Review of Pharmacology - 9E (2015)

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Review of Pharmacology 16. Local anaesthetic used as an antiarrhythmic agent is: (a) Bupivacaine (b) Lignocaine (c) Cocaine (d) Chlorprocaine 17. Pin index of oxygen is which one of the following: (a) 2, 5 (b) 3, 5 (c) 1, 5 (d) 3, 6 18. All of the following are intravenous anesthetic induction agents except: (a) Thiopentone sodium (b) Ketamine (c) Etomidate (d) Bupivacaine Anaesthesia 424 https://kat.cr/user/Blink99/
Anaesthesia Explanations 1. Ans (c) It is given orally for treatment of cardiac arrhythmias (Ref: Katzung 12/e p453, 457, 458) • All local anaesthetics (LA) are weak bases. These drugs act by penetrating the axonal membrane (in unionized form) and blocking the voltage gated sodium channels from within (in ionized form). Resting sodium channels are less sensitive to block than active and inactive channels. • Vasoconstrictors like adrenaline can prolong the duration of action and decrease the systemic toxicity. • Lignocaine is the most commonly used LA and is the drug of choice for ventricular tachycardia. However because of very high first pass metabolism, it is not effective orally. • All LA can cause cardiotoxicity and neurotoxicity. Bupivacaine is most cardiotoxic LA. 2. Ans. (c) 7mg/kg (Ref: Goodman and Gilman 12/e p576) • For normal healthy adults, the individual maximum recommended dose of lignocaine HCl with epinephrine should not exceed 7 mg/kg of body weight, and in general it is recommended that the maximum total dose not exceed 500 mg. • When used without epinephrine the maximum individual dose should not exceed 4.5 mg/kg of body weight, and in general it is recommended that the maximum total dose does not exceed 300 mg. • For intravenous regional anaesthesia, the dose administered should not exceed 4mg/kg in adults. 3. Ans (a) Digital block (Ref: Katzung 11/e p446) Vasoconstrictors are contraindicated if LAs are used for organs with end arteries (tips of fingers, toes, nose, pinna and penis) due to risk of ischemia and necrosis. 4. Ans (a) Prilocaine (Ref: Katzung 11/e p449) • The administration of large doses (> 10 mg/kg) of prilocaine during regional anesthesia may lead to accumulation of the metabolite o-toluidine, an oxidizing agent capable of converting hemoglobin to methemoglobin. • The treatment of methemoglobinemia involves the intravenous administration of reducing agents (eg, methylene blue or ascorbic acid), which rapidly convert methemoglobin to hemoglobin. 5. Ans. (d) Cocaine (Ref: Ajay Yadav 3/e p105) First local anaesthetic to be used clinically was cocaine by Carl Koller. 6. Ans. (a) Intercostal (Ref: Miller’s Anaesthesiology/591) • The greater the blood supply to the area injected, the greater is the systemic absorption. Sites of absorption from greatest to least inlcude: • Interpleural > Intercostal > Pudendal > Caudal > Epidural > Brachial plexus > Infiltration 7. Ans. (b) Need to cross the cell membrane to produce the block (Ref: Katzung 10/e p417; KDT 6/e p353) General Anaesthesia Pharmacology • Local anaesthetics cross the neuronal membrane in un-ionized state and become ionized again in the neuron to block sodium channels. Due to this reason, sodium bicarbonate increases the rapidity of onset of action (LA are weak bases and in alkaline medium easily cross the membrane). • Un-myelinated and weakly myelinated fibres are blocked first and then the myelinated ones. • These do not affect the resting membrane potential rather inhibit the depolarization. • Resting nerves are less sensitive to block by LA than the stimulated nerves. 8. Ans. (b) Pia and arachnoid (Ref: Katzung 10/e p419; KDT 6/e p359) In spinal anaesthesia, drug is deposited in sub-arachnoid space (i.e. between pia and arachnoid) whereas in epidural anaesthesia, it is given outside the duramater. 9. Ans. (a) Lignocaine concentration is initially higher in relatively well perfused tissues such as brain and heart (Ref: KDT 6/e p355) • Lignocaine has very high first pass metabolism. • Its metabolism is dependent on hepatic blood flow. Its t 1/2 increases in patients with CHF. • It is initially distributed rapidly to well perfused tissues (like brain and heart) but action terminates rapidly due to redistribution. 425 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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(c) Regular measurements of blood c
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210. A patient Rajnish having depre
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242. Drug useful in malignant hyper
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279. Preferred drug for alcohol wit
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314. Morphine can administered by a
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(c) Analgesia (d) Mydriasis 348. Di
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17. Antiparkinson drug known to cau
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53. Which drug is the most useful i
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Central Nervous System 15. Ans. (c)
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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
Page 395 and 396: Central Nervous System 212. Ans. (a
Page 397 and 398: Central Nervous System 258. Ans. (a
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 and 416: Anaesthesia • These drugs release
Page 417 and 418: Anaesthesia Anaesthetic MAC (% atm)
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: Anaesthesia 138. Thiopental sodium
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
Page 467 and 468: 80. The anticoagulant of choice in
Page 469 and 470: 6. Mechanism of action of clopidogr
Page 471 and 472: Hematology Explanations 1. Ans. (c)
Page 473 and 474: Hematology 17. Ans. (d) Oprelvekin
Page 475 and 476: Hematology 51. Ans. (a) Dabigatran:
Page 477 and 478: Hematology 71. Ans. (c) Warfarin (R
Page 479 and 480: Hematology 106. Ans. (c) Streptokin
Page 481 and 482: CHAPTER 11 Respiratory System Cough
Page 483 and 484: Respiratory System fast acting also
Page 485 and 486: 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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