Review of Pharmacology - 9E (2015)

Review of Pharmacology
Central Nervous System
169. Ans. (a) Imipramine (Ref: Katzung 10/e p483; KDT 6/e p449)
170. Ans. (b) MDP (Ref: Katzung 10/e p470; KDT 6/e p436)
171. Ans. (c) Schizophrenia (Ref: Katzung 10/e p465; KDT 6/e p425)
172. Ans. (c) Anti-psychotic drugs (Ref: Katzung 10/e p467; KDT 6/e p429-430)
Atypical antipsychotic drugs are known to cause hyperglycemia, hyperlipidemia, insulin resistance and weight gain.
Minimum risk of these metabolic adverse effects is with ziprasidone.
173. Ans. (b) Anxiety (Ref: KDT 6/e p445; Katzung 11/e p524)
• Nausea and insomnia are the most common adverse effects seen with fluoxetine therapy.
• Anxiety is the next most frequent adverse effect followed by loose stools.
174. Ans. (d) Extrapyramidal side effects (Ref: KDT 6/e p429)
Clozapine is an atypical antipsychotic drug. It does not block D 2
receptors, therefore chances of extrapyramidal symptoms
are least with this drug.
175. Ans. (a) Anticholinergics (Ref: KDT 6/e p421)
176. Ans. (b) Atropine (Ref: KDT 6/e p431)
Oculogyric crisis is a type of acute dystonic reaction (upward deviation of eyes) seen with the use of typical antipsychotic
agents (D 2
blockers).
177. Ans. (b) Selective serotonin reuptake enhancement (Ref: KDT 6/e p447)
178. Ans. (a) It is a MAO-A inhibitor (Ref: KDT 6/e p420)
Selegeline and rasagiline are selective MAO-B inhibitors useful in Parkinsonism. These drugs inhibit the metabolism of
dopamine in the brain and thus can decrease wearing off effect. Cheese reaction (seen with non-selective MAO inhibitors
like tranylcypromine) is not associated with these agents.
179. Ans. (d) Sodium ion is a specific antidote for lithium clearance (Ref: KDT 6/e p434, 435, 436, 437)
• There is no specific antidote for lithium.
• Lithium is the drug of choice for the treatment of bipolar disorder and prophylaxis of acute mania.
• It is a narrow therapeutic index drug and requires therapeutic drug monitoring.
• Amiloride is the drug of choice for lithium induced diabetes insipidus.
180. Ans. (d) Bromocriptine (Ref: KDT 6/e p236)
Prolactin release inhibitory substance released by hypothalamus is same as dopamine. Thus, dopamine agonists like bromocriptine
reduce the secretion of prolactin whereas dopamine antagonists like antipsychotic drugs may result in hyperprolactinemia.
181. Ans. (d) Akathisia (Ref: KDT 6/e p431)
Continous purposeless to and fro movement without anxiety is called akathisia. It is an extrapyramidal syndrome caused
by D 2
blockers like haloperidol.
182. Ans. (c) Imipramine (Ref: KDT 6/e p444)
Features are typical of tricyclic antidepressant poisoning. TCAs possess anticholinergic activity that can result in tachycardia.
These agents can lead to metabolic acidosis (pH < 7·4, HCO 3
–
< 24 mmol/L). Seizures and myoclonic jerks are other
features of TCA poisoning.
183. Ans. (c) Furosemide (Ref: KDT 6/e p436)
Loop diuretics and thiazides cause Na + loss in the nephron, this leads to compensatory increase in reabsorption of Na + and
Li + in the proximal tubules.
184. Ans. (c) Ebstein’s anomaly (Ref: Katzung 10/e p472)
185. Ans. (b) Neuroleptic malignant syndrome (Ref: KDT 6/e p431)
186. Ans. (a) Alprazolam; (b) Paroxetine; (c) Venlafaxine; (d) Buspirone (Ref: CMDT 2010/941-942)
• Benzodiazepines (like lorazepam, oxazepam, temazepam or alprazolam) are usually indicated for generalized anxiety
disorder (GAD).
• Buspirone is a non-sedating anti-anxiety drug.
• SSRIs (like paroxetine) and venlafaxine are indicated for chronic treatment of GAD.
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