NCCPA Pharmacology 3 — Questions and Answers
Question 1: Which antiepileptic drug inhibits sodium channels AND is a first-line agent for trigeminal neuralgia?
- Valproate
- Levetiracetam
- Carbamazepine (Correct answer)
- Phenobarbital
Correct answer: Carbamazepine
Carbamazepine is the drug of choice for trigeminal neuralgia and works by stabilizing inactivated sodium channels.
Question 2: A patient receiving aminoglycoside therapy should be monitored for which two major adverse effects?
- Hepatotoxicity and cardiotoxicity
- Nephrotoxicity and ototoxicity (Correct answer)
- Pulmonary toxicity and neurotoxicity
- Myelosuppression and hepatotoxicity
Correct answer: Nephrotoxicity and ototoxicity
Aminoglycosides are directly toxic to renal proximal tubule cells and cochlear/vestibular hair cells, causing nephrotoxicity and ototoxicity.
Question 3: A patient with type 2 diabetes develops lactic acidosis while on metformin. Which condition most likely precipitated this complication?
- Hyperglycemia
- Acute kidney injury (Correct answer)
- Hyperlipidemia
- Peripheral neuropathy
Correct answer: Acute kidney injury
Metformin-associated lactic acidosis occurs when renal failure allows metformin to accumulate, inhibiting hepatic lactate clearance.
Question 4: Which anticoagulant's effect can be reversed by protamine sulfate?
- Warfarin
- Rivaroxaban
- Heparin (Correct answer)
- Dabigatran
Correct answer: Heparin
Protamine sulfate binds and neutralizes heparin through ionic interactions, reversing its anticoagulant effect.
Question 5: Which immunosuppressant inhibits calcineurin, thereby blocking IL-2 transcription and T-cell activation?
- Mycophenolate mofetil
- Azathioprine
- Cyclosporine (Correct answer)
- Sirolimus
Correct answer: Cyclosporine
Cyclosporine binds cyclophilin to inhibit calcineurin, preventing NFAT dephosphorylation and IL-2 gene transcription.
Question 6: A patient on SSRIs is started on tramadol. What serious interaction should be anticipated?
- QT prolongation
- Serotonin syndrome (Correct answer)
- Hypertensive crisis
- Agranulocytosis
Correct answer: Serotonin syndrome
Tramadol inhibits serotonin reuptake and combined with SSRIs can cause life-threatening serotonin syndrome.
Question 7: Which antihypertensive drug class is contraindicated in bilateral renal artery stenosis?
- Calcium channel blockers
- Beta-blockers
- ACE inhibitors (Correct answer)
- Alpha-1 blockers
Correct answer: ACE inhibitors
ACE inhibitors dilate the efferent arteriole and can cause acute renal failure in bilateral renal artery stenosis by dropping GFR.
NCCPA Pharmacology 3
Which antiepileptic drug inhibits sodium channels AND is a first-line agent for trigeminal neuralgia?