Review of Pharmacology - 9E (2015)

Review of Pharmacology
97. Ans. (a) Dexamethasone (Ref: Goodman and Gilman 12/e p123-29-1230)
To suppress fetal androgen production effectively and consequent virilization, dexamethasone must be initiated before 10
weeks of gestation.
Note: To treat congenital adrenal hyperplasia in baby hydrocortisone is used.
Endocrinology
98. Ans. (c) Liver (Ref: Internet)
• MR is expressed in many tissues, such as the kidney, colon, heart, central nervous system (hippocampus), brown
adipose tissue and sweat glands.
99. Ans (d) Metabolic acidosis (Ref: CMDT 2010/1056)
• Aldosterone causes retention of Na + and water and removal of K + and H + . Therefore, excess of aldosterone may result
in hypernatremia, hypertension (due to retention of Na + ) and hypokalemia (due to removal of K + ) and metabolic
alkalosis (due to removal of H + ).
100. Ans. (c) Loffler’s syndrome (Ref: CMDT 2010/266, 1018)
• Corticosteroids are contra-indicated in psychosis and herpes simplex.
• Treatment of choice for subacute thyroiditis is aspirin. Thyrotoxic symptoms are treated with propanolol. Transient
hypothyroidism, if symptomatic, can be treated with thyroxine.
• Prednisolone produce dramatic relief in eosinophilic pulmonary syndromes like Loeffler syndrome.
101. Ans. (a) Ointment (Ref: Katzung 11/e p1048,1060)
‘Ointment bases tend to give better activity to the corticosteroids than do cream or lotion vehicles’.
Ability of the vehicle to retard evaporation from the surface of skin varies as
Tinctures (least) < wet dressings < Lotions < Gels < Aerosols < Powders < Pastes 20-25 mg/day) or equivalent is given for more than 2-3 weeks. In the question,
there is no mention of time.
• Patients developing HPA axis suppression must be provided with steroids for stressful situiations for ONE
YEAR after withdrawal.
• Chances of HPA-axis suppression is minimum with inhaled route as compared to oral route.
105. Ans. (b) Binds to the plasma membrane receptors and following internalization influence nuclear changes (Ref: KDT 6/e
p232)
• Steroids act by binding to intracellular receptors.
106. Ans. (c) ↑ Lipocortin (Ref: KDT 6/e p279)
The mechanism of anti-inflammatory and immunosuppressive action of glucocorticoids are:
• Induction of Lipocortins (now known as annexins) in macrophages, endothelium, and fibroblasts that result
in inhibition of PLP.A 2
• Decrease in cytokine production, e.g. IL-1, IL-2, IL-3, IL-6, TNF-alpha, GM-CSF and gamma-interferon by
macrophages, lymphocytes and endothelium.
• Inhibit IgE mediated histamine and LTC 4
release from the basophils.
• Decreased production of ELAM-I, ICAM-I in endothelial cells.
• Decreased production of collagenase.
• Decreased production of acute phase reactants from macrophages and endothelial cells.
107. Ans. (a) Ketoconazole; (b) Aminoglutethimide (Ref: Harrison’s 16/e p2141, KDT 6/e p287)
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