Pharmacology MCQs – Autonomic Nervous System (B. Pharma/ D. Pharma/ GPAT/ Pharmacist/ DI)

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Parasympathomimetics 1. Cholinomimetics are not used in (a) Glaucoma (b) Myasthenia gravis (c) Postoperative atony (d) Partial heart block 2. A patient presents to emergency with pinpoint pupil, salivation, lacrimation, tremors and red tears. Plasma cholinesterase level was 30% of normal. Most probable Diagnosis is (a) Organophosphate poisoning (b) Datura poisoning (c) Opioid poisoning (d) Pontine haemorrhage 3. Lid retraction is caused by (a) Bimatoprost (b) Latanoprost (c) Brimonidine (d) Apraclonidine 4. What is the probable diagnosis in a patient with a dilated pupil not responsive to 1% pilocarpine (a) Diabetic 3rd nerve palsy (b) Adie’s tonic pupil (c) Uncal herniation (d) Pharmacological block 5. Dilator papillae is supplied by (a) Postganglionic parasympathetic from Edinger Westphal nucleus (b) Postganglionic sympathetic from cervical sympathetic chain (c) Third cranial nerve (d) Sympathetic fibres of front orbtital branch of trigeminal nerve 6. A patient came to the casualty with acute bronchial asthma after treatment for glaucoma. The probable drug may be (a) Timolol (b) Betaxolol (c) Latanoprost (d) Anticholinesterase 7. Which of the following drugs should not be given in a patient with acute angle closure glaucoma (a) Pilocarpine (b) Clozapine (c) Fluphenazine (d) Paroxetine 8. Synaptic transmission in the autonomic ganglion is usually (a) Adrenergic (b) Peptidergic (c) Cholinergic (d) Mediated by substance P 9. Which of the following cranial nerve does not contain parasympathetic motor (GVE) fibres (a) III (b) VI (c) IX (d) X 10. Major neurotransmitter released at end organ effectors of the sympathetic division of the autonomic nervous system is (a) Adrenaline (b) Noradrenaline (c) Dopamine (d) Acetylcholine 11. All of the following agents are used in glaucoma treatment, except (a) Apraclonidine (b) Timolol (c) Pilocarpine (d) Metoprolol 12. Which of the following antiglaucoma medication is UNSAFE in infants (a) Timolol (b) Brimonidine (c) Latanoprost (d) Dorzolamide 13. Diagnosis of myasthenia gravis is done by using (a) Edrophonium (b) Neostigmine (c) Succinylcholine (d) Atropine 14. Which of the following statements is FALSE (a) Hemicholinium prevents the release of ACh from storage vesicles (b) Botulinum toxin increase the ACh release (c) Pralidoxime reactivates acetylcholine esterase (d) Vesamicol inhibit the uptake of choline (e) Organophosphates inhibit acetylcholinesterase 15. True statements about neostigmine are (a) It is a quaternary ammonium compound (b) It is metabolised by liver (c) It can cross the blood brain barrier (d) Prominent effect on cardiac muscle 16. Which of the following provides the best explanation for neostigmine being preferred over physostigmine for treating myasthenia gravis (a) It is better absorbed orally (b) It has longer duration of action (c) It has additional direct agonistic action on nicotinic receptors at the muscle end plate (d) It penetrates blood brain barrier 17. Which of the following properties make pyridostigmine different from neostigmine (a) It is more potent (b) It is longer acting (c) It produces less muscarinic side effects (d) It does not have any direct action on NM receptors 18. Which of the following is the longest acting ocular beta blocker (a) Timolol (b) Betaxolol (c) Cartiolol (d) Metoprolol 19. Several children at a summer camp were hospitalized with symptoms thought to be due to ingestion of food containing botulinum toxin. The effects of botulinum toxin are likely to include (a) Bronchospasm (b) Cycloplegia (c) Diarrhea (d) Skeletal muscle spasms 20. Pinpoint pupil suggests poisoning with (a) DDT (b) Opiates (c) Belladonna (d) Barbiturates 21. Which of the following drug binds only with the anionic site of cholinesterase (a) Physostigmine (b) Neostigmine (c) Edrophonium (d) Pyridostigmine 22. Cholinomimetics are not used is (a) Glaucoma (b) Myasthenia gravis (c) Postoperative atony (d) Partial heart block 23. Correct match of drug and mechanism of action is (a) Brimonidine – Decrease aqueous production (b) Latanoprost – Carbonic anhydrase inhibitor (c) Pilocarpine – Increases uvoescleral outflow (d) Betaxolol – Increases trabecular outflow 24. Cholinomimetic drugs can be used for the treatment of all the following conditions EXCEPT (a) Closed angle Glaucoma (b) Bradycardia (c) Cobra bite (d) Myasthenia gravis 25. Which of the following cranial nerves does not carry parasympathetic outflow (a) Oculomotor (b) Trochlear (c) Facial (d) Glossopharyngeal 26. Mechanism of action of pralidoxime is (a) Stimulation of ACh receptors (b) Inhibition of breakdown of ACh (c) Blockade of ACh receptors (d) Reactivation of AChE enzyme 27. All of the following effects are seen with cholinergic muscarinic receptor stimulation except (a) Sweating (b) Rise in blood pressure (c) Bradycardia (d) Urination 28. A patient Raj Kishore was given pilocarpine. All of the following can be the features seen in him except (a) Sweating (b) Salivation (c) Miosis (d) Cycloplegia 29. Agonistic action at which of the following adrenergic receptors results in the reduction of aqueous secretion (a) β1 receptor (b) β2 receptor (c) M2 receptor (d) α2 receptor 30. A direct acting cholinomimetic that is lipid soluble and has been used in the treatment of glaucoma is (a) Acetylcholine (b) Physostigmine (c) Pilocarpine (d) Neostigmine Parasympatholytics 31. All of the following drugs are useful in detrusor instability except (a) Solefenacin (b) Tolterodine (c) Flavoxate (d) Duloxetine 32. Use of Tiotropium is contraindicated in (a) Bronchial asthma (b) Hypertension (c) Urinary retention (d) Peptic ulcer disease 33. Which one of the following drugs does not produce central anticholinergic syndrome (a) Atropine sulphate (b) Glycopyrrolate (c) Antihistaminics (d) Tricyclic antidepressants 34. Atropine can cause (a) Decreased cardiac output (b) Heart block (c) Hypertension (d) Mydriasis 35. Atropine poisoning causes all, EXCEPT (a) Dilated pupil (b) Excitement (c) Excessive salivation (d) Hot skin 36. All of the following are actions of muscarinic antagonists except (a) Decreases gastric secretion (b) Prolongs AV conduction (c) Decreases tracheobronchial secretions (d) Causes contraction of radial muscle of iris 37. All of the following drug is used for overactive bladder except (a) Duloxetine (b) Darifenacin (c) Oxybutynin (d) Flavoxate 38. Botulinum toxin produces skeletal muscle paralysis by (a) Enhancing release of norepinephrine (b) Inhibiting release of acetylcholine (c) Direct damage to nerve endings (d) Producing haemolysis 39. Drug of choice for mushroom poisoning is (a) Atropine (b) Physostigmine (c) Adrenaline (d) Carbachol 40. Which of the following drugs increases gastrointestinal motility (a) Glycopyrrolate (b) Atropine (c) Neostigmine (d) Fentanyl 41. Which of the following drugs does not cross blood placental barrier (a) Atropine (b) Glycopyrolate (c) Physostigmime (d) Hyoscine hydro bromide 42. All of the following are actions of muscarinic agonists except (a) Decreases gastric secretion (b) Prolongs AV conduction (c) Decreases tracheobronchial secretions (d) Causes contraction of radial muscle of iris 43. Which of the following drug is commonly used in narcoanalysis (a) Atropine sulphate (b) Scopolamine hydrochloride (c) Phenobarbitone (d) Morphine 44. All of the following drugs are useful in detrusor instability except (a) Solefenacin (b) Tolterodine (c) Flavoxate (d) Duloxetine 45. Botulinum toxin blocks neuromuscular transmission by which of the following mechanism (a) Closure of Ca++ channels at presynaptic membrane (b) Closure of Na+ channels at the postsynaptic membrane (c) Opening of K+ channels at the presynaptic membrane (d) Opening of Cl– channels at the postsynaptic membrane 46. Botulinum toxin produces skeletal muscle paralysis by (a) Enhancing release of norepinephrine (b) Inhibiting release of acetylcholine (c) Direct damage to nerve endings (d) Producing hemolysis 47. Use of tiotropium is contraindicated in (a) Bronchial asthma (b) Hypertension (c) Urinary retention (d) Peptic ulcer disease 48. Drug of choice for mushroom poisoning is (a) Atropine (b) Physostigmine (c) Adrenaline (d) Carbachol 49. Which one of the following drugs does not produce central anticholinergic syndrome (a) Atropine sulphate (b) Glycopyrrolate (c) Antihistaminic (d) Tricyclic antidepressants 50. Atropine can cause (a) Decreased cardiac output (b) Heart block (c) Hypertension (d) Mydriasis 51. Intramuscular injection of atropine causes initial bradycardia. The reason for this effect being seen is (a) Stimulation of medullary vagal center (b) Stimulation of vagal ganglia (c) Blockade of M2 receptors of SA nodal cells (d) Blockade of muscarinic auto receptor on vagal nerve endings 52. The difference between hyoscine and atropine is that hyoscine (a) Exerts depressant effects on the CNS at relatively low doses (b) Exerts more potent effects on the heart than on the eye (c) Is longer acting (d) Has weaker antimotion sickness activity 53. You are being asked to give your expert opinion as a toxicologist regarding an effective antidote for belladonna poisoning. Which of the following agents would you suggest (a) Neostigmine (b) Physostigmine (c) Pilocarpine (d) Methacholine 54. What is the most dangerous effect of belladonna in very young children (a) Dehydration (b) Hallucination (c) Hypertension (d) Hyperthermia 55. Accepted therapeutic indications for the use of antimuscarinic drugs include all of the Following except (a) Hypertension (b) Motion sickness (c) Parkinson’s disease (d) To produce mydriasis and cycloplegia 56. Which is the shortest acting mydriatic (a) Atropine (b) Tropicamide (c) Cyclopentolate (d) Homatropine 57. Oxybutynin acts by (a) Nicotine receptor stimulation (b) Muscarinic receptor stimulation (c) Muscarinic receptor inhibition (d) α-receptor inhibition 58. Atropine poisoning causes all, EXCEPT (a) Dilated pupil (b) Excitement (c) Excessive salivation (d) Hot skin 59. Which of the following drugs is useful in prophylaxis of motion sickness (a) Hyoscine (b) Metoclopramide (c) Prochlorperazine (d) Ondansetron 60. Clinical signs of atropine intoxication are as follows, EXCEPT (a) Decreased bowel sounds (b) Dry skin (c) Scarlet flushing of face (d) Increased bowel sounds Sympathomimetic 61. Which of these is an FDA approved indication for use of modafinil as an adjunct (a) Major depression and associated lethargy (b) Narcolepsy (c) Obstructive sleep apnea (d) Shift work disorder 62. Vasopressor of choice in pregnancy is (a) Ephedrine (b) Phenylephrine (c) Methoxamine (d) Mephentermine 63. Sympathomimetic drugs are useful in the therapy of all the following conditions except (a) Acute decompensated heart failure (b) Hypotension (c) Hypertension (d) Erectile dysfunction 64. Which of the following is not an alpha adrenoceptor agonist (a) Clonidine (b) Methyldopa (c) Guanabenz (d) Guanfacine 65. Uses of α2 agonists are all except (a) To produce sedation (b) Glaucoma (c) Benign hyperplasia of prostate (d) Hypertension 66. The only non-catecholamine sympathomimetic drug out of the following is (a) Adrenaline (b) Ephedrine (c) Dopamine (d) Isoprenaline 67. Which of the following drugs shows the phenomenon of vasomotor reversal of Dale after administration of an α adrenergic blocker (a) Adrenaline (b) Noradrenaline (c) Isoprenaline (d) All of the above 68. A drug is shown to activate dopaminergic D1 and D2 and adrenergic α and β1 but not β2 receptors. Which of the following can be the drug being talked about (a) Dopamine (b) Dobutamine (c) Methoxamine (d) Phenylephrine 69. Dopamine is preferred in treatment of shock because of (a) Renal vasodilatory effect (b) Increased cardiac output (c) Peripheral vasoconstriction (d) Prolonged action 70. All are side effects of salbutamol EXCEPT (a) Palpitation (b) Muscle tremors (c) Sedation (d) Throat irritation 71. Epinephrine is most useful in (a) Bronchial asthma (b) Anaphylactic shock (c) Peripheral vascular disease (d) Wide angle glaucoma 72. Which of the following drug acts as combined alpha and beta adrenergic receptor agonist (a) Dobutamine (b) Phenylephrine (c) Fenoldopam (d) Noradrenaline 73. Which of the following agent is not used in erectile dysfunction (a) PGE2 (b) Vardenafil (c) Phenylephrine (d) Alprostadil 74. What is True about dobutamine (a) Dobutamine decreases peripheral resistance (b) Acts on D1 and D2 receptors (c) Decrease kidney circulation (d) Has no effect on coronary circulation 75. Which of the following drug is a long acting beta2 agonist (a) Albuterol (b) Salmeterol (c) Pirbuterol (d) Orciprenaline 76. One of the following activities is not mediated through β2 adrenergic receptors (a) Stimulation of lipolysis (b) Increased hepatic gluconeogenesis (c) Increased muscle glycogenolysis (d) Smooth muscle relaxation 77. Fenoldopam is used in the management of (a) Hypertensive emergencies (b) Congestive heart failure (c) Migraine prophylaxis (d) Tachyarrhythmia 78. The rate-limiting step for norepinephrine synthesis is (a) Conversion of phenylalanine to tyrosine (b) Conversion of tyrosine to DOPA (c) Conversion of DOPA to dopamine (d) Conversion of dopamine to norepinephrine 79. Which of the following is an adverse effect of β2 agonists (a) Hypoglycaemia (b) Hypomagnesaemia (c) Hypophosphatemia (d) Hypokalaemia 80. Which is not an endogenous catecholamine (a) Dopamine (b) Dobutamine (c) Adrenaline (d) Noradrenaline 81. β2 selective agonists are often effective in (a) Angina due to coronary insufficiency (b) Asthma (c) Delayed labour (d) All the above 82. Which of the following increases systolic and diastolic BP for prolonged period (a) Epinephrine (b) Dopamine (c) Ephedrine (d) All of these 83. Norepinephrine action at the synaptic cleft is terminated by (a) Metabolism by COMT (b) Metabolism by MAO (c) Reuptake (d) Metabolism by acetyl cholinesterase 84. Which of the following is not true about adrenergic receptors (a) α1 receptors are usually presynaptic (b) β1 receptors are predominantly found in heart (c) Noradrenaline stimulates β1 receptors (d) α2 receptor stimulation inhibits transmitter release 85. Major Metabolite of noradrenaline in urine is (a) VMA (b) HVA (c) Normetanephrine (d) Metanephrine 86. Methyldopa acts on which of the following receptor (a) α2 (b) α1 (c) β1 (d) D1 87. Which of the following drug acts as combined alpha and beta adrenergic receptor agonist (a) Dobutamine (b) Phenylephrine (c) Fenoldopam (d) Noradrenaline 88. Which of the following agent is not used in erectile dysfunction (a) PGE2 (b) Vardenafil (c) Phenylephrine (d) Alprostadil 89. Which is True about dobutamine (a) Dobutamine decreases peripheral resistance (b) Acts on D1 and D2 receptors (c) Decrease kidney circulation (d) Has no effect on coronary circulation 90. Which of the following concentrations of epinephrine does not correspond to the respective route of administration (a) 1:10000 for intravenous route (b) 1:1000 for inhalational route (c) 1:1000 for intramuscular route (d) 1:1000 for subcutaneous route Sympatholytic 91. The most important action of beta blockers in glaucoma is which of the following (a) Membrane stabilizing effect (b) Retinal neuron protecting effect (c) Decrease in the production of aqueous humour (d) Pupillary constriction 92. All of the following are therapeutic uses of prazosin, except (a) Peripheral vascular disease (b) Phaeochromocytoma (c) Lupus Erythematous (d) Scorpion sting 93. All of the following drugs are nonselective β blockers with no pharmacological action on any other receptor EXCEPT (a) Propranolol (b) Timolol (c) Sotalol (d) Carvedilol 94. All of the following are cardio selective beta blockers except (a) Atenolol (b) Esmolol (c) Bisoprolol (d) Propranolol 95. Beta blockers that can be used in renal failure are all except (a) Propranolol (b) Pindolol (c) Sotalol (d) Oxprenolol 96. Beta blocker with peripheral vasodilator action is (a) Carvedilol (b) Propranolol (c) Atenolol (d) Acebutolol 97. The following is not true about the use of beta blockers in heart failure (a) It should be initiated at very low dose (b) It is most effective in new onset decompensated heart failure (c) Slow upward titration of dose is required (d) Carvedilol is most widely used in this condition 98. All are true about beta blockers except (a) Atenolol is longer acting than metoprolol (b) Labetalol has both alpha and beta blocking action (c) Carvedilol has alpha agonistic and selective β1 blocking action (d) Nadolol has longest half-life 99. Combined alpha and beta blockers are (a) Carvedilol (b) Prazosin (c) Tamsulosin (d) Milrinone 100. True statement about esmolol is/are (a) It is an α Blocker (b) It has a long half-life (c) It is not cardio selective (d) It can cause bradycardia 101. Contraindications of beta blockers are (a) Anaemia (b) Heart block (c) Hypertension (d) Arrhythmia 102. Which of the following is used in beta blocker overdose (a) Atropine (b) Norepinephrine (c) Insulin (d) Thyroxin 103. Side effects of timolol maleate include (a) Hypertension (b) Nausea (c) Depression (d) Tachycardia 104. Βeta blockers with intrinsic sympathomimetic properties are (a) Propanolol (b) Pindolol (c) Esmolol (d) Butoxamine 105. Properties making cardio selective beta blockers desirable are (a) Less bronchoconstriction (b) Less likely to cause glucose intolerance (c) May be used in Raynaud’s disease (d) All of the above 106. Propanolol is useful in the treatment of all of the following except (a) Angina (b) Partial atrioventricular block (c) Idiopathic hypertrophic sub aortic cardiomyopathy (d) Familial tremor 107. Atenolol is indicated in all EXCEPT (a) Hypertension (b) Partial heart block (c) Hypertrophic obstructive cardiomyopathy (d) Classical angina 108. Which of the following is a selective β2 antagonist (a) Esmolol (b) Betaxolol (c) Butoxamine (d) Celiprolol 109. The most important action of beta blockers in glaucoma is which of the following (a) Membrane stabilizing effect (b) Retinal neuron protecting effect (c) Decrease in the production of aqueous humor (d) Pupillary constriction 110. All of the following are therapeutic uses of prazosin, except (a) Peripheral vascular disease (b) Phaeochromocytoma (c) Lupus Erythematosus (d) Scorpion sting 111. All of the following drugs are nonselective β blockers with no pharmacological action on any other receptor EXCEPT (a) Propanolol (b) Timolol (c) Sotalol (d) Carvedilol 112. All of the following are cardio selective beta blockers except (a) Atenolol (b) Esmolol (c) Bisoprolol (d) Propanolol 113. Beta blockers that can be used in renal failure are allexcept (a) Propanolol (b) Pindolol (c) Sotalol (d) Oxprenolol 114. Beta blocker with peripheral vasodilator action is (a) Carvedilol (b) Propranolol (c) Atenolol (d) Acebutolol 115. The following is not true about the use of beta blockers in heart failure (a) It should be initiated at very low dose (b) It is most effective in new onset decompensated heart failure (c) Slow upward titration of dose is required (d) Carvedilol is most widely used in this condition 116. All are true about beta blockers except (a) Atenolol is longer acting than metoprolol (b) Labetalol has both alpha and beta blocking action (c) Carvedilol has alpha agonistic and selective β1 blocking action (d) Nadolol has longest half life 117. Beta adrenergic blocker having cardioselectivity, intrinsic sympathomimetic activity and membrane stabilizing property is (a) Carvedilol (b) Atenolol (c) Acebutolol (d) Metoprolol 118. All of the following are features of metoprolol in comparison to propanolol except (a) It is ineffective in suppressing muscle tremor (b) It is safer in diabetics (c) It is less likely to cause bradycardia (d) It is less likely to worsen Raynaud’s disease 119. Which of the following effects of adrenaline would be blocked by phentolamine but not by propanolol (a) Cardiac stimulation (b) Relaxation of bronchial smooth muscle (c) Relaxation of the uterus (d) Contraction of the radial smooth muscle in the iris 120. Propanolol is useful in the treatment of all of the following except (a) Angina (b) Partial atrioventricular block (c) Idiopathic hypertrophic subaortic cardiomyopathy (d) Familial tremor Welcome to Pharmacy India, your go-to destination for comprehensive and high-quality Pharmacology Autacoids Multiple Choice Questions (MCQs)! We are excited to offer a rich repository of MCQs tailored for pharmacy professionals, students, and enthusiasts seeking to enhance their knowledge in the dynamic field of pharmacology.

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HISTAMINICS, ANTIHISTAMINICS and 5HT 1. Which is not a 2nd generation antihistaminic agent (a) Cetirizine (b) Cyclizine (c) Loratidine (d) Fexofenadine 2. A peptide that causes increased capillary permeability and edema is (a) Histamine (b) Angiotensin II (c) Bradykinin (d) Renin 3. Ergometrine is commonly used for (a) PostPartum Hemorrhage (b) To shorten 2nd stage of labour (c) Dysmenorrhea (d) Toxemia of pregnancy 4. The H3 receptor agonist exhibits all of the following actions EXCEPT (a) Inhibition of H1 receptor induced wakefulness (b) Increase in H1 mediated gastrin secretion (c) Inhibition of H1 mediated bronchoconstriction (d) Negative chronotropic effect on atria 5. Second generation antihistaminic used in allergic rhinitis are (a) Azelastine (b) Fexofenadine (c) Desloratidine (d) All of the above 6. All of the following actions of histamine are mediated through H1 receptors except (a) Release of EDRF from vascular endothelium resulting in vasodilation (b) Direct action on vascular smooth muscle causing vasodilation (c) Bronchoconstriction (d) Release of catecholamines from adrenal medulla 7. Which of the following drugs can cause hypotension by release of histamine from mast cells (a) Aspirin (b) Procaine (c) Morphine (d) Sulfadiazine 8. All of the following antihistaminic agents lack anticholinergic property except (a) Promethazine (b) Astemizole (c) Levocetirizine (d) Loratidine 9. The drug possessing antagonistic action at histamine, serotonin and muscarinic receptors is (a) Promethazine (b) Terfenadine (c) Cyproheptadine (d) Hydroxyzine 10. Agents which have limited activity on local area is termed as (a) Autacoids (b) Hormones (c) Enzymes (d) All of the above 11. Histamine is released from (a) Parietal cell (b) Mast cell (c) Goblet cell (d) All of the above 12. Which of the following is location of non-mast cell histamine (a) Brain (b) Epidermis (c) Gastric mucosa (d) All of the above 13. Histamine effect on bronchial smooth muscle (a) Contraction (b) Relaxation (c) No effect (d) Contraction and then Relaxation 14. Histamine affect which receptor to stimulate gastric acid secretion (a) H1 (b) H2 (c) H3 (d) H4 15. Which of the following drug does not produce drowsiness as compare to 1st generation antihistaminic drugs (a) Cetirizine (b) Levocetirizine (c) Diphenhydramine (d) Both A and B 16. Antivertigo drug which modulates calcium channels and has prominent labyrinthine suppressant property is (a) Cyproheptadine (b) Cinnarizine (c) Clemastine (d) Cetirizine 17. Ketoconazole should not be given to a patient being treated with astemizole because (a) Ketoconazole induces the metabolism of astemizole (b) Dangerous ventricular arrhythmias can occur (c) Astemizole inhibits the metabolism of ketoconazole (d) Astemizole antagonizes the antifungal action of ketoconazole 18. True statement about fexofenadine is (a) It undergoes high first pass metabolism in liver (b) Terfenadine is an active metabolite of this drug (c) It does not block cardiac K+ channels (d) It has high affinity for central H1 receptors 19. H1 antihistaminic having best topical activity is (a) Loratadine (b) Cetrizine (c) Astemizole (d) Azelastine 20. Histamine exerts the following actions EXCEPT (a) Dilatation of large blood vessels (b) Dilatation of small blood vessels (c) Stimulation of isolated Guinea pig heart (d) Itching 21. All 5HT receptors are heptahelical serpentine receptors except (a) 5HT1 (b) 5HT2 (c) 5HT3 (d) 5HT4 22. Antihistaminic used in motion sickness is (a) Cetirizine (b) Meclizine (c) Diphenhydramine (d) Fexofenadine 23. Most important receptor involved in chemotherapy induced vomiting is (a) Histamine H1 receptor (b) Serotonin 5HT3 receptor (c) Dopamine D2 receptor (d) Opioid µ receptor 24. Selective 5HT4 agonist useful in gastroesophageal reflux disease and lacking arrhythmogenic property is (a) Buspirone (b) Sumatriptan (c) Cisapride (d) Tegaserod 25. The nonsedative antihistamines are all EXCEPT one (a) Fexofenadine (b) Desloratidine (c) Levocetirizine (d) Cinnarizine 26. Ketanserin is (a) 5HT1B antagonist (b) 5HT2 antagonist (c) 5HT1A agonist (d) 5HT1D antagonist 27. The long acting classical H1 antihistaminic include which of the following (a) Chlorpheniramine (b) Astemizole (c) Cetrizine (d) Clemastine 28. Which of the following drugs, if given with terfenadine, can cause ventricular arrhythmias (a) Ketoconazole (b) Griseofulvin (c) Ampicillin (d) Sparfloxacin 29. One of the following is not a 5HT receptor antagonist (a) Ketanserin (b) Lanreotide (c) Methysergide (d) Tropisetron 30. Antihistaminic used in motion sickness is (a) Cetirizine (b) Meclizine (c) Diphenhydramine (d) Fexofenadine 31. Select the antihistaminic which modulates calcium channels and has prominent labyrinthine suppressant property (a) Cyproheptadine (b) Cinnarizine (c) Clemastine (d) Cetirizine 32. 5HT antagonist is (a) Clozapine (b) Ketanserin (c) Sumatriptan (d) Cisapride 33. Which of the following serotonergic receptors is an autoreceptor (a) 5HT1A (b) 5HT2A (c) 5HT3 (d) 5HT4 34. Which of the following anxiolytic is a 5HT 1A agonist (a) Benzodiazepines (b) Hydroxyzine (c) Buspirone (d) Sertaline 35. Which one is not an action of Serotonin 5HT (a) increases motility (b) Contract of smooth muscles (c) Increase of Urine (d) Increases capillary pressure & permeability 36. Which one of the following the 5HT distribute to (a) A neurotransmitter, in midbrain (b) A smooth muscles (c) Pancreas (d) Thyroid glands 37. Which of the following statement is incorrect for 5 – HT1 (a) It plays a major role in regulation of GI motility (b) It promotes aggregation of platelets (c) It acts only as peripheral neuro transmitter (d) It acts as mediator in reaction to scorpion bite 38. Granisetron is used in (a) Motion sickness (b) Sedation in endoscopy (c) Chemotherapy induced nausea and vomiting (d) Gastrooesophageal reflux disease 39. Methysergide used as drug of choice in migraine but not now because (a) MI (b) Peptic ulcer (c) Pulmonary fibrosis (d) Arrhythmias Ergot Alkaloids and Migraine 40. Drugs used in prophylaxis of migraine are all EXCEPT (a) Propranolol (b) Flunarizine (c) Topiramate (d) Levetiracetam 41. All of the following can be used for prophylaxis of migraine except (a) Sumatriptan (b) Valproate (c) Propranolol (d) Topiramate 42. Drugs used for prophylaxis of migraine is/are (a) Flunarizine (b) Beta blocker (c) Sodium valproate (d) All of the above 43. Which of the following is most useful for reversing severe ergot induced vasospasm (a) Ergotamine (b) Methysergide (c) Nitroprusside (d) Phenoxybenzamine 44. Selective 5HT1B/1D receptor agonist useful in acute migraine is (a) Buspirone (b) Ondansetron (c) Frovatriptan (d) Ketanserin 45. Ergot alkaloid commonly used to prevent postpartum haemorrhage is (a) Methyl ergometrine (b) Ergotamine (c) Dihydroergotamine (d) Dihydroergotoxine 46. Choose the correct statement about sumatriptan (a) It activates 5HT1A receptors (b) It tends to suppress both pain and vomiting in migraine (c) It does not carry risk of precipitating coronary vasospasm (d) It is combined with ergotamine for the treatment of severe migraine 47. Drug of choice in acute severe migraine is (a) Ergotamine (b) Sumatriptan (c) Dihydroergotamine (d) Propranolol 48. Select the ergot compound which is primarily used for dementia (a) Bromocriptine (b) Ergotamine (c) Codergocrine (d) Methysergide 49. The ‘amine’ ergot alkaloid differs from ‘amino acid’ ergot alkaloid in that it has (a) High oral bioavailability (b) Better CNS penetrability (c) Weaker oxytocic action (d) Strong anti5HT action 50. Methyl ergometrine is used in the prophylaxis of (a) Migraine (b) Postpartum haemorrhage (c) PIH (d) None of the above 51. Select the correct statement in relation to drug therapy of migraine (a) Simple analgesics like paracetamol are ineffective in migraine (b) Ergot alkaloids are used for prophylaxis as well as treatment of migraine attacks (c) Use of ergot alkaloids is restricted to severe or resistant cases (d) Ergot alkaloids should be given till 24 hours after an attack has subsided 52. The non-steroidal anti-inflammatory drugs are more effective in migraine (a) Without aura (b) With aura (c) Than ergotamine (d) When combined with propranolol 53. Ergotamine relieves migraine by (a) Blocking vascular α adrenergic receptors (b) Blocking vascular 5HT2 receptors (c) Dilating cranial arteriovenous shunt channels (d) Constricting cranial vessels and reducing perivascular neurogenic inflammation 54. Prophylactic therapy of migraine (a) Is recommended in all cases (b) Benefits upto 70% patients of moderate to severe migraine (c) Needs to be continued lifelong without interruption (d) Reduces the severity but increases the frequency of migraine attacks Eicosanoids and NSAIDs 55. Which of the following is/are example of eicosanoid (a) Prostaglandin (b) Prostacyclin (c) Thromboxane (d) All of the above 56. Paracetamol generally affect which of the following type of COX (a) COX1 (b) COX2 (c) COX3 (d) None of the above 57. Angiotensinogen is synthesized in (a) Liver (b) Kidney (c) Brain (d) Heart 58. Following are uses of prostaglandins EXCEPT (a) First trimester of pregnancy (b) Cervical ripening during labour (c) Postpartum haemorrhage (d) Dysmenorrhoea 59. Which of the prostaglandin analogue is used in wide angle glaucoma (a) PGE1 (b) PGF2alpha (c) PGE2 (d) PGD2 60. Which of the following drugs inhibit an enzyme in the prostaglandin synthesis (a) Alteplase (b) Aspirin (c) Aprotinin (d) Aminocaproic acid 61. Which of the prostaglandin analogue is used in NSAID induced gastritis (a) PGE1 (b) PGF2alpha (c) PGE2 (d) PGD2 62. Substance P has following number of amino acids (a) 10 (b) 11 (c) 12 (d) 13 63. NSAID drugs have following action (a) Analgesic (b) AntiPyretic (c) AntiInflammatory (d) All of the above 64. Which of the following is side effect of NSAID (a) Gastric erosion (b) Peptic ulcer (c) Initiation of bleeding (d) All of the above 65. Acetaminophen is also known as (a) Paracetamol (b) Aceclofenac (c) Nimesulide (d) Aspirin 66. The side effect of NSAID in most of the case is generally associated with (a) Inhibition of COX1 (b) Inhibition of COX2 (c) Inhibition of COX3 (d) All of the above 67. Aspirin inhibits which of the following enzymes (a) Lipoprotein lipase (b) Lipoxygenase (c) Cyclooxygenase (d) Phospholipase D 68. A patient on aspirin will have increase in (a) Bleeding time (b) Clotting time (c) Prothrombin time (d) Activated partial thromboplastin time 69. Misoprostol is a (a) Prostaglandin E1 analogue (b) Prostaglandin E2 analogue (c) Prostaglandin antagonist (d) Antiprogestin 70. All of the following are correct statements EXCEPT (a) PGs and leukotrienes are derived from arachidonic acid (b) Cox II is induced by cytokines at the site of inflammation (c) Cox I is an inducible enzyme (d) Leukotrienes cause smooth muscle contraction 71. Which NSAID undergoes enterohepatic circulation (a) Phenylbutazone (b) Aspirin (c) Ibuprofen (d) Piroxicam 72. Therapeutic uses of prostaglandin El include all of the following EXCEPT (a) Medical termination of pregnancy (b) Impotence (c) Primary pulmonary hypertension (d) Maintenance of patent ductus arteriosus 73. True statements about TXA2 is (a) It is formed in platelets (b) It is formed from PGG2/H2 (c) It is prothrombotic (d) All of the above 74. COX pathway is inhibited by (a) Aspirin (b) Ondansetron (c) Betamethasone (d) Calcitonin 75. Which of the following is/are cyclooxygenase inhibitors (a) Naproxen (b) Prednisolone (c) Sumatriptan (d) Betamethasone 76. Which of the following drugs inhibit platelet cyclooxygenase reversibly (a) Alprostadil (b) Aspirin (c) Ibuprofen (d) Prednisolone 77. Which of the following is a component of slow reacting substance of anaphylaxis (SRS(A) (a) LTC4 (b) LTB4 (c) Misoprostol (d) Prostacyclin 78. Which of the following drugs reduces the activity of phospholipase A2 (a) Alprostadil (b) Aspirin (c) Ibuprofen (d) Prednisolone 79. The chief advantage of ketorolac over aspirin is that the former (a) Can be combined more safely with an opioid such as codeine (b) Does not prolong bleeding time (c) Is available in a parenteral formulation that can be used intramuscularly or intravenously (d) Is less likely to cause acute renal failure in patients with preexisting renal impairment 80. Irreversible inhibitor of cyclooxygenase is (a) Aspirin (b) Phenylbutazone (c) Indomethacin (d) Piroxicam 81. Prostaglandin E2 analogs can be used for all of the following conditions except (a) Treatment of patent ductus arteriosus (b) Treatment of bronchial asthma (c) Cervical priming (d) Treatment of NSAID induced peptic ulcer 82. Aspirin in low doses produces long lasting inhibition of platelet cyclooxygenase because (a) Platelet contain low quantity of COX (b) Platelets cannot synthesize fresh COX molecules (c) Platelets bind aspirin with high affinity (d) Platelet COX is inducible 83. Zafirlukast acts by blocking the action of (a) Prostacyclin (b) Platelet activating factor (c) Leukotriene B4 (d) Leukotriene C4/D4 84. True statement about cyclooxygenase –2 is (a) It is not inhibited by indomethacin (b) It is inducible (c) It generates cytoprotective prostaglandins in gastric mucosa (d) It is found only in fetal tissues 85. All of the following effects are produced by inhibitors of prostaglandin synthesis except (a) Prolongation of bleeding time (b) Prolongation of prothrombin time (c) Prolongation of labour (d) Gastric mucosal damage 86. All of the following actions of aspirin are mediated by inhibition of prostaglandin synthesis except (a) Analgesia (b) Closure of patent ductus arteriosus (c) Hyperventilation (d) Bleeding tendency 87. Use of aspirin in a diabetic patient can result in (a) Hyperglycemia (b) Hypoglycemia (c) Ketoacidosis (d) Alkalosis 88. The plasma half-life of aspirin (a) Is independent of dose (b) Is longer for anti-inflammatory doses compared to that for analgesic dose (c) Is shorter for anti-inflammatory doses compared to that for analgesic dose (d) Can be increased by alkalinizing the urine 89. Analgesic that itself can cause headache as a side effect is (a) Indomethacin (b) Mephenamic acid (c) Piroxicam (d) Aspirin 90. Rofecoxib as compared to indomethacin is (a) Less likely to cause gastric ulcer and their complications (b) Likely to be more effective in rheumatoid arthritis (c) Not likely to produce renal complications (d) All of the above 91. NSAID proposed to be acting via inhibition of COX3 is (a) Nimesulide (b) Paracetamol (c) Ketorolac (d) Rofecoxib 92. Which of the following NSAIDs has been approved for use in children (a) Indomethacin (b) Ibuprofen (c) Ketorolac (d) Piroxicam 93. Among NSAIDs aspirin is unique because it (a) Irreversibly inhibits its target enzyme (b) Reduces the risk of colon cancer (c) Reduces fever (d) Selectively inhibits COX2 enzyme 94. The antidote of choice in paracetamol poisoning is (a) Flumazenil (b) Sodium bicarbonate (c) Nacetylcysteine (d) Methylene Blue 95. Prostaglandin useful for the prevention of duodenal ulcer is (a) Dinoprost (b) Misoprostol (c) Alprostadil (d) Carboprost 96. Prostaglandin inhibiting action of aspirin is useful in the treatment of all of the following conditions, EXCEPT (a) Analgesia and antipyresis (b) Closure of ductus arteriosus (c) Uricosuria (d) Anti-inflammatory and anti-platelet aggregation 97. Which of the following drugs inhibit an enzyme in the prostaglandin synthesis (a) Aminocaproic acid (b) Aspirin (c) Aprotinin (d) Alteplase 98. Misoprostol, a prostaglandin analogue is useful as (a) Uterine relaxant (b) Antiulcer (c) Bronchodilator (d) Vasodilator 99. Drug commonly causing analgesic nephropathy is (a) Aspirin (b) Ibuprofen (c) Phenacetin (d) Phenylbutazone 100. Which one of the following is aspirin (a) Methyl salicylate (b) Paraaminobenzoic acid (c) Paraaminosalicylic acid (d) Acetyl salicylic acid 101. True about COX2 are all EXCEPT (a) It is constitutionally expressed on some cell surfaces (b) Activation of COX2 leads to ulcer protective effect on gastric mucosa (c) Induced at the site of inflammation (d) It is utilized in generation of eicosanoids with a ring structure 102. Which of the following is non-opioid analgesic and does not inhibit prostaglandin synthesis (a) Nefopam (b) Tenoxicam (c) Ketorolac (d) Piroxicam 103. All are true about Reye’s Syndrome Except (a) Hepatic encephalopathy (b) Seen with ampicillin therapy (c) Fever and rash (d) Viral associated 104. Ibuprofen acts on (a) Lipoxygenase pathway (b) Cyclooxygenase pathway (c) Kinin system (d) Serotonin system 105. Which of the following prostaglandin analogues is used in glaucoma (a) Misoprostol (b) Latanoprost (c) Enprostil (d) Rioprostil 106. Cycloxygenase enzyme is not inhibited by (a) Aspirin (b) Warfarin (c) Phenylbutazone (d) Diclofenac 107. Which prostaglandin helps in cervical ripening (a) PGI2 (b) PGF2 (c) PGE2 (d) PGD2 108. Rofecoxib was withdrawn due to (a) Ischemic heart disease (b) Renal complication (c) Liver adenoma (d) Gastric ulcer 109. Which of the following statements is true of ketorolac (a) Has potent anti-inflammatory activity (b) Its analgesic efficacy is equal to morphine in postoperative pain (c) Is used as preanaesthetic analgesic (d) It interacts with opioid receptor 110. Use of aspirin in children with viral disease is associated with (a) Metabolic acidosis (b) Reye’s syndrome (c) Renal tubular acidosis (d) Fixed drug eruption Rheumatoid Arthritis and Gout 111. Which of the following drugs cause oligospermia (a) Leflunomide (b) Penicillamine (c) Methotrexate (d) Sulfasalazine 112. Allopurinol prevents conversion of (a) Hypoxanthine to xanthine (b) Xanthine to hypoxanthine (c) Hypoxanthine to I.M.P. (d) Xanthine to uronic acid 113. Which of the following disease modifying antirheumatoid drugs is a prodrug (a) Etanercept (b) Nimesulide (c) Sulfasalazine (d) Colchicine 114. All of the following drugs can produce hyperuricemia except (a) Ethambutol (b) Pyrazinamide (c) Sulfinpyrazone (d) Hydrochlorothiazide 115. Gout is an example of (a) Metabolic acidosis (b) Metabolic disorder (c) Genetic disorder (d) None of the above 116. The cause of gout is (a) Over synthesis of uric acid (b) Over synthesis of insulin (c) Saturation of uric acid in blood (d) Both A and C 117. Agent which increase elimination of uric acid via urine is called as (a) Uricosouric agents (b) Purine synthesis inhibitor (c) Leukocyte inhibitor (d) Antidiuretic 118. Colchicine MOA is (a) Inhibition of Leukocyte migration (b) Inhibition of Phagocytosis (c) Inhibition of Xanthine oxidase (d) Both A and B 119. Osteoarthritis is result of (a) Physical work load (b) Autoimmune disorder (c) Genetic disorder (d) Metabolic disorder 120. Rheumatic Arthritis cause is (a) Autoimmune disorders (b) Injury (c) Genetics (d) None of the above 121. Which of the following disease modifying anti-rheumatoid drugs is a prodrug (a) Etanercept (b) Nimesulide (c) Sulfasalazine (d) Colchicine 122. All of the following drugs can produce hyperuricemia except (a) Ethambutol (b) Pyrazinamide (c) Sulfinpyrazone (d) Hydrochlorothiazide 123. Drug of choice for acute gout is (a) Colchicine (b) Indomethacin (c) Allopurinol (d) Dexamethasone 124. Most common dose limiting adverse effect of colchicine is (a) Sedation (b) Kidney damage (c) Diarrhea (d) Muscle paralysis 125. Which of the following drugs is useful in chronic gout but is not a uricosuric agent (a) Probenecid (b) Phenylbutazone (c) Sulfinpyrazone (d) Allopurinol 126. Allopurinol is useful in all of the following conditions EXCEPT (a) Cancer chemotherapy induced hyperuricemia (b) Hydrochlorothiazide induced hyperuricemia (c) Acute gouty arthritis (d) Kala –azar 127. Rasburicase is a newer drug used in gout. It act by (a) Decreasing urate synthesis (b) Increasing urate oxidation (c) Decreasing intestinal absorption of uric acid (d) Increasing renal excretion of uric acid 128. A drug that is effective for rheumatoid arthritis but is not appropriate for osteoarthritis is (a) Acetaminophen (b) Infliximab (c) Keterolac (d) Rofecoxib 129. Which of the following is a DMARD (a) Desferrioxamine (b) Penicillamine (c) Succimer (d) Dimercaprol 130. Which of the following increases uric acid excretion (a) Allopurinol (b) Aspirin (c) Colchicine (d) Probenecid 131. Which of the following drugs is useful in acute attack of gout (a) Furosemide (b) Sulfinpyrazone (c) Allopurinol (d) Piroxicam 132. Allopurinol potentiates the action of (a) Corticosteroids (b) Probenecid (c) 6-Mercaptopurine (d) Ampicillin 133. Probenecid interacts with (a) Streptomycin (b) Ampicillin (c) Vancomycin (d) Erythromycin 134. Drug useful for gout (a) Pyrazinamide (b) Rifampicin (c) Allopurinol (d) Naloxone 135. Loading dose of leflunomide in rheumatoid arthritis is (a) 20 mg (b) 10 mg (c) 100 mg (d) 400 mg 136. Leflunomide is used in the treatment of (a) Rheumatoid arthritis (b) Dermatomyositis (c) Bony metastasis (d) Postmenopausal osteoporosis 137. Which of the following disease modifying antirheumatic drugs (DMARDs) is the drug of first choice (a) Methotrexate (b) Gold compounds (c) Dpenicillamine (d) Anakinra Miscellaneous 138. Most common cause of Mobius syndrome is use of which of the following drug in pregnancy (a) Misoprostol (b) Thalidomide (c) Methotrexate (d) Dinoprostone 139. Which of the following agent is not used for treatment of erectile dysfunction (a) PGE2 (b) Vardenafil (c) Phenylephrine (d) Alprostadil 140. Which of the following drugs has covalent interaction with its target (a) Aspirin (b) Penicillin (c) Nitric oxide (d) Bosentan 141. Which of the following is used to treat severe pulmonary hypertension (a) Angiotensin I (b) Omapatrilat (c) Bosentan (d) Endothelin 142. The primary endogenous substrate for nitric oxide synthase (NOS) is (a) Citrulline (b) Arginine (c) Heme (d) Methionine 143. Which of the following NSAID has good tissue penetrability with concentration in synovial fluid (a) Ketorolac (b) Diclofenac sodium (c) Sulindac (d) Piroxicam 144. Best drug for chronic gout in patient with renal impairment is (a) Naproxen (b) Probenecid (c) Allopurinol (d) Sulfinpyrazone 145. Alprostadil is not used for (a) Erectile dysfunction (b) Pulmonary hypertension (c) Patent ductus arteriosus (d) Critical limb ischemia 146. Ergometrine is not used for initiation of labour because (a) Slow onset of action (b) Foetal hypoxia (c) Increases blood pressure (d) Act on D2 receptors to cause vomiting 147. NSAID given in once daily dose is (a) Naproxen (b) Ketoralac (c) Piroxicam (d) Paracetamol 148. Most commonly used drug for prophylaxis of migraine is (a) Sumatriptan (b) Propranolol (c) Valproate (d) Flunarizine MORE PHARMACOLOGY MCQS

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