NSG6005
Advanced Pharmacology
Midterm Assessment Review
(With Solutions)
2026
1
,Multiple Choice Questions (MCQs)
Which enzyme primarily metabolizes most benzodiazepines in the liver?
A) CYP3A4
B) CYP2D6
C) CYP1A2
D) CYP2C9
Answer: A) CYP3A4
Rationale: Benzodiazepines like midazolam and diazepam are mainly
metabolized by CYP3A4, making interactions with CYP3A4 inhibitors
clinically significant.
Which of the following drugs is considered a narrow therapeutic index
medication requiring close plasma level monitoring?
A) Digoxin
B) Metoprolol
C) Lisinopril
D) Furosemide
Answer: A) Digoxin
Rationale: Digoxin has a narrow therapeutic window; subtherapeutic or
toxic levels can cause severe complications.
What is the mechanism of action of the drug class known as proton pump
inhibitors (PPIs)?
A) Block histamine H2 receptors
B) Inhibit Na+/K+ ATPase pump in gastric parietal cells
C) Inhibit H+/K+ ATPase pump in gastric parietal cells
D) Neutralize gastric acid
Answer: C) Inhibit H+/K+ ATPase pump in gastric parietal cells
Rationale: PPIs irreversibly inhibit the H+/K+ ATPase pump, reducing
gastric acid secretion.
Which antihypertensive medication is contraindicated in pregnancy due
to its teratogenic effects?
A) Labetalol
2
, B) Methyldopa
C) ACE inhibitors
D) Nifedipine
Answer: C) ACE inhibitors
Rationale: ACE inhibitors can cause fetal renal damage and are
contraindicated in pregnancy.
Which of the following drugs is known to cause QT prolongation and
torsades de pointes?
A) Amiodarone
B) Ondansetron
C) Ciprofloxacin
D) All of the above
Answer: D) All of the above
Rationale: Amiodarone, ondansetron, and ciprofloxacin are all associated
with QT prolongation risk.
True/False Questions
Digoxin toxicity is often exacerbated by hypokalemia.
Answer: True
Rationale: Low potassium levels increase digoxin binding affinity to
Na+/K+ ATPase, increasing toxicity risk.
Warfarin acts by inhibiting vitamin K-dependent clotting factors II, VII, IX,
and X.
Answer: True
Rationale: Warfarin inhibits the recycling of vitamin K, necessary for
activating these clotting factors.
NSAIDs typically cause selective COX-2 inhibition.
Answer: False
Rationale: Traditional NSAIDs inhibit both COX-1 and COX-2; selective
COX-2 inhibitors are a specific subclass.
Beta-2 adrenergic receptor agonists primarily cause bronchoconstriction.
3
Advanced Pharmacology
Midterm Assessment Review
(With Solutions)
2026
1
,Multiple Choice Questions (MCQs)
Which enzyme primarily metabolizes most benzodiazepines in the liver?
A) CYP3A4
B) CYP2D6
C) CYP1A2
D) CYP2C9
Answer: A) CYP3A4
Rationale: Benzodiazepines like midazolam and diazepam are mainly
metabolized by CYP3A4, making interactions with CYP3A4 inhibitors
clinically significant.
Which of the following drugs is considered a narrow therapeutic index
medication requiring close plasma level monitoring?
A) Digoxin
B) Metoprolol
C) Lisinopril
D) Furosemide
Answer: A) Digoxin
Rationale: Digoxin has a narrow therapeutic window; subtherapeutic or
toxic levels can cause severe complications.
What is the mechanism of action of the drug class known as proton pump
inhibitors (PPIs)?
A) Block histamine H2 receptors
B) Inhibit Na+/K+ ATPase pump in gastric parietal cells
C) Inhibit H+/K+ ATPase pump in gastric parietal cells
D) Neutralize gastric acid
Answer: C) Inhibit H+/K+ ATPase pump in gastric parietal cells
Rationale: PPIs irreversibly inhibit the H+/K+ ATPase pump, reducing
gastric acid secretion.
Which antihypertensive medication is contraindicated in pregnancy due
to its teratogenic effects?
A) Labetalol
2
, B) Methyldopa
C) ACE inhibitors
D) Nifedipine
Answer: C) ACE inhibitors
Rationale: ACE inhibitors can cause fetal renal damage and are
contraindicated in pregnancy.
Which of the following drugs is known to cause QT prolongation and
torsades de pointes?
A) Amiodarone
B) Ondansetron
C) Ciprofloxacin
D) All of the above
Answer: D) All of the above
Rationale: Amiodarone, ondansetron, and ciprofloxacin are all associated
with QT prolongation risk.
True/False Questions
Digoxin toxicity is often exacerbated by hypokalemia.
Answer: True
Rationale: Low potassium levels increase digoxin binding affinity to
Na+/K+ ATPase, increasing toxicity risk.
Warfarin acts by inhibiting vitamin K-dependent clotting factors II, VII, IX,
and X.
Answer: True
Rationale: Warfarin inhibits the recycling of vitamin K, necessary for
activating these clotting factors.
NSAIDs typically cause selective COX-2 inhibition.
Answer: False
Rationale: Traditional NSAIDs inhibit both COX-1 and COX-2; selective
COX-2 inhibitors are a specific subclass.
Beta-2 adrenergic receptor agonists primarily cause bronchoconstriction.
3
