What is this structure called?
a) 6-acetylmorphine
b) 3-acetylmorphine
c) heterocodeine
d) heteromorphine
2. Propose the likely analgesic activity of 3-acetylmorphine relative to diamorphine and 6- acetylmorphine.
a) 3-acetylmorphine should be more active than 6-acetylmorphine and diamorphine.
b) 3-acetylmorphine should be less active than 6-acetylmorphine and diamorphine.
c) 3-acetylmorphine should be more active than 6-acetylmorphine and less active than diamorphine.
d) 3-acetylmorphine should be less active than 6-acetylmorphine and more active than diamorphine.
3. Levorphanol is an analgesic which is five times more active than morphine.
To which class of compounds does this structure belong?
a) Benzomorphans
b) 4-phenylpiperidines
c) Morphinans
d) Enkephalins
4. To what extent are the three nitrogens of histamine ionised at blood pH?
a) all three nitrogens are fully ionised
b) all three nitrogens are not ionised at all
c) the side chain nitrogen is fully ionised and the heterocyclic nitrogens are not ionised
d) the side chain nitrogen and one of the heterocyclic nitrogens are fully ionised
5. Three binding regions were proposed to be present in the binding site of the H2 receptor. Which of the following statements is incorrect?
a) There is a binding region for the imidazole ring of histamine analogues which is common for agonists and antagonists.
b) There is a binding region which interacts ionically with the α-nitrogen of histamine and results in agonist activity.
c) There is a binding region further away from the imidazole ring that produces an antagonist effect if occupied.
d) The α-nitrogen of histamine can only bind to the agonist binding region while the guanyl group of Nα-guanylhistamine can only bind to the antagonist binding region.
6. Codeine acts as a cough sedative by
(a) Producing mild nausea
(b) Depressing bronchiolar secretions
(c) Depressing pulmonary action
(d) Depressing cough center
7. The greatest threat from morphine poisoning is
(a) Renal shutdown
(b) Paralysis of spinal cord
(c) Respiratory depression
(d) None of the above
8. A very common side effect of morphineis
(a) Allergic response
(b) Blood dyscrasias
(c) Constipation
(d) Visceral pain
9. Morphine produces analgesia by acting at
(a) Peripheral pain receptors
(b) A spinal site
(c) Suspraspinal sites
(d) Both (b) and (c)
10. In man sedation caused by morphine is characterized by
(a) Initial excitement
(b) Little or no motor incoordination
(c) Rise in seizure threshold
(d) All of the above
11. Instead of depressing, morphine stimulates
(a) Vasomotor centre
(b) Edinger westphal nucleus
(c) Temperature regulating centre
(d) Cough centre
12. In a comatose patient suspected of poisoning, which of the following findings would be against the drug being morphine
(a) Selegiline
(b) Chlorgiline
(c) Moclobemide
(d) Tranylcypromine
13. Morphine dependence is characterized by
(a) Marked drug seeking behavior
(b) Physical dependence without psychic dependence
(c) Physical as well as psychic dependence
(d) Both (a) and (c)
14. Some drugs containing an ester group are inactive in vitro, but are active once the drug has been absorbed in vivo. What term is used for such drugs?
a) postdrugs
b) predrugs
c) metabolites
d) prodrugs
15. Esters are frequently used as prodrugs. Which of the following statements is false?
a) Ester prodrugs are more easily absorbed from the gut than the parent drug if the parent drug is highly polar.
b) Esters are more susceptible to hydrolysis if the alcohol moiety has an electron donating group.
c) Esters can be used to mask a polar alcohol, phenol or carboxylic acid group.
d) It is preferable if the leaving group from ester hydrolysis is a natural chemical such as an amino acid.
16. Fluphenazine decanoate is an ester prodrug for the antipsychotic drug fluphenazine, and is administered by intramuscular injection. Which of the following statements is true?
a) Hydrolysis of the ester reveals a carboxylic acid group on fluphenazine.
b) The ester is hydrophobic which means that it is taken up in fat tissue.
c) The ester is hydrophilic and rapidly enters the blood supply.
d) The ester is rapidly hydrolysed in blood since the pH of blood is slightly alkaline.
17. The following structure is an important medicine.
What is the structure called?
a) Diamorphine
b) Morphine
c) Codeine
d) Thebaine
18. Morphine is an important analgesic.
What interactions are involved in binding the phenol group to the target binding site?
a) Ionic interactions
b) Hydrogen bonding interactions
c) van der Waals binding interactions
d) The group has no binding role
19. The following structure is used as an analgesic.
What is the name of the structure?
a) Diamorphine
b) Morphine
c) Codeine
d) Thebaine
20. Codeine is used as an analgesic.
Which of the following statements is false?
a) The structure is a weaker analgesic than morphine.
b) The structure acts as a prodrug.
c) The structure is converted to morphine in the brain.
d) The coloured methyl group masks an important binding group. 21.Omeprazole is an important proton pump inhibitor.
Which region is prone to metabolism?
a) A
b) B
c) C
d) D
22. Which microorganism has been associated with the appearance of ulcers?
a) Eschericia coli
b) Staphylococcus aureus
c) Enterococcus faecalis
d) Helicobacter pylori
23. What bacterial enzyme aids the survival of Helicobacter pylori in the stomach? a)carbonic anhydrase
b) β-lactamase
c) urease
d) transpeptidase
24. Which of the following narcotics has thelongest duration of effect?
(a) Methadone
(b) Controlled-release morphine
(c) Levorphanol
(d) Transdermal fentanyl
25. The emetic action of morphine is due to
(a) Irritation of gastrointestinal tract
(b) Stimulation of cerebral cortex
(c) Stimulation of medullary vomiting center
(d) Stimulation of emetic chemoreceptor triggerzone
26. The following structures show some of the important molecules leading to the discovery of burimamide (B).
What strategy was used in developing burimamide from SK&F 91581?
a) extension
b) chain extension
c) substituent variation
d) isosteric replacement
27. The following structures show some of the important molecules leading to the discovery of burimamide (B).
Which of the following statements concerning burimamide is untrue?
a) It established the existence of H2-receptors
b) It was a good antagonist at H2 receptors with only weak partial agonist activity
c) It inhibited gastric acid release from parietal cells
d) It indicated that binding to the antagonist binding region involved hydrogen bonding and not ionic bonding
28. The following diagram shows development of H2-antagonists from burimamide (structure B).
A sulphur atom was inserted into the side chain of structure C. What effect did this change have?
a) it introduced an extra binding interaction
b) it stabilised the molecule
c) it increased the percentage population of the active heterocyclic tautome
d) it prevented ionisation of the terminal functional group
29. The following diagram shows development of H2-antagonists from burimamide (structure B).
What was the rationale for the introduction of the coloured methyl group?
a) to block metabolism at that region of the heterocyclic ring
b) to introduce a group which would be metabolised in a predictable fashion
c) to introduce an electron withdrawing group on the heterocyclic ring to reduce the chance of ionisation
d) to introduce an electron donating group on the heterocyclic ring to favour the active tautomer
30. The following diagram shows development of H2-antagonists from burimamide (structure B).
Why was the thiourea functional group in D changed to a guanidine group in E?
a) To introduce a basic group which could ionise and allow ionic interactions with the binding region.
b) To replace an unnatural functional group with a naturally occurring group in order to reduce side effects.
c) To increase the number of hydrogen bond donors present to acquire extra binding interactions.
d) To change the geometry and stereochemistry of the functional group such that it fitted the binding region more closely.
31. The following diagram shows development of H2-antagonists from burimamide (structure B).
Why was the cyanide group introduced into structure F (cimetidine)?
a) It is an electron donating group and increases the basicity of the functional group such that it
protonates and becomes ionised.
b) It is an electron withdrawing group and increases the basicity of the functional group such that it protonates and becomes ionised.
c) It is an electron donating group and decreases the basicity of the functional group such that it does not become protonated and remains un-ionised.
d) It is an electron withdrawing group and decreases the basicity of the functional group such that it does not become protonated and remains un-ionised.
32. All of the following diuretic inhibit Na+ K+ 2Cl- symporter except
a) Furosemide
b) Thiazide
c) Ethacrynic acid
d) Mersalyl
33. Thiazide diuretics does not cause
a) Hypercalcemia
b) Hypomagnesia
c) Hyperkalemia
d) Hyperuricemia
34. Drugs that can be used for producing alkalinization of urine is
a) Hydrochlrothiazide
b) Furosemide
c) Acetazolamide
d) Spironolactone
35. Canrenone is metabolite of
a) Ethacrynic acid
b) Amphicilin
c) Spironolactone
d) Furosemide
36. Cerebral edema is treated with
a) Osmotic diuretics
b) Furosemide
c) Acetazolamide
d) Thiazides
37. Anthranilic acid diuretic is
a) Furosemide
b) Mannitol
c) Bumethanide
d) Ethacrynic acid
38. Potassium Sparing diuretic is
a) Amiloride
b) Triamterene
c) Spironolactone
d) All
39. Which of the following drug is carbonic anhydrase inhibitor
a) Ethacrynic acid
b) Acetazolamide
c) Mannitol
d) Acarbose
40. ”Lasix” is a brand name of
a) Mannitol
b) Mersalyl
c) Thiazide diuretic
d) Furosemide
41. Which of the following is phenoxyacetic acid derivative
a) Ehacrynic acid
b) Mannitol
c) Furosemide
d) Acetazolamide
42. Diuretics increase the rate of urine flow and sodium excreation and are used to adjust the
of body fluid
a) volume
b) composition
c) both a and b
d) none of these
43. Diuretics cause significant decrease in blood volume and it is helpful in hypertension
a) increase
b) remains
c) decrease
d) none of these
44. In m-disulphamoyl benzene derivatives maximum diuretics activity is obtained when is substituted by Cl-,Br-,CF3 or NO2 group.
a) 1st
b) 2nd
c) 3rd
d) 4th
45. The loop diuretics actually attach to the Cl- binding site of this contrasport protein to inhibiting the reabsorbtion of
a) CaCO3
b) CaCl
c) NaCl
d) both a and b
46. Carbonic anhydrase is an enzyme that is present in that catalyses the reversible reaction.
a) proximal convulated tubule
b) distalconvulated tubule
c) glomerules
d) none of these
47. Aldosterone inhibitor the aldosterone action on receptor
a) corticoid
b) mineralocorticoid
c) both a and b
d) none of these
48. The acidic protons makes positive the formation of water soluble sodium salt that can be used for of the diuretics.
a) topically
b) sublingual
c) IV
d) none of these
49. The loss of group eliminates the diuretic effect but not the antihypertensive action.
a) hydroxyl
b) phosphate
c) sulphamoyl
d) none of these
50. Loop diuretic block uric acid secreation at proximal tubule ,thereby causing
a) hypercalaemia
b) hypocalaemia
c) hypouricaemia
d) hyperuricaemia
51. Histamine is biosynthesized by of basic amino acid Histidine.
a) carboxylation
b) decarboxylation
c) carbonation
d) none of these
52. Histamine is stored in the secretary granules of mast cells of positively charge and negatively charge acidic group on on the other secretary granules as
a) heparin
b) non heparin
c) both
d) none of these
53. After the release of antihistamine by mast cells its bind with histaminergic receptor to the release of histamine.
a) inhibit b)enhance c)increase d)none of these
54. IUPAC Name
a) 1[(4-chorophenyl )-phenyl methyl ]-4-[(3-methyl phenyl) methyl ]piperazine.
b) 1[(4-chorophenyl )-phenyl methyl ]-4-[(2-methyl phenyl) methyl ]piperazine
c) 1[(3-chorophenyl )-phenyl methyl ]-4-[(3-methyl phenyl) methyl ]piperazine
d) none of these
55. The histaminergic receptor are
a) H1 receptor
b) G-protein couple receptor
c) both
d) none of these
56. Enositol phosphate cause rapid release of from endolasmic reticulum.
a) Cl
b) Ca+
c) both
d) none of these
57. Which antagonist also called as anti ulcer?
a) H1
b) H2
c) Both
d) none of these
58. Branching of carbon atom the activity
a) initiates
b) increase
c) reduce
d) none of these
59. The action the receptor and inhibit H+K+ atpase and reduce the activation of parirtal
cell torelease the gastric acid.
a) proton pump inducer
b) pump proton inhibitor
c) proton pump inhibitor
d) None of the above
60. Which group at orthopostion destroy the activity bysteric effect?
a) methyl
b) methoxy
c) methane
d) none of these
61. Once activated, the proton pump inhibitors bind to exposed amino acids in the proton pump. Which amino acid is involved?
a) serine
b) cysteine
c) lysine
d) histidine
62. Two regions of cimetidine are susceptible to metabolism. Which regions?
a) A and B
b) A and C
c) B and D
d) A and D
63. To what extent are the three nitrogens of histamine ionised at blood pH?
a) all three nitrogens are fully ionised
b) all three nitrogens are not ionised at all
c) the side chain nitrogen is fully ionised and the heterocyclic nitrogens are not ionised
d) the side chain nitrogen and one of the heterocyclic nitrogens are fully ionised
64. Morphine is contraindicated in head injury because
(a) It does not relieve the pain of head injury
(b) It can raise intracranial tension
(c) It can cause constipation
(d) It is liable to cause addiction
65. Which of the following opioids is more potent than morphine ?
(a) Pethidine
(b) Fentanyl
(c) Dextropropoxyphene
(d) Tramadol
66. Which of the following opioid analgesics is similar to codeine in pharmacological profile but is less constipating ?
(a) Methadone
(b) Buprenorphine
(c) Butorphanol
(d) Dextropropoxyphene
67. Select the analgesic which acts throughopioids as well as additional spinal mono aminergic mechanisms.
(a) Tramadol
(b) Ethoheptazine
(c) Dextropropoxyphene
(d) Alfentanil
68. An opioid analgesic is preferred overaspirin like analgesic in the following condition.
(a) Acute gout
(b) Burn
(c) Toothache
(d) Neuralgia
69. Morphine has high affinity for thefollowing opioid receptor(s).
(a) μ (Mu)
(b) k (Kappa)
(c) d (Delta)
(d) All of the above
70. Which of the following is an agonist-antagonist type of opioid analgesic
(a) Pethidine
(b) Pentazocine
(c) Fentanyl
(d) Buprenorphine
71. Pentazocine differs from morphine in that
(a) It is inactive by the oral route
(b) It does not produce physical dependence
(c) It has a lower ceiling of analgesic effect
(d) Its action is not blocked by naloxone
72. Which action of morphine is incompletelyreversed by naloxone ?
(a) Analgesia
(b) Respiratory depression
(c) Sedation
(d) Miosis
73. Lower dose of naloxone is required to
(a) Antagonise the actions of nalorphine
(b) Antagonise the actions of pentazocine
(c) Precipitate withdrawal in mildly morphine dependent subjects
(d) Precipitate withdrawal in highly morphine dependent subjects
74. Structures (I) and (II) are prodrugs of the antibiotic chloramphenicol.
Which of the following statements is true?
a) Structure I is more water soluble than chloramphenicol.
b) Structure II is more water soluble than chloramphenicol.
c) Structure I is used to achieve higher concentrations for injections.
d) Structure II is used to reduce the bitter taste of chloramphenicol.
75. Which of the following statements is true with respect to phosphate prodrugs?
a) Phosphate esters are more polar in nature than the parent drug.
b) Phosphate esters are less water soluble than the parent drug.
c) Phosphate esters are more likely to cross cell membranes than the parent drug.
d) Phosphate esters are resistant to drug metabolism.
76. Candoxatril is an ester prodrug for candoxatrilat which inhibits protease enzymes. Which of the following statements is incorrect?
a) Hydrolysis of the ester reveals a carboxylic acid group on candoxatrilat.
b) The parent drug can be administered orally, whereas the ester prodrug cannot.
c) The bicyclic leaving group is non-toxic.
d) The bicyclic system is electron withdrawing and speeds up the rate of ester hydrolysis.
77. Levorphanol is an analgesic which is five times more active than morphine.
What happens when the N-methyl group is replaced with an N-allyl group?
There is an increase in activity
b) There is a decrease in activity
c) There is a loss of all activity
d) The compound becomes an antagonist
78. The following molecule (etorphine) is used in veterinary medicine.
What is it used for?
a) Sedation
b) Analgesia
c) Treatment of diarrhoea
d) Pupil constriction
79. Etorphine is used in veterinary medicine.
What chemical reverses the effects of this molecule?
a) Buprenorphine
b) Etorphine
c) Diprenorphine
d) Thebaine
80. The following agent is used clinically as an analgesic.
What is it called?
a) etorphine
b) thebaine
c) buprenorphine
d) diprenorphine
81. Buprenorphine is used clinically as an analgesic.
Which of the following statements is true?
a) The above structure is more effective than morphine at treating severe pain.
b) The above structure achieves the same level of pain relief at lower doses than those required by morphine.
c) The above structure has no side effects.
d) The above structure can be taken orally.
82. The binding site of analgesic receptors has two hydrophobic binding regions in the vicinity of the ionic binding region. One is responsible for agonist activity and the other is responsible for antagonist activity. Which of the following statements is true?
a) The antagonist hydrophobic binding region is closer to the ionic binding region than the agonist hydrophobic binding region.
b) The agonist hydrophobic binding region is closer to the ionic binding region than the antagonist hydrophobic binding region.
c) The antagonist hydrophobic binding region and agonist hydrophobic bind regions are equidistant from the ionic binding region.
d) The relative positions of the hydrophobic regions vary depending on the type of analgesic receptor concerned.
83. Consider the following analgesic.
What is the source of this structure?
a) Opium
b) Frog
c) An endogenous compound present in the body
d) Snake venom
84. Morphine is the structure chiefly responsible for the biological activity of opium. What is the name given to the chemical that is chiefly responsible for the biological activity of a natural extract?
a) Lead compound
b) Active principle
c) Pharmacophore
d) Lead principle
85. Two regions of cimetidine are susceptible to metabolism. Which regions?
a) A and B
b) A and C
c) B and D
d) A and D
86. The following diagram shows various conformations for the cyanoguanidine group of cimetidine.
Two of these conformations were found to be disfavoured. Which ones and what was the implication of this for receptor binding?
a) EZ and ZE. It proved the chelation theory of hydrogen bonding.
b) EZ and ZZ. It established that there was only one hydrogen bonding interaction with the receptor in this region.
c) EE and ZZ. It established that there were two hydrogen bonding interactions to different groups within the same binding region.
d) EE and ZE. No conclusions could be drawn.
87. Once activated, the proton pump inhibitors bind to exposed amino acids in the proton pump. Which amino acid is involved?
a) serine
b) cysteine
c) lysine
d) histidine
88. The following mechanism shows how proton pump inhibitors are activated. Which arrow is incorrect?
a) A
b) B
c) C
d) D
89. Omeprazole is an important proton pump inhibitor.
Which region is prone to metabolism?
a) A
b) B
c) C
d) D
90. Which microorganism has been associated with the appearance of ulcers?
a) Eschericia coli
b) Staphylococcus aureus
c) Enterococcus faecalis
d) Helicobacter pylori
91. Which of the following is an amine autocoid?
a) Prostaglandines
b) Leukotrienes
c) Histamine
d) Bradykinin
92. Which of the following drug is an anti histaminic?
a) Promethazine
b) Pilocarpine
c) Prednisolone
d) Cycloserine
93. Which of the following is not an anti histamine?
a) Cetirizine
b) Cyclizine
c) Loratidine
d) Fexofenadine
94. Which of the following drug cause QT Prolongation?
a) Loratidine
b) Levocetrizine
c) Fexofenadine
d) Finasteride
95. Which of the following action is not caused H1 receptors?
a) Vasoconstriction
b) Gastric acid secretion
c) Increase permeability
d) Bronchoconstriction
96. H1 antihistaminic having best topical activity?
a) Loratidine
b) Cetirizine
c) Astemizole
d) Azelastine
97. Which anti histaminic can be used in day times?
a) Diphenhydramine
b) Dimenhydrinate
c) Clorpheniramine maleate
d) Promethazine
98. H1 receptor blockers with least sedative action?
a) Terfenadine
b) Promethazine
c) Astemizole
d) Clorpheniramine
99. Fexofenadine is metabolic product of
a) Loratidine
b) Astemizole
c) Cetrizine
d) Terfenadine
100. All are the uses of anti histaminics except
a) Uriticaria
b) Motion sickness
c) Pruritus
d) Glaucoma
101. Osmotic diuretics are contraindicated in
a) Increased intracranial tension
b) Increased intraocular tension
c) Established acute renal failure
d) Poisonings
102. Furosemide increases the excretion of all of the followings except
a) Sodium
b) Potassium
c) Uric acid
d) Calcium and magnesium
103. Drug of choice for nephrogenic diabetes insipidus is:
a) Lypressin
b) Terlipressin
c) Desmopressin
d) Vasopressin
104 All of the following drugs are nephrotoxic except
a) Amphotericin
b) Lithium
c) Metronidazole
d) Cocaine
105. The dose related toxicity of loop diuretics is:
a) Allergic reaction
b) Deafness
c) Hypomagnesemia
d) Hyperuricemia
106. Concurrent use of Spironolactone & ACE inhibitors should be avoided because of danger of
a) Hyperglycemia
b) Hyperkalemia
c) Hypokalemia
d) Hypoglycemia
107. Following are the uses of Amiloride except
a) Adjunct to K+ wasting diuretics
b) Lithium induced nephrogenic diabetes insipidus
c) Congestive heart failure
d) a and b
e) a, b and c
108. Following statements about osmotic diuretics is true except
a) Mannitol gets filtered in glomerulus, but cannot be reabsorbed
b) To maintain osmotic balance, water is retained in the urine
c) Their presence leads to an increase in the osmolarity of the filtrate
d) All of the above
e) None of the above
109. Based on V2 receptor, followings are the therapeutic uses of vasopressin except:
a) Diabetes insipidus
b) Bedwetting in children
c) Bleeding esophageal varices
d) Hemophilia
110. Long term use of loop diuretics causes ………………….
a) Cirrhosis of liver
b) Deafness
c) Distal nephron hypertrophy
d) Renal insufficiency
111. Which of the following diuretics has anti-androgen effects?
a) Metolazone
b) Furosemide
c) Spironolactone
d) Dorzolamide
112. Which of the following diuretics is an epithelial sodium channel blocker?
a) Eplerenone
b) Mannitol
c) Bendroflumethiazide
d) Amiloride
113. Which of the following diuretics is metabolised into the active substance canrenone?
a) Amiloride
b) Spironolactone
c) Furosemide
d) Bumetanide
114. What is the primary target for thiazide diuretics?
a) Proximal convoluted tubule
b) Ascending loop of Henle
c) Distal convoluted tubule
d) Both B and C
115. Which class of diuretics work by acting on the proximal tubule?
a) Carbonic anhydrase inhibitors
b) Loop diuretics
c) Potassium-sparing diuretics
d) Thiazide diuretics
116. Thiazide diuretics are associated with a dose-related increase in LDL cholesterol and triglycerides.
a) True
b) False
c) Both a) & b) true
d) None of the above
117. Which of the following diuretics is used in the treatment of glaucoma?
a) Acetazolamide
b) Eplerenone
c) Mannitol
d) Bumetanide
118. Potassium-sparing diuretics can cause a potentially harmful interaction if taken with ACE inhibitors.
a) True
b) False
c) Both a) & b) true
d) None of the above
119. Loop diuretics and thiazide diuretics should not be administered together.
a) True
b) False
c) Both a) & b) true
d) None of the above
120. Which one of the following is osmotic diuretic-
a) glycerol
b) Mannitol
c) Isosorbide
d) All of above
Answer Key:
Que Ans Que Ans Que Ans Que Ans Que Ans Que Ans
1 A 21 A 41 A 61 D 81 B 101 A
2 B 22 D 42 C 62 D 82 A 102 A
3 C 23 C 43 C 63 C 83 C 103 C
4 C 24 D 44 D 64 B 84 B 104 C
5 D 25 D 45 C 65 B 85 B 105 B
6 D 26 B 46 A 66 D 86 C 106 B
7 C 27 B 47 B 67 A 87 B 107 D
8 C 28 C 48 C 68 B 88 C 108 D
9 B 29 D 49 C 69 A 89 A 109 C
10 B 30 B 50 D 70 B 90 D 110 C
11 B 31 D 51 A 71 C 91 C 111 C
12 A 32 B 52 A 72 C 92 A 112 D
13 D 33 C 53 A 73 D 93 B 113 B
14 D 34 C 54 A 74 B 94 C 114 C
15 B 35 C 55 B 75 A 95 B 115 A
16 B 36 A 56 B 76 B 96 D 116 A
17 B 37 A 57 B 77 D 97 C 117 A
18 B 38 D 58 C 78 A 98 A 118 A
19 C 39 B 59 C 79 C 99 D 119 B
20 C 40 D 60 B 80 C 100 D 120 D