Choose the best answer from the given choices and write the letter of your choice
on the Answer Sheet
1. The FDA assigns the letters A, B, C, D, and X to drugs approved for human use. To
which of the following does this classification apply?
A. Amount of dosage reduction needed as serum creatinine clearances fall
B. Amount of dosage reduction needed in presence of liver dysfunction
C. Fetal risk when given to pregnant women
D. Relative margins of safety/therapeutic index
2. We administer a therapeutic dose of a drug that selectively and competitively blocks
the postsynaptic Alpha-adrenergic (alpha-1) receptors. It has no effects on
presynaptic alpha adrenergic receptors (alpha-2) or beta-adrenergic receptors found
anywhere in the periphery, whether as an agonist or antagonist. Which of the
following is the most likely drug?
A. Ephedrine B. Labetalol C. Phentolamine D. Prazosin
3. We have a patient with essential hypertension, and unusually high circulating
catecholamine levels. Our goal is to block both alpha and beta adrenergic receptors
using just one drug. Which of the following is capable of doing that?
A. Labetalol B. Metoprolol C. Nadolol D. Timolol
4. A patient with chronic obstructive pulmonary disease (COPD, e.g., emphysema) is
receiving an orally inhaled muscarinic receptor-blocking drug to maintain
bronchodilation. Which of the following drug is this patient most likely taking?
A. Albuterol C. Ipratropium
B. Diphenhydramine D. Pilocarpine
5. We have a 48-year-old female patient with a history of myasthenia gravis. She has
been treated with an oral acetylcholinesterase inhibitor for several years, and has
done well till now. She presents with muscle weakness and other signs and
symptoms that could reflect either a cholinergic crisis (excess dosages of her
1|Page Pharmacology and Toxicology Model Exam
, maintenance drug) or a myasthenic crisis (insufficient treatment). We will use a
rapidly acting parenteral acetylcholinesterase inhibitor (AChE) to help make the
differential diagnosis.
Which of the following drugs would be most appropriate for this use?
A. Edrophonium B. Physostigmine C. Pralidoxime D. Pyridostigmine
6. It is common to include small amounts of epinephrine (EPI) in solutions of local
anesthetics that will be administered by infiltration (injection around sensory nerve
endings), as when a skin laceration needs suturing. Which of the following is the
most likely reason for, or outcome of, including the EPI?
A. To counteract cardiac depression caused by the anesthetic
B. To prevent anaphylaxis in patients who are allergic to the anesthetic
C. To reduce the risk of toxicity caused by systemic absorption of the anesthetic
D. To shorten the duration of anesthetic action
7. “First-generation” (older) histamine H1 blockers such as diphenhydramine,
phenothiazine antipsychotic drugs (e.g., chlorpromazine), and tricyclic
antidepressants (e.g., imipramine) have pharmacologic actions, side effects,
toxicities, and contraindications that are very similar to those of which of the
following?
A. Atropine B. Bethanechol C. Neostigmine D. Propranolol
8. The attending with whom you are working in the emergency department quizzes you
on your basic knowledge of local anesthetics and their uses. She asks you to identify
the drug that is suitable for topical administration (e.g., to mucous membranes), but
cannot be given parenterally because of its physicochemical properties, which
render it very poorly soluble. Which of the following drugs is the best answer to her
question?
A. Benzocaine B. Bupivacaine C. Etidocaine D. Procaine
9. A physician considers placing a patient on long-term (months, years) phenobarbital
for control of a relatively common medical condition. For most of these indications,
newer and arguably more efficacious drugs are available and preferred. For which of
2|Page Pharmacology and Toxicology Model Exam
, the following, however, is it still considered reasonable and appropriate to use this
barbiturate?
A. Alcohol withdrawal signs/symptoms
B. Anxiety management
C. Certain epilepsies D. Sleep disorders such as insomnia
10. We have a patient with Parkinson’s disease. Signs and symptoms can be classified
as “moderate” now but progressive and not responding well to current drug therapy.
The physician decides to empirically assess an antiparkinson drug that is a selective
inhibitor of monoamine oxidase type B (MAO-B). Which of the following drugs would
that be?
A. Bromocriptine B. Carbidopa C. Phenelzine D. Selegiline
11. After a few weeks on a drug, a patient reports profound thirst and the production of
copious volumes of clear (dilute) urine each day. Which of the following drugs is
most likely responsible for the signs and symptoms?
A. Diazepam B. Fluoxetine C. Haloperidol D. Lithium
12. A 31-year-old woman has been treated with fluoxetine for 5 months. She is
diagnosed with another medical problem and receives one or more drugs that,
otherwise, would be suitable and probably problem-free. She is rushed to the ED
with unstable vital signs, muscle rigidity, myoclonus, CNS irritability and altered
consciousness, and shivering. Which of the following add-on drugs most likely
causes these responses?
A. Codeine for cough C. Sumatriptan for migraine
B. Loratadine for seasonal allergies D. Zolpidem for short-term insomnia
13. A 72-year-old woman with a long history of anxiety that has been treated with
diazepam decides to triple her daily dose because of increasing fearfulness about
“environmental noises.” Two days after her attempt at self-prescribing, she is found
3|Page Pharmacology and Toxicology Model Exam
on the Answer Sheet
1. The FDA assigns the letters A, B, C, D, and X to drugs approved for human use. To
which of the following does this classification apply?
A. Amount of dosage reduction needed as serum creatinine clearances fall
B. Amount of dosage reduction needed in presence of liver dysfunction
C. Fetal risk when given to pregnant women
D. Relative margins of safety/therapeutic index
2. We administer a therapeutic dose of a drug that selectively and competitively blocks
the postsynaptic Alpha-adrenergic (alpha-1) receptors. It has no effects on
presynaptic alpha adrenergic receptors (alpha-2) or beta-adrenergic receptors found
anywhere in the periphery, whether as an agonist or antagonist. Which of the
following is the most likely drug?
A. Ephedrine B. Labetalol C. Phentolamine D. Prazosin
3. We have a patient with essential hypertension, and unusually high circulating
catecholamine levels. Our goal is to block both alpha and beta adrenergic receptors
using just one drug. Which of the following is capable of doing that?
A. Labetalol B. Metoprolol C. Nadolol D. Timolol
4. A patient with chronic obstructive pulmonary disease (COPD, e.g., emphysema) is
receiving an orally inhaled muscarinic receptor-blocking drug to maintain
bronchodilation. Which of the following drug is this patient most likely taking?
A. Albuterol C. Ipratropium
B. Diphenhydramine D. Pilocarpine
5. We have a 48-year-old female patient with a history of myasthenia gravis. She has
been treated with an oral acetylcholinesterase inhibitor for several years, and has
done well till now. She presents with muscle weakness and other signs and
symptoms that could reflect either a cholinergic crisis (excess dosages of her
1|Page Pharmacology and Toxicology Model Exam
, maintenance drug) or a myasthenic crisis (insufficient treatment). We will use a
rapidly acting parenteral acetylcholinesterase inhibitor (AChE) to help make the
differential diagnosis.
Which of the following drugs would be most appropriate for this use?
A. Edrophonium B. Physostigmine C. Pralidoxime D. Pyridostigmine
6. It is common to include small amounts of epinephrine (EPI) in solutions of local
anesthetics that will be administered by infiltration (injection around sensory nerve
endings), as when a skin laceration needs suturing. Which of the following is the
most likely reason for, or outcome of, including the EPI?
A. To counteract cardiac depression caused by the anesthetic
B. To prevent anaphylaxis in patients who are allergic to the anesthetic
C. To reduce the risk of toxicity caused by systemic absorption of the anesthetic
D. To shorten the duration of anesthetic action
7. “First-generation” (older) histamine H1 blockers such as diphenhydramine,
phenothiazine antipsychotic drugs (e.g., chlorpromazine), and tricyclic
antidepressants (e.g., imipramine) have pharmacologic actions, side effects,
toxicities, and contraindications that are very similar to those of which of the
following?
A. Atropine B. Bethanechol C. Neostigmine D. Propranolol
8. The attending with whom you are working in the emergency department quizzes you
on your basic knowledge of local anesthetics and their uses. She asks you to identify
the drug that is suitable for topical administration (e.g., to mucous membranes), but
cannot be given parenterally because of its physicochemical properties, which
render it very poorly soluble. Which of the following drugs is the best answer to her
question?
A. Benzocaine B. Bupivacaine C. Etidocaine D. Procaine
9. A physician considers placing a patient on long-term (months, years) phenobarbital
for control of a relatively common medical condition. For most of these indications,
newer and arguably more efficacious drugs are available and preferred. For which of
2|Page Pharmacology and Toxicology Model Exam
, the following, however, is it still considered reasonable and appropriate to use this
barbiturate?
A. Alcohol withdrawal signs/symptoms
B. Anxiety management
C. Certain epilepsies D. Sleep disorders such as insomnia
10. We have a patient with Parkinson’s disease. Signs and symptoms can be classified
as “moderate” now but progressive and not responding well to current drug therapy.
The physician decides to empirically assess an antiparkinson drug that is a selective
inhibitor of monoamine oxidase type B (MAO-B). Which of the following drugs would
that be?
A. Bromocriptine B. Carbidopa C. Phenelzine D. Selegiline
11. After a few weeks on a drug, a patient reports profound thirst and the production of
copious volumes of clear (dilute) urine each day. Which of the following drugs is
most likely responsible for the signs and symptoms?
A. Diazepam B. Fluoxetine C. Haloperidol D. Lithium
12. A 31-year-old woman has been treated with fluoxetine for 5 months. She is
diagnosed with another medical problem and receives one or more drugs that,
otherwise, would be suitable and probably problem-free. She is rushed to the ED
with unstable vital signs, muscle rigidity, myoclonus, CNS irritability and altered
consciousness, and shivering. Which of the following add-on drugs most likely
causes these responses?
A. Codeine for cough C. Sumatriptan for migraine
B. Loratadine for seasonal allergies D. Zolpidem for short-term insomnia
13. A 72-year-old woman with a long history of anxiety that has been treated with
diazepam decides to triple her daily dose because of increasing fearfulness about
“environmental noises.” Two days after her attempt at self-prescribing, she is found
3|Page Pharmacology and Toxicology Model Exam
