PHARMACOLOGY-I

UNIT-III
10 mark questions:
1. Explain the Steps in neurohumoral transmission.
2. Explain mechanism of action, pharmacological action, therapeutic uses and adverse reaction of
Acetylcholine.
3. Define and classify sympathomimetics drugs. Explain the pharmacological action, therapeutic uses and
adverse drug reactions of propranolol.
4. Classify peripherally acting skeletal muscle relaxants. Write the mechanism of action and
pharmacological actions of d-Tubocurarine.

5 Mark questions:
1. Write a note on Nasal decongestants.
2. Write the mechanism action and therapeutic uses of Tamsulosin.
3. Define and classify local anesthetics. Describe the pharmacological actions of Lignocaine.
4. Write a note drugs used in myasthenia gravis.
5. Classify β-adrenergic blockers. Write a note on Phenoxybenzamine.
6. Write the mechanism of action and pharmacokinetic profile of Succinylcholine.
7. Explain the synthesis, storage and release of catecholamines.

MCQs: (Each question carries 1 mark)

1. Muscarinic receptors are located in:
a) Autonomic ganglia b) Skeletal muscle neuromuscular junctions
c) Autonomic effector cells d) Sensory carotid sinus baroreceptor zone
2. Indicate the location of M2 cholinoreceptor type:
a) Heart b) Glands c) Smooth muscle d) Endothelium
3. Which of the following cholinomimetics activates both muscarinic and nicotinic receptors?
a) Lobeline b) Pilocarpine c) Nicotine d) Bethanechol
4. Indicate a cholinomimetic agent, which is related to direct-acting drugs:
a) Edrophonium b) Physostigmine c) Carbachol d) Isoflurophate
5. Acetylcholine is not used in clinical practice because:
a) It is very toxic b) The doses required are very high
b) It is very rapidly hydrolyzed d) It is very costly
6. Parasympathomimetic drugs cause:
a) Bronchodilation b) Mydriasis c) Bradycardia d) Constipation
7. Which of the following direct-acting cholinomimetics has the shortest duration of action?
a) Acetylcholine b) Methacholine c) Carbachol d) Bethanechol
8. Indicate a reversible cholinesterase inhibitor:
a) Isoflurophate b) Carbochol c) Physostigmine d) Parathion
9. Which of the following cholinesterase inhibitors is irreversible?
a) Physostigmine b) Edrophonium c) Neostigmine d) Isoflurophate
10. Isofluorophate increases all of the following effects except:
a) Lacrimation b) Bronchodilation c) Muscle twitching d) Salivation
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11. Indicate a cholinesterase inhibitor, which has an additional direct nicotinic agonist effect:
a) Edrophonium b) Carbochol c) Neostigmine d)Lobeline
12. Which of the following cholinomimetics is commonly used in the treatment of glaucoma?
a) Pilocarpine b) Lobeline c) Acethylcholine d) Neostigmine
13. Indicate the organophosphate cholinesterase inhibitor, which can be made up in an aqueous solution for
ophthalmic use and retains its activity within a week:
a) Physoctigmine b) Edrophonium c) Echothiophate d) Neostigmine
14. Indicate the reversible cholinesterase inhibitor, which penetrates the blood-brain barrier:
a) Physostigmine b) Edrophonium c) Neostigmine d) Piridostigmine
15. Which of the following cholinomimetics is used in the treatment of atropine intoxication?
a) Neostigmine b) Carbochol c) Physostigmine d) Lobeline
16. The excessive stimulation of muscarinic receptors by pilocarpine and choline esters is blocked
competitively by:
a) Edrophonium b) Atropine c) Pralidoxime d) Echothiophate
17. The dominant initial sights of acute cholinesterase inhibitors intoxication include all of the following
except:
a) Salivation, sweating b) Mydriasis c) Bronchial constriction d) Vomiting and diarrhea
18. M3 receptor subtype is located:
a) In the myocardium
b) In sympathetic postganglionic neurons
c) On effector cell membranes of glandular and smooth muscle cells
d) On the motor end plates
19. Indicate a muscarinic receptor-blocking drug:
a) Scopolamine b) Pipecuronium c) Trimethaphan d) Pilocarpine
20. Which of the following agents is a ganglion-blocking drug?
a) Homatropine b) Hexamethonium c) Rapacuronium d) Edrophonium
21. Indicate the skeletal muscle relaxant, which is a depolarizing agent:
a) Vencuronium b) Scopolamine c) Succinylcholine d) Hexamethonium
22. Which of the following drugs is a nondepolarizing muscle relaxant?
a) Pancuronium b) Succinylcholine c) Hexamethonium d) Scopolamine
23. The mechanism of atropine action is:
a) Competitive ganglion blockade b) Competitive muscarinic blockade
c) Competitive neuromuscular blockade d) Noncompetitive neuromuscular blockade
24. Atropine is highly selective for:
a) M1 receptor b) M2 receptor c) M3 receptor d) All of the above
25. All of the following parts of the heart are very sensitive to muscarinic receptor blockade except:
a) Atria b) Sinoatrial node c) Atrioventricular node d) Ventricle
26. Atropine is frequently used prior to administration of inhalant anesthetics to reduce:
a) Muscle tone b) Secretions c) Nausea and vomiting d) All of the above
27. Indicate the antimuscarinic drug, which is used as a mydriatic:
a) Pilocarpine b) Neostigmine c) Homatropine d) Ipratropium
28. Indicate an antimuscarinic drug, which is effective in the treatment of mushroom poising:
a) Pralidoxime b) Pilocarpine c) Homatropine d) Atropine
29. Antimuscarinics are used in the treatment of the following disorders EXCEPT:

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a) Glaucoma b) Motion sickness c) Hyperhidrosis d) Asthma

30. The treatment of the antimuscarinic effects can be carried out with:
a) Neostigmine b) Hexametonium c) Homatropine d) Acetylcholine
31. Contraindications to the use of antimuscarinic drugs are all of the following except:
a) Glaucoma b) Myasthenia c) Bronchial asthma d) Motion sickness
32. Nondepolarisation neuromuscular blocking agents:
a) Block acetylcholine reuptake
b) Prevent access of the transmitter to its receptor and depolarization
c) Block transmission by an excess of a depolarizing agonist
d) All of the above
33. Indicate the long-acting neuromuscular blocking agent:
a) Rapacuronium b) Mivacurium c) Tubocurarine d) Rocuronium
34. Which of the following neuromuscular blocking drugs is an intermediate-duration muscle relaxant?
a) Vecuronium b) Tubocurarine c) Pancuronium d) Rapacuronium
35. Which depolarizing agent has the extremely brief duration of action?
a) Mivacurium b) Rapacuronium c) Rocuronium d) Succinylcholine
36. Which of the following neuromuscular blockers causes transient muscle fasciculations?
a) Mivacurium b) Pancuronium c) Succinylcholine d) Tubocurarine
37. Which neuromuscular blocking agent has the potential to cause the greatest release of histamine?
a) Succylcholine b) Tubocurarine c) Pancuronium d) Rocuronium
38. Indicate the neuromuscular blocker, which causes tachycardia:
a) Tubocurarine b) Atracurium c) Pancuronium d) Succinylcholine
39. Which of the following diseases can augment the neuromuscular blockade produced by nondepolarizing
muscle relaxants?
a)Myasthenia gravis b) Burns c) Asthma d) Parkinsonism
40. Indicate the agent, which effectively antagonizes the neuromuscular blockade caused by
nondepolarizing drugs:
a) Atropine b) Neostigmine c) Acetylcholine d) Pralidoxime
41. Sympathetic stimulation is mediated by:
a) Release of norepinephrine from nerve terminals
b) Activation of adrenoreceptors on postsynaptic sites
c) Release of epinephrine from the adrenal medulla
d) All of the above
42. Which of the following sympathomimetics acts indirectly?
a) Epinephrine b) Norepinephrine c) Ephedrine d) Methoxamine
43. Catecholamine includes following EXCEPT:
a) Ephedrine b) Epinephrine c) Isoprenaline d) Norepinephrine
43. Epinephrine decreases intracellular camp levels by acting on:
a) α1 receptor b) α2 receptor c) beta1 receptor d) beta2 receptor
44. Direct effects on the heart are determined largely by:
a) Alfa1 receptor b) Alfa2 receptor c) Beta1 receptor d) Beta2 receptor
45. Which of the following effects is related to direct beta1-adrenoreceptor stimulation?
a) Bronchodilation b) Vasodilatation c) Tachycardia d) Bradycardia

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46. Distribution of alfa adrenoreceptor subtypes is associated with all of the following tissues except those
of:
a) Heart b) Blood vessels c) Prostate d) Pupillary dilator muscle
47. Beta adrenoreceptor subtypes is contained in all of the following tissues EXCEPT:
a) Bronchial muscles b) Heart c) Pupillary dilator muscle d) Fat cells
48. In which of the following tissues both alfa and beta1 adrenergic stimulation produces the same effect?
a) Blood vessels b) Intestine c) Uterus d) Bronchial muscles
49. The effects of sympathomimetics on blood pressure are associated with their effects on:
a) The heart b) The peripheral resistance
c) The venous return d) All of the above
50. Which of the following drugs causes bronchodilation without significant cardiac stimulation?
a) Isoprenaline b) Terbutaline c) Xylometazoline d) Methoxamine
51. Beta1 receptor stimulation includes all of the following effects EXCEPT:
a) Increase in contractility b) Bronchodilation
c) Tachycardia d) Increase in conduction velocity in the atrioventricular node
52. Which of the following agents is an alfa2-selective agonist with ability to promote constriction of the
nasal mucosa?
a) Xylometazoline b) Phenylephrine c) Methoxamine d) Epinephrine
53. Which of the following drugs is a nonselective alfa receptor antagonist?
a) Prazosin b) Phentolamine c) Metoprolol d) Reserpine
54. Indicate the alfa1-selective antagonist:
a) Phentolamine b) Dihydroergotamine c) Prazosin d) Labetalol
55. Indicate the irreversible alfa receptor antagonist:
a) Tolazoline b) Labetalol c) Prazosin d) Phenoxybenzamine
56. Which of the following drugs is a nonselective beta receptor antagonist?
a) Metoprolol b) Atenolol c) Propranolol d) Acebutolol
57. Indicate the beta1-selective antagonist:
a) Propranolol b) Metoprolol c) Carvedilol d) Sotalol
58. Which of the following agents is a beta2–selective antagonist?
a) Tolazolin b) Pindolol c) Ergotamin d) Butoxamine
59. Which of the following drugs is a reversible nonselective alfa, beta antagonist?
a) Labetalol b) Phentolamine c) Metoprolol d) Propranolol
60. Indicate the indirect-acting adrenoreceptor blocking drug:
a) Tolazoline b) Reserpine c) Carvedilol d) Prazosin
61. The principal mechanism of action of adrenoreceptor antagonists is:
a)Reversible or irreversible interaction with adrenoreceptors
b)Depletion of the storage of catecholamines
c) Blockade of the amine reuptake pumps
d)Nonselective MAO inhibition
62. Which of the following drugs is useful in the treatment of pheochromocytoma?
a) Phenylephrine b) Propranolol c) Phentolamine d) Epinephrine
63. Propranolol is used in the treatment all of the following diseases EXCEPT:
a) Cardiovascular diseases b) Hyperthyroidism
c) Migraine headache d) Bronchial asthma

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64. Metoprolol and atenolol:

a) Are members of the beta1-selective group b) Are nonselective beta antagonists
c) Have intrinsic sympathomimetic activity d) Have an anesthetic action
65. Local anesthetics produce:
a) Analgesia, amnesia, loss of consciousness
b) Blocking pain sensation without loss of consciousness
c) Alleviation of anxiety and pain with an altered level of consciousness
d)A stupor or somnolent state
66. Indicate the drug, which has greater potency of the local anesthetic action:
a) Lidocaine b) Bupivacaine c) Procaine d) Mepivacaine
67. Ionizable group is responsible for:
b)The potency and the toxicity b) The duration of action
c) The ability to diffuse to the site of action d) All of the above
68. Which one of the following local anesthetics is an ester of benzoic acid?
a) Lidocaine b) Procaine c) Ropivacaine d) Cocaine
69. Indicate the local anesthetic, which is an ester of paraaminobenzoic acid:
a) Mepivacaine b) Cocaine c) Procaine d) Lidocaine
70. Which of the following local anesthetics is an acetanilide derivative?
b) Tetracaine b) Lidocaine c) Cocaine d) Procaine
71. Indicate the local anesthetic, which is mainly used for regional nerve block anesthesia:
a) Dibucaine b) Bupivacaine c) Tetracaine d) Cocaine
72. Which of the following local anesthetics is used for infiltrative and regional anesthesia?
a) Procaine b) Lidocaine c) Mepivacaine d) All of the above
73. Indicate the local anesthetic, which is used for spinal anesthesia:
b) Tetracaine b) Cocaine c) Dibucaine d) Bupivacaine
74. Which of the following local anesthetics is called a universal anesthetic?
c) Procaine b) Ropivacaine c) Lidocaine d) Bupivacaine
75. Most serious toxic reaction to local anesthetics is:
d) Seizures b) Cardiovascular collapse
e) Respiratory failure d) All of the above

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