Match: Suez Canal University Faculty of Pharmacy 18 May 2009 Dept. of Pharm.

chem Third year A nucleoside A nucleotide DNA RNA Pyrimidines Purines Pentosephosphate Hydrogen bonding 5end 3end G-C A-T Exon intron Pentose+ base Pentose+ base+ phosphoric acid Deoxyribonucleotide Ribonucleotide Thymine, cytosine, uracil Adenine, guanine Backbone of nucleic acids Stabilizes double helix of DNA Start of polynucleotide chain End of polynucleotide chain 3 hydrogen bonds 2 hydrogen bonds Base- pairing Antiparallel 2 complementary strands Associated with proteins in chromatin Double helix 3types, messenger, transfer and ribosomal Uric acid is the end product of metabolism Single strand nucleic acid Coding region in DNA Non-coding region in DNA Most of the length of DNA A small part of the length of DNA

Question 1 In atubular form: Draw the structures of the following generically nomenclated drugs. Give their chemical names and medicinal uses. a. chlorambucil b. sulphadiazine c. chloramphenicol d.thiamine HCl e. methotrexate f. vitamin A g. dexocycline h. Acyclovir 1. Show how can you synthesize (a) and (b) 2. Analysis for 3. Structural requirements for (d) 4. Mode of action for (e) and (f) Question 2 Comment on the following; illustrate your answer with structures. 1. Hammett substitution constant (6) 2. The topless scheme 3. Oxidative deamination 4. Glucuronic acid conjugation 5. Stability of penicillins 6. The combination of sulphonamide with dihydrofolate reductase inhibitor

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Mark true(T) or false(F): 1.DNA replication requires unwinding of double helix 2. DNA replication requires RNA primer 3. DNA replication requires a promoter region 4. DNA replication requires all 4 dNTPs 5. DNA replication requires melting of double helix 6. DNA replication requires proof-reading 7. DNA replication runs in the 5-3 direction 8. DNA replication is semi- conservative 9. DNA replication is bi-directional 10. DNA replication requires ligase enzyme 11. DNA replication involves formation of Okazaki fragments 12. RNA transcription requires initiation and termination signals 13. RNA transcription requires apromotor region 14. RNA transcription requires a promoter region upstream of target sequence 15. RNA transcription requires a promoter region downstream of target sequence 16. RNA transcription requires all 4 NTPs

Question 3 (30 marks) Guided with the provided structures, complete the following (write the missing part only):

1. Chlorohexidine has broad-spectrum activity,but it is not active against.. 2. Drug2 has bactericidal activity against arelatively broad range of. Including and .. 3. Rifampin ,asymisynthetic derivative of rifamycin B ,was released as.agent.toxic effects associated with its use are relatively infrequent ,e.g .and. 4. Iodoquinol is recommended for acute and chronic .,but it is not effective in 5. Drug5 is considered adrug of choice for the .and treatment of.. 6. Ofloxacine , marketed under the name ..and used in treatment of awide range of infections including .,...and. 7. Drug1 is ..agent in species of human malaria, also the drug concentrate in the liver cells , this relatively high localization in liver may be an important factor in their usefulness of treatment of
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8. Pyrimetamine is slowly excreted through the urine, asingle weekly dose of is sufficient for suppression, and its mode of action is 9. Trimethoprim not to be as selective for as pyrimethamine 10. drug3 is abroad-spectrum anthelmintic; widely used for the treatment . Infection .the drug undergoes rapid and extensive first-pass metabolism to.,which is the active form in plasma 11. levamisol, marketed under the name used as asingle oral dose for ..and its mode of action is 12. Gliclazide is very similar to tolbutamide with the exception of..found in gliclazide ,which increase its lipophilicity over that of tolbutamide and consequently increase its . 13. drug4 is abroad-spectrum drug that is used topically for the treatment of .and 14. ketoconazole is recommended for the treatment of infections e.g .and its mode of action is .. Question 4 (35marks) in a tabular form, draw the structures of the following chemically nomenclated drugs,give their generic names and medicinal uses. a. 1-{(2,4-dichlorophenyl)-2-[(2,4-dichlorophenyl)methoxy]ethyl}-1Himidazole mononitrate b. 1-{p-[2-(5-chloro-o-anisamido)ethyl]phenyl}sulphonyl}-3cyclohexyl rea c. 5-chloro-N-(2-chloro-4-nitrophenyl)-2-hydroxybenzamide d. 2-(cyclohexacarbonyl)-1,2,3,6,7,11b-hexahydro-4H-pyrazino(1,2alpha)isoquinoline-4-one e. 2,4-Diamino-5-(p-chlorophenyl)-6-ethylpyrimidine f. 1-ethyl1-6-fluoro-7-(4-methylpiperazin-1-yl)-4-oxo-quinoline-3carboxylic acid g. 2-methyl1-5-nitroimidazole-1-ethanol h. Pyrazine-2-carboxamide i. N,N,N,N,N,N-hexamethylpararosaniline chloride B.comment on the following: 1. Synthesis of (a), (b) & (c) 2. Mode of action of (d)& (c ) 3. Assay of (g) & (h) 4.SAR of (f)
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93- Salivary amylase breaks (16) bonds of dietary starch. 94- Insulin is important for glucose uptake by hepatocyte. 95- Oxaloacetate is able to cross the mitochondrial membrane. 96- Glucose can be synthesized from triacylglycerol. 97- The propionyl residue from odd chain fatty acid is glucogenic. 98- Glucose is a major source of carbon for cholesterol synthesis. 99- Cholesterol is synthesized from mitochondrial acetyl CoA. 100-Cholesterol activates ACAT to store Cholesterol esters in cell. 101-the enzymes for ketolysis are found in liver. 102-caroxypeptidase B cleaves aromatic amino acids from C-terminal of peptides. 103-Collagen is a triple helix protein and high in phenylalanine. 104-myoglobin becomes saturated at lower oxygen partial pressure. 105-the 2,3-bisphosphoglyerate increases the affinity of hemoglobin for oxygen. 106-at physiologic pH , the -amino group carries no charge. 107-at low pH hemoglobin can release O2 easily. 108- -helix structure of a protein is stabilized mainly by the peptide bond. 109-sickle cell anemia is a mutation in the -chain of hemoglobin.

3) illustrate the following biochemical transformations showing all enzymes and cofactors : a. glycerol to glucose b. citrate to ketone bodies and mevalonate

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62- The anti-codon for the codon 5-AUG-3 is . 63- Cholesterol is a precursor of . And . 64- HB A 1c is formed from the reaction of . 65- The mechanisms of termination of a transcription in prokaryotes are . And . 66- Aspirin blocks . That produce PG and TXA from 67- Fatty acid synthase is located in .

Suez Canal University Faculty of Pharmacy

8 June 2008

dept. of Pharm.chem third year

2) Indicate whether the following statements are true (T) or false

(F) . write all answers in answer sheet II: 68- glycogen is a substrate for gluconeogenesis. 69- Oxaloacetate is the product of alanine transaminase reaction. 70- Caramoyl phosphate synthetase is a cytosolic enzyme. 71- Succinyl CoA can be produced from tryptophan. 72- Allosreric modulators cannot negatively influence enzyme activity. 73- The lineweaver-BURK plot of enzyme is linear. 74- The step between glyceraldehydes-3-phosphate and 3phosphoglyerate involves NADH oxidation. 75- Phosphofructokinase generates ATP. 76- The rate limiting enzyme in glucolysis is aldolase. 77- Gluconeogenesis occurs in liver during exercise. 78- Glucose can be synthesized from palmitic acid. 79- Diabetic patients suffer from decrease in glycogen synthesis. 80- Insulin increases gluconeogenesis. 81- Acyl CoA synthetase is found in mitochondria. 82- B-ketothiolase is found in mitochondria. 83- The active site of an enzyme binds competitive inhibitors. 84- The main function of TCA cycle is to generate co2. 85- In TCA,thiamine pyrophosphate forms covalent intermediate with ketoglutarate. 86- The degradation of glucogen produces more glucose than glucose-1-phosphate. 87- Most oxidases from water. 88- NAD/NADH are strong oxidizing agent. 89- The protein complexes of respiratory chain contain iron. 90- Thermogenin couples electron transport and oxidative phosphorylation. 91- The inner mitochondrial membrane is permeable to NADH. 92- Iron is onvoloved in fenton reaction.
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Question 1 (46 Marks) A ) Draw the structures of the following generic named drugs; Give their chemical names and Medicinal uses:1- Ampicillin 2- Cyclophosphamide 3- Tetracycline 4- Sulphamethoxazole 5- Thiamine HCL 6- Zidovudine 7- Vitamin E a- Analysis of 1 b- Synthesis of 2 c- Stability of 3 d- Mode of action of 4 e- Structure requirements for 5 B ) For each ONE of the following drugs listed below select the related drug in A. Discuss this relation. 1- Vitamin C 2- Acyclovir 3- Trimethoprim 4- Clavulenic acid 5- Rollitetracycine 6- Vitamin B5 7- Carmustin Question 2 A) Comment on the following:1- Hammett substitution constant.

2- Criag plot.

B) Give the metabolic pathway of the following drugs;1- Diazepam 2- Epinephrin 3- Paracetamol

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Question 3 (30 Marks) Guided with the provided structures, complete the following (Write the missing part only ):

1) Chlorohexidine has broad-spectrum.. Activity, but it is not active against 2) Drugs 2 has bactericidal activity against a relatively broad range of .. Including and . 3) Rifampin, a semisynthetic derivative of rifamycin B, was released as.. agent. Toxic effects associated with its use are relatively infrequent , e.g.............and 4) Iodoquinol is recommended for acute and chronic but it is not effective in .. 5) Drug 5 is considered a tdrug of choice for the . and treatment of 6) Ofloxacine, marketed under the name ... and used in treatment of a wide range of infections Including and.. 7) Drug 1 is .. agent in species of human malaria, also the drug concentrate in the liver cells, this relatively high localization in liver may be an important factor in their usefulness for treatment of . 8) Pyrimetamine is slowly excreted through the urine, a single weekly dose of is sufficient For suppression , and its mode of action is . 9) Trimethoprim not to be as selective for as pyrimethamine.
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31- Fructose intolerance is due to the absence of . 32- Non-clssical galactosemia is a deficiency of . 33- The main source of NADPH for fatty acid synthesis is . 34- The rate limiting enzyme in fatty acid synthesis is . 35- Glycerol kinase is absent in . 36- Carnitine is required for . 37- Vitamin B12 is a cofactor for . And . 38- Creatine is produced from ... And . 39- The amino acid degraded to acetyl coA and acetoacetate is . 40- The defective enzyme in phenylketonuria is . 41- The toxicity if ammonia is due to depletion in . 42- Phosphatidyl choline provides the fatty acid for the synthesis of . By LCAT 43- ... And ... Are precursors for synthesis of ceramide 44- . cLeaves aromatic amino acids from the C-terminal end of peptides 45- cleavage of meta-ala-tyr-arg-gly- with trypsin will produce . 46- Serotonin is derived from the amino acid . 47- The amino acid that can undergo deamination by dehydratase is . 48- Obstruction of the bile duct can increase the serum level of . 49- Serine is converted to . By a tetrahydrofolate requiring reaction. 50- The enzyme that seals between two DNA chains is . 51- The enzyme that hydrolyzes RNA primer of replication is . 52- The enzyme that unwinds the DNA preceding the replication fork is . 53- The subunit that enables RNA polymerase holoenzyme to recognize the promoter is . 54- The three stop genetic code are and . 55- Rifampin inhibits transcription by . 56- The main characters of mitochondrial DNA are 1.2.3.4. 57- The post-transcriptional processing of hnRNA in eukaryotes are . And . 58- The key intermediate for cholesterol synthesis is . By the enzyme . To form mevalonate 59- The main apoprotien found in LDL are . And . 60- The end product of purine catabolism in human is . 61- The primary bile acids are . And .
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Biochemistry questions
1) complete the following sentences in answer sheet 1: 1- phosphfructokinase converts .. to .. 2- substrates for gluconeogenesis are .. and .. 3- aspartate transaminase requires the cofactor .. 4- carbamoyl phosphate synthetase combines .. and ... 5- argininosuccinate synthetase couples .. with 6- arginase results in the formation of .. and 7- competitive inhibitors change .. and do not change ... 8- the reaction of fructose -6-phosphate to pyruvate generates ... ATP. 9- the regulatory enzyme in gluconeogenesis is .. 10- the product of enoyl coA hydratase is .. 11- the complete B-oxidation of palmitic acid results in .. 12- isocitrate dehydrogenase is allosterically activated by .. 13- succinate dehydrogenase requires the cofactor .. 14- isoctirate dehyrogenase removes.. from isocitrate 15- pyruvate dehydrogenase is inhibited by..and 16- the precursor of serine biosynthesis is .. 17- the carbons of cysteine are derived from 18- has a higher energy phosphate than ATP 19- inhibits cytochrome oxidase 20- an example of substrate level phosphorylation is 21- hexokinase is inhibited by 22- in the TCA cycle , the number of co2 released is 23- a hormone that stimulates gluconeogenesis is 24- glucose-6-phosphatase is formed only in and 25- the rate of limiting enzyme in glycogenolysis is 26- the rate of limiting enzyme in glycogenesis is 27- transketolase requires the cofactor . 28- glucose-6-phosphatase dehydrogenase deficiency leads to . 29- Aldolase B catalyzes the reaction of . 30- Sorbitol dehyrdogenase is found mainly in the .
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10) Drug 3 is a broad-spectrum anthelmintic; widely used for the treatment infection. The Drug undergoes rapid and extensive first-pass metabolism to ., which is the active form in plasma. 11) Levamisol marketed under the name .., used as a single oral dose for. And its mode of action is . 12) Gliclazide is very similar to tolbutamide with the exception of .. found in gliclazide, which increases its lipophilicity over that of tolbutamide and consequently increases its .. 13) Drug 4 is a broad-spectrum . drug that is used topically for the treatment of and 14) Ketoconazole is recommended for the treatment of . infections e.g . and its mode of action is . Question 4 In a tubular form, draw the structure of the following chemically nomenclated drugs, give their generic names and medicinal names. a) 1-{(2,4-Dichlorophenyl )-2-[(2,4-dichlorophenyl )methoxy]ethyl}-1Himidazolemononitrate b) 1-{P-[2-(5-chloro-o-anisoamido)ethyl]phenyl}sulphonyl}-3-cyclohexyl urea c) 5-chloro-N-(2-chloro-4-nitrophenyl)-2-hydroxybenzamide. d) 2-(Cyclohexylcarbonyl)-1,2,3,6,7,11b-hexahydro-4H-pyrazino(2,1alpha)isquinoline-4-one. e) 2,4-Diamino-5-(p-chlorophenyl)-6-ethylpyrimidine. f) 1-Ethyl-6-fluro-7-(4-methylpiperazin-1-yl)-4-oxo-quinoline-3-carboxylic acid g)2-Meyhul-5-nitroimidazole-1-ethonl. h) pyrazine-2-carboxamide. i) N,N,N,N,N",N"-hexamethylpararosaniline chloride B) Comment on the following: 1) Synthesis of (a),(b)&(c) 2) Mode of action of (d)&(e) 3) Assay of (g)&(h) 4) SAR of (f)

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Suez Canal University Faculty of Pharmacy

June 10, 2006

Dept. of Pharm.chem Third year

Question 1 A) Draw the structures of the following chemically nomenclated drugs. Give their generic names and medicinal uses. a) Diphenyl-2-chlorophenyl -1-imidazolyl methane. b) 1-(Hexahydro-1H-azepin-1-yl)-3-(p-tolysulphonyl)urea c) 2-Amino-1,9-dihydro-9-[(2-hydroxyethyloxy)methyl]-6H-purin-6one. d) 2-(1,2-Dihydroxyethyl)-3,4-dihydroxyfuran-5-one e) 3-Amino--ethyl-2,4,6-triiodohydrocinnamic acid f) 2-Bis-(2-chloroethyl)amino-tetrahydro-2H-1,2,3oxazaphosphorine-2-oxide g) N1-(4,6-Dimethyl-2-pyrimidinyl)-N4-acetyl sulphonamide h) D (-) Threo-2-dichloroacetamido-1-(p-nitrophenyl)-1,3propanediol B) 1- Mode of action of (a) 3- Metabolism 2- Assay of (d) 4- Synthesis of (g) and (h)

68. Barbiturates may lose their efficacy after 10 days of consecutive use. 69. Carbamazepine, phenytoin, and valporate are effective in the treatment of generalized tonic-clonic seizures. 70. Febrile seizures are generalized tonic-clonic seizures associated with elevated body temperatures in adults. 71. Morphine is a strong respiratory stimulant. 72. Severe withdrawal symptoms can be precipitated in morphine addicts by the administration of naloxone. 73. Paracetamol is an effective anti-inflammatory agent. 74. Succinycholine has a longer duration of action than pancuronium. 75. Neostigmine may reverse the overdose toxicity of d-tubocurarine. Suez Canal University Faculty of Pharmacy Department of pharmacology & Toxicology June4, 2006 Third year

ALL QUESTIONS ARE TO BE ATTEMPTED 1- Classify antiarrythmic drugs, then discuss the pharmacological effects of quinidine mentioning the most common side effects. (15 points) 2- Discuss the mechanism of action, pharmacological effects andmost common adverse reactions of digitalis therapy. (10 points) 3-Account shortly on: (10 points) -Calcium channel blockers -Loop diuretics 4- Discuss briefly: (10 points) -Beta-2 selective agonists in treatment of bronchial asthma -Mast call stabilizers

Question 2 In a tabular form; Draw the structures of the following generically nomenclated drugs. Give their chemical names and medicinal uses. a) Thiamine b) Busulfan c) Penicillin G d) Cephadroxil e) Tetracycline f) Nalidixic acid 1- Mode of action for (a) and (b). 2- Acid-stable form of ;Give reason. 3- Stability of (d). 4- Prodrug of (e); synthesis pathway. 5- Second generation of (f) Question 3 Comment on the following; Illustrate your answer with structures. a) Molecular hybridization b) Transport regulation c) Diasterioisomer
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42. Parkinson's disease may result from imbalance between the cholinergic and dopaminergic activities in the brain. 43. Drug holidays are applied when the patient has become increasingly responsive to the therapeutic effects of levodopa. 44. Carbidopa is an effective therapeutic agent in the treatment of Parkinson's disease. 45. Administration of vitamin B6 may enhance the effects of L-dopa. 46. Similar to dopamine , L-dopa can easily pass across the blood-brain barrier. 47. Benzhexol may be effective in improving the Parkinsonian symptoms. 48. Selegiline acts by inhibiting MAO-type A enzyme. 49. Febrile seizures are treated chronic administration of antiepileptic drugs. 50. Drug choice of antiepileptic agent is based on the type of seizure. 51. Valproate is effective in the treatment of both tonic-clonic and absence seizures. 52. Febrile seizures are treated chronically with antiepileptic drugs. 53. Diazepam is the drug of choice for myoclonic seizures. 54. Phenytoin is equally effective in both partial and tonic-clonic seizures. 55. Gradual withdrawal of antiepileptic drugs is a must. 56. Polytherapy is more effective than monotherapy in the management of seizures. 57. Methadone can be used to suppress the opiate withdrawal symptoms. 58. All opiate addicts demonstrate dilated eye pupil, which is diagnostic. 59. Codeine has an anti-tussive property. 60. Morphine possesses an anti-diarrheal property. 61. Naloxone can reverse the respiratory depressant effect of morphine. 62. Prostaglandins act as an inflammatory mediator via the stimulation of pain receptors. 63. NSAIDs' toxicity is due to blocking prostaglandins' synthesis. 64. Selective Cox-II inhibitors have lower side effects than non-selective inhibitors. 65. Atropine, morphine, diazepam, metoclopramide and pancuronium are useful pre-anesthetic medications. 66. Allopurinol and probenecid are useful agents in the management of hyperurecemia. 67. Hyperuricemia always results in gout.
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d) Metabolism involving tertiary aliphatic amine e) Glucuronic acid conjugation f) The combination between: 1- Sulphamethoxazole and trimethoprin 2- Amoxicillin and clavulonic acid. Question 4 A) Illustrate a synthetic procedure that can be utilized to transform each of the Following starting materials into mentioned drugs. Give their chemical names and medicinal uses. a) P-(N-methylamino) phenol ------------ Diloxanide furoate b) Quinoxalin ------------------------------- Pyrazinamide c) p-Chlorophenyl acetonitrile ------------ Pyrimethamine d) 5-Chlorosalicylic acid ------------------- Niclosamide e) 5-Nitro-2-furaldehyde ------------------- Nitrofurazone B) Complete the following sentences: 1- Praziquantel is a broad-spectrum agent, that is effective against a variety of .., its mode of action is . and administered as .. . 2- Povidone- iodine is a complex of .., effective against .., its mechanism of action is . 3- .. is an example of cationic surfactant drugs and its mechanism of action is 4- Gentian violet is much more effective against .. than .., it is used topically as in treatment of .. . 5- Mebendazole is a broad-spectrum effective against a variety of including and administered as . 6- To attain prolonged immunization in area infected with hyperendemic malaria, administration of .. and every 4 months is recommended. 7- Clofazimine is a bacteriostatic agent, used in treatment of .., it is the drug of choice in infection caused by .. . 8- Isoniazide is of special value in treating .. Because it gains access to all organs and to all body fluids, It is assayed as follows . . 9- Albendazole is a broad-spectrum .., widely used for the treatment of .... 10- Metornidazole was first marked for the topical treatment of ...., the drug also possesses useful .. activity, it is effective against both .. and .
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Suez Canal University

Faculty of Pharmacy

Pharmacology & toxicology department

Third year Time allowed 3 hrs

Answer each of the following MCQs by marking the correct letter. Choose one answer only for each question: 1. A drug: a-creates anew function for the cell b- Does not affect the cell function c- Increases or decreases the functional activity of the cell d-none of the above 2. Which of the following factors modifies the movement of the drug molecules from the site of administration into the body and body components? a. Lipid diffusion b. simple diffusion c. Facilitative diffusion (special carriers) d. Pinocytosis e. all of the above 3. Which of the following statements is true? a. The protein-bond drug is the portion of drug that is therapeutically active b. Drugs cross the placenta mainly by active transport c. The LD50 is the toxic dose required producing death in 50% of the animals d. The ED50 is 50% of the animal dose that is dethal to the animals e. None of the above 4. The rate of urinary excretion of acidic drugs such as aspirin and barbiturates is increased by: a. Administration of sodium bicarbonate b. Administration of ascorbic acid c. None of the above d. Keeping the urine at neutral pH 5. Which of the following routes of injection is suitable for administration of large quantity? a. Intramuscular b. Intravenous c. Bone marrow injection d. Subcutaneous
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17. The released neurotransmitter can be removed from the secretory site by reuptake, diffusion, and metabolism. 18. Stimulation of the adrenergic receptors, alpha- and beta, produces opposite effects on the blood vessels. 19. Both sympathomimetics and parasympatholytics cause dilation of the eye pupil. 20. Selective 2-blockers are especially useful for asthmatic patients. 21. Epinephrine is administrated by intravenous infusion. 22. Phenylephrine is used as a nasal decongestant because of its sympatholytic activity. 23. Unlike isoproterenol, salbutamol is an orally effective 2-agonist. 24. Postural hypotension and reflex tachycardia may take place during treatment with alpha-blockers. 25. Propranolol can be used in the treatment of hypertension in asthmatic patients. 26. Acetylcholine is a useful parasympathomimetic therapeutic agent. 27. Neostigmine can be used to treat the overdose of d-tubocurarine. 28. Antidepressant drugs include tranylcypromine. 29. Acute administrator of tricyclic antidepressants causes an increase in the adrenergic activity in the brain. 30. Levo-dopa can be used safely with MAOIs. 31. Benzodiazepines are more safer than barbiturates in the treatment of insomnia. 32. Major depression is caused by a decreased activity of the brain monoamines, as stated by the amine hypothesis. 33. MAOIs can be administered safely with any type of food. 34. Phenelzine is safer than amoxapine in the treatment of depression. 35. Lithium is the drug of choice for mania. 36. A brupt withdrawal of an ideal hypnotic may produce drug withdrawal syndrome. 37. Schizophrenia may result from an excessive dopamine transmission in the mesolimbic dopaminergic system. 38. Antipsychotics may antagonize the dopaminergic, cholinergic, histaminic and -adrenergic receptors. 39. The therapeutic effects of antipsychotics depend on their ability of blocking the cholinergic receptors. 40. Haloperidol treatment may be accompanied by extrapyramidal symptoms. 41. Naloxone administration can precipitate withdrawal syndrome in morphinc-dependent patients.
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130- Omeprazole and cimitidine are not used together in the same patient because: a. Their additive side effects b. Acid medium is required for full action of cimitidine c. Alkaline medium is required for full action of cimitidine d. Acid medium is required for full action of omeprazole

pharmacology questions
I. Mark (T) for True and (F) for false Statements, Use the provided Answer Sheet 1.Passive diffusion is a minor route of drug transport across cell membranes. 2. Absorption via active transport is directly proportional to drug concentration. 3. Bound drugs can be distributed in the body at lower rates. 4. The first pass metabolism may enhance the bioavailability of drugs. 5. Antagonist effects can always be reversed by the administration of high doses of the agonist. 6. Drug safety is inversely proportional to the value of the therapeutic index. 7. Metabolism always results in inactivation of drugs. 8. Substance with similar structures may inhibit each other's absorption by active transport. 9. Children and elderly are similarly prone to the adverse effects of drugs. 10. Barbitiorates may potentiate the analgesic effect of aspirin. 11. Tolerance is an increased response to the usual dose of a drug after repeated administration. 12. The term "craniosacral" refers to the origin of the sympathetic nerves. 13. Acetylecholine is a neurotransmitter found at both sympathetic and parasympathetic ganglia. 14. Norepinephrine is a neurotransmitter released by each sympathetic nerve. 15. The distribution of the nicotinic receptors is limited to the autonomic ganglia. 16. Adrenergic receptors can only be activated by epinephrine and norepinephrine.
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e. b and c only 6. Idiosyncrasy is a term which denotes: a. Indirect consequences of primary drug action b. An abnormal reaction to a drug due to genetic abnormalities c. An effect which is the result of an antigen-antibody reaction d. Powerful pharmacological action obtained by the usual dose of the drug e. An abnormal reaction to a drug due to an unknown cause different from a, b and c 7. Conditions responsible for excessive or unusual drug effects include: a. Unusual sensitivity, either allergic in nature or an idiosyncratic reaction b. Administration of the drug too frequently or for a prolonged period of time c. The presence of other drugs which activate or inhibit hepatic microsomal enzymes d. All of the above e. None of the above 8. Binding of drugs to plasma proteins render them: a. Easily excreted by kidneys b. Biologically active c. Biologically inactive d. Of long duration of action e. None of the above 9. Acetylcholine is the neurotransmitter at all of the following sites EXCEPT: a. Muscarinic receptor sites b. NicotinicM receptor sites c. Nicotinic N receptor sites d. Adrenergic ganglia e. 2- adrenergic receptor sites 10. All of the following are typically cholinergic effects EXCEPT: a. A decrease in heart rate b. An increase in papillary diameter c. An increase in atrioventricular(AV) conduction time d. An increase in secretion of sweat
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e. A contraction of bronchial muscle 11. The mechanism of action of botulinum toxin is: a. Mimicry of ACH b. Prevention of the synthesis of ACH c. Prevention of release of ACH d. Potentiation of action of cholinesterase e. Inhibition of action of cholinesterase 12. All of the following statements are true for pilocarpine EXCEPT: a. Cause contraction of intestinal tract b. May be used to treat asthma c. Induce vasodilatation d. Is effective for open- angle glaucoma e. Produce marked diaphoresis (sweating) 13. Which of the following statements concerning nicotinic and muscarinic receptors is FALSE? a. Nicotine has the property of being both cholinergic stimulant and blocking agent b. The nicotinic receptors of autonomic ganglia and skeletal muscle are not entirely identical c. The autonomic ganglion cells have both nicotinic and muscarinic receptors d. Atropine blocks the excitatory muscarinic actions of ACH but not the inhibitory actions e. None of the above 14. Symptoms of poisoning with insecticides containing irreversible anticholinesterase include all of the following EXCEPT: a) Distended bladder. b) Abdominal cramps. c) Wheezing. d) Ataxia. e)Muscle weakness 15. In myasthenia gravis, the following statement(s) is (are) correct: a) Neostigmine is given for diagnostic purposes. b) Thymectomy is effective in case of autoimmune type. c) Pyridostigmine is usually preferred as its action smoother than that of neostigmine. d) a and c only. e) All of the above
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122- The following are serotonine-receptor blocks except: a- Famotidine b- Ondansetron c- Ritanserin d- Cyproheptadine 123- The following are not loop diuretics except: a- Acetazolamide b- Spironolactone c- Chlorothiazide d- Ethacrynic acid 124- Acetazolamide is used in the following clinical conditions except: a- Glucoma b- Urinary acidification c- Urinary alkalinization d- Acute mountain sickness 125- The diuretic that selectively inhibits NaCl reabsorption in the thick ascending limb of the loop of Henle is: a. Manitol b. Furosemide c. Amiloride d. Bendroflumethazide 126- Loop diuretics are used in: a. Acute pulmonary edema b. Acute hypercalcaemia c. Acute renal failure d. All of the above e. a and b 127- Tthiazides are not used in: a. Hypertension b. Congestive heart failure c. Diabetes mellitus d. Nephrogenic diabetes insipidus 128- Spironolactone acts through: a. Excessive potassium diuresis b. Antagonizing aldosterone c. Direct interference with Na+ selection ion channels d. Enhancing water secretion by osmosis 129- One of the following drugs is used in Zollinger Ellison syndrome: a. Acetylsalicylic acid b. Adrenaline c. Propanolol d. Ranitidine
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115- Sucralfate improves symptoms of peptic ulcer patient through: a- Polymerization and selective binding to necrotic ulcer tissue. b- Directly adsorb bile salts. c- Stimulation of endogenous prostaglandin synthesis. d- All of the above. e- None of the above. 116- Histamine is released by the following except: a- Chorpheniramine b- Immediate allergic reaction c- Mechanical injury to mast cells d- Morphine 117- Histamine causes: a- Hypertensive crisis b- Decrease systolic and diastolic blood pressure c- No effect on blood pressure 118- Terfenadine and cyproheptadine are: a- H1 receptor antagonists. b- H2 receptor antagonists. c- H3 receptor antagonists. 119- Sedation is a common side effect of the following antihistamines except: a- Diphenhydrinate. b- Cyclizine. c- Promethazine d- Loratidine. 120- Serotonine causes skin flush by: a- Dilatation of small arterioles b- Constriction of small arterioles c- Dilatation of veins d- Constriction of veins 121- The effect of seretonine on the gastrointestinal tract includes: a- Increase in intestinal secretions b- Inhibition of intestinal secretion c- Contraction of GIT smooth muscles d- Inhibition of GIT smooth muscles

16-All of the following statements concerning physostigmine and neostigmine are true EXCEPT: a) Both are classified as reversible cholinesterase inhibitors. b) Physostigminie is well absorbed orally. c) A major problem encountered with neostigmine is the unpleasant CNS effects which result from its administration. d) Physostigmine has useful clinical application in treatment of glaucoma. e) Neostigmine has useful clinical application in post operative urine retention. 17-Which of the following is not a characteristic effect of atropine? a) Diarrhea b) Cycloplegia c) Urine retention. d) Bronchodilitation e) None of the above. 18-Atropine has useful clinical application in: a) Glaucoma b) Nocturnal c) Obesity d) Grand mal epilepsy. e)None of the above 19-Which of the following statements concerning ganglionic stimulant is FALSE: a) Will usually produce ganglionic blockade when used in sufficiently high doses. b) These are compounds which stimulate the central cholinergic receptors in the autonomic ganglia. c) Include nicotine and tetramethylammonium. D) Are useful clinically. e) None of the above. 20- Ganglionic blockade is likely to: a) Cause generalized vasodilatation and decrease peripheral resistance. b) Increase the desire to urinate. c) Decrease I.O.P. d) Increase the cardiac output. e) Increase the motility and the secretion of GIT.

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21- All of the following statements are true for trimetaphane EXCEPT: a) It is a short acting ganglionic blocker with rapid onset. b) Used clinically in treatment of hypertensive encephalopathy. c) Used to decrease autonomic hyper-rellexia occurring in spinal cord injury. d) It has a serotonin liberating property. e) None of the above. 22- In response to fight and flight. The following may occur: a) Bronchospasm b) Hypoglycemia. c) Mydriasis. d) vasodilatation of the skin blood vessels e) b and d only. 23- Which of the following is (are) correct: a) Epinephrine causes contraction of spleen and increases erythrocyte in blood circulation. b) Epinephrine causes contraction of the uterus in pregnancy by stimulation of -adrenergic receptors. c) Epinephrine increase blood glucose level through stimulation of 1 adrenergic receptor. d) Epinephrine increases the tone and motility of GIT by and stimulation. e) All of the above. 24- Lipolysis could be stimulated by: a) Epinephrine. b) Norepinephrine. c) Isoprenaline. d) All of the above. e) a and c only. 25- stimulation of 1 adrenergic receptors causes: a) Increased heart rate b) Decreased renal secretion of rennin. c) Relaxation or intestinal smooth muscles. d) a and b only. e) a and c only. 26- Stimulation of 2 adrenergic receptors causes: a) Stimulation of skeletal muscle glycogenolysis. b) Stimulation of liver glycogenolysis. c) Bronchodilatation.
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109- Inhibitors of cicosanoid synthesis include: a- Corticosteroids and non steroidal anti-inflammatory drugs. b- Excessive administration of calcium. c- Magnessium depletion. 110- The following drugs are bronchodilators except: a- Ephedrine. b- Salmeterol. c-Zafirlukast. d- Propranolol. 111- Methylxanthins dilate bronchi because they: a- Activate muscarinic receptors. b- Inhibit phosphodiestraze enzyme. c- Stimulate beta-2 receptors in the bronchi tree. d- All of the above 112- Ranitidine cures peptic ulcer through: a- Blocking III-receptors. b- Increase of gastric mucus secretion. c- Blocking H2 receptors. d- Relaxation of gastric smooth muscles. 113- A patient suffering from epilepsy and peptic ulcer at the same time and receiving cimetidine and phenytoin together: a- The dose of phenytoin must be increased to obtain the same effect. b- The dose of phenytoin must be reduced to obtain the same effect. c- No change of phenytoin dose. d- Phenytoin has to be replaced by another anti-epileptic drug. 114- Omeprazole cures peptic ulcer through: a- Blocking H1 receptors. b- Its anti-muscarinic effect. c- Inhibition of gastric parietal cell proton pump. d- Neutralizing gastric HCl chemically.

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102- Toxicity of cardiac glycosides is treated by: a. Administration of calcium b. Administration of sodium c. Administration of potassium d. Administration of magnesium 103- in the management of acute attack of angina pectoris, nitrates and nitrite are used: a. orally b. transdermally c. sublingually d. parentrally 104- Nitrates and nitrites selectively relax vascular smooth muscle by: a. Formation of cGMP b. Formation of cAMP c. Suppression of cGMP d. Suppression of cAMP 105- Nitroglycerin: a. Increase platelet aggregation b. Decrease platelet aggregation c. Increase platelet formation d. Increase platelet destruction 106-Isosorbid dinitrate is used in: a. Effort angina b. Variant angina c. Unstable angina d. All of the above e. a and b 107-The cyclooxygenase pathway of arachidonic acid produces: a. LTB4, LTE4 and LTC4 b. PGE2, PGf2a, PDG2 c. TxA2, PGD2, PGf2a, PGE2 d. TxA2 and dihydroxyeicosatrienoic acid 108- Eicosanoids express their action through: a. direct action on target tissue b. combining with specific receptors c. electrical stimulation d. mechanical stimulation

d) b and c only.

e) All of the above.

27- Epinephrine causes rise in systolic and diastolic blood pressure due to: a) An increase of force of heart contraction. b) An increase in heart rate. c) Vasoconstriction of skeletal muscle blood vessel. d) a and b only. e) All of the above. 28- Administration of an infusion of norepinephrine to a person will result in: a) A decrease in AV transmission. b) An increase in peripheral resistance. c) An increase in heart rate. d) A decrease in mean blood pressure. e) A decrease in diastolic blood pressure. 29- Dopamine: a) Reduces peripheral resistance when administered in high concentration. b) Has minimal 1 effects on the heart. c) Causes renal vasodilatation through D1 -receptors. d) Rapidly enters the CNS. e) All of the above. 30- Isoprenaline is used for treatment of: a) Hypotension. b) Heart block. c) Hypertension. d) Atrial tachycardia. e) All of the above. 31- The combination of - adrenergic stimulant and -adrenergic blockade causes The following EXCEPT: a) Mydriasis. b) Bronchodilatation. c) vasodilatation. d) Uterine relaxation. e) None of the above. 32- stimulation of presynaptic 2 adrenoceptor: a) Can lead to increase in release of norepinephrine from the sympathetic nerves.
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b) Is apart of the control mechanism which regulates the release of norepinephrine. c) Occur after administration of clonidine. d) Occur after administration of prazosine. e) b and c only 33- Non-catecholamines differ from catecholamines in that they: a) Have a short duration of action. b) Tend to have greater CNS effects following oral administration. c) Don't act indirectly. But usually combine directly with adrenergic and receptors. d) Are not effective if administered orally. c) None of the above. 34- Tyramine: a) Is an indirectly acting sympathomimetic amine. b) Releases norepinephrine from sympathetic never ending. c) Can cause hypertension in persons treated with MAO inhibitor. d) b and c only. e) All of the above. 35- The actions of amphetamine include: a) Arise in both diastolic and systolic pressure. b) Anorexia. c) Analgesic. d) Delay and partial reversal of fatigue. e) All of the above. 36- -adrenergic blocking agents: a) Reverse the pressor action of norepinephrine. b) Are effective against drugs which stimulate -receptors. c) Block and reverse the Pressor action of epinephrine. d) a and c only. e) All of the above. 37- Phaeochromocytoma is diagnosed by one of the following drugs: a) Phentolamine. b) Isoprenaline. c) Guanethidine. d) Phenylephrine. e) None of the above. 38- The adrenergic blocking action of ergot alkaloid: a) Is decreased by hydrogenation. b) Is increased by hydrogenation. c) Is mostly manifested on -adrenergic receptors.
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96- Diltiazem and verapamil reduce elevated blood pressure by: a. Dilatation of peripheral arterioles b. Inhibition of calcium influx into arterial smooth muscle cells c. Decrease heart rate and cardiac output d. All of the above e. b and c 97- Captopril reduces elevated blood pressure by: a. Inhibition of the angiotensine converting enzyme b. Preservation of bradykinin c. Reduction of peripheral resistance d. All of the above e. a and c 98- Losartan reduces elevated blood pressure by: a. Blocking of the angiotensine converting enzyme b. Blocking angiotensin receptors c. Bocking alpha adreno-receptors d. Blocking beta adreno- receptors e. all of the above 99- The positive inotropic effect of cardiac glycoside is due to: a. Stimulation of Na+/K+ ATPase b. Inhibition of Na+/K+ ATPase c. Stimulation of mixed function oxidase d. Inhibition of mono amine oxidase 100- The net result of the mechanical effect of digitalis on cardiac muscle is: a. Decrease of intracellular potassium b. Increase of intracellular potassium c. Increase of intracellular free calcium d. Decrease of intracellular free calcium 101- The parasympathomimetic effect(s) of digitalis is (are) due to: a. Sensitization of the baroreceptors b. Central vagal stimulation c. Ffacilitation of muscarinic transmission at the cardiac muscles d. All of the above e. b and c
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d - a and b

e-all of the above

90-Reserpine reduces blood pressure by: a-Depletion of central neurons from sympathetic neurotransmitters b-Depletion of peripheral neurons from sympathetic neurotransmitters. c-Blocking the transmitter vesicles to take up and store catecholamines. d-All of the above 91-Propranolol antagonizes catecholamine by: a- Blocking alpha-1 receptors b- Blocking beta-1 receptors. c- Blocking beta-2 receptors. d- Blocking both alpha and beta receptors. e- Blocking both beta-1 and beta-2 receptors. 92-Propranolol when used in patients with bronchial asthma it: a-Improves patient condition. b- Worsening of the asthma. c- Induces tachycardia d- Has no effect 93-Selective beta blockers are: a- Metoprolol and propranolol b- Nadolol and carteolol c- Atenolol and betaxolol. d- Labetalol and carvedilol 94-Prazosin and doxazosin are: a. Potent diuretics b. Potassium spring diuritcs c. Non-selective beta blockers d. Alpha blockers 95- Minoxidil: a. Dilates veins not arterioles b. Dilates arterioles not veins c. Dilates both veins and arterioles d. Dilates capillaries
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d) a and c only. e) None of the above. 39- Ergotamine: a) Is valuable for preventing migraine. b) In overdose can cause gangrene of the extremities by its adrenoreceptor agonist action. c) Is safe to use in pregnancy. d) Is needed in severe acute attack of migraine. e) a and b only. 40- Your pharmacology laboratory has been given an unknown compound for screening. It is found to cause miosis decrease the heart rate. increase bronchial gland secretion and causes sweating. You would classify this compound as: a) Alpha agonist. b) Muscarinic agonist. c) Beta agonist. d) Antimuscarinic. e) None of the above. Mark (T) for true statements and (F) for false statements: 41-( ) Substance -p is part of an endogenous pain-inhibiting mechanism. 42-( ) Antidepressant drugs must be discontinued by gradual withdrawal of the dose. 43-( ) Acute administration of tricyclic antidepressants causes an increase in the adrenergic activity in the brain. 44-( ) Antacids may increase the rate of absorption of diazepam. 45-( ) Benzodiazepines have no potential of drug abuse. 46-( ) Abrupt withdrawal of an ideal hypnotic may produce drug withdrawal syndrome. 47-( ) Barbiturates may lose their efficacy after 10 days of consecutive use. 48-( ) Schizophrenia may result from an excessive dopamine transmission in the mesolimbic dopaminergic system. 49-( ) Antipsychotics may antagonize the dopaminergic, cholinergic, histaminic and -adrenergic receptors. 50-( ) Parkinson's disease may result from imbalance between the cholinergic and dopaminergic activities in the brain. 51-( ) Drug holidays are applied when the patient has become increasingly responsive to the therapeutic effects of levodopa. 52-( ) Carbamazepine, phenytoin, and valproate are effective in the treatment of generalized tonic-clonic seizures.
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53-( ) Febrile seizures are generalized tonic-clonic seizures associated with elevated body temperatures in adults. 54-( ) Morphine is a strong respiratory stimulant. 55-morphine is useful analgesic agent for asthmatic patients. 56-( ) Severe withdrawal symptoms can be precipitated in morphine addicts by the administration of naloxone. 57-( ) Methadone can be used to suppress the opiate withdrawal symptoms. 58-( ) Atropine, morphine, diazepam, metoclopramide and pancuronium are useful pre-anesthetic medications. 59-( ) Epinephrine may be used in conjunction with local anesthetics 60-( ) Local anesthetics have minimal systemic toxicity 61-( ) The therapeutic effects of NSAIDs can be explained on the basis of decreasing prostagandins synthesis 62-( ) Paracetamol is an effective anti-inflammatory agent 63-( ) Acetaminophen may produce hepato-toxicIity in chronic alcohol drinkers 64-( ) Allopurinol and probenecid are useful agents in the management of hyperurecemia 65-( ) Overdose of neuromuscular blocking agents may cause prolonged apnea Choose the most appropriate drug therapy (only one) for each of the following cases: 66- A patient with urinary retention suffers from major depression (Amitriptyline, Tranylcypromine, Trazodone) 67- An elderly patient suffers anxiety (Diazepam, Chiotdiazepoxide, lorazepam) 68- A patient with past history of drug abuse suffers from insomnia (Flurazepam, Phenobarbital, Diaphenhydramine) 69- A schizophrenic patient with glaucoma (Haloperidol, Thioridazen, Chlorpromazine) 70- A severly disabled Parkinson's patient with "off" phenomenon (Morphine, Levodopa, Bromocriptine) 71- A schizophrenic patient with insomnia (Molmicne, Chlortomzine, Haloperidol) 72-A chila with absence seizures (Clonazepam, Ethosuximide, valproate) 73-An asthmatic patient with severe muscle pain (Piroxicam, Morphine, Methadone)
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74-A patient with an acute attack of gout (Levorphanol, Ibuprofen, Probenecid) 75-A patient received an overdose of gallamine (Neostigmine, Succinylcholine, d-tubocurarine) Give the equivalent for each of the following: 76- A neurotransmitter that may be involved in a sleep inducing mechanism (..) 77-The most common inhibitory neurotransmitter in the brain (..) 78-Aselective inhibitor of serotonin-reuptake (..) 79-A wide spread abnormal discharge of neurons in both cerebral hemispheres (..) 80-A monoamine oxidase-type B inhibitor. (.) 81- A major adverse effect of NSAIDs (...) 82-apartial agonist/antagonist opioid (...) 83-A disease-modifying ant rheumatic drug (..) 84-A drug used for induction of anesthesia () 85-A depolarizing neuromuscular blocker (..) 86-Methyl dopa and clonidine reduce blood pressure by: a- Blocking Beta adrenergic receptors. b- Inducing sodium and water diuresis. c- Reducing sympathetic outflow from vasopressor center. d- All of the above 87-Rapid withdrawal of clonidine after prolonged use may lead to: a- Dry mouth and mental depression. b- Excessive hypotension. c- Life threatening hypertensive crisis. d- Normalization of blood pressure 88-Guanethidine reduces elevated blood pressure by: a-Potassium diuresis. b-Reversible inhibition of norepinephrine release from sympathetic nerve endings. c-Inhibition of acetylcholine release d-Blocking both alpha and beta adrenergic receptors. 89-adverse effect(s) of guanethidine is (are): a-Postural hypotension. b-Retrograde or delayed ejaculation. c-Decrease blood flow to heart and brain
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