Pharmacology MCQ Quiz - Objective Question with Answer for Pharmacology - Download Free PDF

• Cyclosporine is an immunosuppressant medication commonly used to prevent organ rejection after a renal transplantation. It works by inhibiting the activity of the immune system to reduce the risk of the body attacking the transplanted organ.
• One of the primary concerns for clients taking cyclosporine is the increased risk of infections due to the suppression of the immune system. The body's normal ability to fight off infections is compromised, making even minor infections potentially serious.
• Clients must be taught to be vigilant for signs of infection such as fever, chills, sore throat, cough, or any other unusual symptoms and to report these immediately to their healthcare provider.

• Rationale: Hypotension, or low blood pressure, is not commonly associated with cyclosporine. In fact, cyclosporine can sometimes cause hypertension (high blood pressure), making this option incorrect.

• Rationale: Although GI disturbances such as nausea, vomiting, and diarrhea can occur with cyclosporine use, they are not as critical as the risk of infections. Monitoring and managing GI symptoms is important, but it does not require the same level of immediate alertness as signs of infection.

• Rationale: Hair loss is not a common side effect of cyclosporine. While some clients may experience changes in hair growth, it is not a primary concern and does not require the same level of vigilance as monitoring for signs of infection.

• Among the given options, being alert for signs of infection is the most critical aspect for clients taking cyclosporine post-renal transplantation due to the immunosuppressive nature of the medication. Prompt identification and treatment of infections are essential to prevent serious complications.

• Prednisolone is a corticosteroid medication commonly used in chemotherapy protocols for conditions like Acute Lymphoblastic Leukemia (ALL). It works by suppressing the immune system and inflammation.
• One of the well-known side effects of corticosteroids like Prednisolone is mood changes. These mood changes can include symptoms such as irritability, anxiety, euphoria, and even depression.
• The mood changes are due to the effect of corticosteroids on the central nervous system, altering neurotransmitter levels and affecting mood regulation.

• Rationale: Alopecia, or hair loss, is commonly associated with chemotherapy agents like alkylating agents and antimetabolites, rather than corticosteroids like Prednisolone.

• Rationale: Anorexia, or loss of appetite, is not a typical side effect of Prednisolone. In fact, corticosteroids can increase appetite rather than suppress it.

• Rationale: Weight loss is not commonly associated with Prednisolone. Instead, corticosteroids can lead to weight gain due to increased appetite and fluid retention.

• Among the given options, mood changes are the anticipated side effect when a 5-year-old child with ALL is started on a chemotherapy protocol that includes Prednisolone. Mood changes are a common and significant side effect of corticosteroid therapy due to their impact on the central nervous system.

• Prednisolone is a corticosteroid medication used to treat a variety of conditions, including inflammation, allergic reactions, and autoimmune diseases. One of the significant side effects of corticosteroids like prednisolone is their impact on blood glucose levels.
• Corticosteroids can induce hyperglycemia (high blood sugar levels) by increasing gluconeogenesis in the liver and reducing the sensitivity of tissues to insulin.
• Monitoring blood sugar levels hourly in patients receiving prednisolone is crucial to detect and manage hyperglycemia promptly, preventing potential complications such as diabetic ketoacidosis or hyperosmolar hyperglycemic state.
• Regular blood sugar checks allow healthcare providers to adjust medication dosages or introduce insulin therapy if necessary to maintain optimal glucose levels.

• Rationale: While monitoring urine output is important in many clinical scenarios, it is not directly related to the primary side effects of prednisolone. Urine output monitoring is more relevant in conditions involving fluid balance and kidney function.

• Rationale: Urine specific gravity measures the concentration of solutes in the urine, which can indicate hydration status and kidney function. However, it is not directly related to the side effects of prednisolone and would not provide specific information about blood sugar levels.

• Rationale: Monitoring the blood level of prednisolone is not a common practice in clinical settings. The therapeutic and toxic effects of prednisolone are generally monitored through clinical signs and symptoms rather than direct measurement of drug levels.

• Among the given options, checking blood sugar levels hourly is the most important nursing intervention for a patient receiving prednisolone. This monitoring helps in early detection and management of hyperglycemia, a common and potentially serious side effect of corticosteroid therapy.

• Cathartics are substances that accelerate defecation. They are often used to relieve constipation or to clear the bowels before a medical procedure such as a colonoscopy.
• Cathartics work by stimulating bowel movements, either by increasing the bulk of the stool, softening it, or by irritating the intestinal lining to induce peristalsis (the wave-like muscle contractions that move food through the digestive tract).

• Rationale: Carminatives are substances that help in the expulsion of gas from the intestines, thereby relieving bloating and discomfort. They do not promote bowel evacuation but rather alleviate symptoms of gas and indigestion.

• Rationale: Astringents are substances that cause the contraction of body tissues, typically used to reduce bleeding from minor abrasions or as a cosmetic to tighten the skin. They do not facilitate intestinal evacuation.

• Rationale: Antimycotics, also known as antifungal agents, are used to treat fungal infections. They do not have any role in promoting bowel movements or intestinal evacuation.

• Among the given options, cathartics are the substances specifically used for intestinal evacuation. They are essential in medical practices for clearing the bowel, especially before diagnostic procedures or surgeries.

• Patients with acute kidney injury (AKI) often have compromised kidney function, which can affect the body's ability to regulate electrolytes.
• ACE inhibitors (Angiotensin-Converting Enzyme inhibitors) are commonly prescribed to manage conditions such as hypertension and heart failure by blocking the conversion of angiotensin I to angiotensin II, which leads to vasodilation and decreased blood pressure.
• One significant side effect of ACE inhibitors is hyperkalemia, an elevated level of potassium in the blood. This occurs because ACE inhibitors reduce the production of aldosterone, a hormone that promotes the excretion of potassium in the urine.
• In patients with AKI, the kidneys are already impaired in their ability to excrete potassium efficiently, which can exacerbate the risk of hyperkalemia.
• Hyperkalemia can lead to serious cardiac complications, including arrhythmias and cardiac arrest, making it crucial for the nurse to monitor serum potassium levels closely in these patients.

• Rationale: While serum phosphate levels can be affected in kidney injury due to the kidneys' role in phosphate excretion, ACE inhibitors do not typically have a direct effect on phosphate levels. Therefore, monitoring phosphate is not as critical as monitoring potassium in this context.

• Rationale: Serum copper is not commonly affected by either acute kidney injury or ACE inhibitor use. Copper levels are more related to liver function and certain genetic disorders, making it irrelevant in this scenario.

• Rationale: Although magnesium levels can be influenced by kidney function, they are not as critically impacted by ACE inhibitors as potassium levels are. Monitoring magnesium is not the primary concern in patients with AKI receiving ACE inhibitors.

• Among the given options, monitoring serum potassium levels is essential for patients with acute kidney injury receiving ACE inhibitors, due to the high risk of hyperkalemia and its potentially severe cardiac consequences.

• Chloramphenicol causes dose-dependent, reversible bone marrow suppression due to mitochondrial injury.
• It is due to its ability to reversibly inhibit mitochondrial protein synthesis and also the damage to the inner membrane of mitochondria. Hence Option 3 is the Correct Answer.

Concept

• Chloramphenicol is an antibiotic given for the treatment of serious infections and systemic infections.
• Chloramphenicol is mainly semisynthetic, a broad-spectrum antibiotic derived from Streptomyces venequelae and it has bacteriostatic activity.

Other side effects of chloramphenicol are:

• aplastic anaemia
• diarrhoea
• inflammation of the small intestine and the colon (enterocolitis)
• headache
• nausea
• nightmares
• inflammation of the optic nerve
• weakness and numbness in your hands and feet
• rash
• inflamed and sore mouth
• vomiting

Additional Information

•  Gray baby syndrome is a very serious side effect in which an infant experiences a life-threatening reaction to the antibiotic Chloramphenicol.
•  It occurs due to circulatory collapse that occurs in premature and newborn infants and is associated with excessively high serum levels of chloramphenicol.
• It is mainly characterized by ashen-grey colour skin, abdominal distention, vomiting, flaccidity, cyanosis, circulatory collapse, and death.

The correct answer is Methyl Salicylate.

Key Points

• Its molecular formula is C₈H₈O₃.
• Molecular Weight: 152.15 g/mol.
• Methyl salicylate is an organic ester naturally produced by many species of plants, particularly wintergreens.
• It is also synthetically produced, used as a fragrance, in foods and beverages, and in liniments.
• Methyl salicylate appears as a colorless yellowish or reddish liquid with an odor of wintergreen.
• It was first extracted and isolated from plant species Gaultheria procumbens in 1843.

​Important Points

• It exhibits a characteristic odor and taste of wintergreen.
• For acute joint and muscular pain, methyl salicylate is used as a rubefacient and analgesic in deep heating liniments.
• It is used as a flavoring agent in chewing gums and mints in small concentrations.
•  It is used as an antiseptic in Listerine mouthwash produced by the Johnson & Johnson company.

​Additional Information

• Ethyl salicylate:
  • Molecular Formula: C9H10O3.
  • Molecular Weight: 166.17 g/mol.
  • Ethyl salicylate is a hydroxybenzoic acid.
  • colorless to pale yellow liquid with a spicy, anisic, wintergreen-like odor.
  • slightly soluble in water, glycerol; soluble in organic solvents, oils.
• Propyl salicylate:
  • Molecular Formula: C₁₀H₁₂O₃.
  • Molecular Weight: 180.2 g/mol.
• Butyl salicylate:
  • Molecular Formula: C₁₁H₁₄O₃.
  • Molecular Weight: 194.23 g/mol.
  • It is used as a flavoring agent.

The correct answer is Antacid. 

• "Eno, Gelusil, Digene", etc are the types of Antacid. 

Key Points

• Drugs: 
  • Drugs are substances of low molecular mass, that interact in the body and produce a biological response. 
  • Specific drugs have been prescribed to patients by a doctor, as per necessity. 
• Role & Effects of Drugs: 
  • Either increases or decreases the role of enzyme-catalyzed reactions is the main role of drugs.
  • The inhibition of enzymes is a common motive in the action of the drug.
• Therapeutic effect:
  • The beneficial effect of a drug like the treatment of symptoms in the human body.
  • And the cure of a disease is known as the therapeutic effect. 

Additional Information

The following table shows the following types of drugs with respective features & examples.

Explanation:

• Hippocrates is a Greek physician who was born in 460 B.C. He has been the most outstanding figure in the history of medicine. He is also described as the father of medicine (Hence option 1 is correct).

Key Points

• The 'Hippocratic oath' is an oath taken by physicians and other healthcare professionals around the world, swearing in to practice medicine honestly. 
• Hippocrates's big legacy is the development of clinical observation that is the diagnosis, prognosis, observation, and treatment.

Further, His important contributions to epidemiology are:

• He attempted to use rational versus supernatural means to explain disease occurrence.
• He recognized that disease not only affects individuals but populations as well.
• He wrote three books that dealt with epidemiologic concepts include- Epidemic I, Epidemic III, and Air, Water and Place.
• He differentiated between endemic disease and epidemic disease.
• He recognized associations between the environment and other factors for example water conditions, housing, and climate, etc.

Additional Information

• Paul Berg: is an American biochemist born in 1926. He received a Nobel prize in chemistry in 1980 for his research involving you click acids. Berg is often referred to as 'Father of Genetic Engineering.
• Galen: was a Greek physician, surgeon, and philosopher in the Roman empire. He is called the 'Father of Medical Investigation'. He influenced the development of a variety of scientific disciplines, including anatomy, physiology, pathology, pharmacology, and neuroscience.
• Karl Landsteiner: was an Austrian biologist, physician, and immunologist born in1868. He is described as the 'Father of Transfusion Medicine' and posthumously awarded with 'Lasker Award' in 1946.

Concept:-

• Prednisolone is a Glucocorticoid drug used to reduce inflammation, and adrenal Insufficiency and is also used in some cancers.
• Prednisolone is a glucocorticoid similar to cortisol used for its anti-inflammatory, immunosuppressive, anti-neoplastic, and vasoconstrictive effects
  • Every medication has a maximum dose in a day according to the child's weight. Prednisolone is a corticosteroid that is allowed 2 mg/kg/day in the above case.
  • The order reads as 10mg four times a day. Therefore, 10 mg*4 = 40 mg per day is the maximum dose for the child.

Explanation:

• The prescribed dose is 40 mg per day.
• If we assume the child's weight as x.
• 2 mg * x(kg) * 1 = 40 mg per day
• x = 40/2
• 20 kgs is the weight of the child.
• 1 kg = 2.20462 lbs (pounds)

Therefore, 20 kg = 44 pounds.

Concept:

 Adrenaline - It is secreted in the Medulla at the adrenal gland as well as some neurons of the Central Nervous System.

• It is known as an emergency hormone because it initiates the quick reaction which makes the individual think and respond quickly to the stress.
• The functions of Adrenaline include - increases the metabolic rate, dilation of blood vessels, etc.

Uses Of Adrenaline

• Anaphylactic Shock
• Cardiac Arrest
• Control Of Haemorrhage
• With Local Anaesthetics
• Acute Bronchial Asthma
• Glaucoma

Contraindications

• Angina pectoris
• Hypertension
• Patients on β blockers

Additional Information

Concept:

• Anti-epileptic drugs = (AEDs) -> used treatment for epilepsy.
• Midazolam nasal spray is a prescription medicine used for the short-term treatment of seizure clusters
• Intranasal midazolam is administered as an antiepileptic and also seen to be effective and reasonably safe for the treatment of acute seizures in the case of the pediatric population.
• Midazolam is a new imidazobenzodiazepine. This drug is more potent and has a shorter duration of action than diazepam. It acts by slowing activity in the brain to induce relaxation and sleep.
• Dose: 5mg/0.1mL per single-dose spray

Additional Information

• Diazepam is a drug used to treat anxiety, alcohol withdrawal, and seizures. It is also used to relieve muscle spasms and to provide sedation as  pre procedures. This mainly works by calming the brain and nerves. it also belongs to a class of drugs known as benzodiazepines.
• Clobazam is a benzodiazepine used to help control seizures (convulsions) that occur with Lennox-Gastaut syndrome . It works in the brain to prevent seizures. 
• Nitrazepam also belongs to the Benzodiazepine family of drugs. They are usually administered in the short-term treatment of insomnia (as well as other sleeping problems such as regular night awakenings, early morning awakenings, and trouble falling asleep.

Explanation-

Orphan drugs

• It is used to treat rare medical conditions.
• These drugs are developed by the pharmaceutical industry for public health needs and not for economic reasons.
• It is used to treat acute intermittent porphyria, variegate porphyria, and hereditary coproporphyria.
• Ibuprofen can also be categorized as an orphan drug because it has been used to treat an orphan disease, namely patent ductus arteriosus in neonates.
• Eloctate, Nelarabine, Raxibacumab etc are examples of orphan drugs.

Additional Information

Key Points 

Orphan Drugs are the ones which are used for the treatment of rare diseases and Rare drugs are rare because of their rare availability.

Concept-

• 'Antibiotics' term was coined by Selman Waksman.
• Anti is a Greek word that means ‘against’, and bio means ‘life’, together they mean ‘against life’ (in the context of disease-causing organisms); whereas with reference to human beings, they are ‘pro life’ and not against.
• Antibiotics are antimicrobial drugs.
• Antibiotics are used as drugs to treat infections because of their low toxicity for humans and animals.
• Antibiotics function either by killing bacteria or inhibiting the growth of bacteria.

Explanation-

Streptomycin

• Streptomycin was first isolated by Albert Schatz on October 19, 1943.
• Streptomycin is produced by Streptomyces griseus.
• Streptomycin is used to treat a bacterial infection, it is regarded as an antibiotic.

• The tetracyclines antibiotics were discovered by Benjamin Minge Duggar in 1948.
• The tetracycline produced by Streptomyces aureofaciens.
• Tetracyclines inhibit bacterial growth rather than killing them, so it is regarded as an antibiotic.

• Penicillin was the first antibiotic to be discovered.
• Penicillin was discovered by Alexander Fleming.
• Penicillin is produced by Penicillium notatum.
• Penicillins work by inhibiting bacterial cell wall synthesis, so it is regarded as an antibiotic.

Therefore the correct option is 'All the Above'

Additional Information

• Antibiotics have greatly improved our capacity to treat deadly diseases such as plague, whooping cough (kali khansi), diphtheria (gal ghotu) and leprosy (kusht rog), which used to kill millions all over the globe.
• Antibiotics are obtained from lichens, fungi, eubacteria and actinomycetes.

Concept –

• IV bolus is a large number of fluid or drug doses given intravenously .
• It given by slowly intravenous infusion
• Administration should be via volumetric infusion pump  through the peripheral line .

Additional Information

• Dilute CNS :- this means that they speed up central nervous system increasing heart rate temperature  , blood pressure  increasing in energy level
• Slow intrusion :- movement of tooth back into the bone
• Orange juice :- it contain antioxidant and potassium regular consumption, including improving health.

 Important Points

• Potassium plays important roles in transmission nerve signals ,muscles contraction.