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Review of Pharmacology - 9E (2015)

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Review of Pharmacology 13. Ans. (a) Flu like syndrome is usually seen with rifampicin being taken on daily basis • Flu like syndrome is seen more commonly when rifampicin is administered on alternate days. • Only first line antitubercular drug that do not require dose adjustment in renal failure is rifampicin. • Pyrazinamide and ethambutol can cause hyperuricemia. • Ethambutol causes red green colour blindness as early appearing adverse effect. 14. Ans. (c) Rifampicin (Ref: KDT 6/e p753) • Best and the fastest acting drug for leprosy is rifampicin. • Clofazimine and dapsone are bacteriostatic agents. 15. Ans. (d) Rifampicin (Ref: KDT 6/e p741) • Rifampicin is a powerful enzyme inducer. It increases the metabolism of protease inhibitors and thus decreases the efficacy of anti-retroviral therapy. • Another drug, rifabutin is devoid of these interactions and is the preferred agent for treatment of mycobacterial infections in patients on anti-retroviral therapy. 16. Ans. (a) Pyrazinamide; (d) Rifampicin; (e) Isoniazid (Ref: KDT 6/e p740-743) 17. Ans. (b) Infectious mononucleosis like syndrome; (c) Agranulocytosis; (e) Skin pigmentation (Ref: KDT 6/e p752) Chemotherapy B: Antimicrobials for Specific Conditions • Dapsone administration can result in hemolytic anaemia and methemoglobinemia. • Other side effects are: agranulocytosis, hepatitis, peripheral neuropathy, gastrointestinal intolerance, headache, pruritus, nephrotic syndrome, fever, rash and psychosis. • Cutaneous reaction include: Allergic rashes, fixed drugs eruption, hypermelanosis, phototoxicity and exfoliative dermatitis. • In borderline and lepromatous leprosy, dapsone may result in erythema nodosum leprosum. • A rare syndrome known as DDS - syndrome or infectious mononucleosis like syndrome or sulfone syndrome may also be seen. • G-6-PD deficiency is not a side effect of dapsone, it is an X-linked recessive disorder. 18. Ans. (c) Delay or prevent the emergence of resistance (Ref: KDT 6/e p745) 19. Ans. (c) Clofazimine should not be given to patients who are intolerant to dapsone or who fail to improve during treatment with dapsone (Ref: KDT 6/e p752, 753) • Acedapsone is a repository form of dapsone. Single i.m. injection of acedapsone keep on releasing the drug for 3 months. • Rifampicin is used once in a month (supervised dose) for the treatment of leprosy. It prevents the emergence of resistance to dapsone. • Clofazimine can result in skin pigmentation, discolouration of secretions and dryness of skin (icthyosis). • Clofazimine has no cross-allergenicity with dapsone. 20. Ans. (a) One should discontinue treatment if hyperuricemia occurs (Ref: Katzung 10/e p775) • Pyrazinamide is a first line antitubercular drug that can cause hyperuricemia and hepatotoxicity. • Non gouty arthralgia is very common adverse effect of this drug. Hyperuricemia per se is not the indication for discontinuation of pyrazinamide. 21. Ans. (a) Respiratory syndrome (Ref: KDT 6/e p741) 22. Ans. (c) Intestinal (Ref: KDT 6/e p749) Corticosteroids are absolutely contra-indicated in intestinal TB due to risk of perforation. 23. Ans. (a) Azithromycin (Ref: KDT 6/e p730, 731) The regimen used for the treatment of Mycobacterium avium complex in AIDS patients is REC (Rifabutin, ethambutol and clarithromycin). These drugs are given once daily. Clarithromycin can be replaced with azithromycin which is long acting and can be administered once a week. 24. Ans. (b) Rifampicin (Ref: Goodman & Gilman 11/e p1205, 1208, 1211; KDT 6/e p741) 620 • Ethambutol is bacteriostatic drug. • INH and rifampicin are equally effective against intra as well as extracellular mycobacteria. INH require a concentration of 0.025 µg/ml whereas rifampicin inhibits the growth of bacteria at a concentration of 0.005 µg/ml. • Pyrazinamide acts more in acidic pH and it requires a concentration of 12.5 µg/ml. • Thus, most active drug for extra-cellular bacteria is rifampicin. https://kat.cr/user/Blink99/

25. Ans. (b) Ethionamide (Ref: KDT 6/e p743) PAS and ethionamide can lead to hypothyroidism 26. Ans. (a) Rifampicin (Ref: Goodman & Gilman 11/e p1209; KDT 6/e p742) Chemotherapy B: Antimicrobials for Specific Conditions 27. Ans. (d) Streptomycin (Ref: KDT 6/e p743) Streptomycin and ethambutol are not hepatotoxic. Read carefully, option (c) is ethionamide not ethambutol. 28. Ans. (d) All of the above (Ref: KDT 6/e p750) • Most atypical Mycobacteria are resistatnt to the usual antitubercular drugs, though pulmonary disease caused by M. avium complex or M. kansasii may respond to prolonged treatment with Rifampicin, Isoniazid and Ethambutol. • Drugs that are used are: –– Rifabutin –– Clofazimine –– Quinolones e.g. ciprofloxacin –– Newer macrolides like clarithromycin and azithromycin. 29. Ans. (c) INH (Ref: KDT 6/e p741) • Peripheral neuritis and a variety of neurological manifestations (paraesthesias, numbness, mental disturbances, rarely convulsions) are the most important dose dependent toxic effects of INH. • These are due to interference with utilization of pyridoxine and its increased excretion in urine. 30. Ans. (c) Pyrazinamide (Ref: KDT 6/e p742) • Arthralgia is caused by pyrazinamide, which may be non-gouty or due to hyperuricemia secondary to inhibition of uric acid secretion in the kidney. • Ethambutol also produces hyperuricemia due to interferance with urate excretion. 31. Ans. (d) Rifampicin (Ref: KDT 6/e p742) Streptomycin and capreomycin are nephrotoxic whereas ethambutol accumulates in renal failure and thus should be avoided in presence of severe renal failure. 32. Ans. (b) Ethambutol (Ref: KDT 6/e p742) 33. Ans. (b) Clarithromycin (Ref: KDT 6/e p750) • Treatment of MAC infection is REC (Rifabutin + Ethambutol + Clarithromycin) • Clarithromycin alone can be used for the prophylaxis of MAC infections in HIV positive patients. • Azithromycin can also be used in place of clarithromycin. 34. Ans. (b) Cycloserine (Ref: KDT 6/e p744) 35. Ans. (c) B 6 (Ref: KDT 6/e p741) Pyridoxine (vitamin B 6 ) is administered for the prevention as well as treatment of isoniazid induced peripheral neuropathy. 36. Ans. (a) Streptomycin (Ref: KDT 6/e p743) Streptomycin and ethambutol do not cross blood brain barrier whereas INH and pyrazinamide have maximum CNS penetration. 37. Ans. (a) Streptomycin (Ref: KDT 6/e p742, 743) Ethambutol and streptomycin are first line anti-tubercular drugs that are NOT hepatotoxic. 38. Ans. (d) Coronary artery disease (Ref: KDT 6/e p740-741) INH causes hepatitis, peripheral neuritis and neurological manifestations (paresthesias, numbness, mental disturbance rarely convulsion). Its toxic metabolitre accumulates in the presence of renal failure. So we are left with last option; coronary artery disease, which is our answer of exclusion. 39. Ans. (b) Streptomycin + Ethambutol (Ref: KDT 6/e p742-743) 40. Ans. (b) INH (Ref: Katzung 11/e p825) 41. Ans. (b) Optic neutritis (Ref: Katzung 11/e p827) 42. Ans. (a) Dapsone (Ref: Katzung 11/e p831) 43. Ans. (d) Mutation (Ref: Katzung 11/e p824,826,827) 621 Chemotherapy B: General Antimicrobials Pharmacology for Specific Conditions 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 166. Ans.

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    Autonomic Nervous System 194. Ans.

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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 178. Ans. (a)

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    Cardiovascular System 217. Ans. (a)

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    Cardiovascular System 237. Ans. (a)

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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 286. Ans. (b

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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 366. Ans. (b

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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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    Chemotherapy A: General Considerati

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    Chemotherapy A: General Considerati

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    Contd... Chemotherapy A: General Co

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    Chemotherapy A: General Considerati

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    Clinical Uses Chemotherapy A: Gener

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    Chemotherapy A: General Considerati

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    Chemotherapy A: General Considerati

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    Chemotherapy A: General Considerati

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    Important Points About Antimicrobia

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    Chemotherapy A: General Considerati

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    Chemotherapy A: General Considerati

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    Chemotherapy A: General Considerati

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    Chemotherapy A: General Considerati

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    Chemotherapy A: General Considerati

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    Chemotherapy A: General Considerati

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    Chemotherapy A: General Considerati

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    Chemotherapy A: General Considerati

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    Chemotherapy A: General Considerati

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    Chemotherapy A: General Considerati

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    Chemotherapy A: General Considerati

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    Chemotherapy A: General Considerati

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    Chemotherapy A: General Considerati

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    128. Ans. (b) Trovafloxacin (Goodma

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    Chemotherapy C: Antineoplastic Drug

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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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    Other Topics and Adverse Effects Co

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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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