藥理學(xué)歷年試題七年制

山東（2008——2009學(xué)年第二學(xué)期2006級(jí)臨床醫(yī)學(xué)七年制藥理學(xué)期末考試試題（A卷）FINALTERMEXAMNATIONOFPHARMACOLOGYFOR一、（每題2分，共10分FirstpassMedianeffectivedose,PostantibioticCellcyclespecific二、選擇題（A0.8分?X1分,50分TypeAchoicequestions(onlyoneanswerisaffinityforreceptorsbutnointrinsicnobothaffinityandintrinsicaffinityandweakintrinsicaffinityandlowhighaffinityandPD2affinitydissociationeliminationrateAdrugeliminatedwithkinetics,theconcentrationofthedrugsmais200mg/L,at10o’clockinthemorningafteradministrationofasingledose,thedrugsmaconcentrationis25mg/L,at10o’clockonsecondmorning,itst1/2A.4hB.6hC.12hD.10hE.ThedrugthatitstherapeuticindexisthelargestDrugADrugBDrugCDrugDDrugEpatientsdeveloptolerancetothepatientsdiminishtolerancetothethesensitivityofbacteriatothedrugthesensitivityofbacteriatothedrugdecreases,afterrepeatedEnoneofThemechanismoftreatingPhenobarbitalpoisoningwithbicarbonatesodiumisthatNutralizatesStimulatesPhenobarbitaltransferencefromthebraintotheBasinesurinefluids,preventPhenobarbitalfromreuptaking,andexcretionofBandCareAandCareIntheexistenceofcompetitiveantagonist,thedoseeffectcurveoftheagonistdosenotwillshifttorightparallelymovetowillbewillPatientswithmyastheniagravisaremoreeffectivelytreatedFromthefollowingindicationsfortheuseofphentolamine,whichistreatmentofhypertensioncausedbysurgicalmanipulationofdiagnosisofpheochromacytoma(嗜鉻細(xì)胞瘤primarymicrocirculationAtropinecannotbeusedtotreatpatientsneostigmineWhichoneofthefollowingdescriptionsisbRblockersdelayrecoveryofbloodglucoseafterbRblockerspromoterenninbRblockersinhibitconversionofT4tobRblockersdecreaseintraocularbRblockerscaninducereboundThedrugchoiceinthetreatmentofanaphylacticshockantihistamineAllofthefollowingstatementsabouttheactionofScolinearetrueIthasmuscleIthasganglionicblockingactionattherapeuticItpromotesthereleaseofIthasItbelongstodepolarizingneuromuscularWhichofthefollowingtherapeuticprojectscouldbeusedinthetreatmentofpatientswithorganophosphateintoxication?atropine+atropine+pralidoximeatropine+atropine+atropine+Allofthefollowingstatementsabouttheactionofphenylephrine素aretrueItisweakindecreasingrenalbloodItcanbeusedtoexamineretinaduetoitsactionofItisα1RItcanbeusedtotreatparoxysmalsupraventricularItcanbeusedtocontrolhypotensioncausedbyThereleasedneurotransmitternorepinephrineisdisposedmainlybyliverdrugCOMTinsynapticneuronalnonneuronalMAOinsynaptic onepatientis imipramineandanother theyarebothlikelytoakathisiaB.tardivedyskinesiaC.constipationanddryD.diarrhea TheoralantipsychoticdrugthatwouldbeusedforthepatientwithchronicpsychosestomaintaincurativeeffectisclozepineB.penfluridolC.D.chlorprothixeneE.toincreasetheabsorptionoftoinhibitlevodopadecarboxylationinthetoinhibitMAOD.toinhibitE.toincreaseLdopaconvertingtodopamineWhichisthedrugchoiceinthetreatmentofabsencephenytoinsodiumB.C.amobarbitalD.ethosuximideE.ThecardinalmechanismofantidepressantactionoftricyclicagentsBlockadeofNEand5HTreuptakeBlockadeofNEand5HTreuptakeStimulationofreticularascendingactivatingBlockadeof5HTreuptakeBlockadeofNEreuptakeWhichofthefollowinggesicdrugscanbeusedforpethidineB.morphineC.D.methadoneE.LithiumcarbonatecanbeusedtoParkinson’sdiseaseB.depressionC.manicD.insomniaWhichofthefollowingstatementsaboutphenytoinisnothassedativeeffectB.canbeusedforpatientswithcanbeusedtotreatpatientswithcanbeusedtomanagepatientswithtrifacialcancausegingivalhyperWhichofthefollowingdrugsis(are)hepaticmicrosomalenzymeA.rifampicinB.alcoholC.phenytoinD.phenpbarbitalE.allAspirincaninduceallofthefollowingeffectreducingfeverB.reducingprostaglandinsynthesisininflamedstimulatingrespiratorywhentakenintoxicinducingtendancytobleedingE.reducingWhichoneofthefollowingdrugsactsfromtheinnersideofthemembraneandbindmoreeffectivelytocalciumchannelsinopenstate?VerapamilB.NicorandilC.D.FlunarizineE.Whichoneofthefollowingmostdirectlydescribesthemechanismofactionofcardiacglycosides?stimulatesproductionofinhibitssodiumpotassiumdecreasestheintracellularlevelofKincreasesintracellularsodiumincreasesreleaseofcalciumfromthesarcosmicAllofthefollowingmeasurescanbeusedinthetreatmentofdigoxininducedarrhythmiaEXCEPTstopdigoxinadministrationimmediafurosemideareusedtopromotetheexcretionofpotassiumchlorideatropineThemechanismofantihypertensiveeffectoflosartandecrementofrenininhibitionofangiotensinconvertingblockadeoftheangiotensinⅡincrementofbradykinincausingvasodilationACEinhibitorscandoallofthefollowingdecreasethebloodcausingdryinhibittheformationofangiotensinpromotetheexcretionincreasebradykininconcentrationintheWhichofthefollowingantianginaldrugsisnotsuitableforpatientswithvariantangina?VerapamilB.NifedipineC.D.PropranololE.ThebestchoicetreatedforthehypertensivepatientwithheartfailureisVerapamilB.CaptoprilC.D.PrazosinE.AllofthefollowingstatementsaboutamiodaronearetrueitincreasesAPDanditsuppressesprematureventricularcontractionandventricularitblocksαanditcancausehyperorithasreverseWhichofthefollowingstatementsaboutCatoprilisItcausesreflextachycardiaItdoesnotcauselipidmetabolismIncreasingbradykininduetoitseemstoberesponsibletoItiscontraindicatedtopregnantItiscontraindicatedto lrenalarteryThedrugusefulinpreventingasthmabutlackingbronchodilatoractioniscromolynsodiumB.ephedrineC.D.labetololE.WhichofthedrugsisusedforantifibrinolysisvitKB.ridogrelC.tranexamicD.adenosineE.TheantietmechanismofaspirininhibitingsynthesisofTXA2ininhibitingsynthesisofTXA2inpromotingsynthesisofPGI2inpromotingsynthesisofPGE2inpromotingsynthesisofPGI2inThesevereadversereactionofbiguanideshypoglycemiaB.lacticacidosisC.D.blooddyscrasiasE.hepaticWhichofthefollowingstatementsaboutantiinfl actionofglucocorticoidsisNOTinhibitingboththeearlyandthelatemanifestationof inhibitingthereleaseofarachidonicaffectingalltypesof toryincreasingtheamountofInducingapoptosisof toryWhichofthefollowingmechanismsbestaccountsfortheantithyroideffectofmethylthiouracil？InhibitingperoxidaseanddecreasingthethyroxinInhibitingthethyroidInhibitingtheabsorptionofInterferingwiththeutilizationofposingtheWhichofthefollowingoralhypoglycemicagentscanbeusedindiabetesinsipidus?Glyburide（格列本脲）BMetformin（甲福明）CAcarbose（阿D.Pioglitazone(吡格列酮)E.Repaglinide(瑞格列奈Whichofthefollowingdrugscaninhibitthesynthesisofbacterialcellwall,butdoesnotbelongtoβlactamantimicrobials Whichofthefollowingdrugsisthefirstchoiceintreating smap A.tetracyclineB.azithromycinC.gentamicinD.penicillinE.kanamycinSulfonamideactsynergisticallywithtrimethoprimbecauseA.sulfonamidesinhibitthemetabolismoftrimethoprimtrimethopriminhibitthemetabolismofbothdrugsactatthesamestepininhibitingfolicacidbothdrugsactatdifferentstepsininhibitingfolicacidnoneoftheWhichofthefollowingstatementsaboutthemechanismofantibacterialdrugsismostaccurate?aminoglycosidesbindtoreceptorsonthe50sribosomalsubunittopreventattaentofaminoacyltRNAcephalosporinsinhibitthesynthesisofprecursorofthelinearpeptidoglycanchainofthecellwallfluoroquinolonesinhibitDNAdependentRNApenicillinGbindstoPBPstoinhibitthesynthesisof esofWhichofthefollowingdrugscantreatosteomyelitiscausedbyG+bacteria?penicillinGB.polymyxinC.D.clindamycinE.WhichofthefollowingdrugscanbeusedtotreatAciclovir(阿昔洛韋BzidovudineC.D.idoxuridine(碘苷)E.vidarabine(阿糖腺苷WhichofthefollowingcompatibilityadministrationispenicillinG+penicillinG+penicillinG+Awomanishospitalizedfor oniaandtreatedwithintravenousantibiotic,onthe3rdday,shedevelopedseriousdiarrhea,stoolispositiveforClostridiumdifficiletoxin.WhatisthebestA.clindamycinB.cefaclorC.metronidazoleD.erythromycinE.chloramphenicolTypeXchoicequestions(oneormoreanswersmaybePropranololcan’tbeusedinpatientsRaynaud’ssyndromeB.branchialasthmaC.D.atrioventricularblockE.Whichofthefollowingdrugscanbeusedintreatment mannitolB.timololC.D.pilocarpineE.Whichofthestatementsaboutdiazepamis(are)antianxiouseffectinasmalldoseB.sedative&hypnosisinlargerC.shorteningREMsleepD.reducingNREME.canbeusedforstatusMorphinecannauseaandvomitingB.euphoriaC.D.respiratorydepressionE.WhichofthefollowingdrugsbelongtothefirstlinedrugstherapyforhypertensioninA.AvasodilatorsuchasAcalciumchannelblockersuchasAblockersuchasAdiureticsuchasAnACEinhibitorsuchasWhichofthefollowingdrugsis(are)usefulintreatmentofventriculartachycardia?PropafenoneB.DigitoxinC.D.LidocaineE.WhichofthefollowingdrugsusedinpepticulcereradicateOmeprazoleB.sucralfateC.colloidalbismuthD.cimetidineE.sodiumWhichofthefollowingstatementaboutinsulinareitcancauseanaphylacticitcancausehyperglycemicitcanbeadministrateditsmechanismofactionisthroughintracellularreceptoritcanbeusedinIDDMandWhichis(are)theeffectiveagentagainstpseudomonasaeruginosaamongthefollowingdrugsgenetamicinB.carbenicillinC.D.ampicillinE.MetronidazolecanbeusedinthetreatmentSyphilisB.TrichomonasvaginalisC.BacterialdysenteryD.AnaerobicE.Helicobacterpylori三、問答題（共40分Pleasedescribethetreatmentofacuteorganophosphates（8PleasecomparethedifferencesbetweenchlorpromazineandNSAIDsinbodytemperatureregulation.（8points）PleasedescribethemechanismsofβAdrenoceptorblockersinthetreatmentofcongestiveheartfailure.（8points）Describetheaimandmechanismofcombineduseof 術(shù)).（8Pleasedescribetheantibacterialspectrumof（82005級(jí)臨床藥理學(xué)期末考試試題（A卷）答一、（共10分b上與藥物完全一樣的制劑Firstpasselimination：首過消除，從胃腸道吸收靜脈系統(tǒng)的藥泄的量大，除。Medianeffectivedose,ED50：半數(shù)有效量，能引起50%的實(shí)驗(yàn)動(dòng)物應(yīng)時(shí)的藥物劑量稱為半數(shù)有效量Postantibioticeffect：抗菌后效應(yīng)，將細(xì)菌于濃度高于MIC某種抗繁殖不能恢復(fù)正常，這種現(xiàn)象稱為抗菌后效應(yīng)Cellcyclespecificagents：僅對(duì)細(xì)胞增殖周期中的某一期細(xì)滅作用的藥物二、題（共50分）單選（共40分） 44. 50.多選（10分 55. 三、問答題（共40分Pleasedescribethetreatmentofacuteorganophosphates答（1）消除毒物：通過皮膚，催吐減少吸收；通過洗胃，導(dǎo)促進(jìn)排泄（2分（2）應(yīng)用解物阿托品能迅速對(duì)抗體內(nèi)Ach的M樣作用如引起的流涎出汗，心率減慢等作用。應(yīng)盡量早期給藥，并根據(jù)情況采用較大劑量，達(dá)到阿托品化（3分(3)AchE藥（氯解磷定/碘解磷定：可恢復(fù)AchE活性，也可與有機(jī)磷直接結(jié)合，成為無毒的產(chǎn)物排出體外（3分PleasecomparethedifferencesbetweenchlorpromazineandNSAIDsinbodytemperatureregulation.（8答：(1)機(jī)制氯丙嗪作用于下丘腦體溫調(diào)定點(diǎn)的多巴胺受體(2分)，界環(huán)境溫度的變化而變化(1分)；NSAIDs通過抑制環(huán)氧酶減PGE2的成，使體溫調(diào)定點(diǎn)下調(diào)(2分)，降低發(fā)熱機(jī)體的體溫(1分)(2)應(yīng)用丙嗪用于低溫麻醉和人工冬眠(1分)NSAIDs用于發(fā)熱及風(fēng)濕(1分)。PleasedescribethemechanismsofβAdrenoceptorblockersinthetreatmentofcongestiveheartfailure.（8答：交感神經(jīng)活性明顯升高、RAAS激活等神經(jīng)體液的紊亂在心衰中β-受體阻斷藥通過抗交感神經(jīng)及RAAS而治療CHF抑制交感神經(jīng)過度興奮和上調(diào)β-受體：β-受體阻斷藥通過阻斷心臟β-受體拮抗交感神經(jīng)過度興奮對(duì)心臟的損害，通過上調(diào)衰竭心臟的β-受體及恢復(fù)其信號(hào)轉(zhuǎn)導(dǎo)能力，改善其對(duì)兒茶酚胺的敏感性。(2分抑制RAAS激活：β-受體阻斷藥通過抑制RAAS激活減少腎素、心率，減少心肌耗氧，從而改善心肌缺血和心臟舒張功能。(2分抗心律失常及抗心肌缺血：能減少急性心血管及猝死的發(fā)生，改善患者預(yù)后。(2分β-受體阻斷藥對(duì)心功能的影響是雙向的短期效應(yīng)為心功能，長期用藥，明顯改善心功能與血流動(dòng)力學(xué)。(2分Describetheaimandmechanismofcombineduseoflargedoseiodineand術(shù)).（8答:甲亢術(shù)前應(yīng)服用硫脲類及大劑量碘化服用硫脲類目的：為減少在麻醉和術(shù)后的合并癥及甲狀腺危象，術(shù)前應(yīng)先服用硫脲類藥物，使甲狀腺恢復(fù)或接近正常（2分原理：硫脲類可抑制過氧化物酶，抑制甲狀腺激素的合成（2分服用大劑量碘化物的目的及原理：由于用硫脲類后負(fù)反饋性引起SH分泌增多，使腺體增生，組織脆而充血，不利于手術(shù)進(jìn)行，所以在術(shù)前周加服量碘化（2分抑制TSH使腺體增生的作腺體縮小變韌，利于手術(shù)進(jìn)行及減少（2分Pleasedescribetheantibacterialspectrumoffluoroquinolones.（8氟喹諾酮類的抗菌譜包括（1）G－菌：腸桿菌屬、假單孢菌屬、奈瑟球菌屬、桿菌屬、彎曲桿菌屬等（3分）（2分軍團(tuán)菌、衣原體、支原體、結(jié)核桿菌的、厭氧菌等（3分制作人：山東大學(xué)2010級(jí)臨七四班藥理組時(shí)間：201332日星期六【試題】山東大學(xué)/醫(yī)學(xué)院/2005級(jí)/臨床醫(yī)學(xué)七年制/藥理學(xué)試山東（2007——2008學(xué)年第二學(xué)期2005級(jí)臨床醫(yī)學(xué)七年制藥理學(xué)期末考試試題（A卷）FINALTERMEXAMNATIONOFPHARMACOLOGYFOR一、（每題2分，共10分Postantibiotic二、選擇題（A0.6分;X1分,40分TypeAchoicequestions(onlyoneanswerispA2isdissociationeliminationrateAweakbasedrugwithpKa9,ifthemediuminwhichitisdissolvedhasapH7,whatwillberatiooftheconcentrationsofionizedtounionizedformsofthebase？Whichofthefollowingisunlikelytobeassociatedwithoraldrugadministrationofanenteric-coateddosageform?irritationtothegastricmucosawithnauseaanddestructionofthedrugbygastricacidordigestiveunpleasanttasteoftheformationofnonabsorbabledrug-foodvariabilityinabsorptioncausedbyfluctuationsingastricemptyingWhichofthefollowingstatementisNOTuptake1isthemainpathwayofNAuptake2mostlyhappensinuptake1isakindofactiveWhichofthefollowinganticholines seagentsisdrugchoiceinthetreatmentofAlzheimer’sdisease?WhichofthefollowingisNOTtheindicationofpreventionofmotionWhichofthefollowingmydriasisagentsbelongstoadrenoceptorTorelieveanxietysymptoms,weusuallyWhichofthefollowingdrugsiscontraindicatedinthepatientswithAllofthefollowingproduceasignificantdecreaseinperipheralchronicadministrationofACEβ-RCalciumchannelinducedarrhythmiaEXCEPTstopdigoxindiureticagentssuchasfurosemideareusedtopromotetheexcretionofdigoxinThereasonthatdigoxincanreducetheventricularrateofatrialfibrillationpatientisDecreasingautomaticityofDecreasingautomaticityofReducingtheconductionofA-VimprovingcardiacshorteningtheeffectiverefractoryperiodWhichofthefollowingisthemostseriousmainsideeffectofstatinsandthiseffectwouldbeincreasedifastatinistakenwithciclosporin,gemfibrozilornicotinicacid?GastrointestinalElevatedbloodMigraineTheantihypertensivemechanismofdiureticsforlong-termuseincreasingwaterandsodiumexcretionfromthedecreasingsodiumconcentrationinvascularsmoothmuscleincreasingtheactivityofdecreasingtheactivityofdecreasingthesecretionofInwhichofthefollowingdrugsorthostatichypotensionoccursmostfrequentlyinfirstuse?WhichofthefollowingstatementsaboutcatoprilisinhibitingcausingdryItiscontraindicatedtopregnantpromotetheexcretionincreasebradykininconcentrationintheWhichofthefollowingdrugsisnotsuitabletotreatthepatientwithanginapectoris paniedwithasthma?isosorbideThedrugchoiceforventriculararrhythmiacausedbycardiacglycosidespoisoningissodiumWhichofthefollowingmechanismbestaccountsforthedecreasingbloodsugareffectofglibenclamide?stimulatingβ-cellinpancreaticislanddirectly,promoptingthereleaseinhibittheactivityofdecreasingtheabsorptiongofincreasethesensitivityofinsulintotargetdirectlyactivitinginsulin-Whichofthefollowingstatementsaboutthetreatmentofchronicheartfailureiswrong?patientswithevidenceoffluidretentionshouldreceiveatreatmentwithanACEinhibitorandaβ-Rblockershouldbeinitiatedandmaintainedunlessspecificallycontraindicated.digoxinmaybeaddedifneededtoreducesymptomsortoslowtheventricularresponseinpatientswithrapidatrialfibrillation.patientswithsevereheartfailureshouldalsoreceiveaβ-RspironolactonemayreducemortalityinpatientswithsevereheartA76-year-oldmalewithCHFandhearinglossisgivenadiureticaspartofaregimenthatincludesdigoxinandanACEinhibitor.Inthecourseoftreatment,hedevelopsanAVconductiondefectandisfoundtobehypomagnesemic.Shealsohasworseninghearingloss,whichisreversedwhenthedrugstopped.Whichofthefollowingdiureticsdidsheused?A70-year-oldfemaleistreatedwithsublingualnitroglycerinforheroccasionalboutsofangina.Whichofthefollowingisinvolvedintheactionofnitroglycerin?phosphodiessephosphorylationoflightchainsofcGMP56-year-oldfemalehasrecentlydevelopedessentialhypertension,forwhichsheisreceivingchlorothiazidetolowerherbloodpressure.WhichofthefollowingionswouldnotincreasingconcentrationinherA58-year-oldpatientwithahistoryofhypertensionandcongestiveheartfailureadministratingsomedrugs,nowhecominsofnausea,digoxinisstopped,whichofthefollowingdrugsalsomustbestopped?Whichofthefollowingdiseasecanbetreatedwithlargedoseofiodium?solidendemicmildTheappropriatetargetinthenephronoffurosemideNa+/K+/2Cl-cotransporteroftheluminalmembraneintheascendinglimbofHenle’sloopNa+/2Cl-cotransporteroftheluminalmembraneinthedistalcompeteswithaldosteroneforintracellularcytosmicreceptorNa+/H+exchangeroftheluminalmembraneincollectingcarbonicanhydraseofproximalBeingantagonizing5-HT3receptor,thedrugwithsignificanteffectagainstvomitingisE.VitKisasubstancetopreventorreducebleedingcausedWhichofthefollowingmechanismsbestaccountsfortheanti-thyroideffectofmethylthiouracil？inhibitingperoxidaseanddecreasingthethyroxininhibitingthethyroidinhibitingtheabsorptionofinterferingwiththeutilizationofposingtheA60-year-olddiabeticmaleistreatedwithpioglitazone.Whatisthemechanismofpioglitazone?increasedreleaseofendogenousdecreasedsmaglucagonincreasedhepaticincreasedtargettissuesensitivitytodecreasedintestinalabsorptionofWhichofthefollowingisthemostimportantapproachinpreventingpepticulcersfromrecurrence?coatingtheulcereradicatinginfectionwithH.inhibitingsecretionofgastricacidattheprotonblockingreceptoractivationofgastricacidWhichofthefollowingstatementsaboutinsulinisNOTItcancausehyperglycemicItcan’tbeadministratedItsmechanismofactionisthroughintracellularreceptorItcanbeusedinIDDMandItcancauseanaphylacticAllofthefollowingareindicationsofglucocorticoidsrheumaticpepticchildhoodacuteWhichofthefollowingstatementsaboutheparinistrueslowonsetofnoanticoagulativeeffectinpossessinganticoagulativeeffectinItcanbeadministratedTheantiasthmaticeffectofsalbutamolisattributedtoA．stimulationofβ2receptorblockadeofM-activationofguanylatecyclaseD．increaseofintracellularcGMPE．inhibitionofphosphodiesWhichofthefollowingtherapiesisthebestforapatientwithstatusaminophyllinep.o.B．hydrocortisonei.v.inhalingsodiuminhalingbeclomethasoneE．salbutamolp.o.A75-year-oldwomanishospitalizedforponiaandtreatedwithanintravenousantibiotic,onthe3rdday,shedevelopedseriousdiarrhea,stoolispositiveforClostridiumdifficiletoxin.Whatisthebesttreatment?E.A35-year-oldfemale insofitchingin lexaminationoftheurinerevealstrichomonads,whatisthepreferredtreatmentfortrachomoniasis?E.Allofthefollowingstatementsaboutantibioticsareaccuratethecephalosporinsinhibitcellwallsynthesisbyinhibitingβ-tetracyclinesinhibitproteinsynthesisofbacterialbyin ctingwiththe30sribosomalsubunit.aminoglycosidesinhibitproteinsynthesisofbacterialbyin withthe30sribosomalsubunit.polymyxinsacttodisrupttheselectivepermeabilityofbacterialcellmembranesbyinsertionintothelipidbilayer. esofWhichofthefollowingagentsisNOT cytarabine（Ara-fluorouracil（5-mercaptopurine（6-WhichofthefollowingdrugscanbeusedtotreatWhichofthefollowingantibioticsismosteffectiveagainstinfectioncausedbymethicillin-resistantstaphylococcusaureus（MRSA）?WhichofthefollowingagentsmaycausedamagetogrowingWhyisvitaminB6usuallyprescribedwithitactsasacofactorofitpreventssomeadversereactionofINHithasantituberculosisitpreventsmetabolismofitdecreasestheoccurrenceofCommonpropertiesofaminoglycosideantibioticsincludeallofthefollowingexceptpoorabsorptionafteroralextensivemetabolismindependenceonglomerularfiltrationfortheircommonlyproducecommonlyproduceA30-year-oldmalediabeticwithrenalcomplicationsdevelopsacutenephritis,P.aeruginosaisfoundinurineculturesandbloodcultures.CombinedtherapyisinstitutedwithanaminoglycosidesandwhichoftheAyoungwomanusinganoralcontraceptiveistobetreatedforpulmonarytuberculosis.SheisadvisedtouseanadditionalmethodofcontraceptionsincetheefficacyoftheoralagentiscommonlydecreasedifherdrugregimenWhichofthefollowingdrugsisthedrugchoiceinthetreatmentofseverefungalp oniaorcryptococcalmeningitis?C．a(chǎn)mphotericinBAllofthefollowingantibioticsactbyinterferingwithproteinsynthesisErythromycincannotbeusedforpatients legionella TypeXchoicequestions(oneormoreanswersmaybeWhichofthefollowingdrugsbelongtothefirst-linedrugstherapyforhypertensionincurrent?avasodilatorsuchasacardiacglycosidesuchasaβ-receptorblockersuchasathiazidediureticsuchasanACEinhibitorsuchasWhichofthefollowingis(are)nottheindicationofapreventingacuterenalcongestiveheartoliguriacausedbyWhichofthefollowingstatementsaboutamiodaroneare(is)itincreasesAPDanditblocksαandβ-itcancausepulmonaryitcancausehyper-orithasreverseuse-Whichof diabetessevere diabetesmellitusaftertheexcisionofpancreas?Whichofthefollowingstatementsaboutdicumarolis(are)true?A.VitaminKisitscompetitiveantagonistItcaninactivatecoagulantfactorⅡa,Ⅶa,Ⅸa,Itiseffectiveinvivo,notinCimetidinecanweakenitsanticoagulantItcaninhibittheaggregationofMetronidazolecanbeusedinthetreatmentBacterialHelicobacterpyloriAyoungwomanwithpregnancyshouldavoidusingwhichofthefollowingdrugstotreaturinarytractinfectioncausedbygram-negativeQuinolonescanNOTbeusedinthepatientshaveepilepsyareingrowthanddevelopmentaretakingareareallergictoWhichofthefollowingclinicalindicationsmayrequireacombinationofantibiotics?treatmentofmixedtreatmentoftreatmentofcryptococcaltreatmentoftreatmentofsevereinfectionsofunknown三、問答題（共50分Pleasedescribethepharmacologicaleffects,clinicaluses,adversereactionsandcontraindicationsofatropineinophthalmological（眼科的）diseasesaccordingtotheirinterrelationship.（10points）PleasecomparethedifferencesofgesiceffectsbetweenNSAIDsandopiodgesics.（10points）PleasedescribethepharmacologicaleffectsandclinicalusesofPleasedescribetheadverseeffectsofglucocorticoidswhentheywerelongtermusedinlargedose?（10points）PleasedescribetheadversereactionsandpreventmeasuresofpenicillinG.(102005級(jí)臨床醫(yī)學(xué)七年制藥理學(xué)期末考試試題（A卷）一、first-orderkinetics：一級(jí)消除動(dòng)力學(xué)，即恒比消除，指藥物在體內(nèi)therapeuticindex：治療指數(shù)，即LD50/ED50的比值ceo味上與藥物完全一樣的制劑。otaniotcectMIC或后，細(xì)菌的生長仍然受到抑制的效應(yīng)。Suerecto菌株趁機(jī)大量繁殖，引起新的，稱為二重。 多 三、問答題Pleasedescribethepharmacologicaleffects,clinicaluses,reactionsandcontraindicationsofAtropineinophthalmological

眼科的diseasesaccordingtotheirinterrelationship.（10points）藥物的藥理作用決定臨床應(yīng)用和不良反應(yīng)——2阿托品在眼科的作用擴(kuò)瞳（阻斷瞳孔/虹膜括約肌上的M受體升高眼內(nèi)壓（擴(kuò)瞳，前房；調(diào)節(jié)麻痹（阻斷睫狀肌上M受體，懸韌帶拉緊，晶狀體變扁平——每項(xiàng)基本作用各1分，解釋機(jī)制加1分，共4；驗(yàn)光配（調(diào)節(jié)麻痹作用每項(xiàng)應(yīng)用0.5對(duì)應(yīng)作用加0.5分3阿托品不良反應(yīng)及在眼科的癥眩光（括瞳（升高眼內(nèi)壓視物模糊（調(diào)節(jié)麻痹（0.5分，青光眼（升高眼內(nèi)壓（0.5分）PleasecomparethedifferencesbetweenNSAIDsand gesics（10points）（1）類鎮(zhèn)痛機(jī)制是激動(dòng)阿片受體；阿司匹林類是抑制PGS的合成（2分）（2類鎮(zhèn)痛部位主要在中樞阿司匹林類主要是在外周（2分（）類鎮(zhèn)痛作用強(qiáng)大，各種類型的疼痛均有效；阿司匹林類中（2分））（4類鎮(zhèn)痛應(yīng)用多種疼痛均有效特別是幾種劇痛如、嚴(yán)重?zé)齻中g(shù)心肌梗死等引起的除鎮(zhèn)痛外一般僅（2分））（2分）類能產(chǎn)生欣和成癮性；阿司匹林類不產(chǎn)生欣和成癮性（2分）pleasedescribethepharmacologicaleffectsandclinicalusesofcalciumchannelblockersincardiovascularsystem(10points)答案鈣通道阻滯劑對(duì)心血管的作用：對(duì)心臟有負(fù)性肌力、負(fù)性頻率（3分分。鈣通道阻滯劑主要用于防治心血管疾病，如：高血壓（1分、分、預(yù)防動(dòng)脈粥樣硬化發(fā)生（1分。longtermusedinlargedose（10points）醫(yī)源性腎上腺皮質(zhì)功能亢進(jìn)：物質(zhì)代謝紊亂所致（1分，具體松（1分）多毛，痤瘡（1分）高血壓，高血脂，尿糖等（1分誘發(fā)或加重（1分心血管系統(tǒng)并發(fā)癥：高血壓，動(dòng)粥（1分消化系統(tǒng)并發(fā)癥：誘發(fā)加重潰瘍（1分肌萎縮，骨質(zhì)疏松，傷口愈合遲緩（1分青光眼（1分PleasedescribetheadversereactionsofpenicillinGandhowtoprevent?(10points)答案（1）反應(yīng)（或過敏反應(yīng)包括一般反應(yīng)如：藥疹，皮炎，藥熱等（1分）嚴(yán)重：過敏性休克（1分）赫氏反應(yīng)（1分預(yù)防過敏性休克的措，①詳細(xì)詢問病史用藥史藥物過敏史 過敏史過敏史，禁用（1分前進(jìn)行皮試（1分，用藥24小時(shí)以上及更換藥物批號(hào)需重新進(jìn)行皮試（1分）③不要在沒有搶救設(shè)備和藥物的情況下使用青霉素（1分④青霉素溶液要現(xiàn)用現(xiàn)配（1分⑤一旦出現(xiàn)過敏性休上注（1分重者需同時(shí)用GCS和抗組胺藥，同時(shí)采用其他急救措施如吸氧等以防引起（1制作人：山東大學(xué)2010級(jí)臨七四班藥理組時(shí)間：201332日星期六山東（20062007學(xué)年第二學(xué)期2004床醫(yī)學(xué)七年制藥理學(xué)期末考試試題（A卷一、（A0.5分，X型每1分,50分TypeAChoicequestions(onlyoneansweris1．Adrugwitht1/23hoursisgivenintravenously,thesteadystateofsmaconcentrationcanbeexpectedA．3B．8C．10D．15E．20Whichofthefollowingistrueforadrugwhoseeliminationfromsmashowsfirstordertheofthedrugisproportionaltothedrugconcentrationintheamounteliminatedperunittimeistherateofeliminationisproportionaltothesmaeliminationinvolvesaraenzymereactionoperatingat alaplotofdrugconcentrationversustimeisastraightdrugeliminatedwithkinetics,theconcentrationofthedruginsma200mg/L,at10o’clockinthemorningafteradministrationofasingledose,thedrugsmaconcentrationis25mg/L,at10o’clockonseconddaymorning,itst1/2Aspirinisaweakacidwith4.5ofpKa,whatpercentageoflipidsolubleformwillbeinthestomachjuicewith2.5ofInthisgraph，drugsA，BandC AhasagreaterpotencythanAhasagreaterefficacythanBhaslesspotencythanAhasagreaterpotencythanBhasagreaterefficacythanWhichofthefollowingstatementsisif10mgofdrugAproducesthesameresponseas100mgofdrugB,drugAismoreefficaciousthandrugthegreatertheefficacy,thegreaterthepotencyofainselectingadrug,potencyisusuallymoreimportantthanacompetitiveantagonistincreasesvariationinresponsetoadrugamongdifferentindividualsismostlikelytooccurwithadrugshowingalargetherapeuticaweakaciddrugwithpKaofaweakbasedrugwithpKaofaweakbasedrugwithpKaofaweakaciddrugwithpKaofaweakbasedrugwithpKaofThemechanismoftreatingphenobarbitalpoisoningwithsodiumisthatstimulatesPhenobarbitaltransferencefromthebraintothealkalinizesurinefluid,preventsPhenobarbitalfromreuptake,andstimulatesexcretionofbothBandCarebothAandCareAfterrepeatedadministrationofphenobarbitalsodium,thepatientsthedrugislessuseful,thisphenomenonissideresidualTheeffectofpilocarpineoneyemiosis,increaseintraocularpressure,paralysis miosis,decreaseintraocularpressure,spasm mydriasis,increaseintraocularpressure,spasm AllofthefollowingstatementsarerelatedwithsuccinylcholinehavemusclefasciculationbeforemusclehavenoganglionicblockingactionsattherapeuticcanbeantagonizedbyelevatebloodpotassiumassistantagentsofAmalepatientisbroughttotheemergencydepartmentfollowingingestionofanunknownsubstance.Heisfoundtohaveanelevatedtemperature,hotandflushedskin,dilatedpupils,andtachycardia.Ofthefollowing,whichwouldmostlikelycausetheseApredictablydangeroussideeffectofmetoprololthatconstitutesacontraindicationtoitsclinicaluseinsusceptiblepatientsistheinductionanginaWhichofthefollowingtherapeuticprojectswouldbeusedinthetreatmentofpatientwithA．a(chǎn)tropine+norepinephrineB．a(chǎn)tropine+neostigmineD．a(chǎn)tropine+E．a(chǎn)tropine+ThereleasednorepinephrineisdisposedmainlybyA．themetabolismintheliverenzymaticreuptakebytheneuronalterminalE.MAOandCOMTintheTheelevatedbloodpressurecausedbyepinephrinemaybereversedEpinephrinemaybemixedwithcertainanesthetics,suchasprocaine,inordertostimulatelocalwoundincreasethepotencyofthelocalenhancetheirin ctionwithneuralmembranesandtheirabilitytodepressnerveretardtheirsystemicfacilitatetheirdistributionalongWhichiscorrectdescriptionabouttheβadrenoceptorbothcardiacexcitationandbronchialdilationbelongtoβ1bothcardiacexcitationandbronchialdilationbelongtoβ2bothcardiacexcitationandvasculardilationbelongtoβ1bothcardiacexcitationandvasculardilationbelongtoβ2bothvasculardilationandbronchialdilationbelongtoβ2WhichisNOTtheindicationofphentolamine?diagnosisof ualprimaryperipheralvascularocclusiveChlorpromazinecanbeusedcoronaryheartWhichofthefollowingstatementsaboutaspirinisitsgesiaisduetoinhibitionofPGitismainlyusedtorelieveheadacheandotherdullitsmainadverseeffectisGIitcaninhibititinhibitsthesynthesisofbothPGI2andExtrapyramidalsymptomscausedbychlorpromazineisdueblockingDAreceptorinmidbrainlimbicinhibitingαreceptorininhibitingDAreceptorintuberoinfunfibularinhibitingMreceptorinblockingDAreceptorinnigrostriatalThemainreasonforthecombinationuseoflevodopawithcarbidopatoincreasetheabsorptionoftoinhibitlevodopadecarboxylationinthetoinhibittoinhibittoincreaseLdopaconvertingtodopamineAthreemontholdinfantisbroughttotheemergencyroomwithseizuresoftheTonicclonictype. Hismotherreportsthattheseseizureshavebeenoccurringfor50min.ThetreatmentofchoiceWhichoneofthefollowinggesicdrugscanb