Review of Pharmacology - 9E (2015)

Review of Pharmacology
Inhibition of PG synthesis is responsible for analgesic, antipyretic, anti-inflammatory and antiplatelet actions of aspirin.
This action is also utilized in the treatment of PDA. High doses of aspirin cause uricosuria whereas therapeutic doses result
in hyperuricemia. These effects are unrelated to its action on PG synthesis.
104. Ans. (b) Aspirin (Ref: KDT 6/e p187)
105. Ans. (b) Anti-ulcer (Ref: KDT 6/e p632, 634)
106. Ans. (c) Phenacetin (Ref: KDT 6/e p198)
It is a prodrug of paracetamol and is commonly implicated in the causation of analgesic nephropathy.
107. Ans. (d) Acetyl salicylic acid (Ref: KDT 6/e p187)
108. Ans. (b) Activation of COX-2 leads to ulceroprotective effect on gastric mucosa (Ref: KDT 6/e p178, Katzung 9/e p582)
• COX-2 is constitutively active within kidney, endothelium and brain. Recommended doses of COX-2 inhibitors
cause renal toxicities similar to those associated with other NSAIDs.
• COX-2 inhibitors have been shown to have less gastrointestinal side effects because COX-1 is mainly involved
in protection from gastric ulcers.
• Constitutive COX-1 isoform tend to be house keeping in function while COX-2 is induced during inflammation.
• COX have role in synthesis of PG’s from arachidonic acid, PGs have 20C fatty acids containing cyclopentane
ring.
• Selective COX-2 inhibitors increase the risk of MI.
109. Ans. (a) Nefopam (Ref: KDT 6/e p199)
110. Ans. (b) Seen with ampicillin therapy (Ref: KDT 6/e p189)
111. Ans. (b) Cyclooxygenase pathway (Ref: Katzung 11/e p626-627)
Autacoids
112. Ans. (b) Latanoprost (Ref: Katzung 11/e p315)
113. Ans. (b) Warfarin (Ref: KDT 6/e p184-185)
114. Ans. (c) PGE 2
(Ref: KDT 6/e p181)
115. Ans. (a) N-acetylcysteine (Ref: KDT 6/e p199)
116. Ans. (c) Rofecoxib (Ref: KDT 6/e p200)
117. Ans. (a) Ischemic heart disease (Ref: KDT 6/e p197)
118. Ans. (b) Its analgesic efficacy is equal to morphine in post-operative pain (Ref: KDT 6/e p194)
• Ketorolac is an NSAID promoted for systemic use mainly as an analgesic, not as an anti-inflammatory drug (though
it has typical NSAID properties).
• The drug does appear to have significant analgesic efficacy and has been used successfully to replace morphine in
some situations involving mild to moderate postsurgical pain.
119. Ans. (b) Reye’s syndrome (Ref: KDT 6/e p189)
120. Ans. (d) Sulfasalazine (Ref: Goodman and Gilman 12/e p1466)
Sulfasalazine can cause a reversible infertility in males owing to changes in sperm number and morphology.
121. Ans. (a) Hypoxanthine to xanthine; (d) Xanthine to uric acid (Ref: KDT 6/e p209)
Xanthine oxidase catalyses the conversion of hypoxanthine to xanthine as well as xanthine to uric acid. This enzyme is inhibited by
allopurinol.
122. Ans. (c) Gastric mucosal damage (Ref: KDT 6/e p189)
123. Ans. (c) Sulfasalazine (Ref: KDT 6/e p203)
124. Ans. (c) Sulfinpyrazone (Ref: KDT 6/e p205)
This drug is uricosuric agent and is used in the treatment of hyperuricemia.
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