A 60-year-old male has a six year history of hypertension for which he is receiving candesartan, amlodipine, bendrofluamethiazide and aliskiren.
Which of the following best describes the mechanism of action of aliskiren?

A 35-year-old male is treated for an acute exacerbation of ulcerative colitis. Six weeks post-discharge, he is re-admitted with sepsis and labs show pancytopenia. What drug is responsible?

Lead poisoning:

Which of the following is a metabolic effect of Exenatide?

Which of the following compounds is the toxic metabolite that accumulates during Paracetamol overdose and is reduced by treatment with N-acetylcysteine?

Which of the following antiemetics functions as a cholinergic muscarinic antagonist?

A 33 year old woman has a history of general anxiety disorder.
She is most likely to develop physical dependence to which of the following medications?

A 21 year old man is admitted to a psychiatric ward for stabilization of an acute episode of psychosis. He has been started on an antidepressant, an antipsychotic, and has required additional medications on several occasions for agitation. He develops a sustained muscular contraction involving his left neck muscles, with associated pain and distress on the fifth day of his hospitalization. Out of the following which is most likely responsible for it?

A male patient with bipolar disorder is being treated with lithium. Which one of the following is the most likely side effect of this therapy?

An 80 year old man, resident of a nursing home has developed symptoms of depression including withdrawal and sadness. The staff also reports that he doesn´t want to leave his room, and often expresses a desire to stay in bed all day. After performing an appropriate evaluation and recommending non-pharmacologic interventions, you also decide that pharmacologic treatment is indicated. The most appropriate antidepressant is

A 77 year old man presents with progressive tremors that had been there over the past 2 years. The tremor interferes with everyday habits. No other medical problem is present. He abstains from alcohol and tobacco products. Physical examination is remarkable for an action tremor of the upper extremities and a head tremor. No rigidity or gait disorder is noted. Which of the following is most appropriate as initial drug therapy for this problem?

A 25 year old male is brought to the emergency department by his family because he says that he is being followed by gangsters and that they are going to kill him. Temperature is 37.8°C (100.0°F), pulse is 110/min and blood pressure is 160/95 mmHg. His pupils are dilated. The remainder of the physical examination is normal. The family states that he has a history of drug abuse. The drug that most likely caused this reaction is

Propranolol cannot be used in

A 61-year-old lady has osteoporosis. She takes alendronate. By what mechanism does this drug function against osteoporosis?

Which of the following drugs lower blood sugar by interfering with intestinal absorption of complex carbohydrates but does not affect fasting blood sugar?

A 36 year old man is brought to the Emergency Department unconscious. He is warm and sweaty. His heart rate is 52 bpm; his BP is 90/60. His pupils are constricted, his eyes are teary, and he is drooling. You assume he is suffering from a toxidrome. Which of the following antidote would you give him?

Cyanide toxicity results from which of the following?

Cyanide toxicity results from which of the following?

Pharmacological agent that is NOT associated with exacerbations of systemic lupus erythematosus in susceptible individuals is

A 25 year old female attempts suicide by taking an overdose of diazepam. She is rushed to the emergency department, where the attending physician will most likely administer which treatment?

A 65 year old man with Parkinson is diagnosed with clinical depression. What agent would be most effective in helping to alleviate the signs and symptoms associated with Parkinson disease and his depression?

A 19 year old girl is brought to the ER after a crush injury. She develops reddish urine and her creatinine rises from 1.0 to 4.0 mg/dL. She also develops edema globally. A diuretic should be prescribed to alleviate the edema and minimize damage to kidneys from her myoglobinemia. Which diuretic that is contraindicated in this case?

A 66 year old man develops a vesicular rash localized to a narrow circumferential band on one side his chest. The rash is very painful and the vesicles are confluent, with some ulceration. Rest of the examination is not significant. What would be the most appropriate course of therapy?

During phase I clinical trials pharmacokinetic parameters of a new antimicrobial agent are being determined. Recently it has been determined that the half life of this new agent is 9 hours. One subject had an adverse reaction and the drug was immediately discontinued. How much time will it take for plasma drug level to reach approximately 6% of steady state levels?

A patient with total cholesterol of 272 mg/dL and LDL level of 210 mg/dL. is prescribed a drug that inhibits the formation of VLDL by the liver. Which symptoms will this patient likely experience from this drug?

A 64 year old man has precordial chest pain that is often precipitated by stress or exertion and is generally relieved quickly by rest and/or nitrates. ECG shows evidence of ischemia during stress testing. Angiography shows narrowing of several major heart vessels. Which drug would likely worsen his angina?

A 27 year old HIV positive female has of vaginal discharge, profound vaginal itching as well as the appearance of multiple clear vesicles on her external labia. Smear reveals several multinucleated giant cells with nuclear homogenization and Cowdry type A bodies. What treatment would recommend for use in this patient?

The agent prescribed to a 29 year old male for CML is a cell cycle S phase specific antimetabolite. Side effects include myelosuppression and hyperuricemia. If the neoplastic cells delete the gene encoding HGPRT, they will become resistant to this drug. The antineoplastic agent for the treatment is which one of the following?

A 45 year old man presents with severe pneumonia. He recently returned from a business trip, and has a history of smoking and alcohol use. CXR shows extensive consolidation affecting portions of each lung lobe. Culture on charcoal yeast extract medium grows out a small gram negative bacterium. Which antibiotic is the most appropriate treatment?

A 48 year old alcoholic has 2 days of severe worsening pain with redness and swelling of his first metatarsophalangeal joint. No history of injury or trauma is present. He is afebrile with no other symptoms. The most appropriate therapy is

A 77-year-old man is agitated and confused. He has small pupils, a heart rate of 50 bpm, and is frothing at the mouth. What is the most likely poison?

A middle lady presents with cervical and inguinal lymphadenopathy. She is also experiencing pins and needles in a glove and stocking distribution, and has gum hypertrophy. She has a previous history of epilepsy and is on regular medication. Which of the following drugs is most likely to cause her symptoms?

A 61-year-old with idiopathic Parkinson´s disease has motor oscillations and on-off periods. She had received Co-beneldopa for 5-years. 
Selegiline was added to her treatment. Which one of the following enzymes does Selegiline act on to cause this adjuvant action?

Which of the following anti-microbials is associated with prolongation of the QT interval?

A 40-year-old male has chest pain, confusion and agitation after taking a recreational drug. He is confused, has a temperature of 38.3°C and a blood pressure of 190/102 mmHg. Which of the following drugs has he taken?

A 70-year-old lady with mitral valve disease and atrial fibrillation is taking warfarin. Lately her INR has fallen and the dose of warfarin has had to be increased. Which of the following new treatments may account for this change?

A lady aged 35 years comes to the office for a Papanicolaou (Pap) test, On a review-of-system checklist, she checks ´yes´ to depressive symptoms, insomnia, and anxiety. On asking, she admits to feeling depressed for about 4 months, after a recent job change. She is not suicidal. On further questioning, she admits that she repeatedly checks her locks and constantly worries about cleanliness; this is her life time routine, but finds it very time- consuming. Which one of the following drugs is the best choice for this patient?

A 35 year old man is under your treatment for anxiety, panic disorder, and a history of alcoholism. He has been abstinent from alcohol for 6 years. The greatest risk of physical dependence is associated with which of the following?

Typical antipsychotic drugs act by which of the following mechanism?

A major advantage of second- generation (atypical) antipsychotics compared with first-generation antipsychotics is

All are neuropsychological effects of hallucinogens, except

The primary mechanism of sucralfate in gastroesophageal reflux disease (GERD) is which of the following?

What is the drug of choice in preventing meningococcal infections?

Antihypertensive agent that is most likely to cause hyperkalemia is which one of the following?

A 62 year old woman being treated with cytotoxic drugs develops fever of 40°C (104°C) and a gram positive alpha hemolytic coccus is cultured from her blood in 6.5% NaCl on bile/esculin agar. Agent is vancomycin resistant according to Kirby Bauer antibiotic sensitivity test. The mechanism of vancomycin resistance in this infectious agent is

A 28 year old female presents with urinary frequency, urgency, and burning on urination. Fever is absent. Urinalysis indicates the presence of pyuria and bacteriuria. The patient is prescribed an antibiotic and is informed that the use of antacids could lead to a therapeutic failure. The patient most likely prescribed which one of the following?

A firefighter was burned over 60% of his body. He is rushed to the ER and during the surgery the anesthesiologist notices tall peaked T waves and prolongation of the PR interval, accompanied by progressive widening of the QRS complex so that it appears to merge with the T waves. He goes into ventricular fibrillation then asystole, and cannot be resuscitated. What is most likely responsible for this patient´s ECG changes?

A female attempts suicide by ingesting 25 tables of extra strength acetaminophen. She is rushed to the emergency room. The medication that will most likely to be administered to this patient is which one of the following?

Drug acting on the kidney has been shown to increase urine flow rate. Following diagram shows the effects on renal excretion. Which one of the following is most likely blocked by the drug?

A 68 year old man diagnosed with supraventricular tachycardia is given a medication that blocks potassium channels, prolongs repolarization, widens the QRS, and prolongs the QT interval. Which medication was most likely prescribed?

A 55 year old man has epigastric pain that occurs at regular intervals daily partially relieved by antacids and food. Upper endoscopy reveals an ulcer in the first part of duodenum. Spiral shaped, motile, oxidase positive and catalase positive rods with multiple flagella atone pole are cultured from the lesion. The most effective treatment is

A 73 year old male with a history of mitral valve replacement is currently on an oral anticoagulant. His prothrombin time is monitored on a regular basis. 7 days after starting an oral antibiotic he develops hematuria. Which drug is most likely responsible for this new symptom?

A 56 year old woman with a history of food allergies presents with whole body itching and welts on her torso. She ate some Thai food with a peanut sauce base, and the patient is allergic to peanuts. She denies any difficulty breathing, and her blood pressure is 120/70 mm Hg. Respiratory exam is normal. She is given Diphenhydramine. What change will occur as a result of administering Diphenhydramine?

A newborn infant is diagnosed with pulmonary atresia. To prevent severe cyanosis, the patency of the ductus arteriosus must be maintained. Which drug can artificially prolong the patency of the ductus arteriosus in this child?

A 71 year old man has chronic heartburn. It is painful for him to bend over, and he sleeps on a wedge shaped pillow to try to reduce the burning sensation. The medication that would be the most efficacious in reducing his symptoms is

A 31 year old female with a history of tonic clonic seizures complains of double vision, thickened gums, and growth of facial hair since starting a new drug. Which anticonvulsant medication is most likely responsible for her symptoms?

A 25 year old male underwent treatment for Hodgkin lymphoma 1 year ago. He presents with increasing dyspnea and cough. Exam is remarkable for rales bilaterally. Arterial blood gases show hypoxia, and bilateral pulmonary infiltrates are seen on CXR. Which agent most likely produced these side effects?

A pilot working for a major commercial airline suffers from hay fever. The medication that would be most suitable for the pilot during working hours is which one of the following?

Which of the following best describes the pharmacological actions of Ondansetron?

Which of the following is NOT associated with hyponatraemia and hyperkalaemia?

Which of the following are centrally acting antihypertensive therapy?

A 50 year old lady has a three year history of sero-positive erosive rheumatoid arthritis. She has recently started methotrexate therapy. What agent she should be receiving in conjunction with methotrexate?

A 52 year old lady with a history of paroxysmal atrial fibrillation has been successfully treated for depression with sertraline (zoloft). However, she has persistent insomnia, and a 10-day trial of zolpidem (Ambien) has yielded minimal improvement. What would be the most appropriate addition to her current medication?

The benzodiazepines that has the shortest elimination half life in the body is

A patient presents to the ER with drug overdose. He has fever, tachycardia, dilated pupils a blood pressure of 220/110 mmHg. What is the most likely cause?

All of the following are associated with hyponatremia, EXCEPT

Barbiturate toxicity is attributable to which of the following mechanism?

Which diuretic works at the loop of Henle?

All of the following can cause hypercalcemia, EXCEPT

A potassium sparing diuretic is which one of the following?

ECG of a 72 year old woman with a history of congestive heart disease reveals the presence of atrial fibrillation. What drug would be most likely prescribed to decrease the conduction through the AV node?

A 58 year old man has a 10 year history of hypertension. Labs reveal that the plasma renin activity 3-4 times higher than normal. Losartan is prescribed. After its administration, which would be expected to increase in this patient?

A patient being diagnosed with bulimia and depression is started an antidepressant by an inexperienced physician. Over the course of a few weeks of treatment, the dose is gradually increased. He develops seizures and is brought to the emergency department. The antidepressant that this patient was most likely taking is which one of the following?

During 1960s, dentists at psychiatric institutions for children noted an unusual presentation of gingival overgrowth in many epileptic patients. Most had severe convulsive seizures that would last for more than half an hour at a time. Though some conjectured an association between generalized seizures and gingival epithelial overgrowth, the dental findings were later attributed to the common use of some medications for epilepsy. The molecular mechanism of this drug associated with this unusual phenomenon is most similar to the mechanism of which cardiovascular drug?

A 30 year old pregnant woman is told by her obstetrician to avoid taking aspirin. Use of aspirin is contraindicated, especially during the last part of pregnancy, because aspirin affects which hematologic parameters?

A 66 year old man with palpitations and fatigue is diagnosed with atrial fibrillation and treated with digoxin. Later his serum digoxin levels are found to be above the therapeutic range. He is at highest risk for developing digoxin toxicity if he also develops which abnormality?

A 66 year old man diagnosed with metabolic syndrome is prescribed a medication that decreases blood glucose, decreases triglycerides, decreases C-reactive protein levels, increases HDL cholesterol levels and, in some patients, lowers blood pressure. He was most likely prescribed which drug?

After a seizure a patient is brought to the ER. His mother describes a sudden loss of consciousness associated with a tonic contraction of muscles and total loss of postural control. The patient has a series of rhythmic contractions of all four limbs in the ER. What is the most appropriate pharmacotherapy?

A 68 year old male is has fever, chills, and a productive cough for four days. Exam shows a quite ill male with blood pressure of 110/70 mm Hg, heart rate of 102/min, respiratory rate of 24/min, and temperature of 38.7°C (101 .7°F). There is dullness to percussion, and decreased breath sound over the left lung base. Sputum Gram´s stain reveals abundant neutrophils, a few epithelial cells, and numerous gram-positive diplococci. The antibiotic that would be the most appropriate choice for empiric therapy of his infection is

A 58 year old male is diagnosed with a small pulmonary embolism. He is admitted to the hospital and started on heparin therapy. The anticoagulant effect of this drug would be most appropriately associated by which laboratory value?

A woman aged 54 years complains of a rapid heart rate and dry mouth. According to her the symptoms occur in the morning after taking her medication. Which drug is most likely the cause of these symptoms?

A 42 year old man previously had an allergic reaction to bupivacaine. Which local anesthetic should be avoided in this patient?

A 51 year old man has signs and symptoms of amyotrophic lateral sclerosis. Which drug would likely prolong the survival of this patient?

A 48 year old overweight female presents with symptoms of cholelithiasis. If the physician decides on medical treatment, which would be the most appropriate agent?

A diabetic male aged 55 years is brought to the emergency department in an unresponsive state. Lab values are: PCO2: 19 mm Hg, Bicarbonate: 11mEq/L, pH: 6.9. The most appropriate immediate treatment for this patient is

A 48 year old man has acute pain in his big toe. Investigations reveal a uric acid level of 10 mg/dL. He is started on a drug (Drug A). After the resolution of the acute attack, he is started on a second medication (Drug B). Drug B decreases both the serum and urine levels of uric acid. Which one is Drug B?

A 65 year old male presents with difficulty in micturition. He is diagnosed with benign Prostatic hyperplasia and is started on finasteride. Which hormone production would be selectively inhibited?

A 55 year old man is receiving treatment with Imatinib for chronic myeloid leukaemia. What is the mechanism of action of Imatinib?

Which of the following is true of radioactive iodine (₁₃₁I) therapy?

A farmer, on treatment for depression is admitted acutely 1 hour following an intentional overdose of an unidentified substance. On examination he is bradycardic, hypotensive, disorientated, hypersalivating, and has small pupils. He has most likely ingested:

A 64-year-old female presents with dry mouth of 3 months duration. She is taking medication for hypertension, stress incontinence and reflux esophagitis. Which of the following may be responsible for her dry mouth?

A 36 year old lady, who is on antipsychotic medication, develops stiffness in her arms and neck. Which of the following side affects of medication she have?

Which of the following anti-depressants is least likely to cause drug interactions?

An 81 year old chronic schizophrenic, who is heavily taking medications presents to you with constant, involuntary chewing motions and repetitive movements of his legs. The most likely diagnosis is

True regarding Raloxifene (Evista)

A 17-year-old boy is being treated for rhabdomyosarcoma with doxorubicin. Which one of the following drug toxicities is associated with the use of this drug?

The treatment of choice for opiate poisoning is

Which one of the following antibiotics is contraindicated for use in patients suffering from myasthenia gravis?