Review of Pharmacology - 9E (2015)

Review of Pharmacology
Autonomic Nervous System
55. Ans. (c) Brimonidine (Ref: KDT 6/e p146)
56. Ans. (a) Physostigmine (Ref: KDT 6/e p101)
57. Ans. (b) Betaxolol (Ref: KDT 6/e p145)
58. Ans. (b) Parathion (Ref: KDT 6/e p105)
59. Ans. (c) Decreasing breakdown of acetylcholine (Ref: KDT 6/e p101)
60. Ans. (c) Edrophonium (Ref: KDT 6/e p105, Katzung 11/e p104)
Physostigmine, neostigmine and pyridostigmine are carbamates by chemical nature, they bind to both esteritic as well as
anionic site whereas edrophonium is an alcohol and binds to anionic site only.
61. Ans. (a) Aminoglycosides (Ref: KDT 6/e p722)
Aminoglycosides can result in neuromuscular blockade that can aggravate myasthenia gravis.
62. Ans. (b) Neuromuscular junction (Ref: Katzung 11/e p98)
Bethanechol acts on muscarinic receptors only whereas physostigmine increases Ach, thus can stimulate both muscarinic
and nicotinic receptors. Neuromuscular junction contains N M
receptors, thus will be affected by physostigmine but not by
bethanechol.
63. Ans. (a) Pralidoxime (Ref: KDT 7/e p111)
Oximes are ineffective in carbamate poisoning. Rather, these can worsen the poisoning due to weak anticholinesterase
activity of its own.
64. Ans. (b) Glycopyrrolate (Ref: KDT 7/e p116)
• Glycopyrrolate is a quarternary ammonium compounds and is thus water soluble and unable to penetrate BBB.
65. Ans. (b) Prolongs A-V conduction (Ref: Katzung, 11/e p113-123)
• Muscarinic antagonists will produce actions opposite to parasympathetic system, thus it will decrease gastric as well
as respiratory secretions.
• Action of ACh through muscrainic receptors is to increase the AV conduction, thus resulting in bradycardia.
Antagonist will thus result in opposite effect i.e. shorten the AV conduction.
• ACh via muscarinic receptors cause contraction of sphictor pupillae muscle and result in miosis. Muscarinic
antagonists will have opposite effect i.e. mydriasis. However, this mydriasis is a passive effect due to relaxation of
constrictor pupillae. These agents themselves do not cause contraction of radial muscle of iris; however, they stop the
counteracting effect of sphincter pupillae and allow the radial muscle to do its work.
Therefore, although both (b) and (d) can be the answers, if only one option need to be choosen, We will definitely go with
answer as (b).
66. Ans (b) Darifenacin, (c) Oxybutynin and (d) Flavoxate (Ref: Campbell-Walsh. Urology, 9/e p2102, Goodman and Gilman, 11/e
p231-232, CMDT 2010/71)
Most likely, this question has typographic mistake and they have forgotton to write EXCEPT in the question, because anticholinergic
drugs are indicated for overactive bladder and darifenacin, solefenacin, oxybutynin, flavoxate, tolterodine and
fesoterodine are commonly used for this condition. So, if except is in the option, then answer would obviously be duloxetine.
67. Ans (a) Atropine (Ref: Modi’s Medical Jurisprudence and Toxicology. 23rd, 2005/92, 403, 429-430, Goodman and Gilman 12/e
p234-235)
These are the characteristic features of anti-cholinergic overdose.
68. Ans (a) Anticholinergic (Ref: Katzung 11/e p122)
69. Ans. (b) Scopolamine hydrochloride (Ref: J Psychiatry and Law 1993:3: 447-471)
Controlled administration of intravenous hypnotics to obtain information from subjects who are unable or unwilling to
provide it otherwise, is known as Narcoanalysis or Narcosynthesis.
Drugs used for narcoanalysis are:
– Ethanol
– Scopolamine
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