一、单项选择题：在每小题给出的A、B、C、D、E五个选项中，只有一个最佳答案。
1、某药口服后只有少部分进入体内循环，较确切的表述是其 ···································································· （ ）
A、吸收少 B、被消化液破坏多 C、生物利用度低 D、效价低 E、排泄快
2、药物的首关消除常发生的主要给药途径是 ································································································ （ ）
A、口服 B、肌注 C、舌下含服 D、静注 E、皮下注射
2、副作用是指在哪种剂量下产生的不良反应 ································································································ （ ）
A、最小有效量 B、治疗剂量 C、大剂量 D、阈剂量 E、与剂量无关
3、药物的半数有效量（ED50）是指 ················································································································ （ A、引起50%动物死亡的剂量 B、达到50%有效血药浓度的剂量 C、与50%受体结合的剂量 D、产生50%最大效应时的剂量 E、引起50%动物有效的剂量 4、药物的血浆半衰期主要取决于其 ················································································································ （ A、药物剂量 B、消除速率 C、给药途径 D、给药间隔 E、分布容积
5、临床上用于治疗青光眼的药物是 ················································································································ （ A、毛果芸香碱 B、肾上腺素 C、东莨菪碱 D、异丙肾上腺素 E、阿托品
6、新斯的明临床上禁用于 ································································································································ （ A、机械性肠梗阻和尿潴留 B、术后腹气胀 C、术后尿潴留 D、阵发性室上性心动过速 E、重症肌无力
7、临床上治疗重症肌无力应首选 ···················································································································· （ A、毒扁豆碱 B、肾上腺素 C、毛果芸香碱 D、酚妥拉明 E、新斯的明 8、胆碱酯酶抑制药不用于下列哪种情况 ········································································································ （ A、青光眼 B、重症肌无力 C、手术后腹气胀 D、房室传导阻滞 E、阵发性室上性心动过速
9、治疗剂量的阿托品，病人出现口干、皮肤干燥、面红等反应称为························································· （ A、兴奋作用 B、副作用 C、毒性反应 D、继发作用 E、变态反应
10、临床上阿托品类药禁用于 ·························································································································· （ A、虹膜睫状体炎 B、内脏绞痛 C、青光眼 D、房室传导阻滞 E、窦性心动过缓
11、具有中枢抑制作用的M受体阻断药是 ····································································································· （ A、阿托品 B、丙胺太林 C、东莨菪碱 D、后马托品 E、山莨菪碱
12、临床上治疗胃肠绞痛应首选下列何药 ······································································································ （ A、吗啡 B、阿托品 C、阿司匹林 D、后马托品 E、毛果芸香碱
13、山莨菪碱在临床上主要用于治疗 ·············································································································· （ A、虹膜炎 B、胃肠绞痛和感染性休克 C、心动过速 D、青光眼 E、晕动病
14、过量最易引起心律失常、心室颤动的药物是 ·························································································· （
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A、肾上腺素 B、多巴胺 C、异丙肾上腺素 D、间羟胺 E、麻黄碱
15、对伴有心肌收缩力减弱及尿量减少而血容量已补足的中毒性休克患者最好选用 ······························· （ ）
A、麻黄碱 B、肾上腺素 C、多巴胺 D、异丙肾上腺素 E、去甲肾上腺素
16、临床上肾上腺素不适用以下哪一种情况 ·································································································· （ ）
A、心脏骤停 B、局部止血 C、充血性心力衰竭 D、过敏性休克 E、支气管哮喘
17、麻黄碱预防支气管哮喘时，病人出现的中枢兴奋症状，请问这是该药的 ··········································· （ ）
A、过敏反应 B、毒性反应 C、副作用 D、继发反应 E、后遗效应
18、临床上发生青霉素引起的过敏性休克，抢救时应首选 ·········································································· （ A、去甲肾上腺素 B、多巴胺 C、异丙肾上腺素 D、间羟胺 E、肾上腺素 19、氯丙嗪在剂量过大时，病人出现低血压可用下列哪个药纠正 ······························································ （ A、肾上腺素 B、多巴胺 C、异丙肾上腺素 D、去甲肾上腺素 E、麻黄碱
20、普萘洛尔能诱发下列哪种严重反应而禁用于伴有此疾病的患者··························································· （ A、精神抑郁 B、消化性溃疡 C、支气管哮喘 D、贫血 E、高脂血症
21、长期使用β受体阻断剂突然停药可产生 ·································································································· （ A、心动过缓 B、血压过低 C、支气管哮喘 D、反跳现象 E、血糖过低
22、临床上可用于治疗外周血管痉挛性疾病的药物是 ·················································································· （ A、多巴胺 B、酚妥拉明 C、东莨菪碱 D、普萘洛尔 E、哌唑嗪 23、下列关于苯二氮类药物的叙述哪项是错误的 ······················································································ （ A、是目前最常用的镇静催眠药 B、治疗焦虑症 C、可用于心脏电复律前给药 D、长期应用不会产生耐受性和依赖性 E、治疗小儿高热惊厥 24、关于地西泮的错误叙述是 ·························································································································· （ A、大剂量不引起麻醉 B、小于镇静剂量即产生抗焦虑作用 C、久用产生依赖性 D、对快波睡眠影响大 E、肌内注射吸收慢且不规则 25、地西泮中毒特异性抢救药物是 ·················································································································· （ A、碳酸氢钠 B、氟马西尼 C、山梗菜碱 D、尼可刹米 E、佐匹克隆
26、苯巴比妥急性中毒时为加速其从肾脏排泄，应采取的主要措施是 ······················································· （ A、静滴碳酸氢钠 B、静滴低分子右旋糖酐 C、静滴10%葡萄糖 D、静滴大剂量维生素 E、静滴甘露醇
27、氯丙嗪抗精神病的作用机制是 ·················································································································· （ A、阻断中脑边缘系统和中脑皮质通路中的多巴胺受体 B、阻断结节漏斗部通路中的多巴胺受体 C、阻断黑质纹状体通路中的多巴胺受体 D、阻断α受体 E、直接抑制中枢作用 28、下列氯丙嗪描述错误的是 ·························································································································· （ A、加强中枢抑制药的作用 B、抑制生长激素的分泌 C、对晕动病的呕吐有效 D、可降低正常体温
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E、可引起体位性低血压 29、氯丙嗪临床上不用于 ·································································································································· （ ）
A、低温麻醉 B、治疗呃逆 C、躁狂症状 D、晕动性呕吐 E、人工冬眠
30氯丙嗪药理作用不包括 ································································································································· （ ）
A、阻断M受体 B、阻断α受体 C、阻断β受体 D、阻断中脑边缘系统DA受体 E、阻断中脑皮质通路中的DA受体
31、氯丙嗪在剂量过大时引起的低血压可用下列哪个药纠正 ······································································ （ ）
A、肾上腺素 B、多巴胺 C、异丙肾上腺素 D、去甲肾上腺素 E、麻黄碱
32、临床上吗啡急性中毒引起的呼吸抑制，最宜选用的中枢兴奋药是 ······················································· （ A、咖啡因 B、二甲弗林 C、甲氯芬酯 D、洛贝林 E、尼可刹米
33、临床上用于解救吗啡急性中毒的特效药物是 ·························································································· （ A、喷他佐辛 B、哌替啶 C、芬太尼 D、曲马朵 E、纳洛酮
34、临床上胆道平滑肌痉挛引起的胆绞痛应首选 ·························································································· （ A、吗啡 B、阿托品 C哌替啶 D、吗啡+哌替啶 E、阿托品+哌替啶 35、吗啡的镇痛作用最适用于 ·························································································································· （ A、其他镇痛药无效时的急性锐痛 B、脑外伤疼痛 C、三叉神经痛 D、分娩止痛 E、内脏绞痛
36、哌替啶的临床应用不包括 ·························································································································· （ A、人工冬眠 B、急性锐痛 C、麻醉前给药 D、心源性哮喘 E、腹泻 37、迅速诱发吗啡戒断症状的药物是 ·············································································································· （ A、喷他佐辛 B、纳洛酮 C、美沙酮 D、曲马朵 E、可待因
38、吗啡的药理作用有······································································································································ （ A、镇静、安定、平喘 B、镇痛、镇静、抗震颤麻痹 C、镇痛、兴奋呼吸 D、镇痛、欣快、止泻 E、镇静、安定、散瞳
39、解热镇痛抗炎药的镇痛作用特点是 ·········································································································· （ A、对各种疼痛均有效 B、镇痛部位在中枢 C、可抑制缓激肽的释放 D、抑制阿片受体，可用于钝痛 E、减轻PG的致痛作用和痛觉增敏作用 40、伴有胃溃疡的风湿性关节炎患者最好选用 ······························································································ （ A、消炎痛 B、布洛芬 C、阿司匹林 D、保泰松 E、对乙酰氨基酚
41、阿司匹林预防血栓形成的机制是 ·············································································································· （ A、抑制TXA2合成 B、促进PGI2合成 C、促进TXA2合成 D、抑制PGI2合成 E、抑制凝血酶原
42、几无抗炎抗风湿作用的解热镇痛药物是 ·································································································· （ A、保泰松 B、布洛芬 C、阿司匹林 D、对乙酰氨基酚 E、吡罗昔康
43、临床上治疗交感神经兴奋引起的窦性心动过速最佳的药物是 ······························································ （ A、普萘洛尔 B、普罗帕酮 C、奎尼丁 D、利多卡因
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E、胺碘酮
44、地高辛过量引起的心律失常最佳治疗的选择药物是 ·············································································· （ ）
A、奎尼丁 B、苯妥英钠 C、利多卡因 D、维拉帕米 E、胺碘酮
45、急性心肌梗死所致的心律失常最佳的选择是 ·························································································· （ ）
A、奎尼丁 B、苯妥英钠 C、利多卡因 D、维拉帕米 E、普罗帕酮
46、临床上阵发性室上性心动过速最佳的选择药物是 ·················································································· （ ）
A、奎尼丁 B、苯妥英钠 C、利多卡因 D、维拉帕米 E、胺碘酮
47、利多卡因对下列何种心律失常无效 ·········································································································· （ A、室上性心动过速 B、室性早搏 C、室性心动过速 D、心脏手术中触发的室性心律失常 E、地高辛引起的室性心律失常 48、临床上地高辛主要用于治疗 ······················································································································ （ A、慢性心功能不全 B、房室传导阻滞 C、室性早搏 D、重度二尖瓣狭窄 E、心包炎
49、强心苷类药物引起的最常见的心脏不良反应是 ······················································································ （ A、室性早搏 B、房室传导阻滞 C、窦性心动过速 D、心室颤动 E、心包炎
50、强心苷类药物神经毒性的特征性表现是 ·································································································· （ A、色视觉障碍 B、心脏传导阻滞 C、窦性心动过速 D、心室颤动 E、消化道反应
51、强心苷引起的传导阻滞可选用下列何药治疗 ·························································································· （ A、阿托品 B、利多卡因 C、苯妥英钠 D、氯化钾 E、肾上腺素
52、关于硝酸甘油的描述，错误的是 ·············································································································· （ A、扩张静、动脉血管 B、减少心肌耗氧量 C、减少心室容积 D、减慢心率 E、加快心率
53、下列何种疾病不宜使用普萘洛尔 ·············································································································· （ A、劳累型心绞痛 B、变异型心绞痛 C、高血压 D、甲状腺功能亢进 E、快速型心律失常
54、普萘洛尔单用于心绞痛治疗时产生的负面效应是 ·················································································· （ A、心率减慢 B、舒张期延长 C、心室容积增大 D、改善心肌能量代谢 E、改善缺血心肌供血
55、硝酸甘油、普萘洛尔、硝苯地平治疗心绞痛的共同作用是 ·································································· （ A、降低心肌耗氧量 B、减慢心率 C、降低室壁张力 D、扩张冠状动脉 E、降低心肌收缩力
56、高血压伴有快速型心律失常患者最好选择 ······························································································ （ A、硝苯地平 B、桂利嗪 C、尼莫地平 D、普萘洛尔 E、卡托普利
57、长期用药突然停药，易出现心率加快的药物是 ······················································································ （ A、哌唑嗪 B、氢氯噻嗪 C、普萘洛尔 D、维拉帕米 E、卡托普利
58、具有中枢降压作用的抗高血压药是 ·········································································································· （ A、可乐定 B、洛沙坦 C、氢氯噻嗪 D、硝苯地平
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E、卡托普利
59、高血压伴痛风和糖耐量异常的患者不宜选用 ·························································································· （ ）
A、普萘洛尔 B、洛沙坦 C、哌唑嗪 D、氢氯噻嗪 E、卡托普利
60、下列抗高血压药物中属于ACEI的药物是 ······························································································· （ ）
A、卡托普利 B、普萘洛尔 C、美托洛尔 D、阿替洛尔 E、噻吗洛尔
61、下列哪一种利尿药作用最强 ······················································································································ （ ）
A、氢氯噻嗪 B、呋塞米 C、氨苯蝶啶 D、螺内酯 E、布美他尼
62、作用于远曲小管近端抑制Na+、Cl-重吸收的药物是 ·············································································· （ A、氢氯噻嗪 B、螺内酯 C、布美他尼 D、氨苯蝶啶 E、甘露醇
63、临床上急性肺水肿应首选 ·························································································································· （ A、甘露醇 B、螺内酯 C、氢氯噻嗪 D、呋塞米 E、氯噻酮
64、继发性醛固酮增多症应选用 ······················································································································ （ A、布美他尼 B、螺内酯 C、氯噻酮 D、山梨醇 E、氨苯蝶啶 65、临床上脑水肿伴心功能不全者宜选用 ······································································································ （ A、甘露醇 B、呋塞米 C、氨苯蝶啶 D、氯噻酮 E、高渗葡萄糖 66、呋塞米（速尿））的主要适应证不包括 ···································································································· （ A、急性肺水肿 B、药物急性中毒 C、急性肾功能衰竭 D、急性肝功能衰竭 E、脑水肿
67、呋塞米与何药合用易加重对听力的损害 ·································································································· （ A、青霉素 B、庆大霉素 C、头孢菌素 D、红霉素 E、喹诺酮类
68、肝素的作用特点不包括 ······························································································································ （ A、口服、注射均有效 B、体内外均有抗凝作用 C、起效快,作用持续时间短 D、抗凝作用依赖于抗凝血酶Ⅲ E、可溶解已形成的血栓 69、华法林的抗凝作用机制是 ·························································································································· （ A、抗血小板聚集 B、激活抗凝血酶Ⅲ C、溶解纤维蛋白 D、促进纤维酶原激活 E、竞争性拮抗维生素K 70、尿激酶过量引起出血宜选用 ······················································································································ （ A、维生素K B、维生素B12
C、铁剂
D、氨甲苯酸 E 鱼精蛋白
71、临床上硫酸亚铁主要用于 ·························································································································· （ A、恶性贫血 B、缺铁性贫血 C、再生障碍性贫血 D、巨幼红细胞性贫血 E、肿瘤化疗药物所致白细胞减少 72、肝素抗凝血机制主要是 ······························································································································ （ A、抗血小板聚集 B、激活抗凝血酶Ⅲ C、竞争性拮抗维生素K D、溶解纤维蛋白 E、促进纤溶酶原激活
73、奥美拉唑减少胃酸分泌的机制是 ·············································································································· （ A、抑制H+-Na+
-ATP酶 B、抑制H+-K+-ATP酶 C、抑制H+-Ca2+
-ATP酶 D、抑制Na +-K +-ATP酶
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E、抑制Na +-Ca2+-ATP酶 74、甲氧氯普胺镇吐机制是 ······························································································································ （ ）
A、阻断多巴胺受体 B、激动多巴胺受体 C、阻断吗啡受体 D、激动吗啡受体 E、阻断组胺受体
75、硫酸镁中毒时应选下列何药对抗 ·············································································································· （ ）
A、钾盐 B、钠盐 C、钙剂 D、镁盐 E、中枢抑制药、
76、能阻断胃壁细胞H+泵的抗消化性溃疡药是 ····························································································· （ ）
A、米索前列醇 B、奥美拉唑 C 丙谷胺 D、丙胺太林 E、西米替丁
77、能促进胃粘液分泌，保护溃疡面的药物是 ······························································································ （ A、氢氧化铝 B、哌仑西平 C、碳酸氢钠 D、奥美拉唑 E、米索前列醇
78、临床上最适合用可待因治疗的病症是 ······································································································ （ A、支气管哮喘 B、慢性咳嗽 C、痰多咳嗽 D、支气管镜检前预防咳嗽 E、伴胸痛的剧烈干咳
79、有阿托品样和局麻作用的镇咳药是 ·········································································································· （ A、苯佐那酯 B、右美沙芬 C、可待因 D、喷托维林 E、氯化铵
80、主要用于预防过敏性哮喘的平喘药是 ······································································································ （ A、沙丁胺醇 B、异丙肾上腺素 C、异丙阿托品 D、氨茶碱 E、色甘酸钠 81、心源性哮喘可选用······································································································································ （ A、肾上腺素 B、氨茶碱 C、异丙肾上腺素 D、沙丁胺醇 E、异丙阿托品
82、痰粘稠不易咳出的支气管哮喘病人宜选用 ······························································································ （ A、可待因 B、喷托维林 C、吗啡 D、氯化铵 E、苯佐那酯
83、伴有心率过快的支气管哮喘病人可用 ······································································································ （ A、肾上腺素 B、异丙肾上腺素 C、沙丁胺醇 D、吗啡 E、阿托品
84、临床H2受体阻断药雷尼替丁可治疗 ········································································································ （ A、过敏性休克 B、过敏性哮喘 C、过敏性鼻炎 D、消化性溃疡 E、抗晕止吐
85、无中枢作用的H1受体阻断药是 ················································································································ （ A、西咪替丁 B、特非那定 C、苯海拉明 D、异丙嗪 E、氯苯那敏
86、下列何药不属于H1受体阻断药的是 ········································································································ （ A、苯海拉明 B、阿司咪唑 C、异丙嗪 D、氯苯那敏 E、法莫替丁
87、H1受体阻断药对下述那种过敏反应效果最好 ························································································· （ A、荨麻疹 B、支气管哮喘 C、过敏性休克 D、接触性皮炎 E、药疹
88、对心脏有毒性作用的抗组胺药是 ·············································································································· （ A、异丙嗪 B、苯海拉明 C、洋地黄 D、阿司咪唑
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E、氯苯那敏
89、糖皮质激素诱发或加重感染的主要原因是 ······························································································ （ ）
A、病人对激素不敏感 B、激素能直接促进病原微生物繁殖 C、激素抑制免疫反应，降低机体抵抗力 D、使用激素时应用有效抗菌药物 E、激素剂量不足，不能控制感染
90、下列哪项不属于长期应用糖皮质激素引起的不良反应 ·········································································· （ ）
A、高血压 B、低血钾 C、低血糖 D、皮肤变薄 E、向心性肥胖
91、下列对糖皮质激素叙述正确的是 ·············································································································· （ ）
A、可直接中和细菌内毒素和细菌外毒素 B、可抑制胃酸分泌，促进胃粘液分泌
C、能够兴奋中枢，出现欣快、激动等，甚至可诱发精神病 D、可明显增加血中中性白细胞的数量，增强其游走吞噬功能 E、可抑制免疫过程的多个环节，但对机体正常免疫力无影响 92、糖皮质激素类药物不具有 ·························································································································· （ A、抗炎作用 B、提高免疫功能 C、抗休克作用 D、抗毒作用 E、免疫抑制作用
93、糖皮质激素用于治疗严重感染性疾病时必须 ·························································································· （ A、加用促肾上腺皮质激素 B、逐渐增大剂量 C、尽量采用隔日疗法 D、与有效足量的抗菌药物合用 E、用药至症状改善后一周以巩固疗效
94、用于甲状腺手术前准备，可使腺体缩小变硬、血管减少，有利于手术进行的药物是 ······················· （ A、丙硫氧嘧啶 B、131
I C、卡比马唑 D、小剂量碘 E、大剂量碘 95、丙硫氧嘧啶的主要作用机制是 ·················································································································· （ A、抑制甲状腺激素的生物合成 B、抑制甲状腺摄取碘 C、抑制甲状腺素的释放 D、抑制TSH分泌 E、抑制T3转化为T4
96、抑制甲状腺球蛋白水解酶而减少甲状腺激素释放的药物是 ·································································· （ A、丙硫氧嘧啶 B、大剂量碘和碘化物 C、卡比马唑 D、甲巯咪唑 E、阿替洛尔
97、治疗粘液性水肿的药物是 ·························································································································· （ A、甲状腺激素 B、碘化钾 C、甲巯咪唑 D、卡比马唑 E、放射性碘
98、可引起粒细胞减少的药物是 ······················································································································ （ A、硫脲类 B、磺酰脲类 C、大剂量碘剂 D、甲状腺激素 E、双胍类
99、能促进胰岛细胞释放胰岛素的降糖药是 ································································································ （ A、小剂量胰岛素 B、精蛋白锌胰岛素 C、甲苯磺丁脲 D、二甲双胍 E、苯乙双胍
100、下述哪一种糖尿病不需要首选胰岛素治疗 ···························································································· （ A、合并严重感染的中型糖尿病 B、轻或中型糖尿病 C、妊娠期糖尿病 D、幼年重型糖尿病 E、胰岛素依赖型糖尿病 101、糖尿病性昏迷宜选用 ································································································································ （ A、胰岛素 B、甲苯磺丁脲 C、甲福明 D、格列本脲 E、格列齐特
102、成年肥胖型糖尿病宜选用 ························································································································ （ A、正规胰岛素 B、格列本脲 C、双胍类 D、甲苯磺丁脲 E、氯磺丙脲
103、双胍类降糖药的主要作用机制是 ············································································································ （
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A、抑制胰高血糖素的分泌 B、促进胰岛素分泌 C、促进葡萄糖的排泄 D、促进脂肪细胞对葡萄糖的摄取和糖酵解 E、以上都不是
104、青霉素G对下列哪种细菌不敏感 ··········································································································· （ ）
A、脑膜炎奈瑟菌 B、破伤风梭菌 C、变形杆菌和肠道杆菌 D、溶血性链球菌 Ｅ、梅毒螺旋体
105、青霉素Ｇ的主要不良反应是 ···················································································································· （ ）
A、耳毒性 B、肾毒性 C、肝毒性 D、过敏反应 E、二重感染
106、下列有关头孢菌素的叙述，错误的是 ···································································································· （ ）
A、抗菌机制与青霉素类相似 B、第三代头孢菌素有肾毒性 C、第三代头孢菌素对β-内酰胺酶稳定性较高 D、第一代头孢菌素对铜绿假单胞菌无效 E、与青霉素类有部分交叉过敏反应 107、肺炎支原体感染的首选药是 ···················································································································· （ A、头孢菌素 B、阿奇霉素 C、多西环素 D、氨苄西林 E、氨曲南
108、下列哪种药物不属于氨基糖苷类抗生素 ································································································ （ A、庆大霉素 B、妥布霉素 C、克拉霉素 D、丁胺卡那霉素 E、卡那霉素
109、伴有肾功能不全的铜绿假单胞菌感染患者宜选用 ················································································ （ A、头孢他啶 B、庆大霉素 C、多粘菌素 D、氨苄西林 E、多西环素
110、下列何药作为治疗伤寒、副伤寒的首选药 ···························································································· （ A、庆大霉素 B、青霉素 C、红霉素 D、四环素 E、氯霉素
111、可影响骨、牙生长的抗生素是 ················································································································ （ A、氯霉素 B、青霉素 C、链霉素 D、红霉素 E、四环素
112、下列何药作为治疗军团菌病的首选药之一 ···························································································· （ A、庆大霉素 B、青霉素G C、大环内酯类 D、磺胺嘧啶 E、氯霉素
113、氨基苷类抗生素的主要不良反应不包括 ································································································ （ A、耳毒性 B、肾毒性 C、肝毒性 D、过敏反应 E、阻断神经肌肉作用
114、长期使用易引起二重感染的抗菌药物是 ································································································ （ A、红霉素 B、链霉素 C、庆大霉素 D、四环素 E、阿奇霉素
115、喹诺酮类药物抗菌作用机制是 ················································································································ （ A、抑制细菌DNA螺旋酶 B、抑制细菌二氢叶酸还原酶 C、抑制细菌蛋白质合成 D、抑制细菌二氢叶酸合成酶 E、抑制细菌转肽酶
116、喹诺酮类药物一般不宜用于 ···················································································································· （ A、老年人 B、婴幼儿 C、溃疡病患者 D、妇女 E、肝病患者
117、喹诺酮类抗菌药的特点是 ························································································································ （ A、主要对革兰阴性菌有效 B、主要对革兰阳性菌有效 C、主要用于尿路感染 D、主要用于肠道感染 E、抗菌谱广、抗菌活力强、毒性低、剂量小 118、磺胺类药物抗菌作用机制是抑制 ············································································································ （
） ） ） ） ） ） ） ） ） ） ） ）A、二氢叶酸还原酶 B、二氢叶酸合成酶 C、四氢叶酸还原酶 D、一碳单位转移酶 E、叶酸还原酶
119、抗结核的一线药下列哪些是最正确的 ···································································································· （ ）
A、异烟肼、利福平、链霉素 B、异烟肼、利福平、PAS C、异烟肼、链霉素、PAS D、异烟肼、乙胺丁醇、PAS E、异烟肼、链霉素、丙硫异烟肼 120、可产生球后视神经炎的抗结核药是 ········································································································ （ ）
A、乙胺丁醇 B、利福平 C、PAS D、异烟肼 E、以上都不是
121、应用异烟肼时常并用维生素B6的目的是 ······························································································ （ ）
A、增强治疗 B、防治周围神经炎 C、延缓抗药性 D、减轻肝损害 E、以上都不是
122、对结核杆菌作用最强、对纤维化病灶中的结核杆菌有效的抗生素是 ················································· （ A、对氨水杨酸 B、链霉素 C、异烟肼 D、乙胺丁醇 E、庆大霉素
123、抗结核病药的用药原则不包括 ················································································································ （ A、早期用药 B、联合用药 C、长期用药 D、反复用药 E、规律性用药
二、判断题：正确的在题前括号内打“√”，错误的打“×”。
（ × ）1、所有药物经肝脏代谢后，药物的作用和毒性都将减弱 （ √ ）2、新斯的明可用于缓解术后腹气胀和尿潴留
（ × ）3、毒扁豆碱作用机理与毛果芸香碱相似，主要用于治疗青光眼 （ √ ）4、山莨菪碱解痉作用强，可代替阿托品用于治疗中毒性休克、胃肠绞痛 （ × ）5、麻黄碱中枢作用强，可用于治疗失眠 （ √ ）6、间羟胺（阿拉明）常替代去甲肾上腺素，用于休克早期及低血压的治疗
（ √ ）7、大剂量巴比妥类可产生麻醉作用，临床上常作为麻醉药使用 不确定 （ √ ）8、硫酸镁过量引起的呼吸抑制、血压下降，可静脉注射钙剂对抗 （ √ ）9、地西泮静注是控制癫痫持续状态的首选药之一 （ × ）10、氯丙嗪对各种疾病、药物、晕动病引起的呕吐有效 （ × ）11、吗啡有强大选择性镇痛作用，可用于颅内压升高引起的头痛 （ × ）12、所有解热镇痛抗炎药均具有解热、镇痛、抗炎抗风湿作用 （ √ ）13、氯沙坦（洛沙坦）主要用于不能耐受ACEI干咳的高血压患者 （ √ ）14、硝普钠主要用于高血压危象、高血压脑病及恶性高血压的紧急救治 （ × ）15、洛伐他汀（美降之）适用于高三酸甘油脂为主的高脂血症 （ × ）16、吉非贝齐、苯扎贝特等适用于高胆固醇血症为主的高脂血症 （ × ）17、肝素引起的自发性出血可用维生素K解救 （ × ）18、香豆素类抗凝血药过量引起自发性出血，可用鱼精蛋白K解救 （ √ ）19、链激酶过量引起自发性出血，可用氨甲苯酸解救 （ √ ）20、充血性心力衰竭患者扩充血容量慎用右旋糖酐
（ × ）21、长期应用利尿药呋塞米（速尿）应注意血钾过高 （ √ ）22、甘露醇禁用于慢性心功能不全、活动性颅内出血及尿闭患者 （ √ ）23、苯海拉明、异丙嗪的主要不良反应为嗜睡、乏力等 （ × ）24、平喘药色甘酸钠起效快，主要用于各型哮喘的急性发作 （ × ）25、平喘药氨茶碱有中枢兴奋作用，故临睡前服用常合用催眠药 （ √ ）26、抗甲状腺药丙硫氧嘧啶不良反应以粒细胞缺乏多见 （ × ）27、大剂量碘为合成甲状腺激素的必需原料，参与甲状腺激素的合成 （ √ ）28、氯霉素最严重的不良反应为抑制骨髓造血功能 （ √ ）29、万古霉素可有效治疗抗生素尤其是克林霉素引起的假膜性肠炎 （ √ ）30、喹诺酮类可骨关节软组织损伤，故不宜用于儿童及孕妇
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药理复习
1药理学：是研究药物与机体或病原体相互作用的规律和原理的一门学科。
2药物效应动力学：简称药效学，主要研究药物对机体的作用、作用规律及作用机制
3药物代谢动力学：简称药动学，主要是定量研究药物在生物体内吸收、分布、代谢和排泄规律 4副作用：也称副反应，系指应用治疗量的药物后所出现的治疗目的以外的药理作用。 5毒性作用：用药剂量过大或用药时间过长而引起的不良反应。 6效能：药物所能产生的最大效应
7效价强度：药物引起一定效应所需的剂量。反映药物与受体亲和力。
8治疗指数：通常将半数致死量（LD50）和半数有效量（ED50）的比值称为治疗指数，用以表示药物的安全性。 9首过效应：指口服药物经胃肠道吸收后，首先进入肝门静脉系统，某些药物在肠粘膜和肝脏部分可被代谢灭活而使药量减少，药效降低
10肝肠循环：指经胆汁或部分经胆汁排入肠道的药物，在肠道中又重新被吸收，经门静脉又返回肝脏的现象。 11生物利用度：经任何途径给予一定剂量的药物后达到全身血循环内药物的百分比称生物利用度。 12血浆半衰期：是指血浆中药物浓度下降一半所需的时间,其长短可以反映药物消除的速度。
13稳态浓度：经过4~5个半衰期后血药浓度稳定在一个水平线上，此时的血浆药物浓度称血浆稳态浓度
14身体依赖性：亦称“生理依赖性”或“成瘾性”。反复使用某些神经或精神药物造成的一种适应状态。其特点是用药者一旦断药，将产生一系列令人难以忍受的戒断症状。
15精神依赖性：又称心理依赖性，是指药物使人产生一种心满意足的愉快感觉，因而需要定期地或连续地使用它以保持那种舒适感或者为了避免不舒服。
1、药物的不良反应主要包括哪些类型？请举例说明。
包括副作用、毒性反应、后遗效应、变态反应、继发反应和特异质反应等。
副作用：阿托品用于解除胃肠道痉挛时，可引起口干、心悸、便秘等副反应。毒性反应：阿司匹林抗血小板聚集，可诱发十二指肠溃疡，导致出血甚至可引起穿孔。后遗效应：链霉素等可引起永久性耳聋。变态反应：亦称过敏反应，青霉素的过敏反应可导致皮疹、发热、哮喘、过敏性休克等。继发反应：四环素等广谱抗生素长期服用导致二重感染。停药反应，如长期服用可乐定降压，停药次日血压将明显回升。特异质反应：红细胞6-磷酸葡萄糖脱氢酶缺乏病人服用有氧化作用的药物如磺胺等就可能引起溶血。 2、试述β肾上腺素受体阻断药的临床应用及禁忌证。
临床应用：①心律失常、②心绞痛和心肌梗死、③高血压、④充血性心力衰竭、⑤甲亢，青光眼，肌震颤；禁忌症：禁用于心功能不全、窦性心动过缓、重度房室传导阻滞和支气管哮喘等，慎用于心肌梗死及肝功能不良患者。 3、简述地西泮的药理作用及临床应用。
本品为苯二氮卓类抗焦虑药，具有①抗焦虑、②镇静、催眠、③抗惊厥、抗癫痫、④中枢性肌肉松弛作用。应用：①焦虑症及各种神经官能症。②失眠，麻醉前给药和心脏电击复律或境内检查前给药。③癫痫。④子痫，破伤风，小儿高热引起的惊厥。⑤脑血管意外或脊髓损伤性中枢性肌强宜或腰肌劳损、内镜检查等所致肌肉痉挛。 4、简述吗啡的临床应用和主要不良反应。
阿片类生物碱，为阿片受体激动剂。①镇痛②止泻③心源性哮喘。不良反应：直立性低血压、呼吸抑制、恶心、呕吐、便秘等肠道不适，少尿、尿频、尿急等排尿问题，嗜睡、注意力分散、妄想、幻觉等，戒断反应等 5、简述抗心律失常药对心脏基本电生理的作用。
一降低自律性：降低动作电位4相斜率、提高动作电位的发生阈值、增加静息膜电位绝对值、延长APD等方式。二减少后除极：钠通道和钙通道阻滞药可减少滞后除极的发生，缩短APD的药物可减少后除极的发生。 三消除折返：改变传导性，延长ERP
6、简述强心苷的临床应用和主要不良反应。
临床应用①慢性心功能不全、②心律失常：心房颤动、心房扑动和阵发性室上性心动过速。
不良反应：①防止中毒，②胃肠道反应：厌食、恶心、呕吐、腹泻、腹痛。③.神经系统：头痛、疲乏、眩晕、恶梦、视力模糊、色视障碍（黄、绿视）④心脏毒性：室性早搏、房室结性、室性心动过速、房室传导阻滞等。 7、简述抗心绞痛药的分类和代表药。
1硝酸酯类（硝酸甘油） 2β肾上腺素受体阻断药（普萘洛尔） 3钙通道阻滞药（硝苯地平） 8、治疗消化性溃疡的药物有哪几类？每类举一代表药名。
1抗酸药（氢氧化铝） 2粘膜保护药（硫糖铝） 3抗幽门螺杆菌药（克拉霉素）
4抑制胃酸分泌药（H2受体阻断药：西咪替丁，胃质子泵抑制剂：奥美拉唑，促胃液素受体阻断药：丙谷胺，M1受体阻断药：哌仑西平）
9、试述胰岛素的主要不良反应及其防治。
①低血糖症：及早摄食糕饼糖食或糖水以缓解 ②.过敏反应：调换高纯度制剂如单组分人胰岛素 ③胰岛素抵抗：改用单组分人胰岛素、改用口服抗糖尿病药物 ④脂肪萎缩或增生：更换注射部位 ⑤胰岛素性水肿，屈光失常
10、简述第三代氟喹诺酮类的作用特点。
①抗菌作用强，抗菌谱广，尤G-杆菌；②向细胞内趋化作用，对军团菌、支原体、衣原体、分枝杆菌、沙门菌属（特别是伤寒杆菌）的作用好 ③口服吸收好，生物利作用度高，半衰期长，蛋白结合率低，服药次数少，使用方便 ④不良反应少，耐受性好，与其他抗菌药无交叉耐用药性
1、试述阿托品的药理作用、临床应用、不良反应及禁忌证?
药理作用：松弛内脏平滑肌；抑制腺体分泌；解除迷走神经对心脏的抑制，使心跳加快；散大瞳孔，使眼压升高；大剂量兴奋呼吸中枢。
临床应用：1解除平滑肌痉挛2抑制腺体分泌3眼科：虹膜睫状体炎、验光检查眼底4缓慢型心律失常：治疗迷走神经过度兴奋所致的窦房阻滞、房室阻滞等缓慢型心律失常5抗休克6解救有机磷酸之类中毒。不良反应：口干、视力模糊、瞳孔散大、皮肤干燥、心率加快，小便困难，心悸。随着剂量增大，其不良反应逐渐加重，甚至出现明显中毒症状。禁忌症：青光眼及前列腺肥大者禁用。
2、试述解热镇痛药阿司匹林的药理作用、临床应用、主要不良反应及如何防治？ 药理作用①镇痛。②抗炎。③解热。④抗风湿。⑤抗血栓；
临床应用：1感冒发热，肌肉痛，关节痛等2急性风湿热，类风湿关节炎 3预防血栓形成治疗心肌梗死，缺血性心脏病；
不良反应：1胃肠道反应（餐后服用，同时服用止酸药，合用米索前列醇减少溃疡发生率）2凝血障碍（维生素K可以预防）3水杨酸反应（立即停药，加服，静脉滴注碳酸氢钠溶液以碱化尿液）4过敏反应（皮疹，荨麻疹，血管神经性水肿和过敏性休克患者禁用）5瑞夷综合症：儿童引起瑞夷综合症，以肝衰竭合并脑病为突出表现（病毒感染者可用对乙酰氨基酚）6阿司匹林哮喘：（停肾上腺素可部分对抗支气管收缩） 3、叙述抗高血压药物的分类？各类的代表药?应用时应注意哪些问题？。
一．利尿药：长期服用可引起高尿酸血症，痛风病人禁用，糖尿病病人慎用。作为基础降压药用于各型高血压，常与其他降压药合用，以增强疗效和减少不良反应。氢氯噻嗪。
二．交感神经抑制药 1中枢性降压药：用于中度高血压，兼有溃疡病的高血压患者。不良反应有口干、便秘、嗜睡、抑郁等。可乐定 ；2神经节阻断药：美加明 ；3交感神经末梢阻滞药：影响儿茶酚胺的贮存及释放。利舍平 三．肾素-血管紧张素系统抑制药1血管紧张素转化酶抑制剂：适用于各种类型高血压，合并胰岛素抵抗、左心室肥厚、心衰、急性心肌梗死等高血压患者。卡托普利；2血管紧张素II受体阻断药：可用于各型高血压。氯沙坦 四．钙拮抗剂：用于轻、中、重度高血压及高血压伴有糖尿病、哮喘、高脂血症、肾功能不全或心绞痛患者。硝苯地平。
五．血管扩张药：用于高血压危象，本品需要避光且药液需要新配。例：硝普钠。
六．肾上腺素受体阻断药：主要不良反应为支气管收缩、心脏过度抑制和反跳现象，支气管哮喘病人禁用，长期用药不能突然停药。例：普萘洛尔β;哌唑嗪a1；卡维地洛aβ。 4、试述糖皮质激素药理作用和临床用途、长期用药应注意哪些问题？
药理作用：①允许；②抗炎，抗毒；③免疫抑制与抗过敏；④抗休克；⑤其他：1退热2刺激骨髓造血功能3提高中枢神经系统兴奋性4长期大剂量出现骨质疏松5增强血管对其他活性物质的反应性。
临床用途：1严重感染2自身免疫性疾病3替代疗法4血液病，皮肤病，脑水肿5解除炎症症状及抑制瘢痕形成
长期用药：1可引起消化系统并发症，诱发或加剧胃、十二指肠溃疡、出血或穿孔，还可诱发胰腺炎或脂肪肝。2诱发或加重感染3肾上腺皮质功能亢进综合征，表现有满月脸、水牛背、高血压、多毛、糖尿等，停药消失，必要时加用抗高血压药4钠、水潴留和血脂升高可引起高血压和动脉粥样硬化5发生骨质疏松、肌肉萎缩、伤口愈合缓慢等6促进糖原异生，引起糖尿病，所以尽量减少糖皮质激素的用量，最好停药。7有癫痫或精神病史者禁用或慎用。8停药反应：长期应用尤其是连日给药的病人，停药需经缓慢的减量过程，不可骤然停药，停用后连续应用ACTH（促肾上腺皮质激素）7天左右；在停药一年内如遇应激情况（感染或手术），应及时投予足量的糖皮质激素。
5、试述头孢菌素的作用机制、各代头孢菌素各举一个代表药并叙述它们的作用特点和临床应用？
作用机制：头孢菌素为杀菌药，能与细菌细胞壁上的PBPs结合，妨碍黏肽的形成，抑制细胞壁合成。
一代：对G+菌具有良好的抗菌作用，对G-菌的作用稍差，可被细菌产生的β-内酰胺酶所破坏。用以治疗敏感菌引起的呼吸道、尿路及皮肤软组织感染。例：头孢氨苄，唑啉，他定。
二代。抗菌谱比一代广，对G+菌的作用略逊于一代，而对G-菌有明显作用，对厌氧菌有一定作用，但对铜绿假单胞菌无效，对多种β-内酰胺酶比较稳定，比一代肝肾毒性小。可用于治疗敏感菌所致肺炎、胆道感染、菌血症、尿路感染和其他组织器官感染等。例：头孢呋辛，克洛
三代：对G+菌的作用不及一代、二代，对G-菌包括肠杆菌类、铜绿假单胞菌及厌氧菌有较强的作用。对β-内酰胺酶有较高的稳定性。可用于危及生命的败血症、脑膜炎、肺炎、骨髓炎及尿路严重感染的治疗，能有效控制严重的铜绿假单胞菌感染。例：头孢克肟，甲肟
四代：对G+菌、G-菌与均有高效，对β-内酰胺酶高度稳定；可用于治疗对三代耐药的细菌感染，抗菌谱更广，抗菌活性更强。例：头孢匹罗，吡肟
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