MODULE 1

General Pharmacology

1. A patient with angina pectoris was helping himself with nitroglycerin. One day the patient used nitroglycerin several times because of frequent episodes of pain. So as the last sublingual administration of nitroglycerin did not relieve pain, the patient addressed his doctor. Doctor advised him to withdraw nitroglycerin for 8 hours and prescribed another drug. After 8 hours the effect of nitroglycerin was restored. Which phenomenon did take place in this case?

A. Increase in nitroglycerin metabolismB. Increase in protein bindingC. Decrease of absorptionD. Drug dependenceE. Tolerance*.

2. Metabolism can render pharmacological activity to some initially inert substances (pro-drug). Point out the substance, which is pro-drug, used for treatment of hypertension.

A. Levodopa*B. SalbutamolC. VerapamilD. ReserpineE. Propranolol.

3. A patient who has been treated with diazepam on account of neurosis complains of toothache. Doctor administered him an analgetic, but its dose was lower than average therapeutic dose. What phenomenon did the doctor take into account while prescribing the patient an underdose?

A. SummationB. Potentiation*C. CumulationD. ToleranceE. Drug dependence.

4. A patient with frequent attacks of stenocardia was prescribed sustak-forte to be taken one tablet twice a day. At first the effect was positive but on the second day stenocardia attacks resumed. What can explain inefficiency of the prescribed drug?

A. Tachyphylaxis*B. SensibilizationC. DependenceD. CumulationE. Idiosyncrasy.

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5. A man who has been taking a drug for a long time cannot withhold it because this causes impairment of psychic, somatic and vegetative functions. Name the syndrome of different disturbances caused by drug discontinuation:

A. IdiosyncrasyB. SensibilizationC. TachyphylaxisD. Abstinence*E. Cumulation.

6. What is the mechanism of absorption of drug which is lipophilic and unionized?

A. Active transportB. Passive diffusion*C. FiltrationD. PinocytosisE. Binding to protein.

7. Which route of administration results in 100% bioavailability of drug?

A. OralB. SubcutaneousC. InhalationalD. Intravenous*E. Intramuscular.

8. Chloramphenicol is highly toxic in newborn. What is the cause of such toxicity?

A. Intensive binding to proteinB. Deficiency of metabolizing enzymes in liver*C. Penetration into the cellD. Inhibition of protein synthesisE. Inhibition of nucleic acid synthesis.

9. What is the result of tubular reabsorption of drug?A. Increase in duration of action*B. Increase in excretionC. Increase in distributionD. Decrease in duration of actionE. Loss of pharmacologic activity.

10. Anticoagulant drug warfarin is bounding to plasma albumin. How its effect can be changed in case of hypoalbuminemia?

A. Effect unchangedB. Increased*C. Decrease

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D. Significant delayed onset of effectE. Abolishing of effect .

11. Passive reabsorption from tubular urine (pH of 5) of a drug administered IV would be reduced if the drug were

A. A weak base*B. A weak acidC. Water solubleD. Protein bound E. None of the above.

12. Patient suffering from angina pectoris was helping himself by sublingual usage of nitroglycerin. One day he used the drug several times. The last use did not relieve his pain. What phenomenon does occur?

A. AntagonismB. Tachyphylaxis*C. HypersensitivityD. CumulationE. Binding to protein.

13. Point out the kind of drug interaction that permits to use one of them in lower dose.

A. AntagonismB. CumulationC. Potentiation*D. ToleranceE. Additive synergism.

14. Patient with infection of GIT was treated with antibiotic. Which type of therapy is it?

A. SymptomaticB. PathogeneticC. Ethiotropic*D. ReplacementE. Stimulating.

15. Alongside with therapeutic effect drugs can cause side effects. In which dose they can occur?

A. In overdoseB. In therapeutic dose*C. In threshold doseD. In subthreshold doseE. At any dose.

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16. Patient suffering from gastric peptic ulcer was treated with M-cholinoblocker. What is the mechanism of this drug action?

A. EnzymaticB. Receptor*C. Direct chemicalD. Physicochemical E. Action on ion channels of membrane.

17. A patient with chronic cardiac insufficiency was prescribed digoxin in average therapeutic dose. After 2 weeks of treatment the symptoms of intoxication (bradycardia, extrasystole, nausea) were developed. Point out the phenomenon responsible for intoxication.

A. TachyphilaxisB. Material cumulation*C. IdiosyncrasyD. Functional cumulationE. Tolerance.

18. The patient with heart failure was using digitoxin. His condition initially improved, but with time the manifestations of heart failure have increased again, and symptoms of glycoside intoxication apeared. What is the cause of patient's condition worsening?

A. PotentiationB. Cumulation*C. TachyphylaxisD. SensitizationE. Idiosyncrazy.

19. Analgesic effect of methamizole(analgin) in the dental pain develops in 0.5 hour and lasts for 1.5-2 hours. Tablets "Piraminal" in the same situation are faster and longer acting. What is the phenomenon responsible for difference in the action of these drugs?

A. Chemical antagonismB. Functional antagonismC. Undirectional antagonismD. PotentiationE. Summation*.

20. In the elderly patient with symptoms of senile atonic constipation long-term treatment with drug buckthorn has led to a weaking effect. What is this phenomenon?

A. Tolerance*B. CumulationC. SensibilizationD. Desensitization

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E. Tachyphylaxis.

21. During the barbituric anesthesia in a patient respiratory depression occurred. After intravenous injection of 10 ml 0.5% solution of bemegride the patient's condition improved, the volume of pulmonary ventilation inceased. Point out the phenomenon responsible for curative effect of bemegride in this case

A. Direct synergisnmB. Undirectional antagonismC. Direct antagonism*D. Indirect antagonismE. Indirect synergism.

22. A child of 2 years admitted to the infectious deseases hospital with a diagnosis of bacillary dysentery. What a way of enteral administration of antimicrobial agent polymyxin is the most rational, if child has uncontrollable vomiting?

A. SubcutaneousB. IntravenousC. OralD. Rectal*E. Inhaled.

23. In a patient with traumatic brain injury there are such symptoms: the obscured consciousness, inpaired respiration, filiform pulse, absence of reflexes. Which route of drug administration for urgent aid is the most appropriate in this case?

A. RectalB. Intravenous*C. SubcutaneousD. OralE. Inhaled.

24. In poisoning with mushrooms containing muscarine atropine is used as an antidote. Which of the following mechanisms, typical for atropine, leads to the neutralization of the poison mushroom - muscarine?

A. AntimetabolicB. Physical and chemicalC. AntienzymaticD. Receptor*E. Enzymatic.

25. Prolonged use of certain drugs before pregnancy can disrupt fetal development. What is the name of this action?

A. Fetotoxic

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B. EmbriotoxicC. TeratogenicD. Mutagenic*E. Carcinogenic.

26. With long-term treatment by antipsychotic drugs at therapeutic doses in patient, along with the restoration of the psychic function, some undesired effects such as tension in the skeletal muscles, stiffness of gait, and some autonomic disorders occurred. What the type of drug’s effects should include these?

A. AftereffectB. OverdoseC. The main therapeutic effectD. IntoxicationE. Side effects*.

27. After clinical and laboratory examination of a patient with diabetes mellitus insulin was appointed for treatment.What is the type of this therapy?

A. EtiotropicB. Replacement*C. PathogeneticD. SymptomaticE. Functional.

28. In order to reduce toothache a patient was recommended to take methamisol (analgin). What the type of pharmacotherapy was used?

A. FunctionalB. PathogeneticC. CausalD. SubstitutionE. Symptomatic*.

29. In 18 years old patient with shoulder phlegmon intramuscular injection of penicillin was made, after which he developed tachycardia, filiform pulse, fall of blood pressure to 80/60 mm Hg. What type of pathological response was originated?

A. PotentiationB. Anaphylaxis*C. ToleranceD. AntagonismE. Tachyphylaxis.

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Local anesthetics

30. To lance abscess doctor performed local anesthesia with therapeutic dose of anesthetic, but it was not sufficient. What was the cause of decrease in anesthetic effect?

A. Quick absorption of drugB. Quick metabolism of anestheticC. Alkaline mediumD. Acidic pH of tissues*E. Neutral medium.

31. Surgeon is going to perform the operation under local anaesthesia. The probable duration of operation is more than 2 hours. In past patient was complaining for ventricular extrasystole. Which anaesthetic is reasonable to chose for local anaesthesia?

A. Tetracaine(decaine)B. Procaine(novocaine)C. Benzocaine(anaesthesine)D. Trimecaine*E. Cocaine.

32. Dentist revealed that his patient is suffering from hypersensitivity to procaine. Which of the following agents may be used for local anaesthesia?

A. Benzocaine(anaesthesine)B. PiromecaineC. Dicaine(tetracaine)D. Lidocaine*E. Cocaine.

33. Which of the listed drugs is usually added to local anaesthetic to prolong its action and to decrease toxicity?

A. NoradrenalineB. EphedrineC. Adrenaline*D. ReserpineE. Atropine.

34. A 25-year-old woman with red and itchy eczematoid dermatitis visits your office, She had a dental procedure one day earlier with administration of a local anesthetic. There were no other findings, although she indicated that she had a history of allergic reactions. Which of the following drugs is most likely involved?

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A. Procaine*B. EtidocaineC. BupivacaineD. CocaineE. Lidocaine.

35. For the patient with gastroenteritis doctor prescribed preparation of tannin derivative with anti-inflammatory effect on the basis of the astringent mechanism. Which of the following drugs was prescribed?

A. Bismuth subnitratB. TanninC. XeroformD. Tanalbin*E. De-nol.

36. Patient 75 years old suffers from chronic constipation. What the drug of a group of emollients can be assigned to this patient?

A. Senna leaf*B. PhenolphtaleinC. NeostigmineD. Magnesium sulfate (enterally)E. Camphor spirit.

37. Bed sores appeared in patient on strict bed regiment. What the irritating drug was prescribed by physician to improve blood circulation in the area of bed sores

A. Camphor spirit*B. Vishnevsky’s ointmentC. Wilkinson's ointmentD. A solution of potassium permanganateE. Talc.

38. A child with acute poisoning with datura seeds doctor prescribed oral usage of activated charcoal. Specify the mechanism of its action.

A. Adsorptions alkaloids on the surface*B. Insoluble salts formationC. Block of sensory receptors of the stomachD. Precipitation of proteins on the surface of gastric mucous

membraneE. Formation of protective layer of the colloid on the mucous

membranes.

39. The drug from the group covering agents with antacid effect was prescribed to patients with gastric ulcer. Which of the following medications was prescribed?

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A. TanninB. Decoction of oak barkC. Almagel*D. Infusion of sage leavesE. Bismuth subnitrate.

40. Athlete has a sharp muscular pain in the back after training. What the irritating drug is helpful in this case?

A. The turpentine oil*B. A solution of mentholC. AmmoniaD. ValidolE. Chloroform.

41. Gastric lavage with a solution of tannin was performed to the patient with alkaloid poisoning. What the concentration of tannin solution should be used for this purpose?

A. 0.5%*B. 0.1%C. 0,01D. 0,05E. 0,1.

42. The patient suffers from hemorrhoids. For pain relief doctor prescribed rectal suppositories with local anesthetic. Point out anesthetic used in this dosage form.

A. CocaineB. TetracaineC. NovocaineD. TrimekaineE. Benzocaine (Anestesin)*.

43. Doctor applied paste with benzocaine to reduce the itching of the forearm skin. Due to which of the following properties of benzocaine it is used in soft dosage form?

A. Good absorptionB. Poor solubility*C. The high degree of distributionD. The good solubilityE. Inadequate absorption.

44. The patient will have surgery on the limbs of more than 2 hours duration, which anesthetist plans to hold under local anesthesia. Which of the following drugs should be selected for long-term conduction anesthesia?

A. Novocaine

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B. CocaineC. TetracaineD. BenzocaineE. Lidocaine*.

Cholinomimetics

45. Patient with complaints of dryness in the mouth, photophobia and disturbances of vision was admitted to the reception-room. Skin is hyperemic and dry, pupils are dilated, tachycardia. Poisoning with belladonna alkaloids was diagnosed on further examination. What medicine should be prescribed as antidote?

A. DiazepamB. Prozerin (Neostigmine)*C. AtropineD. PilocarpineE. Dipyroxim.

46. Patient with pin-point pupils, sweating, salivation, abdominal cramps, disturbances in respiration was admitted to the emergency room. Poisoning with what substance is the most likely occurred?

A. Non-narcotic analgesicsB. SedativesC. Narcotic analgesicsD. М-cholinergic antagonistsE. Muscarine*.

47. In the patient, after the stroke, paralysis of hand and leg appeared. To restore the movements of paralyzed extremities patient was treated with physical exercises and cholinomimetics. Which of listed drugs was used for this purpose?

A. AceclidineB. PilocarpineC. PhysostigmineD. Ambenonium chloride (oxazyl)*E. Lobeline.

48. A known patient of myasthenia gravis came to you with his disease well controlled by neostigmine; but he asked you to give him drug that needs more rare usage. Choose the necessary drug.

A. PhysostigmineB. AtropineC. Ambenonium chloride*

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D. ArminE. Pralidoxime.

49. A49-year old frequent business traveler presents to his physician requesting medication to help him with nausea and dizziness that he gets during turbulent flights. A scolopamine patch is prescribed for his motion sickness. Which of the following is the most likely side effects from this patch?

A. BradycardiaB. DiaphoresisC. DiarrheaD. SalivationE. Urinary retention*.

50. In complex treatment of a child, suffering from cerebral palsy, a doctor decided to include anticholinesterase drug moderately improving mental development. Choose this drug.

A. PhysostigmineB. Neostigmine (Proserinum)C. Galanthamine*D. PilocarpineE. Lobeline.

51. Analeptical remedy of reflective type from the N-cholinomimetics group was given to the patient for restoration of breathing after poisoning with carbon monoxide, What medicine was prescribed to the patient?

A. Adrenalin hydrochlorideB. Atropine sulphateC. MesatonD. PentaminE. Lobeline hydrochloride*.

52. A patient with complaints of dryness in the mouth, photophobia and vision impairment was admitted in the reception-room. Skin is hyperemic, dry, pupils, are dilated, tachycardia. Poisoning with belladonna alkaloids was diagnosed on further examination. What medicine should be prescribed?

A. ArmineB. DipiroximC. PilocarpineD. DiazepamE. Prozerin*.

53. On the 2-3rd day after stomach resection intestinal peristalsis wasn't restored. What is to be administered for stimulation of gastrointestinal tract?

A. Atropine sulfateB. Prasosin

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C. AcetylcholineD. Proserin(Neostigmine)*E. Cyclodole.

54. The patient developed postoperative intestinal atony. After injection of M-cholinomimetic the patient's condition was improved. Point out the drug that was used in this cvase

A. ArminumB. Aceclidine*C. Ambenonium chloride (Oxazylum)D. AtropineE. Platyphylline.

55. After completion of abdominal surgery conducted with the use of nondepolarizing myoreolaxant, the patient did not restored spontaneous breathing. What kind of drug is able to restore breathing in this case?

A. ScopolamineB. Aceclidine C. PilocarpineD. Neostigmine*E. Izonitrozinum.

56. A child poisoned by mushrooms containing muscarine was brought to the toxicological department Which drug should be used for emergency assistance in the first place?

A. PapaverineB. Sodium thiosulfateC. Atropine*D. UnitiolE. Dipiroxim.

57. A patient with signs of poisoning by organophosphorus insecticides was delivered to the hospital emergency department What medication should be applied as a first-aid?

A. Atropine*B. UnitiolC. PananginD. ChlorpromazineE. Glucose.

58. The patient was taken to the emergency department with complaints of dryness in the mouth, photophobia and blurred vision. On examination hyperemic dry skin, dilated pupils, tachycardia were revealed, and poisoning with belladonna alkaloids was diagnosed. Which of the drugs is advisable to apply?

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A. Neostigmine*B. PilocarpineC. DipiroximD. DiazepamE. Arminum.

59. The patient in the postoperative period to stimulate intestinal motility and tone of the bladder has been appointed agent of a group of anticholinesterase. Identify it among the following products:

A. Propranolol (Anaprilin)B. MannitolC. ReserpineD. DichlotiazidE. Neostigmine*.

60. The patient poisoned with carbon monoxide to restore breathing was treated with analeptic of a reflex type from group of N-cholinomimetics. Which drug was assigned to the patient?

A. Adrenalin hydrochlorideB. PentaminC. Lobeline hydrochloride*D. MezatonE. Atropine sulfate.

61. Specify the M-cholinomimetic used for treatment of glaucoma:A. Neostigmine methylsulfateB. Pilocarpine*C. AdrenalineD. NorepinephrineE. Phenylephrine (Mesatonum).

62. Which of the following medicines is anticholinesterase agent:A. ClonidineB. AtropineC. AdrenalineD. AcetylcholineE. Neostigmine*.

63. Which group is pilocarpine?A. M-cholinomimetics*B. AnticholinesteraseC. AdrenomimeticsD. AdrenoblockersE. Cholinoblockers.

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64. Enter the N-cholinomimetic, which stimulates the reflex of breath:A. NeostigmineB. PilocarpineC. Lobeline*D. AtropineE. Adrenaline.

Cholinoblockers

65. Teenager with fracture of hand was presented to the emergency room. To perform reposition of fractured bones it was necessary to relax skeletal muscle. For this purpose myorelaxant causing sustained depolarization of the post junctional membrane was administered. Which of the following agents was used?

A. PancuroniumB. AtracuriumC. D-tubocurarineD. Succinylcholine*E. Millectine.

66. Patient suffering from gastric peptic ulcer was treated with cholinotropic drug selectively blocking M1 cholinoceptors of parietal gastric glands. Point out this drug?

A. AtropineB. PlathyphyllineC. MetacineD. Pirenzepine*E. Hyoscine (scopolamine).

67. Young boy with burns is brought to emergency ward. There is history of death of one of his family members due to succinylcholine induction. So we will avoid succinylcholine because it

A. Causes hyperkalemiaB. Cause hepatotoxicityC. Causes muscle painsD. Can trigger malignant hyperthermia*E. Can cause spasm of masseter muscle.

68. A patient given succinylcholine for skeletal muscle relaxation during an operation, is not recovered for the last 1 hour. What must be used to restore spontaneous respiration?

A. CarbogenB. Lobelin

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C. NeostigmineD. Blood transfusion*E. Caffeine.

69. A 59 year old man develops excessive salivation and sweating, diarrhea, and bradycardia while being treated with neostigmine for myasthenia gravis. Which of the following is the most appropriate therapy for these symptoms and signs?

A. Atropine*B. CarbacholC. EdrophoniumD. EpinephrineE. Pralidoxime.

70. A patient with symptoms of phosphorganic poisoning was taken to emergency department. Which of the following drugs mast be used as a drug of first aid?

A. UnithyolumB. Potassium chlorideC. Atropine*D. Chlorpromazine (Aminazine)E. Glucose.

71. After abdominal surgery performed under general anaesthesia with non- depolarizing myorelaxant spontaneous respiration was not restored. Which of the following drugs is to be used as an antidote of non-depolarizing myorelaxant?

A. AceclidinumB. PilocarpinC. Neostigmine (Proserin)*D. HyascineE. Isonitrosine.

72. A 5 years old child was taken to toxicological department with Belladonna poisoning. Alongside with peripheral manifestations the CNS symptoms were displayed. Which of the following agents has to be administered as an antidote?

A. AceclidinB. PilocarpinC. Neostigmine (Proserin)D. AdrenalineE. Galanthamine hydrobromide*.

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73. For testing refraction of eye atropine was instilled into conjunctival sac. On completion of the procedure another cholinergic drug was used to counteract mydriasis and cycloplegia, caused by atropine. Point this drug.

A. Pilocarpine*B. LobelineC. Hyoscine (Scopolamine) D. Phenylephrine (Mesatonum)E. Pirenzepine.

74. Administration of pirenzepine in patients with gastric peptic ulcer is not accompanied by numerous side effects characteristic for atropine and other M-cholinoblckers due to

A. Inability to penetrate through blood brain barrierB. Selective inhibition of M1 –cholinoceptors*C. Inhibition of all types of M –cholinoceptorsD. Inhibition of cholinesteraseE. Significant protein binding.

75. It is known that administration of tubocurarine during surgery can enhance the development of postoperative paralytic ileus. What is the mechanism of this side effect of tubocurarine?

A. Inhibition of M –cholinoceptorsB. Inhibition of cholinesteraseC. Ganglion blocking activity*D. Stimulation of M –cholinoceptorsE. Stimulation of both M – and N-cholinoceptors.

76. Which of the following conditions is alleviated by centrally acting anti-cholinergic drugs?

A. DepressionB. Multiple sclerosis C. Mania D. Parkinsonism*E. Psychosis.

77. A 50-year-old male farm worker has been brought to the emergency room. He was found confused in the orchard and since then has remained unconscious. His heart rate is 45 and his blood pressure is 80/40 mm Hg. He is sweating and salivating profusely. Which of the following should be prescribed?

A. PentamineB. NorepinephrineC. PhysostigmineD. Atropine*E. Proserine.

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78. Introduction of a pharmaceutical substance to an experimental animal resulted in reduction of salivation, pupil mydriasis. Next intravenous introduction of acetylcholine didn't lead to any significant changes of heart rate. Name this substance:

A. ProserinB. Atropine*C. PropranololD. AdrenalineE. Salbutamol.

79. A patient had to go through an operation. Doctors introduced him dithylinum (listenone) and performed intubation. After the end of operation and cessation of anesthesia the independent respiration wasn't restored. Which enzyme deficit prolongs the action of muscle relaxant?

A. Pseudocholinesterase*B. K-Na-adenosine triphosphataseC. N - acetyltransferaseD. Succinate dehydrogenaseE. Carbanhydrase.

80. A patient with fracture of his lower jaw was admitted to the maxillofacial department. It was decided to fix his bones surgically under anaesthetic. After intravenous introduction of muscle relaxant there arose short fibrillar contractions of the patient's facial muscles. What muscle relaxant was applied?

A. Dithylinum*B. Pipecuronium bromideC. DiazepamD. MelictineE. Tubocurarin chloride.

81. If a man has an attack of bronchiospasm it is necessary to reduce the effect of vagus on smooth muscles of bronchi. What membrane cytoreceptors should be blocked for this purpose?

A. M-cholinoreceptors*B. beta-adrenoreceptorsC. alfa- and beta-adrenoreceptorsD. alfa-adrenoreceptorsE. N-cholinoreceptors.

82. The patient with bronchial asthma uses inhaled form M - holinoblocker. In this case, as a rule, characteristic side effects such as blurred, constipation tachycardia do not appear. Point out the drug that patient uses.

A. PlatifillinB. Atropine

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C. MetacinD. Ipratropium Bromide*E. Pirenzepine.

83. For the treatment of patients with essential hypertension doctor prescribed the drug from the group M – cholinoblocker. Enter the drug.

A. Platyphylline*B. AtropineC. ScopolamineD. MetacinE. Gastrotsepin.

84. The drug selectively blocking M1 - cholinergic receptors was assigned to patient suffering from gastric peptic ulcer. What this drug is?

A. Pirenzepine*B. AtropineC. Platyphylline D. MethacinumE. Scopolamine.

85. A patient with a fracture of the mandible was delivered to the Maxillofacial department. It was decided to connect the bones surgically under general anesthesia. After intravenous injection of muscle relaxant transient fibrillar contractions of facial muscles were observed. What kind of muscle relaxant was used?

A. Dithylinum*B. Tubocurarine chlorideC. Pipecuroniub bromideD. MellictinumE. Diazepam.

86. Dentist in order to reduce salivation during the filling of the tooth prescribed the drug to the patient. What the medicine was prescribed?

A. Adrenalin hydrochlorideB. Phenylephrine (Mezaton)C. Neostigmine D. Pilocarpine hydrochlorideE. Atropine sulfate*.

87. Iintroduction of the drug in experimental animals decreases salivation, dilates pupils, and on the subsequent intravenous injection of acetylcholine heart rate did not change significantly. Specify the name of the substance:

A. Propranolol (Anaprilin)B. Neostigmine methylsulfate

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C. AdrenalineD. SalbutamolE. Atropine*.

88. Dithylinum was injected to the patient before surgery and intubation was performed. After the operation, and termination of anesthesia spontaneous breathing was not restored. Deficiency of which enzyme is responsible for prolongation of this muscle relaxant action?

A. Carbonic anhydraseB. Pseudocholinesterase*C. Succinate dehydrogenaseD. K-Na-ATPaseE. N-acetyltransferase.

89. The preparation of the depolarizing neuromuscular blocking agents should be assign to the patient with a broken limb for short-lasting surgical procedure. Choose the drug.

A. Atropine sulfateB. PentaminC. Dithylinum*D. CytitonumE. Tubocurarine chloride.

90. In a patient with myasthenia after the treatment with neostigmine nausea, diarrhea, and hypersalivation appeared. Point out the drug to eliminate these side effects.

A. Atropine Sulfate*B. Phenylephrine (Mezaton)C. PhysostigmineD. IsoprenalineE. Pyridostigmine bromide.

91. In poisoned patient dryness of mucous membranes of the mouth and dilated pupils were observed. What is the mechanism of these symptoms development?

A. Stimulation of N-cholinergic receptorsB. Stimulation of the M-cholinergic receptorsC. Adrenoceptor blockadeD. M-cholinergic receptor blockade*E. Stimulation of adrenergic receptors.

92. In the patient with a forearm injury during the bone repositioning Dithylinum was used for muscle relaxation. Full recovery of muscle tone and function took more than an hour. What can be the cause of significant lengthening of the drug’s action?

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A. Genetic deficiency of monoamine oxidaseB. Genetic deficiency of butyrylcholinesterase*C. Inhibition of microsomal oxidationD. Genetic deficiency of hydroxylaseE. Formation of the active metabolite.

Adrenomimetics and sympathomimetics

93. A patient with bronchial asthma is administered inhalation of 0,5 percent isadrine solution. Bronchospasm was relieved but the patient began complaining of pain in the heart region and palpitation. It is connected with the stimulation of :

A. alpha one – adrenoreceptrosB. Beta two – adrenoreceptrosC. Beta one – adrenoreceptros*D. Acetylchloline synthesisE. M-chlolinoceptors.

94. Patient with bronchial asthma was taking tablets, which caused insomnia, headache, increased blood pressure. What medicine can cause such complications?

A. Chromolin sodiumB. AdrenalineC. EuphylineD. Ephedrine*E. Izadrine.

95. Spasm of smooth muscle of bronchi developed in the patient. Usage of activators of what membrane cytoreceptors is physiologically valid to decrease attack?

A. alpha-аdrenoreceptorsB. beta-adrenoreceptors*C. alpha-and- beta-аdrenoreceptorsD. N-cholinoreceptorsE. М-cholinoreceptors.

96. In the treatment of patient suffering from congestive heart failure resistant to digitalis adrenomimetic was used as inotropic agent. Point out which of the following drugs was administered.

A. PhenylephrineB. PartusistenC. Dobutamine*D. Xylometazoline

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E. Naphazoline.

97. 63 years patient with symptoms of collapse was admitted into emergency department. Doctor has chosen noradrenaline to overcome collapse. What mechanism is responsible for therapeutic effect of this drug?

A. Activation of alfa1 receptors*B. Activation of beta adrenoceptorsC. Activation of dopaminergic receptorsD. Blockade of M –cholinoceptorsE. Activation of serotonin receptors..

98. Dopamine increases urine production in a shocked patient because it:

A. Increase cardiac outputB. Decreases aldosterone releaseC. Decreases ADH releaseD. Causes peripheral vasodilationE. Causes renal arterial dilation*.

99. To perform fundoscopy ophthalmologist instilled in the eye an agent capable of causing mydriasis without cycloplegia. Point out this agent.

A. Phenylephrine (Mesatonum)*B. NoradrenalineC. AtropineD. PilocarpineE. Isoprenaline (Isadrinum).

100. A patient with bronchial asthma addresses his doctor with complaints about unpleasant palpitations that occur after usage of inhalation form of isoprenaline (isadrinum).What is the cause of this side effect?

A. stimulation of alfa1– adrenoceptrosB. stimulation of alfa2– adrenoceptrosC. stimulation of beta1– adrenoceptros*D. stimulation of beta2– adrenoceptrosE. inhibition of M-chlolinoceptors.

101. A patient with moderate hypertension was treated with the drug that realizes its effect by decrease in noradrenaline release from sympathetic nerve endings. While treatment patient experienced drowsiness. What the drug was used?

A. PrazosinB. Reserpin*C. DrotaverineD. AtenololE. Dichlorothiazide.

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102. Surgical treatment of benign tumor of prostate in 67- year patient was postponed instead pharmacotherapy with adrenergic drag was started. Point out which of the drugs was most probably used.

A. AdrenalineB. EphedrineC. Prazosine*D. Propranolol (Anaprilinum)E. Atenolol .

103. A patient has got a spasm of smooth muscles of bronchi. Blockers of what membrane cytoreceptors are physiologically reasoned to stop an attack?

A. beta-adrenoreceptorsB. M-cholinoreccptors*C. alpha- and beta-adrenoreceptorsD. H-cholinoreceptorsE. alpha -adrenoreceptors.

104. A patient ill with bronchial asthma didn't inform his doctor that he had attacks of stenocardia. Doctor administered him a medication, which taking resulted in less frequent attacks of bronchial asthma. but stenocardia attacks became more frequent. What medication was administered?

A. Cromolyn sodiumB. SalbutamolC. AminophyllineD. PhenotherolE. Isadrin*.

105. An ophthalmologist used a 1% mesaton solution for the diagnostic purpose (pupil dilation for eve-ground examination). What is the cause of mydriasis induced by the drug?

A. Activation of alfa1 adrenoreceptors*B. Activation of beta1 adrenoreceptorsC. Activation of M-cholinoreceptorsD. Block of alfa1 adrenoreceptorsE. Activation of alfa2 adrenoreceptors.

106. At the doctor's the dentist- surgeon injected 1% - procaine for conduction anesthesia. It caused the change in patient’s condition: the skin was covered with sticky and cold sweat, the pulse became almost impalpable, breathing became rare and weak. Realizing that anaphylactic shock is originated, a doctor immediately introduced intravenously drug that promptly improved the patient's condition. Which of the following drugs can be used for first aid in severe allergic reactions?

A. Ipratropium bromide

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B. LabetalolC. FenoterolD. Adrenaline*E. Dobutamine.

107. A patient with heart failure, resistant to cardiac glycosides was admitted to hospital. A doctor appointed adrenomimetic as inotropic (cardiotonic) drug. Which of these adrenomimetic has inotropic (cardiotonic) action?

A. Dobutamine*B. Phenylephrine (Mezaton)C. NaphazolineD. FenoterolE. Halazolin.

108. In the maternity ward there is a pregnant woman with the danger of miscarriage. Which of the following agents can be used to save the pregnancy?

A. ReserpineB. IsoprenalinC. NicergolineD. EphedrineE. Fenoterol (Partusisten)*.

109. The patient went to the doctor for medical examination. In the queue while waiting an attack of asthma originated. Which group of drugs is advisable to use to provide first aid?

A. N - cholinomimeticsB. SympathomimeticsC. Beta-adrenomimetics*D. Beta-adrenoblockersE. M - cholinomimetics.

110. In anesthetic practice adrenaline is usually added to the local anesthetics to prolong analgesia and reduce side effects. What the effect of adrenaline contributes to this?

A. Reducing the sensitivity of pain receptorsB. Constriction of blood vessels*C. Increase in peripheral resistanceD. Stimulation of the antinociceptive systemE. CNS depression.

111. In the course of therapy of a patient a number of complications such as mydriasis, tachycardia, and increased blood pressure have occurred. Which of the listed drugs can cause such side effects?

A. Propranolol (Anaprilin)

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B. Adrenaline*C. PhentolamineD. IsoprenalineE. Norepinephrine.

112. A patient made an inhalation of medication to relieve an attack of asthma it quickly improved patient condition but caused tachycardia. Which of the following agents can lead to such a complication?

A. FenoterolB. AtenololC. MetoprololD. Isoprenaline*E. Salbutamol.

113. A pregnant woman with a danger of abortion is admitted to obstetric department. Which of these drugs should be applied to save the pregnancy?

A. Salbutamol*B. OxytocinC. Neostigmine methylsulfateD. DinoprostonE. Quinine.

114. An ambulance was called to women 28 years old in connection with an attack of asthma. After intramuscular injection of ephedrine her condition was improved. However, after 49 minutes the attack was repeated, ephedrine injected once more acted weaker, in the third attack of bronchospasm that occurred in half an hour, ephedrine did not cause any effect.What is the name of this phenomenon?

A. AddictionB. BiotransformationC. EliminationD. AdsorptionE. Tachyphylaxis*.

115. In a patient during a visit to the dentist an acute hypotension occurred. Which of the drugs that stimulate adrenergic structures should be used to normalize blood pressure?

A. NaphazolineB. XylometazolineC. Phenylephrine (Mezaton)*D. ErgotamineE. Doxozasin.

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116. In the experimental modeling of mechanism of inotropic effect of adrenaline activation of one of listed receptors was revealed. Point out these receptors.

A. M-Cholinergic receptorsB. Beta-1 - adrenoceptors*C. Beta 2 - adrenergic receptorsD. Alpha 2 - adrenergic receptorsE. Alpha 1 - adrenergic receptors.

117. A patient with acute rhinitis was often applying intranasally 5% solution of ephedrine hydrochloride. The effectiveness of the drug was declining with each usage and on the third day disappeared entirely? What is the cause of rapid decrease in drug’s efficacy (tachyphylaxis)?

A. The progressive decrease in noradrenaline storage in sympathetic nerve endings*

B. Violation of the synthesis of norepinephrine in the sympathetic nerve endings

C. The increase in the reuptake of neurotransmitterD. Adrenoceptor blockadeE. Violation of the process of neurotransmitter release from the depot.

Antiadrenergic drugs sympatholytics

118. The patient with a history of asthma have developed atrial fibrillation, that requires agent appointment. Which of the listed antiarrhythmic drug is contraindicated in this case?

A. NifedipineB. VerapamilC. Propranolol (Anaprilin)*D. ProcainainamideE. Ajmaline.

119. A patient with fibrillation, who has had bronchial asthma in his anamnesis, should be administered antiarrhythmic drug. Which preparation from the suggested group is contraindicated for this patient?

A. AjimalineB. VerapamilC. NovocainamideD. NifedipineE. Propranolol (Anapriline )*.

120. 72-year woman suffering from angina pectoris was treated by propranolol (anaprilinium). On the background of the treatment the cough with

26

bronchospastic components was developed. Doctor replaced propanolol by atenolol. It results in abolishing of respiratory disturbances. What is the reason of beneficial effect of atenolol ?

A. Block of M-cholinoreceptorsB. Absence of action upon beta2- adrenoceptors*C. Stimulating of M-cholonoreceptorsdD. Inhibition of m-cholinireceptorsE. Absence of action on alfa- adrenoceptors.

121. Doctor prescribed selective alfa1-adrenoceptor blocker for treatment of hypertensive patient. Which of the following drugs belongs to this group?

A. MetoprololB. PhentolamineC. CordaroneD. TropaphanE. Doxazosine*.

122. Patient with angina pectoris was treated with drug decreasing oxygen demands of myocardium. While treatment, patient starts to complain of extremities coldness especially fingers. Which of the drug was used?

A. AtenololB. Propanol (anaprilin)*C. ReserpineD. PrazosinE. Labetalol.

123. Patient with Raynaud disease was treated with phentolamine. What is the mechanism of action of this drug?

A. Blockade of B-adrenoceptorsB. Blockade of alpha adrenoceptors*C. Decrease in neurotransmitter amountD. D Stimulation of central alpha2 adrenoceptorsE. Blockade of central M-cholinoceptors.

124. Patient with initial form of hypertension complains of pain in heart and tachycardia. Which of the following drugs has to be used in the treatment of this patient

A. PhentolamineB. DihydroergotamineC. Propranolol (Anaprilin)*D. PrazosinE. Guanethidine(Octadinum).

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125. Patient having in the past episodes of bronchial asthma addressed doctor with angina pectoris. Doctor decided to treat patient with B-adrenoblocker. Which of B-adrenoblocker is not contraindicated in this case?

A. Anapriline(Propranolol)B. Atenolol*C. OxprenololD. PindololE. Nadolol.

126. Middle aged woman addressed doctor complaining on the attack of periodical headache. On examination migraine was diagnosed. Doctor prescribed anti-adrenergic drug. Point out the most suitable drug.

A. PhentolamineB. Dihydoergotamine*C. AtenololD. DopamineE. Reserpine.

127. For treatment of hypertensive patient doctor prescribed antiadrenergic drug, first administration of which in therapeutic dose caused “first dose syncope”. Which drug was most probably used?

A. MetoprololB. Atenolol C. Prazosin*D. ReserpinE. Propranolol.

128. A 43 year-old male patient is suffering from hypertension. His blood pressure was successfully controlled by monotherapy with adrenoblocker. With time treatment was complicated with diarrhoea and impotence. The patient addressed his doctor and the drug was changed for another adrenoblocker. Which of adrenoblockers can cause above listed side effects?

A. MetoprololB. SalbutamolC. PropranololD. DobutamineE. Prazosin*.

129. In the presence of a beta-blocker, administration of adrenaline is most likely to cause:

A. HypoglycemiaB. HypokalemiaC. Hypertension*D. HyperglycemiaE. Hypotension..

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130. Doctor prescribed selective alfa1-adrenoceptor blocker for treatment of hypertensive patient. Which of the following drugs belongs to this group?

A. MetoprololB. PhentolamineC. CordaroneD. TropaphanE. Prazosin*.

131. A 62-year-old patient, prone to bronchoconstriction, addressed his doctor with complaints of tachyarrhythmia troubling him several times a day. The doctor prescribed anaprilin (propranolol). Administration of drug provoked severe attack of bronchospasm. What is the mechanism of this side effect?

A. Stimulation of M1- cholinoceptorsB. Inhibition of alfa-adrenoceptorsC. Inhibition of beta2 - adrenoceptors*D. Increase in n. vagus toneE. Stimulation of leukotriene release.

132. A young woman with 6 months pregnancy visited her doctor complaining of periodical slight contractions of uterus. To prevent premature labour doctor prescribed partusisten (fenoterol). What is the mechanism of action of this drug?

A. Stimulation of beta2 - adrenoceptors*B. Inhibition of beta2 - adrenoceptorsC. Stimulation of alfa1 - adrenoceptorsD. Inhibition of alfa1 - adrenoceptorsE. Stimulation of M-cholinoceptors.

133. The patient with the initial form of hypertension complains of pain in the heart and tachycardia. Which of the following drugs should be used in the treatment of this patient?

A. PrazosinB. PhentolamineC. DihydroergotamineD. Propranolol (Anaprilin)*E. Reserpine.

134. A doctor prescribed the drug to the patient with hypertension. The drug is acting by selective block of alpha 1 - adrenergic receptors. What the drug was prescribed?

A. MetoprololB. Doxazosin*C. Phentolamine

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D. Propranolol (Anaprilin)E. Reserpine.

135. The patient in case of angina chest pain regularly takes nitroglycerin, however, recently angina pectoris complicated by extrasystoles and episodes of bronchospasm. Which of beta - blockers better to appoint for such a patient?

A. TimololB. Propranolol (Anaprilin)C. OxprenololD. Atenolol*E. Nadolol.

136. Patients with essential hypertension (stage II) used one of antihypertensive drugs. After a while blood pressure decreased, but the patient began to complain of fatigue, sleepiness, apathy. Later on, a pain in the stomach occurred, and gastric peptic ulcer was diagnosed. What the drug was used?

A. Reserpine*B. VerapamilC. CaptoprilD. DibazolE. Furosemide.

137. A patient with ischemic heart disease was admitted to cardiology department. To prevent attacks of angina pains drug of beta-1adrenoblockers was assigned. Name this drug:

A. Metoprolol*B. Morphine hydrochlorideC. FurosemideD. OxytocinE. Atropine sulfate.

138. Hypertensive patients is taking sympatholytic. Enter the drug.A. Propranolol (Anaprilin)B. Reserpine*C. AdrenalineD. AtropineE. Phenylephrine (Mesatonum).

139. Note the non-selective beta-blocker.A. MezatonumB. AtenololC. AdrenalineD. SalbutamolE. Propranolol (Anaprilin)*.

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140. The patient with hypertension was appointed cardioselective beta-blocker. Which drug is assigned to the patient?

A. ReserpineB. Propranolol (Anaprilin)C. Metoprolol*D. AtropineE. Adrenaline.

141. To patient with a tachyarrhythmia doctor prescribed a beta-blocker. Enter the drug.

A. AdrenalineB. Propranolol (Anaprilin)*C. AtropineD. IsoprenalineE. Salbutamol.

142. The patient suffering from angina takes a selective beta-adrenoblocker. Enter the drug.

A. Metoprolol*B. PrazosinC. AtropineD. PilocarpineE. Propranolol (Anaprilin).

143. Non selective alpha-adrenoblocker is prescribed for diagnostic purposes to a woman with a suspected pheochromocytoma. Point out this drug

A. Fentolamin*B. Propranolol (Anaprilin)C. SalbutamolD. Phenylephrine (Mesatonum)E. Clonidine.

The drugs for general anaesthesia

144. To anaesthetize the manipulation connected with burn surface treatment, a patient was intravenously injected a medication for short-acting narcosis.1 minute later the patient being under anesthesia had elevated blood pressure, tachycardia, increased tone of skeletal muscles; the reflex were reversed. After awakening the patient had disorientation and the visual hallucination. What medicine was injected to the patient?

A. SombrevinB. Thiopental sodium

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C. Nitrous oxideD. Ketamine*E. Diethyl ether.

145. The anaesthetic used along with halothane to give excellent analgesia and rapid induction is

A. Nitrous oxide*B. ThiopentalC. DesfluraneD. PropofolE. Choroform.

146. To anaesthetize the manipulation related to burn surface treatment, a patient was intravenously injected a medication for short-acting narcosis. 1 minute later the patient being under anaesthesia had increased blood pressure, tachycardia, increased tone of sceletal muscles reflexes remained. After awakening the patient had desorientation and visual hallucinations. What medication was the patient injected?

A. Nitrous oxideB. Thiopental sodiumC. Ketamine*D. Diethyl etherE. Sombrevin.

147. Dental surgeon made tooth extraction in a patient under general anesthesia. Which of the following medications can be used in this case for short-term noninhalation general anesthesia?

A. Ketamine*B. PredionC. Thiopental sodiumD. HalothaneE. Nitrogen oxide.

148. To make the treatment of burn surface painless intravenous general anesthetic for short-term anesthesia was injected to patient. Anesthesia developed in 1 minute during anesthesia increase in blood pressure, tachycardia, increase in tone of skeletal muscles have occurred. On the recovery from anesthesia patient experienced disorientation and visual hallucinations. What is the drug entered the patient?

A. Ether for anesthesiaB. SombrevinC. Ketamine*D. Thiopental sodiumE. Nitrous oxide.

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149. To do a biopsy of breast tumors in 35 years old woman analgesia is required. What type anesthesia should be used?

A. Potentiated anesthesia with muscle relaxantsB. Combined mixed anesthesiaC. Neurolept-analgesia*D. Basic anesthesia (Na-hydroxybutyrate)E. Inhalation anesthesia.

150. A 28 years old woman addressed the dentist about dental prosthetics. Because she is allergic to local anesthetics, dental treatment was necessary to carry out under general anesthesia. Which general anesthetic drug should be used for this purpose, taking into consideration short duration of manipulation?

A. Sodium hydroxybutyrateB. Ketamine*C. ThiopentalD. HalothaneE. Hexobarbital (Hexenalum).

151. To anesthetize the procedure of taking a biopsy in patient a drug that causes a fast anesthesia lasting about 5 minutes was injected intravenously. During anesthesia there were involuntary movements, slight decrease in blood pressure, short-term respiratory arrest, which was quickly restored. What kind of drug was used?

A. HalothaneB. KetamineC. PredionD. Propanidid*E. Sodium hydroxybutyrate.

152. Generalized tonic-clonic seizures with loss of consciousness were periodically occurring in a patient after an injury; these seizures were followed by a general depression of central nervous system. What the drug should be assign to prevent seizures?

A. Trihexyphenidyl (Cyclodolum)B. MidantanC. LevodopaD. Disilfiram (Teturam)E. Phenobarbital*.

153. Identify the drug that has sedative, hypnotic, anesthetic, anti-hypoxic, myorelaxant actions and it is used as general anesthetic and hypnotic.

A. Sodium hydroxybutyrate*B. Hexobarbital C. Chloral hydrate

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D. DiazepamE. Thiopental sodium.

154. The patient takes disulfiram (teturam). What is the indication for use of this drug?

A. PsychosisB. Preparation for surgeryC. Fear and anxietyD. NeurosisE. Alcoholism*.

Hypnotic, antiepileptic and antiparkinsonian drugs

155. A 5 years old child from time to time have seizures with loss of consciousness. The doctor diagnosed epilepsy (large seizures). Which drug is advisable to appoint a patient?

A. Phenobarbital*B. Benactizin(Amizulum)C. Trihexyphenidyl (Cyclodolum)D. EthosuximideE. Levodopa.

156. A man aged 68 with trembling hands and incoordination diagnosed with Parkinson's disease. Which drug is advisable to appoint a patient?

A. PhenytoinB. FinlepsinC. EthosuximideD. PhenobarbitalE. Trihexyphenidyl (Cyclodolum)*.

157. 40 years woman addressed doctor with complaints of psychic disturbances appeared with long-term usage of phenobarbital as a hypnotic. What the drug should be used instead of phenobarbital?

A. Sodium hydroxybutyrateB. BromizovalC. Chloral hydrateD. Nitrazepam*E. Noxiron.

158. Due to emotional stress a man permanently is in a state of nervous tension and has poor sleep. The doctor gave him a diazepam. Which of the following effects of diazepam is the base for its clinical application in this case?

A. Hypotensive

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B. Anxiolytic (Tranquilizing)*C. AnalgesicD. AnticonvulsantE. Antidepressant.

159. A patient suffering from insomnia addressed his doctor. The main problem was in the difficulties with sleep onset. Doctor prescribed zolpidem. Which of the following characteristics is true for this agent?

A. It belongs to benzodiazepine derivativesB. It belongs to barbituratesC. It has the ability to cause quick onset of sleep*D. It’s poorly absorbed from GITE. It’s poorly bind to protein.

160. A 46- year-old patient with a history of epilepsy (grand mal) developed status epilepticus. Choose the drug to arrest convulsions.

A. Sodium valproateB. Diazepam*C. LevodopaD. ChlorpromazineE. Droperidol.

161. An antiepileptic drug, which prevents metabolism of GABA, was included in complex therapy of patient with epilepsy (grand mal). Point out this drug

A. PhenytoinB. PhenobarbitoneC. CarbamazepineD. EthosuximideE. Sodium valproate*.

162. Patient with phenobarbital poisoning was presented to emergency department. To promote kidney excretion of poison sodium bicarbonate was administered intravenously. What mechanism is responsible for an increase in barbiturate excretion?

A. Increase in polarity of barbiturate*B. Increase in fat solubility of barbiturateC. Increase in barbiturate reabsorptionD. Increase in rate of glomerular filtrationE. Decrease in protein binding.

163. Deficiency in dopamine production by neurons of strio-pallidal system is considered to be one of the main causes of Parkinson’s disease. Point out the drug used for replacement therapy of this disease

A. Atropine

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B. DopamineC. Levodopa*D. CarbidopaE. Amantadine.

164. The patient was taken the mixture prescribed by neuropathologist for neurasthenia for 2 weeks. Patient felt better but developed coryza, conjunctivitis, rash, inertia, decrease of memory. Bromizm was diagnosed. What should be prescribed to decrease symptoms?

A. Glucose solution 5%B. Calcium chlorideC. Natrium chloride*D. PolyglucinE. Asparcam.

165. The antiepileptic drug which causes nystagmus, ataxia and gum hypertrophy is

A. Phenytoin*B. PhenobarbitoneC. CarbamazepineD. EthosuximideE. Valproic acid.

166. A 16 years boy is a known as patient suffering from epilepsy. Following several years of a drug therapy, gingival hyperplasia developed. For which drug this side effect is characteristic?

A. AlprazolamB. CarbamazepineC. Valproic acidD. EthosuximideE. Phenytoin*.

167. A woman, which is on phenytoin, wants to conceive. What advice you can give to her about drug?

A. Increase the dose of phenytoinB. Change to valproic acidC. Addition of valproic acidD. Change to phenobarbitone*E. Decrease the dose of phenobarbitone.

168. An old epileptic patient on phenytoin is having status eplilepticus. What will you give to this patient in emergency?

A. PhenytoinB. CarbamazepineC. Diazepam*

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D. Valproic acidE. Primidone.

169. Disulfiram is widely used in medical practice to prevent alcocholism. It inhibits aldehyde dehydrogenase. Increased level of what metabolite causes aversion to alcochol?

A. Propionic aldehydeB. MethanolC. Ethanol*D. AcetaldehydeE. Malonyc aldehyde.

Pharmacology of opioid analgesics

170. Very painful uterine contractions have been occurring in a pregnant woman at normal term. To relieve the woman’s condition during labour, a doctor decided to use opioid (narcotic) analgesic. Which of the listed drugs can be used in this case?

A. Trimeperidine (Promedolum)*B. MorphineC. Metamizole (Analginum)D. PapaverineE. Codeine.

171. A 60-year-old male is brought to emergency room. He is comatose and his pupils are constricted. Physician suspects opium overdose. What is the best drug to be administered?

A. FlumazanilB. Calcium carbonateC. Sodium bicarbonateD. Naloxone*E. Atropine.

172. A young man was taken to emergency department with numerous traumas of chest and head. Anesthesiologist proposed to inject morphine to relieve patient’s condition, but traumatologist rejected proposition of his colleague. Why morphine is contraindicated in this case?

A. It increases intracranial pressure*B. It stimulates vagal centerC. It decreases intraocular pressureD. It causes miosisE. It depresses center of cough reflex.

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173. It is known that morphine can cause a shift of blood from pulmonary to systemic circuit. It results in lowering of resistance in pulmonary vascular bed. In which case in may be used?

A. BronchitisB. PneumoniaC. Pulmonary oedema*D. Bronchiectatic diseaseE. Emphysema.

174. Patient in unconscious state was admitted to the emergency room. Skin is cold, pupils are pinpoint like, breathing is heavy, with cycles of the Cheyne- Stokes type, blood pressure is decreased, urinary bladder is overloaded. Poisoning with what substance is the most likely?

A. Neosigmin (Proserinum)B. SedativesC. M-cholinergic antagonistsD. Nor-narcotic analgesicsE. Narcotic analgesics*.

175. Examination of a patient revealed extremely myotic pupils, sleepiness, infrequent Chain-Stoke's respiration. urinary retention, slowing-down of heart rate, enhancement of spinal reflexes. What substance caused the poisoning?

A. AtropineB. PhosphacoleC. CaffeineD. Morphine*E. Barbital.

176. A patient with acute morphine poisoning was delivered to a hospital. What specific narcotic antagonist should be chosen in this case?

A. UnithiolB. ParacetamolC. DigoxinD. MethacinE. Naloxone*.

177. A young man with an addiction to opioid drugs denies drug dependence. Introduction of one of these drugs will help to prove drug dependence. Point out this drug.

A. MorphineB. CodeineC. Trimeperidine (Promedol)D. FentanylE. Pentazocine*.

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178. A 30 years old patient was delivered to emergency department with a fractured thigh bone after a car accident. The patient had dramatically reduced blood pressure to 70/40 mm Hg, weak pulse, enhanced pain response to touch to damaged area. What should be used for prevention of traumatic shock in patient?

A. Metamizol (Analgin)B. PapaverineC. Morphine*D. ParacetamolE. Pentazocine.

179. The patient with inoperative lung cancer metastasizing in the spine was suffering from severe pain. To relieve patient's condition analgesic is required. Which drug should be administered?

A. AnalgineB. CodeineC. ParacetamolD. Morphine*E. Papaverine.

180. On arrival of ambulance a 25 years old patient was unconscious and 15 vials of morphine solution were found near him patient had periodic breathing, slowed heart rate, suppressed reflexes except for the knee, and narrowed pupils he was taken to the emergency department. What measure should be applied in the first place?

A. Gastric lavage*B. DiureticC. Antiarrhythmic drugD. EnemaE. Induction of vomiting.

181. A child of 4 years is hospitalized to the orthopedic department with a fractured ankle with displacement. The reposition of bone fragments required analgesia. What medication should be used?

A. AnalginB. Promedol*C. Morphine hydrochlorideD. PanadolE. Omnopon.

182. Choose a specific antagonist of narcotic analgesics.A. Caffeine-sodium benzoateB. EthimizolC. Bemegride

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D. StrychnineE. Naloxone*.

183. A patient with symptoms of renal colic is admitted to the urology department. Which of these drugs should be advised to provide him first aid?

A. MorphineB. Trimeperidine (Promedol)*C. PentazocineD. FentanylE. Tramadol.

184. A patient with dislocation of shoulder was admitted to traumatologic department. The reduction of dislocation should be performed under neuroleptanalgesia. Chose the opioid analgesic used for this purpose.

A. NaloxoneB. CordiaminC. MorphineD. EthimizolE. Fentanyl*.

Pharmacology of nonopioid analgesics

185. A 67 year-old male patient suffering from arthritis was treating himself with acetyl salicylic acid (aspirin). In 2 weeks patient addressed doctor complaining of pain in epigastric area. On examination of the patient doctor prescribed anti-inflammatory agent, selectively inhibiting COX–2. Point out this drug.

A. ParacetamoleB. Diclophenac-sodiumC. Celecoxib*D. Metamisole (Analginum)E. Indomethacine.

186. In complex treatment of a patient with angina pectoris non- narcotic analgesic exerting antiplatelet activity was included. Point out this agent.

A. MeperidineB. MorphineC. TramadolD. MetamizoleE. Aspirin*.

187. Due to inhibition of COX aspirin exerts all the following effects except

40

A. Anti-inflammatory B. AntiplateletC. Increase in warfarin efficacy*D. AntipyreticE. Analgesic.

188. A patient with toothache was relieving his pain with help of metamizole (analginum). Point out another useful effect of this drug that contributes to the improvement of patient’s condition

A. Sedative effectB. Anti-inflammatory effect*C. AntIplatelet effectD. Antioxidative effectE. Antimicrobial effect.

189. The usage of acetylsalicylic acid resulted in occurrence of epigastric pain in patient. On examination of the patient gastric ulcer was revealed. What the mechanism is responsible for ulcerogenity of this drug?

A. Stimulation of pepsin secretionB. Inhibition of prostaglandin synthesis*C. Increase in bile production and its refluxD. Spasm of vesselsE. Spasm of gastric smooth muscles.

190. Doctor visited a 5-year-old child with fever and complaints of headache. Doctor suspected the onset of viral infection. To relieve patient’s condition doctor prescribed non-opioid analgesic, which additionally exerts antipyretic effect but lacks anti-inflammatory action. Point out the prescribed drug

A. Metamizole (Analginum)B. CelecoxibC. AspirinD. Acetaminophen (Paracetamol)*E. Diclophenac-sodium.

191. After the usage of acetylsalicylic acid a patient developed epigastric pain because of exacerbation of his ulcer. What is the mechanism of this drug ulcerogenity?

A. Stimulation of pepsin secretionB. Antiprostagladinic effect*C. Cholagogic effectD. Spasm of vesselsE. Immunodepressive effect.

192. Point out non- narcotic analgesic, which exerts antiplatelet activity.

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A. MeperidineB. MorphineC. TramadolD. MetamizoleE. Aspirin*.

193. A 2-year-old child is often catching a cold with fever. Which antipyretic drug is safer at this age than acetylsalicylic acid?

A. AnalginB. IndomethacinC. Paracetamol*D. PhenylbutazoneE. Phenylbutasone.

194. A 7 year child have caught cold, he was shivering, fever up to 39,2 ° C, his respiratory rate - 45 per minute, pulse - 105 beats per minute. The doctor diagnosed an acute viral infection, and appointed a baby aspirin. By means of what mechanism the drug realized its antipyretic effect in this case?

A. The overall calming effectB. Slowing down heartbeatC. Increase in heat output*D. Slowing of the respiratory rhythmE. Reduction of heat production.

Neuroleptics, antianxiety, and sedative agents

195. A patient was treated for psychosis for 2 weeks. The psychic patient's condition improved but rigidity, tremor, and hypokinesia developed. Which of the drugs can cause such complications?

A. DiazepamB. Chlorpromazine (Aminazine)*C. AmytriptilineD. PiracetamE. Chlordiazepoxide.

196. A 60 years old woman addressed her doctor complaining of side effects which appeared while treatment with chlorpromazine (aminazinum). She was troubled with tremor and disturbances of movements. What is the mechanism of this side effect?

A. Activation of hyppocampusB. Inhibition of reticular formation (alfa1 - adrenoceptors)C. Inhibition of neostriatum (D2 receptors)*D. Inhibition of hypothalamus

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E. Inhibition of hyppocampus.

197. A 50 years old patient with chronic alcoholism became aggressive. To abolish aggression, chlorpromazine was administered intramuscularly. The patient’s attempt to rise soon after an injection resulted in loss of consciousness. What is the probable cause of such complication?

A. Blockade of reticular formationB. Disturbance of coronary blood circulationC. Blockade of alfa- adrenoceptors*D. Inhibition of hypothamusE. Blockade of M- cholinoceptors.

198. After emotional stress, patient was permanently in a condition of nervous tension and had poor sleep. Doctor prescribed him diazepam. Which of the listed effects of this drug is responsible for its clinical use?

A. Hypotensive effectB. Analgesic effectC. AnticonvulsantD. Tranquilizing*E. Anti psychotic.

199. Point out the neuroleptic that is most commonly used in neuroleptanalgesia.

A. ChlorpromazineB. Droperidol*C. DiazepamD. ChlorprotixeneE. Sulpiride.

200. A patient on a particular psychotropic medication complains of severe dizziness. His blood pressure in a supine position is 115/80 mm hg on standing it drops to 82/50 mm hg. Which of the following drugs is most likely responsible for these symptoms?

A. CarbamazepineB. Chlorprozamine*C. ChlordiazepoxideD. CortisoneE. Ibuprofen.

201. A patient has been taking a mixture prescribed by neuropathologist for neurasthenia for two weeks. The patient feels better but has developed coryza, conjunctivitis, rash, inertia, decrease of memory. She is diagnosed with bromizm. What should be prescribed to decrease the

A. Glucose solution 5%B. Polyglucin

43

C. AsparcamD. Natrium chloride*E. Kalium chloride.

202. A patient who has been treated in a neural clinic and has been taking a sedative for a long time got the following complication: cough, rhinitis, epiphora. What drug caused these disturbances?

A. Sodium bromide*B. ValerianC. PhenazepamD. ReserpineE. Diazepam.

203. Select the most appropriate drug for the systematic treatment of a patient with severe productive psychotic symptoms (delirium and hallucinations).

A. Trifluoperazine (Triftazin)*B. ClozapineC. MedazepamD. AmitriptylineE. Buspirone.

204. Neuroleptics have the properties of eliviating delusions, hallucinations, reducing of aggression and psychomotor agitation. This action is called:

A. Antipsychotic*B. HypodynamicC. Antihysteric D. AnxiolyticE. Antineurotic.

205. A 40 years patient delivered to psychiatric clinic in a state of agitation, aggression, delusions. What medication should be administered?

A. Sodium bromideB. Chlorpromazine*C. ReserpineD. Tincture of valerianE. Amitriptyline.

206. The patient with schizophrenia was appointed chlorpromazine. What the pharmacological effect is the basis for assigning it to the patient?

A. HypothermicB. HypotensiveC. Antipsychotic*D. Antiemetic

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E. Myorelaxant.

207. A patient addressed a doctor complaining of anxiety, fear, uneasiness, inner tension. Which drug should be assigned?

A. Tincture of valerianB. Pavlov MedicineC. Diazepam*D. Tincture of leonuriE. Etaminal sodium.

208. On examination of the patient, unstable blood pressure, irritability, emotional imbalance, poor sleep were revealed, and doctor has prescribed chlordiazepoxide (elenium). Which of the following statements is ground for prescription elenium in this case?

A. PsychosisB. CardiopathyC. HypertentionD. Coronary artery diseaseE. Neurosis*.

209. The presence of which syndrome is the basis for the appointment of diazepam?

A. Lingering paralysisB. Inadequate perceptions (hallucinations)C. Euphoric state of pathological originD. Anxiety*E. Pathological thought disorder.

210. Patient 38 years old suffering from schizophrenia for a long time is on the psychotropic drugs. He addressed the doctor with complaints of disturbances of motor coordination, hand tremor, drowsiness. Which group of drugs can cause such a condition?

A. Antipsychotics*B. AntidepressantsC. AnalgesicsD. AdaptogensE. Psychomotor stimulants.

211. A single parenteral administration of the drug in the patient with schizophrenia caused severe hypotension. To which of these groups does drug belong?

A. NootropicsB. Antipsychotics*C. TranquilizersD. Antidepressants

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E. CNS stimulants.

212. A patient with acute myocardial infarction experienced persistent chest pain. The ineffectiveness of drugs previously designated gave the grounds for doctor to use neuroleptanalgesia. Which antipsychotic agent is used for this type of anesthesia?

A. ChlorpromazineB. TriftazinumC. MetaperazineD. Droperidol*E. Thioridazine.

213. A patient with schizophrenia is taking typical neuroleptic. Which of the effects is the basis for its application in schizophrenia?

A. Antipsychotic*B. AntiemeticC. HypothermicD. MyorelaxantE. Hypotensive.

214. A patient addressed the doctor with complaints of poor health, depression, skin rashes. An interview revealed that the patient within three weeks was taking sedative medicine, prescribed by a neurologist. With the admission of which drugs complaints of patient were associated?

A. Bromides*B. LithiumC. TranquilizersD. AntipsychoticsE. Preparations of valerianae.

Psychotropic stimulating agents. Antidepressants. Psychomotostimulants. Analeptics. Nootropic drugs

215. A patient with poisoning caused by carbon monoxide was administered directly acting analeptic drug. What medicine was used?

A. CodeineB. EphedrineC. Caffeine*D. Atropine sulfateE. Lobeline.

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216. A premature newborn was apnoic. Directly acting analeptic drug was given to restore breathing. What medicine was most probably administered to the patient?

A. Ethymisolum*B. Phenylephrine (Mesatonum)C. Adrenaline hydrochlorideD. Atropine sulfateE. Lobeline hydrochloride.

217. A psychiatrist was invited to a patient who made an attempt to commit suicide. Doctor diagnosed endogenous depression. Choose the most suitable drug for treatment of this patient.

A. Nootropil (piracetam)B. Amytriptyline*C. SydnocarbumD. EthymisolumE. Caffeine.

218. A patient had a stroke. Which of the listed drugs is necessary to include in the complex therapy in order to improve mental performance?

A. CaffeineB. Piracetam*C. DiazepamD. PhenazepamE. Amitryptiline.

219. What is the main mechanism by which amitriptyline increases amount of catecholamines in CNS synapses?

A. Increase in catecholamines release from presynaptic membraneB. Increase in catecholamines synthesis in presynaptic membraneC. Prevention of catecholamines degradation in the synapseD. Inhibition of neuronal re uptake of catecholamines*E. Inhibition of MAO.

220. Analeptical directly acting drug was given to the patient for restoration of breathing after poisoning with carbon monoxide. What medicine was prescribed to the patient?

A. PentaminB. MesatonC. Caffeine*D. Atropine sulphateE. Lobeline hydrochloride.

221. Which of the following characteristics of amphetamines is most likely to be responsible for increasing blood pressure?

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A. Indirect release of endogenous catecholamines*B. Inhibition of catecholamines metabolismC. Metabolism to false neuro-chemical transmittersD. Potent alpha1 adrenergic transmittersE. Potent beta-2 adrenergic agonist.

222. The CNS stimulation produced by methylxanthines, such as caffeine, is most likely due to the antagonism of one of the following recertors:

A. Glycine receptorsB. Adenosine receptors*C. Glutamate receptorsD. GABA receptorsE. Cholinergic muscarinic receptors.

223. A patient who has been treated with diazepam on account of neurosis complains of toothache. Doctor administered him an analgetic, but its dose was lower then average therapeutic dose. What phenomenon did the doctor take into account while prescribing the patient an underdose?

A. Drug dependenceB. CumulationC. ToleranceD. SummationE. Potentation*.

224. Pharmacological effects of antidepressants are connected with inhibitionof an enzyme catalyzing biogenic amines noradrenaline and serotonine in the mitochondrions of cerebral neurons. What enzyme participates in this process?

A. LyaseB. Monoamine oxidase*C. TransaminaseD. PeptidaseE. Decarboxylase.

225. A psychiatrist was called for the woman who tried to commit suicide on examination the state of endogenous depression was diagnosed. Which drug is most efficient for treatment of this patient?

A. Piracetam (Nootropil)B. Amitriptyline*C. SydnokarbD. AethimizolumE. Caffeine.

226. Which agent will you choose for increase in mental performance and decrease of tiredness?

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A. BuspironeB. NialamideC. SidnokarbD. ImipramineE. Caffeine*.

227. Doctor recommended taking caffeine the patient with pathological sleepiness.Which of the following mechanisms of action provides its therapeutic effect in this disease?

A. The concentration and increased inhibition in the cerebral cortexB. Increased synthesis of dopamineC. Enhancement the processes of excitation in the brain*D. Inhibition of the midbrain reticular formationE. The weakening of the excitation in the brain.

228. Point out preferable analeptic in acute barbiturate poisoningA. CordiaminumB. CaffeineC. CamphorD. Bemegride*E. Aethimizolum.

229. The patient had a stroke. Which of the following drugs should be included in the combined therapy to improve the metabolism of the brain?

A. Piracetam*B. CaffeineC. DiazepamD. PhenazepamE. Amitriptyline.

230. Which the drug from the group of psychomotor stimulants can cause the development of drug addiction?

A. Amphetamin (Phenaminum)*B. MeridilC. SidnokarbD. BemithylumE. Caffeine.

231. Which of the following effects of piracetam is used for chronic vascular disorders of the brain?

A. Anticonvulsant activityB. Improvement of mental performance*C. Antiwithdrawal effectD. Improvement of physical activityE. Antipsychotic effect.

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232. The patient complains of fatigue, general weakness, decrease in visual acuty, low blood pressure. Which drug is helpful in this case?

A. Liquid extract of Eleutherococcus*B. PhenibutC. PiracetamD. Dry extract of ValerianaE. Amitriptyline.

233. The primary goal of medical aid in vascular collapse is an increase in blood pressure. Which of the following medications can be used for this purpose?

A. AethimizolumB. DiphenhydramineC. BemegrideD. Caffeine-sodium benzoate*E. Ketotifen.

234. A patient admitted to the neurological department complains of memory loss and cognitive disability after trauma of the head. What kind of medication is needed to improve the metabolism of the brain?

A. CaffeineB. Metamizole (Analginum)C. Piracetam (nootropil)*D. SidnokarbE. Meridil.

235. A psychiatrist was called for the woman who tried to commit suicide on examination the state of endogenous depression was diagnosed. Which drug is most efficient for treatment of this patient?

A. Piracetam (Nootropil)B. Amitriptyline*C. SydnokarbumD. AethimizolumE. Caffeine.

236. Which agent will you choose for increase in mental performance and decrease of tiredness?

A. NialamideB. DiazepamC. ImipramineD. BuspironeE. Caffeine*.

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237. When should you expect for a specific therapeutic effect of pantocrinum in its systematic application?

A. After 9-15 days*B. After 30-60 minutesC. 1-3 daysD. After 30-45 daysE. After 3-6 hours.

238. Doctor recommended taking caffeine the patient with pathological sleepiness. Which of the following mechanisms of action provides its therapeutic effect in this disease?

A. Enhancement the processes of excitation in the brain*B. Increased synthesis of dopamineC. The concentration and increased inhibition in the cerebral cortexD. Inhibition of the midbrain reticular formationE. The weakening of the excitation in the brain.

239. Point out preferable analeptic in acute barbiturate poisoningA. CaffeineB. Bemegride*C. CamphorD. CordiaminumE. Aethimizolum.

240. The patient had a stroke. Which of the following drugs should be included in the combined therapy to improve the metabolism of the brain?

A. CaffeineB. DiazepamC. Piracetam*D. PhenazepamE. Amitriptyline.

241. The primary goal of medical aid in vascular collapse is an increase in blood pressure. Which of the following medications can be used for this purpose?

A. DiphenhydramineB. BemegrideC. Caffeine-sodium benzoate*D. AethimizolumE. Ketotifen.

242. A patient admitted to the neurological department complains of memory loss and cognitive disability after trauma of the head. What kind of medication is needed to improve the metabolism of the brain?

A. Piracetam (nootropil)*

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B. Metamizole (Analginum)C. CaffeineD. SydnokarbumE. Meridil.

243. Which of the following tonics is derived from animal products?A. Tincture ginsengB. Pantocrine*C. SaparalumD. EcdistenumE. Securininum.

244. Among the antidepressant drugs there are those that inhibit neuronal norepinephrine reuptake. Point out such drug.

A. FluoxetineB. NialamideC. ChlorprothixeneD. ChlorpromazineE. Maprotilime*.

245. Mark pharmacological effect, limiting the use of strychnine as analeptic.

A. Stiffness in skeletal muscle, convulsions*B. HypercatharsisC. Increased metabolismD. Strengthening of sight and hearingE. Impact on hematopoiesis.

246. What drug from the group of analeptics is preferable to use in newborn asphyxia?

A. CaffeineB. Aethimizolum*C. CamphorD. CordiaminumE. Corazolum.

247. A 19 years old boy addressed doctor complaining of discomfort in the heart area. Doctor asked him about smoking and other bad habits. Patient denied all of mentioned bad habits, and sad he likes coffee and uses up to 8 glasses of strong drink a day. Why coffee containing caffeine can worsen heart function?

A. It causes tachycardia, increases in oxygen demand of the heart*B. It slows impulse conduction in the heartC. It weakens the force of heart contractionsD. It causes a narrowing of the coronary vessels

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E. It decreases automaticity of the heart.

248. What is the mechanism of action of antidepressant pirlindol (pirazidol)?

A. The reversible inhibition of MAO*B. Irreversible inhibition of MAOC. Selective inhibition of neuronal capture of catecholaminesD. Non-selective inhibition of neuronal capture catecholaminesE. Inhibitor of vesicular capture catecholamines.

249. A patient with symptoms of mental depression in the drug treatment did not keep the doctor recommended a diet that caused the rise in blood pressure. Which group of antidepressants requires compliance in this condition?

A. Tricyclic antidepressantB. Nonselective MAO inhibitors*C. Selective inhibitors of catecholamines reuptakeD. Lithium preparations

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