PTCB Pharmacology #5 2 — Questions and Answers
Question 1: Which bisphosphonate is administered intravenously once yearly for osteoporosis?
- Alendronate
- Ibandronate (monthly IV)
- Zoledronic acid (Correct answer)
- Risedronate
Correct answer: Zoledronic acid
Zoledronic acid (Reclast) is given as a single IV infusion once yearly for osteoporosis. This is useful for patients unable to tolerate or comply with weekly/monthly oral bisphosphonate regimens.
Question 2: Carbamazepine (Tegretol) requires monitoring for which serious adverse effect?
- Pulmonary fibrosis
- Aplastic anemia and agranulocytosis (Correct answer)
- Renal calculi
- Hepatic adenoma
Correct answer: Aplastic anemia and agranulocytosis
Carbamazepine carries a black box warning for aplastic anemia and agranulocytosis. CBC monitoring is required, especially at treatment initiation. It is also a potent CYP3A4 inducer.
Question 3: Which GLP-1 receptor agonist is administered as a once-weekly subcutaneous injection?
- Exenatide (Byetta)
- Semaglutide (Ozempic) (Correct answer)
- Liraglutide (Victoza)
- Dulaglutide (Trulicity)
Correct answer: Semaglutide (Ozempic)
Semaglutide (Ozempic) is a once-weekly GLP-1 receptor agonist. Exenatide (Byetta) is twice daily, liraglutide (Victoza) is once daily, and dulaglutide (Trulicity) is also once weekly. Ozempic/Wegovy (higher dose) is also approved for weight management.
Question 4: Which of the following is the primary pharmacological effect of opioids?
- Blocking sodium channels in pain neurons
- Binding mu, kappa, and delta opioid receptors to reduce pain transmission (Correct answer)
- Inhibiting prostaglandin synthesis
- Enhancing GABA-mediated inhibition
Correct answer: Binding mu, kappa, and delta opioid receptors to reduce pain transmission
Opioids bind to G-protein coupled opioid receptors (mu, kappa, delta) in the brain, spinal cord, and periphery, inhibiting pain signal transmission, producing analgesia, euphoria, and respiratory depression.
Question 5: Anticholinergic drugs block which neurotransmitter's receptor?
- Serotonin
- Norepinephrine
- Dopamine
- Acetylcholine (Correct answer)
Correct answer: Acetylcholine
Anticholinergic drugs block muscarinic acetylcholine receptors. Effects include dry mouth, urinary retention, constipation, tachycardia, blurred vision, and confusion — often remembered as "dry as a bone, blind as a bat, mad as a hatter, red as a beet."
Question 6: Which of the following is a TNF-alpha inhibitor biologic used for rheumatoid arthritis?
- Abatacept
- Tocilizumab
- Adalimumab (Correct answer)
- Baricitinib
Correct answer: Adalimumab
Adalimumab (Humira) is a fully human monoclonal antibody TNF-alpha inhibitor used for RA, Crohn's disease, psoriasis, and other inflammatory conditions. Abatacept is a T-cell costimulation inhibitor; tocilizumab is an IL-6 inhibitor; baricitinib is a JAK inhibitor.
PTCB Pharmacology #5 2
Which bisphosphonate is administered intravenously once yearly for osteoporosis?