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EXAMINATION 2

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DIRECTIONS: Each numbered item or incomplete statement in this section is followed by answers or by completions of the statement. Select the ONE lettered answer or completion that is BEST in each case.

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  1. A patient is admitted to the emergency department with signs and symptoms that could be due to either a muscarinic stimulant or an opioid. Which of the following is a common effect of both muscarinic stimulant drugs and opioids?

    • (A) Decreased peristalsis

    • (B) Decreased secretion by salivary glands

    • (C) Hypertension

    • (D) Inhibition of thermoregulatory sweat glands

    • (E) Miosis

  2. Which statement about nitric oxide is most correct?

    • (A) Nitric oxide is synthesized in vascular endothelium and the brain

    • (B) Nitric oxide is released from storage vesicles by acetylcholine

    • (C) Nitric oxide synthase is stimulated by nitroprusside

    • (D) Nitric oxide synthase is inhibited by histamine

    • (E) Nitric oxide causes pulmonary vasoconstriction

  3. A 35-year-old patient is brought to the emergency department in a drug-induced coma. Blood samples taken over the next several hours show a declining drug concentration, as shown in the graph below. Which of the following drugs is the most likely cause of this patient’s coma?

    Image not available.

    • (A) Aspirin

    • (B) Diazepam

    • (C) Ethanol

    • (D) Phenytoin

  4. In a laboratory study of a new agent, the activity of a membrane-bound enzyme was found to be increased by the drug. Analysis of this enzyme molecule revealed that it is an integral tyrosine kinase, the extracellular domain of which binds ligands while the intracellular domain phosphorylates tyrosine residues. Which of the following receptors communicate their activation by turning on an integral intracellular tyrosine kinase domain?

    • (A) Acetylcholine nicotinic receptors

    • (B) G protein-coupled receptors

    • (C) Insulin receptors

    • (D) Steroid receptors

    • (E) Vitamin D receptors

  5. A patient with a myocardial infarction, heart failure, and an arrhythmia is to receive lidocaine by constant IV infusion. The target plasma concentration is 3 mg/L. The pharmacokinetic parameters for lidocaine in the general population are Vd 70 L, CL 35 L/h, and t1/2 1.4 h. An infusion is begun. The plasma concentration of lidocaine is measured 2.8 h later and reported to be 2.4 mg/L. This indicates that the final steady state plasma concentration in this patient will be

    • (A) 1.5 mg/L

    • (B) 2.4 mg/L

    • (C) 3.2 mg/L

    • (D) 4.6 mg/L

    • (E) 6.9 mg/L

  6. A new drug for the prophylaxis of asthma is under development in a pharmaceutical company. Before human trials can begin, FDA regulations require that

    • (A) All acute and chronic animal toxicity data be submitted to the FDA

    • (B) The drug be shown to be free of carcinogenic effects

    • (C) The drug be shown to be safe in animals with the target disease

    • (D) The drug be studied in 3 mammalian species

    • (E) The effect of the drug on reproduction be studied in at least 2 animal species

  7. A family with 3 young children during a harsh winter in New York is using their old stove and city gas to heat their ...

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