Review of Pharmacology - 9E (2015)

Cardiovascular System
237. Ans. (a) Hypotension (Ref: KDT 6/e p484)
Short acting ACE inhibitors like captopril may result in postural hypotension. ACE inhibitors do not affect serum calcium
levels.
238. Ans. (d) Pheochromocytoma (Ref: KDT 6/e p486, 487)
ACE inhibitors are useful in hypertension, MI and left ventricular dysfunction. These should be avoided in high renin situations
like pheochromocytoma due to the risk of severe postural hypotension.
239. Ans. (b) Digoxin (Ref: KDT 6/e p502)
Digitalis is used to control ventricular rate in atrial fibrillation. It increases the refractoriness of AV node and decreases the
conduction through AV node.
240. Ans. (b) Hypokalemia (Ref: KDT 6/e p484)
ACE inhibitors result in hyperkalemia and not hypokalemia.
241. Ans. (d) Enalapril (Ref: KDT 6/e p484)
242. Ans. (c) Verapamil (Ref: Goodman & Gilman 11/e p836)
Verapamil is present as a racemic mixture of R and S-verapamil. S-verapamil has more stronger negative dromotropic action
and higher first pass metabolism than R-verapamil.
243. Ans. (a) Thiazide diuretics; (b) b-blockers; (e) Phenytoin (Ref: Harrison’s 17/e p2153; KDT 6/e p274)
244. Ans. (a) Systemic vasconstriction; (e) Retention of water (Ref: KDT 6/e p481)
245. Ans. (a) ACE inhibitors (Ref: Harrison 17/e p281)
ACE inhibitors cause hyperkalemia whereas amphotericin B and thiazides (e.g. chlorthalidone) can cause hypokalemia.
246. Ans. (a) Thiazides; (c) Propanolol; (d) Frusemide (Ref: KDT 6/e p274; Harrison 17/e p2305 )
247. Ans. (a) Persistent cough; (b) Taste changes; (c) First dose hypotension; (e) Angioedema (Ref: KDT 6/e p484)
For details, see text
248. Ans. (a) Verapamil; (c) MAO-Inhibitors; (d) Tricylic antidepressants; (e) Ferrous sulphate (Ref: KDT 6/e p530-655)
• The drugs causing constipation are:
––
Verapamil, MAO-inhibitors
––
Tricyclic antidepressants
––
Ferrous sulphate
• Other important drugs which cause constipation are ganglion blockers, opioids, calcium carbonate, sedatives, antihistamines
and laxative abuse itself.
• Quinidine causes diarrhoea
249. Ans. (d) Theophylline (Ref. KDT 6/e p219)
Propanolol, verapamil and clonidine cause hypotension as well as bradycardia. Theophylline results in reflex tachycardia
due to its vasodilatory action.
tahir99 - UnitedVRG
250. Ans. (d) All of the above (Ref: KDT 6/e p486, 487)
251. Ans. (d) Potential to induce cough in susceptible individuals (Ref: KDT 6/e p488)
252. Ans. (c) Candesartan (Ref: KDT 6/e p488)
253. Ans. (a) It does not potentiate bradykinin (Ref: KDT 6/e p488)
254. Ans. (d) Bradykinin (Ref: KDT 6/e p490, 491)
255. Ans. (a) Erythromycin (Ref: KK Sharma 2/e p331)
The diagnosis in this condition is rhabdomyolysis suggested by myoglobinuria (red coloured urine without RBCs) and
raised creatinine kinase levels. Statins can cause serious side effects like myopathy and hepatitis. Most statins are metabolized
by cytochrome P-450 3A4, with the exception of pravastatin. Concomitant administration of drugs that inhibit statin
metabolism (e.g. macrolides) is associated with increased incidence of statin induced myopathy and rhabdomyolysis.
Acute renal failure is a possible sequela of rhabdomyolysis.
256. Ans. (a) Losartan (Ref: KDT 6/e p488)
257. Ans. (c) Captopril (Ref: KDT 6/e p484)
258. Ans. (b) Digoxin (Ref: KDT 6/e p497)
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