1. The real first question on the test. She wants to get pregnant. What will increase her fertility? Clomiphrene.

2. 75-year old male has urinary urgency, frequency, and dysuria. He basically has Benign Prostatic Hypertrophy. What mechanism of action drug due you treat him with? The drug Finesteride, which blocks the conversion of testosterone to dyhydrotesosterone (DHT).

3. He has Rickettsia Rickesstia bite him. He needs tetracycline, and you need to know that it binds to the 30S Ribosome.

4. What is the best way to excrete something? Answer is a weak acid with a pKa of 4 and a urinary pH of 8.

5. 53-year old woman has dizziness, dry mouth, and nasal stuffiness for 4 hours. She has fine tremor, muscular rigidity, and her speech is irrational. When she gets up, she faints. What drug caused this? Answer is Chlorpromazine.

6. Male given aminoglycoside for UTI. Which is adverse effect? Nephrotoxicity*. 7. Mechanism of action of tPA. Answer is A on the chart with stimulates the

conversion of plasminogen to plasmin. 8. Know chloroquine resistance mechanism of action. 9. What increases renal blood flow? Answer is Dopamine. 10. SSRI’s blocks uptake of Serotonin (+++), Norepinephrine (0,+), and

Dopamine (0,+). 11. He has allergic symptoms. Drug works, but when he stops taking it in, symptoms

reoccur. Answer is alpha-1 agonist. 12. They show in the question Angiotensin II. Answer is Losartin. 13. What causes vasodilation? Answer is bradykinin. 14. What other sympathomimetic should he take for fast relief? Answer is albuterol. 15. Answer is Succuinylcholine, Neostigmine. It shows a control, and the muscular

activity decreased, then the muscular activity increased. 16. A question on how NO works. Answer is increase cGMP.17. Another question on how sildenafil works, a nswer is cGMP again.18. At equilibrium, answer is 100. 19. A 21 y/o college student diagnosed with cold sores was prescribed Acyclovir.

MOA – Depends on viral thymidine kinase to inhibit viral DNA polymerase*.20. Administer cilistatin with imiprime. Also know the enzyme is renal

dihydropeptidase. 21. Painter and the picture shows basophilic stippling. Answer is lead toxicity. 22. Treatment of S. aureas that is resistant. Answer is vancomycin. 23. Answer is Nitric Oxide. 24. There is a 40 year old and a 70+ year old and digoxin concentration in the 40 year

old is .25 and in the 70+ year old is .125. They have a difference in renal clearance.

25. The answer is a transmembrane with seven subunits. 26. 4 year old child undergoes anesthesia. Her blood pressure increases/heart rate.

Answer is ketamine. 27. How do statins work? Increase LDL receptor. 28. Statins do rhabdomyalysis.

29. How to you treat atrioventricular nodal reentrant arrhythmia. Answer is adenosine.

30. Disopyramide is a strong anticholinergic. 31. Question describes the mechanism of action of cisplatin and etoposide. 32. The person has AML so you know when they undergo chemotherapy, uric acid

will increase. So you give a drug that works on xanthine oxidase. 33. Pt with Testicular cancer was chemo. Crackles, basilar infiltrate as side effect.

Bleomycin* <Bleomycin does pulmonary toxicity.> 34. She has elevated AST and ALT. She took Acetominophen. 35. Question describes person who is a narcoleptic (can’t seem to stay awake). The

person should take methylphenidate. 36. Cough occurs at the mu receptor. 37. The person who is hyperthyroid should take PTU. 38. Mechanism of action of the Glitazones is decreased resistance to insulin. 39. Mechanism of action of Metformin is inhibits gluconeogenesis and increases

glycolysis. 40. What causes an initial burst of LH and FSH? Answer is leuprolide. 41. He drinks alcohol and vomits. What enzyme is the drug working on? Answer is

alcohol dehydrogenase. 42. The mechanism of action of metronizaole is it forms toxic metabolites in the

bacterial cell. 43. Don’t take alcohol when on metronizaole. 44. Person has encephalopathy. Answer is Ammonia (NH3).45. Codeine gets converted to morphine46. Fluroquinolines work by inhibiting DNA gyrase. 47. Person has sputum production (describing pneumonia). Take a drug that inhibits

the cell wall synthesis. 48. Know the difference between potency (Drug dissolved) and efficacy (SE). 49. Another question relating to potency and efficacy. Answer on the test was X is

more potent than Y and Z. 50. Drug follows first order kinetics. It takes 12 hours from drug to go from 50 mg to

25 mg. How long will it take for drug to go into the 10-15 area. Answer is 24 hours.

51. Mechanism of action of sulfonylureas. ATPase K+ channel.52. Person has megaloblastic anemia. Takes drug X but still has neurological

problems. What is drug X? Answer is folate. 53. B1 Thiamine is what the alcoholic is missing. 54. Treat Candida by Amphoterin B. 55. Fluconazole is an inhibitor of P450, so it increases the concentration of drugs. 56. Zanamivir works by inhibiting neuraminidase. 57. Treat CMV by gancylcovir. 58. Treat myasthenia gravis by pyridostigmine. 59. Person has organophosate poisoning. Answer is parathion. 60. What is topically used to treat glaucoma? Answer is timolol. 61. What drug is really good for Congestive Heart Failure? Answer is ACE

inhibitors.

62. Complaing of migraine. Family history of mom with migraines and taking beta blocker. You prescribe sumatriptan. MOA – Serotonin agonist causing vasoconstriction*Sumatripin for migranes works on the serotonin receptor.

63. How to you treat cyanide tox icity. Give sodium thiocyante. 64. Question describing a person getting a reaction to antipsychotics. Answer is

Neuroleptic Malignant Syndrome. 65. Quinidine blocks sodium (Na+) channels.66. Quinidine causes cinconism (headache, tinnitus, etc.). 67. Hydrochlorothiazine does hyperuricemia. 68. Mannitol does a decrease in intracellular pressure. 69. pH goes form 7.48 to 7.35. The drug given was Acetozolamide. 70. The person has too much aldosterone with a palpable renal mass. Give

spironolactone.71. Don’t give Misoprisol to a pregnant woman. 72. Metoclopramide is a D2 antagonist. 73. Warfarin decreases the synthesis of clotting factors. 74. Cyclosporine works by inhibiting the production of IL-2 and its receptor. 75. Question asks what inhibits secretion of IL-2 and other cytokines. Answer is

Tacrolimus. 76. Reticulocyte count is 0.5%. Hematocrit is 22%. Give a blood transfusion. 77. She has menstruation and is anemic. Give ferrous sulfate only. 78. Person has diabetes insipidus with hypernatremia. How do you correct it? Correct

is by desmopressin. 79. Another question on diabetes insipidus. There is a change in the amino acid

sequence from ADH to desmopressin. 80. Description of pancreatitis with pain radiating to the back. Answer is lipase. 81. Amiodarone does pulmonary fibrosis. 82. She has benzodiazepenes in her purse. Avoid giving flumazenil to the baby

because it can cause seizures. 83. What increases digoxin toxicity. Answer is hypokalemia. 84. How do you lessen the heart rate? Give beta-blockers/calcium channel

blockers. 85. Aspirin works on inhibits thromboxane formation for preventing MIs. 86. She has an infection (gram negative). Answer on the test is amoxicillin. 87. Sulmonimides work on inhibiting the enzyme dihydroperoate synthase. 88. Methotrexate works on dihydrofolate reductase. 89. Botulinum toxin works by preventing release of acetylcholine. 90. Know the enzyme step that reserpine blocks (from dopamine to norepinephrine it

is dopamine beta-hydroxylase). a. Blocks the transporter that transports dopamine into the vesicles

(transporter is vesicular monoamine transporter = VMAT)91. Know the receptor involved in Beta 2. It is Gs and does an increase in cAMP. 92. Docusate is a fecal softener.

=================================But wait… There’s more!

93. 27 y/o with UTI was prescribed Sulfonamide. Which describes mechanism of E.Coli resistance to Sulfonamide? Mutation of dihydropteroate synthase*

94. 35 y/o male presented with fever and black urine was prescribed a drug that caused ringing in his ear. Which of the following drugs is causing this adverse effect? Quinine*

95. Prescribed drug that reduces cold sores caused by herpes simplex. What is moa? Activated by Thymidine Kinase*

96. Which of the following best describes the effects of cilastatin on imipenem? Inhibits renal dipeptidase*

97. 54 y/o male comes to the office complaining of constipation for 3 days. Which of the following stool softener does not increase bulk or peristalsis? Sodium Docusate. (Psyllium – bulk, Polyethylene glycol – colonoscopy)*

98. Which is indicated as first line Rx of acute attack of Asthma? Short acting B2 agonist albuterol*

99. A 45 y/o male diagnosed with pneumonia is prescribed drug indicated to clear the thick sputum associated. MOA – Breaks disulfide bonds, decreasing mucus viscosity*

100. 36 y/o male develops resistance against a 4-aminoquinolone derivative drug. Which organism is the cause of the drug failure? Plasmodium Falciparum*

101. The anesthesiologist in the OR used an inhalational anesthetic with low blood gas Partition Coefficient. You understand that the anesthetic has which of the following characteristics? Always pick the drug that causes the lowest blood partition coefficient – Rapid recovery rate, even if the procedure is prolonged. (Drug like NO)*

102. Fruit and vegetable harvester with bronchospasms, runny nose, muscle weakness, sweating, bradycardia. Due to insecticide. Cause is cholinergic activation or activation of muscarinic receptors*

103. 27 y/o male is admitted to the ER with methanol poisoning. The patient was treated with Ethanol and stabilized. Which of the following best explains the rationale behind the use of ethanol? Ethanol inhibits alcohol dehydrogenase on methanol

104. Pt with MI given drug causing lysis of coronary artery thrombosis. MOA is – plasminogen activator*

105. Homeless with schizo has fever muscle rigidity after haloperidol. Which is essential in diagnosis of the adverse effect? – CPK (neuroleptic

106. Pt with HTN prescribed drug that cause accumulation of cyanide…..Na+ nitroprusside. (Treat with Na+ thiocyanate)*

107. Person with re-entrant tachycardia – adenosine*108. HIV has fever, Cryptococcus meningitis. Best approach is Amphotercin B (anti-fungal)*109. Increased NO increased cGMP (Na nitroprusside moa)*110. Person has stroke. Given Botulinum B. MOA – block cholinergic neuromuscular

transmission (or nicotinic receptors). *111. Alendronate/fosamax – an oral bisphosphanate that inhibits bone resorption.

Hypercalcemia treated by IV bisphosphonate caused by bone cancer*

112. Person with symptoms of Grave’s Dz/thyrotoxicosis – propylthiouracil*113. HIV+ has interstitial pneumonitis caused by CMV. Use Gancyclovir (antiviral). When

dealing with CMV, always pick drug ending in “–cyclovir”**114. Pt with HCM is given disopyramide for uncontrolled antiarryhtmia. Person now has

urinary retention. Cause of urinary retention? – muscarinic receptors blockade**115. HTN takes drug decreased LH and testosterone – spironolactone (K sparing diuretics

and ACE inhib cause HYPERkalemia)**