PHARMACOLOGY AND CLINICAL
PHARMACY – SET 4 (QUESTIONS 1–
100) – 2026 LATEST UPDATE –
VERIFIED ANSWERS WITH
RATIONALES – A+ GRADE
Subject: Pharmacology and Clinical Pharmacy
Direction: Choose the letter of the BEST answer. Each
question is worth 1 point.
1. Which of the following statements best describes
the mechanism by which bromocriptine produces its
desired effects?
A. Blockade of estrogen receptors
B. Increasing synthesis of follicle-stimulating hormone (FSH)
C. Inhibition of prolactin release
D. Stimulation of ovarian estrogen and progestin synthesis
Correct Answer: C. Inhibition of prolactin release.
Rationale: Bromocriptine is a dopamine agonist that inhibits
prolactin release from the anterior pituitary. It is used for
hyperprolactinemia, prolactinomas, and to suppress
lactation.
2. A 23-year-old woman desires a combined oral
contraceptive for pregnancy protection. Which of the
following patient factors would lead a health
professional to recommend an alternative form of
contraception?
A. Evidence of hirsutism
B. History of gastrointestinal reflux disease and is currently
taking omeprazole
C. History of migraine with aura
D. History of pelvic inflammatory disease
Correct Answer: C. History of migraine with aura.
Rationale: Combined oral contraceptives are
contraindicated in women with migraine with aura because
of the increased risk of stroke. Alternative contraception
1
,should be recommended. Hirsutism, GERD, and PID are not
contraindications.
3. Blood glucose levels may be increased by the use
of:
A. Protein consumption
B. Biguanides
C. Glucocorticoids
D. Angiotensin-converting enzyme (ACE) inhibitors
Correct Answer: C. Glucocorticoids.
Rationale: Glucocorticoids increase blood glucose by
promoting gluconeogenesis and reducing insulin sensitivity.
Biguanides and ACE inhibitors lower blood glucose; protein
consumption has minimal effect.
4. Amiodarone causes thyroid abnormalities mainly
due to:
A. Inhibition of thyroid peroxidase
B. Blockage of peripheral thyroxine receptors
C. Its large iodine content
D. Induction of the catabolism of T3
Correct Answer: C. Its large iodine content.
Rationale: Amiodarone contains approximately 37% iodine
by weight, and its large iodine content can cause both
hypothyroidism and hyperthyroidism. It can also inhibit
thyroid peroxidase and block peripheral T4 receptors, but the
iodine content is the primary cause.
5. Which of the following is NOT used in
pharmacotherapy of benign prostatic hyperplasia?
A. Oxybutynin
B. Prazosin
C. Goserelin
D. Dutasteride
Correct Answer: A. Oxybutynin.
Rationale: Oxybutynin is an anticholinergic used for
overactive bladder, not BPH. Prazosin is an alpha-blocker,
2
,goserelin is a GnRH agonist, and dutasteride is a 5-alpha-
reductase inhibitor — all used in BPH.
6. A patient who has received sertraline optimal
effective dose for 2 weeks for the treatment of her
first episode of major depression complains that the
medication is not working and would like to be
switched to another agent. What is the appropriate
recommendation?
A. Call the physician to recommend switching the patient to
MAOIs
B. Encourage the patient to continue with the current
regimen, and inform him or her that it may take 4–6
weeks before the full response is evident
C. Recommend adding lithium to augment the current
regimen
D. Recommend combining with mirtazapine
Correct Answer: B. Encourage the patient to continue
with the current regimen, and inform him or her that
it may take 4–6 weeks before the full response is
evident.
Rationale: Antidepressants like sertraline typically take 4–6
weeks to achieve full therapeutic effect. At 2 weeks, it is too
early to conclude treatment failure. The patient should be
encouraged to continue and be monitored.
7. Which of the following mood stabilizers would be
most appropriate in liver disease?
A. Lithium
B. Valproic acid
C. Carbamazepine
D. Lamotrigine
Correct Answer: A. Lithium.
Rationale: Lithium is renally excreted and does not require
hepatic metabolism, making it the safest mood stabilizer in
liver disease. Valproic acid, carbamazepine, and lamotrigine
are hepatically metabolized and can worsen liver function.
3
, 8. A 36-year-old woman presents with a 2-month
history of depressed mood. This is the patient's first
episode of major depression. Which of the following
antidepressants would be most appropriate in the
treatment of this patient?
A. Nortriptyline
B. Escitalopram
C. Phenelzine
D. Mirtazapine
Correct Answer: B. Escitalopram.
Rationale: Escitalopram (an SSRI) is first-line for major
depression due to its efficacy and favorable side effect
profile. Nortriptyline (TCA) and phenelzine (MAOI) are
reserved for refractory cases. Mirtazapine is also effective
but causes more sedation and weight gain.
9. Which of the following glucocorticoids produces the
least sodium retention?
A. Hydrocortisone
B. Dexamethasone
C. Prednisolone
D. Fludrocortisone
Correct Answer: B. Dexamethasone.
Rationale: Dexamethasone has minimal mineralocorticoid
activity and therefore causes the least sodium retention.
Hydrocortisone and fludrocortisone have significant
mineralocorticoid effects; prednisolone has moderate effects.
10. A patient with his first major depression episode
should receive antidepressant therapy for at least
after remission:
A. 2 weeks
B. 6 weeks
C. 2 months
D. 6–12 months
Correct Answer: D. 6–12 months.
Rationale: After remission of a first episode of major
depression, antidepressant therapy should be continued for
4
PHARMACY – SET 4 (QUESTIONS 1–
100) – 2026 LATEST UPDATE –
VERIFIED ANSWERS WITH
RATIONALES – A+ GRADE
Subject: Pharmacology and Clinical Pharmacy
Direction: Choose the letter of the BEST answer. Each
question is worth 1 point.
1. Which of the following statements best describes
the mechanism by which bromocriptine produces its
desired effects?
A. Blockade of estrogen receptors
B. Increasing synthesis of follicle-stimulating hormone (FSH)
C. Inhibition of prolactin release
D. Stimulation of ovarian estrogen and progestin synthesis
Correct Answer: C. Inhibition of prolactin release.
Rationale: Bromocriptine is a dopamine agonist that inhibits
prolactin release from the anterior pituitary. It is used for
hyperprolactinemia, prolactinomas, and to suppress
lactation.
2. A 23-year-old woman desires a combined oral
contraceptive for pregnancy protection. Which of the
following patient factors would lead a health
professional to recommend an alternative form of
contraception?
A. Evidence of hirsutism
B. History of gastrointestinal reflux disease and is currently
taking omeprazole
C. History of migraine with aura
D. History of pelvic inflammatory disease
Correct Answer: C. History of migraine with aura.
Rationale: Combined oral contraceptives are
contraindicated in women with migraine with aura because
of the increased risk of stroke. Alternative contraception
1
,should be recommended. Hirsutism, GERD, and PID are not
contraindications.
3. Blood glucose levels may be increased by the use
of:
A. Protein consumption
B. Biguanides
C. Glucocorticoids
D. Angiotensin-converting enzyme (ACE) inhibitors
Correct Answer: C. Glucocorticoids.
Rationale: Glucocorticoids increase blood glucose by
promoting gluconeogenesis and reducing insulin sensitivity.
Biguanides and ACE inhibitors lower blood glucose; protein
consumption has minimal effect.
4. Amiodarone causes thyroid abnormalities mainly
due to:
A. Inhibition of thyroid peroxidase
B. Blockage of peripheral thyroxine receptors
C. Its large iodine content
D. Induction of the catabolism of T3
Correct Answer: C. Its large iodine content.
Rationale: Amiodarone contains approximately 37% iodine
by weight, and its large iodine content can cause both
hypothyroidism and hyperthyroidism. It can also inhibit
thyroid peroxidase and block peripheral T4 receptors, but the
iodine content is the primary cause.
5. Which of the following is NOT used in
pharmacotherapy of benign prostatic hyperplasia?
A. Oxybutynin
B. Prazosin
C. Goserelin
D. Dutasteride
Correct Answer: A. Oxybutynin.
Rationale: Oxybutynin is an anticholinergic used for
overactive bladder, not BPH. Prazosin is an alpha-blocker,
2
,goserelin is a GnRH agonist, and dutasteride is a 5-alpha-
reductase inhibitor — all used in BPH.
6. A patient who has received sertraline optimal
effective dose for 2 weeks for the treatment of her
first episode of major depression complains that the
medication is not working and would like to be
switched to another agent. What is the appropriate
recommendation?
A. Call the physician to recommend switching the patient to
MAOIs
B. Encourage the patient to continue with the current
regimen, and inform him or her that it may take 4–6
weeks before the full response is evident
C. Recommend adding lithium to augment the current
regimen
D. Recommend combining with mirtazapine
Correct Answer: B. Encourage the patient to continue
with the current regimen, and inform him or her that
it may take 4–6 weeks before the full response is
evident.
Rationale: Antidepressants like sertraline typically take 4–6
weeks to achieve full therapeutic effect. At 2 weeks, it is too
early to conclude treatment failure. The patient should be
encouraged to continue and be monitored.
7. Which of the following mood stabilizers would be
most appropriate in liver disease?
A. Lithium
B. Valproic acid
C. Carbamazepine
D. Lamotrigine
Correct Answer: A. Lithium.
Rationale: Lithium is renally excreted and does not require
hepatic metabolism, making it the safest mood stabilizer in
liver disease. Valproic acid, carbamazepine, and lamotrigine
are hepatically metabolized and can worsen liver function.
3
, 8. A 36-year-old woman presents with a 2-month
history of depressed mood. This is the patient's first
episode of major depression. Which of the following
antidepressants would be most appropriate in the
treatment of this patient?
A. Nortriptyline
B. Escitalopram
C. Phenelzine
D. Mirtazapine
Correct Answer: B. Escitalopram.
Rationale: Escitalopram (an SSRI) is first-line for major
depression due to its efficacy and favorable side effect
profile. Nortriptyline (TCA) and phenelzine (MAOI) are
reserved for refractory cases. Mirtazapine is also effective
but causes more sedation and weight gain.
9. Which of the following glucocorticoids produces the
least sodium retention?
A. Hydrocortisone
B. Dexamethasone
C. Prednisolone
D. Fludrocortisone
Correct Answer: B. Dexamethasone.
Rationale: Dexamethasone has minimal mineralocorticoid
activity and therefore causes the least sodium retention.
Hydrocortisone and fludrocortisone have significant
mineralocorticoid effects; prednisolone has moderate effects.
10. A patient with his first major depression episode
should receive antidepressant therapy for at least
after remission:
A. 2 weeks
B. 6 weeks
C. 2 months
D. 6–12 months
Correct Answer: D. 6–12 months.
Rationale: After remission of a first episode of major
depression, antidepressant therapy should be continued for
4
