Review of Pharmacology - 9E (2015)

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Review of Pharmacology 10. Ans. d. The onset of analgesia is 30–60 minutes after parenteral administration and 1–2 hours after oral administration (Ref: Goodman and Gilman 12th/506-507) Methadone • The onset of analgesia occurs 10–20 minutes after parenteral administration of methadone and 30–60 minutes after oral administration. • Methadone is a long-acting µ opioid receptor agonist with pharmacological properties qualitatively similar to those of morphine. • It is well absorbed from the GI tract and can be detected in plasma within 30 minutes of oral ingestion. • Primary uses are relief of chronic pain and in maintenance therapy of opioid addiction. Latest Papers 11. Ans. c. From onset of regular respiration to cessation of spontaneous breathing (Ref: KDT 7th/373-374) The plane of surgical anesthesia during ether anesthesia is defined as from onset of regular respiration to cessation of spontaneous breathing. Guedel’s Stages of Anesthesia • Guedel described four stages with ether anesthesia, dividing the stage III into four planes. I: Stage of analgesia • It starts from beginning of anesthetic inhalation and lasts up to the loss of consciousness. • Pain is progressively abolished. • Patient remains conscious, can hear and see, and feels a dream-like state; amnesia develops by the end of this stage. • Reflexes and respiration remain normal. • Though some minor operations can be carried out during this stage, it is rather difficult to maintain. The use is thus limited to short procedures. II: Stage of delirium • It lasts from loss of consciousness to the beginning of regular respiration. • Apparent excitement is seen – patient may shout, struggle and hold his breath. • Muscle tone increases. • Jaws are tightly closed • Breathing is jerky. • Vomiting, involuntary micturition or defecation may occur. • Heart rate and BP may rise and pupils dilate due to sympathetic stimulation. • No stimulus should be applied or operative procedure carried out during this stage. • This stage is inconspicuous in modern anesthesia. III: Stage of surgical anesthesia • It extends from onset of regular respiration to cessation of spontaneous breathing. • This has been divided into four planes, which may be distinguished as: –– Plane I: Roving eyeballs –– Plane II: Loss of corneal and laryngeal reflexes –– Plane III: Pupil starts dilating and light reflex is lost –– Plane IV: Intercostal paralysis, shallow abdominal respiration, dilated pupil IV: Stage of medullary paralysis • It lasts from cessation of spontaneous breathing to failure of circulation and death. • Pupil is widely dilated, muscles are totally flabby, pulse is thready or imperceptible and BP is very low. 12. Ans. a. Ketamine (Ref: Morgan 4/e p197-199) Ketamine should be avoided in patients with history of seizures as it further increases ICP and also causes delirium and hallucinations. Contraindications of Ketamine: • Head injury, intracranial space occupying lesion, eye injury (increases ICT, IOT). • Ischemic heart disease, vascular aneurysm and hypertension (increases myocardial oxygen demand and blood pressure. • Psychiatric diseases and drug addicts (more incidence of hallucination and emergence reaction). 756 https://kat.cr/user/Blink99/
13. Ans. a. Hypokalemia (Ref: Harrison 18th/351) Laxative abuse is associated with hypokalemia. Latest Papers 14. Ans. c. Ceftriaxone (Ref: Harrison 18th/3414) Erythromycin and sulfamethoxazole are bacteriostatic drugs and cannot be relied upon in serious infections like bacterial meningitis. Streptomycin is an aminoglycoside effective mainly against gram negative bacteria but is not preferred for meningitis due to following reasons: • It cannot kill gram positive organisms responsible for bacterial meningitis like Streptococcus, Staphylococcus and Listeria, etc. • To prevent the emergence of drug resistance; as it is first line antitubercular drug. Ceftriaxone is a third generation cephalosporin with broad spectrum antibacterial activity and good CSF penetration. It is commonly used for empirical treatment of acute bacterial meningitis. 15. Ans. b. Beta lactam antibiotics (Ref: Katzung 12th/907-908) Friends, this question has been unnecessarily made controversial by giving different answers in different books for competitive exams. Please try to search for the references provided in those books. Now coming to explanation: • The terms time dependent killing (TDK) and concentration dependent killing (CDK) are applicable only for cidal drugs. Beta lactams and vancomycin follow TDK whereas aminoglycosides and fluoroquinolones follow CDK. • Long post-antibiotic effect is shown by most of the drugs against gram positive bacteria (including aminoglycosides, beta lactams, clindamycin and macrolides) but few drugs have long PAE against gram negative bacteria. The table given in katzung is modified as: General Latest Pharmacology Papers Now coming to options: • Clindamycin and erythromycin are static drugs, so can be easily excluded • Fluoroquinolones follow CDK. • So, answer is beta lactams as these follows TDK and have long PAE against gram positive cocci. 16. Ans. d. Lamivudine (Ref: Katzung 12th/870) Lamivudine is nucleoside reverse transcriptase inhibitor (NRTI), not the non-nucleoside reverse transcriptase inhibitor (NNRTI). NNRTIs incude: • Efavirenz • Nevirapine • Delavirdine • Etravirine • Rilpivirine 17. Ans. c. Ethionamide (Ref: KDT 7th/771) Ethionamide and PAS are two antitubercular drugs associated with hypothyroidism and goiter. 757 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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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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Page 729 and 730: Drugs of Choice Contd... Hypertensi
Page 731 and 732: Contd... VRSA LINEZOLID/STREPTOGRAM
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Page 735 and 736: New Drugs 52. Canakinumab: A human
Page 737 and 738: New Drugs 100. Ecallantide: A plasm
Page 739 and 740: New Drugs 153. Laronidase: Recombin
Page 741 and 742: New Drugs 204. Peginesatide: A pept
Page 743 and 744: New Drugs been approved for the tre
Page 745 and 746: New Drugs and B lymphocytes after e
Page 747 and 748: New Drugs prevents nausea and vomit
Page 749 and 750: CHAPTER 20 Recent Topics TRICYCLIC
Page 751 and 752: Recent Topics 2. Drugs 5-HT 2 recep
Page 753 and 754: Recent Topics Arginine NOS NO + Cit
Page 755 and 756: Recent Topics Contd... Drug Tetracy
Page 757 and 758: Recent Topics -- If the patient has
Page 759 and 760: CHAPTER 21 Latest Papers AIIMS Nove
Page 761 and 762: Latest Papers explanations 1. Ans.
Page 763 and 764: • Clindamycin and erythromycin ar
Page 765 and 766: Latest Papers AIIMS May 2014 1. Whi
Page 767: Latest Papers explanations 1. Ans.
Page 771 and 772: NOTES _____________________________
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Page 775 and 776: Image Based Questions 1. The result
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Page 781 and 782: 14. A 72-year-old male, Hemraj was
Page 783 and 784: (rapid vs slow induction of anesthe
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Review of Pharmacology - 9E (2015)

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