MCQs PHARMACOLOGY: Drugs acting on GIT

44.1 Histamine H2 blockers attenuate the gastric secretory response to acetylcholine and pentagastrin as well because: A. H2 blockers block gastric mucosal cholinergic and gastrin receptors as well B. H2 blockers inhibit the proton pump in gastric mucosa C. Acetylcholine and gastrin act partly by releas-ing histamine in gastric mucosa D. Histamine, acetylcholine and gastrin all act through the phospholipase C-IP3AG path-way in gastric mucosa

44.2 For healing duodenal ulcer the usual duration of H2 blocker therapy is: A. 4 weeks B. 6 weeks C. 8 weeks D. 12 weeks (p. 590) 44.3 What is true of acid control therapy with H2 blockers: A. It generally heals duodenal ulcers faster than gastric ulcers B. It checks bleeding in case of bleeding peptic ulcer C. It prevents gastroesophageal reflux D. Both ‘A’ and ‘B’ are correct

ans 4 4 . 1 C 4 4 . 2 C 4 4 . 3 A


44.4 In the intact animal H2 receptor antagonists poten-tiate the following action of histamine: A. Cardiac stimulation B. Fall in blood pressure C. Uterine relaxation D. Bronchospasm

44.5 Gynaecomastia can occur as a side effect of: A. Bromocriptine B. Cimetidine C. Famotidine D. Levodopa

44.6 Which histamine H2 blocker has most marked inhibitory effect on microsomal cytochrome P-450 enzyme: A. Cimetidine B. Ranitidine C. Roxatidine D. Famotidine

44.7 Choose the correct statement about H2 receptor blockers: A. They are the most efficacious drugs in inhibit-ing gastric acid secretion B. They cause fastest healing of duodenal ulcers C. They prevent stress ulcers in the stomach D. They afford most prompt relief of ulcer pain (Note: Proton pump inhibitors are the most effica-cious drugs in inhibiting gastric acid secretion. They also cause faster healing of duodenal ulcers. Antacids and proton pump inhibitors relieve ulcer pain more promptly. However, injected i.v. H2 blockers are extensively used for prophylaxis of gastric erosions and bleeding in acutely stressful conditions.)

ans 4 4 . 4D 4 4 . 5 B 4 4 . 6 A 4 4 . 7 C


44.8 Ranitidine differs from cimetidine in the following respect: A. It is less potent B. It is shorter acting C. It does not have antiandrogenic action D. It produces more CNS side effects

44.9 Compared to H2 blockers, omeprazole affords the following: A. Faster relief of ulcer pain B. Faster healing of duodenal ulcer C. Higher efficacy in healing reflux esophagitis D. All of the above

44.10 Choose the drug which blocks basal as well as stimulated gastric acid secretion without affecting cholinergic, histaminergic or gastrin receptors: A. Famotidine B. Loxatidine C. Omeprazole D. Pirenzepine

44.11 Omeprazole exerts practically no other action except inhibition of gastric acid secretion because: A. It transforms into the active cationic forms only in the acidic pH of the gastric juice B. Its active forms have selective affinity for the H+K+ATPase located in the apical canaliculi of gastric parietal cells C. Its cationic forms are unable to diffuse out from the gastric parietal cell canaliculi D. All of the above

ans 4 4 . 8 C 4 4 . 9D 44.10 C 4 4 . 1 1D


44.12 The most efficacious drug for inhibiting round the clock gastric acid output is: A. Omeprazole B. Cimetidine C. Pirenzepine D. Misoprostol

44.13 The following is true of proton pump inhibitors except: A. They are the most effective drugs for Zolinger Ellison syndrome B. Their prolonged use can cause atrophy of gastric mucosa C. They inhibit growth of H. pylori in stomach D. They have no effect on gastric motility

44.1 4 The first choice drug for nonsteroidal antiinflammatory drug associated gastric ulcer is: A. Omeprazole B. Misoprostol C. Ranitidine D. Sucralfate

44.15 Select the drug which is an inhibitor of gastric mucosal proton pump: A. Carbenoxolone sodium B. Sucralfate C. Famotidine D. Lansoprazole

44.16 The following class of gastric antisecretory drug also reduce gastric motility and have primary effect on juice volume, with less marked effect on acid and pepsin content: A. Histamine H2 blockers B. Anticholinergics C. Proton pump inhibitors D. Prostaglandins

ans 44.12 A 44.13 B 44.14 A 44.15D 44.16 B

44.17 The primary mechanism by which prostaglandins promote ulcer healing is: A. Inhibition of gastric acid secretion B. Augmentation of bicarbonate buffered mucus layer covering gastroduodenal mucosa C. Increased bicarbonate secretion in gastric juice D. Increased turnover of gastric mucosal cell

44.18 Choose the antiulcer drug that inhibits gastric acid secretion, stimulates gastric mucus and bicarbonate secretion and has cytoprotective action on gastric mucosa: A. Misoprostol B. Sucralfate C. Carbenoxolone sodium D. Colloidal bismuth subcitrate (

44.19 The following statement is true about misoprostol: A. It relieves peptic ulcer pain, but does not promote ulcer healing B. It heals nonsteroidal antiinflammatory drug induced gastric ulcer not responding to H2 blockers C. It produces fewer side effects than H2 blockers D. It is the most effective drug for preventing ulcer relapse

44.20 The ‘acid neutralizing capacity’ of an antacid is governed by: A. The equivalent weight of the antacid B. The pH of 1N solution of the antacid C. The rate at which the antacid reacts with HCl D. Both ‘A’ and ‘C’

ans 44.17 B 44.18 A 44.19 B 44.20D


44.21 As an antacid, sodium bicarbonate has the following disadvantages except: A. It causes acid rebound B. In ulcer patients, it increases risk of per-foration C. It has low acid neutralizing capacity D. It is contraindicated in hypertensives

44.22 The following is true of aluminium hydroxide gel except: A. It is a weak and slowly reacting antacid B. Its acid neutralizing capacity decreases on storage C. It interferes with absorption of phosphate in the intestine D. It causes loose motions as a side effect

44.23 Choose the correct statement about magaldrate: A. It is a mixture of magnesium and aluminium hydroxides B. It has a rapid as well as sustained acid neutralizing action C. Its acid neutralizing capacity is 2 m Eq/g D. It causes systemic alkalosis

44.24 Antacid combinations of magnesium and aluminium salts are superior to single component preparations because: A. They have rapid as well as sustained acid neutralizing action B. They are less likely to affect gastric emptying C. They are less likely to alter bowel movement D. All of the above

ans 44.21 C 44.22D 44.23 B 44.24D

44.25 In peptic ulcer, antacids are now primarily used for: A. Prompt pain relief B. Ulcer healing C. Preventing ulcer relapse D. Control of bleeding from the ulcer

44.26 Sucralfate promotes healing of duodenal ulcer by: A. Enhancing gastric mucus and bicarbonate secretion B. Coating the ulcer and preventing the action of acid-pepsin on ulcer base C. Promoting regeneration of mucosa D. Both ‘A’ and ‘B’ are correct

44.27 Antacids administered concurrently reduce efficacy of the following antipeptic ulcer drug: A. Cimetidine B. Colloidal bismuth C. Sucralfate D. Pirenzepine

44.28 The following antiulcer drug does not act by reducing the secretion of or neutralizing gastric acid: A. Magaldrate B. Sucralfate C. Misoprostol D. Omeprazole

44.29 The most important drawback of sucralfate in the treatment of duodenal ulcer is: A. Low ulcer healing efficacy B. Poor relief of ulcer pain C. High incidence of side effects D. Need for taking a big tablet four times a day

ans 44.25 A 44.26 B 44.27 C 44.28 B 44.29D


44.30 Choose the correct statement about colloidal bismuth subcitrate: A. It causes prolonged neutralization of gastric acid B. It has anti-H.pylori activity C. It relieves peptic ulcer pain promptly D. All of the above are correct

44.31 Eradication of H.pylori along with gastric antisecre-tory drugs affords the following benefit(s): A. Faster relief of ulcer pain B. Faster ulcer healing C. Reduced chance of ulcer relapse D. Both ‘B’ and ‘C’ are correct

44.32 The drugs employed for anti-H.pylori therapy include the following except: A. Ciprofloxacin B. Clarithromycin C. Tinidazole D. Amoxicillin

44.33 The following is true of anti-H.pylori therapy except: A. It is indicated in all patients of peptic ulcer B. Resistance to any single antimicrobial drug develops rapidly C. Concurrent suppression of gastric acid enhances efficacy of the regimen D. Colloidal bismuth directly inhibits H.pylori but has poor patient acceptability

44.34 The preferred regimen for preventing duodenal ulcer relapse is: A. Maintenance antacid regimen B. Maintenance H2 blocker regimen C. On demand intermittent H2 blocker regimen D. Maintenance sucralfate regimen

ans 44.30 B 44.31D 44.32 A 44.33 A 44.34 B

45.1 The most dependable emetic used to expel ingested poisons is: A. Intramuscular emetine B. Oral syrup ipecacuanha C. Intramuscular apomorphine D. Oral bromocriptine

45.2 In a conscious patient of poisoning, use of an emetic is permissible in case the ingested poison is: A. Ferrous sulfate B. Sodium hydroxide C. Kerosine D. Morphine

45.3 The most effective antimotion sickness drug suitable for short brisk journies is: A. Promethazine theoclate B. Cinnarizine C. Prochlorperazine D. Hyoscine

45.4 In case of hill journey, antimotion sickness drugs are best administered at: A. Twelve hours before commencing journey B. One hour before commencing journey C. Immediately after commencing journey D. At the first feeling of motion sickness

45.5 Chlorpromazine and its congeners suppress vomiting of following etiologies except: A. Motion sickness B. Radiation sickness C. Postanaesthetic D. Uremic

ans 4 5 . 1 C 4 5 . 2 A 4 5 . 3D 4 5 . 4 B 4 5 . 5 A


45.6 Choose the phenothiazine compound which has selec-tive labyrinthine suppressant action, is used for vomiting and vertigo, but not in schizophrenia: A. Triflupromazine B. Prochlorperazine C. Trifluoperazine D. Thioridazine

45.7 Metoclopramide has the following actions except: A. Increases lower esophageal sphincter tone B. Increases tone of pyloric sphincter C. Increases gastric peristalsis D. Increases intestinal peristalsis

45.8 Metoclopramide blocks apomorphine induced vomit-ing, produces muscle dystonias and increases prolac-tin release indicates that it has: A. Anticholinergic action B. Antihistaminic action C. Anti 5-HT3 action D. Antidopaminergic action

45.9 Activation of the following type of receptors present on myenteric neurones by metoclopramide is primarily responsible for enhanced acetylcholine release improving gastric motility: A. Muscarinic M1 B. Serotonergic 5-HT3 C. Serotonergic 5-HT4 D. Dopaminergic D2

45.10 Select the prokinetic-antiemetic drug which at rela-tively higher doses blocks both dopamine D2 as well as 5-HT3 receptors and enhances acetylcholine release from myenteric neurones: A. Cisapride B. Prochlorperazine C. Metoclopramide D. Domperidone

ans 4 5 . 6 B 4 5 . 7 B 4 5 . 8D 4 5 . 9 C 45.10 C


45.11 Which prokinetic drug(s) produce(s) extrapyramidal side effects: A. Metoclopramide B. Cisapride C. Domperidone D. All of the above

45.12 The progastrokinetic action of the following drug(s) is attenuated by atropine: A. Domperidone B. Metoclopramide C. Cisapride D. Both ‘B’ and ‘C’

45.13 A patient returning from dinner party meets with road accident and has to be urgently operated upon under general anaesthesia. Which drug can be injected intramuscularly to hasten his gastric emptying: A. Methylpolysiloxane B. Promethazine C. Metoclopramide D. Apomorphine

45.14 Select the correct statement regarding the antiemetic efficacy of the three prokinetic drugs metoclopramide, domperidone and cisapride: A. Cisapride is the most effective B. Metoclopramide is the most effective C. Domperidone is the most effective D. All three are equally efficacious

45.15 Which antiemetic selectively blocks levodopa induced vomiting without blocking its antiparkinsonian action: A. Metoclopramide B. Cisapride C. Domperidone D. Ondansetron

ans 45.11 A 45.12D 45.13 C 45.14 B 45.15 C


45.16 The following prokinetic drug has been implicated in causing serious ventricular arrhythmias, particularly in patients concurrently receiving erythromycin or ketoconazole: A. Domperidone B. Cisapride C. Mosapride D. Metoclopramide

45.17 Indicate the drug which does not improve lower esophageal sphincter tone or prevent gastroesopha-geal reflux, but is used as first line treatment of gastroesophageal reflux disease: A. Sodium alginate + aluminium hydroxide gel B. Omeprazole C. Mosapride D. Famotidine

45.18 Select the drug(s) which afford(s) relief in gastro-esophageal reflux by increasing lower esophageal sphincter tone and promoting gastric emptying, but without affecting acidity of gastric contents: A. Sodium alginate B. Metoclopramide C. Cisapride D. Both ‘B’ and ‘C’

45.19 The fastest symptomatic relief as well as highest healing rates in reflux esophagitis are obtained with: A. Prokinetic drugs B. H2 receptor blockers C. Proton pump inhibitors D. Sodium alginate

ans 45.16 B 45.17 B 45.18D 45.19 C