Review of Pharmacology - 9E (2015)

Central Nervous System
326. Ans. (c) Seizures (Ref: KDT 6/e p459)
Pethidine is mainly metabolized by hydrolysis to meperidinic acid but a minor pathway of metabolism involving methylation
to nor-pethidine is also present. In overdose of pethidine, this minor pathway assumes importance and there is accumulation
of nor-pethidine. This compound possesses excitatory properties and can lead to tremors, mydriasis, delirium,
myoclonus and convulsions.
327. Ans. (a) Cefixime (Ref: KDT 6/e p383)
Drugs showing disulfiram like reaction with alcohol are
• Cefamandole, Cefoperazone, cefotetan
• Moxalactam
• Chlorpropamide
• Metronidazole
• Griseofulvin
• Procarbazine
328. Ans. (d) Naltrexone (Ref: KDT 6/e p467)
• Naltrexone is a long acting, orally effective opioid antagonist that can be used as the maintenance treatment of opioid
addicts. It is also used to decrease the craving for alcohol.
329. Ans. (c) Methadone (Ref: KDT 6/e p459, 460)
• Methadone is a long acting opioid agonist that has equal potency to morphine.
• It can be used orally for opioid replacement and opioid rotation therapy.
• Due to longer half life, it produces mild withdrawal symptoms.
330. Ans. (d) Naltrexone (Ref: KDT 6/e p467)
331. Ans. (b) Zolpidem (Ref: KDT 6/e p398)
332. Ans. (c) Fentanyl (Ref: KDT 6/e p459)
Fentanyl can be used as a transdermal patch for prolonged treatment of cancer associated pain.
333. Ans. (a) Formaldehyde and formic acid (Ref: Katzung 11/e p1024)
Methyl alcohol (methanol) is metabolized to formaldehyde by alcohol dehydrogenase and then to formic acid by aldehyde
dehydrogenase. These compounds are responsible for the toxicity. Formic acid can lead to coma and blindness also. Therefore,
inhibitor of alcohol dehydrogenase, Fomepizole is used for treatment of methanol overdose.
334. Ans. (b) Naloxone (Ref: Katzung 11/e p395)
Naloxone is an i.v. opioid antagonist used for acute opioid poisoning. It has no role in alcoholism.
335. Ans. (a) Rhinorrhea and lacrimation (Ref: KDT 6/e p457)
• Withdrawal symptoms are opposite of the acute effect of drug. For opioids, these include lacrimation, rhinorrhea,
lacrimation, yawning, piloerection, diarrhea, nausea, coughing, mydriasis, sweating and twitching of muscles.
336. Ans. (a) Morphine (Ref: Katzung 10/e p499)
Opioids like morphine can be used to treat severe pain associated with terminal cancers.
General Central Nervous Pharmacology System
337. Ans. (a) Parenterally administered (Ref: KDT 6/e p467)
• Naltrexone is chemically related to naloxone and is a pure opioid antagonist. It is more potent than Naloxone.
• It differs from Naloxone in being orally active and having a long duration of action (1-2 days) which is used
to prevent relapse of heapy drinking.
• Side effects are nausea and headache; high doses can cause hepatotoxicity.
338. Ans. (b) Kappa (Ref: KDT 6/e p462)
339. Ans. (c) Naloxone (Ref: KDT 6/e p456)
340. Ans. (a) Heroin (Ref: KDT 6/e p467)
Naltrexone is an orally effective opioid antagonist. It is useful for the maintenance of the patient of opioid poisoning once
it has been treated with naloxone. Heroin is an opioid, whose poisoning can be treated by naloxone and naltrexone.
341. Ans. (a) Amoxicillin (Ref: KDT 6/e p386, 706, 799)
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