PAPER 1

1) Allopurinol in chronic gout.

2) Nitrates in angina pectoris.
3) N-acetyl cysteine in paracetamol poisoning.
4) Carbonic anhydrase inhibitor in open angle glaucoma.
5) Adrenaline along with local anesthetics.
6) Varenicline in smoking cessation.
7) Glycopyrrolate as preanesthetic medication.
8) Olanzapine in Psychosis.
9) Edrophonium in myasthenia gravis.
10) Levodopa carbidopa combination in Parkinsonism.
11) Mannitol in cerebral edema.
12) Fluoxetine in depression.
13) Hydrochlorothiazide in hypertension.
14) Adrenaline in anaphylactic shock.
15) Aspirin in prevention of myocardial infraction.
16) Morphine in Myocardial Infection.
17) Isoxuprine in threatened abortion.
18) Prostaglandins in peptic ulcers.
19) Tamsulosin in benign prostatic hypertrophy.
20) Hypertonic Mannitol in glaucoma.
21) Levocetirizine in allergic disorders.
22) Glycopyrrolate in preanesthetic medication.
23) Valproic acid in generalized tonic clonic seizures.
24) Pharmacological basis for the use of furosemide in congestive
cardiac failure.
25) Pharmacological basis for use of ACE inhibitors in
hypertension.
26) Pharmacological basis for use of steroids in bronchial asthma.
27) Pharmacological basis for the use of amantadine in
Parkinson’s disease.
28) Pharmacological basis for the use of streptokinase in
myocardial infarction.
29) Pharmacological basis for the use of dimercaprol in mercury
poisoning.
30) Half-life of drugs.
31) Pharmacological basis for the use of paracetamol in fever.
32) Pharmacological basis for the use of morphine in left
ventricular failure.
33) Pharmacological basis for the use of sumatriptan in migraine.
34) Pharmacological basis for the use of nitrates in angina.
35) Pharmacological basis for the use of dopamine in cardiogenic
shock.
36) Pharmacological basis for the use of terlipressin in acute
bleeding esophageal varices.
37) Pharmacological basis for the use of calcium disodium edetate
in lead poisoning.
38) Pharmacological basis for the use of amended in
Parkinsonism’s disease.
39) Pharmacological basis for use of beta blocker in heart failure.
40) Anticholinergic drug usage in neurodegenerative diseases.
41) Pharmacological basis for use of oral anticoagulants in
preventing deep vein thrombosis.
42) Clinical uses of prostaglandin analogues.
43) Advantages and disadvantages of fixed dose combination of
drugs.
44) Disease modifying drugs in rheumatoid arthritis.
45) Zero order elimination kinetics.
46) Oral iron chelating agent.
47) Pharmacological basis for the use of aminophylline in
bronchial asthma.
48) Pharmacological basis for the use of benzhexol in drug
induced parkinsonism.
49) Pharmacological basis for the use of pralidoxime in
organophosphorus poisoning.
50) Pharmacological basis for the use of adenosine in treatment of
paroxysmal supraventricular tachycardia.
51) Pharmacological basis for the use of dobutamine in
cardiogenic shock.
52) Pharmacological basis for the use of N- acetylcysteine in
acute paracetamol toxicity in children.
53) Pharmacological basis for the use of edrophonium in
diagnosing myasthenia gravis.
54) Pharmacological basis for the use of disulphiram in chronic
Alcoholism.
55) Pharmacological basis for the use of pilocarpine in glaucoma.
56) Pharmacological basis for the use of short acting hypnotics in
elderly.
57) Pharmacological basis for the use of premedication before
anaesthesia.
58) Pharmacological basis for the use of calcium disodium edetate
in lead poisoning.
59) Pharmacological basis for the use of adrenaline in
anaphylactic shock.
60) Pharmacological basis for the use of potassium in toxicity due
to digoxin.
61) Pharmacological basis for the use of ethanol in methyl alcohol
poisoning.
62) Pharmacological basis for the use of dopamine in cardiogenic
shock.
63) Pharmacological basis for the use of levodopa and carbidopa
in parkinsonism.
64) Pharmacological basis for the use of aspirin and clopidogrel in
ischemic heart disease.
65) Pharmacological basis for the use of ipratropium bromide in
COPD patients.
66) Pharmacological basis for the use of furosemide and
spironolactone in patients with ascites and edema.
67) Pharmacological basis for the use of pilocarpine in acute
congestive glaucoma.
68) Pharmacological basis for the use of tamsulosin in benign
hypertrophy of prostate.
69) Pharmacological basis for the use of zolpidem in sleep onset
insomnia.
70) Pharmacological basis for the use of nitrates and calcium
channel blockers in angina patients.
71) Pharmacological basis for the use of alfa receptor blockers in
benign prostatic hyperplasia.
72) Pharmacological basis for the use of thiopentone sodium in
induction of anaesthesia.
73) Pharmacological basis for the combined use of levodopa and
carbidopa in Parkinsonism.
74) Pharmacological basis for the use of sildenafil in erectile
dysfunction.
75) Pharmacological basis for the use of adenosine in paroxysmal
supra ventricular tachycardia.
76) Pharmacological basis for the use of Morphine in acute left
ventricular failure.
77) Pharmacological basis for the use of fluticasone and
salmeterol in asthma.
78) Pharmacological basis for the use of Brimonidine in
glaucoma.
79) Why Phenylephrine and not atropine used for fundoscopic
examination?
80) What is Pharmacological basis for use of Digoxin in atrial
fibrillation?
81) Why Phenytoin sodium to be avoid in young girls having
grand mal epilepsy?
82) Why Levodopa not effective in drug induced Parkinsonism?
83) What is the basis of use of Propranolol in thyrotoxicosis?
84) Why Cromolyn sodium is not effective in acute attack of
bronchial asthma?
85) Write two advantages of Angiotensin receptor blockers over
ACE inhibitors.
86) Define partial agonist. Give 1 example.
87) Give reasons Pyridostigmine is preferred to Neostigmine for
myasthenia gravis.
88) Mention merits of combining adrenaline with local anaesthetic
agents.
89) Justify: Ipratropium bromide is not used as a single agent for
acute attack of asthma.
90) Enlist therapeutic uses of ACE inhibitors.
91) Enlist therapeutic basis for the use of fomepizole in methanol
poisoning.
92) Justify Thiopentone sodium is an ultra-short acting
barbiturate.
93) Explain pharmacological basis for the use of atorvastatin in
hypercholesterolaemia.
94) Give two examples of a) Inhaled steroids b) Mucolytic agents.
95) Why aluminium containing antacids are combined with
magnesium containing antacids?
96) Give rationale for uses of flavoxate in cystitis.
97) What are the advantages of neurolept analgesia?
98) Why leukotriene modifiers are not preferred as rescue drugs in
acute attack of asthma?
99) What is the rationale for use of nicotine transdermal patches in
chronic smokers?
100) Explain is the pharmacological basis for use furosemide for
pulmonary edema. What is the dose and route of
administration?
101) Why salt depletion should be watched for and prevented in
patients taking lithium carbonate?
102) Name an antihypertensive of choice in pregnancy. State the
reasons for the same.
103) Why timolol but not propranolol is used in glaucoma?
104) Why certain drug shows first dose response (exaggerated
response to first dose)?
105) Explain how clonidine controls diarrhoea and tenesmus of
diabetic GIT autonomic neuropathy?
106) How thiopentone sodium in IV bolus dose acts as ultra short
acting general anaesthetic?
107) Give reasons: Thiopental is preferred over phenobarbital for
induction of G.A.
108) Explain why sodium nitroprusside is contraindicated in
patients with renal impairment?
109) State the main uses of dicyclomine and propantheline.
110) Why ethyl alcohol is useful in the treatment of methyl alcohol
poisoning?
111) Give any two examples in which the drug act through its
physical property with explanation.
112) Define cumulative toxicity. Give two examples.
113) Write the basis of edrophonium test in myasthenia Gravis.
114) Write two drugs used in acute gout with different mechanism
of action.
115) Define disulfiram like reaction with alcohol.
116) Write difference between nifedipine and Amlodipine.
117) Write prostaglandin analogue used in glaucoma.
118) Write drugs used in acute asthma.
119) Enumerate mydriatics and their two uses.
120) Write pharmacological basis of using ethyl alcohol in methyl
alcohol poisoning.
121) Tachyphylaxis.
122) Write four therapeutic uses of anticholinesterases.
123) Enumerate two morphine antagonist and their uses.
124) Drugs used in paroxysmal supraventricular tachycardia.
125) Define agonist. Enumerate two therapeutically useful agonists
on cholinergic receptors.
126) Name two drugs each obtained from plant and animal sources
respectively and one therapeutic use of each drug.
127) Two advantages and two disadvantages of intramuscular route
of drug administration.
128) Enumerate the disadvantages of fixed dose drug combination.
129) Therapeutic uses of anticholinergic agents.
130) Drugs used in paracetamol poisoning.
131) Uricosuric drugs.
132) Non benzodiazepines hypnotic.
133) Safety margin of drugs.
134) Therapeutic status of lithium in maniac depressive psychosis.
135) Give two examples of pharmacokinetic type of drug
interactions.
136) Give two examples of enzyme inducers.
137) Why should morphine be avoided in patients head injury?
138) Why adrenaline is used with local anaesthetic?
139) Give two indications of therapeutic drug monitoring.
140) Mention two advantages of benzodiazepines over barbiturates
as hypnotic.
141) Why biliary colic is treated with atropine morphine
combination?
142) Why ACE inhibitors should not be combined with potassium
sparing diuretics?
143) Disulfiram in alcohol de addiction.
144) Aspirin as anti-platelets agent.
145) Adrenaline and lignocaine combination for local anaesthetic.
146) Nitro-glycerine in acute attack of angina.
147) What is basis for use of physostigmine in atropine poisoning
and not neostigmine?
148) Nitro-glycerine in acute attack of angina.
149) What is basis for use of physostigmine in atropine poisoning
and not neostigmine?
150) Define anti tussive. Give indication of their use.
151) Give two examples of skeletal muscle relaxants. Give two
indications of their use.
152) Give two uses and 2 adverse effects of potassium sparing
diuretics.
153) What care will you take to prevent digitalis toxicity?
154) Potassium sparing diuretics are weak diuretics. Explain.
155) Write instruction for a patient to whom you are prescribing
sublingual nitro-glycerine.
156) Give two examples of fixed dose combinations that you
consider rational.
157) Write one preferred drug-regimen for eradication of H. Pylori
158) mention one regime for treating H. pylori infection.
159) What are the limitations in using neostigmine for treatment of
myasthenia gravis?
160) How will you manage apnoea caused by succinyl choline?
Give reason.
161) What is toxic effect of paracetamol overdose? How will you
treat it?
162) Write instructions for a patient to whom you’re prescribing
xylometazoline nasal drops.
163) What is Time synergism? Give one example.
164) What is Reye's syndrome? What care will you take to prevent
it?
165) What are the Limitations for use of ACE inhibitors in
hypertension?
166) Atropine is combined with neostigmine for reversal of curare
effect post operatively. Explain Why?
167) Dobutamine is preferred over nor-adrenaline in shock,
Explain.
168) What is pro-drug? Explain its advantage by giving one
example.
169) Write instructions for a patient to whom you are prescribing
nitro-glycerine tablets.
170) What is Zero order kinetics? Give examples.
171) Mucolytics.
172) Naloxone is preferred over nalorphine in acute morphine
poisoning Explain.
173) Drug treatment of pheochromocytoma
174) Define pharmacopoeia.
175) Succinylcholine Apnoea and its management.
176) Role of acetazolamide in glaucoma. Explain.
177) In what various ways salbutamol can be administered for
cause bronchial asthma?
178) Why beta-receptor blocker is used along with alpha-blocker in
treatment of Pheochromocytoma.
179) How of colchicine bring benefit in gouty arthritis?
180) Point out a few peculiarities of edrophonium.
181) Point out a few peculiarities of trimethaphan.
182) Mention the effect and appropriate use of bromhexine.
183) Mention two advantages of Doxycycline over Tetracycline.
184) What is difference between hyper-reactivity and
hypersensitivity? Explain giving examples.
185) Why patient is advised to spit out nitro-glycerine tablet after
relief from acute anginal pain? What is the consequence if
patient swallows that tablet?
186) Give two reasons for combining potassium sparing diuretics
with thiazide diuretics.
187) Atropine is combined with neostigmine while treating
myasthenia gravis. What is role of atropine here.
188) Name two topical nasal decongestants. Write adverse effects
of these preparations.
189) Out of dextromethorphan and codeine what will you prefer as
an antitussive drug? Justify.
190) What is the therapeutic index. Is it possible that a drug can
have two therapeutic indices. Give example.
191) Physicians should not increase dose of phenytoin sodium
rapidly while treating grand mall epilepsy. Why?
192) What is natural tolerance? Explain giving example.
193) What is Monday morning sickness?
194) Explain why Selegiline is used in Parkinson’s disease?
195) Explain why some drugs enhance the metabolism of other
drugs?
196) What do you mean by doctor induced disease? Explain giving
example.
197) Sudden withdrawal of propranolol causes rebound
hypertension, why?
198) Thiazides is used in patient with renal stone, why?
199) Explain why aspirin is advised in thrombo-embolic
cardiovascular conditions?
200) Why Spironolactone is combined with furosemide?
201) Why corticosteroids should not be abruptly withdrawn?
202) How will you prevent Nitrate tolerance in chronic angina?
203) Why Ethanol is used in acute Methanol poisoning?
204) Why tamsulosin is preferred in Benign prostatic hypertrophy?
205) How Allopurinol is effective in chronic gout?
206) Why Atenolol offers better quality of life than Propranolol in
hypertension?
207) Why Levodopa is not effective in drug induced Parkinsonism?
208) Loop diuretics are also called "High ceiling diuretics”
209) 5-alpha reductase inhibitors are useful in treatment of benign
hyperplasia of prostate.
210) Pralidoxime is used effective in organophosphate poisoning.
211) Levodopa is not effective in drug induced Parkinsonism.
212) Older anti-histaminic are ineffective in Bronchial asthma.

213) Aspirin should be stopped one week before surgery.

214) Why sodium bicarbonate is used in poisoning of weakly
acidic drugs?
215) Why Propranolol is contraindicated in diabetes mellitus?
216) Nitro-glycerine is given sublingually in acute angina pain.
217) Adrenaline is given in anaphylactic shock.
218) Tamsulosin is used in benign prostatic hyperplasia.
219) Angiotensin Converting Enzyme-Inhibitors cause dry hacking
cough.
220) Methadone is used for maintenance therapy in chronic opiate
dependence.
221) Ethyl alcohol is used in methyl alcohol poisoning.
222) Timolol is used topically in chronic simple glaucoma.
223) Loop diuretics are ineffective in acute lithium overdose.
224) Why Oxytocin and not the ergometrine is used for induction
of labour?
225) Mention two rational fixed dose combinations.
226) Mention two advantages of Fluoxetine over imipramine
227) Why ethanol is used in acute methanol poisoning?
228) How will you prevent nitrate tolerance in angina?
229) Mention two indications if atropine injection.
230) Why isotonic saline and not the dextrose solution is preferred
in management of hypovolemic shock?
231) Why loperamide should not be used in bacterial dysentery?
232) Why pentazocine is contraindicated in acute myocardial
infarction?
233) Why N-acetyl cystine is used in the paracetamol poisoning?
234) Why Lisinopril should not be given to a pregnant woman?
235) Mention the rationale in using low dose aspirin in chronic
prophylaxis of myocardial infarction.
236) What is the rationale behind using misoprostol in peptic ulcer
induced by NSAIDS?
237) Why ergometrine is not suitable for inductions of labour?
238) Name 2 drugs used in Alzheimer’s disease and mention their
mechanism of action.
239) Name 2 drugs used in ventricular arrhythmias.
240) Name an orally effective pure morphine antagonist.
241) Why Lidocaine IV Loading dose is given in three divided
portions?
242) Why should beta-blockers NOT be stopped abruptly by the
patient with angina pectoris?
243) Why nasal decongestants avoided in patients with
hypertension?
244) Why is Dopamine preferred as a vasopressor in cardiogenic
shock?
245) Name an antianxiety drug which does not interact with
Benzodiazepine receptors?
246) Why are statins given at night?
247) Name an antiepileptic drug which causes Neural-Tube defects
if given during pregnancy.
248) Name a non-steroidal anti-inflammatory drug which does not
act by prostaglandin inhibition.
249) What is "Foetal Hydantoin syndrome"?
250) What is rule of right in "Rational Use of Medicine”?
251) Why cardiac stimulant like adrenaline, not used in congestive
cardiac failure.
252) Why aspirin is contraindicated in pregnancy (56 days
onwards)?
253) A 17 years old girl diagnosed as a patient of generalized tonic
clonic seizures. Which anti-seizure drugs you will not prefer
to this girl and why?
254) Why subcutaneous route of adrenaline is not preferred in
anaphylactic shock? which route is preferred?
255) Classify class I anti-arrhythmic drug.
ANSWERS

1) Allopurinol in Chronic Gout:

- Allopurinol inhibits xanthine oxidase, reducing uric acid

production.

- Lowers serum urate levels, preventing urate crystal formation

and inflammation in joints.

2) Nitrates in Angina Pectoris:

- Nitrates convert to nitric oxide, dilating coronary arteries.

- Vasodilation enhances coronary blood flow, reducing anginal

symptoms.

3) N-Acetyl Cysteine in Paracetamol Poisoning:

- N-Acetyl Cysteine replenishes depleted glutathione, enhancing

paracetamol detoxification.

- Mitigates oxidative damage in the liver, preventing toxicity.

4) Carbonic Anhydrase Inhibitor in Open-Angle Glaucoma:

- Inhibits carbonic anhydrase, reducing aqueous humor

production.

- Lowers intraocular pressure, preserving optic nerve function.

5) Adrenaline Along with Local Anesthetics:

- Adrenaline vasoconstriction prolongs local anesthetic action.

- Delays systemic absorption, reducing toxicity and enhancing

anesthetic efficacy.

6) Varenicline in Smoking Cessation:

- Partial agonist at nicotinic receptors, reduces withdrawal

symptoms.

- Attenuates nicotine's rewarding effects, aiding in smoking

cessation.

7) Glycopyrrolate as Preanesthetic Medication:

- Antimuscarinic action decreases salivary and bronchial

secretions.

- Ensures a clear airway and dry surgical field during anesthesia.

8) Olanzapine in Psychosis:

- Atypical antipsychotic blocking dopamine and serotonin

receptors.
 - Alleviates positive and negative symptoms, restoring
neurochemical balance.

9) Edrophonium in Myasthenia Gravis:

- Acetylcholinesterase inhibitor increases acetylcholine at

neuromuscular junctions.

- Improves muscle strength by enhancing neurotransmission.

10) Levodopa Carbidopa Combination in Parkinsonism:

- Levodopa is a precursor to dopamine, Carbidopa prevents

peripheral conversion.

- Augments central dopamine levels, alleviating Parkinson's

symptoms.

11) Mannitol in Cerebral Edema:

- Osmotic diuretic draws water from brain tissue.

- Reduces intracranial pressure by decreasing cerebral edema.

12) Fluoxetine in Depression:

- Selective serotonin reuptake inhibitor (SSRI).

 - Elevates serotonin levels, alleviating depressive symptoms and
improving mood.

13) Hydrochlorothiazide in Hypertension:

- Thiazide diuretic promotes sodium and water excretion.

- Reduces blood volume, lowering blood pressure.

14) Adrenaline in Anaphylactic Shock:

- Alpha and beta-adrenergic agonist.

- Counters vasodilation and bronchoconstriction, mitigating

anaphylaxis.

15) Aspirin in Prevention of Myocardial Infarction:

- Irreversible inhibition of platelet cyclooxygenase.

- Diminishes thromboxane A2, inhibiting platelet aggregation

and preventing clot formation.

16) Morphine in Myocardial Infection:

- Opioid analgesic relieves pain and anxiety.

 - Vasodilation and preload reduction decrease myocardial
oxygen demand.

17) Isoxuprine in Threatened Abortion:

- Beta-2 adrenergic agonist relaxes uterine smooth muscle.

- Suppresses uterine contractions, preventing threatened

abortion.

18) Prostaglandins in Peptic Ulcers:

- Misoprostol, a synthetic prostaglandin E1 analog.

- Maintains gastric mucosal integrity, preventing NSAID-

induced ulcers.

19) Tamsulosin in Benign Prostatic Hypertrophy:

- Alpha-1 receptor antagonist relaxes prostatic smooth muscle.

- Relieves urinary symptoms associated with benign prostatic

hypertrophy.

20) Hypertonic Mannitol in Glaucoma:

- Osmotic agent reduces intraocular pressure.

 - Draws fluid from the eye, relieving glaucomatous pressure.

21) Levocetirizine in Allergic Disorders:

- Second-generation antihistamine.

- Blocks histamine receptors, alleviating allergic symptoms.

22) Glycopyrrolate in Preanesthetic Medication:

- Antimuscarinic agent reduces salivary and respiratory

secretions.

23) Valproic Acid in Generalized Tonic Clonic Seizures:

- Enhances GABAergic transmission, stabilizing neuronal

activity.

- Controls seizures in generalized tonic-clonic epilepsy.

24) Pharmacological Basis for the Use of Furosemide in

Congestive Cardiac Failure:

- Loop diuretic inhibits sodium reabsorption in the loop of

Henle.

- Reduces preload by promoting fluid excretion, relieving

congestive heart failure.
25) Pharmacological Basis for the Use of ACE Inhibitors in
Hypertension:

- Inhibits angiotensin-converting enzyme, decreasing

angiotensin II.

- Vasodilation and sodium excretion lower blood pressure.

26) Pharmacological Basis for the Use of Steroids in Bronchial

Asthma:

- Corticosteroids reduce airway inflammation and

hyperresponsiveness.

- Inhibit the release of inflammatory mediators, suppress immune

response, and enhance beta-2 receptor sensitivity, alleviating
bronchoconstriction in asthma.

27) Pharmacological Basis for the Use of Amantadine in

Parkinson's Disease:

- Amantadine enhances dopamine release and inhibits reuptake.

- Alleviates Parkinsonian symptoms by modulating dopaminergic

transmission and reducing motor dysfunction.
28) Pharmacological Basis for the Use of Streptokinase in
Myocardial Infarction:

- Streptokinase converts plasminogen to plasmin, promoting

fibrinolysis.

- Dissolves thrombi in coronary vessels, restoring blood flow and

minimizing myocardial damage.

29) Pharmacological Basis for the Use of Dimercaprol in Mercury

Poisoning:

- Dimercaprol forms stable complexes with mercury.

- Facilitates mercury excretion, reducing toxicity and preventing

organ damage.

30) Half-life of Drugs:

- Half-life represents the time for drug concentration to decrease

by half.

- Influences dosing intervals and duration of drug action.

31) Pharmacological Basis for the Use of Paracetamol in Fever:

- Paracetamol inhibits prostaglandin synthesis in the

hypothalamus.
 - Reduces fever by resetting the temperature-regulating center.

32) Pharmacological Basis for the Use of Morphine in Left

Ventricular Failure:

- Morphine alleviates symptoms of left ventricular failure.

- Reduces preload and afterload, relieving pulmonary congestion

and enhancing cardiac output.

33) Pharmacological Basis for the Use of Sumatriptan in Migraine:

- Sumatriptan is a serotonin receptor agonist.

- Constricts cranial blood vessels and inhibits trigeminal nerve

activation, relieving migraine.

34) Pharmacological Basis for the Use of Nitrates in Angina:

- Nitrates convert to nitric oxide, promoting vasodilation.

- Dilates coronary arteries, increasing blood flow to relieve

angina.

35) Pharmacological Basis for the Use of Dopamine in Cardiogenic

Shock:
 - Dopamine stimulates dopamine receptors and beta-1 adrenergic
receptors.

- Increases cardiac contractility and heart rate, improving cardiac

output in cardiogenic shock.

36) Pharmacological Basis for the Use of Terlipressin in Acute

Bleeding Esophageal Varices:

- Terlipressin is a vasopressin analogue.

- Induces vasoconstriction, reducing blood flow to varices and

preventing bleeding.

37) Pharmacological Basis for the Use of Calcium Disodium

Edetate in Lead Poisoning:

- Calcium disodium edetate chelates lead ions.

- Facilitates lead excretion, reducing toxicity and preventing

further accumulation.

38) Pharmacological Basis for the Use of Amantadine in

Parkinsonism’s Disease:

- Amantadine enhances dopamine release and inhibits reuptake.

 - Alleviates Parkinsonian symptoms by modulating dopaminergic
transmission and reducing motor dysfunction.

39) Pharmacological Basis for the Use of Beta Blocker in Heart

Failure:

- Beta-blockers reduce sympathetic stimulation.

- Attenuate cardiac remodeling, improve contractility, and

enhance survival in heart failure.

40) Anticholinergic Drug Usage in Neurodegenerative Diseases:

- Anticholinergics mitigate acetylcholine deficiency in

neurodegenerative disorders.

- Alleviate symptoms such as tremors and rigidity in conditions

like Parkinson's disease.

41) Pharmacological Basis for the Use of Oral Anticoagulants in

Preventing Deep Vein Thrombosis:

- Oral anticoagulants (e.g., warfarin) inhibit vitamin K-dependent

clotting factors.

- Prevent thrombus formation, reducing the risk of deep vein

thrombosis.
42) Clinical Uses of Prostaglandin Analogues:

- Prostaglandin analogues (e.g., misoprostol) are used to prevent

NSAID-induced peptic ulcers.

- Maintain gastric mucosal integrity by enhancing mucus

secretion.

43) Advantages and Disadvantages of Fixed Dose Combination of

Drugs:

- Advantages include simplified dosing, improved adherence, and

synergistic effects.

- Disadvantages may involve limited titration and potential for

increased side effects.

44) Disease Modifying Drugs in Rheumatoid Arthritis:

- Disease-modifying antirheumatic drugs (DMARDs) suppress

inflammation and modify the course of rheumatoid arthritis.

- Methotrexate, for example, inhibits immune cell activation,

reducing joint damage.

45) Zero Order Elimination Kinetics:

 - Zero-order kinetics involves a constant rate of drug elimination.

- Independent of drug concentration, requiring careful dosing

adjustments.

46) Oral Iron Chelating Agent:

- Deferoxamine is an oral iron chelator.

- Binds excess iron, facilitating its excretion in conditions like

iron overload.

47) Pharmacological Basis for the Use of Aminophylline in

Bronchial Asthma:

- Aminophylline is a bronchodilator that inhibits

phosphodiesterase.

- Increases intracellular cAMP, relaxing smooth muscles and

improving airflow in asthma.

48) Pharmacological Basis for the Use of Benzhexol in Drug-

Induced Parkinsonism:

- Benzhexol is an anticholinergic.

- Alleviates drug-induced parkinsonism by blocking excess

acetylcholine and restoring balance.
49) Pharmacological Basis for the Use of Pralidoxime in
Organophosphorus Poisoning:

- Pralidoxime reactivates acetylcholinesterase inhibited by

organophosphates.

- Restores normal neuromuscular function and counteracts

toxicity.

50) Pharmacological Basis for the Use of Adenosine in Treatment

of Paroxysmal Supraventricular Tachycardia:

- Adenosine activates A1 receptors, inhibiting AV node

conduction.

- Terminates reentrant pathways, restoring normal heart rhythm

in paroxysmal supraventricular tachycardia.

51) Pharmacological Basis for the Use of Dobutamine in

Cardiogenic Shock:

- Dobutamine is a beta-1 adrenergic agonist.

- Increases myocardial contractility and cardiac output,

improving tissue perfusion in cardiogenic shock.

52) Pharmacological Basis for the Use of N-Acetylcysteine in

Acute Paracetamol Toxicity in Children:
 - N-Acetylcysteine replenishes glutathione, counteracting
paracetamol-induced hepatotoxicity.

- Acts as a precursor for glutathione, enhancing detoxification

and preventing liver damage.

53) Pharmacological Basis for the Use of Edrophonium in

Diagnosing Myasthenia Gravis:

- Edrophonium inhibits acetylcholinesterase temporarily.

- Improves neuromuscular transmission, producing a rapid but

short-lived increase in muscle strength, aiding in myasthenia
gravis diagnosis.

54) Pharmacological Basis for the Use of Disulfiram in Chronic

Alcoholism:

- Disulfiram inhibits aldehyde dehydrogenase.

- Causes acetaldehyde accumulation upon alcohol ingestion,

leading to aversive effects, discouraging alcohol consumption.

55) Pharmacological Basis for the Use of Pilocarpine in Glaucoma:

- Pilocarpine stimulates muscarinic receptors.

 - Contracts the ciliary muscle, facilitating aqueous humor
outflow and reducing intraocular pressure in glaucoma.

56) Pharmacological Basis for the Use of Short-Acting Hypnotics

in the Elderly:

- Short-acting hypnotics (e.g., zolpidem) enhance GABAergic

activity.

- Induce sleep with a shorter duration, minimizing the risk of

residual sedation in the elderly.

57) Pharmacological Basis for the Use of Premedication Before

Anesthesia:

- Premedication (e.g., benzodiazepines) reduces anxiety and

provides sedation.

- Enhances anesthetic effects, improves patient cooperation, and

reduces the required anesthetic dose.

58) Pharmacological Basis for the Use of Calcium Disodium

Edetate in Lead Poisoning:

- Calcium disodium edetate chelates lead ions.

- Facilitates lead excretion, reducing toxicity and preventing

further accumulation.
59) Pharmacological Basis for the Use of Adrenaline in
Anaphylactic Shock:

- Adrenaline stimulates alpha and beta adrenergic receptors.

- Counteracts vasodilation and bronchoconstriction, rapidly

reversing anaphylactic shock.

60) Pharmacological Basis for the Use of Potassium in Toxicity

Due to Digoxin:

- Potassium counteracts digoxin-induced arrhythmias.

- Restores intracellular potassium levels, reducing the risk of

toxic effects.

61) Pharmacological Basis for the Use of Ethanol in Methyl

Alcohol Poisoning:

- Ethanol competes with methanol for alcohol dehydrogenase.

- Slows methanol metabolism, preventing the formation of toxic

metabolites.

62) Pharmacological Basis for the Use of Dopamine in Cardiogenic

Shock:
 - Dopamine stimulates dopamine receptors and beta-1 adrenergic
receptors.

- Increases cardiac contractility and heart rate, improving cardiac

output in cardiogenic shock.

63) Pharmacological Basis for the Use of Levodopa and Carbidopa

in Parkinsonism:

- Levodopa is a dopamine precursor, and carbidopa inhibits its

peripheral conversion.

- Enhances central dopamine levels, alleviating motor symptoms

in Parkinsonism.

64) Pharmacological Basis for the Use of Aspirin and Clopidogrel

in Ischemic Heart Disease:

- Aspirin inhibits platelet aggregation, and clopidogrel is an ADP

receptor antagonist.

- Dual antiplatelet therapy reduces thrombus formation,

preventing ischemic events.

65) Pharmacological Basis for the Use of Ipratropium Bromide in

COPD Patients:

- Ipratropium is an anticholinergic bronchodilator.

 - Relaxes bronchial smooth muscles, improving airflow in COPD
by blocking acetylcholine action.

66) Pharmacological Basis for the Use of Furosemide and

Spironolactone in Patients with Ascites and Edema:

- Furosemide is a loop diuretic, and spironolactone is a

potassium-sparing diuretic.

- Combined diuretic therapy reduces fluid retention in conditions

like cirrhosis.

67) Pharmacological Basis for the Use of Pilocarpine in Acute

Congestive Glaucoma:

- Pilocarpine constricts the pupil and increases aqueous humor

outflow.

- Reduces intraocular pressure rapidly in acute congestive

glaucoma.

68) Pharmacological Basis for the Use of Tamsulosin in Benign

Hypertrophy of Prostate:

- Tamsulosin is an alpha-1 adrenergic antagonist.

- Relaxes prostate smooth muscle, improving urinary flow in

benign prostatic hypertrophy.
69) Pharmacological Basis for the Use of Zolpidem in Sleep Onset
Insomnia:

- Zolpidem enhances GABAergic activity.

- Promotes sleep onset by binding to the alpha-1 subtype of the

GABA-A receptor.

70) Pharmacological Basis for the Use of Nitrates and Calcium

Channel Blockers in Angina Patients:

- Nitrates dilate coronary arteries, and calcium channel blockers

reduce myocardial oxygen demand.

- Alleviate angina symptoms by improving coronary blood flow

and decreasing cardiac workload.

71) Pharmacological Basis for the Use of Alpha Receptor Blockers

in Benign Prostatic Hyperplasia:

- Alpha receptor blockers (e.g., tamsulosin) relax prostate smooth

muscle.

- Improve urinary flow and alleviate symptoms of benign

prostatic hyperplasia.
72) Pharmacological Basis for the Use of Thiopentone Sodium in
Induction of Anesthesia:

- Thiopentone sodium is a short-acting barbiturate.

- Induces rapid and smooth anesthesia by enhancing GABAergic

inhibition.

73) Pharmacological Basis for the Combined Use of Levodopa and

Carbidopa in Parkinsonism:

- Levodopa is a dopamine precursor, and carbidopa inhibits its

peripheral conversion.

- Carbidopa enhances levodopa's central effects, optimizing

therapeutic efficacy in Parkinsonism.

74) Pharmacological Basis for the Use of Sildenafil in Erectile

Dysfunction:

- Sildenafil is a phosphodiesterase type 5 (PDE5) inhibitor.

- Enhances nitric oxide-mediated vasodilation, promoting penile

blood flow and improving erectile function.

75) Pharmacological Basis for the Use of Adenosine in Paroxysmal

Supraventricular Tachycardia:
 - Adenosine activates A1 receptors, inhibiting AV node
conduction.

- Terminates reentrant pathways, restoring normal heart rhythm

in paroxysmal supraventricular tachycardia.

101) Salt Depletion in Patients Taking Lithium Carbonate:

- Lithium is a monovalent cation that competes with sodium for

reabsorption in the renal tubules.

- Salt depletion increases renal lithium reabsorption, raising

serum lithium levels, and risking lithium toxicity.

102) Antihypertensive of Choice in Pregnancy:

- Methyldopa is a preferred antihypertensive in pregnancy.

- It's a centrally acting alpha-2 adrenergic agonist with a safe

profile, avoiding harm to the fetus.

103) Timolol vs. Propranolol in Glaucoma:

- Timolol is a non-selective beta-blocker with good ocular

penetration.

- Propranolol, with CNS penetration, poses systemic side effects.

Timolol lowers intraocular pressure without these concerns.
104) First Dose Response of Certain Drugs:

- Enhanced sensitivity results from receptor occupancy changes.

- Reduced receptor reserve or increased responsiveness

contributes to the exaggerated initial response.

105) Clonidine in Diabetic GIT Autonomic Neuropathy:

- Clonidine stimulates alpha-2 receptors, reducing sympathetic

outflow.

- Controls diarrhea and tenesmus by modulating autonomic

imbalance in diabetic neuropathy.

106) Thiopentone Sodium as Ultra-Short-Acting General

Anesthetic:

- Rapid brain entry and redistribution contribute to its short

duration.

- Increased lipid solubility allows rapid induction followed by

quick clearance from the CNS.

107) Thiopental vs. Phenobarbital for Induction of General

Anesthesia:

- Thiopental has a faster onset and shorter duration.

 - Rapid induction and recovery make it preferable over
phenobarbital for anesthesia.

108) Sodium Nitroprusside Contraindication in Renal Impairment:

- Metabolism releases cyanide, requiring renal clearance.

- In renal impairment, cyanide buildup occurs, risking toxicity.

109) Main Uses of Dicyclomine and Propantheline:

- Dicyclomine and propantheline are antispasmodics used for

irritable bowel syndrome and functional gastrointestinal
disorders.

110) Ethyl Alcohol in Methyl Alcohol Poisoning:

- Ethyl alcohol competes with methanol for alcohol

dehydrogenase.

- Slows methanol metabolism, preventing toxic metabolite

formation.

111) Drug Action via Physical Property:

- Activated Charcoal: Adsorbs toxins due to its large surface area.

 - Osmotic Diuretics (e.g., Mannitol): Induce diuresis by
osmotically drawing water into the renal tubules.

112) Cumulative Toxicity:

- Accumulation of a drug due to impaired elimination.

- Examples include lithium causing nephrotoxicity and digoxin

leading to cardiac toxicity.

113) Edrophonium Test in Myasthenia Gravis:

- Edrophonium inhibits acetylcholinesterase temporarily.

- Improvement in muscle strength after injection confirms

myasthenia gravis diagnosis.

114) Drugs in Acute Gout:

- Colchicine: Inhibits microtubule formation, reducing

inflammation.

- NSAIDs (e.g., Indomethacin): Decrease inflammation and pain.

115) Disulfiram-Like Reaction:

- Adverse reaction to alcohol consumption while on disulfiram.

 - Symptoms include flushing, nausea, and palpitations.

116) Nifedipine vs. Amlodipine:

- Nifedipine: Short-acting dihydropyridine calcium channel

blocker.

- Amlodipine: Long-acting dihydropyridine, offering sustained

blood pressure control.

117) Prostaglandin Analogue in Glaucoma:

- Latanoprost: Increases uveoscleral outflow, lowering

intraocular pressure.

118) Drugs in Acute Asthma:

- Short-Acting Beta-Agonists (e.g., Albuterol): Bronchodilation.

- Systemic Corticosteroids: Anti-inflammatory effects.

119) Mydriatics and Their Uses:

- Atropine: Pupil dilation for eye examinations.

- Phenylephrine: Pupil dilation during eye surgery.

120) Pharmacological Basis of Ethyl Alcohol in Methyl Alcohol
Poisoning:

- Ethyl alcohol competes with methanol for alcohol

dehydrogenase.

- Prevents the formation of toxic metabolites.

121) Tachyphylaxis:

- Rapid reduction in response to a drug upon repeated

administration.

122) Therapeutic Uses of Anticholinesterases:

- Myasthenia Gravis: Neostigmine.

- Alzheimer's Disease: Donepezil.

123) Morphine Antagonists:

- Naloxone: Reverses opioid effects.

- Naltrexone: Used in opioid addiction.

124) Drugs in Paroxysmal Supraventricular Tachycardia:

- Adenosine: Slows AV node conduction.

 - Verapamil: Blocks AV nodal conduction.

125) Agonist Definition and Examples on Cholinergic Receptors:

- Agonist: Activates a receptor.

- Bethanechol (muscarinic) and Nicotine (nicotinic): Examples

on cholinergic receptors.

126) Drugs from Plant and Animal Sources:

- Plant Sources:

- Morphine (from Papaver somniferum): Analgesic, obtained

from opium poppy.

- Aspirin (from Willow Bark): Antiplatelet, anti-inflammatory.

- Animal Sources:

- Heparin (from Animal Tissues): Anticoagulant.

- Insulin (from Pancreas of Animals): Glycemic control in

diabetes.

127) Intramuscular Route of Drug Administration:

- Advantages:

1. Absorption is generally faster than oral route.

2. Suitable for poorly soluble drugs.

 - Disadvantages:

1. Pain and discomfort.

2. Risk of tissue damage or infection.

128) Disadvantages of Fixed Dose Drug Combination:

1. Limited individualization of doses.

2. Increased risk of side effects and drug interactions.

129) Therapeutic Uses of Anticholinergic Agents:

- Used to treat conditions like:

1. Motion Sickness: Scopolamine.

2. COPD: Ipratropium.

130) Drugs in Paracetamol Poisoning:

- N-Acetylcysteine: Replenishes glutathione, preventing

hepatotoxicity.

131) Uricosuric Drugs:

- Probenecid: Increases renal excretion of uric acid.

132) Non-Benzodiazepine Hypnotic:

- Zolpidem: Induces sleep without significant muscle relaxant or

anticonvulsant effects.

133) Safety Margin of Drugs:

- The difference between the minimum effective dose and the

minimum toxic dose.

134) Therapeutic Status of Lithium in Manic-Depressive

Psychosis:

- Effective in controlling manic episodes.

- Requires careful monitoring due to a narrow therapeutic range.

135) Pharmacokinetic Drug Interactions:

1. Inhibition of Cytochrome P450: Fluoxetine inhibits

metabolism, increasing levels of warfarin.

2. Competition for Renal Tubular Secretion: Probenecid and

penicillin compete for renal transport.

136) Enzyme Inducers:

1. Phenytoin: Induces cytochrome P450 enzymes.

 2. Rifampin: Induces hepatic enzymes.

137) Avoiding Morphine in Head Injury:

- Morphine may mask changes in neurological status, hindering

assessment of head injury severity.

138) Adrenaline with Local Anesthetic:

- Vasoconstriction: Prolongs local anesthesia by reducing

systemic absorption.

139) Indications of Therapeutic Drug Monitoring:

1. Narrow Therapeutic Index: e.g., Digoxin.

2. Variable Pharmacokinetics: e.g., Aminoglycosides.

140) Advantages of Benzodiazepines over Barbiturates as

Hypnotics:

1. Lower risk of respiratory depression.

2. Less potential for overdose.

141) Atropine-Morphine Combination in Biliary Colic:

 - Atropine: Reduces spasm in the sphincter of Oddi.

- Morphine: Provides analgesia.

142) ACE Inhibitors and Potassium-Sparing Diuretics:

- Risk of hyperkalemia due to dual potassium-retaining effects.

143) Disulfiram in Alcohol Deaddiction:

- Inhibits aldehyde dehydrogenase, causing acetaldehyde

accumulation, leading to aversive reaction.

144) Aspirin as Antiplatelet Agent:

- Irreversibly inhibits COX, reducing platelet aggregation.

145) Adrenaline-Lignocaine Combination for Local Anesthesia:

- Adrenaline: Vasoconstriction, prolongs anesthesia.

- Lignocaine: Local anesthetic.

146) Nitroglycerine in Acute Attack of Angina:

- Vasodilation reduces myocardial oxygen demand.

147) Physostigmine in Atropine Poisoning vs. Neostigmine:

- Physostigmine crosses the blood-brain barrier, treating central

effects of atropine poisoning.

148) Nitroglycerine in Acute Attack of Angina:

- Vasodilation reduces myocardial oxygen demand.

149) Physostigmine in Atropine Poisoning vs. Neostigmine:

- Physostigmine crosses the blood-brain barrier, treating central

effects of atropine poisoning.

150) Antitussive Definition and Indication:

- Antitussive: Suppresses cough reflex.

- Indicated for symptomatic relief in conditions like upper

respiratory tract infections.

151) Skeletal Muscle Relaxants:

- Examples:

1. Baclofen

2. Diazepam

- Indications:
 1. Spasticity: Baclofen.

2. Muscle Spasms: Diazepam.

152) Potassium-Sparing Diuretics:

- Uses:

1. Hypertension

2. Edema in Heart Failure

- Adverse Effects:

1. Hyperkalemia

2. Gynecomastia

153) Preventing Digitalis Toxicity:

- Care:

1. Monitor serum digoxin levels.

2. Adjust dosage based on renal function.

154) Weak Diuretic Action of Potassium-Sparing Diuretics:

- Explanation:

1. Act on collecting ducts.

2. Limited impact on overall sodium and water excretion.

155) Sublingual Nitroglycerin Instructions:

- Place one tablet under the tongue during chest pain.

- Wait 5 minutes; if pain persists, take another. Max 3 doses.

- Sit or lie down to avoid dizziness.

156) Rational Fixed Dose Combinations:

1. Amoxicillin + Clavulanate: Broad-spectrum antibacterial.

2. Amlodipine + Telmisartan: Antihypertensive with vasodilator

and angiotensin II receptor blockade.

157) Preferred Drug Regimen for H. Pylori Eradication:

- Triple Therapy:

1. Clarithromycin

2. Amoxicillin or Metronidazole

3. Proton pump inhibitor (PPI)

158) Regimen for Treating H. Pylori Infection:

- Quadruple Therapy:

1. Bismuth subsalicylate
 2. Metronidazole

3. Tetracycline

4. PPI

159) Limitations of Neostigmine in Myasthenia Gravis:

- Limited Effect on Central Muscles:

1. Poor penetration of blood-brain barrier.

2. Ineffective against myasthenic weakness in bulbar muscles.

160) Managing Apnea caused by Succinylcholine:

- Management:

1. Ensure patent airway.

2. Provide ventilatory support.

- Reason:

- Succinylcholine causes transient apnea by depolarizing

neuromuscular blockade.

161) Toxic Effect of Paracetamol Overdose:

- Toxicity:

- Hepatotoxicity leading to liver failure.

 - Treatment:

- N-acetylcysteine administration.

162) Xylometazoline Nasal Drops Instructions:

- Administer 2-3 drops in each nostril.

- Use every 8-10 hours as needed.

- Avoid prolonged use to prevent rebound congestion.

163) Time Synergism:

- Definition:

- Combined effect of drugs administered together is greater than

the sum of their individual effects.

- Example:

- Combining penicillin and aminoglycosides in bacterial

infections.

164) Reye's Syndrome and Prevention:

- Syndrome:

- Rare but serious liver and brain disorder in children.

- Prevention:
 - Avoid aspirin in viral illnesses.

165) Limitations of ACE Inhibitors in Hypertension:

- Contraindicated in:

1. Bilateral renal artery stenosis.

2. Pregnancy (especially second and third trimesters).

166) Atropine with Neostigmine for Curare Reversal:

- Explanation:

- Atropine counters excessive muscarinic effects caused by

neostigmine.

167) Dobutamine Preference over Noradrenaline in Shock:

- Explanation:

- Dobutamine increases cardiac output without significant

vasoconstriction, suitable for cardiogenic shock.

168) Pro-Drug and Advantage:

- Example:

- Enalapril (Pro-Drug) converts to Enalaprilat (Active Form)

 - Advantage:

- Improved bioavailability and prolonged duration of action.

169) Nitroglycerine Tablets Instructions:

- Place one tablet under the tongue during chest pain.

- Wait 5 minutes; if pain persists, take another. Max 3 doses.

- Sit or lie down to avoid dizziness.

170) Zero Order Kinetics:

- Examples:

1. Ethanol: Constant amount metabolized per unit time.

2. Phenytoin (at high doses): Saturation of metabolic enzymes.

171) Mucolytics:

- Agents that break down or thin mucus for easier clearance.

172) Naloxone over Nalorphine in Morphine Poisoning:

- Explanation:

- Naloxone has a higher affinity and specificity for opioid

receptors, rapidly reversing respiratory depression.
173) Drug Treatment of Pheochromocytoma:

- Alpha-Blockers (e.g., Phenoxybenzamine):

1. Control hypertension.

2. Facilitate surgical removal.

174) Pharmacopoeia:

- Official compilation of medicinal substances with standards for

purity and quality.

175) Succinylcholine Apnea Management:

- Management:

- Ventilate and support respiration until spontaneous breathing

resumes.

- Monitor neuromuscular function and vital signs.

176) Acetazolamide in Glaucoma:

- Role:

- Carbonic anhydrase inhibitor.

- Reduces aqueous humor production, lowering intraocular

pressure.
 - Used in open-angle and angle-closure glaucoma.

177) Salbutamol Administration in Bronchial Asthma:

- Ways:

1. Inhalation via Metered-Dose Inhaler (MDI).

2. Nebulization for acute attacks.

3. Oral tablets for sustained relief.

178) Beta-Alpha Blocker Combination in Pheochromocytoma:

- Purpose:

- Alpha-blockers control immediate symptoms.

- Beta-blockers prevent reflex tachycardia and arrhythmias.

179) Colchicine in Gouty Arthritis:

- Benefit:

- Anti-inflammatory.

- Inhibits microtubule polymerization, reducing leukocyte

migration.

- Effective in acute gout attacks.

180) Peculiarities of Edrophonium:

- Fast Onset:

- Rapidly acting acetylcholinesterase inhibitor.

- Short Duration:

- Brief duration of action (5-10 minutes).

- Diagnostic Use:

- Used for the Tensilon test in myasthenia gravis.

181) Peculiarities of Trimethaphan:

- Short Duration:

- Very short-acting ganglionic blocker.

- Intravenous Use:

- Administered by IV infusion.

- Limited Clinical Use:

- Rarely used due to side effects.

182) Bromhexine Effect and Use:

- Effect:

- Mucolytic: Reduces viscosity of respiratory secretions.

- Use:
 - Respiratory conditions with excessive mucus.

183) Advantages of Doxycycline over Tetracycline:

1. Broader Spectrum:

- Effective against additional bacterial species.

2. Improved Absorption:

- Better absorbed, especially in the presence of food.

184) Hyper-Reactivity vs. Hypersensitivity:

- Hyper-Reactivity:

- Exaggerated physiological response (e.g., increased

bronchoconstriction).

- Hypersensitivity:

- Immune-mediated abnormal response (e.g., allergic reaction).

185) Spitting out Nitroglycerine Tablet:

- Advice:

- Sublingual absorption for rapid effect.

- Consequence of Swallowing:

- Hepatic first-pass metabolism, reducing effectiveness.

186) Combining Potassium-Sparing Diuretics with Thiazides:

1. Synergistic Diuretic Effect:

- Thiazides act on distal tubule.

- Potassium-sparing diuretics act on collecting ducts.

2. Prevention of Hypokalemia:

- Thiazides cause potassium loss, countered by potassium-

sparing diuretics.

187) Role of Atropine in Myasthenia Gravis:

- Purpose:

- Counteracts excessive muscarinic effects caused by

acetylcholinesterase inhibitors like neostigmine.

188) Topical Nasal Decongestants:

1. Oxymetazoline

2. Xylometazoline

- Adverse Effects:

- Rebound congestion with prolonged use.

- Local irritation and dryness.

189) Preference between Dextromethorphan and Codeine:

- Choice:

- Dextromethorphan, as it has less abuse potential and side

effects.

- Justification:

- Codeine carries a risk of dependence and respiratory

depression.

190) Therapeutic Index (TI):

- Definition:

- Ratio of the dose that produces toxicity to the dose that

produces a therapeutic response.

- Example:

- Warfarin has a narrow therapeutic index.

191) Slow Increase of Phenytoin Sodium in Grand Mal Epilepsy:

- Reason:

- Rapid increase may lead to dose-related toxicity (ataxia,

diplopia).
 - Avoidance of adverse effects and CNS depression.

192) Natural Tolerance:

- Definition:

- Decreased response to a drug due to long-term use.

- Example:

- Chronic alcohol users may develop tolerance to the sedative

effects of alcohol.

193) Monday Morning Sickness:

- Definition:

- Term used for hangover symptoms after excessive alcohol

consumption during the weekend.

194) Use of Selegiline in Parkinson’s Disease:

- Explanation:

- Selective MAO-B inhibitor, delaying dopamine breakdown.

- Adjunctive therapy in Parkinson's disease.

195) Drug-Drug Interactions Enhancing Metabolism:

 - Explanation:

- Inducing drug increases the activity of drug-metabolizing

enzymes, accelerating metabolism.

196) Doctor-Induced Disease:

- Definition:

- Refers to iatrogenic conditions caused by medical treatment.

- Example:

- Drug-induced hepatitis from certain medications.

197) Sudden Withdrawal of Propranolol and Rebound

Hypertension:

- Explanation:

- Beta-blocker withdrawal leads to unopposed alpha-adrenergic

activity, causing increased peripheral vascular resistance and
rebound hypertension.

198) Thiazides in Patients with Renal Stone:

- Reason:

- Thiazides reduce calcium excretion, preventing calcium

oxalate stone formation.
199) Aspirin in Thrombo-Embolic Cardiovascular Conditions:

- Explanation:

- Antiplatelet action inhibits thrombus formation, reducing the

risk of myocardial infarction and stroke.

200) Combining Spironolactone with Furosemide:

- Purpose:

- Furosemide induces potassium loss; spironolactone

counteracts hypokalemia.

- Used in edematous conditions.

201) Abrupt Withdrawal of Corticosteroids:

- Reason:

- Adrenal suppression due to exogenous steroid use.

- Abrupt withdrawal may lead to adrenal insufficiency.

- Tapering is necessary to allow adrenal recovery.

202) Preventing Nitrate Tolerance in Chronic Angina:

- Method:

- Use nitrate-free intervals to prevent continuous exposure.

 - Administer short-acting nitrates only during angina episodes.

- Employ combination therapy with other anti-anginal drugs.

203) Ethanol in Acute Methanol Poisoning:

- Purpose:

- Competes with methanol for alcohol dehydrogenase.

- Ethanol forms a non-toxic metabolite, preventing methanol

conversion to toxic metabolites.

204) Tamsulosin in Benign Prostatic Hypertrophy:

- Selective Alpha-1A Blockade:

- Specific affinity for prostate smooth muscle alpha-1A

receptors.

- Reduces urinary obstruction without affecting blood pressure.

205) Allopurinol in Chronic Gout:

- Mechanism:

- Inhibits xanthine oxidase, reducing uric acid synthesis.

- Prevents urate crystal formation, lowering gout attacks.

206) Atenolol vs. Propranolol in Hypertension:

- Quality of Life:

- Atenolol is cardioselective, causing fewer central nervous

system side effects than non-selective Propranolol.

- Fewer adverse effects contribute to better patient tolerability.

207) Levodopa in Drug-Induced Parkinsonism:

- Reason:

- Drug-induced parkinsonism involves dopamine receptor

blockade.

- Levodopa requires intact dopaminergic neurons for

conversion to dopamine.

208) Loop Diuretics as "High Ceiling Diuretics":

- Characteristic:

- Provide high diuresis even with severe renal impairment.

- Act on the thick ascending limb of the loop of Henle.

209) 5-Alpha Reductase Inhibitors in BPH:

- Mechanism:
 - Inhibit conversion of testosterone to dihydrotestosterone.

- Reduces prostate size, relieving urinary symptoms.

210) Pralidoxime in Organophosphate Poisoning:

- Action:

- Reactivates acetylcholinesterase inhibited by

organophosphates.

- Restores cholinesterase activity, reversing toxicity.

211) Levodopa in Drug-Induced Parkinsonism:

- Reason:

- Drug-induced parkinsonism involves dopamine receptor

blockade.

- Levodopa requires intact dopaminergic neurons for

conversion to dopamine.

212) Ineffectiveness of Older Antihistaminics in Asthma:

- Explanation:

- Lack of bronchodilatory effects.

- Anticholinergic properties may worsen airway obstruction.

213) Discontinuation of Aspirin Before Surgery:

- Reason:

- Increased bleeding risk during and after surgery.

- Aspirin inhibits platelet aggregation, affecting hemostasis.

214) Sodium Bicarbonate in Weakly Acidic Drug Poisoning:

- Action:

- Alkalinizes urine, promoting ion trapping.

- Enhances elimination of weak acids, preventing reabsorption.

215) Contraindication of Propranolol in Diabetes Mellitus:

- Reason:

- Masks hypoglycemic symptoms (tachycardia, tremors).

- Impairs glycogenolysis and can worsen hypoglycemia.

216) Sublingual Nitroglycerine in Acute Angina:

- Rapid Absorption:

- Facilitates quick onset of vasodilation.

- Immediate relief of anginal pain.

217) Adrenaline in Anaphylactic Shock:

- Action:

- Alpha and beta-adrenergic effects.

- Counteracts vasodilation, bronchoconstriction, and vascular

permeability.

218) Tamsulosin in Benign Prostatic Hypertrophy:

- Alpha-1A Selectivity:

- Specifically targets alpha-1A receptors in the prostate,

reducing urinary symptoms.

219) ACE Inhibitors and Cough:

- Mechanism:

- Bradykinin accumulation leads to a dry, hacking cough.

- Switching to an angiotensin receptor blocker may alleviate

cough.

220) Methadone in Opiate Dependence:

- Purpose:
 - Long-acting opioid agonist.

- Reduces withdrawal symptoms, aids in maintenance therapy.

221) Ethyl Alcohol in Methyl Alcohol Poisoning:

- Action:

- Competes for alcohol dehydrogenase, reducing methanol

metabolism.

- Prevents the formation of toxic metabolites.

222) Topical Timolol in Chronic Simple Glaucoma:

- Mechanism:

- Reduces intraocular pressure by decreasing aqueous humor

production.

- Used as a first-line treatment.

223) Loop Diuretics in Acute Lithium Overdose:

- Ineffectiveness:

- Lithium reabsorption occurs predominantly in the proximal

tubule.
 - Loop diuretics act on the loop of Henle, limiting lithium
excretion.

224) Oxytocin vs. Ergometrine for Induction of Labor:

- Preference:

- Oxytocin is selective, acting on uterine receptors.

- Ergometrine has vasoconstrictive effects and may cause

hypertension.

225) Rational Fixed Dose Combinations:

1. Combination of ACE Inhibitor and Diuretic

2. Combination of Beta-Blocker and Calcium Channel Blocker

- Optimal synergy with complementary mechanisms of action.

226) Advantages of Fluoxetine over Imipramine:

- Selective Serotonin Reuptake Inhibition (SSRI):

1. Safety Profile:

- Fluoxetine has a favorable safety profile compared to

imipramine.

- Reduced risk of overdose-related toxicity.

2. Side Effect Profile:

 - Lower incidence of anticholinergic side effects (dry mouth,
constipation) and cardiovascular effects.

- Better tolerability and compliance.

227) Ethanol in Acute Methanol Poisoning:

- Mechanism:

- Ethanol competes with methanol for alcohol dehydrogenase.

- Slows down methanol metabolism, preventing the formation

of toxic metabolites.

228) Preventing Nitrate Tolerance in Angina:

- Intermittent Dosing:

- Administer nitrates with nitrate-free intervals.

- Prevents continuous exposure, reducing the risk of tolerance.

229) Indications of Atropine Injection:

1. Bradycardia:

- Increases heart rate by blocking vagal effects.

2. Organophosphate Poisoning:
 - Antidote for cholinergic toxicity by reversing excessive
muscarinic effects.

230) Isotonic Saline in Hypovolemic Shock:

- Rationale:

- Restores intravascular volume without altering osmolarity.

- Provides effective volume expansion in hypovolemic states.

231) Avoiding Loperamide in Bacterial Dysentery:

- Reason:

- Loperamide is an opioid agonist with no antibacterial effects.

- Delays clearance of bacteria, potentially worsening bacterial

infections.

232) Contraindication of Pentazocine in AMI:

- Reason:

- Pentazocine is a mixed opioid receptor agonist/antagonist.

- Can increase myocardial oxygen demand and worsen

ischemia in acute myocardial infarction.
233) N-Acetyl Cysteine in Paracetamol Poisoning:

- Action:

- Acts as a precursor of glutathione, enhancing detoxification of

the reactive metabolite of paracetamol.

- Prevents hepatotoxicity.

234) Lisinopril in Pregnancy:

- Contraindication:

- Can cause fetal harm and death when used in the second and
third trimesters.

- Associated with oligohydramnios, renal dysfunction, and

neonatal skull hypoplasia.

235) Low Dose Aspirin in Myocardial Infarction Prophylaxis:

- Rationale:

- Inhibits platelet aggregation, reducing the risk of clot

formation.

- Low doses provide antiplatelet effects without significant

bleeding risk.

236) Misoprostol in NSAID-Induced Peptic Ulcer:

 - Mechanism:

- Synthetic prostaglandin E1 analog.

- Counteracts NSAID-induced inhibition of protective

prostaglandins, reducing ulcer formation.

237) Ergometrine in Labor Induction:

- Limitation:

- Causes sustained uterine contractions.

- May compromise fetal oxygenation and lead to hypertonic

contractions.

238) Drugs for Alzheimer’s Disease:

1. Donepezil:

- Acetylcholinesterase inhibitor, enhances cholinergic

transmission.

2. Memantine:

- NMDA receptor antagonist, regulates glutamate levels.

239) Drugs for Ventricular Arrhythmias:

1. Lidocaine:
 - Class 1b antiarrhythmic, stabilizes cardiac cell membranes.

2. Amiodarone:

- Class III antiarrhythmic, prolongs action potential duration.

240) Orally Effective Morphine Antagonist:

- Naloxone:

- Reverses opioid effects by competitive binding to receptors.

- Used in opioid overdose.

241) Lidocaine Loading Dose in Three Divided Portions:

- Pharmacokinetics:

- Minimizes the risk of toxicity.

- Allows for slower distribution and reduced initial peak levels.

242) Abrupt Stopping of Beta-Blockers in Angina:

- Reason:

- Withdrawal can lead to rebound angina, exacerbating

symptoms.

- Gradual tapering is essential to prevent adverse

cardiovascular effects.
243) Avoiding Nasal Decongestants in Hypertension:

- Vasoconstriction:

- Nasal decongestants can cause systemic vasoconstriction.

- Raises blood pressure, potentially worsening hypertension.

244) Dopamine in Cardiogenic Shock:

- Selective Vasodilation:

- At lower doses, dopamine selectively dilates renal and

mesenteric vasculature.

- Improves renal perfusion without excessive cardiac

stimulation.

245) Antianxiety Drug Not Interacting with Benzodiazepine

Receptors:

- Buspirone:

- Acts as a serotonin receptor agonist and partial agonist at

dopamine receptors.

- Lacks direct interaction with benzodiazepine receptors.

246) Statins Given at Night:

- Cholesterol Synthesis:

- Most cholesterol synthesis occurs at night.

- Administering statins during this period maximizes efficacy.

247) Antiepileptic Causing Neural Tube Defects:

- Valproic Acid:

- Associated with an increased risk of neural tube defects when

used in pregnancy.

248) NSAID without Prostaglandin Inhibition:

- Acetaminophen:

- Lacks significant anti-inflammatory effects.

- Mainly acts centrally to reduce fever and pain.

249) Foetal Hydantoin Syndrome:

- Effect of Phenytoin Use During Pregnancy:

- Causes congenital abnormalities in infants born to mothers

taking phenytoin.
 - Includes facial dysmorphism, developmental delay, and
growth abnormalities.

250) Rule of Right in Rational Use of Medicine:

- Guideline:

- Right Patient, Right Drug, Right Dose, Right Route, Right

Time.

- Ensures safe and effective use of medications.

251) Cardiac Stimulants and Congestive Cardiac Failure:

- Basis:

- In congestive cardiac failure (CCF), the heart is already

compromised.

- Adrenaline increases heart rate and contractility, raising

oxygen demand.

- May worsen ischemia and exacerbate heart failure symptoms.

252) Aspirin Contraindication in Pregnancy:

- Basis:

- Aspirin in late pregnancy (56 days onwards) may lead to

premature closure of the ductus arteriosus.
 - Associated with potential harm to the fetus, such as fetal renal
impairment and oligohydramnios.

253) Anti-Seizure Drugs in a 17-Year-Old with Generalized Tonic-

Clonic Seizures:

- Avoided Drugs:

- Valproic acid and carbamazepine might be avoided.

- Valproic acid associated with teratogenicity, and

carbamazepine may cause neural tube defects.

- Preference for drugs with better safety profiles in

reproductive-age females.

254) Subcutaneous Adrenaline in Anaphylactic Shock:

- Reasons:

- Subcutaneous absorption is slower and less predictable than

intramuscular or intravenous routes.

- Anaphylaxis requires rapid onset and reliable absorption.

- Intramuscular route is preferred for quicker and more

consistent absorption.

255) Class I Anti-Arrhythmic Drugs Classification:

- Subclasses:

1. Class IA:

- Moderate Na+ channel blockers (e.g., quinidine,

procainamide).

- Prolong action potential duration.

2. Class IB:

- Fast Na+ channel blockers (e.g., lidocaine, mexiletine).

- Shorten action potential duration.

3. Class IC:

- Potent Na+ channel blockers (e.g., flecainide, propafenone).

- Minimal effect on action potential duration.