Which one of the following drugs exerts its primary therapeutic benefit by immunosuppressing the inflammatory response in asthma?

A 26 year old prostitute develops erythematous, painful, ulcerated lesions on her labia and perineum. She is prescribed a drug in order to minimize the frequency and duration of symptomatic outbreaks. This drug most likely inhibits which one of the following?

A 72 year old is brought to the ER after the development of periorbital edema, a maculopapular rash on her chest, and a fever of 101°F (38.3°C). Investigation reveals blood urea nitrogen of 77 mg/dL and a serum creatinine of 3.1 mg/dL. Urinalysis indicates mild proteinuria and eosinophils, but is negative for glucose and ketones. Her past medical history is significant for hypertension, diabetes, and osteoarthritis. What drug caused the appearance of her signs and symptoms?

On examination, a premature infant is found to be in acute distress, and has blue skin and mucous membranes. Echocardiogram shows transposition of the great vessels and patient´s ductus arteriosus. Which of the following agents should be administered to maintain the patent ductus arteriosus?

During an experiment norepinephrine was injected intravenously and smooth muscle contraction was measured (control curve). Curves X, Y, and Z are the result of three separate experiments, in which norepinephrine was administered shortly after an unknown drug. The three most likely drugs (X, Y, Z) used in the three consecutive experiments include

A male aged 72 years is diagnosed with prostate cancer. He declines surgical therapy, and is treated with Flutamide. The mechanism of action of this drug is which one of the following?

A 58 year old man experienced an anaphylactic reaction after a medication to treat his chronic arthritis pain. The patient has a past medical history significant for “sulfa” allergy. He most likely took which drug?

In normal volunteers the pharmacokinetic properties of a new drug are being studied during phase I clinical trials. The volume of distribution and clearance determined in the first subject are 40 L and 2.0 L/hour, respectively. What is the half-life of the drug in this subject?

A high potency typical antipsychotic agent is studied in neuron in a bath that contains acetylcholine, dopamine, norepinephrine, and serotonin. The studied receptor is the same one that is responsible for the therapeutic efficacy of this agent in schizophrenic patients. Which effect would likely occur intracellularly after addition of this agent to the bath?

A carotid occlusion experiment is performed before and after giving an antagonist agent. The results of the effects on mean arterial pressure and heart rate are shown above. Which one of the following receptors is most likely blocked by the antagonist?

A 31 year old male undergoing surgery for a mitral valve replacement receives 2 units of packed red blood cells, 2 units of fresh frozen plasma, and heparin intraoperatively. After surgery, he recovers well with no large changes in vital signs. Several days later; his platelet level is found to be 85,000/mm3, though the patient remains asymptomatic during this time. The best treatment for this post-surgical complication is

A 65 year old man suffers MI due to thrombotic occlusion of the left circumflex coronary artery. An hour later he is admitted to an intensive coronary unit. A thrombolytic agent is given to prevent further extension of myocardial ischemic necrosis. Which investigation is/are most likely to be affected by giving this medication?

New antihistamine´s pharmacokinetic properties are being studies in normal volunteers during phase I clinical trials. The clearance and half life of the drug are determined to be 4.0 L/hour and 10 hours respectively. Which value is the approximate volume of distribution for this drug?

A patient is given a skeletal muscle relaxant prior to abdominal surgery. Patient soon begins to have hypotension, bronchospasm, and excessive bronchial and salivary secretions. Which skeletal muscle relaxant did this patient likely receive?

A 31 year old 36 weeks pregnant woman is told during that her fetus is in a breech presentation. An external cephalic version (manually turning the fetus from the outside) is scheduled for the following week. For this procedure, the uterus must be relaxed. Which medication would be appropriate for achieving this result?

A young male has a febrile illness and productive cough with green sputum. CXR reveals patchy opacification of both lung fields. History is significant for cystic fibrosis. Which drug combination match the treatment for his condition?

A woman with Graves disease is scheduled for a subtotal thyroidectomy. She is given Propylthiouracil to control her hyperthyroidism until surgery. The enzyme inhibited by this drug is involved in which reaction?

A 23 year old man presents with hypertension, tachycardia, an elevated body temperature, diaphoresis, mydriasis, and severe agitation. According to his mother he uses illicit drugs, although she is not sure which kind. Which agent is the most appropriate therapy for this patient?

A 33 year old male has weight loss, nausea, vomiting, and lethargy. No evidence of edema, orthostatic hypotension, or dehydration is present. Blood samples show hyponatremia, but his urine is highly concentrated. The patient is instructed to drink a large volume of water for water load test and 5 hourly samples of urine are analyzed. All samples show concentrated urine. Which drug caused this condition?

A 65-year-old woman presented 10 hours after ingestion of 12 g of quinine sulphate. Which of the following is the most common characteristic clinical feature in this situation?

Which of the following mechanisms best explains the action of Ezetimibe?

A 19-year-old woman presented six hours after taking 30 g of paracetamol. Which of the following factors is most likely to predict an increased risk of hepatotoxicity from the paracetamol?

A patient is suspected of having taken a substance with anticholinesterase effects. Which of the following combinations of signs, if present, would be the most likely to confirm this effect?

Out of the following drugs, which is best to use in a patient with obsessive compulsive disorder?

For treating patients with post-traumatic stress disorder which is the most appropriate medication?

A 22 year old boy is brought to the ER after being found unresponsive in a street. Physical examination reveals pinpoint pupils unresponsive to light and a respiratory rate of 7 breaths per minute. The most likely cause is which of the following?

A 47 year old female complains of exertional dyspnea for past six months. She is diagnosed with pulmonary fibrosis (PF). She received a variety of medications over a last one year. Her present condition may be caused by which one of the following?

The anticonvulsant medication which is preferred for the treatment of mania or hypomania in patients with bipolar disorder is

The most common side effect of lithium is

A 42 year old female develops in a skin rash when she takes trimethoprim/sulfamethoxazole for a urinary tract infection. The drug that would most likely to cause a similar reaction in this patient is

A patient develops acute renal failure after an overdose of methanol. The antidote of choice is

The drug useful in treatment of iron toxicity is

Warfarin is an anticoagulant used for a variety of cardiac conditions. Which of the following drug does NOT potentiate warfarin´s effects?

Anti-arrhythmic drug that causes lupus like symptoms such as pleural effusions, rash, arthralgia, and positive anti histone antibody is which one of the following?

A 26 year old man is brought to the emergency area of a hospital by the police. He had been picked up after making wild threats to people in convenience store. During the interview at the hospital he exhibits delusions of persecution, ideas of reference, and feelings of omnipotence. Multiple needle marks are noted over his arm veins and he agrees using IV drugs. Examination reveals tachycardia, mydriasis, diaphoresis, and agitation. He is treated with chlorpromazine IM, which reverses his psychotic state. The following agent that can be added to his therapeutic regimen to increase the clearance of this drug from his body is

A 40 year old woman with acute glaucoma is treated and maintained on the oral agent of choice for this condition. Several weeks later she has an arterial pH of 7.34, an arterial PCO2 of 29mm Hg, and plasma a HCO3- of 15 mFq/ L. Abnormality that this woman most likely developed is which one of the following?

A 48 year old man is being treated for type 2 diabetes and hypertension. He is also being treated for a mood disorder. He arrives at the ER complaining of a painful erection over the last 7 hours. What is the most likely cause of his current condition?

A researcher is studying calcium fluxes in cultured cells using confocal laser scanning microscopy. The magnitude of the signal (brightness) is proportional to the strength of the calcium flux. Strongest signal would be produced by stimulation of which receptor type?

A premature neonate born at 32 weeks gestation is diagnosed with neonatal respiratory distress syndrome. This patient´s condition may have been prevented by which one of the following?

A patient is started on a new drug that is noted to decrease sodium reabsorption and increase potassium reabsorption from the distal tubule. The patient was most likely prescribed which medication based on this information?

A 32 year old female has amenorrhea for the past several months. She also states that there is a “watery secretion” coming from both her nipples. Examination reveals a non-puerperal, watery secretion that does not contain white or red blood cells. Investigation reveals elevated serum prolactin levels. Her signs and symptoms are most likely caused by

A 53 year old woman presents to the doctor for a checkup. She is recovering from a wrist fracture after a fall. DEXA of the hip had shown her to have osteoporosis. She became menopausal at age 50 and started hormone replacement therapy because of a strong family history of breast cancer. She now fears a future hip fracture and would like to begin a bone loss prevention regime. Appropriate treatment for this patient is which one of the following?

A 49 year old overweight male has increased thirst and frequent urination. His blood glucose level is 180 mg/dL. 2 hours after oral administration of 75 grams of glucose, his blood glucose level is 202 mg/dL. Past medical history is unremarkable, except for an anaphylactic reaction that occurred one year ago when he was given trimethoprim sulfamethoxazole for a sinus infection. Which drug should be prescribed based on this information?

An adult with AML is administered a combination therapy that must be given intravenously. This drug´s antineoplastic action results from the inhibition of DNA polymerase and predominant toxicities observed are leukopenia and anemia. What is the likely therapeutic agent prescribed?

A 58 year old male has increased thirst and frequent urination. Following the ingestion of 75 g of a glucose solution, he has a blood glucose level of 293 mg/dL. He is started on a diet and exercise program. Which has been shown to exert a therapeutic effect most similar to that seen with diet and exercise in patients with this disease?

A 66 year old male has shaking chills and a temperature of 101°F. Investigation reveals a hematocrit of 23%, and urine tests are positive for blood. He is taking only one medication for his “irregular heartbeat.” The drug that likely caused the appearance of these signs and symptoms is

An 81 year old woman presents complaining of difficulty sleeping and problems coping throughout the day since the recent death of her husband. She requests a medication that will help her through this time of her life. Oxazepam is prescribed. What is the most likely rationale behind prescribing this drug?

An elderly male has ringing in his ears, blurred vision, and upset stomach. He is taking multiple medications. He has had a few episodes of confused, delirious behavior over the past few weeks. The drug responsible for his symptoms is

A smoker aged 57 years with a long history of chronic obstructive lung disease presents with a blood pressure of 150/95 mm Hg. The antihypertensive medication that is CONTRAINDICATED in this patient is which one of the following?

A 72-year-old man is treated for chest infection. For past 6 months,he is receiving Warfarin for atrial fibrillation with normal INR. However, his most recent INR was 5.2 (<1.4).Which one of the following drugs is responsible?

What is the resultant effect when partial opioid agonists are used in association with morphine?

A 58-year-old male with diabetes requests Sildenafil for erectile dysfunction. Which of the following are contraindicated with Sildenafil?

By replenishing which of the following compounds does N-acetylcysteine function as an antidote in paracetamol overdose?

A man aged 46 year is diagnosed pulmonary tuberculosis. Which one of the following investigations is essential prior to starting antituberculous therapy?

A 50 year old female who has had low back pain for several years is admitted to the hospital because the pain has suddenly worsened. She is currently taking oxycodone, amitriptyline, perphenazine, fluoxetine and trazodone. On physical examination, the patient is 10% below her ideal body weight, pupils are constricted and skin turgor is poor. She seems sluggish and her speech is slow. Results of neurologic examination and radiographs of the lumbosacral spine are normal. Which of the following medication you suspect as the cause of her mental symptoms?

Definitely indicated in all patients with prosthetic valves, mitral stenosis, and cardiomegaly:

The beta blocker that would be most useful for lowering blood pressure while minimizing bradycardia is

A 77 year old woman is diagnosed with metastatic breast cancer. The neoplasm is found to be hormonally responsive and treatment was started with Tamoxifen. Which of the following is NOT a major side effect of tamoxifen?

The pharmacologic agents that is most useful for treatment of generalized anxiety disorder is

The therapeutic agent that has the greatest activity against anaerobes such as Bacteroides fragilis is which one of the following?

Which of the following is NOT a side effect of thiazide diuretics?

Bronchospasm is most likely caused by which one of the following antihypertensive agent?

Cefuroxime is believed prescribed to a 52 year old smoker to treat a potential bacterial bronchitis. What is the mechanism of action of Cefuroxime?

Testing of a new antifungal medication is being conducted in phase I clinical trials. Examination of the drug´s pharmacokinetic properties reveals that the drug´s half life is 6 hours. If a continuous intravenous infusion of this drug were started on a research subject, how much time would it take to reach 75% of steady state?

A 25 year old man presents to the emergency department with crushing substernal pain of hour´s duration. ECG reveals an ST segment elevation, and the patient is given a medication that will break down fibrin thrombi. The most common complication of this medication is

A 65 year old chronic alcoholic man is brought to the ER after being found down in an alley. His shirt is bloody. Accurate history cannot be obtained. Examination reveals pallor, dyspnea, tachypnea, and obtundation. BP is low and his pulse rate increased. Endoscopy confirms, active esophageal bleeding. What medication would appropriate to help control his bleeding?

A 24 year old epileptic is maintained on primidone. Liver biopsy shows increased amounts of smooth endoplasmic reticulum. Increase in the activity of which of the following is most closely related with this change?

A 58 year old man is given antibiotic therapy for Pseudomonas aeruginosa with ceftazidime and gentamicin. Assuming that the half live of gentamicin is 3 hours in this patient, what percentage of the initial dose will most likely remain in his body after 6 hours?

A patient is given an immunosuppressive drug that inhibits de novo purine synthesis and is myelosuppressive. Later dose reduction is needed because he is also taking Allopurinol. The drug likely used is

A woman aged 65 years who received antineoplastic therapy 3 weeks earlier, is seen by her physician. ECG shows persistently reduced voltage of the QRS complex. Echocardiography indicates a prolonged systolic time interval and reduced ejection traction. Which agent was most likely included in her antineoplastic regimen?

A 57 year old man has difficulty initiating movements and a resting tremor. On examination, his face appears expressionless and he has a slow shuffling gait. He is started on selegiline. The mechanism of action of this drug is

A female infant´s genetic analysis with a broad, enlarged neck demonstrates an XO karyotype. When she reaches puberty, hormone replacement therapy should be started with which agents?

A 47 year old type 2 diabetic on daily extended release glipizide presents with polyuria and polydipsia. Lab data reveals blood glucose of 192mg/dL. Her diabetes had been well controlled and that she had been symptom free for the past 8 years. Recently, however, she began taking medication for hypertension. Which antihypertensive is she most likely taking?

A 34 year old patient with a history of asthma is being treated for symptoms of hypertension. The beta blockers would be an appropriate therapy for this patient is which one of the following?

A 57 year old man with hypertension and a past medical history of myocardial infarction is prescribed atenolol. How will this drug lower his blood pressure?

A 47 year old woman is under treatment for breast carcinoma. For the past few days, she has been complaining of dysuria and frequency. Investigation reveals the presence of microscopic hematuria. Next day the patient develops gross hematuria. Which drug could be used to treat the side effect from the medication taken by her?

A 58 year old man with a history of MI has shortness of breath. On exam, his heart rate is 110/min, respiratory rate is 22/min and has peripheral edema. Auscultation reveals normal sinus rhythm with an S3 gallop. Ejection fraction is reduced. Which drug would alleviate his symptoms by reducing both the preload and afterload on the heart without affecting its isotropic state?

A 44 year old woman is brought to the hospital after collapsing on the sidewalk in front of the hospital. Initial evaluation reveals severe hypotension, and she is given intravenous norepinephrine. Which drug antagonizes both the vascular and cardiac actions of the given medication?

Correct statement regarding Oseltamivir is which one of the following?

Which term best describes the affinity of a drug for its receptor?

An alcoholic male of 39 year of age has successfully completed outpatient alcohol detoxification and has plans to participate in Alcoholics Anonymous. The medication that can help in relapse prevention is which one of the following?

Which of the following is a centrally acting antihypertensive agent?

Which side effect induced by traditional neuroleptic agents responds to treatment with Beta- blockers?

All of the following are chelating agents EXCEPT

A type 1 anti-arrhythmic useful in converting atrial fibrillation to sinus rhythm.

Administration of diuretics is recommended for all of the following conditions EXCEPT

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

A hypertensive presents with a dry, hacking cough. He is taking captopril, which is an angiotensin converting enzyme inhibitor. Which of the following is NOT a side effect of ACE inhibitors?

Which of the following is NOT a side effect of thiazide diuretics?

A lupus like reaction is most likely caused by which antihypertensive agent?

Nausea, vomiting, seizures, and arrhythmias are caused by toxic levels of theophylline. Which one of the following CANNOT increase theophylline levels?

A 57 year old man had a mild MI. After improvement a drug is prescribed that, when administered to children, has been associated with Reye syndrome following an active varicella infection. The prescribed drug inhibits platelet aggregation by decreasing the production of which one of the following?

What is the most likely early symptom of salicylate intoxication?

A man is diagnosed with lymphoma. He is given a chemotherapeutic agent that acts by first order kinetics. This medication administration would be expected to kill a

A 29 year old woman with chronic renal failure requires kidney transplantation. Cyclosporine is given just before surgery to prevent rejection. After taking cyclosporine, she is most likely to experience which adverse effect?

A 33 year old man has weakness and blurred vision that are typically worsened with effort and improve with rest. Examination shows ptosis and limb muscle weakness on repetitive testing. What is the mechanism of action of the drug that is commonly prescribed for the long term amelioration of these symptoms?

A 16 year old girl has had mild persistent asthma for several years. Her symptoms have worsened recently. A drug that will produce a prolonged increase in cAMP levels for prophylaxis of her symptoms is

A 24 year old epileptic is maintained on primidone. Liver biopsy shows increased amounts of smooth endoplasmic reticulum. Increase in the activity of which of the following is most closely related with this change?

In the ER a 4 year old boy is brought with a recent onset of a rash, urticarial, and a fever of 101°F. According to the mother her son has been complaining that his “bones hurt.” Examination reveals mild lymphadenopathy. His past medical history is unremarkable except that he just finished a 10 day course of Cefaclor suspension for treatment of an upper respiratory infection. What is the appropriate treatment for the boy?

A patient is on naproxen for few months. He presents with multiple complaints about this medication. His physician decides to prescribe celecoxib instead. Which is the benefit of celecoxib over naproxen?