Question 1. The extent to which ionization of a drug takes place is dependent upon pKa of
the drug and the pH of the solution in which the drug is dissolved. Which of
the following statements is NOT correct?
1. pKa of a drug is the pH at which the drug is 50% ionized
2. Small changes of pH near the pKa of a weak acidic drug will not affect its degree
of ionization.
3. Knowledge of pKa of a drug is useful in predicting its behaviour in various body
fluids.
4. Phenobarbitone (an acidic drug) with a pKa of 7.2 is largely unionized at acid pH
and will be about 40% non-ionized in plasma.

Question 2. Loading dose depends on the following factors except:

1. Drug concentration to be achieved
2. Volume of distribution
3. Clearance of the drug
4. Bioavailability of drug

Question 3. Efficacy of a drug refers to:

1. Affinity of drug to bind to receptors
2. Ability of drug to activate the receptors
3. Dose that requires to produce response
4. Maximum response a drug can produce

Question 4. Partial agonist possess

1. High Affinity and High Intrinsic activity
2. High Affinity and Low Intrinsic activity
3. Low Affinity and High Intrinsic activity
4. Low Affinity and Low Intrinsic activity

Question 5. Therapeutic monitoring of plasma level of drug is done  when using all of the
following drugs except
1. Warfarin
2. Gentamicin
3. Cyclosporine
4. Phenytoin

Question 6. Which of the following metabolic reactions is not catalysed by microsomal

enzymes?
1. Glucuronidation
 2. Acetylation
3. Oxidation
4. Reduction

Question 7. In which phase of clinical trials, post-marketing surveillance of a drug is

carried out:
1. Phase I
2. Phase II
3. Phase III
4. Phase IV

Question 8. Ram Prashad is admitted to Guru Teg Bahadur Hospital with respiratory
infection for which antibiotic tobramycin is ordered. The clearance and Vd of
tobramycin in him are 160 ml/min and 40 L, respectively. If you wish to give
Ram Prashad an intravenous loading dose to achieve the therapeutic plasma
concentration of 4 mg/L rapidly, how   much should be given?
1. 0.1 mg
2. 10 mg
3. 115.2 mg
4. 160 mg

Question 9. Drug X is normally administered to patients at a rate of 50 mg/hour.

Elimination of the drug X from body takes place as:

• Hepatic Metabolism 10%

• Biliary Secretion 10%
• Renal Excretion 80%
This drug has to be administered to a 65 years old patient Uttaam Singh, with
a GFR of 60 ml/min. (assuming normal GFR is 120ml/min). Liver and biliary
functions are normal in this patient. What should be the dose rate of drug X in
this patient?
1. 50 mg/hour
2. 30 mg/hr
3. 15 mg/hr
4. 100 mg/hr.

Question 10. All of the following effects are seen with cholinergic muscarinic receptor
stimulation except:
1. Sweating
2. Rise in blood pressure
3. Bradycardia
 4. Urination

Question 11. Sunder Lal, 28 year old farmer is found convulsing in the farm. Heart rate is
100/min and blood pressure is 180/110 mm Hg. Diarrhea, sweating and
urination are apparent. Pupils are pin point. Drug poisoning is suspected.
Most probable cause is:
1. Acetaminophen overdose
2. Amphetamine toxicity
3. Organophosphate poisoning
4. Atropine poisoning

Question 12. Which of the following drugs shows the phenomenon of vasomotor reversal of
Dale after administration of an α adrenergic blocker?
1. Adrenaline
2. Noradrenaline
3. Isoprenaline
4. All of the above

Question 13. Intravenous administration of norepinephrine in a patient already taking an

effective dose of atropine will often:
1. Increase heart rate
2. Decrease total peripheral resistance
3. Decrease pupil size
4. Has no effect on cardiovascular system

Question 14. In a patient Kishore having hypertension, propanolol was given. Though the
drug controlled hypertension but it reduced resting heart rate to 50/min.
Which of the following β blockers can be used in this patient as an effective
substitute which DOES NOT cause severe bradycardia?
1. Pindolol
2. Labetalol
3. Bisoprolol
4. Atenolol
Question 15. Identify the unknown drug (given at arrow) by observing its effect on dog
blood pressure.

1. Low dose adrenaline

2. High dose adrenaline
3. Nor-Adrenaline
4. Isoprenaline

Question 16. Mr. Surya Kant was prescribed a first generation H1 antihistaminic drug. He
should be advised to avoid:
1. Driving motor vehicles
2. Consuming processed cheese
3. Strenuous physical exertion
4. All of the above

Question 17. Two antihistaminic drugs terfenadine and astemizole were withdrawn from
the market following the occurrence of cardiac arrhythmias when they were
present in high levels in the blood. These effects were explained by the fact:
1. Use of these drugs by addicts
2. Genetic predisposition to metabolize succinylcholine slowly
3. Concurrent treatment with phenobarbitone
4. Treatment of these patients with erythromycin, a macrolide antibiotic
Question 18. Which of the following patient characteristics is a possible reason for the use of
celecoxib in the treatment of arthritis?
1. History of severe rash after treatment with a sulfonamide antibiotic
2. History of gout
3. History of peptic ulcer disease
4. History of type 2 DM

Question 19. Individuals with alcoholic cirrhosis of liver may develop severe hepatotoxicity
after doses of acetaminophen that are not toxic to individuals with normal
liver function. This increased sensitivity to acetaminophen’s toxicity is due to:
1. Decrease availability of acetaldehyde dehydrogenase
2. Decreased hepatocellular stores of glutathione
3. Decreased activity of Cytochrome P450 enzymes
4. Increased liver blood flow

Question 20. Drugs that reduce myocardial remodeling in CHF include all of the following
except:
1. Carvedilol
2. Digoxin
3. Enalapril
4. Spironolactone

Question 21. Mechanism of action of digitalis in atrial fibrillation is:

1. By decreasing cardiac contractility
2. Na+ K+ ATPase inhibition
3. Increase in refractoriness of AV nodal tissue
4. By causing bradycardia

Question 22. A diabetic patient with bilateral renal artery stenosis requires a drug for the
treatment of high blood pressure. Which of the following drugs will be most
appropriate for this patient?
1. Hydrochlorthiazide
2. Metoprolol
3. Enalapril
4. Amlodipine

Question 23. In which of the following patients would enalapril be the best first line agent
for high blood pressure control?
1. A 62 year old man with renal artery stenosis
 2. A 32 year old pregnant female
3. A 41 year old woman with hyperkalemia
4. A 56 year old diabetic woman

Question 24. A 40-year-old politician suffered from attacks of chest pain diagnosed as
angina pectoris. He had a tense personality, resting heart rate was 96/min,
blood pressure was 170/104mm Hg, but blood sugar level and lipid profile
were normal. Select the most suitable antihypertensive for the initial therapy
in his case:
1. Nifedipine
2. Hydrochlorothiazide
3. Atenolol
4. Methyldopa

Question 25. Lignocaine is useful for the treatment of:

1. Atrial fibrillation
2. Paroxysmal supraventricular tachycardia
3. Digitalis induced ventricular extrasystoles
4. All of the above

Question 26. Losartan is similar to enalapril in all of the following features except:
1. Anti-hypertensive efficacy
2. Potential to reverse left ventricular hypertrophy
3. Lack of effect on carbohydrate tolerance
4. Potential to induce cough in susceptible individuals

Question 27. Which of the following drugs act by inhibition of AT1 subtype of angiotensin
receptors?
1. Ramipril
2. Lovastatin
3. Candesartan
4. Sumatriptan

Question 28. Which of the following is NOT associated with thiazide diuretics?
1. Hypercalciuria
2. Hyponatremia
3. Hypokalemia
4. Hyperuricemia
Question 29. Important difference between leuprolide and ganirelix is that ganirelix:
1. Can be given orally
2. Immediately reduces gonadotropin secretion
3. Must be given in a pulsatile fashion
4. Initially stimulates release of LH and FSH

Question 30. Mechanism of action of propyl-thiouracil in a 40 year old patient with

hyperthyroidism is:
1. Inhibition of organification of iodine
2. Inhibition of oxidation of iodine
3. Inhibition of coupling of two DIT residues
4. All of the above

Question 31. In the treatment of hypothyroidism, thyroxine is preferred over liothyronine

because thyroxine
1. Is faster acting
2. Has higher affinity for thyroid hormone receptors
3. Has a longer half life
4. Can be made more easily by recombinant DNA technology

Question 32. Which of the following drugs promotes the release of endogenous insulin?
1. Acarbose
2. Glipizide
3. Metformin
4. Pioglitazone

Question 33. Metformin is NOT effective in lowering of blood sugar  level in which of the
following patients?
1. Non diabetics
2. Obese diabetics
3. Type 2 diabetics
4. Diabetics not responding to sulfonylureas

Question 34. A 54- year old obese patient with type 2 diabetes mellitus and a history of
alcoholism probably should not receive metformin because it can increase the
risk of:
1. Disulfiram like reaction
 2. Hypoglycemia
3. Lactic acidosis
4. Severe hepatic toxicity

Question 35. Based on the given mechanism of action as shown in the  Figure, Drug A is
likely to be:

1. Exenatide
2. Vildagliptin
3. Canagliflozin
4. Pramlintide
Question 36. The drug X is used in osteoporosis. Its mechanism of action is shown in the
Figure below. X is likely to

1. Teriparatide
2. Alendronate
3. Denosumab
4. Estrogen

Question 37. Select the regime of corticosteroids which has the maximum adverse effect
potential?
1. Prednisolone 20 mg/day oral for one year
2. Prednisolone 60 mg/day oral for 7 days
3. Dexamethasone 4 mg intravenous daily for 3 days
4. Methyl-prednisolone 1000 mg intravenous twice single dose

Question 38. Which of the following is an indication for the use of raloxifene?
1. Chronic renal failure
2. Hypoparathyroidism
3. Renal osteodystrophy
4. Post-menopausal osteoporosis
Question 39. Chronic use of which of the following medications is most likely to cause
osteoporosis?
1. Lovastatin
2. Propanolol
3. Warfarin
4. Prednisone

Question 40. A 52 year-old postmenopausal patient has evidence of low bone mineral
density. She and her physician are considering therapy with raloxifene or a
combination of conjugated estrogens and medroxyprogesterone acetate. Which
of the following patient characteristics is MOST likely to lead them to select
raloxifene?
1. Previous hysterectomy
2. Recurrent vaginitis
3. Strong family history of breast cancer
4. Troublesome hot flushes

Question 41. A drug ‘X’ primarily reduces the static component of urinary obstruction in
benign hypertrophy of prostate and takes more than 3 months to exert its
beneficial effect. Which of the following is ‘X’?
1. Tamsulosin
2. Terazosin
3. Finasteride
4. Amphetamine

Question 42. Teriparatide can be used for the treatment of :

1. Osteoporosis
2. Hormone responsive breast carcinoma
3. Polycystic ovarian disease
4. Hyperparathyroidism

Question 43. Which of the following statements regarding barbiturates is accurate?

1. Benzodiazepines exhibit a steeper dose response relationship as compared to
barbiturates
2. Barbiturates may increase the half lives of drugs metabolized by the liver
3. Alkalization of the urine will accelerate the elimination of phenobarbitone
4. Respiratory depression caused by barbiturate overdosage can be reversed by
flumazenil

Question 44. All of the following statements about flumazenil are true except
 1. It is a specific antagonist of benzodiazepines
2. It may be used to treat barbiturate poisoning
3. It is given intravenously
4. It acts on same site on GABA channel where benzodiazepines bind

Question 45. A patient of Parkinsonism developed this condition after treatment. Which of
the following drugs is likely to cause this adverse effect?

1. Levo-dopa
2. Amantadine
3. Selegiline
4. Pramipexole

Question 46. Which statement is CORRECT about pramipexole?

1. Activates brain dopamine receptors
2. Commonly a first line therapy for Parkinson’s disease
3. Not an ergot derivative
4. All of the above

Question 47. In treatment of Parkinsonism, L-Dopa is combined with carbidopa mainly:

1. To decrease the treatment duration
2. To decrease central side effects of L-Dopa
3. To decrease effectiveness of L-Dopa
4. To increase crossing of L-Dopa through blood brain barrier

Question 48. A 72-year-old patient with Parkinsonism presents with swollen feet. They are
red, tender and very painful. You could clear up these symptoms within a few
days if you tell the patient to stop taking:
 1. Amantadine
2. Benztropine
3. Bromocriptine
4. Levodopa

Question 49. Which antiepileptic drug can lead to this adverse effect:

1. Phenytoin
2. Carbamazepine
3. Valproate
4. Lamotrigine

Question 50. Which of the following statement about phenytoin is true?

1. It follows zero order kinetics
2. It is not teratogenic
3. It is excreted unchanged in urine
4. It does not induce microsomal enzymes

Question 51. High plasma drug concentration of phenytoin can cause which of the following
adverse effects?
1. Ataxia
2. Hirsutism
3. Gum hyperplasia
4. All of the above
Question 52. Prolonged use of one of the following anticonvulsant drugs can produce weight
loss:
1. Gabapentin
2. Oxcarbazepine
3. Topiramate
4. Valproic acid

Question 53. A 20 years old female with generalized tonic clonic epilepsy well controlled of
phenytoin 300 mg/day, becomes pregnant. Pick the correct advise you would
give her:
1. Stop Phenytoin + start Phenobarbitone and Folic acid
2. Stop Phenytoin + start Lamotrigine and Folic acid
3. Stop Phenytoin + start Magnesium infusion
4. Continue with Phenytoin and add Tab. Folic acid and during the last 2 weeks of
pregnancy  give oral Vitamin K too

Question 54. All actions of chlorpromazine are based on its anti-dopaminergic property
EXCEPT:
1. Antipsychotic
2. Hyperprolactinemic
3. Antiemetic
4. Hypotensive

Question 55. One of the following limitations of typical tricyclic    antidepressants has been
overcome by selective serotonin reuptake inhibitors. Which is it?
1. Frequent anticholinergic, sedative and hypotensive side effects
2. High risk of cardiac arrhythmias and seizures in overdose
3. Delayed response
4. Both (a) and (b) are correct

Question 56. A psychiatric patient taking medication develops a tremor, thyroid

enlargement and leucocytosis. Drug implicated is:
1. Clomipramine
2. Haloperidol
3. Lithium
4. Olanzapine

Question 57. The intense craving experienced by the people recovering from chronic
alcoholism can be treated by a      drug which acts by being an:
 1. Agonist of serotonin receptors
2. Agonist of alpha adrenoceptors
3. Agonist of beta adrenoceptors
4. Antagonist of opioid receptors

Question 58. Epinephrine added to a solution of lignocaine for a peripheral nerve block
will:
1. Increase risk of convulsions
2. Increase the duration of action of the local anesthetic
3. Both (a) and (b)
4. None of these

Question 59. One of the following statements about succinylcholine is true:

1. It may induce life threatening hyperkalemia
2. It has a long duration of action
3. It is the drug of choice in non traumatic rhabdomyolysis
4. It is useful in patients with spinal cord injuries with paraplegia

Question 60. Postoperative vomiting is uncommon with this   intravenous anaesthetic agent
and patients are able to   ambulate sooner than those who receive other
anaesthetic agents:
1. Ketamine
2. Enflurane
3. Propofol
4. Remifentanil

Question 61. A drug that binds to and inhibits Gp IIb/IIIa glycoprotein and is responsible
for platelet antiaggregatory effects is:
1. Clopidogrel
2. Enoxaparin
3. Fondaparinux
4. Tirofiban

Question 62. All of the following are true regarding low molecular weight heparin except:
1. It has higher and predictable bioavailability
2. It inhibits both factor IIa and Xa
3. PT; aPTT monitoring is not required
4. It has more favorable pharmacokinetics
Question 63. Which of the following drugs is effective in the treatment of acute asthmatic
attack?
1. Zafirlukast
2. Nedocromil
3. Prednisolone
4. Salbutamol

Question 64. Drug of choice for the treatment of peptic ulcer caused due to chronic use of
NSAIDs is:
1. Pirenzepine
2. Loxatidine
3. Misoprostol
4. Esomeprazole

Question 65. Which of the following drugs is NOT excreted in bile:

1. Erythromycin
2. Ampicillin
3. Rifampicin
4. Gentamicin

Question 66. TRUE statement regarding vancomycin is:

1. It is bacteriostatic
2. It has the advantage of high oral bioavailability
3. It is not susceptible to penicillinases
4. Staphylococcal enterocolits occurs commonly with its use

Question 67. This drug has activity against many strains of P. aeruginosa. However, when it
is used alone, resistance has emerged during the course of treatment. The drug
should not be used in penicillin-allergic patients. Its activity against gram-
negative rods is enhanced if it is given in combination with tazobactam. Which
of the following drugs is being described?
1. Amoxicillin
2. Aztreonam
3. Piperacillin
4. Vancomycin

Question 68. The mechanism of action of tetracyclines involves:

 1. Binding to the 50S ribosomal subunits
2. Inhibition of translocation
3. Blockade of binding of aminoacyl-tRNA to bacterial ribosomes
4. Selective inhibition of ribosomal peptidyl transferase

Question 69. The combination of trimethoprim and sulfamethoxazole is effective against

which of the following opportunistic infections in the AIDS patient?
1. Disseminated Herpes simplex
2. Cryptococcal meningitis
3. Pneumocystis jiroveci
4. Tuberculosis

Question 70. Drugs that can be used to treat infections caused by Bacteroides fragilis are all
EXCEPT:
1. Metronidazole
2. Trovafloxacin
3. Vancomycin
4. Amikacin

Question 71. Select the drug which is used to treat antibiotic   associated
pseudomembranous enterocolitis and is a   component of anti H. pylori triple
drug regimen:
1. Amoxicillin
2. Vancomycin
3. Metronidazole
4. Clotrimazole

Question 72. Antitubercular drug most commonly implicated in causing peripheral

neuropathy is:
1. Rifampicin
2. Pyrazinamide
3. Isoniazid
4. Ethambutol

Question 73. A patient of multidrug resistant tuberculosis is on antitubercular drugs. After

a few months he develops an inability to distinguish between red and green
color. Most likely drug causing these symptoms is:
1. Rifampicin
2. Ethambutol
 3. Cycloserine
4. Ethionamide

Question 74. Select the drug that is active against both HIV and hepatitis B virus:
1. Lamivudine
2. Indinavir
3. Didanosine
4. Efavirenz

Question 75. Which of the following binds to viral envelope glycoprotein preventing the
conformational changes required for the fusion of viral and cellular
membranes?
1. Abacavir
2. Indinavir
3. Enfuvirtide
4. Oseltamivir

Question 76. The fastest acting erythrocytic schizontocidal drug among the following is:
1. Artemether
2. Mefloquine
3. Chloroquine
4. Proguanil

Question 77. Metronidazole is LEAST likely to be effective in the treatment of:

1. Hepatic amoebiasis
2. Infection caused by Bacteroides fragilis
3. Pseudomembranous colitis
4. Pneumocystosis

Question 78. The antimetabolite ‘X’ inhibits DNA polymerase and is one of the most active
drugs in the treatment of leukemia. Although myelosuppression is dose
limiting, the drug may also cause cerebellar dysfunction, including ataxia and
dysarthria. Which of the following can be ‘X’?
1. Bleomycin
2. Cytarabine
3. Mercaptopurine
4. Methotrexate
Question 79. Which of the following monoclonal antibodies is a humanized antibody?
1. Rituximab
2. Palivizumab
3. Infliximab
4. Basiliximab

Question 80. A patient present with the features as shown in the figure  after treatment with
an anticancer drug. The likely drug is:

1. Cisplatin
2. 5-Fluorouracil
3. Methotrexate
4. Imatinib