3395 Krok-1 Pharmacology icon

3395 Krok-1 Pharmacology

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2. A patient was delivered to emergency department with poisoning by mushrooms, among which fly-agaric has casually appeared. The injection of atropine sulfate was prescribed to patient except the gastric lavage, active carbon, saline laxative drugs, and infusion therapy. Name a type of interaction between the atropine and muscarine.

A. Physicochemical antagonism.

B. Indirect functional antagonism.

C. Intermediary antagonism.

D. Chemical antagonism.

*E. Direct functional one-way antagonism.

3. Nausea, vomiting, diarrhoea, and twitching of skeletal muscles developed in patient with myasthenia after administration of proserinum. What drug can eliminate these symptoms?

A. Phenylephrine (mesatonum).

B. Physostigmine.

C. Pyridostigmine bromide.

D. Isoprenaline (isadrinum).

*E. Atropine.

4. As a rule, the attacks of bronchial asthma develop in patient at night, and are accompanied by bradycardia, spastic pain of intestine, and diarrhoea. What group of drug can eliminate these symptoms?

A. Sympatholytics.

B. N-cholinoblockers and blockers of H2-histamine receptors.

C. -Adrenoblockers.

D. -Adrenoblockers.

*E. M-cholinoblockers.

5. It is necessary to expand the pupils for examination of the eye fundus. Call the drug, which is used for this purpose in clinic.

A. Acetylcholine.

B. Pilocarpine.

C. Ezerinum.

D. Adrenaline.

*E. Atropine.

6. The drugs of this group are used for decrease of salivary glands secretion, prevention of laryngospasm, nausea, and bradycardia. Call this group.

A. Cholinesterase regenerators.

B. Myorelaxants.

C. M-cholinomimetics.

D. Inhibitors of cholinesterase.

*E. M-cholinoblockers.

7. Bronchospasm has developed in a worker as a result of careless using of organophosphorus substances. What broncholytic should be used in this situation?

A. Ephedrine.

B. Berotec (fenoterol).

C. Aminophylline (euphyllinum).

D. Adrenaline.

*E. Atropine.

8. Atropine is used as antidote in case of poisoning with fly-agaric mushrooms. What is the mechanism of atropine action, which causes the elimination of toxic effects of muscarine?

A. Enzymatic.

B. Physicochemical.

C. Anti-enzymatic.

D. Metabolic.

*E. Competition for the same receptors.

9. A 48-year-old male was delivered to urologic department with symptoms of renal colic. Choose a drug, which is most rational in this case.

A. Fenthanyl.

B. Morphine.

C. Metamizole (analginum).

D. Trimeperidine (promedolum).

*E. Atropine.

10. The decrease of salivation and expansion of pupils are developed in experimental animal after introduction of drug A. After following intravenous administration of acetylcholine the heart rate has not changed. Call the drug A.

A. Salbutamol.

B. Adrenaline.

C. Propranolol (anaprilinum).

D. Proserinum.

*E. Atropine.

11. A female with glaucoma asked the pharmacist with the request to give out to her eye drops with atropine sulfate. But pharmacist has explained her that this drug is contraindicated for her. Why atropine is contraindicated in glaucoma?

A. It oppresses eye reflexes.

B. It causes paralysis of accommodation.

C. It causes expansion of pupils.

D. It reduces acuteness of vision.

*E. It causes increase of intraocular pressure.

12. A patient was delivered to the hospital with the following symptoms: dizziness, thirst, impairment of swallowing, bad vision of near subjects. Patient has tachypnoe, expanded pupils, and excitement. The blood pressure is 110/70 mm Hg, heart rate is 110 per 1 minute. These symptoms testify overdose of:

A. Caffeine.

B. Morphine.

C. Ephedrine.

D. Aminazine (chlorpromazine).

*E. Atropine.

13. Mydriasis and paralysis of accommodation have developed in patient after dropping into eyes the solution of drug A. Call the group, to which the drug A. concerns.

A. -Adrenomimetics.

B. M-cholinomimetics.

C. Cholinesterase inhibitors.

D. -Adrenomimetics.

*E. M-cholinoblockers.

14. A patient, who receives the treatment concerning bronchial asthma, also suffers from glaucoma. The drugs of which group are not recommended to this patient for treatment of asthma?

A. Adrenoblockers.

B. Adrenomimetics.

C. Miotropic spasmolytics.

D. Glucocorticoids.

*E. M-cholinoblockers.

15. Atropine sulfate was prescribed to patient for interruption of intestine colic. What disease is contraindication for administration of atropine?

A. Dizziness.

B. Bronchial asthma.

C. Node tachycardia.

D. Hypotension.

*E. Glaucoma.

16. A 6-year-old child was delivered to hospital with markedly expressed symptoms of psychomotor excitement, impairment swallowing, and hoarse voice. The skin is dry and hot. The pupils are expended. Tachycardia is observed. The doctor has established, that child had taken some berries of dark-violet colour. What substance is the cause of poisoning?

A. Metacinium.

B. Pirenzepine.

C. Pilocarpine.

D. Platyphyllin.

*E. Atropine.

17. It is necessary to prescribe M-cholinoblocker for patient who suffers from ulcer disease of stomach (with hyperacidic syndrome) and glaucoma. What drug may be prescribed to this patient?

A. Homatropine.

B. Adiphenine (spasmolytinum).

C. Atropine.

D. Scopolamine.

*E. Metacinium.

18. The increase of heart rate, mydriasis, and significant dryness of mucous membranes has developed in patient after introduction of atropine. What drug should be prescribed to patient for reduction of these symptoms?

A. Strophanthine.

B. Metacinium.

C. Salbutamol.

D. Ephedrine hydrochloride.

*E. Proserinum.

19. A 40-year-old male was delivered to the hospital with acute attack of hepatic colic, which is accompanied by sharp pain. What drug should be introduced first of all?

A. Morphine.

B. Codeine.

C. Metamizole (analginum).

D. Pentazocine.

*E. Atropine.

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

A. Dipyroxime.

B. Pilocarpine.

C. Armine.

D. Diazepam.

*E. Proserinum.

21. 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. Pentamine.

B. Proserinum.

C. Physostigmine.

D. Noradrenaline.

*E. Atropine.

22. Pirenzepine was prescribed to a woman for stomach ulcer treatment. What pharmacological group can this medication be referred to?

A. Local anaesthetics.

B. Acetylcholinesterase reactivators.

C. -Adrenergic blockers.

D. Selective 1-adrenergic blockers.

*E. Selective M1-cholinergic antagonists.

23. A patient with glaucoma appealed to a pharmacist with the request to give her atropine sulfate eye drops, but she was explained, that atropine sulfate is contraindicated in case of glaucoma. Why?

A. It narrows the field of vision.

B. It leads to a paralysis of accommodation.

C. It dilates pupils.

D. It reduces distance of vision.

*E. It increases intraocular pressure.

24. A doctor has been appealed to by a man who has preliminary been examined by an ophthalmologist. Patient complains of thirst and bad vision of close subjects. Objectively he demonstrates tachypnoea, mydriatic pupils, general excitation, garrulity, though the speech is obscure. Arterial pressure is 110/70, pulse is 110 per minute. The overdose of which drug can cause these symptoms?

A. Caffeine sodium benzoate.

B. Morphine hydrochloride.

C. Ephedrine hydrochloride.

D. Aminazine.

*E. Atropine sulfate.

25. Sharp pain in the eye area of patient has developed after the use of atropine in eye drops during examination of the eye fundus. From anamnesis it became clear that patient suffers from mild form of glaucoma. Why atropine is contraindicative at glaucoma?

A. Atropine oppresses eye reflexes.

B. Atropine causes paralysis of accommodation.

C. Atropine narrows pupils.

D. Atropine affects vision.

*E. Atropine increases intraoccular pressure.

26. The victim with acute poisoning by fly-agaric was delivered to urgent department. What drug should be prescribed to him?

A. Omeprazole.

B. Dithylinum.

C. Diazolinum.

D. Furacilinum.

*E. Atropine sulfate.

27. A patient suffering from myasthenia has been administered proserin. After its administration the patient has got nausea, diarrhoea, twitch of tongue and skeletal muscles. What drug would help to eliminate the intoxication?

A. Physostigmine.

B. Mesatonum.

C. Pyridostigmine bromide.

D. Isadrinum.

*E. Atropine sulfate.

28. A patient with drug intoxication presented with the dryness of oral mucous membrane and mydriatic pupils. Such action of this drug is associated with the following effect:

A. Adrenoceptor block.

B. Nicotinic cholinoceptor stimulation.

C. Adrenoceptor stimulation.

D. Muscarinic cholinoceptor stimulation.

*E. Muscarinic cholinoceptor block.

^ N-Cholinoblocking Drugs

1. The breathing does not restore more than 30 minutes after introduction of suxamethonium (dithylinum) to patient for performing of short operation. What is the aid for this patient?

A. Forced diuresis.

B. Haemodialysis.

C. Haemosorption.

D. Peritoneal dialysis.

*E. Blood transfusion.

2. A patient with fracture of the bottom jaw was delivered to the hospital. The myorelaxant was introduced to him for performing of operation. The short-term twitching of face muscles was observed after drug introduction. What drug was introduced to the patient?

A. Mellictinum.

B. Tubocurarine chloride.

C. Pipecuronium.

D. Diazepam.

*E. Suxamethonium (dithylinum).

3. The symptoms of overdose of dithylinum have appeared in a patient during operation. What measure can decrease these symptoms?

A. N-cholinoblockers.

B. Introduction of cholinesterase inhibitors.

C. Ganglion blockers.

D. M-cholinoblockers.

*E. Blood transfusion.

4. The stopping of breathing had developed in a 42-year-old woman after operation on kidney with the use of dithylinum. Choose the drug which can restore the muscles tone.

A. Galantamine.

B. Proserinum.

C. Strychnine nitrate.

D. Caffeine.

*E. Blood plasma.

5. The curare-like drugs (myorelaxants) are used in clinic for decrease or stopping of impulse transmission from motor nerve endings to muscular cells. What is the mechanism of these drugs action?

A. Decrease of mediator releasing in synaptic cleft.

B. Blockade of Ca2+ moving through channels of postsynaptic membrane.

C. Inhibition of Na+,K+-ATPase activity.

D. Inhibition of acetylcholinesterase.

*E. Blockade of N-cholinoceptors of postsynaptic membrane.

6. The breathing of patient is not restored after ending of operation with reposition of fractured bone of hip. What drug should be introduced to patient for elimination of relaxation?

A. Aceclidine.

B. Platyphyllin.

C. Cyclodolum.

D. Atropine.

*E. Proserinum.

7. A patient with dislocation of a humeral joint was delivered to hospital. For relaxation of skeletal muscles the doctor has introduced to him dithylinum. In norm this drug acts during 5–7 minutes. But in this patient the drug action lasted for 8 hours. What is probable cause of this phenomenon?

A. Potentiation of effect by other drug.

B. Decrease of microsomal enzymes activity.

C. Decrease of drug excretion.

D. Material cumulation.

*E. Hereditary insufficiency of blood cholinesterase.

8. It is necessary to prescribe the myorelaxation short-acting drug to patient for reposition of fractured bone of hip. Choose the drug.

A. Mellictinum.

B. Arduan.

C. Tubocurarine.

D. Decametonium.

*E. Suxamethonium (dithylinum).

9. The operation with the use of tubocurarine was performed to patient with abdominal wound. In the end of operation after restoration of breathing, the doctor has administered gentamycin to patient. But unexpectedly the breathing stopped and skeletal muscles had relaxed. What effect is the base of this phenomenon?

A. Sensibilization.

B. Cumulation.

C. Tolerance.

D. Antagonism.

*E. Potentiation.

10. The relaxation of skeletal muscles and inhibition of breathing has lasted more than 2 hours in patient in the result of introduction of dithylinum. Indicate the enzyme, insufficiency of which in plasma is the cause of this phenomenon.

A. Glutathione peroxidase.

B. Catalase.

C. Acetylcholinesterase.

D. Glucose-6-phosphate dehydrogenase.

*E. Butyrilcholinesterase.

11. The introduction of dithylinum to patient with dislocation of a humeral joint has caused the apnoea. The doctor introduced proserinum to patient, but breathing is not restored. What substance should be introduced to this patient?

A. Atropine.

B. Galantamine.

C. Dipyroxime.

D. Isonitrosine.

*E. Blood.

12. Myorelaxant was introduced to patient for relaxation of skeletal muscles before reposition of bone fracture. This introduction has caused respiratory arrest. After introduction of fresh blood the breathing has restored. Call the myorelaxant, which was introduced to patient.

A. Pancuronium.

B. Diplacinum.

C. Tubocurarine chloride.

D. Pipecuronium.

*E. Dithylinum.

13. The signs of tubocurarine overdose have arisen in patient after operation. What drug group should be introduced to patient for elimination of overdose?

A. N-cholinoblockers.

B. Ganglion blockers.

C. Adrenomimetics.

D. M-cholinoblockers.

*E. Cholinesterase inhibitors.

14. Dithylinum (lysthenon) was introduced for tracheal intubation. After finish of operation the breathing did not restore. What enzyme insufficiency is the cause of this phenomenon?

A. K, Na-ANPase.

B. Succinate dehydrogenase.

C. Carboangidrase.

D. N-acetyltransferase.

*E. Butyrilcholinesterase.

15. Tubocurarine was introduced to patient for operation of resection of stomach. What drug should be introduced for restoration of breathing?

A. Benzohexonium.

B. Dithylinum.

C. Cytitonum.

D. Aethymizole.

*E. Proserinum.

16. A patient with fracture of an average part of the femur with displacement was delivered to traumatologic department. For reposition of bone 10 ml of 2% dithylinum solution was introduced intravenously to patient. As a result of this the long apnoea and myorelaxation have developed. What enzyme insufficiency is the cause of this phenomenon?

A. N-acetyltransferase.

B. Transferase.

C. Glucose-6-phosphate dehydrogenase.

D. Methemoglobin reductase.

*E. Butyrilcholinesterase.

17. After a short-term operative intervention with the use of dithylinum, for over 30 minutes a patient was noticed to have respiratory depression, previous muscle tone hasn’t restored. What assistance is it necessary to render to the patient?

A. Peritoneal dialysis.

B. Haemodialysis.

C. Haemosorption.

D. Forced diuresis.

*E. Blood or plasma transfusion.

18. Before an operative intervention a dithylinum solution was injected to a patient and intubation was performed. After the operative intervention self-breathing hasn’t restored. What enzyme insufficiency in the organism of the patient predetermines such prolonged effect of the muscle relaxant?

A. Na+, K+-ATP-ase.

B. Succinate dehydrogenase.

C. Carbonicanhydrase.

D. N-acetyltranspherase.

*E. Pseudocholinesterase.

19. Tubocurarine chloride was applied to a patient under combined narcosis as a muscle relaxant while performing the resection of the stomach. What antagonist should be injected to the patient to restore spontaneous breathing?

A. Benzohexonium.

B. Dithylinum.

C. Cytitonum.

D. Aethymizole.

*E. Proserinum.

20. To a patient with femoral bone fracture with the purpose of reduction of the tone of cross-striated muscles with reposition of bone fragments it is necessary to prescribe muscle relaxant of short-term action. What drug is expedient for prescribing to the patient?

A. Mellictinum.

B. Arduan.

C. Tubocurarine chloride.

D. Pirilenum.

*E. Dithylinum.

21. During an operative intervention with additional use of hygronium the patient’s arterial pressure has sharply decreased. What groups of drugs can normalize arterial pressure in the given situation?

A. N-cholinomimetics.

B. -Adrenergic blockers.

C. Ganglionic blockers.

D. M-cholinoblockers.

*E. -Adrenomimetics.

22. Symptoms of dithylinum overdose appeared during an operative intervention. What actions will be expedient to reduce the phenomena of overdose?

A. Introduction of N-cholinergic antagonist.

B. Introduction of anticholinesterase drugs.

C. Introduction of ganglionic blockers.

D. Introduction of M-cholinergic antagonist.

*E. Transfusion of blood or plasma.

23. For the abatement or termination of excitation transmission from the nervous ending to the muscular fiber curare-like substances – muscle relaxants – are clinically used. What is the mechanism of action of this therapeutic agents group?

A. Reduction of mediator elimination into the synaptic cleft.

B. Blockade of calcium ions passing through the channels of the presynaptic membrane.

C. Inhibition of Na+, K+-pumps activity.

D. Depression of acetylcholinesterase.

*E. Blockade of postsynaptic membrane N-cholinergic receptors of the myoneural junction.

24. A 45-year-old female is delivered to urgent unit. It is necessary to perform trachea intubation. What drug should be used in this case?

A. Gentamycin.

B. Nitroglycerin.

C. Metronidazole.

D. Atropine sulfate.

*E. Dithylinum.

25. A patient with a limb fracture must be administered depola-rizing drug from the myorelaxant group for the purpose of a short-time surgery. What drug is it?

A. Cytitonum.

B. Pentamine.

C. Tubocurarine chloride.

D. Atropine sulfate.

*E. Dithylinum.

Adrenomimetic Drugs and Sympathomimetics

1. The acute attack of bronchial asthma had developed in patient who also suffers from angina pectoris. What broncholytic should be used in this case?

A. Atropine sulfate.

B. Adrenaline hydrochloride.

C. Isoprenaline (isadrinum).

D. Aminophylline (euphyllinum).

*E. Salbutamol.

2. The blood pressure had dropped in patient receiving the halothane (phthorotanum) narcosis. What drug can be used for correction of hypotension?

A. Adrenaline.

B. Noradrenaline.

C. Ephedrine.

D. Dopamine.

*E. Mesatonum (phenylephrine).
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