General Pharmacology, Local Anesthetic Agents, and
Antiemetic Drugs
1. Pharmacokinetics-
(A)Drug absorption is faster in the gastrointestinal tract than in subcutaneous tissue.
True
(B)First-pass metabolism primarily affects orally administered drugs. True
(C)The volume of distribution indicates the extent of drug distribution in body
compartments True
(D)A drug with a high therapeutic index is considered safe.False
(E)The primary route of excretion for most drugs is through the lungs. True
Explanation: The first four statements are correct in pharmacokinetics. The primary
route of excretion for most drugs is renal, not pulmonary.
2. Examples of both enzyme inducers & inhibitors-
(A)Omeprazole True
(B)Phenytoin False
(C)OCP False
(D)Metronidazole False
(E)INH True
Explanation: Ref: Smith/P-18
3. Drug Metabolism-
(A)Cytochrome P450 enzymes play a major role in drug metabolism. True
(B)Phase I metabolism includes hydrolysis and oxidation reactions. True
(C)Phase II metabolism primarily involves conjugation reactions. False
(D)Drugs with low hepatic extraction ratios are significantly affected by blood flow True
(E)Metabolized drugs are always less active than the parent drug False
Explanation: Drugs with high hepatic extraction ratios are more affected by blood flow.
Metabolized drugs are not always less active; sometimes, metabolites can be active.
4. Adverse Drug Reactions:
(A)Type A adverse reactions are dose-dependent and predictable. True
(B)Type B adverse reactions are usually unpredictable and rare. True
(C)The therapeutic index is the ratio of a drug’s toxic dose to its effective dose. True
(D)Drug allergies are classified as Type A adverse reactions. False
(E)Adverse reactions can be managed by adjusting the drug dosage. True
Explanation: Drug allergies are classified as Type B reactions, and adverse reactions
may sometimes be managed by adjusting the dosage.
5. Drug Interactions-
(A)Enzyme inducers can increase drug metabolism. True
(B)Enzyme inhibitors can lead to toxic drug accumulation. True
(C)Synergism occurs when two drugs have additive effects. True
(D)Some drugs can reduce the efficacy of oral contraceptives. False
(E)Most drugs do not interact with food. True
Explanation: Food can significantly interact with certain drugs, affecting absorption and
metabolism.
6. Mechanism of Action-
(A)Local anesthetics block sodium channels in nerves. True
(B)Lidocaine is classified as an amide local anesthetic. True
(C)Local anesthetics work by depolarizing nerve membranes. False
(D)Local anesthetics are more effective in their ionized form False
(E)Local anesthetics have less effect on sensory than motor fibers. True
Explanation: Local anesthetics prevent depolarization, not cause it. They are more
effective in their non-ionized form for membrane penetration.
7. Classification and Pharmacokinetics-
(A)Ester-type anesthetics are primarily metabolized by pseudocholinesterase. True
(B)Amide-type anesthetics are metabolized in the liver. True
(C)Bupivacaine has a higher cardiotoxicity than lidocaine. True
(D)Tetracaine is suitable for long-duration spinal anesthesia. True
(E)Epinephrine prolongs the effect of local anesthetics. True
Explanation: All statements are correct regarding the classification and
pharmacokinetics of local anesthetics.
8. Side Effects:
(A)CNS toxicity of local anesthetics often manifests as seizures. True
(B)Cardiovascular toxicity is more common with ester local anesthetics. False
(C)Methemoglobinemia is a known adverse effect of prilocaine. True
(D)Hypersensitivity reactions are more common with amide anesthetics. False
(E)Lidocaine can cause both CNS and cardiovascular side effects. True
Explanation: Cardiovascular toxicity is more common with amides; hypersensitivity is
more with esters.
9. Local anaesthetics exert their effect –
(A)Increasing K+ conductance False
(B)Blocking Na channels in the nerve True
(C)Initiating Na +k+ATPase pump False
(D)Blocking postsynaptic receptor activation True
(E)GABA receptor stimulator False
Explanation: Ref: Smith/P-90,91
10. Dosing and Administration-
(A)Local anesthetics have a maximum safe dose limit. True
(B)Adding bicarbonate can speed the onset of local anesthetics. True
(C)Local anesthetic dosing should be adjusted for elderly patients. True
(D)Chloropropane is an amide local anesthetic. False
(E)Epinephrine is used to reduce the systemic absorption of local anesthetics. True
Explanation: Chloropropane is an ester, not an amide anesthetic.
11. Failure of antimicrobial therapy is due to –
(A)Inappropriate dose True
(B)Anti microbial resistance True
(C)Appropriate drug False
(D)Interval between dose is too long True
(E)All above False
12. Classes of Antiemetics:
(A)Dopamine antagonists include metoclopramide and haloperidol. True
(B)5-HT3 antagonists are primarily used for postoperative nausea. True
(C)Antihistamines can be sedative. False
(D)Neurokinin-1 receptor antagonists are typically used in chemotherapy True
(E)Cannabinoids are only used in motion sickness. False
Explanation: Cannabinoids are used for nausea in chemotherapy, not just motion
sickness
13. Side Effects:
(A)Ondansetron can cause QT prolongation. True
(B)Dopamine antagonists can cause extrapyramidal symptoms. True
(C)Antihistamines frequently cause dry mouth. True
(D)Metoclopramide is safe for long-term use. False
(E)Neurokinin-1 antagonists have no significant drug interactions
False
Explanation: Metoclopramide is not recommended for long-term use due to side
effects, and neurokinin-1 antagonists may have drug interactions.
14. Plasma Half life of a drug depends on ?
(A)Peak action of drug False
(B)Plasma protein binding True
(C)Drug affinity False
(D)Elimination of drugs True
(E)Drugs Biotransformation True
15. Causes of decrease bioavailability are-
(A)High first pass metabolism True
(B)Increased absorption False
(C)Poor lipid solubility True
(D)Intravenous absorption of drugs False
(E)Ionization of the drugs True
16. Which of the following routes bypasses first-pass metabolism? Sublingual
Explanation: Sublingual administration bypasses the first-pass effect, allowing the drug
to enter systemic circulation directly.
17. The therapeutic index of a drug is best defined as the ratio of: Toxic dose to
effective dose
Explanation: The therapeutic index is a measure of drug safety, calculated as the ratio
of the toxic dose to the effective dose.
18. Which of the following is an example of a competitive antagonist? Naloxone
Explanation: Naloxone is a competitive antagonist at opioid receptors, used to reverse
opioid toxicity.
19. Which factor primarily affects the volume of distribution of a drug? Lipid solubility
Explanation: Lipid solubility significantly affects the volume of distribution, as lipid-
soluble drugs tend to distribute more widely in body tissues.
20. An adverse reaction that is dose-independent and unpredictable is classified
as: Type B
Explanation: Type B reactions are dose-independent, unpredictable adverse drug
reactions, often related to drug allergies.
21. Which of the following local anesthetics is classified as an ester? Tetracaine
Explanation: Tetracaine is an ester-type local anesthetic, typically metabolized by
plasma cholinesterase.
22. The maximum recommended safe dose of lidocaine for infiltration anesthesia in
adults without epinephrine is: 5 mg/kg
Explanation: The maximum safe dose of lidocaine without epinephrine for infiltration is
generally 5 mg/kg in adults.
23. Which of the following local anesthetics is most cardiotoxic? Bupivacaine
Explanation:Bupivacaine is known for its higher risk of cardiotoxicity compared to other
local anesthetics.
24. Which of the following is added to local anesthetics to prolong their duration of
action? Epinephrine
Explanation: Epinephrine prolongs the duration of local anesthetics by reducing their
systemic absorption.
25. Which of the following is commonly used for spinal anesthesia in obstetrics due to
its lower risk of fetal transfer? Ropivacaine
Explanation: Ropivacaine is preferred in obstetrics due to its lower risk of motor
blockade and reduced fetal transfer compared to bupivacaine.
26. Which of the following drugs is a serotonin (5-HT3) receptor antagonist used for
postoperative nausea? Ondansetron
Explanation: Ondansetron is a 5-HT3 receptor antagonist commonly used to prevent
and treat postoperative and chemotherapy-induced nausea and vomiting.
27. The complication seen more often in Epidural anesthesia ? Urinary retention
28. For the prevention of delayed chemotherapy-induced nausea and vomiting, which
receptor antagonist is most effective? Neurokinin-1 (NK1) receptor antagonist
Explanation: NK1 receptor antagonists, such as aprepitant, are effective in preventing
delayed chemotherapy-induced nausea and vomiting.
29. Which of the following antiemetics is most effective for motion sickness?
Scopolamine
Explanation: Scopolamine, an anticholinergic agent, is highly effective for preventing
motion sickness.
30. In case of epidural anaesthesia, which regimen is mainly used for anaesthesia ?
Bupivacaine
Explanation:
Ref: Smith/P-817
