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Pharmacology Quiz Questions for Exam 1

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Jak/Stat Pathway of signal transduction responds to activation by--
Cytokines
In the growth factor kinase cascade, Map (Mitogen-activated protein) kinase acts to phosphorylate--
Transcription Factors
Which second messenger in a G protein coupled receptor signal transduction cascade typically increases intracellular calcium
Inositol triphosphate
Which signal transduction pathway is most important in cell division, growth, and differentiation---
Ras/Raf/ Map Kinase
Coupling of a G protein alpha subunit to an agonist occupied receptor initially leads to
Exchange of bound GDP with GTP
The Nicotinic receptor is an example of a
Ligand gated ion channel
In G protein coupled receptor signal transduction, protein kinase A is typically activated by
Cyclic AMP
An agonist for a ligand gated ion channel typically-
Increases the number of open channels
Diacylgycerol (DAG) produces its intracellular effects by
Activating protein kinase C
Class 1 nuclear receptors that control gene transcription
Bind to hormone response elements of DNA
Myasthenia gravis is a disease in which
Autoantibodies are directed against receptor proteins
Receptors for insulin---
Contain tyrosine kinase in their intracellular domain
Which ion inhibits an enzyme (inositol- 1-phosphatase) in the phosphoinositol cycle---
Lithium
The opening of chloride ion channels by gamma-amino butyric acid is facilitated by--
Benzodiazepine drugs
The most rapid response is produced by activation of
Ionotropic receptors
Which type of receptors contains seven transmembrane helices--
G protein coupled receptors
The treatment of chronic myeloid leukemia with imatinib results from the ability of the drug to inhibit a specific----
Tyrosine kinase
Which receptors are activated by proteolytic cleavage and inactivated by phosphorylation---
Thrombin receptors
Which receptors are entirely located intracellulary---
Thyroid hormone receptors
L (long-lasting)- type calcium channels are correctly described as having--
High activation threshold and slow inactivation
The extrusion of calcium from the cell cytoplasm primarily depends on
The ATP-driven calcium pump
The mechanism by which monamine neurotransmitters are released from nerve terminals is---
Calcium - mediated exocytosis
Batrochotoxin binds sodium channels and thereby ---
Prevents channel inactivation
Closure of potassium channels in excitable membranes causes membrane----
Depolarization
In smooth muscle, inositol triphosphate releases calcium from the ----
Sarcoplasmic reticulum
Calcium facilitates the release of nitric oxide by --
Activating nitric oxide synthase
Amiloride affects epithelial ion transport by blocking---
Sodium channels
In the colon, chloride transport is important in---
Fluid reabsorption
A key step in causing smooth muscle contraction is the phosphorylation of----
Myosin light chain
Adrenergic beta-receptor agonists cause smooth muscle relaxation by---
Increasing cyclic AMP formation
The main problem with all types of bioassay is --
Biological variation
If the dose-response curve of two drugs are parallel in a bioassay, it usually indicated that the two drugs ---
Act on the same type of receptors
Quantal dose-response curves are obtained when studying---
All or nothing responses
Transgenic mice that overexpress mutilated forms of amyloid precursor protein provide a useful model for studying---
Alzheimer's disease
Transgenic animal models referred to as Knock outs---
Result from inactivation of an existing gene
Ch8Concerning the effect of pH on the urinary excretion of drugs, it can be correctly stated that--
Urinary alkalinization accelerates excretion of weak acids
Bioavailability is defined as the proportion of ingested drug that---
Reaches the systemic circulation in an active form.
The rectal route of administration ----
Is suitable for persons with nausea and vomiting
The passage of drugs across the blood-brain barrier
Occurs more readily in the chemoreceptor trigger zone
A calculated volume of distribution greater than total body water is most likely to occur with drugs that are
Highly lipid soluble
Drugs are most readily absorbed across cells of the
Vascular endothelium
The binding of drugs to plasma albumin
Is saturable
Most drugs are absorbed across cell membranes of the gut by the process of
Diffusing through aqueous pores
Which drug is absorbed by a membrane carrier that transports phenylalanine?
Levodopa
Transdermal drug administration
Is not subject to first pass hepatic metabolism
Which is true
A non selective carrier actively transports acidic drugs into the proximal tubule,
A non selective carrier actively transports basic drugs into the proximal tubule.
The un ionized forms of drugs that are weak acids or weak bases undergo passive reabsorption in the proximal tubule.
With an acid filtrate, weak bases tend to remain in the tubule and are excreted.

With an acid filtrate, weak acids will be less ionized and therefore more readily reabsorbed
T/F: Biliary excretion may be the main elimination route for some drugs
True
T/F: The unionized forms of drugs can be excreted in saliva, sweat and tears
Some drugs can be excreted in milk
Drugs may be effectively excreted via the lungs
True
T/F: Biotransformation of drugs commonly inbolves two types of biochemical reactions referred to as phase 1 and phase 2 reactions
True
T/F: Drug metabolism usually renders a drug less lipid soluble and more water solube
The phase 1 reactions include oxidation, reduction and hydrolysis of drugs
True
T/F: The key enxymes in the hepatic microsomal oxidation of drugs are from the cytochrome P450 family
Phase 1 reactions commonsly introduce a reactive group into the drug molecule which serves as a point of attack for a phase 2 reaction
Hydrolytic reactions are not usually catalyzed by hepatic microsomal enzymes
True
T/F: Substituent groups involved in phase 2 reactions include glutathione, glucuronyl, acetyl, sulfate, methyl, glycyl
Virtually all conjugates are pharmacologically inactive
True
T/F: Some drugs eg. Carbamazepine, can increase the metabolism of other drugs by inducing the metabolizing enzymes
Induction of the hepatic microsomal enzymes involves increasing the rate of enzymic reaction
Induction of metabolizing enzymes may enhance the toxicity of parecetamol.
True
T/F: The pharmacological action of some drugs , given orally , is reduced because they undergo first pass metabolism
Some drugs become pharmacologically active only after metabolism
True
Which apply to elimination of drugs from the kidney
Because of pH partition, weak acids are more slowly excreted in alkaline urine, and vice versa.
Several important drugs are removed predominantly by renal excretion, and are liable to cause toxicity in elderly persons and patients w renal disease.
Drug elimination and pharmacokineticsHepatic cytochrome P450 drug metabolizing enzymes are primarily found in ---
The smooth endoplasmic reticulum
Phase 2 drug metabolism usually forms what?
Usually forms inactive metabolites
Ketoconazole produces non-competive inhibition of cytochrome P4450
Binding to the ferric form of heme iron
In the first order drug elimination
The rate of elimination is directly proportional to drug concentration
If a drug is administered repeatedly at the same dose and dosage interval, the time required to reach the steady state plasma drug concentration is proportional to the
Elimination half life
If a drug exhibits saturation (zero order) kinetics , then
The rate of drug elimination is constant
In the two compartment pharmacokinetic model, orally administered drugs are
Distributed from the central to the peripheral compartment
Which of the following will be increased if the rate of drug absorption from the gut is reduced?
Duration of action
The volume of plasma from which a drug is eliminated in a unit of time is known as the
Clearance
Inactive pro drugs have been developed to
Increase drug absorption
** Pharmokinetics--- What does the term first order kinetics mean when applied to the elimination of drug from the body?
It means that the concept of a half life can be applied to the plasma conc of the drug.
-A half life for the drug can be quoted. First order kinetics yields an exponential decline in the plasma conc of drug. In a given time interval the same fraction of the remaining drug will be eliminated.
It predicts that the plasma conc of the drug will decline exponentially.
A drug is infused at 10 mg/min and the plasma conc rises to a steady state of 2 mg/ ml. What is the clearance in ml/min?
5 ml/ min
Clearance = 10 (mg/min)/2(mg/ml) = 5 ml/min
Administration rate= elimination rate
Elimination rate = Css x clearance
At equilibrium, a drug is distributed uniformly in the extracellular fluid, is excreted unchanged by glomerular filtration, and is not reabsorbed. What would be the approx. half life of this drug. Single compartment kinetics are assumed. Assume vol of extracellular fluid is 12 liters and that the glomerular filtration rate is 125 ml. min-1
66 min.
Half life = .693 x vol of distribution / clearance

.693 x 12000 / 125 = 66 minutes
Given the data , what is the patients glomerular filtration rate? Inulin (freely filterd at the glomerulus and is not secreted, reabsorbed or metabolized by tubules) was fiven by intravenous infusion at a constant rate. The following values were obtained----
Plasma steady state conc = 4 mg/l
7.5 l/ h
Clearance = elimination rate / Css

GFR = (300 x .1) / 4 = 7.5 l/h
Ch 12 and 13
Chemical mediators and autonomic nervous syst
Cholerginic The release of Ach from cholinergic nerve terminals is stimulated by
Nitric oxide
Co transmitters released from postganglionic sympathetic neurons include
Adenosine triphosphate
ATP
Constriction of bronchi is typically produced by activation of
Muscarinic M3 receptors
Activation of adrenergic beta-2 receptors produces
Relaxation of the ciliary muscle
The enteric system is primarily concerned with the regulation of
Gastrointestinal motility
The co transmitter known as neuropeptide Y enhances the
Vasoconstrictive effect of norepinephrine
The final step in the release of norepinephrine from sympathetic neurons is
Exocytosis
In the parasympathetic nervous system, neurotransmitter action is terminated by
Enzymatic degredation
The enteric nervous system
Releases several peptide neurotransmitters and
Nitric oxide
Ch 13Activation of muscarinic M2 receptors
Increases potassium conductance
Succinylcholine is characteristically an agonist at
Nicotinic receptors in skeletal muscle
The second messengers formed by activation of muscarinic achtylcholine receptors include
Inositol triphosphate
Pilocarpine lowers intraocular pressure by
Contracting the ciliary muscle
The increased release of potassium from denervated muscles by succinylcholine is due to
Denervation supersensitivity
Edrophonium produces reversible inhibition of cholinersterase by
Binding the anionic site
Pyridostigmine enhances neuromuscular transmission in myasthenia gravis patients by
Inhibiting degradation of acetylcholine
Activation of muscarinic M3 receptors leads to
Exocrine gland secretion
The effects produced by topical ocular administration of atropine include
Mydriasis
If a test dose of edrophonium increases muscle weakness in a myasthenia gravis patient being treated with pyridostigmine, it means that
The dose of pyridostigmine is too high
Atropine poisoning in children typically causes
Hyperthermia
Persons with a genetic variant conferring abnormal plasma cholinesterase activity may exhibit prolonged muscle paralysis following administration of
Succinylcholine
The release of acetylcholine from cholinergic nerve terminals is blocked by
Botulinum toxin
Scopolamine is employed clinically in the prevention or treatment of
Motion sickness
The neuromuscular blockade produced by atracurium can be reversed by administration of
Neostigmine
Transient muscle fasciculations followed by paralysis typically occur after administration of
Succinylcholine
CH 14 Noradrenergic Transmission-(Quest Bank)An intravenous infusion of norepinephrine typically---
Increase peripheral resistance and decrease heart rate
In the liver, epinephrine acts via adrenergic beta-2 receptors to
Stimulate phosphorylase and inhibit glycogen synthase
Which drug inhibits the transport of norepinephrine into synaptic vesicles, thereby leading to neurotransmitter depletion---
Reserpine
Doxazosin is an example of a
Selective alpha-1 adrenoceptor antagonist
Irreversible blockade of alpha-adrenoceptors results from covalent binding of these receptors by----
Phenoxybenzamine
The reuptake of norepinephrine by presynaptic nerve terminals (uptake 1) is inhibited by---
Cocaine
The first-line treatment for acute severe type 1 hypersensitivity reactions is ---
Epinephrine
Which adrenergic receptor antagonist increases heart rate at rest but reduces it during exercise---
Pindolol
In the peripheral tissues, the primary end product of norepinephrine metabolism is ---
Vanillylmandelic acid
The adverse effects of beta-adrenoceptor antogonists include
Bronchoconstriction
Selective beta- 3- adrenoceptor agonists are potentially useful in treating obesity because of their ability to
Increase thermogenesis
Symptoms of urinary retention due to benign prostatic hyperplasia may be improved by --
Alpha- 1 - adrenoceptor antagonists
Persons with acute thyrotoxicosis are often treated with propranolol because it--
Decreases cardiac stimulation
Persons with pheochromocytoma may benefit from administration of methyltyrosine because of its ability to
Inhibit norepinephrine synthesis
Which is main clinically important transmitter at junction of the sympathetic postganglionic neuron with smooth muscle
Noradrenaline- it is the important transmitter released from postganglionic sympathetic nerves
Other facts
Dopamine is a precursor for noradrenaline, and is a neurotransmitter in its own right

Adrenaline is a hormone secreted by the adrenal medulla

Acetylcholine is an important neurotransmitter in peripheral nerves
Which is main clinically important transmitter at the junction of the sympathetic preganglionic neuron with postganglionic neurons
Acetylcholine—is the neurotransmitter in sympathetic ganglia
Which is main clinically important transmitter at the junction of the sympathetic preganglionic neurone with the adrenal medulla
Acetylcholine- These preganglionic fibers, sympathetic in origin, use acetylcholine as the neurotransmitter.
Which is the main clinically important transmitter at the junction of the sympathetic postganglionic neuron with sweat glands?
Acetylcholine- released from postganglionic sympathetic neurons, is the transmitter that acts on sweat glands.
At the junction of the sympathetic postganglionic neuron with smooth muscle which of receptors has clinical importance in terms of being targets for drugs--
Alpha 1 adrenoceptors
And
Beta 2 adrenoceptors
At the junction of the sympathetic postganglionic neuron with sweat glands, which receptor has clinical importance
Muscarinic receptors—responsible for most of the secretory activity of sweat glands. Several useful drugs—Atropine in preanaesthetic meds—are antagonists of acetylcholine at these receptors
Which describe the effect of stimulating alpha 1 adrenoceptors
Contraction of vascular smooth muscle
Stimulation of glycogenolysis
Contraction of the radial muscle of the iris
Which statements describe the effects of stimulating beta adrenoreceptors
All of these are true, false modified to be true!
Beta 2- receptor stimulation relaxes bladder detrusor muscle.
Beta 2 receptor stimulation dilates the bronchioles
Beta 1 receptor stimulation increases the rate and force of the heart beat
Beta 2 receptor stimulation dilates the blood vessels
Beta 2 adrenoceptor stimulation results in glycogenolysis
Describe Beta 2 adrenoreceptors
Beta 2 adrenoreceptors cause relaxation of vascular smooth muscle.
Noradrenaline acting thru beta 2 adrenoceptors relaxes vascular smooth muscle by endothelium dependent nitric oxide release
Describe Beta 1 adrenoreceptors
Noradrenaline acting thru alpha 1 adrenoceptors contracts vascular smooth muscle
Beta 1 adrenoceptors are found mainly in the heart and not on vascular smooth muscle
Stimulation of alpha 1 adrenoceptors causes contraction of vascular smooth muscle
Beta 1 adrenoceptors occur mainly on cardiac muscle.
Noradrenaline acting thru beta 1 adrenoceptors increases the force of contraction of the heart
Describe Beta 3 adrenoreceptors
Beta 3 adrenoceptor mediates responses to catecholamines in adipose tissue, -Lipolysis and thermogenesis, also thermogenesis in skeletal muscle
Describe Alpha 2 adrenoreceptors
Alpha 2 adrenoceptors are found on sympathetic nerve terminals. When activated they decrease transmitter release
Which are important in noradrenaline synthesis
Active uptake of tyrosine into noradrenergic neurons.
Conversion of tyrosine to DOPA—the rate limiting step.
Which is true of the release of noradrenaline from synaptic nerve terminals
The action potential opens volatage gated calcium channels, allowing an influx of calcium- necessary for exocytosis- to the nerve ending
Which is true of the uptake mechanisms of nnoradrenaline—Only true ones are listed
Neuronal uptake involves active transport carrier(the norepinephrine transporter) on the noradrenergic varicosity.
About 75% of the NA released from sympathetic neurons is taken back up into the neuron by Neronal uptake by NET.
The substrate specificity of Neuronal uptake by NET is : NA> adrenaline> Isoproterenol.
Which is true of neuronal uptake—(all true)
Noradrenaline is a substrate - it is taken up into the neuron.
Amphetamine is taken up into the neuron.
Some tricyclic antidepressants (TCAs) are substrates.
Which is true of the enzymatic degradation of noradrenaline shown----
Monamine oxidase (MAO) acts within the varicosity
Which are true of adrenoceptor transduction mechanisms
The main second messenger system for alpha 1 effects involves a rise in intracellular calcium
Activation of presynaptic alpha 2 adrenoceptors results in inhibition of the opening of voltage dependent calcium channels
Which is true of beta adrenoceptor transduction mechanisms in smooth muscle.
Beta 2 adrenoceptors are all coupled to G proteins
The main intracellular messenger system for Beta 2 action is adenylyl cyclase/cyclic AMP
Beta 1 adrenoceptor stimulation in cardiac muscle cells results in increased intracellular calcium
Which is true of clinically useful drugs acting on adrenoceptors--
Phenylephrine is an alpha 1 adrenoceptor agonist.
Propranolol is a Beta 1 antagonist
Which is true of clinical use of adrenoceptor agonists--
Adrenaline(epinephrine) given intramuscularly is used to treat acute anaphylaxis
Salbutamol, given by inhalation is used to treat an asthma attack.
Which is true of adrenoceptor antagonists--
Phenoxybenzamine is a non selective irreversible antagonist on alpha 1 adrenoceptors
Doxazosin is a selective alpha 1 adrenoceptor antagonist.
Which is true of alpha adrenoceptor antagonists
Doxazosin an alpha 1 adrenoceptor antagonist is used to treat hypertension.
Tamulosin, a selective alpha 1a receptor antagonist is used to treat benign prostatic hypertrophy
Which statements describe the clinical use of beta adrenoceptor antagonists---
They are used to treat hypertension
They are used to treat angina pectoris
They are used preoperatively to reduce symptoms and gland vascularity in thyrotoxic patients
They are used to treat cardiac dysrhythmias.
Which are unwanted effects of beta adrenoceptor antagonists
Fall in blood sugar.
Fatigue.
Cause bronchoconstriction in some patients.
A statistical technique used to pool data from several independent but related studies is called
Meta-analysis
Describe Muscarinic receptors
Acetylcholine stimulates muscarinic receptors
Muscarinic receptors cause vascular muscle to relax, indirectly thru production of nitric oxide by the vascular endothelium