ICHS Pharmacology Final Exam Questions and Answers |Fall
2026/2027 Update | 100% Correct Latest (Graded A+)
QUESTION 1
A 45-year-old hypertensive patient is prescribed propranolol. Which of the following best
describes the mechanism of action of this drug?
A. Selective β1-receptor antagonism
B. Non-selective β-receptor antagonism
C. α1-receptor antagonism
D. β2-receptor agonism
CORRECT ANSWER: B
RATIONALE: Propranolol is a non-selective beta-blocker that inhibits both β1 and β2 adrenergic
receptors, reducing heart rate and contractility. The other options are incorrect because it does
not selectively block β1 (like metoprolol), act on α1, or function as an agonist.
QUESTION 2
Which of the following antibiotics acts by inhibiting bacterial cell wall synthesis?
A. Ciprofloxacin
B. Gentamicin
C. Penicillin G
D. Erythromycin
CORRECT ANSWER: C
RATIONALE: Penicillin G inhibits transpeptidase enzymes responsible for bacterial cell wall
synthesis. Ciprofloxacin interferes with DNA gyrase, gentamicin inhibits protein synthesis at the
30S ribosome, and erythromycin acts on the 50S ribosomal subunit.
QUESTION 3
Which of the following drugs is a loop diuretic?
A. Spironolactone
B. Furosemide
,C. Hydrochlorothiazide
D. Amiloride
CORRECT ANSWER: B
RATIONALE: Furosemide inhibits the Na⁺/K⁺/2Cl⁻ cotransporter in the thick ascending limb of the
loop of Henle. Spironolactone is a potassium-sparing aldosterone antagonist,
hydrochlorothiazide is a thiazide diuretic, and amiloride blocks epithelial sodium channels.
QUESTION 4
A patient taking warfarin is started on metronidazole. What is the expected interaction?
A. Decreased anticoagulant effect
B. Increased anticoagulant effect and bleeding risk
C. No interaction
D. Reduced warfarin absorption
CORRECT ANSWER: B
RATIONALE: Metronidazole inhibits CYP2C9 metabolism of warfarin, increasing plasma levels
and the risk of bleeding. Monitoring INR is essential.
QUESTION 5
Which cholinergic agonist is primarily used in the diagnosis of asthma?
A. Pilocarpine
B. Bethanechol
C. Methacholine
D. Carbachol
CORRECT ANSWER: C
RATIONALE: Methacholine is a muscarinic agonist used in the methacholine challenge test to
assess airway hyperreactivity in asthma.
QUESTION 6
Which of the following opioid analgesics is a partial agonist at μ receptors and an antagonist at κ
receptors?
,A. Morphine
B. Naloxone
C. Buprenorphine
D. Codeine
CORRECT ANSWER: C
RATIONALE: Buprenorphine acts as a partial μ receptor agonist and κ receptor antagonist,
providing analgesia with lower risk of respiratory depression compared to full agonists.
QUESTION 7
The antidote for benzodiazepine overdose is:
A. Naloxone
B. Flumazenil
C. N-acetylcysteine
D. Atropine
CORRECT ANSWER: B
RATIONALE: Flumazenil competitively inhibits benzodiazepine binding at the GABA_A receptor,
reversing sedation and respiratory depression.
QUESTION 8
Which of the following drugs inhibits dihydrofolate reductase?
A. Sulfamethoxazole
B. Trimethoprim
C. Ciprofloxacin
D. Vancomycin
CORRECT ANSWER: B
RATIONALE: Trimethoprim selectively inhibits bacterial dihydrofolate reductase, blocking
tetrahydrofolate synthesis. Sulfamethoxazole blocks an earlier step, PABA incorporation.
QUESTION 9
A patient develops a persistent dry cough after starting an antihypertensive. Which class of
drugs is most likely responsible?
, A. Calcium channel blockers
B. ACE inhibitors
C. Beta-blockers
D. Diuretics
CORRECT ANSWER: B
RATIONALE: ACE inhibitors increase bradykinin levels in the lungs, leading to the characteristic
dry cough. ARBs do not cause this effect.
QUESTION 10
Which of the following drugs is contraindicated in patients with asthma?
A. Metoprolol
B. Propranolol
C. Atenolol
D. Nebivolol
CORRECT ANSWER: B
RATIONALE: Propranolol blocks β2 receptors in bronchial smooth muscle, leading to
bronchoconstriction, which is dangerous in asthmatic patients.
QUESTION 11
What is the mechanism of action of omeprazole?
A. H₂ receptor blockade
B. Proton pump inhibition
C. Antimuscarinic action
D. Mucosal prostaglandin stimulation
CORRECT ANSWER: B
RATIONALE: Omeprazole irreversibly inhibits the H⁺/K⁺ ATPase in gastric parietal cells,
suppressing acid secretion.
QUESTION 12
Which of the following drugs is a selective COX-2 inhibitor?
2026/2027 Update | 100% Correct Latest (Graded A+)
QUESTION 1
A 45-year-old hypertensive patient is prescribed propranolol. Which of the following best
describes the mechanism of action of this drug?
A. Selective β1-receptor antagonism
B. Non-selective β-receptor antagonism
C. α1-receptor antagonism
D. β2-receptor agonism
CORRECT ANSWER: B
RATIONALE: Propranolol is a non-selective beta-blocker that inhibits both β1 and β2 adrenergic
receptors, reducing heart rate and contractility. The other options are incorrect because it does
not selectively block β1 (like metoprolol), act on α1, or function as an agonist.
QUESTION 2
Which of the following antibiotics acts by inhibiting bacterial cell wall synthesis?
A. Ciprofloxacin
B. Gentamicin
C. Penicillin G
D. Erythromycin
CORRECT ANSWER: C
RATIONALE: Penicillin G inhibits transpeptidase enzymes responsible for bacterial cell wall
synthesis. Ciprofloxacin interferes with DNA gyrase, gentamicin inhibits protein synthesis at the
30S ribosome, and erythromycin acts on the 50S ribosomal subunit.
QUESTION 3
Which of the following drugs is a loop diuretic?
A. Spironolactone
B. Furosemide
,C. Hydrochlorothiazide
D. Amiloride
CORRECT ANSWER: B
RATIONALE: Furosemide inhibits the Na⁺/K⁺/2Cl⁻ cotransporter in the thick ascending limb of the
loop of Henle. Spironolactone is a potassium-sparing aldosterone antagonist,
hydrochlorothiazide is a thiazide diuretic, and amiloride blocks epithelial sodium channels.
QUESTION 4
A patient taking warfarin is started on metronidazole. What is the expected interaction?
A. Decreased anticoagulant effect
B. Increased anticoagulant effect and bleeding risk
C. No interaction
D. Reduced warfarin absorption
CORRECT ANSWER: B
RATIONALE: Metronidazole inhibits CYP2C9 metabolism of warfarin, increasing plasma levels
and the risk of bleeding. Monitoring INR is essential.
QUESTION 5
Which cholinergic agonist is primarily used in the diagnosis of asthma?
A. Pilocarpine
B. Bethanechol
C. Methacholine
D. Carbachol
CORRECT ANSWER: C
RATIONALE: Methacholine is a muscarinic agonist used in the methacholine challenge test to
assess airway hyperreactivity in asthma.
QUESTION 6
Which of the following opioid analgesics is a partial agonist at μ receptors and an antagonist at κ
receptors?
,A. Morphine
B. Naloxone
C. Buprenorphine
D. Codeine
CORRECT ANSWER: C
RATIONALE: Buprenorphine acts as a partial μ receptor agonist and κ receptor antagonist,
providing analgesia with lower risk of respiratory depression compared to full agonists.
QUESTION 7
The antidote for benzodiazepine overdose is:
A. Naloxone
B. Flumazenil
C. N-acetylcysteine
D. Atropine
CORRECT ANSWER: B
RATIONALE: Flumazenil competitively inhibits benzodiazepine binding at the GABA_A receptor,
reversing sedation and respiratory depression.
QUESTION 8
Which of the following drugs inhibits dihydrofolate reductase?
A. Sulfamethoxazole
B. Trimethoprim
C. Ciprofloxacin
D. Vancomycin
CORRECT ANSWER: B
RATIONALE: Trimethoprim selectively inhibits bacterial dihydrofolate reductase, blocking
tetrahydrofolate synthesis. Sulfamethoxazole blocks an earlier step, PABA incorporation.
QUESTION 9
A patient develops a persistent dry cough after starting an antihypertensive. Which class of
drugs is most likely responsible?
, A. Calcium channel blockers
B. ACE inhibitors
C. Beta-blockers
D. Diuretics
CORRECT ANSWER: B
RATIONALE: ACE inhibitors increase bradykinin levels in the lungs, leading to the characteristic
dry cough. ARBs do not cause this effect.
QUESTION 10
Which of the following drugs is contraindicated in patients with asthma?
A. Metoprolol
B. Propranolol
C. Atenolol
D. Nebivolol
CORRECT ANSWER: B
RATIONALE: Propranolol blocks β2 receptors in bronchial smooth muscle, leading to
bronchoconstriction, which is dangerous in asthmatic patients.
QUESTION 11
What is the mechanism of action of omeprazole?
A. H₂ receptor blockade
B. Proton pump inhibition
C. Antimuscarinic action
D. Mucosal prostaglandin stimulation
CORRECT ANSWER: B
RATIONALE: Omeprazole irreversibly inhibits the H⁺/K⁺ ATPase in gastric parietal cells,
suppressing acid secretion.
QUESTION 12
Which of the following drugs is a selective COX-2 inhibitor?
