Review of Pharmacology - 9E (2015)

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Review of Pharmacology Drugs For Leishmaniasis • Leishmaniasis can be visceral (kala-azar), mucocutaneous or cutaneous. Liposomal amphotericin B is the treatment of choice for visceral leishmaniasis. Sodium stibogluconate (pentavalent antimonial compound) is the most commonly used treatment for all forms of the disease. But it must be administered parenterally and is a cardiotoxic (cause QT prolongation) drug. The alternative agents for visceral leishmaniasis are pentamidine, miltefosine and sitamaquine. Last two drugs can be administered orally. Paromomycin has recently been approved for the treatment of kala-azar. • Fluconazole or metronidazole can be used for cutaneous lesions and amphotericin B can be used for mucocutaneous lesions. However, sodium stibogluconate remains the first line therapy. • Other drugs effective against leishmaniasis are ketoconazole, mepacrine and allopurinol. Drug of Choice for Some Protozoal Infections Chemotherapy B: Antimicrobials for Specific Conditions Babesia Balantidium coli Cryptosporidium Cyclospora Isospora Pneumocystis jiroveci Leishmania donovani Giardia lamblia Trichomonas vaginalis Toxoplasma gondii Organism Drug of choice Clindamycin + Quinine Tetracyclines Nitazoxanide/Paromomycin Cotrimoxazole Cotrimoxazole Cotrimoxazole Liposomal amphotericin B Metronidazole Metronidazole T. gondii in pregnancy Spiramycin Early African trypanosomiasis Late (CNS) African trypanosomiasis Chagas disease Pyrimethamine + Sulfadiazine + Folinic acid Suramin Melasoprol Benznidazole Note: • DOC for Kala-azar – Liposomal amphotericin-B [CMDT 2012/1447] • DOC for cutaneous Leishmaniasis – Sodium stibogluconate • Most commonly used drug for Leishmania – Sodium stibogluconate Anti- Helminthic Drugs Various helminthes causing human infestation are 1. Nematodes • Round worm (Ascaris lumbricoides) • Hook worm (Necator americanus and Ancylostoma duodenale) • Pinworm (Enterobius vermicularis) • Threadworm (Strongyloides stercoralis) • Filarial worm (Wuchereria bancrofti and Brugia malayi, Onchocerca volvulus) • Whip worm (Trichuris trichiura) • Trichinea worm (Trichinella spiralis) • Guinea worm (Dracunculus medinensis) 596 https://kat.cr/user/Blink99/
Chemotherapy B: Antimicrobials for Specific Conditions 2. Trematodes • Blood fluke (Schistosoma haematobium, mansoni and japonicum) • Lung fluke (Paragonimus westermani) • Liver fluke (Fasciola hepatica) 3. Cestodes • Pork tapeworm (Taenia solium) • Beef tapeworm (Taenia saginata) • Fish tapeworm (Diphyllobothrium latum) • Dog tapeworm (Echinococcus granulosus) • Dwarf tapeworm (Hymenolepis nana) Albendazole is the drug of choice for the treatment of all nematode infestations inclu ding cutaneous larva migrans (creeping eruption), visceral larva migrans (toxocariasis) and neurocysticercosis except enterobius (mebendazole), wuchereria and brugia (DEC), onchocerca and strongyloides (ivermectin) and dracunculus (Metronidazole). Classification Based on mechanism of action, these drugs may be classified as: • Drugs inhibiting polymerization of beta tubulin: Albendazole, mebendazole, thiaben dazole, triclabendazole • Drugs causing spastic paralysis (NN receptor agonist): Pyrantel pamoate, levamisole • Drugs causing flaccid paralysis (GABAA agonist): Piperazine, ivermectin • Drugs altering microfilarial membrane and increasing phagocytosis: Diethylcarbamazine (DEC) • Drugs causing uncoupling of oxidative phosphorylation: Bithionol, niclosamide • Drugs causing influx of calcium: Praziquantal. Important Points • Albendazole, mebendazole and pyrantel pamoate have wide antihelminthic spectrum. • Albendazole is the drug of choice for the treatment of all nematode infestations inclu ding cutaneous larva migrans (creeping eruption), visceral larva migrans (toxocariasis) and neurocysticercosis except enterobius (mebendazole), wuchereria and brugia (DEC), onchocerca and strongyloides (ivermectin) and dracunculus (Metronidazole). • Praziquantal is the drug of choice for all trematode and cestode infestations except Fasciola hepatica (triclabendazole) and hydatid disease (albendazole). • High dose albendazole if used for greater than 3 months (as for hydatid disease) may cause hepatotoxicity. • DEC acts on both microfilaria and adult whereas ivermectin acts only on microfilaria. • Onchocerciasis is also known as river blindness and is treated by ivermectin. • Ivermectin should be avoided in children below 5 years old. • Niclosamide is used for most cestodes. However it has been superseded by praziquantal for this indication. Praziquantal is the drug of choice for all trematode and cestode infestations except Fasciola hepatica (triclabendazole) and hydatid disease (albendazole). Ivermectin has recently been approved for topical treatment of inflammatory lesions of rosacea. Chemotherapy B: General Antimicrobials Pharmacology for Specific Conditions 597 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)
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67. Ans. (a) Phenytoin (Ref: Katzun
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97. Ans. (a) Hepatitis (Ref: KDT 6/
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Central Nervous System 145. Ans (c)
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Central Nervous System 159. Ans. (d
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Central Nervous System 187. Ans. (b
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Central Nervous System 212. Ans. (a
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Central Nervous System 258. Ans. (a
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Central Nervous System 303. Ans. (c
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Central Nervous System 326. Ans. (c
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Central Nervous System 60. Ans. (a)
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CHAPTER 9 Anaesthesia Local Anaesth
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Anaesthesia trigeminal nerve, cervi
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Anaesthesia Centrally Acting Muscle
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Anaesthesia • These drugs release
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Anaesthesia Anaesthetic MAC (% atm)
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Anaesthesia Methemoglobinemia and l
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Anaesthesia Chloroform • It is a
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Anaesthesia Contd... • It does no
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Anaesthesia Anaesthetic agents of c
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Anaesthesia Multiple Choice Questio
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33. Post dural (Spinal) puncture he
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(b) Dantrolene (c) Succinylcholine
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103. Which of the following drugs a
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Anaesthesia 138. Thiopental sodium
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Anaesthesia Explanations 1. Ans (c)
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Anaesthesia 20. Ans. (d) Seizures a
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Anaesthesia 49. Ans. (b) Meprobamat
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Anaesthesia • The patient underwe
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Anaesthesia 91. Ans. (b) Sevofluran
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Anaesthesia • In pheochromocytoma
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CHAPTER 10 Hematology HAEMATINICS T
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Hematology • Deficiency of folic
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Hematology • Main drugs acting as
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Hematology 1. Oral Anticoagulants
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Hematology • Bioavailability of u
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Hematology • Rodenticides contain
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Hematology Condition • Anemia Dru
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(c) Erythropoietin (d) Filgrastim (
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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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Page 593 and 594: Clofazimine It is a dye with lepros
Page 597 and 598: Foscarnet It is not an antimetaboli
Page 599 and 600: Human Immunodeficiency Virus (HIV)
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Page 631 and 632: Explanations Chemotherapy B: Antimi
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Page 653 and 654: 4-5 years). Another distinguishing
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This drug was used in 1960s as a se
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Chemotherapy C: Antineoplastic Drug
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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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