Pharmacology MCQ Practice dated 13/06/2022
PART I Hypnotic drugs
01. Hypnotic drugs are used to treat:
a) Psychosis
b) Sleep disorders
c) Narcolepsy
d) Parkinsonian disorders
02. Hypnotic drugs should:
a) Reduce anxiety and exert a calming effect
b) Induce absence of sensation
c) Produce drowsiness, encourage the onset and maintenance of sleep
d) Prevent mood swings in patients with bipolar affective disorders
03. Which of the following chemical agents are used in the treatment of insomnia?
a) Benzodiazepines
b) Imidazopyridines
c) Barbiturates
d) All of the above
04. Select a hypnotic drug, which is a benzodiazepine derivative:
a) Zolpidem
b) Flurazepam
c) Secobarbital
d) Phenobarbitone
05. Tick a hypnotic agent – a barbituric acid derivative:
a) Flurazepam
b) Zaleplon
c) Thiopental
d) Triazolam
06. Select a hypnotic drug, which is an imidazopyridine derivative:
a) Pentobarbital
b) Temazepam
c) Zolpidem
d) Chloral hydrate
07. Which of the following hypnotic agents is absorbed slowly?
a) Phenobarbital
b) Flurazepam
c) Triazolam
d) Temazepam
08. Which of the following barbiturates is an ultra-short-acting drug?
a) Secobarbital
b) Amobarbital
c) Thiopental
d) Phenobarbital
09. Indicate the barbituric acid derivative, which has 4-5 days elimination half-life:
a) Secobarbital
b) Thiopental
c) Phenobarbital
d) Amobarbital
10. Indicate the hypnotic benzodiazepine, which has the shortest elimination half-life:
a) Temazepam
b) Triazolam
c) Flurazepam
d) Diazepam
11. Which of the following hypnotic drugs is more likely to cause cumulative and residual
effects?
a) Zolpidem
b) Temazepam
c) Phenobarbital
d) Triazolam
12. Which of the following hypnotic drugs increases the activity of hepatic drug-
metabolizing enzyme systems?
a) Phenobarbital
b) Zolpidem
c) Flurazepam
d) Zaleplon
13. Hepatic microsomal drug-metabolizing enzyme induction leads to:
a) Barbiturate tolerance
b) Cumulative effects
c) Development of physical dependence
d) “hangover” effects
14. Hypnotic benzodiazepines are more powerful enzyme inducers than barbiturates.
a) True
b) False
15. Indicate the hypnotic drug, which does not change hepatic drug-metabolizing enzyme
activity?
a) Flurazepam
b) Zaleplon
c) Triazolam
d) All of the above
16. Barbiturates increase the rate of metabolism of:
a) Anticoagulants
b) Digitalis compounds
c) Glucocorticoids
d) All of the above
17. Which of the following agents inhibits hepatic metabolism of hypnotics?
a) Flumasenil
b) Cimetidin
c) Phenytoin
d) Theophylline
18. Which of the following factors can influence the biodisposition of hypnotic agents?
a) Alterations in the hepatic function resulting from a disease
b) Old age
c) Drug-induced increases or decreases in microsomal enzyme activities
d) All of the above
19. Which of the following hypnotics is preferred for elderly patients?
a) Phenobarbital
b) Flurozepam
c) Temazepam
d) Secobarbital
20. Which of the following hypnotics is preferred in patients with limited hepatic function?
a) Zolpidem
b) Amobarbital
c) Flurozepam
d) Pentobarbital
21. Indicate the mechanism of barbiturate action (at hypnotic doses):
a) Increasing the duration of the GABA-gated Cl- channel openings
b) Directly activating the chloride channels
c) Increasing the frequency of Cl- channel opening events
d) All of the above
22. Imidazopyridines are:
a) Partial agonists at brain 5-TH1A receptors
b) Selective agonists of the BZ1 (omega1) subtype of BZ receptors
c) Competitive antagonists of BZ receptors
d) Nonselective agonists of both BZ1 and BZ2 receptor subtypes
23. Which of the following hypnotic agents is a positive allosteric modulator of GABAA
receptor function?
a) Zaleplon
b) Flurazepam
c) Zolpidem
d) All of the above
24. Indicate a hypnotic drug - a selective agonist at the BZ1 receptor subtype:
a) Flurazepam
b) Zolpidem
c) Triazolam
d) Flumazenil
25. Which of the following hypnotic agents is able to interact with both BZ1 and BZ2
receptor subtypes?
a) Zaleplon
b) Phenobarbital
c) Flurazepam
d) Zolpidem
26. Indicate the competitive antagonist of BZ receptors:
a) Flumazenil
b) Picrotoxin
c) Zolpidem
d) Temazepam
27. Flumazenil blocks the actions of:
a) Phenobarbital
b) Morphine
c) Zolpidem
d) Ethanol
28. Indicate the agent, which interferes with GABA binding:
a) Flurazepam
b) Bicuculline
c) Thiopental
d) Zolpidem
29. Which of the following agents blocks the chloride channel directly?
a) Secobarbital
b) Flumazenil
c) Zaleplon
d) Picrotoxin
30. Which of the following agents is preferred in the treatment of insomnia?
a) Barbiturates
b) Hypnotic benzodiazepines
c) Ethanol
d) Phenothiazide
31. Barbiturates are being replaced by hypnotic benzodiazepines because of:
a) Low therapeutic index
b) Suppression in REM sleep
c) High potential of physical dependence and abuse
d) All of the above
32. Which of the following benzodiazepines is used mainly for hypnosis?
a) Clonozepam
b) Lorazepam
c) Flurazepam
d) Midazolam
33. Indicate the main claim for an ideal hypnotic agent:
a) Rapid onset and sufficient duration of action
b) Minor effects on sleep patterns
c) Minimal “hangover” effects
d) All of the above
34. Which stage of sleep is responsible for the incidence of dreams?
a) REM sleep
b) Slow wave sleep
c) Stage 2NREM sleep
d) All of the above
35. During slow wave sleep (stage 3 and 4 NREM sleep):
a) Dreams occur
b) The secretion of adrenal steroids is at its highest
c) Somnambulism and nightmares occur
d) The secretion of somatotropin is at its lowest
36. All of the hypnotic drugs induce:
a) Increase the duration of REM sleep
b) Decrease the duration of REM sleep
c) Do not alter the duration of REM sleep
d) Increase the duration of slow wave sleep
37. Which of the following hypnotic drugs causes least suppression of REM sleep?
a) Flumazenil
b) Phenobarbital
c) Flurazepam
d) Secobarbital
38. Although the benzodiazepines continue to be the agents of choice for insomnia, they
have:
a) The possibility of psychological and physiological dependence
b) Synergistic depression of CNS with other drugs (especially alcohol)
c) Residual drowsiness and daytime sedation
d) All of the above
39. Hypnotic benzodiazepines can cause:
a) A dose-dependent increase in both REM and slow wave sleep
b) Do not change sleep patterns
c) A dose-dependent decrease in both REM and slow wave sleep
d) A dose-dependent increase in REM sleep and decrease in slow wave sleep
40. Which one of the following hypnotic benzodiazepines is more likely to cause rebound
insomnia?
a) Triazolam
b) Flurazepam
c) Temazepam
d) All of the above
41. Which of the following hypnotic benzodiazepines is more likely to cause “hangover”
effects such as drowsiness, dysphoria, and mental or motor depression the following
day?
a) Temazepam
b) Triazolam
c) Flurazepam
d) None of the above
42. Indicate the hypnotic drug, which binds selectively to the BZ1 receptor subtype,
facilitating GABAergic inhibition:
a) Thiopental
b) Zolpidem
c) Flurazepam
d) Phenobarbital
43. Which of the following statements is correct for zolpidem?
a) Causes minor effects on sleep patterns
b) The risk of development of tolerance and dependence is less than with the use of
hypnotic benzodiazepines
c) Has minimal muscle relaxing and anticonvulsant effects
d) All of the above
44. Which agent exerts hypnotic activity with minimal muscle relaxing and anticonvulsant
effects?
a) Flurazepam
b) Triazolam
c) Zaleplon
d) None of the above
45. Zolpidem and zaleplon have effectiveness similar to that of hypnotic benzodiazepines
in the management of sleep disorders.
a) True
b) False
46. Which of the following hypnotic drugs is used intravenously as anesthesia?
a) Thiopental
b) Phenobarbital
c) Flurazepam
d) Zolpidem
47. Indicate the usual cause of death due to overdose of hypnotics:
a) Depression of the medullar respiratory center
b) Hypothermia
c) Cerebral edema
d) Status epilepticus
48. Toxic doses of hypnotics may cause a circulatory collapse as a result of:
a) Blocking alfa adrenergic receptors
b) Increasing vagal tone
c) Action on the medullar vasomotor center
d) All of the above
PART III Antiparkinsonian agents
01. Which neurons are involved in parkinsonism?
a) Cholinergic neurons
b) GABAergic neurons
c) Dopaminergic neurons
d) All of the above
02. The pathophysiologic basis for antiparkinsonism therapy is:
a) A selective loss of dopaminergic neurons
b) The loss of some cholinergic neurons
c) The loss of the GABAergic cells
d) The loss of glutamatergic neurons
03. Which of the following neurotransmitters is involved in Parkinson′s disease?
a) Acetylcholine
b) Glutamate
c) Dopamine
d) All of the above
04. The concentration of dopamine in the basal ganglia of the brain is reduced in
parkinsonism.
a) True
b) False
05. Principal aim for treatment of Parkinsonian disorders is:
a) To restore the normal balance of cholinergic and dopaminergic influences on the
basal ganglia with antimuscarinic drugs
b) To restore dopaminergic activity with levodopa and dopamine agonists
c) To decrease glutamatergic activity with glutamate antagonists
d) All of the above
06. Indicate the drug that induces parkinsonian syndromes:
a) Chlorpromazine
b) Diazepam
c) Triazolam
d) Carbamazepine
07. Which of the following drugs is used in the treatment of Parkinsonian disorders?
a) Phenytoin
b) Selegiline
c) Haloperidol
d) Fluoxetine
08. Select the agent, which is preferred in the treatment of the drug-induced form of
parkinsonism:
a) Levodopa
b) Bromocriptine
c) Benztropine
d) Dopamine
09. Which of the following agents is the precursor of dopamine?
a) Bromocriptine
b) Levodopa
c) Selegiline
d) Amantadine
10. The main reason for giving levodopa, the precursor of dopamine, instead of dopamine is:
a) Dopamine does not cross the blood-brain barrier
b) Dopamine may induce acute psychotic reactions
c) Dopamine is intensively metabolized in humans
d) All of the above
11. Indicate a peripheral dopa decarboxylase inhibitor:
a) Tolcapone
b) Clozapine
c) Carbidopa
d) Selegiline
12. The mechanism of carbidopa′s action is:
a) Stimulating the synthesis, release, or reuptake of dopamine
b) Inhibition of dopa decarboxilase
c) Stimulating dopamine receptors
d) Selective inhibition of catecol-O-methyltransferase
13. Carbidopa is unable to penetrate the blood-brain barrier, it acts to reduce the peripheral
conversion of levodopa to dopamine.
a) True
b) False
14. When carbidopa and levodopa are given concomitantly:
a) Levodopa blood levels are increased, and drug half-life is lengthened
b) The dose of levodopa can be significantly reduced (by 75%), also reducing toxic side
effects
c) A shorter latency period precedes the occurrence of beneficial effects
d) All of the above
15. Which of the following preparations combines carbidopa and levodopa in a fixed
proportion?
a) Selegiline
b) Sinemet
c) Tolkapone
d) Biperiden
16. Which of the following statements is correct for levodopa?
a) Tolerance to both beneficial and adverse effects develops gradually
b) Levodopa is most effective in the first 2-5 years of treatment
c) After 5 years of therapy, patients have dose-related dyskinesias, inadequate response
or toxicity
d) All of the above
17. Gastrointestinal irritation, cardiovascular effects, including tachycardia, arrhythmias,
and orthostatic hypotension, mental disturbances, and withdrawal are possible adverse
effects of:
a) Amantadine
b) Benztropine
c) Levodopa
d) Selegiline
18. Which of the following agents is the most helpful in counteracting the behavioral
complications of levodopa?
a) Tolkapone
b) Clozapine
c) Carbidopa
d) Pergolide
19. Which of the following vitamins reduces the beneficial effects of levodopa by enhancing
its extracerebral metabolism?
a) Pyridoxine
b) Thiamine
c) Tocopherol
d) Riboflavin
20. Which of the following drugs antagonizes the effects of levodopa because it leads to a
junctional blockade of dopamine action?
a) Reserpine
b) Haloperidol
c) Chlorpromazine
d) All of the above
21. Levodopa should not be given to patients taking:
a) Bromocriptine
b) Monoamine oxydase A inhibitors
c) Carbidopa
d) Nonselective beta-adrenergic antagonists
22. Indicate D2 receptor agonist with antiparkinsonian activity:
a) Sinemet
b) Levodopa
c) Bromocriptine
d) Selegiline
23. Which of the following antiparkinsonian drugs has also been used to treat
hyperprolactinemia?
a) Benztropine
b) Bromocriptine
c) Amantadine
d) Levodopa
24. Indicate a selective inhibitor of monoamine oxidase B:
a) Levodopa
b) Amantadine
c) Tolcapone
d) Selegiline
25. Which of the following statements is correct?
a) MAO-A metabolizes dopamine; MAO-B metabolizes serotonin
b) MAO-A metabolizes norepinephrine and dopamine; MAO-B metabolizes serotonin
c) MAO-A metabolizes norepinephrine and serotonin; MAO-B metabolizes dopamine
d) MAO-A metabolizes dopamine; MAO-B metabolizes norepinephrine and serotonin
26. Treatment with selegilin postpones the need for levodopa for 3-9 months and may
retard the progression of Parkinson′s disease.
a) True
b) False
27. The main reason for avoiding the combined administration of levodopa and an inhibitor
of both forms of monoamine oxidase is:
a) Respiratory depression
b) Hypertensive emergency
c) Acute psychotic reactions
d) Cardiovascular collapse and CNS depression
28. Indicate selective catechol-O-methyltransferase inhibitor, which prolongs the action of
levodopa by diminishing its peripheral metabolism:
a) Carbidopa
b) Clozapine
c) Tolcapone
d) Rasagiline
29. Which of the following antiparkinsonian drugs is an antiviral agent used in the
prophylaxis of influenza A2?
a) Selegiline
b) Sinemet
c) Pergolide
d) Amantadine
30. The mechanism of amantadine action is:
a) Stimulating the glutamatergic neurotransmission
b) Blocking the excitatory cholinergic system
c) Inhibition of dopa decarboxilase
d) Selective inhibition of catechol-O-methyltransferase
31. Which of the following antiparkinsonism drugs is an anticholinergic agent?
a) Amantadine
b) Selegilin
c) Trihexyphenidyl
d) Bromocriptine
32. Mental confusion and hallucinations, peripheral atropine-like toxicity (e.g.Cycloplegia,
tachycardia, urinary retention, and constipation) are possible adverse effects of:
a) Sinemet
b) Benztropine
c) Tolkapone
d) Bromocriptine
33. Indicate the antiparkinsonism drug which should be avoided in patients with glaucoma:
a) Selegilin
b) Levodopa
c) Bromocriptine
d) Trihexyphenidyl
