Review of Pharmacology - 9E (2015)

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Review of Pharmacology Inhalational Agents These agents are stored in cylinders and are delivered to the patient through Boyle’s machine. Colour coding of the cylinders (for identification) and the Pin index system is present for the safety (so that only the required cylinder can fit in the machine at that site). Colour Coding of Cylinders Anaesthesia Pin Index System Air 1,5 O 2 2,5 N 2 O 3,5 CO 2 (>7.5%) 1,6 CO 2 (
Anaesthesia Anaesthetic MAC (% atm) Blood gas partition coefficient Halothane 0.74 2.3 Enflurane 1.68 1.8 Isoflurane 1.15 1.4 Desflurane 6.0 0.42 Sevoflurane 2.05 0.69 Cyclopropane 9.2 0.44 Nitrous oxide 104 0.47 Trilene 0.2 9 Ether 1.92 12 Chloroform 0.8 8 Methoxyflurane 0.16 15 Xenon 70 0.115 Breathing Circuits • Open: Ether, chloroform and ethyl chloride may be used. • Semi-closed (Mapelson circuits): Type A (Magill): Circuit of choice for spontaneous ventilation [fresh gas flow (FGF) = Respiratory minute volume (RMV)] Type B: Not used Type C (Water’s): Not used Type D (Bain’s): Most comonly used circuit and circuit of choice for controlled ventilation (FGF = 1.6 × RMV) Type E (Ayre’s T peice): Paediatric circuit Type F (Jackson Rees’): Most commonly used paediatric circuit. • Closed: Sodalime or barylime are used to absorb CO 2 . Barylime do not contain silica and is less efficient than sodalime. It is preferred in conditions with high production of CO 2 (e.g. malignant hyperthermia). Trilene, sevoflurane and methoxyflurane should not be used in closed circuit). Systemic Effects Respiratory System • All inhalational anaesthetic agents result in respiratory depression (maximum with Enflurane). These also blunt the ventilatory response to hypercapnea and hypoxia (maximum with halothane). • All inhalational agents cause bronchodilation (thus increase anatomical dead space). Maximum bronchodilation is seen with halothane in asthmatics and with sevoflurane in non-asthmatics. • All of these agents reduce the ciliary activity in respiratory system except ether. Cardiovascular System General Anaesthesia Pharmacology • All inhalational agents reduce cardiac output except isoflurane and desflurane. Maximum decrease in cardiac output is seen with enflurane. • Blood pressure is reduced by all of these agents. Maximum reduction in blood pressure is seen with isoflurane. It is therefore used as an agent of choice for producing controlled hypotension. Cyclopropane results in increase in blood pressure. It is therefore preferred in patients having shock. • All agents reduce cardiac contractility (maximum with halothane). • Baroreceptor reflexes are also blunted by all inhalational anaesthetic agents (maximum with halothane). Isoflurane does not blunt these reflexes; therefore is the drug of choice for cardiac patients. Maximum bronchodilation is seen with halothane in asthmatics and with sevoflurane in non-asthmatics. 405 https://kat.cr/user/Blink99/
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Review of Pharmacology Ninth Editio
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Dedicated to My parents, wife Prave
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Preface to the Ninth Edition We wan
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Acknowledgments When emotions are p
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References • Harrison’s Princip
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Contents 1. History of Pharmacology
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CHAPTER 1 History of pharmacology S
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CHAPTER 2 General Pharmacology Phar
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General Pharmacology Note: It is si
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General Pharmacology Drug metaboliz
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General Pharmacology Order of kinet
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General Pharmacology Therapeutic Dr
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General Pharmacology Fig. 2.4: G-pr
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General Pharmacology sigmoid shaped
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General Pharmacology Phase 1: Here,
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General Pharmacology 5. Essential m
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General Pharmacology (b) Bioavailab
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General Pharmacology (c) Are highly
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General Pharmacology (c) Strong aci
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General Pharmacology (a) 50 mg/hour
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General Pharmacology 140. Phamacoge
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General Pharmacology (c) Piroxicam
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206. Which of the following drugs s
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General Pharmacology 29. In which t
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General Pharmacology Explanations 1
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General Pharmacology • Other fact
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General Pharmacology -- Suppose, 10
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General Pharmacology 77. Ans. (a) W
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= 40 L × 4 mg/L = 160 mg Clearance
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General Pharmacology 126. Ans. (c)
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General Pharmacology 154. Ans. (d)
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General Pharmacology Intolerance is
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General Pharmacology 6. Ans. (b) b
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CHAPTER 3 Autonomic Nervous System
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Autonomic Nervous System Functions
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Autonomic Nervous System • Carbac
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Autonomic Nervous System used for g
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Autonomic Nervous System -- Central
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Autonomic Nervous System • Theref
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Autonomic Nervous System • Eye: S
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Autonomic Nervous System • Dopami
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Autonomic Nervous System • Phenox
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Autonomic Nervous System Lipid Inso
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Autonomic Nervous System Drug of Ch
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Multiple Choice Questions Autonomic
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Autonomic Nervous System (c) Organo
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(c) Physostigmime (d) Hyoscine hydr
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Autonomic Nervous System (c) Tropic
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132. A drug that blocks the uptake
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165. Clonidine is used for: (Kolkat
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as an effective substitute which do
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Autonomic Nervous System 13. Which
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Autonomic Nervous System (c) Increa
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Autonomic Nervous System 9. Ans. (a
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Autonomic Nervous System 39. Ans. (
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Autonomic Nervous System - Temazepa
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Autonomic Nervous System 103. Ans.
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Autonomic Nervous System have no ef
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Autonomic Nervous System 23. Ans. (
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CHAPTER 4 Autacoids These are the s
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Autacoids All second generation ant
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Autacoids v v v v v Calcium channel
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Autacoids nary bypass. It can also
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Autacoids to presence of sulfur con
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Autacoids Rheumatoid Arthritis Rheu
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Autacoids It is a monoclonal antibo
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Autacoids Drug of choice Condition
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15. Anti-vertigo drug which modulat
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49. Sumatriptan is: (DPG 1999, TN 2
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81. All of the following effects ar
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114. Which prostaglandin helps in c
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Autacoids 148. Which of the followi
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Autacoids 30. A 15 year old boy was
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Autacoids 16. Ans. (b) Dangerous ve
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Autacoids 56. Ans. (c) Cyclooxygena
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Autacoids 85. Ans. (b) Aspirin supp
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Autacoids 125. Ans. (b) Indomethaci
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Autacoids 13. Ans. (a) Naproxen (Re
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CHAPTER 5 Cardiovascular System CON
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Cardiovascular System In atrial fib
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Cardiovascular System Treatment of
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Cardiovascular System should be use
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Cardiovascular System tive α 1 blo
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Cardiovascular System nifedipine an
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Cardiovascular System Treatment of
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Cardiovascular System ANGINA PECTOR
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Cardiovascular System BETA BLOCKERS
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Cardiovascular System The action po
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Cardiovascular System depolarized c
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Cardiovascular System • Digoxin i
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Cardiovascular System Contd... •
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Cardiovascular System DRUG OF CHOIC
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15. Digoxin toxicity is aggravated
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(c) Treat digoxin toxicity (d) Rapi
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(c) Decreases sodium and increases
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Cardiovascular System 113. All of t
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146. Which of the following drugs i
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Cardiovascular System 180. Characte
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213. In a patient with hypertriglyc
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247. ACE inhibitors cause: (PGI Dec
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Cardiovascular System 16. Dialysis
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Cardiovascular System 53. Which of
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• Nesiritide is a recombinant BNP
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Cardiovascular System 43. Ans. (d)
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Cardiovascular System 81. Ans. (a)
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Cardiovascular System -- Hypertensi
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Cardiovascular System Cyanide has v
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Cardiovascular System 13. Ans (b) P
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CHAPTER 6 Kidney Diuretics Diuretic
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Kidney Uses Main use of loop diuret
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Kidney • Amiloride is more potent
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Kidney Amiloride It is the agent of
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Kidney Multiple Choice Questions di
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30. Which of the following statemen
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66. Advantage of desmopressin over
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Kidney Explanations 1. Ans. (b) Hyp
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16. Ans. (b) Bumetanide (Ref: KDT 6
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Kidney 55. Ans (d) V 4 : Central Ne
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CHAPTER 7 Endocrinology Hormones ar
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Endocrinology Prolactin It causes g
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Endocrinology • In the liver and
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Endocrinology I 131 can be used for
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Endocrinology Drug interactions •
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Endocrinology Lactic acidosis (more
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Endocrinology 3. amylin analogs Pra
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Endocrinology Important Points Maxi
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Endocrinology • Steroids with sel
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Endocrinology • Vitamin D 2 is er
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Endocrinology Denosumab Osteoclasts
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Endocrinology • SERMs are targete
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Endocrinology Contd... • Uliprist
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Endocrinology only pills. Chances o
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Endocrinology Pharmacokinetics Test
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Endocrinology Ergot Derivatives Erg
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Endocrinology Contd... • Hyperpro
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completion of therapy, the patient
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(c) Glucose (d) Starch 47. True abo
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(c) Na + exit/K + entry (d) K + ent
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Endocrinology 113. Which of the fol
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147. Bisphosphonates act by: (AI 20
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180. Women receiving estrogen thera
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(c) Clomiphene (d) Mifepristone (RU
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246. Mechanism of Calcitriol is: (R
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Endocrinology 32. Drug used to cont
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(b) Glimepiride (c) Repaglinide (d)
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Endocrinology Explanations 1. Ans.
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Endocrinology 24. Ans. (c) Propylth
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Endocrinology • When this drug is
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Endocrinology Hypoglycemia is cause
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Endocrinology Drugs causing Addison
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Endocrinology Raloxifene is a selec
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Endocrinology • Enzyme inducers l
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Endocrinology 197. Ans. (b) Blocks
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Endocrinology A spider angioma (als
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Endocrinology 4. Ans (c) Glaucoma (
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Endocrinology 70. Ans. (c) Mifepris
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NOTES _____________________________
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CHAPTER 8 Central Nervous System Se
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Central Nervous System It is admini
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Central Nervous System • Abnormal
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Central Nervous System useful in AD
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Central Nervous System Wilson’s D
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Central Nervous System Important Dr
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Central Nervous System • Lamotrig
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Central Nervous System play a role
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Central Nervous System According to
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Central Nervous System bulimia, pre
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Central Nervous System Anti Manic D
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Central Nervous System dependence,
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Central Nervous System increase hea
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Central Nervous System Actions •
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Central Nervous System Contd... •
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(c) Alkalization of the urine will
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Central Nervous System (c) Ketamine
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79. Drug of choice for myoclonic ep
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(c) Phenytoin (d) Valproic acid 112
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146. Which of the following antipsy
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Page 373 and 374: 314. Morphine can administered by a
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Page 379 and 380: 53. Which drug is the most useful i
Page 381 and 382: Central Nervous System 15. Ans. (c)
Page 383 and 384: Central Nervous System 39. Ans. (b)
Page 385 and 386: 67. Ans. (a) Phenytoin (Ref: Katzun
Page 387 and 388: 97. Ans. (a) Hepatitis (Ref: KDT 6/
Page 389 and 390: Central Nervous System 145. Ans (c)
Page 391 and 392: Central Nervous System 159. Ans. (d
Page 393 and 394: Central Nervous System 187. Ans. (b
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Page 401 and 402: Central Nervous System 303. Ans. (c
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Page 407 and 408: Central Nervous System 60. Ans. (a)
Page 409 and 410: CHAPTER 9 Anaesthesia Local Anaesth
Page 411 and 412: Anaesthesia trigeminal nerve, cervi
Page 413 and 414: Anaesthesia Centrally Acting Muscle
Page 415: Anaesthesia • These drugs release
Page 419 and 420: Anaesthesia Methemoglobinemia and l
Page 421 and 422: Anaesthesia Chloroform • It is a
Page 423 and 424: Anaesthesia Contd... • It does no
Page 425 and 426: Anaesthesia Anaesthetic agents of c
Page 427 and 428: Anaesthesia Multiple Choice Questio
Page 429 and 430: 33. Post dural (Spinal) puncture he
Page 431 and 432: (b) Dantrolene (c) Succinylcholine
Page 433 and 434: 103. Which of the following drugs a
Page 435 and 436: Anaesthesia 138. Thiopental sodium
Page 437 and 438: Anaesthesia Explanations 1. Ans (c)
Page 439 and 440: Anaesthesia 20. Ans. (d) Seizures a
Page 441 and 442: Anaesthesia 49. Ans. (b) Meprobamat
Page 443 and 444: Anaesthesia • The patient underwe
Page 445 and 446: Anaesthesia 91. Ans. (b) Sevofluran
Page 447 and 448: Anaesthesia • In pheochromocytoma
Page 449 and 450: CHAPTER 10 Hematology HAEMATINICS T
Page 451 and 452: Hematology • Deficiency of folic
Page 453 and 454: Hematology • Main drugs acting as
Page 455 and 456: Hematology 1. Oral Anticoagulants
Page 457 and 458: Hematology • Bioavailability of u
Page 459 and 460: Hematology • Rodenticides contain
Page 461 and 462: Hematology Condition • Anemia Dru
Page 463 and 464: (c) Erythropoietin (d) Filgrastim (
Page 465 and 466: Hematology 46. Tirofiban is a: (RJ
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80. The anticoagulant of choice in
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6. Mechanism of action of clopidogr
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Hematology Explanations 1. Ans. (c)
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Hematology 17. Ans. (d) Oprelvekin
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Hematology 51. Ans. (a) Dabigatran:
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Hematology 71. Ans. (c) Warfarin (R
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Hematology 106. Ans. (c) Streptokin
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CHAPTER 11 Respiratory System Cough
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Respiratory System fast acting also
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Respiratory System LT receptor anta
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Respiratory System Condition • Br
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17. The most prominent and dose rel
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Respiratory System 52. In theophyll
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Respiratory System Explanations 1.
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Respiratory System • Inhalational
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CHAPTER 12 Gastrointestinal Tract P
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Gastrointestinal Tract Contd... --
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Gastrointestinal Tract Anti Emetic
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Gastrointestinal Tract Domperidone
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Gastrointestinal Tract Oral Rehydra
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Gastrointestinal Tract Condition
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(c) Misoprostol (d) Omeprazole 15.
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49. The most effective antiemetic f
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Gastrointestinal Tract recent Quest
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Gastrointestinal Tract Explanations
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Gastrointestinal Tract 30. Ans. (b)
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Gastrointestinal Tract 1. EarlyPhas
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Gastrointestinal Tract 17. Ans. (c)
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CHAPTER 13 Chemotherapy A: General
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Chemotherapy A: General Considerati
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contd... Drugs Binds to Mechanism o
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Contd... Chemotherapy A: General Co
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Clinical Uses Chemotherapy A: Gener
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Important Points About Antimicrobia
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128. Ans. (b) Trovafloxacin (Goodma
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CHAPTER 14 Chemotherapy B: Antimicr
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Chemotherapy B: Antimicrobials for
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Clofazimine It is a dye with lepros
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Foscarnet It is not an antimetaboli
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Human Immunodeficiency Virus (HIV)
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16. Bactericidal drugs in ATT are:
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50. Ethambutol should be used very
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120. Regarding ritonavir use in AID
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ACTs). All of the following combina
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ecent Questions asked by National B
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Explanations Chemotherapy B: Antimi
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25. Ans. (b) Ethionamide (Ref: KDT
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CHAPTER 15 Chemotherapy C: Antineop
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Chemotherapy C: Antineoplastic Drug
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4-5 years). Another distinguishing
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GnRH Antagonists Cetrorelix, ganire
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This drug was used in 1960s as a se
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Multiple Choice Questions Chemother
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37. Which of the following statemen
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CHAPTER 16 Immunomodulators IMMUNOS
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Immunomodulators 9. Antibodies Poly
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Immunomodulators Examples of each t
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Immunomodulators Clinical Diagnosis
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(b) Podophylline (c) Interferon (d)
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(c) Cytarabine (d) Cycloserine 51.
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Immunomodulators Explanations 1. An
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Immunomodulators 14. Ans. (a) Syste
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Immunomodulators 33. Ans. (a) Gluco
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CHAPTER 17 Other Topics and Adverse
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Other Topics and Adverse Effects Co
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17. A 2 years old child without fev
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54. Isotretinoin is: (PGI June, 200
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Other Topics and Adverse Effects (c
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Other Topics and Adverse Effects
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Other Topics and Adverse Effects
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Other Topics and Adverse Effects 39
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Other Topics and Adverse Effects 55
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Other Topics and Adverse Effects Dr
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CHAPTER 18 Drugs of Choice Drug of
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Drugs of Choice Contd... Hypertensi
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Contd... VRSA LINEZOLID/STREPTOGRAM
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CHAPTER 19 New Drugs 1. Abatacept:
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New Drugs 52. Canakinumab: A human
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New Drugs 100. Ecallantide: A plasm
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New Drugs 153. Laronidase: Recombin
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New Drugs 204. Peginesatide: A pept
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New Drugs been approved for the tre
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New Drugs and B lymphocytes after e
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New Drugs prevents nausea and vomit
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CHAPTER 20 Recent Topics TRICYCLIC
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Recent Topics 2. Drugs 5-HT 2 recep
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Recent Topics Arginine NOS NO + Cit
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Recent Topics Contd... Drug Tetracy
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Recent Topics -- If the patient has
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CHAPTER 21 Latest Papers AIIMS Nove
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Latest Papers explanations 1. Ans.
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• Clindamycin and erythromycin ar
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Latest Papers AIIMS May 2014 1. Whi
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Latest Papers explanations 1. Ans.
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13. Ans. a. Hypokalemia (Ref: Harri
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NOTES _____________________________
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Image Based Questions https://kat.c
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Image Based Questions 1. The result
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5. A new antiarrhythmic drug is fou
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10. Amarnath, a 58 year old busines
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14. A 72-year-old male, Hemraj was
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(rapid vs slow induction of anesthe
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Review of Pharmacology - 9E (2015)

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