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Pacop pink Flashcards

1
Q

Cimetidine, Ketoconazole, and Allopurinol share a common pharmacokinetic property that predisposes patients taking other drugs concomitantly with any of these agents to toxicity. What is this property?

A

Enzyme inhibition

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2
Q

Biotransformation of orally administered drugs occurring primarily in the liver that reduces the amount of drug finally entering the systemic circulation is often referred to as __________.

A

First pass effect

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3
Q

The preganglionic fibers of the sympathetic nervous system originate from which roots?

A

Thoracolumbar

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4
Q

What neurotransmitter is released by preganglionic fibers as a response to sympathetic stimulation?

A

AcH

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5
Q

What is the dominant ganglionic receptor found in most sympathetic fibers?

A

Nicotinic

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6
Q

What is the neurotransmitter mainly released by postganglionic parasympathetic fibers?

A

AcH

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7
Q

Which of the following non-adrenergic, non-cholinergic neurotransmitters is involved in the action of the enteric nervous system?

A

ATP

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8
Q

In synaptic neurotransmission, which of the following ions plays a significant role in neurotransmitter release

A

Ca

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9
Q

The primary mechanism of neurotransmitter release is accomplished by what process?

A

Exocytosis

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10
Q

What is the amino acid precursor in the synthesis of catecholamines?

A

Tyr

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11
Q

In the biosynthesis of Norepinephrine, what step is considered rate-limiting?

A

Tyr to DOPA

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12
Q

Which of the following substances exert a negative feedback control on Tyrosine Hydroxylase which serves as the mechanism for moment-to-moment regulation of the rate catecholamine synthesis?

A

NE

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13
Q

Reserpine, an alkaloid from Rauwolfia, can lower the blood pressure and depress the CNS. What enzyme of the biosynthetic pathway is inhibited by Reserpine to bring about these effects?

A

Storage in vesicle

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14
Q

What is the main final metabolite of Norepinephrine
and Epinephrine which when abnormally elevated is often used as marker of pheochrytomocytoma

A

3 methoxy 4 hydromandelic acid

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15
Q

Which of the following is an expected response to alpha1 adrenoceptor stimulation?

A

GIT Sphincter constrict

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16
Q

Male px wish to buy otc cold meds. Which data should prevent you from dispensing?
I. Px taking Nifedipine GITTS
II. Px on Tranylcypromine
III. px elderly w/ urinary hesitancy, intermittency, and freq

A

I and III

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17
Q

Stimulation of Alpha-1 receptors leads to the formation of important secondary messengers that promote
calcium release and activation of protein kinase C. These secondary messengers responsible for the effects of alpha-1 stimulation include which of the following?

A

ITP

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18
Q

In which of the following clinical conditions are the agonists of the alpha-1adrenoceptors found to be useful?
I. Nasal congestion
II. HYPOTN
III. Symptomatic Brady

A

I and II

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19
Q

Which of the following effects can be attributed to alpha-2 receptor stimulation?
I. Vasodilation
II. Catecholamine release
III. Vasoconstriction

A

I, II, III

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20
Q

A given adrenergic agent induces uterine relaxation and bronchial smooth muscler elaxation.These effects can be attributed to

A

B2 agonist

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21
Q

What is the dominant adrenergic receptor in the heart?

A

B1 agonist

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22
Q

Which of the following effects is/are consistent with the systemic use of the drug Clonidine?
I. Initial transient increase in bp
II. First dose effect
III. lowering of bp

A

I and III

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23
Q

Epinephrine is considered as the first line for the management of anaphylaxis and anaphylactic shock. Which of the following explain/s the mechanism of action of Epinephrine in anaphylaxis and anaphylactic shock?
I. Inhibit Histamine release by B2 activation
II. A1 activation lead to vasoconstriction
III. B2 activation lead to bronchodil

A

I, II, III

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24
Q

The activity of this drug is attributed to its metabolite which is a false neurotransmitter at the central nervous system

A

Methyldopa

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25
Q

Which of the following inotropic agents is most useful for patient with acute heart failure complicated by acute reduction in creatinine clearance?

A

DA

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26
Q

As an inotropic agent, Norepinephrine (Levophed) has been shown in some small clinical trials to be most useful in which of the following conditions?

A

Septic shock

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27
Q

Which of the following statements is/are true regarding the drug methyldopa
I. Is current clinical use is in the management of hypertension in pregnancy
II. It is associated with warm antibody type of immuno-hemolytic anemia
III. Toxic doses are associated with hepatotoxicity

A

I, II, III

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28
Q

What are known clinical use of b2 agonist
I. Management of premature labor
II. Part of intervention for hyperkalemia
III. Bronchial asthma

A

I, II, III

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29
Q

Accepted ID of Epi

A

Local vasoconstrictor

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30
Q

Clinical use of D1 agonist Fenodolpan

A

Acute tx of HTN

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31
Q

Ff adrenergic most useful for hypodynamic septic shock with hypotn
I. DA
II. Dobutamine
III. NE

A

I and III

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32
Q

Guanfacine and Guanabenz are primarily agonist at

A

Presynaptic A2

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33
Q

Indication of terbutaline
I. SC for recalcitrant acute exacerbation of bronchial asthma
II. Increase HR in symptomatic Bradycardia
III. Adjunct of malignant HTN

A

I and II

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34
Q

Which primarily stimulates B1 receptors

A

Dobutamine

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35
Q

Px complains of muscle weakness after several doses of Salbu nebulization. This condition can be attributed to

A

Hypokalemia induced salbu therapy

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36
Q

BB that has similar vasodilation similar to prazosin

A

Labetalol

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37
Q

BB that is cardioselective

A

Esmolol

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38
Q

Rebound tachycardia and HTN are expected complications of abrupt withdrawal of BB therapy. Which of the ff has the least likelihood of causing rebound

A

Labetalol

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39
Q

BB with shortest DOA

A

Esmolol

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40
Q

Whiich BB has been proven to be useful in mngmt of stable CHF
I. Carvedilol
II. Bisoprolol
III. Mesoprolol

A

I, II, III

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41
Q

In which are BB found to be useful
I. Hypothyroidism
II. Raynauds phenomenon
III. Initial therapy of pheochromocytoma

A

I

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42
Q

In which are bb used with caution or avoided?
I. Px with COPD/asthma
II. Px with peripheral vascular disease
III. Px with MI

A

I and II

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43
Q

Methylphenidate and Dextroamphetamine are centrally acting sympathomimetics which have found use in which of the following conditions?

A

ADHD

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44
Q

Which of the following effects is are consistent with direct stimulation of the muscarinic receptors?
I. Peripheral vasodilation
II. Relaxation of ciliary muscles
III. Negative dromotropic

A

I and III

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45
Q

What is the physiologic event that follows stimulation of the NM type cholinergic receptors?

A

Sodium influx

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46
Q

Bethanecol is clinically used for which of the following conditions?

A

Urinary retention

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47
Q

What is/are the clinical use/s of Edrophonium (Tensilon)?
I. Reverse NM blockers
II. Atropine overdose
III. mngmt of organophospate px

A

I

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48
Q

Tacrine, Donepezil, Rivastigmine and Galantamine are indicated for which of the following condition?

A

Alzheimers

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49
Q

Used for mngmt of glaucoma
I. Pilocarpine-physostigmine combi
II. Ecothiophate
III. Demecarium

A

I, II, III

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50
Q

Which of the following findings maybe consistent with an overdose of or accidental exposure to an organophosphate

A

Emesis

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51
Q

Which of the following effects can be attributed to atropine?

A

Blockade of vagal slowing of heart

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52
Q

In comparison to other antimuscarinic agents, Scopolamine is expected to exert significant CNS effects due to:

A

3” amine

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53
Q

Ipratropium, Oxytropium, and Tiotropium and antimuscarinic agents that are most useful as

A

Relaxant of bronchial muscles

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54
Q

Oxynutinin, Dicyclomine, and Glycopyrrolate are clinically useful for which of the following conditions?

A

GIT hypermotility and urinary incontinence

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55
Q

In most patients admitted to atropine overdose, most poison control experts recommend which of the following measures as primary management?
I. Temperature control with cooling blankets
II. Physostigmine as initial therapy
III. Diazepam for seizure control

A

I and III

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56
Q

Poisoning resulting from ingestion of high dose quarternary antimuscarinic agents can be best managed with which of the following agents?

A

Neostigmine

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57
Q

Which of the following is/are important contraindication to the use of antimuscarinic agents or drugs with atropine-like properties?
I. History of prostatic hyperplasia
II. Glaucoma
III. Hypertension

A

I and III

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58
Q

Trimethaphan is expected to produce which of the following effects?

A

Hypotension

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59
Q

What is the mechanism of skeletal muscle paralysis produced by Succinylcholine?

A

Sustained depolarization of the motor end plate making it unresponsive to other impulses upon repolarization cannot easily depolarized

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60
Q

Which of the following findings is consistent with the skeletal muscle relaxant effect of Pancuronium and Rocuronium?

A

Antagonized by neostigmine

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61
Q

Which of the following inhilational anesthetics produces greatest augmentation of the effect of neuromuscular blockers?

A

Isoflurane

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62
Q

Anaphylactoid reaction may be seen as a side effect with which of the following neuromuscular blockers?

A

Tubocurarine

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63
Q

Which of the following statements correctly describes the side effects of succinylcholine?
I. Negative chonotropic and inotropic effects which can be attenuated by atropine
II. Increase risk of emesis among diabetics and obese patients
III. Hyperkalemia when given to burn or trauma patients or patients with close head injury

A

I, II, III

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64
Q

Which of the following mechanism may explain the ability of beta-blockers to reduce blood pressure in hypertension?

A

Inhibit renin release

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65
Q

Which of the following equations describe the factors that contribute to blood pressure?

A

BP = CO X TPR

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66
Q

Which of the following mechanism explains the blood pressure-lowering effect of thiazide diuretics?
I. Reduction in blood volume and cardiac output
II. Increased vascular compliance
III. Decreased proximal tubular reabsorption of water and sodium

A

I and II

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67
Q

Which of the following drugs inhibit enzyme carbonic anhydrase?

A

Dichlorphenamide

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68
Q

Which side effect of chlorthalidone is prominent especially among the elderly when Chlorthalidone is given at a dose of at leats 50mg/day and significantly reduced when doses are maintained below 50mg/day?

A

Hyponatremia

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69
Q

Why combine amiloride and HCTZ

A

Minimize hypokalemia due to HCTZ

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70
Q

The action of the drug Eplerenone most closely resembles which of the following agents?

A

Spironolactone

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71
Q

Which of the following agents exhibits pharmacodynamic interaction with the thiazide diuretics leading to a reduced diuretic effect?

A

Enalapril

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72
Q

Which of the following mechanism explain the effects of the drug Torsemide and Bumetanide?

A

Inhibition of NaKCl2

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73
Q

ID of Spironolactone
I. Adjunct in mngmt of CHF
II. Cohns Syndrome
III.Nephrogenic Diabtes Insidipus

A

I and II

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74
Q

Which of the following is/are accepted indication/s for the drug Furosemide?
I. Infusion-diuresis in hypercalcemia
II. Oliguric acute renal failure
III. Acute pulmonary edema

A

I, II, III

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75
Q

Which of the following agents is primarily indicated for the management of increased intracranial pressure

A

Mannitol

76
Q

Which of the following agents is most useful for the management of nephrolithiasis due to idiopathic hypercalciuria?

A

HCTZ

77
Q

Which of the following statements correctly describes the characteristics of Indapamide as a drug for hypertension?
I. Its diuretic effect is self-limiting, and may not account for its hypertensive effect after about 2-4 weeks of therapy
II. Long-term use leads to improved blood vessel compliance
III. Has modest vasodilating property

A

I, II, III

78
Q

Which of the following agents maybe associated with ototoxicity which may have increased risk of occuring when patient also recieve aminoglycoside antibiotic?

A

Furosemide

79
Q

MOA of methyldopa

A

Molecule converted to a-methyldopamine and a-norephineprine which stimulate a2 receptors

80
Q

Most frequent use of methyldopa

A

Sedation

81
Q

A 45 years old female in clonidine 1.0mg/day for thee last ffour weeks was brought to the hospital for 1 day history of nervousness, tachycardia and abrupt increase in her blood pressure to 180/130mmHg. Her last intake of clonidine was last 2 days prior to admission. Which of the following is/are appropriate interventions that you can suggest for the patient?
I. Start propanolol 50mg BID
II. Re institue clonidine 1mg/day
III. Start labetalol 200mg/d

A

II and III

82
Q

Which of the following side effects is/ are common to the three drugs: Hydralazine, Diazoxide, and Minoxidil?

A

Reflex tachycardia

83
Q

In which subset of patients should Hydralazine be avoided or used with caution?

A

Px with ischemic heart disease

84
Q

Which of the following drugs if combined with Minoxidil may minimize latter drug’s side effect?

A

Metoprolol + chlortalidone

85
Q

In the management of Pparoxysmal hypertension in pheochromocytoma, which of the following drugs is the
most appropriate initial therapy?

A

Phentolamine

86
Q

Orthostatic hypotension and syncope are manifestations of a phenomenon associated with the first dose of which agent?

A

Doxazosin

87
Q

Constipation, Urinary retention, tachycardia, mydriasis and anhidrosis are expected effects based on the mechanism of action of which of the following drugs?

A

Trimetaphan

88
Q

Which of the following drugs may be used safely for the control of hypertension in pregnant patients with pre-eclampsia?
I. Magnesium Sulfate
II. Methyldopa
III. Hydralazine

A

II and III

89
Q

Which of the following mechanisms explains the action of the drug Sodium Nitropusside?

A

Activation of guanyl cyclase increase cgmp

90
Q

CWhich of the following agents is pure anteriolar vasodilator?

A

Diaxozide

91
Q

Which of the following agents can be used for hypertensive emergencies
I. Enalapril
II. Diazoxide
III. Sodium nitropusside

A

I, II, III

92
Q

The decrease in arterial tone due to vasorelaxant action of sodium nitropusside is associated with

A

Increase cgmp

93
Q

Whgich of the following effects can be attributed to Angiotensin II?
I. Stimulate release of Nitric Oxide
II. Stimulate synthesis and release of Aldosterone
III. Stimulate release of NE

A

II and III

94
Q

Advantage of ARB with ACEi

A

No dry cough

95
Q

Which of the following ACE-Inhibitors require hydrolysis to the active metabolite/s in the body to produce effects?
I. Enalapril
II. Ramipril
III. Perindropil

A

I, II, III

96
Q

In which of the following conditions are ACE-inhibitors found to be clinically useful as first-line treatment?
I. Angina pectoris
II. CHF
III. Diabetic nephropathy

A

II and III

97
Q

The efficacy of ACE-inhibitors in the management of hypertension may be reduced in the presence of certain drugs such as ___________?

A

Ibuprofen

98
Q

In which subset of patients which are ACE-inhibitors avoided as treatment option?
I. Px with bilateral renal artery stenosis
II. Px with hyperkalemia
III. Pregnant in 2nd and 3rd trimester

A

I, II, III

99
Q

Which of the following calcium channel blockers has greater activity on calcium channels in myocardial tissues than calcium channels in the vascular smooth muscles?

A

Verapamil

100
Q

What is the mechanism of action of the diydropyridine calcium channel blockers?

A

Inhibit the L-type calcium channels in the arteriolar smooth muscles

101
Q

In the long-term management of hypertensiion, which of the following agents is/are considered as appropriate maintenance therapy?
I. Regular Nifedipine capsules
II. Enalapril tablets
III. Indapamide tablets

A

II and III

102
Q

What is the most common side effect of Enalapril?

A

Coughs

103
Q

Which of the following anti-hypertensive agents is the most appropriate for elderly male patients with benign prostatic hyperplasia?

A

Prazosin

104
Q

Which of the following anti-hypertensive agents may be more appropriate to use for diabetic patients with evidence of renal disease?

A

enalapril

105
Q

Chinese patients are most likely to be more sensitive to effects of which of the following drugs for hypertension that lower doses may have to be used?

A

metropolol

106
Q

In the management of hypertensive emergencies, which of the following goals or interventions is/are correct?
I. Rapid normalization of the blood pressure within 24 hours
II. Lowering of the mean arterial pressure by about 25%
III. Initiation of oral hypertensives early as soon adequate blood pressure lowering has been achieved

A

II and III

107
Q

Which of the following are important considerations regarding the proper handling of Nitroglycerin tablets
I. Formulations used in the medicine are explosive
II. Sublingual tablets lose their potency when stored in plastic containers
III. These are sensitive to light

A

II

108
Q

Which of the availabe nitrovasodilators has a bioavailabilty of about 100%?

A

ISMN

109
Q

Which of the following statements most closely describes the primary mechanism of action of the nitrovasodilator?

A

Denitrification by glutathione S-transferase leads to release of nitrite ion which is then converted to nitric oxide, a molecule that activates guanylyl cyclase leading to increase cGMP

110
Q

Which of the following tissues exhibit the greatest sensitivity to nitrovasodilators at the lowest effective doses?

A

Veins

111
Q

Which of the following statements correctly explains the primary mechanism of relief of angina pectoris with the use of nitrovasodilators when given at usual doses?

A

Peripheral dilation of the veins leading to reduction in cardiac preload and myocardial oxygen demand

112
Q

Which of the following agents classified as nitrovasodilators is useful in the management of cyanide poisoning?

A

amyl nitrite

113
Q

This side effect of nitrovasodilators is explained in part by the depletion of sulfhydryl moieties in vascular
smooth muscles with continuous use of the drugs, and may be partly reversed bysulfhydryl-regenerating
compunds.

A

tolerance

114
Q

Which of the following agents is/are considered useful as single agent in the acute treatment of vasospastic angina pectoris?
I. Nitrovasodilators
II. Beta-blockers
III. Calcium channel blockers

A

I and II

115
Q

What is the primary limitation with the use of Dihydropyridine CCB management of angina pectoris?

A

reflex tahcycardia

116
Q

What is the most important role of beta-blockers in the management of angina pectoris

A

reduce myocardial oxygen demand by reducing perfusion time making it useful for chronic stable angina

117
Q

Which of the following drugs or drug combination is/are useful in the management of chronic stable angina pectoris?
I. Regular release Nifedipine capsule
II. Metoprolol tablet
III. Metoprolol tablet + Diltiazem tablet

A

II

118
Q

What is the principal mechanism of action of cardiac Glycosides?

A

Inhibit NaKATPase

119
Q

What is the principal mechanism of action of cardiac Glycosides?

A

In about 10% of patients, use of antibiotics can lead to increased oral bioavailability

120
Q

Which of the following is/are mechanical effects of digoxin on myocardial tissues
I. Increase in contractility of myocardial tissues
II. Increase in conduction velocity in the AV node
III. A positive inotropic effect

A

I and III

121
Q

Which of the following is/are expected electrical effect/s of digoxin on myocardial tissues?
I. Decrease in the refractory period of atrial muscles
II. Increase in the refractory period of the AV node
III. A positive inotropic effect

A

I, II, III

122
Q

Which of the following condition may augment the effect of digitalis glycosides in myoccardial tissues?
I. Concurrent use of captopril
II. Reduced oxygenation of myocardial tissues
III. Concurrent administration of calcium gluconate

A

II and III

123
Q

Which of the following is/are the primary indication/s of Digitalis Glycosides?
I. First line drug for the initial management of CHF
II. Useful in controlling the rate of ventricular response in atrial fibrillation
III. Useful in pregnant patients with CHF

A

II and III

124
Q

What is the major mechanism of interaction between Digoxin and Quinidine?

A

Decrease renal clearance of digoxin

125
Q

A 50 years old male patient with CHF was started on the following medications: digoxin 0.25 mg OD,
Hydralazine 10mg BID, furosemide 20mg OD, and ISMN 60mg OD. 1 week after initiating therapy, the
patient was admitted for blurring of vision and palpitation. He feels nauseated and has problems
discriminating colors. Which of the following sourses of action is appropriate?

A

DC digoxin and furo and check serum K level

126
Q

Which of the following intervention may be appropriate in the management of severe cases of digitalis intoxication such as in children and in suicidal overdose?
I. Administration of digoxin immune fab
II. Aadministration of KCl
III. Administration of MgSO4

A

I

127
Q

What is considdered as the toxic plasma concentration of digoxin?

A

> 2ng/mL

128
Q

What is the primary use of drugs like Inamirone and Milrinone?
I. Alternative to digoxin in patients with chronic CHF
II. Management for acute heart failure
III. Management of exacerbation of chronic CHF

A

II and III

129
Q

What is the mechanism of action of Inamrinone and Milrinone in the management of heart failure?

A

increase level of cAMP by inhibiting PDE III

130
Q

Inotropic activity oh the heart in CHF can be increased by which of the following agents?
I. Bipyridines
II. ACE inhibitors
III. Beta-1 agonists

A

I and III

131
Q

Which of the following agents for the heart failure may be associated with arrythmia, thrombocytopenia,
and hepatotoxicity which limit their use in patients with chronic CHF?

A

bypridine

132
Q

Which of the following statements correctly describe/s the appropriate use of drugs for CHF
I. Beta-blockers when used for patients with stable CHF can be given at doses similar to the dose used for hypertension
II. ACE inhibitor dose must be carefully titrated to the maximum allowable or tolerable dose
III. Spironolactone has been found to be most useful as initial drug therapy for CHF even prior to the use of ACE inhibitors or casodilators

A

II

133
Q

Which of the following drugs or drug combinations can reduce both the cardiac preload and afterload in CHF?
I. Hydralazine + Nitrovasodilators
II. Beta-blockers + Loop diuretics
III. Loop diuretics + Digitalis

A

I

134
Q

Which of the following drugs or drug combinations can reduce both the cardiac preload and afterload in CHF?
I. Hydralazine + Nitrovasodilators
II. Beta-blockers + Loop diuretics
III. Loop diuretics + Digitalis

A

II

135
Q

Which of the following drugs is a sodium channel blockers that can prolong the duration of the action potential and dissociates from the channel with intermediate kinetics?

A

Quinidine

136
Q

Which of the following drugs is a sodium channel blockers which has no significant effect on the duration of the action potential and dissociate from the channel with slow kinetics?

A

Flecainide

137
Q

Which of the following beta-blockers have been found to be most useful as anti-arrythmic agent/s?
I. Esmolol
II. Metoprolol
III. Propanolol

A

I and III

138
Q

Which of the following anti-arrythmic agents has been associated with lupus-like side effects?

A

Procainamide

139
Q

What is the drug of choice for the management of sustained ventricular arrythmia associated with acute myocardial infarction?

A

Lidocaine

140
Q

What is the preferred drug for the management of ACUTE episodes of supraventricular tachycardia?

A

Adenosine

141
Q

What is the preferred drug for the management of CHRONIC paroxysmal supreventricular tachycardia?

A

Verapamil

142
Q

What is the primary mechnism of action of the drug Amiodarone?

A

prolong action potential by blocking K channel

143
Q

What side effect/s may be expected with the use of Amiodarone?
I. Hypothyroidism or Htperthyroidism
II. Fatal pulmonary fibrosis
III. Symptomatic bradycardia and heart block particularly in patients with atrioventricular nodal
disease

A

I, II, III

144
Q

Measurement of the serum ALT prior to and during therapy of arrythmia is indicated when which of the following drugs for arrythmia is/are used?

A

amiodarone

145
Q

Which of the following calcium channel blockers is most useful in arrythmia therapy?

A

Verapamil

146
Q

Which of the following effects can be attributed to histamine binding to its H1 receptor?
I. Extravascular smooth muscle contraction
II. Vascular smooth muscle contraction
III. Gastric acid secretion

A

I

147
Q

The triple response of Lewis following intradermal injection of Histamine includes which of the following?
I. Sensory nerve ending stimulation producing flare
II. Erythema caused by contraction of vascular smooth muscles
III. Endothelian cell contraction leading to exudation of fluids

A

I and III

148
Q

Which of the following effects may be expected as a direct consequence of blockade of the H1 receptots
I. Sedation
II. Resolution of initial allergic response
III. Anti-nausea and Anti-emetic effect (anti-motion sickness)

A

II

149
Q

Dimenhydrinate and Diphenhydramine are H1 antihistamines that belong to what chemical class of agents?

A

ethanolamine

150
Q

Which of the following agents is used primarily for its sedating property as the active ingredient of an OTC sleeping aid called Unisom?

A

Doxylamine

151
Q

What class of H1-antihistamines include drugs that sre used as components of OTC “cold” medications

A

alkylamines

152
Q

What is the active metabolite of hydroxyzine which is also available as an H1-antihistamine without
significant sedating side-effect?

A

cetirizine

153
Q

Which of the following H1 anti-histamine chemical groups possess significant atropine-like effect?

A

ethanolamine

154
Q

Which of the following H1-antihistamines has significant blocking effects on 5-HT receptors?

A

cryoheptadine

155
Q

Which of the following H1-antihistamines has significant anti-cholinergic effect to be useful for the
management of dytonia and pseudoparkinsonism associated with the use of neuroleptic agents?

A

diphenhydramine

156
Q

Which of the following H1-antihistamines can block sodium channels in excitable membranes bringing
about local anesthetic effect?

A

diphenhydramine

157
Q

What is the primary mechanism of action of the drug Ondansetron and Granisetron?

A

antagonist at 5HT3 receptor

158
Q

What is the clinical use of the drugs Ondansetron and Granisetron?

A

anti emetic

159
Q

What is the clinical use of the drugs Ondansetron and Granisetron?

A

Tx of acute migraine attack

160
Q

Sumatriptan is contrindicated in which subset of patients?

A

Px with acute ischemic heart disease

161
Q

Which of the following statements is/are correct regarding Arachidonic acid?
I. It is 20-carbon known as eicosapentaenoic acid
II. It is mobilized from phospholipids by the enzyme phospholipase A2
III. It is released from phospholipids by the action of the enzymes phopholipase C and Diglyceride
lipase

A

II and III

162
Q

Which of the following eicosanoids is a product of the metabolism of Arachidonic acid by the
cyclooxygenase enzyme?

A

PG

163
Q

Which of the following correctly differentiate/s COX-1 from COX-2 isozymes?
I. COX-1 is widely distributed and constitutively expressed
II. COX-1 is expressed upon stimulation by sytokines and growth factors
III. COX-2 is expressed by inflammatory and immune cells

A

I and III

164
Q

Epoprostenol, a drug that is being used in the management of primary pulmonary hypertension is an analogue of which eicosanoid?

A

PGI2

165
Q

Which of the following eicosanoids has an analogue that is primary indicated as cytoprotectant in peptic
ulcer disease?

A

PGE1

166
Q

Which of the following effects is caused by Prostacylin?

A

Vasodilation of blood vessel

167
Q

What is the primary indication of the prostaglandin analogue Latanoprost?

A

Mngmt of glaucoma

168
Q

Which of the following statement correctly describes the effects of glucocorticosteroids in eicosanoid
synthesis?
I. Dexamethasone inhibits the expression of the COX-2 gene
II. Glucocorticosteroids inhibit the synthesis of annexins leading to decreased activity of
Phospholipase C
III. Glucocorticosteroid

A

I and III

169
Q

Which of the following drugs classified as NSAIDs inhibit/s the COX-1 more than the COX-2 isozymes?

A

Indomethacin

170
Q

Which of the following drugs classified as NSAIDs inhibit/s the COX-2 morre than the COX-1 isozymes?

A

Celecoxib

171
Q

Which of the following statement/s is correctly describe/s the pharmacokinetics of Aspirin?
I. Aspirin can be absorbed in the stomach and the small intestines in the hydrolyzed form
II. Elimination of aspirin can be best descrined as following a Michaelis-Menten kinetics
III. Acidification of the urine facilitates renal elimination of Salicylates

A

II

172
Q

Which of the following mechanisms may play a role of anti-inflammatory effect of Aspirin?
I. Decreased synthesis of prostaglandins
II. Inhibition of neutrophil migration and adherence
III. Stabilize iysosomes of neutrophils

A

I, II, III

173
Q

At what usual adult dose of aspirin is its anti-inflammatory effect observed?

A

3.2 - 4g/day

174
Q

What is the principal mechanism which can explain anti-pyretic effect of Aspirin?

A

CNS inhibition response to interleukin-1

175
Q

Which of the following statements is/are correct regarding the anti-platelet aggregation effect of Aspirin?
I. Discontinuation of Aspirin immediatel rrestores platelet aggregation in matter of 1-2 days
II. The mechanism involves irreversible actylation of the cyclooxygenase enzyme in platelets
III. The effect is clinically significant in all dose ranges for Aspirin

A

II

176
Q

Which of the following statements must be considered with regard to the effect of Aspirin and other NSAIDs on the gastric mucosa?
I. The risk of GI intolerance can be reduced if Aspirin or any other NSAIDs is taken with meals
II. With Aspirin, the risk of erosive gastritis is obsereved only when Aspirin is given at doses >0.325g/day
III. Gastric irritation is most prominent among NSAIDs that inhibit COX-1 more than COX-2

A

I and III

177
Q

Which of the following drug is currently considered as the preferred drug to prevent erosive gastritis in
patient at risk of developing this side effect when NSAIDs have to be given to the patient?

A

Omeprazole

178
Q

In salicylate poisoning, serum salicylate levels of 50-80mg/dL can present with which of the followingclinical findings?
I. Hyperthermia
II. Respiratory alkalosis
III. Tinnitus and Vertigo

A

II and III

179
Q

A number of the NSAIDs cannot be given to patients with Gouty Arthritis as these may precipitate an acute attack of gout or induce uric acid stone formation. Which of the following NSAIDs should not be given to patient with gout?

A

Tolmetin

180
Q

Which of the following NSAIDs with minimal anti-inflammatory activity is/are primarily indicated as analgesic especially in the management of post-operative pain?
I. Diclofenac
II. Ketorolac
III. Etodolac

A

II and III

181
Q

All the know NSAIDs are weak acids. Which of the following drugs is the only exception?

A

Nabumetone

182
Q

Which of the following statement/s is/are correct regarding Mefenamic Acid, a popular NSAID?
I. It is more toxic than Aspirin
II. The drug should not be used for more than 1 week
III. It should not be given to children

A

I, II, III

183
Q

What is the most important toxicity associated with pyrazolone derivatives like Phenylbutazone which necessitated the withdrawal of a number of these drugs from the market?

A

hematologic toxicities

184
Q

Which of the following NSAIDs is most useful as an analgesic and has been used successfully to replace morphine in some situation involving mild to moderate post surgical pain? When used with an opioid, it may decrease the opioid requirement by as much as 25-50%.

A

Ketorolac

185
Q

What is the primary advantage of drugs like Celecoxib and etericoxib?

A

less ulceration

186
Q

A number of drugs classified as specific COX-2 inhibitors like Rofecoxib (Vioxx) have been withdrawn from the market or are marketed with “black box” warning. What is the primary reason for such actions to be taken against these drugs?

A

Increase risk of thrombosis and cardiac death

187
Q

Which of the following statement/s is/are correct regarding the drug Methotrexate when used for rheumatoid arthritis?
I. The primary mechanism of action involves inhibition of AICAR (aminomidazolecarboxamide) transformylase and thymydylate synthase
II. Toxicity of the drug may be minimized with the use of Leucovorin
III. The drug is contraindicated in pregnancy

A

I, II, III

PCol (1 decks)

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