1. `Essential drugs’ are:
a) Life saving drugs
b) Drugs that meet the priority health care needs of
the population
c) Drugs that must be present in the emergency
bag of a doctor
d) Drugs that are listed in the pharmacopoia of a
country
2. An 'orphan drug' is:
a) A very cheap drug
b) A drug which has no therapeutic use
c) A drug needed for treatment or prevention of a
rare disease
d) A drug which acts on Orphanin receptors
3. Drug administered through the following route is most
likely to be subjected to first-pass metabolism:
a) Oral
b) Sublingual
c) Subcutaneous
d) Rectal
4. Transdermal drug delivery systems offer the following
advantages except:
a) They produce high peak plasma concentration
of the drug
b) They produce smooth and nonfluctuating
plasma concentration of the drug
c) They minimise interindividual variations in
the achieved plasma drug concentration
d) They avoid hepatic first-pass metabolism of
the drug
5. In addition to slow intravenous infusion, which of the
following routes of administration allows for titration of
the dose of a drug with the response:
a) Sublingual
b) Transdermal
c) Inhalational
d) Nasal insufflation
6. Which of the following drugs is administered by intranasal spray/application for systemic action:
a) Phenylephrine
b) Desmopressin
c) Azelastine
d) Beclomethasone dipropionate
7. Compared to subcutaneous injection, the intramuscular injection of
a) Is more painful
b) Produces faster response
c) Is unsuitable for depot preparations
d) Carries greater risk of anaphylactic reaction
8. Select the route of administration which carries the
highest risk of adversely affecting vital functions:
a) Intra arterial injection
b) Intrathecal injection
c) Intravenous injection
d) Intramuscular injection
9. Alkalinization of urine hastens the excretion of
a) Weakly basic drugs
b) Weakly acidic drugs
c) Strong electrolytes
d) Nonpolar drugs
10. Majority of drugs cross biological membranes primarily
by:
a) Passive diffusion
b) Facilitated diffusion
c) Active transport
d) Pinocytosis
11. `Diffusion of drugs across cell membrane:
a) Is dependent upon metabolic activity of the cell
b) Is competitively inhibited by chemically
related drugs
c) Is affected by extent of ionization of drug molecules
d) Exhibits saturation kinetics
12. Which of the following drugs is most likely to be
absorbed from the stomach:
a) Morphine sulfate
b) Diclofenac sodium
c) Hyoscine hydrobromide
d) Quinine dihydrochloride
13. Which of the following is a weakly acidic drug:
a) Atropine sulfate
b) Chloroquine phosphate
c) Ephedrine hydrochloride
d) Phenytoin sodium
14. The most important factor which governs diffusion of
drugs across capillaries other than those in the brain is:
a) Blood flow through the capillary
b) Lipid solubility of the drug
c) pKa value of the drug
d) pH of the medium
15. Active transport of a substance across biological
membranes has the following characteristics except:
a) It is specific
b) It is pH dependent
c) It is saturable
d) It requires metabolic energy
16. Tricyclic antidepressants can alter the oral absorption
of many drugs by:
a) Complexing with the other drug in the intestinal lume
b) Altering gut motility
c) Altering gut flora
d) Damaging gut mucosa
17. Bioavailability of drug refers to:
a) Percentage of administered dose that reaches
systemic circulation in the unchanged form
b) Ratio of oral to parenteral dose
c) Ratio of orally administered drug to that excreted in the f
d) Ratio of drug excreted unchanged in urine to
that excreted as metabolites
18. Bioavailability differences among oral formulations of
a drug are most likely to occur if the drug:?
a) Is freely water soluble
b) Is completely absorbed
c) Is incompletely absorbed
d) Undergoes little first-pass metabolism
19. The most important factor governing absorption of a
drug from intact skin is:
a) Molecular weight of the drug
b) Site of application
c) Lipid solubility of the drug
d) Nature of the base used in the formulation
20. If the total amount of a drug present in the body at a
given moment is 2.0 g and its plasma concentration is
25 μg/ml, its volume of distribution is:
a) 100 L
b) 80 L
c) 60 L
d) 50 L
21. `The following attribute of a drug tends to reduce its
volume of distribution:
a) High lipid solubility
b) Low ionisation at physiological pH values
c) High plasma protein binding
d) High tissue binding
22. Marked redistribution is a feature of
a) Highly lipid soluble drugs
b) Poorly lipid soluble drugs
c) Depot preparations
d) Highly plasma protein bound drugs
23. A nonvolatile, highly lipid soluble drug is metabolized
at a rate of 15% per hour. On intravenous injection it
produces general anaesthesia for 10 min. Which process is responsible for termination of its action
a) Metabolism in liver
b) Plasma protein binding
c) Excretion by kidney
d) Redistribution
24. The blood-brain barrier, which restricts entry of many
drugs into brain, is constituted by:
a) P-glycoprotein efflux carriers in brain
capillary cells
b) Tight junctions between endothelial cells of
brain capillaries
c) Enzymes present in brain capillary walls
d) All of the above
25. Which of the following is not true of the blood-brain
barrier:
a) It is constituted by tight junctions between
the endothelial cells of brain capillaries and
the glial tissue
b) It allows passage of lipid soluble drugs into
the brain
c) It limits entry of highly ionized drugs into the brain
d) It regulates passage of substances from brain
into blood
26. Weakly acidic drugs:
a) Are bound primarily to α1 acid glycoprotein in
plasma
b) Are excreted faster in alkaline urine
c) Are highly ionized in the gastric juice
d) Do not cross blood-brain barrier
27. High plasma protein binding:
a) Increases volume of distribution of the drug
b) Facilitates glomerular filtration of the drug
c) Minimises drug interactions
d) Generally makes the drug long acting
28. The plasma protein bound fraction of a drug:
a) Contributes to the response at the given moment
b) Remains constant irrespective of the total drug
concentration
c) Remains constant irrespective of the disease state
d) Is not available for metabolism unless actively
extracted by the liver
29. Biotransformation of drugs is primarily directed to:
a) Activate the drug
b) Inactivate the drug
c) Convert lipid soluble drugs into nonlipid soluble metabolites
d) Convert nonlipid soluble drugs into lipid soluble metabol
30. Which of the following is a prodrug
a) Hydralazine
b) Clonidine
c) Captopril
d) Enalapril
31. A prodrug is:
a) The prototype member of a class of drugs
b) The oldest member of a class of drugs
c) An inactive drug that is transformed in the
body to an active metabolite
d) A drug that is stored in body tissues and is then
gradually released in the circulation
32. Which of the following cytochrome P450 isoenzymes
is involved in the metabolism of largest number of
drugs in human beings and has been implicated in
some dangerous drug interactions:
a) CYP 3A4
b) CYP 2C9
c) CYP 2E1
d) CYP 1A2
33. The following is not true of the cytochrome P450
isoenzyme CYP2D6:
a) It generates the hepatotoxic metabolite N-acetyl
benzoquinone immine from paracetamol
b) It is involved in demethylation of codeine into
morphine
c) Its altered form is responsible for poor capacity to
hydroxylate many drugs including metoprolol
d) It is inhibited by quinidine
34. The most commonly occurring conjugation reaction for
drugs and their metabolites is:
a) Glucuronidation
b) Acetylation
c) Methylation
d) Glutathione conjugation
35. Microsomal enzyme induction can be a cause of:
a) Tolerance
b) Physical dependence
c) Psychological dependence
d) Idiosyncrasy
36. The following drug metabolizing reaction is entirely
nonmicrosomal:
a) Glucuronide conjugation
b) Acetylation
c) Oxidation
d) Reduction
37. Which of the following types of drug metabolizing
enzymes are inducible:
a) Microsomal enzymes
b) Nonmicrosomal enzymes
c) Both microsomal and nonmicrosomal enzymes
d) Mitochondrial enzymes
38. Induction of drug metabolizing enzymes involves:
a) A conformational change in the enzyme protein
to favour binding of substrate molecules
b) Expression of enzyme molecules on the
surface of hepatocytes
c) Enhanced transport of substrate molecules
into hepatocytes
d) Increased synthesis of enzyme protein
39. Select the drug that undergoes extensive first-pass
metabolism in the liver:
a) Phenobarbitone
b) Propranolol
c) Phenylbutazone
d) Theophylline
40. Drugs which undergo high degree of first-pass metabolism in
a) Have low oral bioavailability
b) Are excreted primarily in bile
c) Are contraindicated in liver disease
d) Exhibit zero order kinetics of elimination
41. Glomerular filtration of a drug is affected by its:
a) Lipid solubility
b) Plasma protein binding
c) Degree of ionization
d) Rate of tubular secretion
42. If a drug undergoes net tubular secretion, its renal
clearance will be:
a) More than the glomerular filtration rate
b) Equal to the glomerular filtration rate
c) Less than the glomerular filtration rate
d) Equal to the rate of urine formation
43. The plasma half life of penicillin-G is longer in the new
born because their:
a) Plasma protein level is low
b) Drug metabolizing enzymes are immature
c) Glomerular filtration rate is low
d) Tubular transport mechanisms are not well
developed
44. If a drug is excreted in urine at the rate of 10 mg/hr at
a steady-state plasma concentration of 5 mg/L, then
its renal clearance is:
a) 0.5 L/hr
b) 2.0 L/hr
c) 5.0 L/hr
d) 20 L/hr
45. Which of the following is not a primary/fundamental,
but a derived pharmacokinetic parameter
a) Bioavailability
b) Volume of distribution
c) Clearance
d) Plasma half life
46. If a drug is eliminated by first order kinetics:
a) A constant amount of the drug will be eliminated per unit time
b) Its clearance value will remain constant
c) Its elimination half life will increase with dose
d) It will be completely eliminated from the body in
2 half life period
47. If a drug has a constant bioavailability and first order
elimination, its maintenance dose rate will be directly
proportional to its:
a) Volume of distribution
b) Plasma protein binding
c) Lipid solubility
d) Total body clearance
48. If the clearance of a drug remains constant, doubling
the dose rate will increase the steady-state plasma
drug concentration by a factor of
a) 3
b) 2
c) 1.5
d) 1.3
49. When the same dose of a drug is repeated at half life
intervals, the steady-state (plateau) plasma drug concentration is r
a) 2–3 half lives
b) 4–5 half lives
c) 6–7 half lives
d) 8–10 half lives
50. The loading dose of a drug is governed by its:
a) Renal clearance
b) Plasma half life
c) Volume of distribution
d) Elimination rate constant
51. Monitoring of blood levels of diuretic drugs is not
practised because:
a) No sensitive methods for measuring blood levels
of diuretics are available
b) It is easier to measure the effect of these drugs
c) Response to diuretics is not related to their
blood levels
d) Diuretics need activation in the body
52. Monitoring plasma drug concentration is useful while
using:
a) Antihypertensive drugs
b) Levodopa
c) Lithium carbonate
d) MAO inhibitors
53. Sustained/controlled release oral dosage form is
appropriate for the following type of drug:
a) An antiarthritic with a plasma half life of 24 hr
b) A sleep inducing hypnotic with a plasma half life
of 2 hours
c) An antihypertensive with a plasma half life of 3
hours
d) An analgesic with a plasma half life of 6 hours
used for relief of casual headache
54. Microsomal enzyme induction has one of the following
features:
a) Takes about one week to developr
b) Results in increased affinity of the enzyme for
the substrate
c) It is irreversible
d) Can be used to treat acute drug poisonings
55. Which of the following drugs acts by inhibiting an
enzyme in the body
a) Atropine
b) Allopurinol
c) Levodopa
d) Metoclopramide
56. The following is a competitive type of enzyme inhibitor:
a) Acetazolamide
b) Disulfiram
c) Physostigmine
d) Theophylline
57. What is true in relation to drug receptors:
a) All drugs act through specific receptors
b) All drug receptors are located on the surface of
the target cells
c) Agonists induce a conformational change in
the receptor
d) Partial agonists have low affinity for the
receptor
58. Drugs acting through receptors exhibit the following
features except:
a) Structural specificity
b) High potency
c) Competitive antagonism
d) Dependence of action on lipophilicity
59. Study of drug-receptor interaction has now shown that
a) Maximal response occurs only when all receptors are occupied by the dru
b) Drugs exert an ‘all or none’ action on a recepto
c) Receptor and drugs acting on it have rigid
complementary ‘lock and key’ structural features
d) Properties of ‘affinity’ and ‘intrinsic activity’ are
independently variable
60. A partial agonist can antagonise the effects of a full
agonist because it has:
a) High affinity but low intrinsic activity
b) Low affinity but high intrinsic activity
c) No affinity and low intrinsic activity
d) High affinity but no intrinsic activity
61. Receptor agonists possess
a) Affinity but no intrinsic activity
b) Intrinsic activity but no affinity
c) Affinity and intrinsic activity with a + sign
d) Affinity and intrinsic activity with a – sign
62. Agonists affect the receptor molecule in the following
manner:
a) Alter its amino acid sequence
b) Denature the receptor protein
c) Alter its folding or alignment of subunits
d) Induce covalent bond formation
63. Receptors perform the following function/functions:
a) Ligand recognition
b) Signal transduction
c) Both ligand recognition and signal transduction
d) Disposal of agonists and antagonists
64. The following receptor type has 7 helical membrane
spanning amino acid segments with 3 extracellular
and 3 intracellular loops:
a) Tyrosine protein kinase receptor
b) Gene expression regulating receptor
c) Intrinsic ion channel containing receptor
d) G protein coupled receptor
65. Which of the following is a G protein coupled recepto
a) Muscarinic cholinergic receptor
b) Nicotinic cholinergic receptor
c) Glucocorticoid receptor
d) Insulin receptor
66. The following receptor has an intrinsic ion channel
a) Histamine H1 receptor
b) Histamine H2 receptor
c) Adrenergic alfa receptor
d) GABA-benzodiazepine receptor
67. Select the receptor that is located intracellularly
a) Opioid μ receptor
b) Steroid receptor
c) Prostaglandin receptor
d) Angiotensin receptor
68. Agonist induced autophosphorylation, internalization
and down regulation is a distinctive feature of:
a) G-protein coupled receptors
b) Intrinsic ion channel containing receptors
c) Tyrosine protein kinase receptors
d) Receptors regulating gene expression
69. All of the following subserve as intracellular second
messengers in receptor mediated signal transduction
except:
a) Cyclic AMP
b) Inositol trisphosphate
c) Diacyl glycerols
d) G proteins
70. The receptor transduction mechanism with the fastest
time-course of response effectuation is
a) Adenylyl cyclase-cyclic AMP pathway
b) Phospholipase C-IP3: DAG pathway
c) Intrinsic ion channel operation
d) Protein synthesis modulation
71. A receptor which itself has enzymatic property is
a) Insulin receptor
b) Progesterone receptor
c) Thyroxine receptor
d) Glucagon recepto
72. Down regulation of receptors can occur as a
consequence of:
a) Continuous use of agonists
b) Continuous use of antagonists
c) Chronic use of CNS depressants
d) Denervation
73. The following statement is not true of log dose-response
curve:
a) It is almost linear except at the ends
b) It is a rectangular hyperbola
c) It facilitates comparison of different agonists
d) It can help in discriminating between competitive
and noncompetitive antagonists
74. When therapeutic effects decline both below and above
a narrow range of doses, a drug is said to exhibit
a) Ceiling effect
b) Desensitization
c) Therapeutic window phenomenon
d) Nonreceptor mediated action
75. Which of the following drugs exhibits ‘therapeutic
window’ phenomenon:
a) Captopril
b) Furosemide
c) Diazepam
d) Imipramine
76. The following statement is not true of ‘potency’ of a
drug:
a) Refers to the dose of the drug needed to produce
a certain degree of response
b) Can be related to that of its congeners by the
relative position of its dose-response curve on
the dose axis
c) It is often not a major consideration in the
choice of a drug
d) It reflects the capacity of the drug to produce
a drastic response
77. ‘Drug efficacy’ refers to:
a) The range of diseases in which the drug is
beneficial
b) The maximal intensity of response that can
be produced by the drug
c) The dose of the drug needed to produce half
maximal effect
d) The dose of the drug needed to produce theraeutic effect
78. Which of the following is always true
a) A more potent drug is more efficacious
b) A more potent drug is safer
c) A more potent drug is clinically superior
d) A more potent drug can produce the same
response at lower doses
79. Higher efficacy of a drug necessarily confers:
a) Greater safety
b) Therapeutic superiority
c) Capacity to produce more intense response
d) Cost saving
80. If the dose-response curves of a drug for producing
different actions are widely separated on the dose
axis, the drug is:
a) Highly potent
b) Highly efficacious
c) Highly toxic
d) Highly selective
81. The therapeutic index of a drug is a measure of its:
a) Safety
b) Potency
c) Efficacy
d) Dose variability
82. Compared to the drug named within parenthesis, which
of the following drugs has a higher potency but lower
efficacy
a) Pethidine (morphine)
b) Furosemide (hydrochlorothiazide)
c) Diazepam (pentobarbitone)
d) Enalapril (captopril)
83. if the effect of combination of two drugs is equal to
the sum of their individual effects, the two drugs are
exhibiting:
a) Potentiation
b) Synergism
c) Cross tolerance
d) Antagonism
84. The antagonism between adrenaline and histamine is
called ‘physiological antagonism’ because:
a) Both are physiologically present in the body
b) They act on physiological receptors
c) Both affect many physiological processes
d) They have opposite physiological effects
85. The antidotal action of sodium nitrite in cyanide poisoning is based
a) Physical antagonism
b) Chemical antagonism
c) Physiological antagonism
d) Noncompetitive antagonism
86. A drug ‘R’ producing no response by itself causes the
log dose-response curve of another drug ‘S’ to shift to
the right in a parallel manner without decreasing the
maximal response: Drug ‘R’ is a:
a) Partial agonist
b) Inverse agonist
c) Competitive antagonist
d) Noncompetitive antagonist
87. A drug which does not produce any action by itself but
decreases the slope of the log dose-response curve and
suppresses the maximal response to another drug is a:
a) Physiological antagonist
b) Competitive antagonist
c) Noncompetitive antagonist
d) Partial agonist
88. The following is not a feature of competitive antagonists
a) Chemical resemblance with the agonist
b) Parallel rightward shift of the agonist log doseresponse curve
c) Suppression of maximal agonist response
d) Apparent reduction in agonist affinity for the
receptor
89. The following is a competitive antagonist of GABA but
a noncompetitive antagonist of diazepam:
a) Picrotoxin
b) Muscimol
c) Flumazeni
d) Bicuculline
90. The dose of the following class of drugs has to be
adjusted by repeated measurement of the affected
physiological parameter:
a) Oral contraceptives
b) Antiepileptics
c) Antidepressants
d) Oral anticoagulants
91. A drug which is generally administered in standard
doses without the need for dose individualization is:
a) Insulin
b) Mebendazole
c) Prednisolone
d) Digoxin
92. Which of the following statements is not true of fixed
dose combination formulations:
a) They are more convenient
b) Contraindication to one of the components does
not contraindicate the formulation
c) The dose of any one component cannot be
independently adjusted
d) The time course of action of the different components may not be identical
93. Fixed dose combination formulations are not necessarily
appropriate for:
a) Drugs administered in standard doses
b) Drugs acting by the same mechanism
c) Antitubercular drugs
d) Antihypertensive drugs
94. A fixed dose combination preparation meant for internal
use must not contain the following class of drug:
a) Thiazide diuretic
b) Fluoroquinolone antimicrobial
c) Corticosteroid
d) H2 blocker
95. Interindividual variations in equieffective doses of a
drug are most marked if it is disposed by:
a) Glomerular filtration
b) Tubular secretion
c) Both glomerular filtration and tubular secretion
d) Hepatic metabolism
96. The pharmacokinetics of drugs in the neonate differs
from that in adults, because their:
a) Intestinal transit is fast
b) Drug metabolizing enzymes are overactive
c) Tubular transport mechanisms are not well
developed
d) Glomerular filtration rate is high
97. Which adverse drug effect is more common in children
than in adults:
a) Isoniazid induced neuropathy
b) Chlorpromazine induced muscle dystonia
c) Digoxin induced cardiac arrhythmia
d) Penicillin hypersensitivity
98. The elderly patients are relatively intolerant to
a) Digoxin
b) Salbutamol
c) Propranolol
d) Nifedipine
99. The following drug adverse effect is specially noted in
men compared to women:
a) Tardive dyskinesia due to neuroleptics
b) Levodopa induced abnormal movements
c) Ampicillin induced loose motions
d) Ketoconazole induced loss of libido
100. Which racial difference in response to drugs has been
mentioned incorrectly below:
a) Africans require higher concentration of atropine to dilate pupils
b) Black races are more responsive to antihypertensive action o
c) Japanese are more prone to develop SMON due
to halogenated hydroxyquinolines
d) Chloramphenicol induced aplastic anaemia is
rare among Indians