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Table 3 The most incorrectly answered questions in DBTs with the most mistakes done

From: Diagnostic branched tree as an assessment and feedback tool in undergraduate pharmacology education

DBT No

Question

No

Incorrect Responses (%)

Question

DBT1

1

46 (41.1)

Phase 1 studies are mainly efficacy studies

2

8 (7.1)

A drug candidate can be directly investigated in human studies without testing in animals

3

58 (51.8)

The LD50 is detected in phase 2 studies

4

15 (13.4)

If the Phase 4 study is successful, a drug license application is made

DBT5

1

33 (29.5)

The purpose of drug metabolism is to make the drug more lipophilic

2

35 (31.3)

The oxidation carried out by microsomal enzymes in the liver is the second phase reaction

3

13 (11.6)

The cytochrome P450 enzyme that metabolizes 50% of all drugs is CYP3A4/5

4

69 (61.6)

Chronic alcohol intake causes CYP enzyme inhibition

DBT6

1

3 (2.7)

Most of the drugs are eliminated by first order kinetics

2

37 (33.0)

The elimination rate of drugs eliminated with first order kinetics is independent of the plasma concentration

3

32 (28.6)

In the first order kinetics, a constant amount of the drug is eliminated per unit of time

4

25 (22.3)

In the zero-order kinetics, the half-life remains constant

DBT7

1

52 (46.4)

The inactivation of an acidic drug with a basic drug is pharmacological antagonism

2

6 (5.4)

The type of antagonism seen between a vasoconstrictor drug and a vasodilator drug is physiological antagonism

3

17 (15.2)

The main effect of the non-competitive antagonist is to reduce the efficacy of the agonist

4

31 (27.7)

A competitive antagonist does not alter the efficacy of the agonist, but increases its potency

DBT8

1

84 (75.0)

A plasma concentration time curve is drawn to demonstrate the potency of an agonist drug

2

31 (27.68)

The smaller the EC50 of a drug, the higher its efficacy

3

85 (75.9)

A gradual dose response curve is used when the drug effect is all or none

4

8 (7.14)

The greater the therapeutic index value of a drug, the safer it is

DBT9

1

50 (44.6)

The ability to activate the receptor after binding to the receptor is called affinity

2

74 (66.1)

An antagonist is a drug that affects in the opposite direction by binding to the receptor

3

7 (6.3)

A partial agonist is a drug that has an agonist-like effect if used alone and reduces the agonist’s effect if used together with an agonist

4

21 (18.8)

The drug with negative intrinsic activity is an inverse agonist

DBT10

1

17 (15.2)

If an agonist has produced maximum effect, it always means that it binds to all receptors

2

0 (0)

The substance that selectively binds to a receptor is called ligand

3

4 (3.6)

In the absence of spare receptors, the concentration that produces half the maximum effect is equal to the concentration required to bind half of all receptors

4

54 (48.2)

Endogenous ligands are always agonists

DBT11

1

14 (12.5)

No secondary messenger is used in G-protein coupled receptor-mediated signaling

2

60 (53.6)

Gs type G-protein activates phospholipase C

3

19 (16.7)

Gq type G-protein activation causes an increase in intracellular calcium

4

24 (21.4)

Bronchodilation is seen as a result of adenylate cyclase activation and cyclic AMP increase with a Gs type G-protein mediated effect

DBT12

1

25 (22.3)

Adrenergic and muscarinic receptors are G-protein coupled receptors

2

51 (45.5)

Nicotinic receptors are G-protein coupled receptors

3

12 (10.7)

The insulin receptor is a tyrosine kinase receptor

4

19 (17.0)

Thyroid hormone receptor is in the nucleus

DBT14

1

9 (8.0)

Beta lactam antibiotics are safe during pregnancy

2

15 (13.4)

Piperacillin is administered only orally

3

57 (50.9)

Sulbactam inhibits transpeptidase enzyme

4

7 (6.3)

Aztreonam can be used in patients with penicillin allergy

DBT15

1

12 (10.7)

Penicillins are bacteriostatic

2

38 (33.9)

Penicillins reversibly inhibit the transpeptidase enzyme

3

4 (3.6)

The main mechanism of penicillin resistance is the production of beta-lactamase enzyme by the bacteria

4

66 (58.9)

Excretion of penicillins occurs by glomerular filtration

DBT16

1

27 (24.1)

Ceftaroline is the only effective cephalosporin for MRSA

2

62 (55.4)

Cefepime can cross the blood brain barrier but is unstable to beta-lactamase

3

12 (10.7)

Ceftazidime is effective against Pseudomonas aeruginosa

4

4 (3.6)

Cefazolin is the most commonly used cephalosporin in surgical prophylaxis