Review of Pharmacology - 9E (2015)

Review of Pharmacology
Cardiovascular System
95. Ans. (d) Nitroprusside (Ref: KDT 6/e p554)
96. Ans. (d) A 56 year old diabetic woman (Ref: KDT 6/e p484, 486)
ACE inhibitors are contra-indicated in bilateral renal artery stenosis, pregnancy and in the setting of hyperkalemia.
97. Ans. (c) Minoxidil (Ref: KDT 6/e p548)
Vasodilators can lead to reflex increase in the sympathetic activity. Activation of b 1
receptors in the heart can cause tachycardia
and release of renin. Latter can result in retention of salt and water.
98. Ans. (b) Hydralazine (Ref: KDT 6/e p547)
It is a vasodilator and can result in reflex tachycardia. All other drugs listed in the question (clonidine, propanolol, reserpine)
decrease the activity of sympathetic system and can result in bradycardia.
99. Ans. (c) Methyl dopa (Ref: KDT 6/e p547)
100. Ans. (b) Isosorbide dinitrate (Ref: KDT 6/e p524, 525)
101. Ans. (b) Enalapril (Ref: KDT 6/e p541, 544, 546)
Thiazides and b-blockers are contra-indicated in diabetic patients. As the patient has frequent travelling job, he is likely
to miss the doses. Therefore, clonidine should be avoided to prevent rebound hypertension. ACE inhibitors are safe and
effective agents in diabetic patients with hypertension.
102. Ans. (c) Atenolol (Ref: KDT 6/e p544)
Tense personality and high resting heart rate (96/min.) makes b-blockers ideal candidate drugs to be used in this case. As
blood sugar and lipid profile is normal, beta blockers can be used safely.
103. Ans. (c) Intravenous infusion of sodium nitroprusside (Ref: KDT 6/e p554)
104. Ans. (b) Prazosin (Ref: KDT 6/e p545-546)
105. Ans. (b) Indapamide (Ref: KDT 6/e p554)
Indapamide is a thiazide like diuretic, having mild diuretic effect, not used in emergency situations.
106. Ans. (d) Minoxidil (Ref: KDT 6/e p516, 549)
107. Ans. (c) Clonidine (Ref: KDT 6/e p545)
108. Ans. (c) In hypertensive patient with gout, diuretics are particularly useful (Ref: KDT 6/e p551)
Antihypertensive in special situations
• In patients with CHF or LV systolic dysfunction, ACE inhibitors are antihypertensive of choice.
• In hypertensive patients with migraine, CCBs are DOC. Beta-Blockers (e.g. propanolol) is also effective.
• In hypertensive patients with gout, PVD, DM, post MI, hyperlipidemia, ACE inhibitors are preferred.
• In hypertensive patients with Raynaud’s phenomena and other peripheral vascular diseases and migraine
CCBs are especially suitable.
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Diuretics such as thiazides and frusemide are contraindicated in patients with hyperuricemia.
109. Ans. (a) Methyldopa (Ref: KDT 6/e p547)
110. Ans. (a) I.V. Lignocaine (Ref: CMDT 2010/364)
111. Ans. (d) Methyldopa (Ref: KDT 6/e p547)
112. Ans. (b) Clonidine (Ref: KDT 6/e p540)
113. Ans. (a) Methyl dopa (Ref: KDT 6/e p547)
114. Ans. (c) ACE inhibitors (Ref: KDT 6/e p551)
115. Ans. (a). Clonidine (Ref: KDT 6/e p546)
116. Ans. (a) Fasudil (Ref: Katzung 12/e p206)
• Rho kinase (ROCK) is a major downstream effector of the small GTPase RhoA. ROCK plays central roles in the organization
of the actin cytoskeleton and is involved in a wide range of fundamental cellular functions such as contraction,
adhesion, migration, proliferation and gene expression.
• Fasudil is an experimental drug that acts by inhibiting the rho kinase and is found to be effective in animal models
for treatment of
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