Probenecid inhibiting penicillin excretion
b) Warfarin increasing clotting time
c) Omeprazole inhibiting acid production
d) Metoclopramide increasing gastric emptying
Answer: a) Probenecid inhibiting penicillin excretion

Pharmacodynamic Drug Interactions

When two drugs with similar effects are combined to produce a greater effect, it is called:
a) Antagonism
b) Synergism
c) Enzyme inhibition
d) Displacement
Answer: b) Synergism
Which of the following is an example of pharmacodynamic antagonism?
a) Beta-blockers and beta-agonists
b) Warfarin and rifampin
c) Carbamazepine and phenytoin
d) Omeprazole and antacids
Answer: a) Beta-blockers and beta-agonists
Which of the following interactions can result in serotonin syndrome?
a) SSRI + MAO inhibitors
b) Warfarin + NSAIDs
c) Omeprazole + Clopidogrel
d) NSAIDs + Diuretics
Answer: a) SSRI + MAO inhibitors
Which of the following drug combinations can result in excessive bleeding?
a) Warfarin + NSAIDs
b) Beta-blockers + Aspirin
c) Antacids + Omeprazole
d) Rifampin + Paracetamol
Answer: a) Warfarin + NSAIDs
Which of the following increases the risk of hyperkalemia?
a) ACE inhibitors + Potassium-sparing diuretics
b) Beta-blockers + Insulin
c) Warfarin + Vitamin K
d) Aspirin + Clopidogrel
Answer: a) ACE inhibitors + Potassium-sparing diuretics
Which of the following drug combinations can cause severe CNS depression?
a) Benzodiazepines + Alcohol
b) Beta-blockers + Salbutamol
c) Warfarin + Vitamin K
d) NSAIDs + Omeprazole
Answer: a) Benzodiazepines + Alcohol
Which of the following drug-disease interactions is correct?
a) NSAIDs worsening peptic ulcer disease
b) Warfarin increasing blood clotting
c) Phenytoin causing hyperglycemia
d) ACE inhibitors reducing serum potassium
Answer: a) NSAIDs worsening peptic ulcer disease
Which drug combination is known to prolong the QT interval, increasing the risk of arrhythmias?
a) Macrolides + Fluoroquinolones
b) Warfarin + Aspirin
c) Omeprazole + Antacids
d) Paracetamol + Ibuprofen
Answer: a) Macrolides + Fluoroquinolones
Which drug interaction leads to lithium toxicity?
a) NSAIDs + Lithium
b) Rifampin + Warfarin
c) Aspirin + Heparin
d) Metformin + Insulin
Answer: a) NSAIDs + Lithium
Which of the following drugs should NOT be taken with tyramine-rich foods due to hypertensive crisis risk?
a) MAO inhibitors
b) Beta-blockers
c) Proton pump inhibitors
d) NSAIDs
Answer: a) MAO inhibitors
The “Black Box Warning” issued by regulatory agencies is used to indicate:
a) Severe ADRs requiring caution
b) Mild drug interactions
c) Drug over-the-counter availability
d) Drug price regulation
Answer: a) Severe ADRs requiring caution
Which of the following can cause life-threatening drug interactions?
a) Warfarin + NSAIDs
b) Digoxin + Diuretics
c) Benzodiazepines + Opioids
d) All of the above
Answer: d) All of the above

Drug Discovery Phase

Which of the following is the first step in drug discovery?
a) Clinical trials
b) Lead identification
c) Marketing approval
d) Post-marketing surveillance
Answer: b) Lead identification
Which approach is commonly used for identifying new drug candidates?
a) High-throughput screening (HTS)
b) Randomized controlled trials
c) Pharmacovigilance
d) Drug recall process
Answer: a) High-throughput screening (HTS)
Which of the following is an example of rational drug design?
a) Identifying drugs through traditional herbal medicine
b) Developing drugs based on known molecular targets
c) Observing serendipitous drug effects
d) Using existing drugs for new indications
Answer: b) Developing drugs based on known molecular targets
Which of the following plays a key role in modern drug discovery?
a) Computer-aided drug design (CADD)
b) Traditional medicine only
c) Case reports
d) Post-marketing surveillance
Answer: a) Computer-aided drug design (CADD)
What is the purpose of lead optimization in drug discovery?
a) To improve the drug’s efficacy, selectivity, and safety
b) To conduct human trials
c) To register the drug with regulatory agencies
d) To withdraw unsafe drugs from the market
Answer: a) To improve the drug’s efficacy, selectivity, and safety
The main objective of the “hit-to-lead” phase in drug discovery is:
a) Identifying potential drug candidates with improved properties
b) Conducting Phase III clinical trials
c) Evaluating pharmacovigilance reports
d) Scaling up for commercial production
Answer: a) Identifying potential drug candidates with improved properties
Which of the following drug discovery methods relies on screening large compound libraries?
a) Random screening
b) Rational drug design
c) Pharmacogenomics
d) Bioinformatics
Answer: a) Random screening

Preclinical Evaluation Phase

Preclinical studies are conducted on:
a) Human volunteers
b) Animal models and in vitro systems
c) Marketed drugs
d) Physicians and researchers
Answer: b) Animal models and in vitro systems
Which of the following is NOT a part of preclinical testing?
a) Toxicity testing
b) Pharmacokinetics studies
c) Clinical trials
d) Pharmacodynamics studies
Answer: c) Clinical trials
Which regulatory guideline is followed for preclinical toxicology studies?
a) Good Laboratory Practice (GLP)
b) Good Manufacturing Practice (GMP)
c) Good Clinical Practice (GCP)
d) FDA Post-marketing Surveillance Guidelines
Answer: a) Good Laboratory Practice (GLP)
Which of the following is NOT assessed in preclinical studies?
a) Acute toxicity
b) Chronic toxicity
c) Human pharmacokinetics
d) Carcinogenicity
Answer: c) Human pharmacokinetics
Which type of preclinical study evaluates the effect of a drug on vital organs such as the liver and kidney?
a) Pharmacodynamics
b) Pharmacokinetics
c) Toxicology
d) Genotoxicity
Answer: c) Toxicology
What is the purpose of Ames test in drug evaluation?
a) To assess genotoxicity and mutagenic potential
b) To determine acute toxicity
c) To evaluate drug metabolism
d) To test cardiovascular effects
Answer: a) To assess genotoxicity and mutagenic potential
Which animal model is commonly used for reproductive toxicity studies?
a) Rabbits
b) Frogs
c) Drosophila (fruit flies)
d) Yeast
Answer: a) Rabbits
The therapeutic index (TI) of a drug is determined in:
a) Preclinical studies
b) Phase I clinical trials
c) Phase II clinical trials
d) Post-marketing surveillance
Answer: a) Preclinical studies
Which of the following is NOT a preclinical study parameter?
a) Carcinogenicity
b) Teratogenicity
c) Post-marketing surveillance
d) Reproductive toxicity
Answer: c) Post-marketing surveillance
Which document must be submitted to regulatory authorities before initiating clinical trials?
a) Investigational New Drug (IND) application
b) New Drug Application (NDA)
c) Drug Master File (DMF)
d) Abbreviated New Drug Application (ANDA)
Answer: a) Investigational New Drug (IND) application

Phases of Clinical Trials

How many phases are involved in clinical trials before drug approval?
a) 2
b) 3
c) 4
d) 5
Answer: c) 4
Which phase of clinical trials is conducted on healthy volunteers?
a) Phase I
b) Phase II
c) Phase III
d) Phase IV
Answer: a) Phase I
The primary goal of Phase I clinical trials is to assess:
a) Drug efficacy
b) Drug safety and pharmacokinetics
c) Post-marketing surveillance
d) Drug marketing potential
Answer: b) Drug safety and pharmacokinetics
Phase II clinical trials primarily evaluate:
a) Drug toxicity
b) Drug efficacy and optimal dose in patients
c) Long-term side effects
d) Drug interactions
Answer: b) Drug efficacy and optimal dose in patients
What is the approximate sample size for Phase II clinical trials?
a) 10–50
b) 100–500
c) 1000–5000
d) 10,000+
Answer: b) 100–500
Which of the following clinical trial phases is a large-scale, randomized controlled trial?
a) Phase I
b) Phase II
c) Phase III
d) Phase IV
Answer: c) Phase III
What is the main objective of Phase III clinical trials?
a) Evaluating long-term adverse effects
b) Determining therapeutic efficacy in a larger population
c) Studying drug metabolism
d) Drug discovery
Answer: b) Determining therapeutic efficacy in a larger population
Which regulatory submission is required after successful completion of Phase III trials?
a) Investigational New Drug (IND) application
b) New Drug Application (NDA)
c) Drug Master File (DMF)
d) Abbreviated New Drug Application (ANDA)
Answer: b) New Drug Application (NDA)
Which clinical trial phase is also called post-marketing surveillance?
a) Phase I
b) Phase II
c) Phase III
d) Phase IV
Answer: d) Phase IV
Which phase of clinical trials helps in detecting rare or long-term side effects?
a) Phase I
b) Phase II
c) Phase III
d) Phase IV
Answer: d) Phase IV
A placebo-controlled study is commonly conducted in which phase?
a) Phase I
b) Phase II
c) Phase III
d) Phase IV
Answer: c) Phase III
A crossover design is frequently used in:
a) Preclinical trials
b) Phase I clinical trials
c) Phase II clinical trials
d) Bioequivalence studies
Answer: d) Bioequivalence studies
Which of the following is an ethical concern in clinical trials?
a) Obtaining informed consent
b) Drug marketing
c) Pricing strategy
d) Packaging design
Answer: a) Obtaining informed consent

Pharmacovigilance

Pharmacovigilance is primarily concerned with:
a) Drug efficacy
b) Drug safety and adverse drug reactions (ADRs)
c) Drug formulation
d) Drug marketing
Answer: b) Drug safety and adverse drug reactions (ADRs)
Which organization is responsible for global pharmacovigilance?
a) World Health Organization (WHO)
b) Food and Drug Administration (FDA)
c) Central Drugs Standard Control Organization (CDSCO)
d) European Medicines Agency (EMA)
Answer: a) World Health Organization (WHO)
The primary function of the Pharmacovigilance Programme of India (PvPI) is:
a) Drug pricing regulation
b) Monitoring adverse drug reactions (ADRs)
c) Drug import/export regulation
d) Preclinical drug testing
Answer: b) Monitoring adverse drug reactions (ADRs)
Which of the following is the main database used for reporting ADRs globally?
a) VigiBase
b) Medline
c) PubMed
d) DrugBank
Answer: a) VigiBase
Spontaneous ADR reporting is also known as:
a) Active surveillance
b) Passive surveillance
c) Controlled clinical trials
d) Cohort studies
Answer: b) Passive surveillance
The Yellow Card Scheme is used for ADR reporting in which country?
a) India
b) United States
c) United Kingdom
d) Japan
Answer: c) United Kingdom
What does the term “signal detection” refer to in pharmacovigilance?
a) Identifying new or rare adverse drug reactions
b) Conducting clinical trials
c) Developing new drugs
d) Testing drug purity
Answer: a) Identifying new or rare adverse drug reactions
Which type of ADR reporting system requires active monitoring of patients?
a) Spontaneous reporting
b) Intensive monitoring
c) Passive surveillance
d) Preclinical testing
Answer: b) Intensive monitoring
Which of the following is an example of a Type A ADR?
a) Dose-dependent side effects (e.g., bleeding with warfarin)
b) Anaphylaxis due to penicillin
c) Carcinogenic effects of a drug
d) Idiosyncratic reactions
Answer: a) Dose-dependent side effects (e.g., bleeding with warfarin)
Which of the following is NOT a method of pharmacovigilance?
a) Cohort studies
b) Case-control studies
c) Drug formulation analysis
d) Spontaneous ADR reporting
Answer: c) Drug formulation analysis
Which regulatory agency oversees pharmacovigilance in the USA?
a) FDA
b) EMA
c) CDSCO
d) WHO
Answer: a) FDA
Which document is required for reporting serious ADRs to regulatory authorities?
a) Periodic Safety Update Report (PSUR)
b) New Drug Application (NDA)
c) Drug Master File (DMF)
d) Informed consent form
Answer: a) Periodic Safety Update Report (PSUR)

———————————————————————————————————–

UNIT-III

Pharmacology of drugs acting on peripheral nervous system

a. Organization and function of ANS.

b. Neurohumoral transmission ,co-transmission and classification of

neurotransmitters.

c. Parasympathomimetics, Parasympatholytics, Sympathomimetics,

sympatholytics.

d. Neuromuscular blocking agents and skeletal muscle relaxants

(peripheral).

e. Local anesthetic agents.

f. Drugs used in myasthenia gravis and glaucoma

Basic Organization of ANS

The autonomic nervous system (ANS) primarily controls:
a) Skeletal muscles
b) Involuntary functions of the body
c) Sensory processing in the brain
d) Cognitive functions
Answer: b) Involuntary functions of the body
The ANS is divided into which two main branches?
a) Somatic and enteric nervous system
b) Sympathetic and parasympathetic nervous system
c) Central and peripheral nervous system
d) Motor and sensory nervous system
Answer: b) Sympathetic and parasympathetic nervous system
Which division of the ANS is responsible for the “fight or flight” response?
a) Sympathetic
b) Parasympathetic
c) Enteric
d) Somatic
Answer: a) Sympathetic
Which division of the ANS is responsible for the “rest and digest” response?
a) Sympathetic
b) Parasympathetic
c) Enteric
d) Somatic
Answer: b) Parasympathetic
The ANS consists of which type of neurons?
a) Sensory neurons only
b) Motor neurons only
c) Both sensory and motor neurons
d) Interneurons only
Answer: c) Both sensory and motor neurons

Sympathetic Nervous System (SNS)

Which neurotransmitter is primarily released by preganglionic sympathetic neurons?
a) Acetylcholine
b) Dopamine
c) Epinephrine
d) Norepinephrine
Answer: a) Acetylcholine
Which neurotransmitter is primarily released by postganglionic sympathetic neurons?
a) Acetylcholine
b) Norepinephrine
c) Dopamine
d) Serotonin
Answer: b) Norepinephrine
Which type of receptors are mainly activated by norepinephrine in the sympathetic nervous system?
a) Muscarinic receptors
b) Nicotinic receptors
c) Adrenergic receptors
d) Dopaminergic receptors
Answer: c) Adrenergic receptors
Which of the following is NOT a function of the sympathetic nervous system?
a) Increased heart rate
b) Pupil dilation
c) Increased digestive secretions
d) Bronchodilation
Answer: c) Increased digestive secretions
Which enzyme is responsible for the breakdown of norepinephrine?
a) Acetylcholinesterase
b) Monoamine oxidase (MAO)
c) Cyclooxygenase (COX)
d) Choline acetyltransferase
Answer: b) Monoamine oxidase (MAO)

Parasympathetic Nervous System (PNS)

Which neurotransmitter is released by both preganglionic and postganglionic parasympathetic neurons?
a) Acetylcholine
b) Norepinephrine
c) Dopamine
d) Glutamate
Answer: a) Acetylcholine
Which type of receptors are found on target organs of the parasympathetic nervous system?
a) Nicotinic receptors
b) Muscarinic receptors
c) Adrenergic receptors
d) Dopaminergic receptors
Answer: b) Muscarinic receptors
Which of the following is a function of the parasympathetic nervous system?
a) Increased heart rate
b) Pupil dilation
c) Increased digestion and peristalsis
d) Bronchodilation
Answer: c) Increased digestion and peristalsis
Which cranial nerve carries the majority of parasympathetic outflow?
a) Optic nerve (CN II)
b) Vagus nerve (CN X)
c) Facial nerve (CN VII)
d) Hypoglossal nerve (CN XII)
Answer: b) Vagus nerve (CN X)
Which enzyme is responsible for the breakdown of acetylcholine in the synaptic cleft?
a) Monoamine oxidase (MAO)
b) Acetylcholinesterase
c) Tyrosine hydroxylase
d) Choline acetyltransferase
Answer: b) Acetylcholinesterase

Comparison of Sympathetic and Parasympathetic Nervous System

Which of the following responses is mediated by the sympathetic nervous system?
a) Decreased heart rate
b) Increased glucose metabolism
c) Constriction of the pupils
d) Increased digestive activity
Answer: b) Increased glucose metabolism
Which of the following responses is mediated by the parasympathetic nervous system?
a) Increased heart rate
b) Increased blood pressure
c) Constriction of the bronchi
d) Pupil dilation
Answer: c) Constriction of the bronchi
Which receptor type is involved in both sympathetic and parasympathetic ganglia?
a) Nicotinic receptors
b) Muscarinic receptors
c) Alpha receptors
d) Beta receptors
Answer: a) Nicotinic receptors
Which of the following structures is innervated only by the sympathetic nervous system?
a) Heart
b) Salivary glands
c) Sweat glands
d) Lungs
Answer: c) Sweat glands
Which receptor is responsible for vasoconstriction mediated by the sympathetic nervous system?
a) Alpha-1 adrenergic receptor
b) Beta-1 adrenergic receptor
c) Beta-2 adrenergic receptor
d) Nicotinic receptor
Answer: a) Alpha-1 adrenergic receptor

Clinical Aspects of ANS Function

Drugs that block sympathetic activity are known as:
a) Cholinergic agonists
b) Beta-blockers
c) Adrenergic agonists
d) Anticholinergics
Answer: b) Beta-blockers
A cholinergic crisis is caused by excessive:
a) Dopamine
b) Norepinephrine
c) Acetylcholine
d) Serotonin
Answer: c) Acetylcholine
Which of the following drugs is a parasympatholytic agent?
a) Atropine
b) Pilocarpine
c) Epinephrine
d) Propranolol
Answer: a) Atropine
Which condition is associated with excessive sympathetic activation?
a) Hypotension
b) Bradycardia
c) Hypertension
d) Digestive disorders
Answer: c) Hypertension
Which of the following is a clinical use of beta-agonists?
a) Bronchodilation in asthma
b) Vasoconstriction in hypertension
c) Decreasing heart rate in arrhythmia
d) Increasing salivation
Answer: a) Bronchodilation in asthma

Neurohumoral Transmission

Neurohumoral transmission refers to the communication between:
a) Neurons and skeletal muscles
b) Neurons and target organs through neurotransmitters
c) Endocrine glands and blood vessels
d) Immune cells and hormones
Answer: b) Neurons and target organs through neurotransmitters
The gap between two neurons where neurotransmission occurs is called:
a) Dendrite
b) Synapse
c) Axon hillock
d) Node of Ranvier
Answer: b) Synapse
The first step in neurotransmission is:
a) Neurotransmitter release
b) Neurotransmitter synthesis
c) Binding to receptors
d) Reuptake of neurotransmitters
Answer: b) Neurotransmitter synthesis
Which ion is essential for neurotransmitter release from synaptic vesicles?
a) Sodium (Na⁺)
b) Potassium (K⁺)
c) Calcium (Ca²⁺)
d) Magnesium (Mg²⁺)
Answer: c) Calcium (Ca²⁺)
The process of neurotransmitter reuptake involves:
a) Degradation of neurotransmitter in the synaptic cleft
b) Uptake of neurotransmitter back into the presynaptic neuron
c) Diffusion of neurotransmitter into cerebrospinal fluid
d) Blocking of neurotransmitter synthesis
Answer: b) Uptake of neurotransmitter back into the presynaptic neuron
Which enzyme degrades acetylcholine at the synapse?
a) Monoamine oxidase (MAO)
b) Acetylcholinesterase
c) Catechol-O-methyltransferase (COMT)
d) Tyrosine hydroxylase
Answer: b) Acetylcholinesterase
Inhibitors of monoamine oxidase (MAO) increase the levels of which neurotransmitter?
a) Acetylcholine
b) Dopamine
c) GABA
d) Glutamate
Answer: b) Dopamine
Neurotransmitter release is inhibited by which type of receptors on the presynaptic neuron?
a) Ionotropic receptors
b) Metabotropic receptors
c) Autoreceptors
d) Adrenergic receptors
Answer: c) Autoreceptors
Which neurotransmitter is released by preganglionic autonomic neurons?
a) Dopamine
b) Acetylcholine
c) Norepinephrine
d) Serotonin
Answer: b) Acetylcholine
Which neurotransmitter is involved in pain transmission in the spinal cord?
a) Glutamate
b) Dopamine
c) Serotonin
d) GABA
Answer: a) Glutamate

Co-transmission

Co-transmission refers to:
a) Release of a single neurotransmitter at the synapse
b) Release of multiple neurotransmitters from a single neuron
c) Binding of neurotransmitters to intracellular receptors
d) Breakdown of neurotransmitters before synaptic release
Answer: b) Release of multiple neurotransmitters from a single neuron
Which of the following neurotransmitters are commonly co-released?
a) Acetylcholine and nitric oxide
b) GABA and glutamate
c) Norepinephrine and neuropeptide Y
d) Serotonin and dopamine
Answer: c) Norepinephrine and neuropeptide Y
In co-transmission, neurotransmitters are stored in:
a) Separate vesicles
b) The nucleus of the neuron
c) The myelin sheath
d) The synaptic cleft
Answer: a) Separate vesicles
Which of the following neurotransmitter pairs demonstrates co-transmission?
a) Acetylcholine and dopamine
b) ATP and norepinephrine
c) Serotonin and GABA
d) Dopamine and glutamate
Answer: b) ATP and norepinephrine
What is the function of neuropeptides in co-transmission?
a) They always act as primary neurotransmitters
b) They modulate the effects of classical neurotransmitters
c) They inhibit neurotransmitter release
d) They break down neurotransmitters
Answer: b) They modulate the effects of classical neurotransmitters

Classification of Neurotransmitters

Neurotransmitters can be classified based on:
a) Their molecular weight
b) Their excitatory or inhibitory function
c) The presence of an axon in the neuron
d) The ability to cross the blood-brain barrier
Answer: b) Their excitatory or inhibitory function
Which of the following is an excitatory neurotransmitter?
a) GABA
b) Dopamine
c) Glutamate
d) Glycine
Answer: c) Glutamate
Which of the following is an inhibitory neurotransmitter?
a) Acetylcholine
b) Serotonin
c) GABA
d) Glutamate
Answer: c) GABA
Which neurotransmitter belongs to the monoamine category?
a) Glutamate
b) Acetylcholine
c) Dopamine
d) Glycine
Answer: c) Dopamine
Which neurotransmitter is classified as a catecholamine?
a) Serotonin
b) Dopamine
c) Acetylcholine
d) GABA
Answer: b) Dopamine
Which enzyme converts dopamine into norepinephrine?
a) Tyrosine hydroxylase
b) Dopamine beta-hydroxylase
c) Acetylcholinesterase
d) Monoamine oxidase
Answer: b) Dopamine beta-hydroxylase
Which neurotransmitter is synthesized from tryptophan?
a) Dopamine
b) Serotonin
c) Acetylcholine
d) Glutamate
Answer: b) Serotonin
Which neurotransmitter is primarily involved in mood regulation?
a) Acetylcholine
b) Dopamine
c) Serotonin
d) GABA
Answer: c) Serotonin
Which neurotransmitter is known as the “reward neurotransmitter”?
a) Dopamine
b) Serotonin
c) GABA
d) Norepinephrine
Answer: a) Dopamine
Which of the following is a gaseous neurotransmitter?
a) Acetylcholine
b) Dopamine
c) Nitric oxide
d) Glutamate
Answer: c) Nitric oxide

Basic Concepts of Parasympathomimetics

Parasympathomimetic drugs mimic the effects of which neurotransmitter?
a) Dopamine
b) Norepinephrine
c) Acetylcholine
d) Serotonin
Answer: c) Acetylcholine
Parasympathomimetic drugs primarily act on which type of receptors?
a) Adrenergic receptors
b) Nicotinic receptors
c) Muscarinic receptors
d) Dopaminergic receptors
Answer: c) Muscarinic receptors
Which of the following is NOT a function of parasympathomimetics?
a) Decreased heart rate
b) Increased digestion
c) Pupil dilation
d) Bronchoconstriction
Answer: c) Pupil dilation
Which enzyme is responsible for breaking down acetylcholine in the synaptic cleft?
a) Monoamine oxidase (MAO)
b) Acetylcholinesterase
c) Catechol-O-methyltransferase (COMT)
d) Dopamine beta-hydroxylase
Answer: b) Acetylcholinesterase
Which of the following is a direct-acting parasympathomimetic drug?
a) Neostigmine
b) Pilocarpine
c) Physostigmine
d) Edrophonium
Answer: b) Pilocarpine

Direct-Acting Parasympathomimetics

Direct-acting parasympathomimetics primarily stimulate:
a) Adrenergic receptors
b) Dopaminergic receptors
c) Muscarinic receptors
d) GABA receptors
Answer: c) Muscarinic receptors
Which of the following is a clinical use of pilocarpine?
a) Hypertension
b) Glaucoma
c) Parkinson’s disease
d) Heart failure
Answer: b) Glaucoma
Which direct-acting parasympathomimetic is used to treat urinary retention?
a) Bethanechol
b) Atropine
c) Propranolol
d) Epinephrine
Answer: a) Bethanechol
Which muscarinic receptor subtype is primarily responsible for heart rate reduction?
a) M1
b) M2
c) M3
d) M4
Answer: b) M2
Which muscarinic receptor subtype is involved in smooth muscle contraction and glandular secretion?
a) M1
b) M2
c) M3
d) M4
Answer: c) M3

Indirect-Acting Parasympathomimetics (Cholinesterase Inhibitors)

Indirect-acting parasympathomimetics work by inhibiting which enzyme?
a) Tyrosine hydroxylase
b) Acetylcholinesterase
c) Monoamine oxidase
d) COMT
Answer: b) Acetylcholinesterase
Which of the following is an example of a reversible cholinesterase inhibitor?
a) Organophosphate
b) Neostigmine
c) Atropine
d) Epinephrine
Answer: b) Neostigmine
Which cholinesterase inhibitor is used in the diagnosis of myasthenia gravis?
a) Edrophonium
b) Physostigmine
c) Atropine
d) Pilocarpine
Answer: a) Edrophonium
Which of the following indirect-acting parasympathomimetics crosses the blood-brain barrier?
a) Neostigmine
b) Pyridostigmine
c) Physostigmine
d) Bethanechol
Answer: c) Physostigmine
Which drug is commonly used in the treatment of Alzheimer’s disease?
a) Rivastigmine
b) Pilocarpine
c) Dobutamine
d) Clonidine
Answer: a) Rivastigmine

Clinical Uses and Adverse Effects of Parasympathomimetics

Which condition is treated using parasympathomimetic drugs?
a) Glaucoma
b) Asthma
c) Hypertension
d) Tachycardia
Answer: a) Glaucoma
Which of the following is an adverse effect of parasympathomimetics?
a) Dry mouth
b) Constipation
c) Excessive salivation
d) Urinary retention
Answer: c) Excessive salivation
Which drug is used as an antidote for organophosphate poisoning?
a) Atropine
b) Pilocarpine
c) Physostigmine
d) Neostigmine
Answer: a) Atropine
A common side effect of cholinergic drugs includes:
a) Bronchodilation
b) Bradycardia
c) Hypertension
d) Pupil dilation
Answer: b) Bradycardia
Which of the following drugs should NOT be given to a patient with asthma?
a) Atropine
b) Propranolol
c) Bethanechol
d) Epinephrine
Answer: c) Bethanechol

Miscellaneous Questions

Which of the following statements about muscarinic receptors is TRUE?
a) They are ligand-gated ion channels
b) They are G-protein-coupled receptors
c) They are activated by norepinephrine
d) They mediate sympathetic nervous system effects
Answer: b) They are G-protein-coupled receptors
Which of the following is a contraindication for parasympathomimetic use?
a) Glaucoma
b) Myasthenia gravis
c) Peptic ulcer disease
d) Urinary retention
Answer: c) Peptic ulcer disease
Which parasympathomimetic drug is used to reverse the effects of neuromuscular blockers after surgery?
a) Neostigmine
b) Pilocarpine
c) Atropine
d) Epinephrine
Answer: a) Neostigmine
Which of the following drugs can cause cholinergic crisis?
a) Organophosphates
b) Beta-blockers
c) Antihistamines
d) Benzodiazepines
Answer: a) Organophosphates
Which symptom is NOT associated with cholinergic toxicity?
a) Muscle weakness
b) Bronchospasm
c) Hypertension
d) Miosis
Answer: c) Hypertension

Parasympatholytics (Anticholinergics)

Parasympatholytic drugs primarily act by blocking:
a) Alpha receptors
b) Beta receptors
c) Muscarinic receptors
d) Dopaminergic receptors
Answer: c) Muscarinic receptors
Which of the following is a classical parasympatholytic drug?
a) Atropine
b) Pilocarpine
c) Neostigmine
d) Physostigmine
Answer: a) Atropine
Which of the following drugs is used to treat bradycardia?
a) Bethanechol
b) Atropine
c) Pilocarpine
d) Neostigmine
Answer: b) Atropine
Which parasympatholytic drug is commonly used to cause pupil dilation (mydriasis) for eye examination?
a) Pilocarpine
b) Tropicamide
c) Bethanechol
d) Neostigmine
Answer: b) Tropicamide
Which of the following is NOT an effect of parasympatholytics?
a) Decreased salivation
b) Bronchodilation
c) Bradycardia
d) Pupil dilation
Answer: c) Bradycardia
Which muscarinic receptor subtype is primarily blocked by parasympatholytics to cause bronchodilation?
a) M1
b) M2
c) M3
d) M4
Answer: c) M3
Which parasympatholytic drug is commonly used for motion sickness?
a) Scopolamine
b) Atropine
c) Pilocarpine
d) Neostigmine
Answer: a) Scopolamine
Which of the following drugs is used to treat overactive bladder?
a) Bethanechol
b) Oxybutynin
c) Pilocarpine
d) Neostigmine
Answer: b) Oxybutynin
Which of the following is NOT an adverse effect of parasympatholytics?
a) Dry mouth
b) Constipation
c) Urinary retention
d) Increased sweating
Answer: d) Increased sweating
Which parasympatholytic drug is used to reduce respiratory secretions before surgery?
a) Atropine
b) Glycopyrrolate
c) Scopolamine
d) Neostigmine
Answer: b) Glycopyrrolate

Sympathomimetics (Adrenergic Agonists)

Sympathomimetic drugs mimic the action of which neurotransmitter(s)?
a) Acetylcholine
b) Dopamine
c) Norepinephrine and Epinephrine
d) Serotonin
Answer: c) Norepinephrine and Epinephrine
Which of the following is a direct-acting sympathomimetic?
a) Epinephrine
b) Ephedrine
c) Amphetamine
d) Cocaine
Answer: a) Epinephrine
Beta-2 adrenergic agonists are primarily used for:
a) Hypertension
b) Asthma
c) Bradycardia
d) Heart failure
Answer: b) Asthma
Which of the following sympathomimetics is used in anaphylactic shock?
a) Dopamine
b) Epinephrine
c) Clonidine
d) Isoproterenol
Answer: b) Epinephrine
Which of the following sympathomimetic drugs is a selective beta-1 agonist?
a) Albuterol
b) Dobutamine
c) Phenylephrine
d) Isoproterenol
Answer: b) Dobutamine
Which adrenergic receptor subtype is responsible for vasoconstriction?
a) Alpha-1
b) Alpha-2
c) Beta-1
d) Beta-2
Answer: a) Alpha-1
Which of the following is a non-selective beta agonist?
a) Albuterol
b) Clonidine
c) Isoproterenol
d) Phenylephrine
Answer: c) Isoproterenol
Which sympathomimetic drug is commonly used as a nasal decongestant?
a) Phenylephrine
b) Albuterol
c) Dobutamine
d) Isoproterenol
Answer: a) Phenylephrine
Which of the following is an indirect-acting sympathomimetic?
a) Epinephrine
b) Dopamine
c) Amphetamine
d) Clonidine
Answer: c) Amphetamine
Which sympathomimetic drug is used for treating ADHD (Attention Deficit Hyperactivity Disorder)?
a) Ephedrine
b) Amphetamine
c) Clonidine
d) Phenylephrine
Answer: b) Amphetamine

Clinical Uses and Side Effects of Sympathomimetics

Which of the following is a common side effect of beta-agonists?
a) Bradycardia
b) Tremors
c) Sedation
d) Miosis
Answer: b) Tremors
Which of the following sympathomimetic drugs is used to treat hypotension?
a) Phenylephrine
b) Albuterol
c) Clonidine
d) Atropine
Answer: a) Phenylephrine
Which sympathomimetic drug is used in cardiogenic shock?
a) Epinephrine
b) Dopamine
c) Phenylephrine
d) Isoproterenol
Answer: b) Dopamine
Which of the following is NOT a therapeutic use of sympathomimetics?
a) Hypertension
b) Asthma
c) ADHD
d) Nasal decongestion
Answer: a) Hypertension
Which alpha-2 agonist is used to treat hypertension?
a) Clonidine
b) Phenylephrine
c) Isoproterenol
d) Albuterol
Answer: a) Clonidine

Basic Concepts of Sympatholytics

Sympatholytic drugs act by:
a) Stimulating adrenergic receptors
b) Blocking adrenergic receptors
c) Increasing norepinephrine release
d) Activating cholinergic receptors
Answer: b) Blocking adrenergic receptors
Sympatholytic drugs are also known as:
a) Adrenergic agonists
b) Cholinergic agonists
c) Adrenergic antagonists
d) Parasympathomimetics
Answer: c) Adrenergic antagonists
Which of the following is a non-selective alpha-blocker?
a) Prazosin
b) Phentolamine
c) Atenolol
d) Propranolol
Answer: b) Phentolamine
Which of the following is a selective alpha-1 blocker used in hypertension?
a) Yohimbine
b) Prazosin
c) Clonidine
d) Epinephrine
Answer: b) Prazosin
Which alpha-blocker is used to treat pheochromocytoma?
a) Propranolol
b) Phentolamine
c) Atenolol
d) Clonidine
Answer: b) Phentolamine

Beta-Blockers (Beta-Adrenergic Antagonists)

Which of the following is a non-selective beta-blocker?
a) Atenolol
b) Propranolol
c) Metoprolol
d) Nebivolol
Answer: b) Propranolol
Which beta-blocker is cardioselective (beta-1 selective)?
a) Propranolol
b) Timolol
c) Atenolol
d) Carvedilol
Answer: c) Atenolol
Which beta-blocker is used in glaucoma treatment?
a) Timolol
b) Metoprolol
c) Labetalol
d) Prazosin
Answer: a) Timolol
Which beta-blocker has both alpha- and beta-blocking properties?
a) Carvedilol
b) Propranolol
c) Atenolol
d) Timolol
Answer: a) Carvedilol
Which of the following is NOT an effect of beta-blockers?
a) Decreased heart rate
b) Bronchodilation
c) Reduced cardiac output
d) Decreased blood pressure
Answer: b) Bronchodilation

Clinical Uses of Sympatholytics

Which condition is commonly treated using beta-blockers?
a) Asthma
b) Hypertension
c) Myasthenia gravis
d) Glaucoma
Answer: b) Hypertension
Which drug is used to prevent migraine headaches?
a) Atenolol
b) Propranolol
c) Metoprolol
d) Clonidine
Answer: b) Propranolol
Which beta-blocker is commonly used in heart failure?
a) Carvedilol
b) Propranolol
c) Timolol
d) Phentolamine
Answer: a) Carvedilol
Which beta-blocker is the drug of choice for treating angina?
a) Timolol
b) Metoprolol
c) Propranolol
d) Phentolamine
Answer: b) Metoprolol
Which of the following is NOT a contraindication for beta-blockers?
a) Asthma
b) Bradycardia
c) Hypertension
d) Heart block
Answer: c) Hypertension

Side Effects and Contraindications

Which of the following is a common side effect of beta-blockers?
a) Tachycardia
b) Bradycardia
c) Hypoglycemia
d) Hyperthermia
Answer: b) Bradycardia
Non-selective beta-blockers are contraindicated in which condition?
a) Hypertension
b) Asthma
c) Arrhythmia
d) Hyperthyroidism
Answer: b) Asthma
Which of the following is a side effect of alpha-blockers?
a) Hypertension
b) Orthostatic hypotension
c) Bronchospasm
d) Tachycardia
Answer: b) Orthostatic hypotension
Which sympatholytic drug can cause rebound hypertension if stopped abruptly?
a) Propranolol
b) Clonidine
c) Atenolol
d) Metoprolol
Answer: b) Clonidine
Which beta-blocker is used to control symptoms of hyperthyroidism?
a) Prazosin
b) Propranolol
c) Phentolamine
d) Epinephrine
Answer: b) Propranolol

Miscellaneous Questions

Which drug is a centrally acting sympatholytic used in hypertension?
a) Clonidine
b) Atenolol
c) Epinephrine
d) Dobutamine
Answer: a) Clonidine
Which alpha-2 agonist is used to manage opioid withdrawal symptoms?
a) Prazosin
b) Clonidine
c) Labetalol
d) Yohimbine
Answer: b) Clonidine
Which drug is a selective alpha-1A blocker used in benign prostatic hyperplasia (BPH)?
a) Prazosin
b) Tamsulosin
c) Carvedilol
d) Yohimbine
Answer: b) Tamsulosin
Which sympatholytic drug is used in hypertensive emergencies?
a) Phentolamine
b) Albuterol
c) Dopamine
d) Isoproterenol
Answer: a) Phentolamine
Which of the following is NOT a clinical use of beta-blockers?
a) Hypertension
b) Anxiety
c) Heart failure
d) Bronchial asthma
Answer: d) Bronchial asthma

Neuromuscular Blocking Agents (NMBAs)

Neuromuscular blocking agents act by blocking:
a) Adrenergic receptors
b) Cholinergic receptors
c) Nicotinic receptors at the neuromuscular junction
d) Muscarinic receptors
Answer: c) Nicotinic receptors at the neuromuscular junction
Which of the following is a depolarizing neuromuscular blocker?
a) Pancuronium
b) Rocuronium
c) Succinylcholine
d) Vecuronium
Answer: c) Succinylcholine
Which enzyme rapidly degrades succinylcholine in the plasma?
a) Acetylcholinesterase
b) Pseudocholinesterase
c) Monoamine oxidase
d) Catechol-O-methyltransferase
Answer: b) Pseudocholinesterase
Which of the following is a competitive (non-depolarizing) neuromuscular blocker?
a) Succinylcholine
b) Pancuronium
c) Acetylcholine
d) Nicotine
Answer: b) Pancuronium
The effect of non-depolarizing neuromuscular blockers can be reversed by:
a) Atropine
b) Neostigmine
c) Succinylcholine
d) Dopamine
Answer: b) Neostigmine
Which neuromuscular blocker has the shortest duration of action?
a) Vecuronium
b) Succinylcholine
c) Pancuronium
d) Atracurium
Answer: b) Succinylcholine
Which of the following is a long-acting neuromuscular blocker?
a) Mivacurium
b) Pancuronium
c) Rocuronium
d) Succinylcholine
Answer: b) Pancuronium
Which non-depolarizing neuromuscular blocker is commonly used for rapid-sequence intubation due to its fast onset?
a) Rocuronium
b) Succinylcholine
c) Atracurium
d) Pancuronium
Answer: a) Rocuronium
Which of the following is a side effect of succinylcholine?
a) Hypertension
b) Hyperkalemia
c) Hypoglycemia
d) Bradycardia
Answer: b) Hyperkalemia
Which of the following drugs is used to reverse neuromuscular blockade caused by rocuronium or vecuronium?
a) Neostigmine
b) Sugammadex
c) Physostigmine
d) Atropine
Answer: b) Sugammadex

Skeletal Muscle Relaxants

Skeletal muscle relaxants are primarily used for:
a) Increasing muscle tone
b) Reducing muscle spasticity
c) Enhancing neuromuscular transmission
d) Treating hypertension
Answer: b) Reducing muscle spasticity
Which of the following is a centrally acting muscle relaxant?
a) Dantrolene
b) Baclofen
c) Succinylcholine
d) Pancuronium
Answer: b) Baclofen
Baclofen acts by:
a) Blocking nicotinic receptors
b) Enhancing GABA-B receptor activity
c) Inhibiting acetylcholinesterase
d) Blocking muscarinic receptors
Answer: b) Enhancing GABA-B receptor activity
Which of the following muscle relaxants acts directly on skeletal muscle?
a) Baclofen
b) Diazepam
c) Dantrolene
d) Cyclobenzaprine
Answer: c) Dantrolene
Dantrolene is used in the treatment of:
a) Epilepsy
b) Malignant hyperthermia
c) Myasthenia gravis
d) Depression
Answer: b) Malignant hyperthermia
Which of the following centrally acting muscle relaxants is also used as an antianxiety drug?
a) Baclofen
b) Diazepam
c) Dantrolene
d) Pancuronium
Answer: b) Diazepam
Which skeletal muscle relaxant is structurally similar to tricyclic antidepressants?
a) Baclofen
b) Cyclobenzaprine
c) Dantrolene
d) Tizanidine
Answer: b) Cyclobenzaprine
Which of the following drugs acts as an alpha-2 agonist and is used for spasticity?
a) Baclofen
b) Tizanidine
c) Dantrolene
d) Diazepam
Answer: b) Tizanidine
Which muscle relaxant is used for spasticity in multiple sclerosis?
a) Succinylcholine
b) Baclofen
c) Rocuronium
d) Vecuronium
Answer: b) Baclofen
Which skeletal muscle relaxant is associated with hepatotoxicity?
a) Baclofen
b) Dantrolene
c) Diazepam
d) Tizanidine
Answer: b) Dantrolene

Side Effects and Clinical Considerations

A common side effect of baclofen is:
a) Hypertension
b) Drowsiness
c) Hyperkalemia
d) Diarrhea
Answer: b) Drowsiness
Which of the following muscle relaxants should NOT be used in patients with liver disease?
a) Tizanidine
b) Diazepam
c) Dantrolene
d) Baclofen
Answer: c) Dantrolene
Which of the following is an important withdrawal symptom of baclofen?
a) Muscle rigidity
b) Hyperthermia
c) Respiratory depression
d) Seizures
Answer: d) Seizures
Which of the following drugs is NOT used to treat spasticity?
a) Baclofen
b) Diazepam
c) Succinylcholine
d) Dantrolene
Answer: c) Succinylcholine
Which skeletal muscle relaxant is commonly used in acute muscle spasms due to injury?
a) Dantrolene
b) Cyclobenzaprine
c) Baclofen
d) Succinylcholine
Answer: b) Cyclobenzaprine

Basic Concepts of Local Anesthetics

Local anesthetics act by blocking which ion channel?
a) Sodium (Na⁺) channels
b) Potassium (K⁺) channels
c) Calcium (Ca²⁺) channels
d) Chloride (Cl⁻) channels
Answer: a) Sodium (Na⁺) channels
Which of the following is an amide-type local anesthetic?
a) Procaine
b) Lidocaine
c) Cocaine
d) Benzocaine
Answer: b) Lidocaine
Which of the following is an ester-type local anesthetic?
a) Bupivacaine
b) Mepivacaine
c) Procaine
d) Ropivacaine
Answer: c) Procaine
Which local anesthetic is used topically and has vasoconstrictive properties?
a) Procaine
b) Cocaine
c) Bupivacaine
d) Lidocaine
Answer: b) Cocaine
Local anesthetics are less effective in which type of tissue?
a) Normal tissue
b) Inflamed tissue
c) Muscle tissue
d) Neural tissue
Answer: b) Inflamed tissue

Pharmacokinetics and Duration of Action

Which of the following local anesthetics has the shortest duration of action?
a) Procaine
b) Bupivacaine
c) Lidocaine
d) Ropivacaine
Answer: a) Procaine
Which factor determines the potency of local anesthetics?
a) pKa value
b) Lipid solubility
c) Protein binding
d) Molecular weight
Answer: b) Lipid solubility
Amide-type local anesthetics are metabolized in the:
a) Plasma by esterases
b) Liver by cytochrome P450 enzymes
c) Kidney by filtration
d) Lungs by oxidation
Answer: b) Liver by cytochrome P450 enzymes
Ester-type local anesthetics are primarily metabolized by:
a) Liver enzymes
b) Plasma cholinesterases
c) Renal filtration
d) Pulmonary metabolism
Answer: b) Plasma cholinesterases
Which of the following local anesthetics has the longest duration of action?
a) Procaine
b) Bupivacaine
c) Lidocaine
d) Mepivacaine
Answer: b) Bupivacaine

Clinical Uses and Applications

Which local anesthetic is commonly used for spinal anesthesia?
a) Procaine
b) Bupivacaine
c) Cocaine
d) Benzocaine
Answer: b) Bupivacaine
Lidocaine is commonly used for:
a) Epidural anesthesia
b) Spinal anesthesia
c) Surface anesthesia
d) All of the above
Answer: d) All of the above
Which local anesthetic is commonly used in infiltration anesthesia?
a) Ropivacaine
b) Lidocaine
c) Bupivacaine
d) Cocaine
Answer: b) Lidocaine
Which local anesthetic is used in ophthalmic procedures?
a) Procaine
b) Tetracaine
c) Ropivacaine
d) Mepivacaine
Answer: b) Tetracaine
Which local anesthetic is used for topical application only?
a) Bupivacaine
b) Benzocaine
c) Mepivacaine
d) Procaine
Answer: b) Benzocaine

Toxicity and Side Effects

Which of the following is a common CNS side effect of local anesthetics?
a) Hypertension
b) Seizures
c) Bradycardia
d) Constipation
Answer: b) Seizures
Which of the following local anesthetics is most cardiotoxic?
a) Lidocaine
b) Bupivacaine
c) Procaine
d) Cocaine
Answer: b) Bupivacaine
Which local anesthetic is least likely to cause allergic reactions?
a) Procaine
b) Lidocaine
c) Tetracaine
d) Benzocaine
Answer: b) Lidocaine
Which of the following is a sign of local anesthetic systemic toxicity (LAST)?
a) Euphoria
b) Tinnitus
c) Hypertension
d) Diarrhea
Answer: b) Tinnitus
Methemoglobinemia is a side effect of which local anesthetic?
a) Lidocaine
b) Benzocaine
c) Bupivacaine
d) Ropivacaine
Answer: b) Benzocaine

Miscellaneous and Special Considerations

Which local anesthetic is safest in pregnancy?
a) Bupivacaine
b) Lidocaine
c) Ropivacaine
d) Procaine
Answer: c) Ropivacaine
Which local anesthetic is used in Bier’s block (Intravenous Regional Anesthesia – IVRA)?
a) Lidocaine
b) Bupivacaine
c) Cocaine
d) Tetracaine
Answer: a) Lidocaine
Which local anesthetic has the highest vasodilatory effect?
a) Lidocaine
b) Procaine
c) Bupivacaine
d) Ropivacaine
Answer: b) Procaine
Which of the following is a method to reduce systemic toxicity of local anesthetics?
a) Administering with epinephrine
b) Increasing the dose
c) Injecting into inflamed tissue
d) Using rapid intravenous administration
Answer: a) Administering with epinephrine
Which of the following local anesthetics has intrinsic vasoconstrictive properties?
a) Lidocaine
b) Cocaine
c) Procaine
d) Bupivacaine
Answer: b) Cocaine

Drugs Used in Myasthenia Gravis (MG)

Myasthenia gravis is caused by:
a) Excess acetylcholine at neuromuscular junctions
b) Autoimmune destruction of nicotinic receptors at neuromuscular junctions
c) Dopamine deficiency
d) Increased norepinephrine levels
Answer: b) Autoimmune destruction of nicotinic receptors at neuromuscular junctions
The drug of choice for symptomatic treatment of myasthenia gravis is:
a) Atropine
b) Neostigmine
c) Diazepam
d) Propranolol
Answer: b) Neostigmine
Which of the following is a long-acting acetylcholinesterase inhibitor used in myasthenia gravis?
a) Edrophonium
b) Pyridostigmine
c) Succinylcholine
d) Physostigmine
Answer: b) Pyridostigmine
Which drug is used for the diagnosis of myasthenia gravis?
a) Neostigmine
b) Edrophonium
c) Physostigmine
d) Atropine
Answer: b) Edrophonium
Which drug is used to distinguish between myasthenic crisis and cholinergic crisis?
a) Pyridostigmine
b) Edrophonium
c) Atropine
d) Diazepam
Answer: b) Edrophonium
Which of the following is an immunosuppressant used in myasthenia gravis?
a) Prednisolone
b) Atropine
c) Salbutamol
d) Lorazepam
Answer: a) Prednisolone
Which of the following is NOT used in the treatment of myasthenia gravis?
a) Azathioprine
b) Mycophenolate mofetil
c) Atropine
d) Tacrolimus
Answer: c) Atropine
Plasmapheresis and intravenous immunoglobulin (IVIG) are used in:
a) Chronic treatment of myasthenia gravis
b) Acute myasthenic crisis
c) Diagnosis of myasthenia gravis
d) Treatment of glaucoma
Answer: b) Acute myasthenic crisis
What is the mechanism of action of acetylcholinesterase inhibitors in myasthenia gravis?
a) Increase dopamine levels
b) Block muscarinic receptors
c) Increase acetylcholine availability at neuromuscular junctions
d) Decrease norepinephrine release
Answer: c) Increase acetylcholine availability at neuromuscular junctions
Which of the following is a side effect of pyridostigmine?
a) Dry mouth
b) Bradycardia
c) Hypertension
d) Mydriasis
Answer: b) Bradycardia

Drugs Used in Glaucoma

Glaucoma is primarily associated with increased:
a) Retinal pressure
b) Intraocular pressure
c) Blood pressure
d) Aqueous humor production
Answer: b) Intraocular pressure
The first-line drug for open-angle glaucoma is:
a) Pilocarpine
b) Timolol
c) Atropine
d) Epinephrine
Answer: b) Timolol
Which class of drugs decreases aqueous humor production in glaucoma?
a) Beta-blockers
b) Cholinergic agonists
c) Carbonic anhydrase inhibitors
d) Both a and c
Answer: d) Both a and c
Which of the following is a prostaglandin analog used in glaucoma?
a) Brimonidine
b) Latanoprost
c) Timolol
d) Dorzolamide
Answer: b) Latanoprost
Which of the following drugs is a cholinergic agonist used in glaucoma?
a) Timolol
b) Pilocarpine
c) Latanoprost
d) Acetazolamide
Answer: b) Pilocarpine
Which of the following drugs works by increasing trabecular and uveoscleral outflow?
a) Timolol
b) Latanoprost
c) Acetazolamide
d) Apraclonidine
Answer: b) Latanoprost
Which of the following drugs is a selective alpha-2 agonist used in glaucoma?
a) Timolol
b) Brimonidine
c) Latanoprost
d) Pilocarpine
Answer: b) Brimonidine
Which drug is used in acute angle-closure glaucoma to rapidly reduce intraocular pressure?
a) Timolol
b) Acetazolamide
c) Latanoprost
d) Pilocarpine
Answer: b) Acetazolamide
Which of the following is an oral carbonic anhydrase inhibitor used in glaucoma?
a) Timolol
b) Dorzolamide
c) Acetazolamide
d) Brimonidine
Answer: c) Acetazolamide
Which of the following local carbonic anhydrase inhibitors is used as an eye drop?
a) Timolol
b) Dorzolamide
c) Latanoprost
d) Pilocarpine
Answer: b) Dorzolamide
Which of the following drugs is contraindicated in asthma patients with glaucoma?
a) Latanoprost
b) Timolol
c) Pilocarpine
d) Brimonidine
Answer: b) Timolol
Which of the following drugs can cause iris pigmentation as a side effect?
a) Timolol
b) Latanoprost
c) Brimonidine
d) Acetazolamide
Answer: b) Latanoprost
What is the mechanism of action of beta-blockers in glaucoma?
a) Increase aqueous humor outflow
b) Decrease aqueous humor production
c) Increase trabecular meshwork drainage
d) Activate alpha receptors
Answer: b) Decrease aqueous humor production
Which of the following is NOT used in the treatment of glaucoma?
a) Timolol
b) Pilocarpine
c) Atropine
d) Acetazolamide
Answer: c) Atropine
Which of the following drugs causes miosis and is used to treat acute angle-closure glaucoma?
a) Latanoprost
b) Pilocarpine
c) Timolol
d) Brimonidine
Answer: b) Pilocarpine

————————————————————————————–

UNIT-IV

Pharmacology of drugs acting on central nervous system

1. General Concepts of Neurohumoral Transmission in the CNS

2. General anesthetics and pre-anesthetics.

3. Sedatives, hypnotics and centrally acting muscle relaxants.

4. Anti-epileptics

5. Alcohols and disulfiram

Which of the following is the main excitatory neurotransmitter in the CNS?
a) GABA
b) Glycine
c) Glutamate
d) Dopamine
Answer: c) Glutamate
Which of the following is the primary inhibitory neurotransmitter in the CNS?
a) Glutamate
b) Acetylcholine
c) GABA
d) Serotonin
Answer: c) GABA
Which neurotransmitter is involved in fast excitatory synaptic transmission in the brain?
a) GABA
b) Glutamate
c) Dopamine
d) Serotonin
Answer: b) Glutamate
Which neurotransmitter is most abundant in the brain and is responsible for learning and memory?
a) GABA
b) Glutamate
c) Acetylcholine
d) Dopamine
Answer: b) Glutamate
Which of the following is NOT a major neurotransmitter in the CNS?
a) Acetylcholine
b) Norepinephrine
c) Histamine
d) Insulin
Answer: d) Insulin

GABA (Gamma-Aminobutyric Acid)

Which enzyme is responsible for the synthesis of GABA?
a) Glutamate decarboxylase
b) Choline acetyltransferase
c) Monoamine oxidase
d) Dopamine beta-hydroxylase
Answer: a) Glutamate decarboxylase
GABA exerts its inhibitory effects by:
a) Increasing sodium influx
b) Decreasing potassium efflux
c) Increasing chloride influx
d) Blocking calcium channels
Answer: c) Increasing chloride influx
GABA acts on which of the following receptors?
a) NMDA
b) AMPA
c) GABA-A and GABA-B
d) Dopamine D2
Answer: c) GABA-A and GABA-B
GABA-A receptors are:
a) Ionotropic (ligand-gated ion channels)
b) Metabotropic (G-protein coupled)
c) Enzyme-linked
d) Cytoplasmic receptors
Answer: a) Ionotropic (ligand-gated ion channels)
Which drug is a GABA-A receptor agonist used for anxiety?
a) Fluoxetine
b) Diazepam
c) Haloperidol
d) Amitriptyline
Answer: b) Diazepam
Which of the following is a GABA-B receptor agonist used as a muscle relaxant?
a) Baclofen
b) Clonazepam
c) Midazolam
d) Phenytoin
Answer: a) Baclofen
Benzodiazepines enhance the effect of which neurotransmitter?
a) Glutamate
b) Acetylcholine
c) GABA
d) Serotonin
Answer: c) GABA
Which of the following drugs is a GABA transaminase inhibitor used in epilepsy?
a) Vigabatrin
b) Carbamazepine
c) Levetiracetam
d) Phenytoin
Answer: a) Vigabatrin
Which of the following conditions is associated with reduced GABA activity?
a) Schizophrenia
b) Parkinson’s disease
c) Epilepsy
d) Alzheimer’s disease
Answer: c) Epilepsy
Barbiturates enhance GABA activity by:
a) Increasing GABA release
b) Increasing the duration of chloride channel opening
c) Blocking GABA reuptake
d) Inhibiting GABA synthesis
Answer: b) Increasing the duration of chloride channel opening

Glutamate (The Major Excitatory Neurotransmitter)

Glutamate acts on which of the following receptors?
a) GABA-A
b) NMDA, AMPA, and Kainate
c) Dopamine D1
d) Serotonin 5-HT2A
Answer: b) NMDA, AMPA, and Kainate
Which of the following glutamate receptors is ionotropic?
a) NMDA
b) Metabotropic Glutamate Receptors (mGluRs)
c) GABA-B
d) Dopamine D2
Answer: a) NMDA
Which of the following is an excitatory amino acid neurotransmitter?
a) GABA
b) Glutamate
c) Glycine
d) Dopamine
Answer: b) Glutamate
Excessive activation of NMDA receptors is associated with:
a) Depression
b) Alzheimer’s disease
c) Excitotoxicity and neuronal death
d) Parkinson’s disease
Answer: c) Excitotoxicity and neuronal death
Which of the following drugs is an NMDA receptor antagonist used in Alzheimer’s disease?
a) Memantine
b) Donepezil
c) Rivastigmine
d) Galantamine
Answer: a) Memantine
Ketamine is a:
a) GABA agonist
b) NMDA receptor antagonist
c) AMPA receptor agonist
d) Dopamine agonist
Answer: b) NMDA receptor antagonist
Which of the following drugs decreases glutamate release?
a) Riluzole
b) Diazepam
c) Amitriptyline
d) Haloperidol
Answer: a) Riluzole
Excitotoxicity caused by excessive glutamate release is implicated in:
a) Schizophrenia
b) Depression
c) Stroke and neurodegeneration
d) Anxiety disorders
Answer: c) Stroke and neurodegeneration
Which of the following is a selective AMPA receptor antagonist?
a) Perampanel
b) Gabapentin
c) Diazepam
d) Carbamazepine
Answer: a) Perampanel
Which amino acid serves as a precursor for glutamate synthesis?
a) Glycine
b) Glutamine
c) Tryptophan
d) Phenylalanine
Answer: b) Glutamine

General Concepts of Neurohumoral Transmission in the CNS

Which of the following neurotransmitters is mainly inhibitory in the spinal cord?
a) Glutamate
b) Dopamine
c) Glycine
d) Serotonin
Answer: c) Glycine
Which neurotransmitter is also known as 5-hydroxytryptamine (5-HT)?
a) Dopamine
b) Serotonin
c) GABA
d) Acetylcholine
Answer: b) Serotonin
Which neurotransmitter is primarily associated with the reward system and motivation in the brain?
a) Glutamate
b) Dopamine
c) Serotonin
d) GABA
Answer: b) Dopamine
Dopamine is mainly synthesized from which amino acid?
a) Tryptophan
b) Tyrosine
c) Histidine
d) Glycine
Answer: b) Tyrosine
Which neurotransmitter is a precursor for serotonin synthesis?
a) Tyrosine
b) Glycine
c) Tryptophan
d) Phenylalanine
Answer: c) Tryptophan

Glycine

Glycine acts as an inhibitory neurotransmitter in which part of the CNS?
a) Brainstem and spinal cord
b) Cerebral cortex
c) Hippocampus
d) Basal ganglia
Answer: a) Brainstem and spinal cord
Which receptor does glycine primarily act on?
a) NMDA receptor
b) Glycine receptor (GlyR)
c) Dopamine D1 receptor
d) Serotonin 5-HT1 receptor
Answer: b) Glycine receptor (GlyR)
Which ion channel is associated with glycine receptors?
a) Sodium
b) Potassium
c) Chloride
d) Calcium
Answer: c) Chloride
Which of the following drugs acts as a glycine receptor antagonist?
a) Strychnine
b) Diazepam
c) Ketamine
d) Fluoxetine
Answer: a) Strychnine
Glycine can act as a co-agonist for which excitatory receptor?
a) GABA-A receptor
b) NMDA receptor
c) Dopamine D2 receptor
d) Serotonin 5-HT2 receptor
Answer: b) NMDA receptor

Serotonin (5-HT)

Serotonin is mainly synthesized in which part of the brain?
a) Basal ganglia
b) Raphe nuclei
c) Substantia nigra
d) Hippocampus
Answer: b) Raphe nuclei
Which enzyme is responsible for the conversion of tryptophan to serotonin?
a) Tyrosine hydroxylase
b) Tryptophan hydroxylase
c) Monoamine oxidase
d) Choline acetyltransferase
Answer: b) Tryptophan hydroxylase
Serotonin is degraded primarily by:
a) Catechol-O-methyltransferase (COMT)
b) Monoamine oxidase (MAO)
c) Acetylcholinesterase (AChE)
d) GABA transaminase
Answer: b) Monoamine oxidase (MAO)
Which serotonin receptor is ionotropic?
a) 5-HT1A
b) 5-HT2A
c) 5-HT3
d) 5-HT4
Answer: c) 5-HT3
Which of the following drugs is a selective serotonin reuptake inhibitor (SSRI)?
a) Fluoxetine
b) Haloperidol
c) Diazepam
d) Levodopa
Answer: a) Fluoxetine
Which serotonin receptor is involved in migraine treatment?
a) 5-HT1B/1D
b) 5-HT3
c) 5-HT4
d) 5-HT7
Answer: a) 5-HT1B/1D
Which of the following serotonin receptors is targeted by atypical antipsychotics like clozapine?
a) 5-HT1A
b) 5-HT2A
c) 5-HT3
d) 5-HT7
Answer: b) 5-HT2A
Which neurotransmitter plays a crucial role in mood regulation, anxiety, and sleep?
a) Dopamine
b) Acetylcholine
c) Serotonin
d) Glutamate
Answer: c) Serotonin

Dopamine

Dopaminergic neurons are primarily located in which brain region?
a) Raphe nuclei
b) Substantia nigra
c) Locus coeruleus
d) Cerebellum
Answer: b) Substantia nigra
Which of the following is a dopamine precursor used in Parkinson’s disease?
a) Fluoxetine
b) Levodopa
c) Haloperidol
d) Risperidone
Answer: b) Levodopa
Dopamine receptors are:
a) Ionotropic
b) Metabotropic (G-protein coupled)
c) Ligand-gated chloride channels
d) Ligand-gated sodium channels
Answer: b) Metabotropic (G-protein coupled)
Which dopamine pathway is involved in motor control and Parkinson’s disease?
a) Mesolimbic pathway
b) Mesocortical pathway
c) Nigrostriatal pathway
d) Tuberoinfundibular pathway
Answer: c) Nigrostriatal pathway
Which dopamine pathway is associated with schizophrenia?
a) Nigrostriatal
b) Mesolimbic
c) Mesocortical
d) Tuberoinfundibular
Answer: b) Mesolimbic
Which of the following drugs is a dopamine D2 receptor antagonist used in schizophrenia?
a) Haloperidol
b) Levodopa
c) Fluoxetine
d) Diazepam
Answer: a) Haloperidol
Which enzyme metabolizes dopamine?
a) Acetylcholinesterase
b) Monoamine oxidase (MAO)
c) GABA transaminase
d) NMDA oxidase
Answer: b) Monoamine oxidase (MAO)

General Anesthetics

Which of the following is an intravenous general anesthetic?
a) Halothane
b) Isoflurane
c) Propofol
d) Nitrous oxide
Answer: c) Propofol
Which of the following inhalational anesthetics is associated with hepatotoxicity?
a) Halothane
b) Isoflurane
c) Sevoflurane
d) Desflurane
Answer: a) Halothane
The Meyer-Overton theory explains the correlation between anesthetic potency and:
a) Blood solubility
b) Lipid solubility
c) MAC value
d) Protein binding
Answer: b) Lipid solubility
Which general anesthetic is commonly used for induction and maintenance due to its rapid onset and recovery?
a) Ketamine
b) Thiopental
c) Propofol
d) Midazolam
Answer: c) Propofol
Which inhalational anesthetic has the lowest minimum alveolar concentration (MAC) and highest potency?
a) Halothane
b) Nitrous oxide
c) Isoflurane
d) Sevoflurane
Answer: a) Halothane
Which of the following inhaled anesthetics has the fastest induction and recovery?
a) Nitrous oxide
b) Halothane
c) Isoflurane
d) Enflurane
Answer: a) Nitrous oxide
Which intravenous anesthetic can cause dissociative anesthesia?
a) Propofol
b) Ketamine
c) Thiopental
d) Etomidate
Answer: b) Ketamine
Which intravenous anesthetic is preferred in patients with cardiovascular instability?
a) Propofol
b) Ketamine
c) Thiopental
d) Isoflurane
Answer: b) Ketamine
Which of the following is a side effect of halothane anesthesia?
a) Hypertension
b) Hyperthermia
c) Hepatotoxicity
d) Seizures
Answer: c) Hepatotoxicity
Which inhalational anesthetic is contraindicated in patients with increased intracranial pressure?
a) Isoflurane
b) Sevoflurane
c) Nitrous oxide
d) Desflurane
Answer: c) Nitrous oxide

Pre-Anesthetic Medications

Which of the following is used as a pre-anesthetic medication to reduce salivary and respiratory secretions?
a) Atropine
b) Midazolam
c) Ketamine
d) Halothane
Answer: a) Atropine
Which benzodiazepine is commonly used as a pre-anesthetic medication?
a) Diazepam
b) Flumazenil
c) Buspirone
d) Phenobarbital
Answer: a) Diazepam
Which opioid is commonly used as a pre-anesthetic for analgesia?
a) Morphine
b) Fentanyl
c) Codeine
d) Aspirin
Answer: b) Fentanyl
Which of the following is used to prevent postoperative nausea and vomiting?
a) Atropine
b) Ondansetron
c) Morphine
d) Propofol
Answer: b) Ondansetron
Which of the following is an α2-adrenergic agonist used as a pre-anesthetic sedative?
a) Midazolam
b) Dexmedetomidine
c) Atropine
d) Succinylcholine
Answer: b) Dexmedetomidine
Which drug is commonly used to reduce anxiety before surgery?
a) Midazolam
b) Naloxone
c) Flumazenil
d) Atropine
Answer: a) Midazolam
Which pre-anesthetic medication is used to prevent bradycardia during anesthesia?
a) Atropine
b) Epinephrine
c) Propofol
d) Naloxone
Answer: a) Atropine
Which of the following is a short-acting benzodiazepine used for conscious sedation before anesthesia?
a) Lorazepam
b) Midazolam
c) Diazepam
d) Alprazolam
Answer: b) Midazolam
Which drug is used as an adjunct to anesthesia for its muscle relaxant properties?
a) Succinylcholine
b) Halothane
c) Atropine
d) Nitrous oxide
Answer: a) Succinylcholine
Which of the following is a major contraindication for the use of succinylcholine?
a) Hyperkalemia
b) Hypertension
c) Tachycardia
d) Hypoglycemia
Answer: a) Hyperkalemia

Adverse Effects and Contraindications

Which of the following general anesthetics is most likely to cause malignant hyperthermia?
a) Nitrous oxide
b) Halothane
c) Ketamine
d) Propofol
Answer: b) Halothane
Which of the following drugs is used to treat malignant hyperthermia?
a) Succinylcholine
b) Dantrolene
c) Atropine
d) Epinephrine
Answer: b) Dantrolene
Which of the following anesthetic agents causes adrenal suppression?
a) Ketamine
b) Etomidate
c) Propofol
d) Isoflurane
Answer: b) Etomidate
Which general anesthetic is contraindicated in epileptic patients?
a) Isoflurane
b) Enflurane
c) Sevoflurane
d) Desflurane
Answer: b) Enflurane
Which inhalational anesthetic is associated with nephrotoxicity due to fluoride ion release?
a) Halothane
b) Enflurane
c) Sevoflurane
d) Desflurane
Answer: b) Enflurane

General Concepts of Sedatives and Hypnotics

Which of the following is classified as a benzodiazepine?
a) Phenobarbital
b) Diazepam
c) Zolpidem
d) Buspirone
Answer: b) Diazepam
Which neurotransmitter is primarily affected by sedatives and hypnotics?
a) Dopamine
b) Acetylcholine
c) GABA
d) Serotonin
Answer: c) GABA
Which receptor is the main target for benzodiazepines?
a) NMDA receptor
b) GABA-A receptor
c) Dopamine D2 receptor
d) Serotonin 5-HT3 receptor
Answer: b) GABA-A receptor
Which of the following benzodiazepines is commonly used for insomnia?
a) Diazepam
b) Lorazepam
c) Midazolam
d) Temazepam
Answer: d) Temazepam
Which of the following drugs is a non-benzodiazepine hypnotic?
a) Zolpidem
b) Alprazolam
c) Clonazepam
d) Phenobarbital
Answer: a) Zolpidem
Which of the following is a long-acting benzodiazepine?
a) Triazolam
b) Midazolam
c) Diazepam
d) Zolpidem
Answer: c) Diazepam
Which of the following barbiturates is commonly used as an anticonvulsant?
a) Pentobarbital
b) Phenobarbital
c) Thiopental
d) Secobarbital
Answer: b) Phenobarbital
Which of the following drugs is a selective melatonin receptor agonist used for insomnia?
a) Buspirone
b) Ramelteon
c) Midazolam
d) Flurazepam
Answer: b) Ramelteon
Which of the following benzodiazepines has the shortest duration of action?
a) Triazolam
b) Alprazolam
c) Diazepam
d) Clonazepam
Answer: a) Triazolam
Which of the following is an anxiolytic that does not cause sedation?
a) Diazepam
b) Buspirone
c) Phenobarbital
d) Midazolam
Answer: b) Buspirone

Mechanism of Action and Pharmacokinetics

Benzodiazepines enhance the effect of GABA by:
a) Blocking NMDA receptors
b) Increasing chloride channel opening frequency
c) Increasing dopamine release
d) Acting as a serotonin agonist
Answer: b) Increasing chloride channel opening frequency
Barbiturates enhance the effect of GABA by:
a) Increasing chloride channel opening duration
b) Increasing serotonin levels
c) Blocking dopamine receptors
d) Decreasing norepinephrine release
Answer: a) Increasing chloride channel opening duration
Which of the following sedative-hypnotics is metabolized by the liver and has active metabolites?
a) Zolpidem
b) Diazepam
c) Buspirone
d) Ramelteon
Answer: b) Diazepam
Which of the following drugs acts as a GABA-B receptor agonist?
a) Phenobarbital
b) Baclofen
c) Flumazenil
d) Ramelteon
Answer: b) Baclofen
Which benzodiazepine has an ultra-short duration and is used for pre-anesthetic sedation?
a) Alprazolam
b) Midazolam
c) Diazepam
d) Clonazepam
Answer: b) Midazolam

Therapeutic Uses

Which of the following is the preferred treatment for acute anxiety?
a) Buspirone
b) Diazepam
c) Ramelteon
d) Zolpidem
Answer: b) Diazepam
Which non-benzodiazepine hypnotic has the least risk of dependence?
a) Phenobarbital
b) Zolpidem
c) Alprazolam
d) Clonazepam
Answer: b) Zolpidem
Which of the following sedative-hypnotics is most suitable for elderly patients with insomnia?
a) Diazepam
b) Triazolam
c) Zolpidem
d) Phenobarbital
Answer: c) Zolpidem
Which drug is commonly used for generalized anxiety disorder but has a delayed onset of action?
a) Diazepam
b) Buspirone
c) Clonazepam
d) Midazolam
Answer: b) Buspirone
Which of the following drugs is preferred for sleep maintenance insomnia?
a) Zolpidem
b) Ramelteon
c) Diazepam
d) Temazepam
Answer: d) Temazepam

Adverse Effects and Toxicity

Which of the following is the most common side effect of benzodiazepines?
a) Hypertension
b) Sedation
c) Hallucinations
d) Hyperactivity
Answer: b) Sedation
Which of the following sedative-hypnotics has the highest risk of respiratory depression?
a) Zolpidem
b) Diazepam
c) Phenobarbital
d) Buspirone
Answer: c) Phenobarbital
Which of the following is the antidote for benzodiazepine overdose?
a) Flumazenil
b) Naloxone
c) Atropine
d) Pralidoxime
Answer: a) Flumazenil
Which of the following drugs can cause anterograde amnesia?
a) Ramelteon
b) Diazepam
c) Buspirone
d) Phenobarbital
Answer: b) Diazepam
Which of the following is NOT an adverse effect of Z-drugs (zolpidem, zaleplon, eszopiclone)?
a) Sleepwalking
b) Next-day sedation
c) Respiratory depression
d) Rebound insomnia
Answer: c) Respiratory depression

General Concepts

Which of the following is a centrally acting muscle relaxant?
a) Dantrolene
b) Baclofen
c) Succinylcholine
d) Pancuronium
Answer: b) Baclofen
Centrally acting muscle relaxants primarily work by:
a) Inhibiting acetylcholinesterase
b) Enhancing GABAergic transmission
c) Blocking nicotinic receptors
d) Increasing dopamine release
Answer: b) Enhancing GABAergic transmission
Which neurotransmitter is primarily involved in the action of centrally acting muscle relaxants?
a) Acetylcholine
b) Dopamine
c) GABA
d) Serotonin
Answer: c) GABA
Which of the following is a GABA-B receptor agonist used as a muscle relaxant?
a) Diazepam
b) Baclofen
c) Tizanidine
d) Dantrolene
Answer: b) Baclofen
Which centrally acting muscle relaxant is also classified as an α2-adrenergic agonist?
a) Baclofen
b) Tizanidine
c) Dantrolene
d) Cyclobenzaprine
Answer: b) Tizanidine

Mechanism of Action

Baclofen exerts its muscle relaxant effects by:
a) Inhibiting GABA-A receptors
b) Stimulating GABA-B receptors
c) Blocking sodium channels
d) Increasing dopamine release
Answer: b) Stimulating GABA-B receptors
Tizanidine reduces muscle spasticity by acting on:
a) GABA-B receptors
b) α2-adrenergic receptors
c) Dopamine receptors
d) NMDA receptors
Answer: b) α2-adrenergic receptors
Cyclobenzaprine is structurally related to:
a) Tricyclic antidepressants
b) Barbiturates
c) Benzodiazepines
d) Dopamine agonists
Answer: a) Tricyclic antidepressants
Diazepam reduces muscle spasms by:
a) Acting as a GABA-A receptor agonist
b) Blocking nicotinic receptors
c) Inhibiting voltage-gated sodium channels
d) Increasing norepinephrine levels
Answer: a) Acting as a GABA-A receptor agonist
Which of the following is NOT a centrally acting muscle relaxant?
a) Carisoprodol
b) Methocarbamol
c) Dantrolene
d) Tizanidine
Answer: c) Dantrolene

Therapeutic Uses

Baclofen is commonly used in the treatment of:
a) Myasthenia gravis
b) Spasticity in multiple sclerosis
c) Parkinson’s disease
d) Epilepsy
Answer: b) Spasticity in multiple sclerosis
Which drug is preferred for spasticity in spinal cord injury patients?
a) Succinylcholine
b) Baclofen
c) Atropine
d) Edrophonium
Answer: b) Baclofen
Which centrally acting muscle relaxant is used for acute musculoskeletal pain?
a) Tizanidine
b) Cyclobenzaprine
c) Diazepam
d) Baclofen
Answer: b) Cyclobenzaprine
Tizanidine is commonly used to treat spasticity associated with:
a) Rheumatoid arthritis
b) Stroke
c) Myasthenia gravis
d) Schizophrenia
Answer: b) Stroke
Which centrally acting muscle relaxant is commonly used for tension headaches?
a) Methocarbamol
b) Cyclobenzaprine
c) Tizanidine
d) Diazepam
Answer: b) Cyclobenzaprine

Adverse Effects

A common side effect of baclofen is:
a) Hypertension
b) Sedation
c) Tachycardia
d) Hallucinations
Answer: b) Sedation
Which of the following drugs can cause severe withdrawal symptoms if stopped abruptly?
a) Tizanidine
b) Diazepam
c) Baclofen
d) Cyclobenzaprine
Answer: c) Baclofen
Which muscle relaxant has a high risk of hepatotoxicity?
a) Baclofen
b) Tizanidine
c) Carisoprodol
d) Cyclobenzaprine
Answer: b) Tizanidine
Cyclobenzaprine is contraindicated in patients with:
a) Liver disease
b) Myasthenia gravis
c) Glaucoma
d) Hyperthyroidism
Answer: d) Hyperthyroidism
Which of the following muscle relaxants is most likely to cause dry mouth and drowsiness?
a) Methocarbamol
b) Tizanidine
c) Diazepam
d) Cyclobenzaprine
Answer: d) Cyclobenzaprine

Drug Interactions

Which of the following drugs should NOT be combined with tizanidine due to increased risk of hypotension?
a) NSAIDs
b) Opioids
c) Antihypertensives
d) Beta-blockers
Answer: c) Antihypertensives
Which centrally acting muscle relaxant can interact with alcohol to cause severe CNS depression?
a) Baclofen
b) Diazepam
c) Tizanidine
d) All of the above
Answer: d) All of the above
Which muscle relaxant should be avoided in combination with strong CYP1A2 inhibitors like ciprofloxacin?
a) Baclofen
b) Tizanidine
c) Methocarbamol
d) Cyclobenzaprine
Answer: b) Tizanidine
Which of the following muscle relaxants has a risk of abuse and dependence?
a) Diazepam
b) Carisoprodol
c) Baclofen
d) All of the above
Answer: d) All of the above
Which drug is preferred for treating chronic muscle spasticity due to spinal cord injuries?
a) Succinylcholine
b) Baclofen
c) Diazepam
d) Dantrolene
Answer: b) Baclofen

Anti-Epileptic Drugs (AEDs)

General Concepts

Which of the following is NOT an anti-epileptic drug?
a) Phenytoin
b) Carbamazepine
c) Atropine
d) Valproate
Answer: c) Atropine
Which neurotransmitter is primarily inhibited by anti-epileptic drugs to reduce seizure activity?
a) Glutamate
b) GABA
c) Dopamine
d) Serotonin
Answer: a) Glutamate
Which of the following anti-epileptic drugs enhances GABAergic activity?
a) Phenytoin
b) Diazepam
c) Ethosuximide
d) Lamotrigine
Answer: b) Diazepam
Which of the following drugs acts by blocking sodium channels?
a) Phenytoin
b) Valproate
c) Ethosuximide
d) Phenobarbital
Answer: a) Phenytoin
Which anti-epileptic drug is the first-line treatment for absence seizures?
a) Phenytoin
b) Carbamazepine
c) Ethosuximide
d) Gabapentin
Answer: c) Ethosuximide

Mechanism of Action

Carbamazepine acts by:
a) Enhancing GABA activity
b) Blocking sodium channels
c) Inhibiting calcium channels
d) Increasing serotonin levels
Answer: b) Blocking sodium channels
Ethosuximide primarily acts by:
a) Blocking sodium channels
b) Enhancing GABA activity
c) Inhibiting T-type calcium channels
d) Blocking NMDA receptors
Answer: c) Inhibiting T-type calcium channels
Which of the following drugs is a GABA transaminase inhibitor?
a) Phenytoin
b) Vigabatrin
c) Carbamazepine
d) Ethosuximide
Answer: b) Vigabatrin
Which drug acts on synaptic vesicle protein 2A (SV2A) to reduce seizures?
a) Phenytoin
b) Levetiracetam
c) Phenobarbital
d) Lamotrigine
Answer: b) Levetiracetam
Which of the following drugs inhibits glutamate release by blocking calcium channels?
a) Gabapentin
b) Phenytoin
c) Diazepam
d) Vigabatrin
Answer: a) Gabapentin

Therapeutic Uses

Which drug is the drug of choice for generalized tonic-clonic seizures?
a) Phenytoin
b) Valproate
c) Ethosuximide
d) Topiramate
Answer: b) Valproate
Carbamazepine is the drug of choice for:
a) Absence seizures
b) Tonic-clonic seizures
c) Trigeminal neuralgia
d) Status epilepticus
Answer: c) Trigeminal neuralgia
Which of the following drugs is preferred in status epilepticus?
a) Diazepam
b) Lamotrigine
c) Topiramate
d) Vigabatrin
Answer: a) Diazepam
Which of the following anti-epileptic drugs is safe in pregnancy?
a) Phenytoin
b) Carbamazepine
c) Lamotrigine
d) Valproate
Answer: c) Lamotrigine
Which drug is preferred in absence seizures when ethosuximide is not tolerated?
a) Carbamazepine
b) Valproate
c) Phenytoin
d) Topiramate
Answer: b) Valproate

Adverse Effects

A common side effect of phenytoin is:
a) Gingival hyperplasia
b) Hepatotoxicity
c) Weight gain
d) Hypertension
Answer: a) Gingival hyperplasia
Valproate is associated with:
a) Hepatotoxicity
b) Nephrotoxicity
c) Pulmonary fibrosis
d) Osteoporosis
Answer: a) Hepatotoxicity
Which anti-epileptic drug can cause Stevens-Johnson syndrome?
a) Lamotrigine
b) Ethosuximide
c) Gabapentin
d) Topiramate
Answer: a) Lamotrigine
Which of the following anti-epileptic drugs causes weight gain?
a) Phenytoin
b) Topiramate
c) Valproate
d) Zonisamide
Answer: c) Valproate
Which anti-epileptic drug is known to cause kidney stones?
a) Carbamazepine
b) Phenytoin
c) Topiramate
d) Ethosuximide
Answer: c) Topiramate

Drug Interactions

Which anti-epileptic drug induces CYP450 enzymes?
a) Phenytoin
b) Ethosuximide
c) Gabapentin
d) Valproate
Answer: a) Phenytoin
Which drug increases lamotrigine levels by inhibiting its metabolism?
a) Carbamazepine
b) Valproate
c) Phenytoin
d) Gabapentin
Answer: b) Valproate
Phenytoin reduces the effectiveness of oral contraceptives by:
a) Inhibiting CYP enzymes
b) Inducing CYP enzymes
c) Increasing estrogen levels
d) Blocking progesterone receptors
Answer: b) Inducing CYP enzymes
Which of the following anti-epileptic drugs has minimal drug interactions?
a) Phenytoin
b) Carbamazepine
c) Levetiracetam
d) Valproate
Answer: c) Levetiracetam
Carbamazepine should not be combined with which drug due to increased risk of toxicity?
a) Phenytoin
b) Valproate
c) Isoniazid
d) Fluoxetine
Answer: b) Valproate

Alcohols and Disulfiram

Alcohols (Ethanol & Methanol)

Which enzyme primarily metabolizes ethanol in the liver?
a) Alcohol dehydrogenase (ADH)
b) Acetylcholinesterase
c) Cytochrome P450
d) Monoamine oxidase (MAO)
Answer: a) Alcohol dehydrogenase (ADH)
Ethanol is primarily metabolized to which of the following?
a) Acetic acid
b) Acetaldehyde
c) Methanol
d) Formic acid
Answer: b) Acetaldehyde
Which cofactor is required for the conversion of ethanol to acetaldehyde?
a) NAD+
b) FAD
c) ATP
d) Coenzyme A
Answer: a) NAD+
What is the major metabolite of ethanol responsible for its toxic effects?
a) Formic acid
b) Acetaldehyde
c) Acetic acid
d) Carbon dioxide
Answer: b) Acetaldehyde
Which of the following is a major effect of ethanol on the central nervous system?
a) CNS excitation
b) CNS depression
c) Increased dopamine release
d) Increased norepinephrine release
Answer: b) CNS depression
Which neurotransmitter system is most affected by ethanol?
a) GABA
b) Dopamine
c) Serotonin
d) Acetylcholine
Answer: a) GABA
Which receptor is primarily responsible for the sedative effects of ethanol?
a) NMDA
b) GABA-A
c) Nicotinic
d) Dopamine D2
Answer: b) GABA-A
Which of the following enzymes plays a role in chronic alcohol metabolism?
a) CYP2E1
b) Acetylcholinesterase
c) Monoamine oxidase
d) Lipase
Answer: a) CYP2E1
Methanol poisoning is caused due to the accumulation of which toxic metabolite?
a) Formaldehyde
b) Acetaldehyde
c) Acetic acid
d) Ethanol
Answer: a) Formaldehyde
Which drug is used as an antidote for methanol poisoning?
a) Disulfiram
b) Fomepizole
c) Atropine
d) Diazepam
Answer: b) Fomepizole

Disulfiram (Antabuse) & Alcoholism Treatment

Which enzyme does disulfiram inhibit?
a) Alcohol dehydrogenase
b) Acetaldehyde dehydrogenase
c) Monoamine oxidase
d) Cytochrome P450
Answer: b) Acetaldehyde dehydrogenase
Disulfiram is used in the treatment of:
a) Depression
b) Alcohol dependence
c) Hypertension
d) Schizophrenia
Answer: b) Alcohol dependence
Which of the following symptoms occurs due to the accumulation of acetaldehyde when alcohol is consumed with disulfiram?
a) Hypoglycemia
b) Disulfiram-ethanol reaction (flushing, nausea, headache)
c) Seizures
d) Hypertension
Answer: b) Disulfiram-ethanol reaction (flushing, nausea, headache)
Which of the following is NOT a symptom of the disulfiram-ethanol reaction?
a) Flushing
b) Hypotension
c) Severe headache
d) Euphoria
Answer: d) Euphoria
Which of the following is an alternative to disulfiram for alcohol dependence?
a) Naltrexone
b) Diazepam
c) Atropine
d) Dopamine
Answer: a) Naltrexone
Which of the following drugs reduces alcohol cravings by acting as an opioid antagonist?
a) Disulfiram
b) Naltrexone
c) Diazepam
d) Acamprosate
Answer: b) Naltrexone
Acamprosate is used for alcohol dependence because it:
a) Inhibits alcohol metabolism
b) Reduces alcohol cravings by acting on NMDA receptors
c) Increases dopamine release
d) Enhances GABAergic activity
Answer: b) Reduces alcohol cravings by acting on NMDA receptors
Which of the following is the safest option for preventing alcohol withdrawal seizures?
a) Disulfiram
b) Diazepam
c) Fomepizole
d) Naltrexone
Answer: b) Diazepam
Which of the following symptoms is associated with alcohol withdrawal?
a) Bradycardia
b) Tremors
c) Hypothermia
d) CNS depression
Answer: b) Tremors
Which of the following medications is NOT used in alcohol withdrawal management?
a) Benzodiazepines
b) Clonidine
c) Disulfiram
d) Beta-blockers
Answer: c) Disulfiram

Chronic Effects of Alcohol

Chronic alcoholism can lead to:
a) Hepatic cirrhosis
b) Parkinson’s disease
c) Hypoglycemia
d) Increased muscle mass
Answer: a) Hepatic cirrhosis
Which of the following vitamin deficiencies is commonly associated with chronic alcohol abuse?
a) Vitamin B1 (Thiamine)
b) Vitamin D
c) Vitamin K
d) Vitamin C
Answer: a) Vitamin B1 (Thiamine)
Wernicke-Korsakoff syndrome in chronic alcoholism is due to the deficiency of:
a) Vitamin B1
b) Vitamin B12
c) Vitamin D
d) Vitamin K
Answer: a) Vitamin B1
Which of the following is NOT a consequence of chronic alcohol use?
a) Liver cirrhosis
b) Pancreatitis
c) Myocardial infarction
d) Peripheral neuropathy
Answer: c) Myocardial infarction
Which condition is characterized by confusion, ataxia, and ophthalmoplegia in chronic alcoholics?
a) Wernicke’s encephalopathy
b) Huntington’s disease
c) Alzheimer’s disease
d) Schizophrenia
Answer: a) Wernicke’s encephalopathy

————————————————————

UNIT-V . Pharmacology of drugs acting on central nervous system

1) Psychopharmacological agents:

a. Antipsychotics, antidepressants, anti-anxiety agents, anti-manics and hallucinogens.

b. Drugs used in Parkinsons disease and Alzheimer’s disease

c. CNS stimulants and nootropics.

d. Opioid analgesics and antagonists

e. Drug addiction, drug abuse, tolerance and dependence.

Antipsychotics and Antidepressants

Antipsychotics

Which neurotransmitter is primarily targeted by antipsychotic drugs?
a) Serotonin
b) Dopamine
c) GABA
d) Acetylcholine
Answer: b) Dopamine
Which dopamine receptor is mainly blocked by typical antipsychotics?
a) D1
b) D2
c) D3
d) D4
Answer: b) D2
Which of the following is a first-generation (typical) antipsychotic?
a) Clozapine
b) Haloperidol
c) Olanzapine
d) Risperidone
Answer: b) Haloperidol
Which of the following is a second-generation (atypical) antipsychotic?
a) Chlorpromazine
b) Haloperidol
c) Risperidone
d) Fluphenazine
Answer: c) Risperidone
Which of the following is a major side effect of typical antipsychotics?
a) Weight loss
b) Extrapyramidal symptoms (EPS)
c) Increased appetite
d) Hypoglycemia
Answer: b) Extrapyramidal symptoms (EPS)
Which atypical antipsychotic has the highest risk of agranulocytosis?
a) Risperidone
b) Olanzapine
c) Clozapine
d) Aripiprazole
Answer: c) Clozapine
Neuroleptic malignant syndrome (NMS) is a rare but serious adverse effect of antipsychotics. Which of the following is NOT a symptom of NMS?
a) Hyperthermia
b) Muscle rigidity
c) Hypotension
d) Altered mental status
Answer: c) Hypotension
Which antipsychotic is a partial agonist at D2 receptors?
a) Clozapine
b) Olanzapine
c) Aripiprazole
d) Haloperidol
Answer: c) Aripiprazole
Which of the following is NOT an extrapyramidal side effect of typical antipsychotics?
a) Tardive dyskinesia
b) Parkinsonism
c) Akathisia
d) Weight gain
Answer: d) Weight gain
Which second-generation antipsychotic has the highest risk of metabolic syndrome?
a) Aripiprazole
b) Clozapine
c) Haloperidol
d) Ziprasidone
Answer: b) Clozapine

Antidepressants

Which of the following is a selective serotonin reuptake inhibitor (SSRI)?
a) Amitriptyline
b) Fluoxetine
c) Mirtazapine
d) Venlafaxine
Answer: b) Fluoxetine
Which neurotransmitter is primarily increased by SSRIs?
a) Dopamine
b) Norepinephrine
c) Serotonin
d) Acetylcholine
Answer: c) Serotonin
Which of the following is a tricyclic antidepressant (TCA)?
a) Sertraline
b) Imipramine
c) Bupropion
d) Mirtazapine
Answer: b) Imipramine
Which of the following is a common side effect of SSRIs?
a) Hypertension
b) Sexual dysfunction
c) Weight loss
d) Hyperglycemia
Answer: b) Sexual dysfunction
Which antidepressant is a norepinephrine-dopamine reuptake inhibitor (NDRI)?
a) Fluoxetine
b) Amitriptyline
c) Bupropion
d) Venlafaxine
Answer: c) Bupropion
Which antidepressant is known for causing sedation due to its antihistaminergic effects?
a) Fluoxetine
b) Mirtazapine
c) Bupropion
d) Venlafaxine
Answer: b) Mirtazapine
Monoamine oxidase inhibitors (MAOIs) can cause hypertensive crisis if taken with foods rich in:
a) Tryptophan
b) Tyramine
c) Vitamin B12
d) Caffeine
Answer: b) Tyramine
Which antidepressant has the highest risk of causing seizures?
a) Sertraline
b) Bupropion
c) Amitriptyline
d) Venlafaxine
Answer: b) Bupropion
Which of the following is a serotonin-norepinephrine reuptake inhibitor (SNRI)?
a) Fluoxetine
b) Sertraline
c) Venlafaxine
d) Mirtazapine
Answer: c) Venlafaxine
Serotonin syndrome is a life-threatening condition caused by excessive serotonin levels. Which of the following is NOT a symptom?
a) Hyperreflexia
b) Hypothermia
c) Agitation
d) Tremors
Answer: b) Hypothermia
Which antidepressant is commonly used for smoking cessation?
a) Bupropion
b) Fluoxetine
c) Amitriptyline
d) Sertraline
Answer: a) Bupropion
Which of the following is NOT a typical side effect of TCAs?
a) Dry mouth
b) Orthostatic hypotension
c) Bradycardia
d) Sedation
Answer: c) Bradycardia
Which of the following antidepressants is most likely to cause weight gain?
a) Bupropion
b) Fluoxetine
c) Mirtazapine
d) Venlafaxine
Answer: c) Mirtazapine
Which of the following is an atypical antidepressant that acts as an NMDA receptor antagonist?
a) Ketamine
b) Fluoxetine
c) Amitriptyline
d) Sertraline
Answer: a) Ketamine
Which antidepressant has the longest half-life?
a) Sertraline
b) Paroxetine
c) Fluoxetine
d) Amitriptyline
Answer: c) Fluoxetine

Anti-Anxiety Agents

General Mechanism and Classification

Which of the following is the most commonly used class of drugs for the treatment of anxiety?
a) Beta-blockers
b) Benzodiazepines
c) Antipsychotics
d) Opioids
Answer: b) Benzodiazepines
Which neurotransmitter is primarily involved in the mechanism of benzodiazepines?
a) Dopamine
b) Norepinephrine
c) GABA
d) Serotonin
Answer: c) GABA
Which receptor do benzodiazepines bind to?
a) NMDA receptor
b) GABA-A receptor
c) Dopamine D2 receptor
d) 5-HT3 receptor
Answer: b) GABA-A receptor
Which of the following is a long-acting benzodiazepine?
a) Lorazepam
b) Diazepam
c) Alprazolam
d) Oxazepam
Answer: b) Diazepam
Which benzodiazepine has a short half-life and is commonly used for acute panic attacks?
a) Diazepam
b) Clonazepam
c) Alprazolam
d) Chlordiazepoxide
Answer: c) Alprazolam
Which of the following drugs is a selective serotonin reuptake inhibitor (SSRI) used in anxiety disorders?
a) Fluoxetine
b) Diazepam
c) Buspirone
d) Propranolol
Answer: a) Fluoxetine

Pharmacology of Anti-Anxiety Agents

Which of the following drugs is a partial agonist at the 5-HT1A receptor and used in generalized anxiety disorder?
a) Lorazepam
b) Buspirone
c) Diazepam
d) Alprazolam
Answer: b) Buspirone
Buspirone differs from benzodiazepines in that it:
a) Acts on GABA receptors
b) Has a rapid onset of action
c) Lacks sedative and muscle relaxant properties
d) Is used for acute anxiety attacks
Answer: c) Lacks sedative and muscle relaxant properties
Which of the following is a beta-blocker used to control performance anxiety?
a) Diazepam
b) Fluoxetine
c) Propranolol
d) Buspirone
Answer: c) Propranolol
Which of the following is a non-benzodiazepine hypnotic that acts on the benzodiazepine receptor site?
a) Buspirone
b) Zolpidem
c) Clonazepam
d) Propranolol
Answer: b) Zolpidem

Adverse Effects and Contraindications

Which of the following is a major side effect of benzodiazepines?
a) Hypertension
b) Respiratory depression
c) Increased appetite
d) Hyperreflexia
Answer: b) Respiratory depression
Benzodiazepines should be avoided in patients with:
a) Epilepsy
b) Anxiety disorders
c) History of drug addiction
d) Insomnia
Answer: c) History of drug addiction
Which of the following drugs is used to reverse benzodiazepine overdose?
a) Naloxone
b) Flumazenil
c) Propranolol
d) Buspirone
Answer: b) Flumazenil
Which of the following is a common withdrawal symptom of benzodiazepines?
a) Diarrhea
b) Seizures
c) Weight gain
d) Euphoria
Answer: b) Seizures
Which of the following is a reason for limiting the long-term use of benzodiazepines?
a) Low efficacy
b) Risk of addiction and dependence
c) No effect on anxiety
d) Increased appetite
Answer: b) Risk of addiction and dependence

Clinical Uses of Anti-Anxiety Agents

Which of the following benzodiazepines is commonly used for insomnia rather than anxiety?
a) Diazepam
b) Clonazepam
c) Temazepam
d) Buspirone
Answer: c) Temazepam
Which of the following is used as first-line treatment for generalized anxiety disorder (GAD)?
a) Diazepam
b) Alprazolam
c) SSRIs (e.g., Sertraline)
d) Barbiturates
Answer: c) SSRIs (e.g., Sertraline)
Beta-blockers like propranolol are most useful in treating:
a) Panic disorder
b) Social anxiety disorder (performance anxiety)
c) Generalized anxiety disorder
d) Obsessive-compulsive disorder
Answer: b) Social anxiety disorder (performance anxiety)
Which of the following drugs can be used for long-term management of anxiety with minimal risk of dependence?
a) Diazepam
b) Buspirone
c) Alprazolam
d) Clonazepam
Answer: b) Buspirone
Which of the following drugs is NOT used in the treatment of anxiety?
a) Propranolol
b) Buspirone
c) Haloperidol
d) Diazepam
Answer: c) Haloperidol

Miscellaneous

Which of the following drugs is NOT recommended for anxiety due to its high abuse potential?
a) Diazepam
b) Barbiturates
c) Buspirone
d) Fluoxetine
Answer: b) Barbiturates
Which of the following benzodiazepines is best suited for treating acute anxiety attacks?
a) Lorazepam
b) Diazepam
c) Clonazepam
d) Oxazepam
Answer: a) Lorazepam
Which class of drugs is preferred in elderly patients with anxiety due to lower risk of sedation and cognitive impairment?
a) SSRIs
b) Benzodiazepines
c) Barbiturates
d) Beta-blockers
Answer: a) SSRIs
Which of the following drugs has a delayed onset of action and is not useful for acute anxiety?
a) Diazepam
b) Buspirone
c) Alprazolam
d) Lorazepam
Answer: b) Buspirone
Which of the following benzodiazepines is the best choice in patients with liver disease due to its lack of active metabolites?
a) Diazepam
b) Lorazepam
c) Clonazepam
d) Alprazolam
Answer: b) Lorazepam

Anti-Manics and Hallucinogens

1. Anti-Manic Drugs (Mood Stabilizers)

Mechanism and Classification

Which of the following is considered the first-line treatment for bipolar disorder?
a) Lithium
b) Fluoxetine
c) Diazepam
d) Clozapine
Answer: a) Lithium
Which of the following is NOT a mood stabilizer?
a) Carbamazepine
b) Valproic acid
c) Haloperidol
d) Lithium
Answer: c) Haloperidol
What is the primary mechanism of action of lithium?
a) Dopamine D2 receptor blockade
b) Inhibition of sodium channels
c) Inhibition of inositol monophosphatase
d) NMDA receptor activation
Answer: c) Inhibition of inositol monophosphatase
Which anticonvulsant is commonly used as a mood stabilizer in bipolar disorder?
a) Phenytoin
b) Valproic acid
c) Phenobarbital
d) Levetiracetam
Answer: b) Valproic acid
Carbamazepine is used as a mood stabilizer primarily for:
a) Bipolar depression
b) Bipolar mania
c) Schizophrenia
d) Anxiety disorders
Answer: b) Bipolar mania

Adverse Effects and Toxicity

Which of the following is a common adverse effect of lithium?
a) Hypertension
b) Hypothyroidism
c) Hyperglycemia
d) Weight loss
Answer: b) Hypothyroidism
Which organ is most commonly affected by lithium toxicity?
a) Liver
b) Kidney
c) Heart
d) Lungs
Answer: b) Kidney
Which electrolyte imbalance increases the risk of lithium toxicity?
a) Hyperkalemia
b) Hypernatremia
c) Hyponatremia
d) Hypercalcemia
Answer: c) Hyponatremia
Which drug can increase lithium levels by reducing its renal clearance?
a) NSAIDs
b) Beta-blockers
c) SSRIs
d) Antihistamines
Answer: a) NSAIDs
Which of the following is a symptom of lithium toxicity?
a) Diarrhea
b) Tremors
c) Confusion
d) All of the above
Answer: d) All of the above

Clinical Uses

Which of the following drugs is an alternative to lithium for bipolar disorder?
a) Fluoxetine
b) Valproic acid
c) Haloperidol
d) Buspirone
Answer: b) Valproic acid
Lamotrigine is primarily used in bipolar disorder for:
a) Acute mania
b) Maintenance therapy and bipolar depression
c) Schizophrenia
d) Anxiety disorders
Answer: b) Maintenance therapy and bipolar depression
Which of the following is a long-term effect of lithium therapy?
a) Liver failure
b) Cardiotoxicity
c) Thyroid dysfunction
d) Hyperprolactinemia
Answer: c) Thyroid dysfunction
Which drug should be avoided in pregnant women with bipolar disorder due to teratogenic effects?
a) Lithium
b) Olanzapine
c) Haloperidol
d) Quetiapine
Answer: a) Lithium
Which of the following drugs is NOT used for acute mania?
a) Lithium
b) Carbamazepine
c) Haloperidol
d) Buspirone
Answer: d) Buspirone

2. Hallucinogens (Psychedelics, Dissociatives, and Deliriants)

Mechanism and Classification

Which neurotransmitter is most associated with the effects of hallucinogens?
a) Dopamine
b) Norepinephrine
c) Serotonin
d) Acetylcholine
Answer: c) Serotonin
Which of the following is a classical hallucinogen?
a) LSD
b) Cocaine
c) Heroin
d) Diazepam
Answer: a) LSD
Which receptor is primarily targeted by LSD?
a) GABA-A receptor
b) NMDA receptor
c) 5-HT2A receptor
d) Dopamine D2 receptor
Answer: c) 5-HT2A receptor
Which of the following drugs is a dissociative anesthetic with hallucinogenic properties?
a) MDMA
b) PCP
c) LSD
d) Mescaline
Answer: b) PCP
Which of the following is a serotonin-releasing empathogen that has both stimulant and hallucinogenic effects?
a) MDMA (Ecstasy)
b) Ketamine
c) Cocaine
d) Heroin
Answer: a) MDMA (Ecstasy)

Effects and Toxicity

Which of the following is a key effect of LSD intoxication?
a) Increased heart rate and hypertension
b) Synesthesia (mixing of senses)
c) Hallucinations
d) All of the above
Answer: d) All of the above
Which hallucinogen is derived from the peyote cactus?
a) LSD
b) Mescaline
c) PCP
d) MDMA
Answer: b) Mescaline
Which hallucinogen is most commonly associated with “flashbacks” or persistent hallucinogen perception disorder (HPPD)?
a) PCP
b) LSD
c) MDMA
d) Ketamine
Answer: b) LSD
Which of the following hallucinogens is most associated with dissociation and out-of-body experiences?
a) LSD
b) PCP
c) MDMA
d) Mescaline
Answer: b) PCP
Which of the following is an adverse effect of MDMA?
a) Hyperthermia
b) Hyponatremia
c) Serotonin syndrome
d) All of the above
Answer: d) All of the above

Clinical Uses and Miscellaneous

Which hallucinogen has been studied for potential therapeutic effects in PTSD treatment?
a) LSD
b) MDMA
c) PCP
d) Ketamine
Answer: b) MDMA
Which hallucinogen has rapid-acting antidepressant effects and is used in treatment-resistant depression?
a) LSD
b) PCP
c) Ketamine
d) MDMA
Answer: c) Ketamine

Drugs Used in Parkinson’s Disease

1. General Mechanism and Classification

Which neurotransmitter is primarily deficient in Parkinson’s disease?
a) Serotonin
b) Dopamine
c) Acetylcholine
d) GABA
Answer: b) Dopamine
Which brain region is most affected in Parkinson’s disease?
a) Hippocampus
b) Substantia nigra
c) Thalamus
d) Medulla oblongata
Answer: b) Substantia nigra
Which of the following drugs is the most effective treatment for Parkinson’s disease?
a) Levodopa
b) Amantadine
c) Selegiline
d) Benztropine
Answer: a) Levodopa
Which enzyme converts Levodopa into dopamine in the brain?
a) Monoamine oxidase
b) Catechol-O-methyltransferase (COMT)
c) DOPA decarboxylase
d) Acetylcholinesterase
Answer: c) DOPA decarboxylase
Which drug is commonly given with Levodopa to prevent its peripheral breakdown?
a) Selegiline
b) Carbidopa
c) Bromocriptine
d) Entacapone
Answer: b) Carbidopa

2. Dopamine Precursors and Dopamine Agonists

Which of the following is a dopamine receptor agonist used in Parkinson’s disease?
a) Pramipexole
b) Levodopa
c) Benztropine
d) Amantadine
Answer: a) Pramipexole
Which of the following is an ergot-derived dopamine agonist?
a) Ropinirole
b) Pramipexole
c) Bromocriptine
d) Apomorphine
Answer: c) Bromocriptine
Which drug is a non-ergot dopamine agonist used in Parkinson’s disease?
a) Pergolide
b) Ropinirole
c) Bromocriptine
d) Cabergoline
Answer: b) Ropinirole
Which dopamine agonist is used for acute rescue therapy in Parkinson’s disease?
a) Apomorphine
b) Pramipexole
c) Amantadine
d) Tolcapone
Answer: a) Apomorphine
Which is a major side effect of dopamine agonists in Parkinson’s disease?
a) Hypotension
b) Hyperprolactinemia
c) Sedation and hallucinations
d) Bradycardia
Answer: c) Sedation and hallucinations

3. Monoamine Oxidase (MAO-B) and Catechol-O-methyltransferase (COMT) Inhibitors

Which enzyme does Selegiline inhibit?
a) MAO-A
b) MAO-B
c) COMT
d) DOPA decarboxylase
Answer: b) MAO-B
Which of the following is a selective MAO-B inhibitor?
a) Entacapone
b) Tolcapone
c) Rasagiline
d) Amantadine
Answer: c) Rasagiline
Which of the following COMT inhibitors is used in Parkinson’s disease?
a) Selegiline
b) Entacapone
c) Bromocriptine
d) Ropinirole
Answer: b) Entacapone
Which COMT inhibitor is associated with hepatotoxicity?
a) Entacapone
b) Tolcapone
c) Amantadine
d) Ropinirole
Answer: b) Tolcapone
What is the role of COMT inhibitors in Parkinson’s treatment?
a) Prevent dopamine reuptake
b) Prevent peripheral degradation of Levodopa
c) Increase dopamine release
d) Inhibit dopamine receptors
Answer: b) Prevent peripheral degradation of Levodopa

4. Anticholinergics and Other Agents

Which of the following drugs is an anticholinergic used in Parkinson’s disease?
a) Pramipexole
b) Benztropine
c) Amantadine
d) Tolcapone
Answer: b) Benztropine
Which symptom of Parkinson’s disease is most improved by anticholinergic drugs?
a) Tremor
b) Bradykinesia
c) Rigidity
d) Postural instability
Answer: a) Tremor
Which of the following drugs is an NMDA receptor antagonist used in Parkinson’s disease?
a) Amantadine
b) Entacapone
c) Rasagiline
d) Carbidopa
Answer: a) Amantadine
Amantadine is useful in Parkinson’s disease because it:
a) Increases dopamine release
b) Inhibits MAO-B
c) Blocks acetylcholine
d) Activates dopamine receptors directly
Answer: a) Increases dopamine release
Which of the following is NOT a commonly used treatment in Parkinson’s disease?
a) Levodopa
b) Carbidopa
c) Donepezil
d) Entacapone
Answer: c) Donepezil

5. Adverse Effects and Contraindications

Long-term use of Levodopa is associated with which complication?
a) Nephrotoxicity
b) Dyskinesia
c) Bradycardia
d) Hypertension
Answer: b) Dyskinesia
Which side effect is commonly seen with Levodopa therapy?
a) Nausea and vomiting
b) Hyperprolactinemia
c) Dry mouth
d) Urinary retention
Answer: a) Nausea and vomiting
Which of the following is a contraindication for Levodopa therapy?
a) Schizophrenia
b) Hypertension
c) Diabetes
d) Hypothyroidism
Answer: a) Schizophrenia
Abrupt withdrawal of dopamine agonists can lead to:
a) Parkinsonism-hyperpyrexia syndrome
b) Serotonin syndrome
c) Myasthenic crisis
d) Neuroleptic malignant syndrome
Answer: a) Parkinsonism-hyperpyrexia syndrome
Which of the following drugs should be avoided in Parkinson’s disease?
a) Haloperidol
b) Amantadine
c) Pramipexole
d) Carbidopa
Answer: a) Haloperidol

Drugs Used in Alzheimer’s Disease

1. General Knowledge and Pathophysiology

Which neurotransmitter is primarily deficient in Alzheimer’s disease?
a) Dopamine
b) Serotonin
c) Acetylcholine
d) Glutamate
Answer: c) Acetylcholine
Which brain region is most affected in Alzheimer’s disease?
a) Hippocampus
b) Substantia nigra
c) Thalamus
d) Cerebellum
Answer: a) Hippocampus
Which of the following is a hallmark of Alzheimer’s disease?
a) Lewy bodies
b) Beta-amyloid plaques and neurofibrillary tangles
c) Dopamine deficiency
d) Demyelination
Answer: b) Beta-amyloid plaques and neurofibrillary tangles
Which enzyme is responsible for breaking down acetylcholine in the brain?
a) Acetylcholinesterase
b) Monoamine oxidase
c) Tyrosine hydroxylase
d) Catechol-O-methyltransferase
Answer: a) Acetylcholinesterase
Which genetic mutation is associated with early-onset Alzheimer’s disease?
a) APOE ε4
b) Presenilin 1 and 2
c) COMT gene
d) Tau protein mutation
Answer: b) Presenilin 1 and 2

2. Acetylcholinesterase Inhibitors

Which class of drugs is primarily used to treat mild to moderate Alzheimer’s disease?
a) Dopamine agonists
b) Acetylcholinesterase inhibitors
c) NMDA receptor antagonists
d) Beta-blockers
Answer: b) Acetylcholinesterase inhibitors
Which of the following is an acetylcholinesterase inhibitor used in Alzheimer’s disease?
a) Memantine
b) Donepezil
c) Ropinirole
d) Levodopa
Answer: b) Donepezil
Which acetylcholinesterase inhibitor is available as a transdermal patch?
a) Donepezil
b) Rivastigmine
c) Galantamine
d) Memantine
Answer: b) Rivastigmine
Which acetylcholinesterase inhibitor also modulates nicotinic receptors?
a) Galantamine
b) Donepezil
c) Rivastigmine
d) Memantine
Answer: a) Galantamine
What is a common side effect of acetylcholinesterase inhibitors?
a) Hypertension
b) Bradycardia
c) Insomnia
d) Hyperprolactinemia
Answer: b) Bradycardia

3. NMDA Receptor Antagonists

Which of the following is an NMDA receptor antagonist used in Alzheimer’s disease?
a) Memantine
b) Donepezil
c) Rivastigmine
d) Galantamine
Answer: a) Memantine
What is the main mechanism of action of Memantine?
a) Blocks acetylcholine receptors
b) Inhibits NMDA receptors to prevent excitotoxicity
c) Increases dopamine release
d) Enhances serotonin levels
Answer: b) Inhibits NMDA receptors to prevent excitotoxicity
Memantine is primarily used for which stage of Alzheimer’s disease?
a) Mild
b) Moderate to severe
c) Early onset
d) Preclinical
Answer: b) Moderate to severe
Which neurotransmitter is primarily affected by NMDA receptor antagonists?
a) Dopamine
b) Serotonin
c) Glutamate
d) Acetylcholine
Answer: c) Glutamate
What is a major advantage of Memantine over acetylcholinesterase inhibitors?
a) It does not cause gastrointestinal side effects
b) It is more effective in mild Alzheimer’s disease
c) It is administered once yearly
d) It completely reverses Alzheimer’s disease
Answer: a) It does not cause gastrointestinal side effects

4. Adverse Effects and Contraindications

Which of the following is a serious side effect of Donepezil?
a) Hepatotoxicity
b) QT prolongation
c) Hypertension
d) Hyperkalemia
Answer: b) QT prolongation
Which side effect is commonly seen with Rivastigmine?
a) Nausea and vomiting
b) Hallucinations
c) Hyperglycemia
d) Dry mouth
Answer: a) Nausea and vomiting
Which condition is a contraindication for acetylcholinesterase inhibitors?
a) Diabetes
b) Bradycardia
c) Hyperthyroidism
d) Rheumatoid arthritis
Answer: b) Bradycardia
Which of the following medications should be avoided in Alzheimer’s disease?
a) Anticholinergic drugs
b) NSAIDs
c) Beta-blockers
d) SSRIs
Answer: a) Anticholinergic drugs
Which of the following is a common behavioral symptom of Alzheimer’s disease?
a) Hyperactivity
b) Apathy and aggression
c) Increased focus
d) Reduced pain perception
Answer: b) Apathy and aggression

5. Recent Advances and Alternative Therapies

Which monoclonal antibody was recently approved for Alzheimer’s treatment?
a) Aducanumab
b) Infliximab
c) Rituximab
d) Tocilizumab
Answer: a) Aducanumab
What is the proposed mechanism of action of Aducanumab?
a) Inhibits NMDA receptors
b) Removes beta-amyloid plaques
c) Blocks dopamine receptors
d) Enhances serotonin release
Answer: b) Removes beta-amyloid plaques
Which vitamin is thought to have a protective effect against Alzheimer’s disease?
a) Vitamin C
b) Vitamin D
c) Vitamin B12
d) Vitamin E
Answer: d) Vitamin E
Which lifestyle factor is considered protective against Alzheimer’s disease?
a) High sugar diet
b) Regular physical activity
c) Smoking
d) Sleep deprivation
Answer: b) Regular physical activity
Which of the following experimental treatments is being investigated for Alzheimer’s disease?
a) Stem cell therapy
b) Levodopa infusion
c) Ketamine therapy
d) Corticosteroids
Answer: a) Stem cell therapy

CNS Stimulants

1. General Knowledge on CNS Stimulants

Which of the following is a major class of CNS stimulants?
a) Opioids
b) Barbiturates
c) Amphetamines
d) Benzodiazepines
Answer: c) Amphetamines
Which of the following is NOT a CNS stimulant?
a) Caffeine
b) Cocaine
c) Diazepam
d) Amphetamine
Answer: c) Diazepam
Which of the following is the primary mechanism of action of CNS stimulants?
a) Enhancing GABAergic activity
b) Increasing dopamine and norepinephrine release
c) Blocking opioid receptors
d) Inhibiting serotonin synthesis
Answer: b) Increasing dopamine and norepinephrine release
Which neurotransmitter is most commonly associated with CNS stimulants?
a) GABA
b) Serotonin
c) Dopamine
d) Acetylcholine
Answer: c) Dopamine
Which of the following is a therapeutic use of CNS stimulants?
a) Sedation
b) Pain relief
c) Treatment of ADHD
d) Hypnotic effect
Answer: c) Treatment of ADHD

2. Classification of CNS Stimulants

Which of the following is a natural CNS stimulant?
a) Amphetamine
b) Cocaine
c) Caffeine
d) Modafinil
Answer: c) Caffeine
Methylxanthines include which of the following drugs?
a) Cocaine
b) Caffeine
c) Morphine
d) Diazepam
Answer: b) Caffeine
Which of the following drugs is classified as a psychomotor stimulant?
a) Phenytoin
b) Methamphetamine
c) Lorazepam
d) Haloperidol
Answer: b) Methamphetamine
Which of the following is a synthetic CNS stimulant?
a) Ephedrine
b) Amphetamine
c) Theophylline
d) Cocaine
Answer: b) Amphetamine
Which stimulant is commonly used in the treatment of narcolepsy?
a) Caffeine
b) Modafinil
c) Codeine
d) Diazepam
Answer: b) Modafinil

3. Pharmacological Effects of CNS Stimulants

Which of the following is an effect of CNS stimulants?
a) Sedation
b) Bradycardia
c) Increased alertness
d) Muscle relaxation
Answer: c) Increased alertness
CNS stimulants increase the release of which neurotransmitter to enhance wakefulness?
a) GABA
b) Dopamine
c) Serotonin
d) Acetylcholine
Answer: b) Dopamine
Which of the following is a potential adverse effect of CNS stimulant use?
a) Depression
b) Hypertension
c) Hypoglycemia
d) Bradycardia
Answer: b) Hypertension
Which system is primarily affected by CNS stimulants?
a) Respiratory system
b) Cardiovascular system
c) Digestive system
d) Skeletal system
Answer: b) Cardiovascular system
Which of the following is NOT a side effect of CNS stimulants?
a) Insomnia
b) Anorexia
c) Increased heart rate
d) Respiratory depression
Answer: d) Respiratory depression

4. Specific CNS Stimulants

Which of the following CNS stimulants is commonly used as a performance-enhancing drug?
a) Modafinil
b) Morphine
c) Diazepam
d) Lithium
Answer: a) Modafinil
Caffeine exerts its stimulatory effect by blocking which receptor?
a) Dopamine
b) Adenosine
c) Serotonin
d) Acetylcholine
Answer: b) Adenosine
Cocaine primarily inhibits the reuptake of which neurotransmitter?
a) GABA
b) Serotonin
c) Dopamine
d) Acetylcholine
Answer: c) Dopamine
Which stimulant is used as a nasal decongestant?
a) Ephedrine
b) Modafinil
c) Diazepam
d) Chlorpromazine
Answer: a) Ephedrine
Which stimulant is frequently used to enhance cognitive function in conditions like ADHD?
a) Phenytoin
b) Methylphenidate
c) Morphine
d) Clonazepam
Answer: b) Methylphenidate

5. Therapeutic Uses and Clinical Applications

Which of the following conditions is treated using CNS stimulants?
a) Hypertension
b) Epilepsy
c) Attention deficit hyperactivity disorder (ADHD)
d) Depression
Answer: c) Attention deficit hyperactivity disorder (ADHD)
Which of the following CNS stimulants is commonly used to treat obesity?
a) Modafinil
b) Phentermine
c) Diazepam
d) Amitriptyline
Answer: b) Phentermine
Which of the following is a stimulant used for neonatal apnea?
a) Amphetamine
b) Caffeine
c) Cocaine
d) Fluoxetine
Answer: b) Caffeine
What is the primary action of amphetamines in ADHD treatment?
a) Increase serotonin release
b) Increase dopamine and norepinephrine availability
c) Decrease GABA activity
d) Enhance opioid receptor activation
Answer: b) Increase dopamine and norepinephrine availability
Which of the following is an adverse effect of long-term CNS stimulant use?
a) Depression
b) Anxiety and paranoia
c) Hypotension
d) Weight gain
Answer: b) Anxiety and paranoia

Nootropics (Cognitive Enhancers)

1. General Knowledge on Nootropics

What are nootropics primarily used for?
a) Treating infections
b) Enhancing cognitive function
c) Inducing sleep
d) Controlling pain
Answer: b) Enhancing cognitive function
Which of the following is NOT a characteristic of nootropics?
a) Enhance memory and learning
b) Improve focus and attention
c) Cause strong sedation
d) Have minimal side effects
Answer: c) Cause strong sedation
Which of the following is considered a true nootropic?
a) Diazepam
b) Piracetam
c) Morphine
d) Propranolol
Answer: b) Piracetam
Which neurotransmitter is most commonly targeted by nootropics?
a) GABA
b) Dopamine
c) Acetylcholine
d) Serotonin
Answer: c) Acetylcholine
Which of the following is NOT a mechanism of action of nootropics?
a) Enhancing neuroplasticity
b) Increasing oxidative stress
c) Modulating neurotransmitter release
d) Improving cerebral blood flow
Answer: b) Increasing oxidative stress

2. Classification of Nootropics

Which of the following is a synthetic nootropic?
a) Ginkgo biloba
b) Modafinil
c) Bacopa monnieri
d) Caffeine
Answer: b) Modafinil
Which class of nootropics enhances acetylcholine function?
a) Racetams
b) Opioids
c) Barbiturates
d) Beta-blockers
Answer: a) Racetams
Which of the following is a natural nootropic?
a) Piracetam
b) Aniracetam
c) Ginkgo biloba
d) Phenibut
Answer: c) Ginkgo biloba
Which nootropic is used to enhance wakefulness and alertness?
a) Modafinil
b) Alprazolam
c) Haloperidol
d) Phenytoin
Answer: a) Modafinil
Which of the following is a choline precursor used as a nootropic?
a) Baclofen
b) Citicoline
c) Levodopa
d) Fluoxetine
Answer: b) Citicoline

3. Mechanism of Action of Nootropics

Which of the following is a key function of racetams like Piracetam?
a) Dopamine receptor blockade
b) Enhancement of glutamate and acetylcholine transmission
c) Inhibition of serotonin reuptake
d) Increase in opioid receptor activity
Answer: b) Enhancement of glutamate and acetylcholine transmission
Which of the following nootropics is known to increase dopamine levels in the brain?
a) Modafinil
b) Propranolol
c) Diazepam
d) Phenobarbital
Answer: a) Modafinil
Which neurotransmitter is most associated with learning and memory enhancement?
a) GABA
b) Acetylcholine
c) Dopamine
d) Histamine
Answer: b) Acetylcholine
Which nootropic enhances cerebral blood flow by inhibiting platelet aggregation?
a) Modafinil
b) Ginkgo biloba
c) Diazepam
d) Carbamazepine
Answer: b) Ginkgo biloba
Which of the following is NOT a commonly proposed mechanism of action for nootropics?
a) Neurotransmitter modulation
b) Mitochondrial function enhancement
c) Neuroinflammation suppression
d) Decreasing synaptic plasticity
Answer: d) Decreasing synaptic plasticity

4. Therapeutic Uses and Clinical Applications

Which of the following conditions is commonly treated using nootropics?
a) Hypertension
b) Dementia and Alzheimer’s disease
c) Epilepsy
d) Schizophrenia
Answer: b) Dementia and Alzheimer’s disease
Which nootropic is often prescribed for cognitive decline in elderly patients?
a) Diazepam
b) Piracetam
c) Codeine
d) Haloperidol
Answer: b) Piracetam
Which nootropic is used to promote alertness in narcoleptic patients?
a) Baclofen
b) Modafinil
c) Amitriptyline
d) Clozapine
Answer: b) Modafinil
Which of the following natural nootropics is believed to improve memory and reduce anxiety?
a) Valerian root
b) Bacopa monnieri
c) Fentanyl
d) Lorazepam
Answer: b) Bacopa monnieri
Which nootropic is known to reduce symptoms of brain fog and improve focus?
a) Alprazolam
b) Caffeine
c) Diazepam
d) Morphine
Answer: b) Caffeine

5. Side Effects and Risks of Nootropics

Which of the following is a potential side effect of high-dose nootropic use?
a) Impaired memory
b) Enhanced sedation
c) Increased blood pressure
d) Bradycardia
Answer: c) Increased blood pressure
Which of the following nootropics has the highest potential for addiction?
a) Piracetam
b) Modafinil
c) Caffeine
d) Adderall (Amphetamine)
Answer: d) Adderall (Amphetamine)
Which of the following nootropics is most likely to cause headaches due to increased cholinergic activity?
a) Citicoline
b) Diazepam
c) Phenobarbital
d) Alprazolam
Answer: a) Citicoline
Excessive use of stimulatory nootropics like Modafinil may lead to which adverse effect?
a) Severe sedation
b) Hallucinations
c) Increased fatigue
d) Cognitive impairment
Answer: b) Hallucinations
Which of the following is a commonly reported withdrawal symptom from stimulant-based nootropics?
a) Increased energy
b) Depression and fatigue
c) Hallucinations
d) Increased appetite
Answer: b) Depression and fatigue

Opioid Analgesics and Antagonists

1. General Knowledge on Opioid Analgesics

Which of the following is a primary function of opioid analgesics?
a) Reducing inflammation
b) Blocking nerve impulses
c) Modulating pain perception in the CNS
d) Inhibiting bacterial growth
Answer: c) Modulating pain perception in the CNS
Which of the following is NOT an opioid analgesic?
a) Morphine
b) Fentanyl
c) Ibuprofen
d) Codeine
Answer: c) Ibuprofen
Opioid analgesics primarily act on which type of receptors?
a) Dopamine receptors
b) Adrenergic receptors
c) Opioid receptors
d) Serotonin receptors
Answer: c) Opioid receptors
Which of the following opioid receptors is responsible for analgesia and euphoria?
a) Mu (µ)
b) Kappa (κ)
c) Delta (δ)
d) Sigma (σ)
Answer: a) Mu (µ)
Which of the following opioids is considered the gold standard for pain relief?
a) Fentanyl
b) Morphine
c) Tramadol
d) Methadone
Answer: b) Morphine

2. Classification of Opioids

Which of the following is a strong opioid agonist?
a) Morphine
b) Buprenorphine
c) Naloxone
d) Tramadol
Answer: a) Morphine
Which of the following is a synthetic opioid?
a) Codeine
b) Fentanyl
c) Morphine
d) Heroin
Answer: b) Fentanyl
Which opioid analgesic is commonly used for opioid addiction treatment?
a) Codeine
b) Tramadol
c) Methadone
d) Buprenorphine
Answer: c) Methadone
Which of the following opioids is a partial agonist at opioid receptors?
a) Morphine
b) Naloxone
c) Buprenorphine
d) Fentanyl
Answer: c) Buprenorphine
Which opioid is commonly used as a cough suppressant?
a) Morphine
b) Codeine
c) Fentanyl
d) Nalbuphine
Answer: b) Codeine

3. Mechanism of Action of Opioids

Opioid analgesics exert their effects by acting on which area of the central nervous system?
a) Cerebellum
b) Thalamus and spinal cord
c) Medulla oblongata
d) Hippocampus
Answer: b) Thalamus and spinal cord
Opioids reduce pain perception by inhibiting the release of which neurotransmitter?
a) Dopamine
b) Glutamate
c) Acetylcholine
d) GABA
Answer: b) Glutamate
Which second messenger system is inhibited by opioid receptor activation?
a) cAMP (Cyclic AMP)
b) IP3-DAG pathway
c) cGMP
d) RAS-RAF pathway
Answer: a) cAMP (Cyclic AMP)
Which of the following is NOT a pharmacological effect of opioid analgesics?
a) Analgesia
b) Respiratory depression
c) Diarrhea
d) Sedation
Answer: c) Diarrhea
Which opioid receptor subtype is mainly responsible for dysphoria and psychotomimetic effects?
a) Mu (µ)
b) Kappa (κ)
c) Delta (δ)
d) Sigma (σ)
Answer: b) Kappa (κ)

4. Adverse Effects and Toxicity of Opioids

What is the most serious side effect of opioid overdose?
a) Bradycardia
b) Respiratory depression
c) Hypertension
d) Seizures
Answer: b) Respiratory depression
Which of the following opioid analgesics has the highest potency?
a) Morphine
b) Codeine
c) Fentanyl
d) Tramadol
Answer: c) Fentanyl
Which opioid is most commonly associated with addiction and abuse?
a) Buprenorphine
b) Codeine
c) Heroin
d) Naloxone
Answer: c) Heroin
Opioid withdrawal symptoms include all of the following EXCEPT:
a) Sweating
b) Diarrhea
c) Respiratory depression
d) Anxiety
Answer: c) Respiratory depression
Which opioid analgesic is considered safest for use during pregnancy?
a) Morphine
b) Fentanyl
c) Methadone
d) Codeine
Answer: c) Methadone

5. Opioid Antagonists

Which of the following is a pure opioid antagonist?
a) Naloxone
b) Buprenorphine
c) Methadone
d) Tramadol
Answer: a) Naloxone
Which opioid antagonist is used in opioid overdose reversal?
a) Naltrexone
b) Naloxone
c) Methylnaltrexone
d) Tramadol
Answer: b) Naloxone
Which opioid antagonist is used for long-term maintenance therapy in opioid addiction?
a) Naloxone
b) Naltrexone
c) Fentanyl
d) Methadone
Answer: b) Naltrexone
Which opioid antagonist is specifically used to treat opioid-induced constipation?
a) Naloxone
b) Naltrexone
c) Methylnaltrexone
d) Codeine
Answer: c) Methylnaltrexone
Which opioid antagonist has a longer duration of action?
a) Naloxone
b) Naltrexone
c) Fentanyl
d) Morphine
Answer: b) Naltrexone

Drug Addiction and Drug Abuse

1. General Concepts of Drug Addiction and Abuse

Which of the following best defines drug addiction?
a) A compulsive, chronic need for a drug despite harmful consequences
b) Occasional use of drugs for recreational purposes
c) Physical dependence on a drug without psychological dependence
d) Use of a drug only in a prescribed manner
Answer: a) A compulsive, chronic need for a drug despite harmful consequences
Drug abuse refers to:
a) Use of a substance in a way that is harmful or unsafe
b) Physical dependence on a drug
c) Psychological need for a drug
d) Use of a drug only for medical purposes
Answer: a) Use of a substance in a way that is harmful or unsafe
Which of the following is a key characteristic of substance dependence?
a) Occasional use of the drug
b) Withdrawal symptoms upon discontinuation
c) No need to increase the dose
d) Lack of drug-seeking behavior
Answer: b) Withdrawal symptoms upon discontinuation
Which neurotransmitter is most associated with the reward system in drug addiction?
a) Serotonin
b) Dopamine
c) Acetylcholine
d) GABA
Answer: b) Dopamine
Which of the following is NOT a risk factor for drug addiction?
a) Genetic predisposition
b) Peer pressure
c) Having a strong support system
d) Early exposure to drugs
Answer: c) Having a strong support system

2. Classification of Commonly Abused Drugs

Which of the following is a CNS stimulant?
a) Heroin
b) Cocaine
c) Alcohol
d) Diazepam
Answer: b) Cocaine
Which of the following is classified as a hallucinogen?
a) Heroin
b) LSD
c) Cocaine
d) Morphine
Answer: b) LSD
Which of the following is NOT a depressant?
a) Alcohol
b) Benzodiazepines
c) Cocaine
d) Barbiturates
Answer: c) Cocaine
Which of the following drugs is an opioid?
a) LSD
b) Methamphetamine
c) Morphine
d) Nicotine
Answer: c) Morphine
Which of the following substances is most associated with physical dependence?
a) Cannabis
b) Caffeine
c) Heroin
d) LSD
Answer: c) Heroin

3. Mechanisms of Drug Addiction

Which brain region is primarily involved in the reward pathway affected by addictive drugs?
a) Hippocampus
b) Hypothalamus
c) Nucleus accumbens
d) Cerebellum
Answer: c) Nucleus accumbens
Which neurotransmitter system is primarily disrupted in opioid addiction?
a) Dopaminergic system
b) Serotonergic system
c) Cholinergic system
d) Glutamatergic system
Answer: a) Dopaminergic system
Which of the following drugs works by inhibiting dopamine reuptake, increasing its levels in the brain?
a) Heroin
b) Cocaine
c) LSD
d) Alcohol
Answer: b) Cocaine
Which of the following is a characteristic effect of long-term drug addiction?
a) Reduced dopamine receptor availability in the brain
b) Increased serotonin release
c) Enhanced response to natural rewards
d) Decreased tolerance
Answer: a) Reduced dopamine receptor availability in the brain
Which of the following best describes drug tolerance?
a) A need for increasing doses to achieve the same effect
b) Severe withdrawal symptoms
c) Psychological craving for a drug
d) Complete loss of response to a drug
Answer: a) A need for increasing doses to achieve the same effect

4. Effects and Consequences of Drug Abuse

Which of the following is a long-term effect of alcohol abuse?
a) Liver cirrhosis
b) Increased cognitive function
c) Reduced tolerance to alcohol
d) Strengthened immune system
Answer: a) Liver cirrhosis
Which of the following drugs is most associated with lung disease?
a) Heroin
b) Cocaine
c) Nicotine
d) LSD
Answer: c) Nicotine
Which drug is most likely to cause flashbacks after stopping its use?
a) Cocaine
b) Heroin
c) LSD
d) Alcohol
Answer: c) LSD
Which of the following withdrawal symptoms is associated with opioid addiction?
a) Excessive energy
b) Profound sleep
c) Muscle aches and sweating
d) Weight gain
Answer: c) Muscle aches and sweating
Which of the following is a potential psychological consequence of methamphetamine abuse?
a) Increased memory
b) Hallucinations and paranoia
c) Decreased dopamine release
d) Reduced pain sensitivity
Answer: b) Hallucinations and paranoia

5. Treatment and Prevention of Drug Addiction

Which drug is commonly used for opioid addiction treatment?
a) Naloxone
b) Methadone
c) Cocaine
d) Diazepam
Answer: b) Methadone
Which of the following is an opioid antagonist used to treat opioid overdose?
a) Morphine
b) Fentanyl
c) Naloxone
d) Tramadol
Answer: c) Naloxone
Which of the following drugs is used in nicotine addiction therapy?
a) Varenicline
b) Diazepam
c) Methadone
d) Naloxone
Answer: a) Varenicline
Which type of therapy is commonly used to treat drug addiction?
a) Cognitive-behavioral therapy (CBT)
b) Antibiotic therapy
c) Chemotherapy
d) Psychosurgery
Answer: a) Cognitive-behavioral therapy (CBT)
Which of the following is a primary goal of drug addiction treatment?
a) Punishment of the addict
b) Helping the person stop drug use and lead a productive life
c) Encouraging continued drug use at a lower dose
d) Avoiding medical interventions
Answer: b) Helping the person stop drug use and lead a productive life

Tolerance and Dependence

1. General Concepts of Tolerance and Dependence

What is drug tolerance?
a) A condition where a drug no longer produces any effect
b) The need for increasing doses to achieve the same effect
c) Complete resistance to a drug’s action
d) A psychological craving for a drug
Answer: b) The need for increasing doses to achieve the same effect
Which of the following is an example of drug tolerance?
a) A patient experiencing withdrawal symptoms after stopping a drug
b) A patient requiring a higher dose of morphine to achieve pain relief
c) A patient developing an allergic reaction to a drug
d) A patient experiencing drowsiness after taking a sedative
Answer: b) A patient requiring a higher dose of morphine to achieve pain relief
What is drug dependence?
a) The inability to metabolize a drug
b) A condition where the body adapts to a drug, leading to withdrawal symptoms upon cessation
c) The increased sensitivity to a drug over time
d) A condition where a drug has no therapeutic effect
Answer: b) A condition where the body adapts to a drug, leading to withdrawal symptoms upon cessation
Which of the following best describes physical dependence?
a) Psychological craving for a drug
b) A state in which withdrawal symptoms occur when the drug is stopped
c) A sudden allergic reaction to a drug
d) Increased effectiveness of a drug over time
Answer: b) A state in which withdrawal symptoms occur when the drug is stopped
Which of the following drugs is most likely to cause both tolerance and dependence?
a) Paracetamol
b) Morphine
c) Ibuprofen
d) Metformin
Answer: b) Morphine

2. Types and Mechanisms of Tolerance

Which of the following is NOT a type of drug tolerance?
a) Pharmacokinetic tolerance
b) Pharmacodynamic tolerance
c) Cross-tolerance
d) Hypersensitivity tolerance
Answer: d) Hypersensitivity tolerance
Pharmacokinetic tolerance occurs due to:
a) Increased metabolism of the drug
b) Decreased receptor sensitivity
c) Increased drug potency
d) Reduced blood flow to the brain
Answer: a) Increased metabolism of the drug
Which type of tolerance occurs when repeated use of a drug reduces receptor sensitivity?
a) Pharmacokinetic tolerance
b) Pharmacodynamic tolerance
c) Innate tolerance
d) Behavioral tolerance
Answer: b) Pharmacodynamic tolerance
Which of the following describes cross-tolerance?
a) Tolerance that occurs due to long-term exposure to a single drug
b) Tolerance to one drug that reduces the effect of another drug with a similar mechanism
c) Tolerance due to decreased enzyme activity
d) Increased sensitivity to a drug over time
Answer: b) Tolerance to one drug that reduces the effect of another drug with a similar mechanism
Which of the following is an example of cross-tolerance?
a) A patient developing tolerance to both alcohol and benzodiazepines
b) A patient requiring a lower dose of a drug due to kidney disease
c) A patient becoming allergic to penicillin
d) A patient experiencing nausea after taking opioids
Answer: a) A patient developing tolerance to both alcohol and benzodiazepines

3. Drug Dependence and Withdrawal Symptoms

Which of the following is NOT a symptom of opioid withdrawal?
a) Sweating
b) Muscle pain
c) Hallucinations
d) Insomnia
Answer: c) Hallucinations
Which of the following drugs is associated with the most severe withdrawal symptoms?
a) Nicotine
b) Heroin
c) Caffeine
d) Paracetamol
Answer: b) Heroin
Which neurotransmitter is primarily involved in drug dependence?
a) Dopamine
b) Acetylcholine
c) Glutamate
d) Histamine
Answer: a) Dopamine
Which of the following is NOT a characteristic of psychological dependence?
a) Craving for the drug
b) Compulsive drug-seeking behavior
c) Physical withdrawal symptoms
d) Emotional distress when the drug is unavailable
Answer: c) Physical withdrawal symptoms
Which of the following substances is most likely to cause psychological dependence?
a) Cocaine
b) Metformin
c) Aspirin
d) Warfarin
Answer: a) Cocaine

4. Clinical Implications of Tolerance and Dependence

Which of the following is a major concern with opioid dependence?
a) Development of an allergic reaction
b) Increased risk of overdose
c) Reduced heart rate
d) Increased immune function
Answer: b) Increased risk of overdose
Which of the following drugs is used to treat opioid dependence?
a) Diazepam
b) Methadone
c) Paracetamol
d) Aspirin
Answer: b) Methadone
Which of the following is a treatment for alcohol dependence?
a) Disulfiram
b) Naloxone
c) Paracetamol
d) Dopamine
Answer: a) Disulfiram
Which of the following is a medication used for nicotine dependence?
a) Varenicline
b) Codeine
c) Metformin
d) Tramadol
Answer: a) Varenicline
Which of the following drugs is an opioid antagonist used to treat opioid overdose?
a) Morphine
b) Naloxone
c) Diazepam
d) Amitriptyline
Answer: b) Naloxone

5. Prevention and Management of Drug Tolerance and Dependence

Which of the following is the best strategy to prevent drug tolerance?
a) Continuous high-dose use of the drug
b) Periodic drug holidays or dose reduction
c) Increasing the dose frequently
d) Using multiple drugs simultaneously
Answer: b) Periodic drug holidays or dose reduction
Which of the following is a major goal of treating drug dependence?
a) Punishment of the patient
b) Helping the patient stop drug use safely
c) Increasing drug dose to prevent withdrawal
d) Preventing all forms of drug use permanently
Answer: b) Helping the patient stop drug use safely
Which of the following behavioral therapies is commonly used in drug dependence treatment?
a) Cognitive-behavioral therapy (CBT)
b) Antibiotic therapy
c) Electroconvulsive therapy
d) Hormone replacement therapy
Answer: a) Cognitive-behavioral therapy (CBT)
Which factor contributes to the development of drug dependence?
a) Genetic predisposition
b) Environmental stressors
c) Repeated drug exposure
d) All of the above
Answer: d) All of the above
Which of the following best describes withdrawal symptoms?
a) A pleasurable feeling when the drug is stopped
b) Psychological and physical distress when drug use is discontinued
c) Immediate relief from all symptoms
d) Complete immunity to the drug’s effects
Answer: b) Psychological and physical distress when drug use is discontinued