Download PGI PG 2020 May Pharm Solved Question Paper

1.Allofthefollowingareactionsof
muscarinicantogonists,except:
a)Decreasegastricsecretions
b)Decreaserespiratorysecretions
c)Contractradialmusclesofiris

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d)FascilitatesAVconduction
e)None
CorrectAnswer-C
Ansis'c'i.e.Contractradialmusclesofiris
Radialmusclesareinnervatedbysympatheticsystemsnotby

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parasympathetic(muscarinic)system
Irismusclesthatcontrolthesizeofpupil
Therearetwotypesofmusclesiniristhatcontrolthesizeof
pupil:
1. Theirissphincterorconstrictorpupillae(circularmuscles):These

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musclesareinnervatedbytheparasympatheticsystemandcause
constrictionofpupil(miosis).
2. Theirisdilatorordilatorpupillae(radialmuscles):Thesemuscles
areinnervatedbysympathetic(a,adrenergic)systemandcause
dilatationofpupil(mydriasis)

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So,pupilsizemaybealteredbyfollowingmechanismsbydifferent
ANSdrugs:
A.Mydriasis(dilatationofpupil)
Sympathomimeticdrugs(a,agonists):Bycontractionofradial
muscles(dilator).

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Antimuscarinicdrugs:Byblockingtheactionofcircularmuscles

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(pupillarysphincter).
B.Miosis(constrictionofpupil)
1. Parasympathomimetic(muscarinic)drgus:Bystimulatingthe
contractionofcircularmuscles(pupillarysphincter).

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2. Sympatholyticdrugs(a,antagonists):Byblockingtheactionofradial
muscles(irisdilator)Aboutotheroptions
Muscarinicantagonists(antimuscarinicdrugs)decreasebothgastric
andrespiratory(bronchial)secretionsoAntimuscarinicdrugs
facilitateAVconduction(seepreviousexplanations).

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2.Whichoneofthefollowinganaesthetic
agentsdoesnottriggermalignant
hyperthermia?
a)Halothane
b)Isotlurane

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c)Suxamethonium
d)Thiopentone
e)None
CorrectAnswer-D
Ans.is'd'i.e.,Thiopentone

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DrugscausingMalignanthyperthermia
Succinylcholine
Enflurane
Methoxyflurane
Phenothiazines

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Halothane
Sevoflurane
MAOinhibitors
Lignocaine
Isoflurane

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Destlurane
TCA
SuccinylcholineisthemostcommoncauseofMH.
Amongstanaesthetics,halothaneismostcommoncause.
CombinationofSchandHalothanehasamuchhigherincidence.

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3.Whichofthefollowingstatementsisfalse
aboutAcyclovir-
a)ItinhibitsDNAsynthesisandviralreplication
b)Itiseffectiveagainstinfluenza
c)Ithaslowtoxicityforhostcells

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d)Renalimpairmentnecessitatesdosereduction
e)None
CorrectAnswer-B
Ans.is'b'i.e.,Itiseffectiveagainstinfluenza
Acyclovir

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Itisadeoxygunosineanalogue-inhibitsDNAsynthesisby?
1. InhibitsherpesvirusDNApolymerasecompetitively.
2. GetsincorporatedinviralDNAandstopslengtheningofDNAstrand.
TheterminatedDNAinhibitsDNApolymeraseirreversibly.
Itispreferentiallytakenupbythevirusinfectedcells.Becauseof

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selectivegenerationoftheactiveinhibitorinthevirusinfectedcells
anditsgreaterinhibitoryeffectonviralDNAsynthesis,acyclovirhas
lowtoxicityforhostcells.
Itisactiveagainstherpesgroupofvirus(HSV-l>HSV-2>VZV=
EBV.CMVisnotinhibited).

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Acyclovirisprimarilyexcretedunchangedinurine,bothby
glomerularfiltrationandtubularsecretion.Renalimpairment
necessitatesdosereduction.

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4.Whichofthefollowingisacommonside-
effectofCisplatin-

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a)Diarrhea
b)Vomiting
c)Pulmonaryfibrosis
d)Alopecia
e)None

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CorrectAnswer-B
Ans.is'b'i.e.,Vomiting
Mostcommonside-effectofCisplatinis:Vomiting(highlyemetic
drug).
Themostimportantdosedependenttoxicityisrenalimpairment.

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Amifostineislabelledforreductionofcisplatininduced
nephrotoxicity.
Tinnitus,deafness,sensoryneuropathy&hlperuricaemiaareother
problems.
Shocklikestatesometimesoccurduringi.vinfusion.

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5.Trueaboutbenzodiazepineis:
a)GABAmimetic
b)GABAfacilitator
c)Notasafedrug
d)Highabsuepotential

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e)Powerfulenzymeinducer
CorrectAnswer-B
Ans.is'b'i.e.,GABAfacilitator
[Ref.:KDTVh/ep.401,402&6th/ep.393;KatzungILth/ep.375;
Goodman&Gilman1Lth/ep.405]

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Mechanismofactionofbenzodiazepines(BZDs):
ActsonGABA-Areceptors.
BZDsreceptorincreasetheconductanceofCl-channel.
BZDsdonotthemselvesincreaseCl-conductance,i.e.theyhave
onlyGABAfacilitatorybutnoGABAmimeticaction.(Barbiturates

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havebothGABAfacilitatoryandGABAmimeticactions).

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6.Firstdosesyncopeisseenin?
a)Alphablocker
b)Betablocker
c)CCB

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d)ACEinhibitors
e)Alloftheabove
CorrectAnswer-A:D
Ans.is'a'i.e.,Alphablocker&'d'i.e.,ACEinhibitors
[Ref:KDTVh/ep.565&6h/ep.546]

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Firstdosehypotension(Firstdosephenomenon):
Thefirst-dosephenomenonisasuddenandseverefallinblood
pressurethatcanoccurwhenchangingfromalyingtoastanding
positionthefirsttimethatanalphablockerdrugisusedorwhen
resumingthedrugaftermanymonthsoff.

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Thisusuallyhappensshortlyafterthefirstdoseisabsorbedintothe
bloodandcanresultinsyncope(fainting).
Thealphablockerprazosinisthemostnotoriousforproducingafirst
dosephenomenon.
Otherdrugsofthesamefamily,doxazosinandterazosincanalso

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causethisphenomenon,thoughlessfrequently.
OtherdrugsassociatedwithitareACEinhibitors,Sargramostim&
Muromonab,CD3.

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7.Whichofthefollowingdrugisnotusedin
thetreatmentofmucormycosis?

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a)Fluconazole
b)Voriconazole
c)Posaconazole
d)5-flucytosine
e)AmphotericinB

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CorrectAnswer-A:B:D
Ans.is'a'i.e.,Fluconazole,'b'i.e.,Voriconazole&'d'i.e.,5-
flucytosine
[Ref:Goodman6Gilman1l,h/ep.1254;KDTVh/ep.795;
www.ncbi.nlm.nih.gov)

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Amongstazole,onlyposaconazoleisactiveagainstmucormycosis
Antifungaltreatmentofmucormycosis:
First-LineMonotherapy:
Mucormycosisisaseriousinfectionandneedstobetreated
with.prescriptionantifungalmedication,usuallyamphotericinB

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(giventhroughanIV),posaconazole(giventhroughanIVororally)
orisavuconazole(giventhroughanIVororally).
Fluconazole,voriconazole,anditraconazoledonothavereliable
activityagainstmucormycosis.
5-flucytosine:

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Flucytosineisnotemployedasthesoletherapyexceptoccasionally
inchromoblastomycosis.
Itisusedinlimitedtothetreatmentofcryptococcalmeningitis,in
conjunctionwithAMP-B.

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8.Antibioticsactingbyinhibitionofprotein

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synthesisinclude?
a)Penicillin
b)Vancomycin
c)Aminoglycoside
d)Fluroquinolones

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e)Chloramphenicol
CorrectAnswer-C:E
Ans.is'c'i.e.,Aminoglycoside,&'e'i.e.Chloramphenicol
[Ref:KDT7/ep.734;Katzung13'h/ep.789]
Inhibitionofproteinsynthesis(translation):

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Drugsactingbyinhibitingproteinsynthesisaretetracyclines,
chloramphenicol.aminoglycosides.Erythromycin,clindamycin,
linezolid.
Allproteinsynthesisinhibitorsarebacteriostaticexcept
aminoglycosidesandstreptograminswhicharebactericidal.

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Thesedrugscanbedividedinto:
a)Basedonthestepsoftranslation(proteinsynthesis)on
whichdrugact:
Freezeinitiation:Aminoglycosides.
Inhibitelongation:Tetracyclines,puromycin,chloramphenicol.

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Inhibittranslocation:Clindamycin,erythromycin.
Causingprematuretermination:Puromycin.
b)Basedonribosomeonwhichtheyact:
30SribosomezTetracycline,streptomycin.
50Sribosome:Chloramphenicol,erythromycin,clindamycin,

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Linezolid,pleuromutilins(retapamulin).
Both305and505ribosomes:Aminoglycoside(except
streptomycin).

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9.Drugscontraindicatedinmyastheniagravis
include?

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a)Neostigmine
b)Neomycin
c)Edrophonium
d)Atropine
e)Paracetamol

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CorrectAnswer-B:D
Ans.is'b'i.e.,Neomycin&'d'i.e.Atropine
Ref:KDTVh/ep.110&/ep.104;Katzung1Ltu/ep.107;internet
Aspirin,non-steroidalanti-inflammatorydrugs(NSAIDs)suchas
ibuprofenandnaproxen,andacetaminophen(paracetamol)are

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consideredsafeforMG,thatis,theyhavenotbeenshownto
worsenMGorcausemuscleweakness.
Neostigmineisusedinmyastheniagravis.
Edrophoniumcanbeusedfordiagnosisofmyastheniagravisas
tensilontest(fordiagnosisofcholinergiccrisis).

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10.Drugswhichhavebotha&receptor
activityinclude?
a)Epinephrine
b)Nor-epinephrine
c)Phenylephrine

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d)Dopamine
e)Isprenaline
CorrectAnswer-A:B:E
Ans.is'a'i.e.,Epinephrine,'b'i.e.Nor-epinephrine&'d'i.e.
Dopamine

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Ref:GoodmanandGilman's12th/ep.812
Nor-adrenalinehasmainlyalphaactionwithslighteffectoncardiac
beta1receptors(alpha&beta1action).
Adrenalinehasnonselectiveactiononbothalpha(alpha1+alpha
2)&beta(beta1+beta2)receptors.

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Phenylephrineisaselectivealpha1agonistandhasnegligiblebeta
action
Dopamineisadopamine(D1&D2)aswellasadrenergicalphaand
beta1agonist(Notbeta2).
Isoprenalinehasbeta(beta1+beta2action),butnoalphaaction.

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11.Sideeffectsoftricyclicantidepressants
include?
a)Diarrhea
b)Weightloss
c)Hypertension

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d)Tremers
e)Urinaryretention
CorrectAnswer-D:E
Ans.is'd'i.e.,Tremors&'e'i.e.,Urinaryretention
[RelKDTVh/ep.459;Goodman&Gilmanllth/ep.448]

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AdverseeffectsofTCAs:
Anticholinergic-Drymouth,badtaste,urinaryretention,blurred
vision,palpitations,constipation.
Sedation,mentalconfusion,weakness.
Increasedappetiteandweightgain.

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Sweatingandfinetremor.

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12.Antiandrogenicdrugsinclude?
a)Danazole
b)Finesteride
c)Ketoconazole

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d)Latrezole
e)Spironolactone
CorrectAnswer-B:C:E
Ans.is'b'i.e.,Finasteride,'c'i.e.Ketoconazole&'e'i.e.
Spironolactone

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[Ref:KDTVh/ep.858,302;Harrison18th/ep.802,803]
Antiandrogensdrugs:
5-alpha-reductaseinhibitors:
Thesedrugsinhibittheenzyme5-alpha-reductasewhichconverts
testosteroneintomoreactivedihydrotestosterone.

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Thesedrugsarefinasterideanddutasteride.
Theseareusedinbenignprostatichypertrophy,hirsutismandrnale
patternbaldness.
Sideeffectsaredecreasedlibido,impotence,skinrashandswelling
oflips.

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Note:-
Finasterideselectivelyinhibitstype-25alpha-reductase,whereas
dutasterideinhibitsbothtype-1andtype-25-alphareductases.
Otherdrugswithantiandrogenicactionare:
SuperactiveGnRHagonists,spironolactone,cimetidine,

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progesteroneandketoconazole.

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13.Dopamineatthedoseof8?g/kg/min
produces?
a)Increasedsystemicvascularresistance
b)Decreasedsystemicvascularresistance

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c)Renalvasodilatation
d)Increasedstrokevolume
e)Increasedheartrate
CorrectAnswer-A:C:D:E
Ans.is'a'i.e.,Increasedsystemicvascularresistance,'c'i.e.

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Renalvasodilation,'d'i.e.Increasedstrokevolume&
'e'i'e..Increasedheartrate
[Ref:Modernpharmacologywithclinicalapplication2d/ep.208;
KDTVh/ep.426;KatzungLlth/ep.139)
Dopamine:

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Itisadopamine(D1&D2)aswellasadrenergicalpha&beta1
agonist(notbeta-2).
TheD1receptorsinrenalandmesentericbloodvesselsarethe
mostsensitive.
I.v.infusionoflowdose(1-5microgram/kg/min)ofdopaminedilates

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thesevesselsbyraisingintracellularcAMp.
Moderatelyhighdosesproduceapositiveionotropiceffect(direct
beta1&D1action+duetoNArelease),butlittlechronotropic
effectonheart).
Theadvantageofthisgreaterinotropiceffect(increasedforceof

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contraction)thanchronotropiceffect(increasedheartrate)of
dopamineisthatitproducessmallerincreaseinoxygendemandby

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theheart.
Largedoses(>10microgram/kg/minproducevasoconstriction
(alpha1action).

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Athighdoses,itiscalledinoconstrictorbecauseithasinotropicand
vasoconstrictoreffect.

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14.Antiviraldrug(s),whichis/areapro-drug?
a)Acyclovir
b)Ganciclovir

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c)Ziduvudin
d)Tenofovir
e)Foscarnet
CorrectAnswer-A:B:C
Ans.is'a'i.e.,Acyclovir,'b'i.e.Ganciclovir&'c'i.e.Zidovudine

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[Ref.KDT7/ep.22&p.24;GoodmanGillmanp.534:Bennet
Brownclinicalpharmap.404;Katzungp.361,385;
ww.ncbi.nlm.nih.gov]
Anti-herpesvirus:Acyclovir,Valacyclovir.penciclovir,Famciclovir,
Garciclovir,valganciclovir.

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Anti-Retrovirus:Nucleosidereversetranscriptaseinhibitors
(NRTIs)-Zidovudine,Didanosine.Zalcitabine,Stavudine,amirudin,
Abacavir.
Foscametisunrelatedtoanynucleicacidprecursor,sodoesnot
requirephosphorylationforactivation.

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Tenofovirisanucleotideanddoesnotrequirebioactivationby
kinases.
Oralbioavailabilityoftenofovirincreaseswithmeals(decreasedfor
otherNRTIs).

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15.Diureticdrugswhicharecarbonic

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anhydraseinhibitorsinclude?
a)Acetazolamide
b)Spironolactone
c)Furesemide
d)Chlorthiazide

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e)Topiramate
CorrectAnswer-A:E
Ans.is'a'i.e.,Acetazolamide&'e'i.e.Topiramate
Ref:KDT7/ep.5g7,420,155;Katzung13h/ep.255]
Carbonicanhydraseinhibitors(acetazolamide):

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Carbonicanhydrase(CAse)isanenzymewhichcatalyzesthe
reversiblereactionofbicarbonateformation.
Theenzymeispresentinrenaltubularcells(specialtyPT),gastric
mucosa,exocrinepancreas,ciliarybodyoftheeye,brainandRBC,
Acetazolamide,dichlorphenamide,methazolamideandtopiramate

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arecarbonicanhydraseinhibitors.
Dorzolamide&Brinzolamideisalsoacarbonicanhydraseinhibitors
specificforCA-II.
Carbonicanhydraseinhibitorsactbyanon-competitive,reversible
inhibitionoftheenzymecarbonicanhydrase.

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Asinhibitionisreversible,actionofcarbonicanhydraseinhibitorsis
selflimiting.

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16.Drugswhichareusedinacuteasthma
include?
a)Budesonide

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b)Terbutaline
c)Salbutamole
d)Theophylline
e)Sodiumcromoglycate
CorrectAnswer-B:C:D

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Ans.is'b'i.e.,Terbutaline,'c'i.e.Salbutamole&'d'i.e.
Theophylline
[Ref:KDTVh/ep.223]
Treatmentofacuteasthma:
Theonlydrugseffectiveforthetreatmentofacuteattackofasthma

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arebronchodilators(beta2-receptoragonists,anticholinergics,and
methylxanthines).
Mildattacks:
Forpatientswithmildattackinhalationofashortactingbeta-2
receptoragonist,e.g.salbutamol(albuterol),terbutalineisused.

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Aninhaledanticholinergic,e.g.ipratropiummaybeaddedifthereis
nosatisfactoryresponsetobeta2-agonistsalone.
Inpatientswhoarerefractorytoinhaledtherapies,i.v.aminophylline
(theophylline)maybeeffective.
Severeattacks:

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Oxygenphtscontinuousadministrationofaerosolizedsalbutamol
(albuterol)plussystemicsteroids,e.g.methylprednisolone,
hydrocortisone.

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Recently,MgSO4hasbeentriedinacutesevereasthmabyIVor
inhalationroute.

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17.Antiplateletdrugswithadenosine
receptorinhibitionpropertyinclude?
a)Ticlopidine
b)Clopidogrel
c)Prasugrel

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d)Abciximab
e)Cilastazole
CorrectAnswer-A:B:C
Ans.is'a'i.e.,Ticlopidine,'b'i.e.Clopidogrel&'c'i.e.Prasugrel
Ref:KDTVh/ep.629&6h/ep.609;KatzunglLth/ep.598

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ADPmediatedplateletactivationthroughcAMPisinhibitedby
(antagonismofP2Y12)receptorsonADP:-
Irreversible:Ticlopidine.clopidogrel.prasugrel
Reversible;Cangrelor,ticagrelor

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18.Drugswithfirstorderkineticsshow?

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a)Increasedclearancewithincreaseinconcentration
b)Decreasedeliminationwithconcentration
c)Norelationrateofeliminationandconcentration
d)Constantfractionofdrugiseliminatedperunittime
e)Halfliferemainsconstant

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CorrectAnswer-A:D:E
Ans.is.a,i.e.,Increasedclearancewithincreasein
concentration,'d'i.e.constantfractionofdrugiseliminatedper
unittime&'e'i.e.Halfliferemainsconstant
[Ref:KDTp.31;Katzung13th/ep48]

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Orderofkinetics:
Therateatwhicheliminationtakeplaceissubjectedtoimportant
influencesthatarereferredtoasorderofkinetics
Therearetwoordersofsuchelimination:
Firstorderkinetic(LinearKinetics)

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Secondorderkinetic(Non-LinearKinetics)
Infirstorderkinetic,
Rateofeliminationdirectlyproportionalplasmaconcentration.
Clearanceremainsconstantbecause,astheplasmaconcentration
Increasestherateofeliminationincreasesproportionately(CL=rate

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ofelimination/PlasmaConc).
HaIfliferemainsconstantbecausetimerequiredtoreducethe
plasmaconcentrationtohalfissame(rateofelimination).

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19.Whichofthefollowingis/aretrueabout
pregabalin:

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a)Approveddrugfordiabeticneuropathy
b)Approvedfortreatmentofgeneralizedtonicclonicseizure
c)Peripheraledemaissideeffect
d)Somnolenceissideeffect
e)ApprovedforuseinPartialseizure

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CorrectAnswer-A:C:D:E
Ans.a.ApproveddrugForDiabeticneuropathy;c.Peripheral
edemaissideeffect;d.Somnolenceissideeffect;e.Approved
foruseinpartialseizures.
[RefKDT7th/419;Katzung13th/4M,419;Harrisontgth/2682;

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PharmacologybySatoskar24th139)
Pregabalinside-effectincludes:Cognitivechanges,sedation&
peripheraledema.
GABAanalog.
Antiseizureactivityandforitsanalgesicproperty.

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Approvedforuseinneuropathicpain,includingpainfuldiabetic
peripheralneuropathy,postherpeticneuralgia&complexregional
painsyndrome.
Toxicityincluded-Somnolence,dizziness,ataxia

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20.Drug(s)usedforoveractivebladder:

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a)Oxybutinin
b)Tolterodine
c)Mirabegron
d)OnabotulinumtoxinA
e)Pirenzepine

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CorrectAnswer-A:B:C:D
Ans.a.Oxybutynin;b.Tolterodine;c.Mirabegron;D.
OnabotulinumtoxinA
[R4KDf7th/117-18;Katzung13th/127-28;Rang&Date8th/366;
PharmacologybySatoskar24th/3OS-07]

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OveractiveBladder:
AntimuscarinicdrugssuchasOxybutynin,Flavoxate,tolterodine&
trospiumareusedforbothneurogenic&non-neurogenicoveractive
bladder.
Sollfenacin&darifenacinarethenewdrugs(M3antagonist)foruse

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inoveractivebladder.
Mirabegronisbeta-3adrenergicagonistusedforoveractivebladder.
OnabotulinumtoxinAisusedassingleintradetrusorinjection,to
treatoveractivebladder.

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21.Allaretrueaboutwarfarinexcept:

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a)ActthroughinhibitionofcoagulationfactorIX
b)Protaminesulphatereversesitsaction
c)MonitoringisdonethroughINR
d)TargetofINRwithwarfarinisgenerally2-3
e)Skinnecrosisisusuallyoccurin3-10daysofinitiationof

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warfarin
CorrectAnswer-B
Ans:b.Protaminesulphatereversesitsaction.
[RefKDT7th/620-24;Katzung13th/590-92;Rang&DaleSth/30q
PharmacologybySatoskar24th/jN-301]

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Warfarininducedskinnecrosisisararecomplicationcharacterized
bytheappearanceofskinlesion3-10daysafterinitiationof
treatment.
DoseofwarfarinadjustedtogiveanINRof2-4,theprecisetarget
dependingontheclinicalsituation.

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Thereferencerangeforprothrombintimeisusuallyaround12-13
secondsandtheINninabsenceofanticoagulationtherapyis0.8-1.
2
Warfarin:Doseregulationisdonebyprothrombintime&INR
(Heparin/aPTT/clottingtime.

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AntagonistisVitK(c.fHeparin-Protaminesulphate).

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22.TrueaboutM/Aofdoxorubicin:
a)Intercalateb/wDNAstrands
b)InhibitionofDNApolymerase
c)InhibitionofRNApolymerase

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d)InhibitionoftopoisomeraseII
e)Inhibitionofproteinsynthesis
CorrectAnswer-A:D
Ans.A.Intercalateb/wDNAstrands;D.InhibitionOf
TopoisomeraseII

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[Ref:KDT7th/867;Katzung13th/932'j5;G6G1lth/1358;
PharmacologybySatoskar24th/835)
Doxorubicin:Itactsasanon-specificinhibitoroftopoisomerase-II,
thusinterferingwithDNAreplication.

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23.Anticholinergicdrugside-effectincludes:

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a)Constipation
b)Urinaryretention
c)Mydriasis
d)Hypothermia
e)Blurringofvision

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CorrectAnswer-A:B:C:E
Ans:A.Constipation.B.UrinaryretentionC.MydriasisE.
Blurringofvision
[Ref:KDT7th/120;GdzG11th/194;Katzung13th/129;Rang&
Dale\th/164-65;PharmacologybySatoskar24th/301).

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Bodytemperatureisfrequentlyelevated.
Unfortunately,children,especiallyinfants,areverysensitiveto
hyperthermiceffectsofatropine.
Constipation&urinaryretention(precipitationespeciallyinelderly)
canoccurwithatropine

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Difficultyinswallowing,drymouth,ferer,dry-flushed&hotskin,
difficultyinmicturition,Mydriasis,photophobia,blurringofnear
vision,palpitations,dreadfulvisualhallucination,ataxia,delirium,
psychoticbehavior,weak&rapidpulse,hypotension,
cardiovascularcollapsewithrespiratorydepression,convulsion&

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coma.

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24.Whichofthefollowingis/aretrueabout
benefitsofSustainedreleaseformulation
ofdrugs:
a)Decreasedincidenceand/orintensityofundesiredeffects

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b)Increasespotencyofthedrug
c)ReleaseofdrugislessinfluencedbypH
d)Prolongdrugeffect
e)Decreasedfrequencyofadministration
CorrectAnswer-A:C:D:E

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AnsA.DecreasedIncidenceand/orIntensityofundesired
effects;c.ReleaseOfDrugIsLessInfluencedBypH;D.
Prolongdrugeffect;E.DecreasedFrequencyofadministration.
[Ref:KDf7th/35;G6'G11th/5;PharmacologybySatoskar24th/7;
http://www.pharmatutor.org/articles/review-sustained-release-

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dosage'forms).
Sustainedreleaseimpliesslowreleaseofthedrugoveratime
period.
Itmayormaynotbecontrolledrelease
Advantagesofsustainedreleasedosageforms:

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Controlofdrugtherapyisachieved.
Rateandextentofdrugabsorptioncanbemodified
Frequencyofdrugadministrationisreduced.
Patientcompliancecanbeimproved.
Drugadministrationcanbemadeconvenient

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Maximizingtheavailabilityofdrugwithminimumdose.
Thesafetymarginofhighpotencydrugcanbeincreased.

---

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25.Trueaboutdrug-responsecurve(DRC):
a)SteepestinmiddleportionoftheDRC
b)InvertedUshapedcurvemaybeforsomedrug

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c)Rectangularhyperbola-whenplottedinlogarithmicscale
d)Sigmoidshape-whenplottedinlogarithmisused
e)Enablescomparisonofpotencyofdrugs
CorrectAnswer-A:B:C:E
Ans.(A)SteepestinmiddleportionoftheDRC(B)InvertedU

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shapedcurvemaybeforsomedrug(C)Rectangularhyperbola-
whenplottedinlogarithmicscale(E)Enablescomparisonof
potencyofdrugs
Dose-ResponseRelationship:
Rectangularhyperbola.

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Sigmoidalcurveindose-responserelationship:thesteepestportion
inthemiddle-wiki.
DRCisusedtomeasure-drugpotency,drugefficacy&drugsafety-
slideshare.
Somedrugscauselow-dosestimulationandhigh-doseinhibitionof

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response.
TheseU-shapedrelationshipsforsomereceptorsystemsaresaidto
displayhormesis.
Severaldrug-receptorsystemscandisplaythispropertye.g.,
prostaglandins,endothelin,andpurinergicandserotonergic

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agonists,amongothers),whichislikelytobeattherootofdrug
toxicity.

---

26.Trueaboutorganophosphoruspoisoning:
a)Atropineisbestforearlytreatment&maintenance
b)Pralidoximeisimportantforrestoringneuromuscular

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transmission
c)Phenytoinistheprimarydrugusedforseizurecontrol
d)Mydriasispresent
e)Pralidoxime&atropineworkssynergistically
CorrectAnswer-A:B:E

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Ans.(A)Atropineisbestforearlytreatment&maintenance
(B)Pralidoximeisimportantforrestoringneuromuscular
transmission(E)Pralidoxime&atropineworkssynergistically
[RefReddy32nd/495-97;G&Gltth/21};KDT7th/111:13th/979-80;
PharmacologybySatoskar24th/297]

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OrganophosPhorusPoisoning:
AIIcaseofAnti-ChEpoisoningmustbepromptlygivenatropine2
mgi.Vrepeatedevery10mintilldryness&othersignsof
atropinizationappear.
Continuedtreatmentwithmaintenancedosesmayberequiredfor1-

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2weeks
Theuseofoximesinorganophosphatepoisoningissecondaryto
thatofatropine.Moreventheclinicalbenefitofoximesishighly
variable.
Controlofconvulsionswithjudicioususeofdiazepam.

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Ocularmanifestationsincludemarkedmiosis'ocularpain'
conjunctivalcongestion,diminishedvision,ciliaryspasm,Andbrow
ache.
Atropineinsufficientdosageeffectivelyantagonizestheactionsat

---

muscarinicreceptorsites,andtoamoderateextentatperipheral

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ganglionicandcentralsites

---

27.Whichofthefollowingdrug(s)actby
inhibitingproteinsynthesisbyattaching
to50Sribosome:
a)Tetracycline

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b)Ampicillin
c)Isoniazid
d)Imipramine
e)Ethionamide
CorrectAnswer-B:C

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Ans.(B)Ampicillin(C)Isoniazid
[KDT7th/734,768;Katzung13th/789]
Tetracyclinesbindto30Sribosome&inhibitaminoacylRNA
attachmenttotheAsite
Erythromycin&clindamycinbindto50Sribosome&hinder

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translocationoftheelongatedpeptidechainbackfromAsitetoP
site.PeptidesynthesismaybeprematurelyTerminated.
ChloramPhenicolbindsto50Ssubunit'Itinterferewithpeptidebond
formation&transferofpeptidechainfromPsite
Aminoglycosidesbindtoseveralsitesat30S&50Ssubunits-freeze

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initiation,interferewithpolysomeformation&causemisreadingof
mRNAcode

---

28.OCPefficacydecreaseswithconcurrent
administrationofwhichofthefollowing
drug(s):

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a)Phenytoin
b)Ampicillin
c)Isoniazid
d)Imipramine
e)Ethionamide

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CorrectAnswer-A:B
Ans.(A)Phenytoin(B)Ampicillin
[RefKDT7th/326;Katzung13th/712;Rang&DaIe9th/434:
PharmacologybySatoskar24th/967).
Contraceptivefailuremayoccurwithconcurrentadministration

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of:
Enzymeinducer:Phenytoin,phenobarbital,primidone,
carbamazepine,rifampin,ritonavir-Metabolismofestrogenic&
progestationalcomponentisincreased.
Tetracyclines-ampicillin.

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Deconjugationofestrogenssecretedinbilefailstooccurtheir
enterohepaticcirculationisinterruptedbloodlevelfal

---

29.Allaretrueabouttamoxifeneexcept:
a)Usedasadjuvanttherapyinestrogenreceptorpositivebreast
cancer

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b)Approvedfortheprimaryprophylaxisofbreastcancerinhigh
riskwoman
c)Noeffectonuterus
d)Pro-estrogeneffectonbone
e)CauseendometrialCa

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CorrectAnswer-A:C:D:E
Ans.(A)Usedasadjuvanttherapyinestrogenreceptorpositive
breastcancer(C)Noeffectonuterus(D)Pro-estrogeneffecton
bone(E)CauseendometrialCa
[Ref;KDT7th/101'02;Katzung13th/106]

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NMislocatedinneuromuscularjunction6causedepolarizationof
muscleendPlate
NNlocatedonautonomicganglia,adrenalmedulla&CNS
Mostsmoothmuscles&glandshaveM26M3subtypes;M3
Predominates.

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Achisamajorneurotransmitteratautonomic,somaticaswellas
centralsites.ReleaseofAchfromnerveterminalhelpinsynaptic
transmission

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30.
Whichoffollowingtrueregarding

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acetylcholinereceptors:
a)M2receptor-heart
b)MIreceptor-smoothmuscle
c)NMreceptorispresentonneuromuscularjunction
d)Synapticjunction-Achistransmitter

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e)NNlocatedonadrenalmedulla
CorrectAnswer-A:C:D:E
Ans.(A)M2receptor-heart(C)NMreceptorispresenton
neuromuscularjunction(D)Synapticjunction-Achis
transmitter(E)NNlocatedonadrenalmedulla

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[Ref;KDT7th/101'02;Katzung13th/106]
NMislocatedinneuromuscularjunction6causedepolarizationof
muscleendPlate
NNlocatedonautonomicganglia,adrenalmedulla&CNS
Mostsmoothmuscles&glandshaveM26M3subtypes;M3

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Predominates.
Achisamajorneurotransmitteratautonomic,somaticaswellas
centralsites.ReleaseofAchfromnerveterminalhelpinsynaptic
transmission

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31.Antibioticofchoicefor

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Stenotrophomonasmaltophiliainfection
is:
a)Ampicillin
b)Trimethoprim-sulfamethoxazole(TMP-SMX)
c)Penicillin

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d)Ciprofloxacin
e)None
CorrectAnswer-B
Ans:b.Trimethoprim-sulfamethoxazole(TMP-SMX)

---

32.TNF-aInhibitorsareusedfor:

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a)Ulcerativecolitis
b)Crohn'sdisease
c)Rheumatoidarthritis
d)Psoariasis
e)Lichenplanus

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CorrectAnswer-A:B:C:D
Ans.A,UlcerativecolitisB,Crohn'sdiseaseC,Rheumatoid
arthritisD,Psoariasis
[RefHanison19th/1961;NeenaKhanna5th/58,68;CMDT2016/641;
KDT7th/883-84).

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TNF-alphaInhibitors:Use
Etanercept-Rheumatoidarthritis,severe/refractoryankylosing
spondylitis,plaquepsoriasis,polyarticularidiopathicjuvenilearthritis.
Infliximab-refractoryrheumatoidarthritis,ankylosingspondylitis,
psoriasis,fistulatingCrohn'sdisease,ulcerativecolitis

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Adalimumab-Useaslikeinfliximab
Certolizumab-Crohn'sdisease
Golimumab-ulcerativecolitisPsoriasis:TreatmentincludesTNF
blockerslikeetanercept,infliximab.

---

33.S/EofBevacizumabincludes:

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a)Hypertension
b)Hemoptysis
c)Malena
d)Cerebellarstroke
e)Notcausegastrointestinalperforation

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CorrectAnswer-A:B:C:D
Ans.A,HypertensionB,HemoptysisC,MalenaD,Cerebellar
stroke
[Ref:KDT7th/871:Katzung13th/937-38;Rang&Dale8th/;
PharmacologybySatoskar24th/840).

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S/EofBevacizumab:
Hypertension
Arterialthromboembolism-heartattack6stroke
Vesselinjury6haemorrhages
Heartfailure

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Proteinuria
Gastrointestinalperforation
Healingdefect

---

34.Trueaboutmethanolpoisoning:
a)Gastricdecontaminationishelpful

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b)Formate&formaldehydeareactivemetabolite
c)TakingwithEthanolcausemoretoxicity
d)Fomipezoleaspecificantagonist,isgivenfortreatment
e)Causehighaniongapacidosis
CorrectAnswer-A:B:D:E

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Ans.A,GastricdecontaminationishelpfuB,Formate&
formaldehydeareactivemetaboliteD,Fomipezoleaspecific
antagonist,isgivenfortreatmentE,Causehighaniongap
acidosis
[Ref:KDT7th/394-96;Katzung13th/393;Pharmacologyby

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Satoskar24th/9s-96).
TreatmentofMethylAlcohol
Fomepizole,analcoholdehydrogenaseinhibitor,isapprovedforthe
treatmentofethyleneglycolpoisoningandmethanolpoisoning.
Ethanolusedintravenouslyastreatmentformethanolpoisoning.

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Methanolconcentrationshigherthan50mg/dlarethoughttobean
absoluteindicationforhemodialysisandtreatmentwithfomepizole
orethanol,althoughformatebloodlevelsareabetterindicationof
clinicalpathology.
Hospitalisation,nursingcare

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Gastriclavage,activatedcharcoal
Treatmentofacidosis/hypoglycemia
Inhibitionofmethanolmetabolism-Givingethylalcoholdtfomepizole
(aspecificinhibitorofalcoholdehydrogenase&drugofchoicefor
methanolpoisoning)

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---

Promotemetabolicdegradationofformate:folinicacidtogetherwith
folicacid
Diuretics,urinealkalinisation
Hemodialysisinseverecase
Maintenanceofnutrition

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---

35.Whichofthefollowingistrueregarding
ropinirolewrtL-dopa:
a)Cognitivesymptomimproves
b)Lowerincidenceofhallucination
c)Causeexcessivesleepiness

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d)Moreeffectiveinthetreatmentofpatientswhohavedeveloped
on/offphenomena
e)Provideneuroprotectiveeffect
CorrectAnswer-C:D:E
Ans.C,CauseexcessivesleepinessD,Moreeffectiveinthe

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treatmentofpatientswhohavedevelopedon/offphenomena
E,Provideneuroprotectiveeffect
[Ref:KDT7th/430-31;G&G535-j8;Katzung13th/478;Rang6Date
8th/494-95;PharmacologybySatoskar24th/237
Allthedopamineagonistsinlargerdosescancoutetevere

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neuropsychiatricadverseeffects.
Ropinirole&Pramipexole
SelectiveD2/D1receptoragonists
Bettertolerateddtdonotshowthefluctuationsinefficacyassociated
withlevodopa.

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Theydo,however,causesomnolence6sometimeshallucinations
(recentevidencesuggeststhattheymaypredisposetocompulsive
behaviours,suchasexcessivegambling,overeating6sexual
excess,relatedtotherewardfunctionsofdopamine
Adisadvantageofcurrentdopamineagonistsistheirshortplasma

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halfLife(6-8hr),requiring3timesdailydosagethoughslowrelease

---

oncedailyformulationsarenowavailable
Trialhavefoundthemtoaffordsymptomreliefcomparableto
levodopa.
Sometrialshavenotedlowerincidenceofdyskinesias6motor

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fluctuationsamongPatientstreatedwiththesedrugsthandose
treatedwithlevodopa
Itislongeractingthanlevodopa.
Highincidenceofhallucination&sleepiness

---

36.Whichofthefollowingdrug(s)comesin

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riskcategoryBofFDAteratogenicrisk
categoriesforpregnancy:
a)Phenytoin
b)Resperidone
c)Olanazapine

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d)Clozapine
e)Arpirazole
CorrectAnswer-D
Ans.D.Clozapine
[Ref:KDT7th/90;Katzung13th/1018;Rang6Dale8th/700;

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PharmacologybySatoskar24th/1122;http://schizophreniabulletin-
oxfordjournal]
CategoryA:
Norisktofetusinhumanstudies
Levothyroxine

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Potassium
Supplementation
MgSO4
CategoryB
Animalstudiesshownorisk

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Humanstudiesarelacking
Penicillins
Cephalosporins
Macrolides
Brimonidine

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---

CategoryC
AnimalstudiesshowPositiveteratogenicrisk
Humanstudiesarenotavailable
Albuterol
Zidovudine

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CCB
Morphine
Atropine
CategoryD
Humanandanimalstudiesshowpositiveteratogenicrisk

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Canbeusedinpregnancybecauseofbenefitsgreaterthanrisk
mightbeacceptable.
Corticosteroids
Azathioprine
Carbamazepine

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Valproate
Methotrexate
Lithium
CategoryX
Humanandanimalstudiesshowpositiveteratogenicrisk

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Absolutelycontraindicatedinpregnancybecauseofriskgreaterthan
benefits.
Thalidomide
isotretinoin
Fluoroquinolones

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Tetracyclines
Chloramphenicol
Warfarin
ACEinhibitors

---

37.Whichofthefollwingis/areactionof

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estrogenexcept:
a)Developmentofthealveolarsystem
b)Proliferationofstromaofbreast
c)Ductalgrowthofthebreast
d)CBoneresorption

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e)Developmentoflobulesofbreast
CorrectAnswer-A:E
Ans.(A)Developmentofthealveolarsystem(E)Development
oflobulesofbreast
Oestrogencausesonlyductdevelopment.

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Progesteroneisresponsibleforglandulardevelopment.
Itpromotesthegrowthofthelobulesandalveolartissueinbreast.
Promotesthedevelopmentofthealveolar(acinar)systemofthe
breast
Estrogen-functions:

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Importantinmaintainingbonemassprimarilybyretargetingbone
resorption.
Producedatpubertycausegrowthofbreastsproliferationofducts
andstroma,accumulationoffat.
Stimulatestromaldevelopmentandductalgrowthinthebreast

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Contributetothegrowthofaxillaryandpubiahair.
Pigmentationintheskin,mostprominentintheregianofthenipplas
andareolae.
Continuousexposuretoestrogensforprolongedperiodsleadsto
hyperplasiaoftheendometrium.

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Decreasetherateofresorptionofbonebypromotingapoptosisof
osteoclastsandbyantagonizingtheosteoclastogenicandpro-
osteoclasticeffectsofparathyroidhormoneandinterleukin-6.

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38.Allaretrueaboutbisphosphonatesexcept
:

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a)Preventreabsorptionofbonebyosteoclast
b)Structurallysimilartopyrophosphate
c)Absorptionincreaseswithfood
d)Canbesafelygiveninliverdisease
e)None

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CorrectAnswer-C
Ans.C.Absorptionincreaseswithfood
Bisphosphonates(BPNs):
BPNsareanalogiesofpyrophosphate;carbonatomreplacing
orygenintheP-O-Pskeleton

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AlloralBNPsarepoorlyabsorbedandproducegastricirritationas
majorsideeffect.
Theyinhibitsboneresorptionandhaverecentlyattracted
considerableattentionbecauseoftheirabilitytoprevent
osteoporosisinadditiontotheirusefulnessinmetabolicbone

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diseasesandhypercalcemia.
MOA:Localizetoregionsofboneresorption&exerttheirgreatest
effectsonosteoclasts.
Foodreducesabsorptionevenfurther,necessitatingtheir
administrationonanemptystomach.

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Nearlyhalfoftheabsorbeddrugaccumulatesinbone;the
remainderisexcretedunchangedintheurine.
Decreasedrenalfunction,esophagealmotilitydisorders&peptic
ulcerdiseasearethemaincontraindications.

---

---

39.Whichofthefollowingis/arenewerdrugs

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forTB:
a)Bedaquiline
b)Clofazimine
c)Coftaroline
d)Rifapentine

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e)Etanercept
CorrectAnswer-A:B:D
Ans.(A)Bedaquiline(B)Clofazimine(D)Rifapentine
NewerAnti-TBdrugs:
CommunityMedicinewithRecentAdvancesbySuryakantha

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4ed/371
Rifabutin
Rifapentine-400mgtwiceweekly.
Macrolides:Roxithrornycin,Clarithromycin,Azithromycin
Amikacin

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Fluoroquinolones:Ciprofloxacin,ofloxacinandsparfloxacin
B-lactamantibiotic:trialsaregoingonwithamoxicillin-clavulanic
acid
Clofazimine-200mg/d
Paromomycin

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Cytokineimmunotherapy:IL-2,cytokinegammainterferonand
cytokineIL-12
Bedaquiline-Multi-drugresistanttuberculosis(MDR-TB)-400mg/d

---

40.Allaretrueaboutoralirontherapyin
anemiaexcept:

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a)Mayworseninflammatoryboweldisease
b)Ittakesminimum2weeksforreticulocytecounttoincrease
c)Generally3-6monththerapyisrequiredtoreplenishironstores
d)Gastrointestinalside-effectslimitsitsdose
e)Hblevelisgenerallyattainedin1-3month

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CorrectAnswer-B
Ans.B.Ittakesminimum2weeksforreticulocytecountto
increase
OralironTherapy:
Followingoraliron,normalHblevelisusuallyobtainedwithin1to3

--- Content provided by‌ FirstRanker.com ---

months.
DependingmainlyontheinitialHblevel.
Itisimportant,however,tocontinuewiththetherapyfor12-20
weeksaftertheHblevelhasreturnedtonormal,inordertoreplenish
thedepletedironstores.

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Thereticulocytecountintheperipheralbloodbeginstorisewithina
week,reachesapeakat10to14daysandreturnstonormalafter3
weeks
AdverseEffectsofOraliron:
Epigastricpain,heartburn,nausea,vomiting,bloatingstainingof

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teeth,metallictaste,col:la,
Alterationofintestinalflora.
Gastricirritationandconstipation.
TreatmentofironDeficiency:

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Abilityofthepatienttotolerateandabsorbmedicinaliron.

--- Content provided by FirstRanker.com ---

---

41.DrugthatcanpotentiateTorsadesde
pointes:
a)Amiodarone
b)Sotalol
c)Chlorpromazine

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d)Cisapride
e)Aspirin
CorrectAnswer-A:B:C:D
Ans,A,AmiodaroneB,SotalolC,Chlorpromazine&D,Cisapride
TorsadesdePointes(VentricularTachycardia)

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Antiarrhythmics:
Quinidine,procainamide,disopyramide,propafenone,amiodarone
Antimalarials:
Quinine,mefloquine,artemisinin,halofantrine
Antibacterials:

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Sparfloxacin,moxifloxacin
Antihistamines:
Terfenadine,astemizole,ebastine
Antidepressants:
Amitriptylineandothertricyclics.

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Antipsychotics:
Thioridazine,pimozide,aripiprazole,ziprasidone
Prokinetic:
Cisapride

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42.Drugwhichcanbegivenbyinhalation

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route:
a)Zileuton
b)Steroid
c)Salbutamol
d)Tobramycin

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e)None
CorrectAnswer-B:C
Ans.(B)Steroid(C)Salbutamol
lnhalatlonalsteroids.Beclomethasone,dipropionate,budesonide,
fluticasonepropionate,flunisolideandciclesonide.

--- Content provided by⁠ FirstRanker.com ---

Salbutamol:usedinformoforal,i.m/s.candinhalation.
Zileuton:Itisavailableonlyasextendedrelease(oral)formulation.
Tobramycin:Usedinformofi.m/i.v,eyedrop

---

43.Liverfunctiontest(LFT)monitoringis/are
requiredinuseofwhichofthefollowing

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DiseaseModifyingAntirheumaticDrugs
(DMARDs):
a)Methotrexate
b)Hydroxychloroquine
c)Sulfasalazine

--- Content provided by​ FirstRanker.com ---

d)Leflunomide
e)Gold
CorrectAnswer-A:D:E
Ans.(A)Methotrexate(D)Leflunomide(E)Gold
DMARDsUsedforthetreatmentofrheumatoidarthritis:

--- Content provided by​ FirstRanker.com ---

Hydroxychloroquine-Funduscopicandvisualfieldtestingevery12
months.
Sulfasalazine-CBCevery2-4weeksforthefirst3months,then
every3months
Methotrexate&Leflunomide-CBC,creatinine,LFTsevery2-3

--- Content provided by​ FirstRanker.com ---

months
Tocilizumab-CBCandLFTsatregularintervals

---

44.Trueabouteffectofsteroidintakein
inflammatoryconditions:
a)Proanaboliceffectonmuscles

--- Content provided by‍ FirstRanker.com ---

b)Tglucoseinplasma
c)-vefeedbackoncorticotropin-releasinghormone(CRH)
production
d)Maycauseosteoporosis
e)None

--- Content provided by⁠ FirstRanker.com ---

CorrectAnswer-B:C:D
Ans.B,TglucoseinplasmaC,-vefeedbackoncorticotropin-
releasinghormone(CRH)production&D,Maycause
osteoporosis
Glucocorticoids:

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GivenchronicallysuppressthepituitaryreleaseofACTH
Glucocorticoidsincreaseserumglucoselevel.
GlucocorticoidsstimulateRNAandproteinsynthesisintheliver,
theyhavecatabolicandantianaboliceffectsintymphofuland
connectivetissue,muscla,peripheralfat'andsldn.

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CortisolhasanegativefeedbackonACTHandCRHproduction.

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45.Drugswhichcanbeusedingestational
hypertension:
a)Metoprolol
b)Labetalol

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c)Methyldopa
d)Sustainedreleasenifedipine
e)Losartan
CorrectAnswer-A:B:C:D
Ans.(A)Metoprolol(B)Labetalol(C)Methyldopa(D)Sustained

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releasenifedipine
Antihypertensiveagentsusedinpregnancy:Methyldopa,
lrydralazlne,labetalol,Nifedipine,atenolol.

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46.Trueaboutosmoticdiuretics:
a)Osmoticdiureticshavetheirmajoreffectinthedistal

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convolutedtubule
b)Contraindicatedincongestiveheartfailure
c)CausesHyperkalemia
d)Increasesrenalbloodflow
e)None

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CorrectAnswer-B:C:D
And.B,ContraindicatedincongestiveheartfailureC,Causes
Hyperkalemia&D,Increasesrenalbloodflow
OsmoticDiuretics:
Majoreffectintheproximaltubuleandthedescendinglimbof

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Henle'sloop.
InhibitsTransportprocessesinthethinkAscLH.
Uses:
Usedtoincreasewaterexcretioninpreferencetosodiumexcretion.
ExtracellularVolumeexpansion-Effectcancomplicateheartfailure

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andmayproducefloridpulmonaryedema-ContraindicatedinCHF.
Causesdehydration,Hyperkalemia,andHypernatremia
Headache,nausea&vomitingarecommonlyobservedinpatients
treatedwithosmoticdiuretics.

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47.Whichofthefollowingdyadsshow

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clinicallysignificantdruginteractions:
a)Vancomycin--AmphotericinB
b)Rantidine-Atorvastatin
c)Warfarin--Aspirin
d)Allopurinol--Azathioprine

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e)Aminoglycoside+Vancomycin
CorrectAnswer-A:C:D:E
Ans.A,Vancomycin--AmphotericinBC,Warfarin--
AspirinD,Allopurinol--Azathioprine&
E,Aminoglycoside+Vancomycin

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Druginteraction:
Drugsmayinteract,butmostcanbecategorizedas
pharmacoKInetic(absorptiondistribution,metabolism,excretion),
phartnacodlmamla(aMitiveorantagonisticeffects),orcombined
interactions.

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Eg:
Aminoglycosides,vancomycin,cyclosporineandothernephrotoxic
drugenhancetherenalimpairmentcausedbyamphotericinB
Allopurinolinhibitsthedegradationofi-mercaptopurineand
azathioprine;theirdosesshouldbereducedto?.

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Enhanced'anticoagulantactionofwarfarin:
HighdosesoFsalicylateshavesynergistichypoprothrombinemic
action&alsodisplacewarfarinfromproteinbindingsite.

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48.Adverseeffectsofmirtazapineis/are:
a)Insomnia

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b)Sedation
c)Sexualdysfunction
d)Vomiting
e)Weightgain
CorrectAnswer-B:E

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Ans.(B)Sedation(E)Weightgain
Mirtazapine
Importantadversedrugreactions
markedsedation
increasedappetite

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weightgain
Somnolence(mostcommon)
Drymouth
Constipation
Dizziness

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Myalgias
Increaseserumcholesterolconcentrationto20percent
Orthostatichypotension
Agranulocytosis

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49.Firstpassmetabolismissignificant

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problemindruggiventhrough:
a)Sublingualroute
b)Rectalroute
c)Intramuscularroute
d)Directlyintostomach

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e)Directlyintolargeintestine
CorrectAnswer-D
Ans.D,Directlyintostomach
Allorallyadministereddru.gsareexposedtodrugmetabolizing
enzymesintheintestinalwallandliver(wheretheyfirstreach

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throughtheportalvein).
Druggivendirectlyintothestomachandintestinestillhavetopass
throughfirstpassmetabolismintheintestinalwallandinliver.
Approximately50%ofthedrugthatitisabsorbedfromtherectum
willbypasstheliver,thusreducingthehepaticfirst-passeffect.

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Presystemicmetabolismlnthcgutandlivercanbeavoidedby
administeringthedrugthroughsublingual,transdermalorparenteral
(i.v/i.m/intradermal/s.c)routes.
Theeventoffirstpassmetabolismdiffersfordlfierentdrugsandis
animportantdatennlnantoforalbioavallabiltty.

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Thehepaticfirst-passeffectcanbeavoidedtoagreatextentbythe
useofsublingualtabletsandtransdermalpreparationsandtoa
lesserextentbytheuseoFrectalsuppositories.
Subltngu.alabsorptionprovidesdirectaccesstosystemicnotportal-
velns.

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Thetranscanalrouteofiersthesameadvantage.

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50.Allaretrueaboutplasmaproteinbinding
except:
a)Acidicdrugsgenerallybindtoplasmaalbuminandbasicdrugs
toa,acidglycoprotein

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b)Plasmabindingdeterminesvolumeofdistribution
c)Moreplasmaproteinbindingmeansmorestorageinliver
d)Moreplasmaproteinbindingmeanslesspenetrationinvascular
membrane
e)Highdegreeofprotein.indinggenerallymakesthedruglong

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acting
CorrectAnswer-C
Ans.C,Moreplasmaproteinbindingmeansmorestoragein
liver
Drugswhicharehighlyproteinboundorionizedremainlargely

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withinthevascularcompartmentandhaveverylowvolumeof
distribution.
Acidicdrugsgenerallybindtoplasmaalbuminandbasicdrugstoa2
acidglycoprotein.
Albuminlsamajorcarrierforacidicdrugs.a1-acidglycoprotein

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blindsbasicdrugs.
Clinicallysignificantimplicationsofplasmaproteinbinding:
Bindingofadrugtoplasmaproteinalsolimitsthedrug'sglomerular
fiLtration.
Drugtransportandmetabolismalsoarelimitedbybindingtoplasma

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proteins.
Proteinbounddrugdoesnotcrossmembranes(exceptthrough

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largeparacellularspaces,suchasincapillaries).
Tendtohavesmallervolumesofdistribution.
Boundfractionofdruginnotavailableforaction.

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Plasmaproteinbindingthustantamountstotemporarystorageofthe
drug.
Highdegreeofproteinbindinggenerallymakesthedruglongacting,

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51.Carbonicanhydraseinhibitors(S)is/are:
a)Acetazolamide

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b)Amiloride
c)Nitrofurantoin
d)Topiramate
e)None
CorrectAnswer-A:D

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Ans.(A)Acetazolamide(D)Topiramate
Carbonicanhydraseinhibitor:Topiramate,Acetazolamida,
methazolamide,dichlorphenamide
orallyinthetreatmentofglaucoma-Acetazolamida,methazolamide,
dichlorphenamide

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Topicallyactivecarbonicanhydraseinhibitors-Dorzolamideand
brinzolamide.

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52.Whichofthefollowingis/aretrueabout
pharmacodynamicsofdrugs:
a)Affinitymeanshowstronglydrugbindstoreceptor

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b)Efficacymeansmaximaleffectbyadrug
c)Irreversibleantagonistmainlyformsionicbondswithreceptor
d)Agonistpotencydependsontwoparameters:affinityand
efficacy
e)Forantagonists,efficacyiszero

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CorrectAnswer-A:B:D:E
Ans.A,Affinitymeanshowstronglydrugbindsto
receptorB,EfficacymeansmaximaleffectbyadrugD,Agonist
potencydependsontwoparameters:affinityandefficacy&
E,Forantagonists,efficacyiszero

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Irreversiblecompetitive(non-equilibrium)antagonismoccurswith
drugsthatpossessreactivegroupsthatformcovalentbondswith
receptor.
ReceptorBlockAntagonisminvolvestwoimportantMechanisms
Reversiblecompetitiveantagonist

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Irreversible,ornon-equilibrium,competitiveantagonism.
Drugsactingonreceptorsmaybeagonistsorantagonists.
Agonistpotencydependsontwoparameters:affinity(i.e.tendency
tobindtoreceptors)andefficacy(i.e.ability,oncebound,toinitiate
changesthatleadtoeffects).

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Forantagonists,efficacyiszero.

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53.Whichofthefollowingis/aretrueabout
Tacrolimus:
a)Amacrolidesantibiotic
b)Structuresimilartocyclosporine

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c)Derivedfromafungus
d)Tcellinhibitor
e)Hirsutismlessevidentthancyclosporine
CorrectAnswer-A:D:E
Ans.(A)Amacrolidesantibiotic(D)Tcellinhibitor(E)Hirsutism

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lessevidentthancyclosporine
Tacrolimus:
Immunosuppressantischemicallydifferentfromcyclosporine,but
hasthesamemechanismofaction100timesmorepotent.
MacrolideantibioticproducedbyStreptomycestsukubaensis(a

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bacteria)
MOA:
InhibitionofhelperTcellsviacalcineurin.
BindstotheimmunophilinFK-bindingprotein(FKBP)
Therapeuticapplication,clinicalefficacyaswellastoxicityprofilaare

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similartocyclosporine.
Hypertension,hirsutism,gurnhyperplasiaandhyperuricemiaare
lessmarkedthanwithcyclosporine,buttacrolimusismorelikelyto
precipitatediabetes,causeneurotoxicityalopeciaanddiarrhoea.
Doselimitingtoxicityisrenal.

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54.TrueaboutLowmolecularweightheparin
(IAMB):
a)Anti-factorXaassaymonitoringrequiredineverypatient
b)ItincreasesaPTTmorethanUFH
c)Canbesafelygiveninrenalfailure

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d)Toxicityistotallyreversedbyprotaminesulphate
e)InactivatefactorXaselectively
CorrectAnswer-E
Ans.E.InactivatefactorXaselectively
LowMolecularWeight(LMW)HeparinsandUFH

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HeparinhasbeenfractionatedintoLMWforms(MW3000-7000)by
differenttechniques..
InactivateFactorXaselectively.
TheyactonlybyinducingaconformationalchangeinATIIIand,not
byprovidingascaffoldingforinteractionofATIIIwiththrombin.

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Asaresult,LMWheparinshavesmallereffectonaPTTandwhole
bloodclottingtimethanunfractionatedheparin(UFH).
Eliminatedprimarilybyrenalexcretionarenottobeusedinpatients
withrenalfailure..
SinceaPTT/clottingtimesarenotprolonged,Laboratorymonitoring

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isnotneeded.
Protaminedoesnotneutralizefondaparinuxanditonlypartially
reversestheanticoagulanteffectofLMWheparins.

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55.TrueaboutMafenide:
a)Canpenetrateeschars

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b)Doesn'tcauseburningsensationwhenappliedtorawsurface
c)Canbeusedorally
d)Maycausemetabolicacidosis
e)None
CorrectAnswer-D

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Ans.D,Maycausemetabolicacidosis
Mafenide:
TypicalsulpHonamide.
Usedonlytotally-inhibitsavarietyofgram-positiveandgram-
negativebacteria.

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Biggestlimitation-Producesburningsensationandseverepain
whenappliedtorawsurface.
Mainlyemployedforbuntdressingtopreventinfection,butnotto
heatalreadyinfectedcases.

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56.Trueaboutcompetitiveantagonistsare?

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a)Itdecreasesefficacyofagonist
b)Itdecreasespotencyofagonist
c)DRCisshiftedtorightside
d)Kmisincreased
e)Vmaxisreduced

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CorrectAnswer-B:C:D
Ans.(B)Itdecreasespotencyofagonist(C)DRCisshiftedto
rightside(D)Kmisincreased
Competitiveinhibition:
kmisincreased.

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V-maxremainsunchanged.
Competitiveantagonist:
1. Antagonistbindstothesamereceptorsasagonist
2. Antagonistresembleschemicallywiththeagonist
3. Thesamemaximalresponsecanbeobtained

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4. Potencyisreduced(RightshiftofDRC)
5. KmisincreasedbutVmaxisunchanged
Noncompetitiveantagonist:
1. Bindstoanothersiteofreceptor
2. Doesnotresemble

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3. Maximalresponseissuppressed
4. Efficacyisreduced(FlatteningofDRC)
5. KmisunchangedbutVmax.isreduced

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57.Physiologicalantagonismisfoundin?
a)Isoprenalineandsalbutamol

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b)Isoprenalineandadrenaline
c)Isoprenalineandpropranolol
d)Adrenalineandhistamine
e)Salbutamolandleukotrienes
CorrectAnswer-D:E

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Ans.(D)Adrenalineandhistamine(E)Salbutamoland
leukotrienes
[RefKDTp.56]
Physiologicalantagonists:
Produceoppositeactionbyactingondifferentreceptors.

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Histamine-bronchoconstriction&adrenaline-bronchodilation.
Leukotrienes-bronchoconstriction&salbutamol-bronchodilation.

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58.Sideeffectofclozapineare?
a)Sedation
b)Seizures

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c)Urinaryincontinence
d)Decreasedsalivation
e)None
CorrectAnswer-A:B:C
Ans.(A)Sedation(B)Seizures(C)Urinaryincontinence

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[Ref:KDTp.429;Katzang/ep-497-498]
Sideeffectsofclozapine
Agranulocytosis
Urinaryincontinence
UnstableBP&Tachycardia

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Hypersalivation(sialorrhoea)
Worseningofdiabetes
Weightgain
Seizures
Sedation

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59.Whichistrueregardingnaltrexone-
a)Itisanopioidantagonist
b)Itisanopioidagonist
c)Usedinalcoholdependence
d)Usedtotreatopioiddependence

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e)Usedasarespiratorystimulant
CorrectAnswer-A:C:D
Ans.(A)Itisanopioidantagonist(C)Usedinalcohol
dependence(D)Usedtotreatopioiddependence
[RefKDp.467;433,353]

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Naltrexone:
Pureopioidantagonistdevoidofagonisticactivity.
RecommendedinalcoholdependencebyUS-FDAasadjuvantin
comprehensivetreatment.
Usedfor'opioidblockade'therapyofpost-addicts.

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Usedtotreatacuteintoxicationandmaintenancetherapyofopioid
withdrawal.However,itcanprecipitatewithdrawalsymptoms.

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60.Whichofthefollowingis/are
cholinomimetic(Cholinergic)drug(s)?
a)Pilocarpine

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b)Neostigmine
c)Bethanechol
d)Donepezil
e)Methacholine
CorrectAnswer-A:C:E

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Ans.(A)Pilocarpine(C)Bethanechol(E)Methacholine
[RefKDT7/ep.104;Katzung11*/ep.98]
Cholinergicdrugsmaybedividedinto:(i)Directlyacting,and(ii)
Indirectlyacting(anticholinesterase).
DirectlyActing:

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Withmuscarinicaction:Acetylcholine,methacholine,carbachol,
bethanechol,pilocarpine,muscarine,arecholine
Withnicotinicaction:-Acetylcholine,carbachol,arecholine(these
threedrugshavebothmuscarinicandnicotiniceffects).
IndirectlyActing(Anticholinesterase):

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Twotypes
Carbamates:Physostigmine,Pyridostigmine,Ambenonium,
Galantamine,Neostigmine,Edrophonium,Donepezil,rivastigmine.
Organophosphates:Echothiophate,Diazinon.

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61.TrueaboutCarvedilol?

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a)alblocker
b)31blocker
c)32blocker
d)Antioxidant
e)Usedinhypertension

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CorrectAnswer-A:B:C:D:E
Ans.(A)alblocker(B)31blocker(C)32blocker(D)Antioxidant
(E)Usedinhypertension
Carvedilol:
1+2+1adrenoceptorblockerwith-blockingpropertyof1:9.

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AntioxidantandantimitoticProPerty.
Producesperipheralvasodilationdueto-1blockadeaswellas
calciumchannelblockade(directeffect).
CardioprotectiveinCHF.
Causesorthostatichypotension.

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62.Interferon-alphaisusedinthetreatment
of?
a)HepatitisB
b)HepatitisC
c)Multiplesclerosis

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d)Chronicgranulomatousdisease
e)Multiplemyeloma
CorrectAnswer-A:B:C
Ans.(A)HepatitisB(B)HepatitisC(C)Multiplesclerosis
[Ref.KDTP.501,802;ClinicalpharmacologistP.712]

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Usesofinterferon-are:
1. CML
2. Non-Hodgkin'slymphoma&cutaneousT-celllymphoma
3. Hairycellleukemia
4. Multiplemyeloma

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5. AIDSrelatedKaposisarcoma
6. ChronicHepatitisB&C
7. HSV,HZV&CMVinfection
8. Rhinoviralcold
9. Condylomaacuminata(HPV)

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10. Malignantmelanoma
11. Renalcellcarcinoma

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63.Trueaboutbedaquilineis?
a)Nottobeusedinsinglelinetherapy
b)Tobeusedincaseofresistancetostreptomycin

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c)Newuniqueantimicrobialintroduced
d)Bactericidaldrug
e)UsedinTBresistanttorifampicin&isoniazide
CorrectAnswer-A:C:D:E
Ans.(A)Nottobeusedinsinglelinetherapy(C)Newunique

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antimicrobialintroduced(D)Bactericidaldrug(E)UsedinTB
resistanttorifampicin&isoniazide
[RefKatung14/ep.849;Lehn'sPharmacologyip.l081]
Bedaquiline(sirturo):
Newantituberculardrug

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Treatmentofmulit-drugresistanttuberculosis
Worksfasterandbetterthanallotheranti-TBdrugs.
Tuberculocidal.
ByinhibitingATPsynthase.
Nocross-resistance.

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PregnancycategoryBdrug.
Uses:
CombinationtherapyformultidrugresistanceTB(i.e.resistanceto
rifampicinandlNH).
NotapprovedfortreatmentoflatentTB,extrapulmonaryTBordrug-

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sensitiveTB.
AdverseEffects:
ProlongationofQTinterval.
Hepatotoxicity.

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64.ExtensivedrugresistanceTBisdefined

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asresistanceto?
a)Amikacin
b)INH
c)Rifampicin
d)Pyrazinamide

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e)Ciprofloxacin
CorrectAnswer-A:B:C:E
Ans.(A)Amikacin(B)INH(C)Rifampicin(E)Ciprofloxacin
[RefKDT7thep.776]
Multidrugresistance(MDR)andextensivedrugresistance

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(XDR)TB:
MDRisdefinedasresistancetoINHandrifampinwithorwithout
resistancetootherdrugs.
XDRisdefinedasresistancetoINHandrifampicinaswellastoall
fluoroquinolonesandoneofinjectabledrugs(capreomycin,

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kanamycin,amikacin).

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65.Alternativetorifamicinbasedtreatmentof
leprosyinpatientwithhepatitis?
a)Clofazimine
b)Ofloxacin

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c)Minocycline
d)Clarithromycin
e)Moxifloxacin
CorrectAnswer-A:B:C:D
Ans.(A)Clofazimine(B)Ofloxacin(C)Minocycline

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(D)Clarithromycin
TheWorldHealthOrganization(WHO)andtheIndianAssociationof
leprologistshaverecommendedanalternativecombinationtherapy
ofClarithromycin,ofloxacinanilclofaziminetobeprescribedinsuch
cases.

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Minocyclinecanbeusedasanalternativetoclarithromycin(i.e.,
minocycline,ofloxacin&clofazimine).

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66.Anticancerdrug(s)whichdoes/donot
suppressbonemarrow?
a)5-FU

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b)Cisplatin
c)Chlorambucil
d)Vincristine
e)Vinblastine
CorrectAnswer-D

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Ans.D.Vincristine
[Ref:Katzungp.951-952]
Anticancerdrugswithbonemarrowsparingeffect:
Vintistine
Bleomycin

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Asparaginase

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67.Apatienthasplateletcount<1lakh,
hemoglobin8gm,whichofthefollowing
anticancerdrugcanbeusedinhim?
a)Cisplatin

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b)Methotrexate
c)Vincristine
d)Vinblastin
e)Dleomycin
CorrectAnswer-C:D

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Ans.(C)Vincristine(D)Vinblastin
Vincristineandbleomycinarebonemarrowsparingdrugs-canbe
usedinanemiaandthrombocytopenia.

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68.Whichofthefollowingdrug(s)cancause
diarrhea?

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a)Zinc
b)Ampicillin
c)Magnesiumhydroxide
d)Aluminiumhydroxide
e)None

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CorrectAnswer-B:C
Ans.(B)Ampicillin(C)Magnesiumhydroxide
Drugscausingdiarrhea:
BroadspectrumantibioticsDigitalisLactose
OCP

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clindamycin
Magnesiumantacids
Lincomycin
Purgative
Cocaine

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Donepezil
Methyldopa
Reserpine
ColchicineGuanethidine
Misoprostol

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Ticlopidine
AmPicillin

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69.Selectivenorepinephrine(noradrenergic)
reuptakeinhibitor(s)is/are?
a)Fluoxetine

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b)Desipramine
c)Imipramine
d)Doxepin
e)Amoxapine
CorrectAnswer-B:E

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Ans.(B)Desipramine(E)Amoxapine
Selectivenoradrenergicreuptakeinhibitors(SNARIs)
Antidepressantswhichhavehighselectivityfornoradrenergic
reuptakeinhibitoroverserotoninreuptakeinhibition.
ThisgroupalsoincludestheTCAswithpredominantNAreuptake

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inhibitoryaction.
Examplesare-Desipramine,Nortriptyline,protriptyline,
Amoxapine,Reboxetine,Atomoxetine,maprotiline.

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70.ManagementofNSAIDstoxicityinclude-
a)Sodiumbicarbonate

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b)Diazepam
c)Phenobarbitone
d)Hemodialysis
e)NH4C1
CorrectAnswer-A:B:C:D

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Ans.(A)Sodiumbicarbonate(B)Diazepam(C)Phenobarbitone
(D)Hemodialysis
[Ref,Principlesofemergencymedicalcarep.301]
IbuprofenisthemostcommonlyusedNSAIDstakeninoverdose
followedbynaproxen.

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Inacuteoverdose,activatedcharcoalcanbeusedas
mechanicalantidote.
VomitingshouldbeinducedbyIpecacsyrup,iftheingestion
occurredwithinminutesofarrival.
Fordehydrationoralorintravenousfluidshouldbegiven.

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Metabolicacidosiswilloftenrespondtofluidresuscitation/IVsodium
bicarbonate.
ConvulsionsaremanagedwithIVbenzodiazepines(diazepam,
lorazepam).Phenobarbitoneissecondchoiceifconvulsionsarenot
controlledbyBZDs.

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Protonpumpinhibitors(omeprazoleetc)canbegivenforpersistent
upperGISymptoms.
Intubationmayberequiredforairwayprotectionduetocomaor
prolongeduncontrolledconvulsionactivity.
ThiopentoneistheDOCintheseconditions.

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71.Trueaboutfirstorderkineticsof
elimination-
a)Constantamountofdrugiseliminated
b)Rateofeliminationisnotrelatedtoplasmaconcentration
c)Clearanceremainsconstant

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d)Halflifedecreaseswithdecreasedconcentration
e)None
CorrectAnswer-C
Ans.C.Clearanceremainsconstant
[RefKDTp.30]

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Firstorderkinetics:
RateofeliminationisdirectlyproportionaltoPlasmaConcentration.
Clearanceremainsconstant-
Duetoincreasingplasmaconcentration,increasestherateof
eliminationproportionately.

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(CL=rateofelimination/PlasmaConc).
Halfliferemainsconstant-
Duetotimerequiredtoreduceplasmaconcentrationtohalfissame
(rateofelimination
changeproportionatelywithplasmaconcentration).

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72.Antibiotic(s)thatrequiredosereductionin
renalfailure?
a)Amikacin
b)AmphotericinB
c)Doxycycline

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d)Rifampicin
e)Ceftriaxone
CorrectAnswer-A:B
Ans.(A)Amikacin(B)AmphotericinB
[Ref:EssentialsofPharmacologyp131]

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Antimicrobialsgivenafterdosereduction:
Aminoglycosides
Ethambutol
Quinolones(exceptGrepa&trovafloxacin)
Cephalosporins(exceptcefoperazone&ceftriaxone)

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Vancomycin
AmphotericinB
Antimicrobialscontraindicated:
Nitrofurantoin
Nalidixicacid

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Cephalothin&cephaloridine
Tetracyclines(exceptdoxycycline)
Methanamine

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73.Trueaboutsugamadexis/are-
a)ItisaSRBA

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b)Usedtoreverserocuroniumblockade
c)UsedtoreverseNMblockade
d)UsetoreverseSchblockade
e)Usedinmalignanthyperthermia
CorrectAnswer-A:B:C

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Ans.(A)ItisaSRBA(B)Usedtoreverserocuroniumblockade
(C)UsedtoreverseNMblockade
[RefKDTep.355;Essentialsofpharmacologyp.113]
Sugammadex:
Neuromuscularreversaldrug,

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1stinanewclassofselectiverelaxantbindingagent(SRBA)or
steroidalmusclerelaxantencapsulators(SMRE).
Modifiedy-cyclodextrinwithhighaffinityforaminosteroidnon-
depolarizingmusclerelaxantsrocuroniumandvecuronium.
Usedtoreverseneuromuscularblockproducedbyrocuroniumand

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vecuronium(rocuronium>vecuronium).
Actsbyformingacomplexwithmusclerelaxant(rocuroniumor
vecuronium).

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74.13agonistsarepreferredoverother
sympathomimeticdrugsfor-

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a)Asthma
b)Uterinerelaxation
c)Nasaldecongesents
d)Orthostatichypotension
e)Glaucoma

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CorrectAnswer-A:B
Ans.(A)Asthma(B)Uterinerelaxation
Clonidineandmethyldopaareusedinhypertension.
Otherusesofclonidineare(i)preanaestheticmedication,(ii)
diarrheaindiabeticneuropathy,(iii)analgesic,(iv)withdrawal

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syndromeofopoid,alcoholandnicotine,(v)prophylaxisofmigrain,
(vi)postmenopausalsyndrome,(vii)suppressiontestfor
pheochromocytoma,and(viii)fortreatmentofADHD.

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75.Longacting13agonist(s)whichis/are
usedasonceadaydrug?

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a)Salmeterol
b)Formoterol
c)Olodaterol
d)Vilanterol
e)Indacaterol

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CorrectAnswer-C:D:E
Ans.C,OlodaterolD,Vilanterol&E,Indacaterol
Ref:Katzung13'h/ep.j40;Rang6Dale8'h/ep.348
Longactingbeta-1agonist
(8-12hrs)

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Giventwicedaily
1. Salmeterol
2. Formoterol
3. Arformoterol
Ultra-longacting

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(24hrs)
givenoncedaily
1. Indacaterol
2. Olodaterol
3. Vilanterol

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76.Drugofchoiceforstrongyloides
stercoralis?
a)Mebendazole
b)Albendazole
c)Ivermectin

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d)Levamisole
e)Diethylcarbamazine
CorrectAnswer-C
Ans.C.Ivermectin
Ref:K.D,T,Thlep,850iKatzung13th/ep.909;SatoskarPharma

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24'ep.816;RangandDale|th/ep.573
Strongyloid-Ivermectin
Anaerobes-Metronidazole
AtypicalPneumonia(mycoplasma)-Erythromycin
Cholera-Doxycycline

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Staphylococci-Penicillin
VRSA-Linezolid
P.Carinii(jiroveci)-Cotrimoxazole
Pseudomonas-
Antipseudomonalbeta-lactam+aminoglycoside

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Streptococcus-Penicillin
Toxoplasma-Cotrimoxazole
ToxoplasmainpregnancySpiramycin.
Rheumaticfever-Benzathinepenicillin
TB-INHwithorwithoutrifamPicin

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Rickettsia-TetracYclines

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InfluenzaAandB-Osetamivir
Diphtheria-Penicillin/Erythromycin
Anthrax
Ciprofloxacin/Doxycycline+Pertussis-ErYthromYcin

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HSV-AcYclovir
LePtosPirosis
Milder-Oralamoxicillin
Severe-IvPenicillinG
Lyme'sdisease-DoxycYcline

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Syphilis-PenicillinG
Pertussis-ErYthromYcin
Actinomycosis-PenicillinG
Lymphogranulomavenereum-AzithromycinorDoxycycline
Legionella-Azithromycinorlevofloxacin

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Plague-StrePtomYcin
Listeria-Ampicillin+Gentamicin
MAC-Azithromycin/clarithromycin
GroupB-streptococcus-Ampicillin
UTI-Cotrimoxazole

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Endocarditis-Amoxicillin/Clindamycin
Babesiosis-Quinine+Clindamycin
Pvivax-Chloroquine
ChloroquineresistantPvivax-Artemisinincombinationtherapy
(ACT)

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77.DOCformycoplasmais/are?
a)Doxycycline
b)Ceftriaxone
c)Azithromycin
d)Penicillin

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e)Gentamycin
CorrectAnswer-A:C
Ans.A,Doxycycline&C,Azithromycin
Ref:Harrisonrgh/ep.1164
ForM.pneumoniaeinfections:

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Azithromycin,clarithromycin,erythromycin,doxycycline,
levofloxacin,moxifloxacin,gemifloxacin(notciprofloxacinor
floxacin).
ForM.Hominis-
Doxycycline,clindamycin

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---

78.Whichofthefollowingdyadofanti-HIV
drugandmechanismofactionis/are
correctlymatched?
a)Maraviroc-Entryinhibitor
b)Reltegravir-Intergaseinhibitor

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c)Indinavir-Proteaseinhibitor
d)Nevirapine-Nonnucleosidereversetranscriptaseinhibitor
e)Darunavir-Fusioninhibitor
CorrectAnswer-B:C:D
Ans.B,Reltegravir-IntergaseinhibitorC,Indinavir-Protease

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inhibitor&D,Nevirapine-Nonnucleosidereversetranscriptase
inhibitor
Antiretroviraldrugs
a)Nucleosidereversetranscriptaseinhibitors(NRTIs)-
Zidovudine,Didanosine,Zalcitabine,Stavudine,Iamivudine,

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Abacadr,Emtricitabine
b)Nucleotidereversetranscriptaseinhibitor+Tenofovir
c)NonNucleosidereversetranscriptaseinhibitors(NNRTIS)-
Nevirapine,Efavirenz,Delavirdine,Etravirine,rilpivirine.
d)Proteaseinhibitors-

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RitonavirIndinavir,NeIfnavb,Saquinavir,amprenavir,Lopinavir,
Fosamprenavir,Atazanavir,Darunavir,Tipranavir.
e)Fusioninhibitor-Enfuvirtide,Maraviroc.
f)Integraseinhibitors-Raltegravir,Elvitegravir.
g)CCR5receptorinhibitor-Maraviroc

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79.Anti-influenzadrugwhichis/aregiven
throughinhalationroute?
a)Amantadine
b)Oseltamivir
c)Zanamivir

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d)Rimantadine
e)None
CorrectAnswer-C
Ans.C.Zanamivir
[Ref:KDT7'/ep.S0l0.3;Park's24't'/e1t.169;Katzung13th/ep.862

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63]
Anti-influenzadrugs
Amantadine,rimantadine,oseltamivirandzanamivir.
Onlyzanamivirisgivenbyparenteralroute(intranasdor
intravenous).allothersaregivenorally.

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Zanamivirhaslowestoralbioavailabilitylowestt1/2(shortestacting).
Rimantadinehasmaximumplasmaproteinbinding,whileoseltamivir
hasminimumplasmaproteinbinding.
Rimantadinehasmaximummetabolism.

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80.Truestatement(s)aboutalbendazole?

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a)Undergoesfirst-passmetabolismintheliver
b)ActiveagainstbothlarvaandadultofNematodes
c)Absorptionincreaseswithfattymeal
d)Excretedintheurine
e)Thiabendazoleislesstoxicthanalbendazole

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CorrectAnswer-A:B:C:D
Ans.A,Undergoesfirst-passmetabolismintheliverB,Active
againstbothlarvaandadultofNematodesC,Absorption
increaseswithfattymeal&D,Excretedintheurine
[Ref:Katzung13't'/ep.90E09;GoodmanandGilmatr'slI't'/ep.

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1079;SatoskarPhanna24't'/ep.818]
Albendazole:
Broad-spectrumoralanthelmintic.
Actsbybindingtotubulinandtherebyinhibitingitspolymerization
Afteroraladministration,itiserraticallyabsorbed(increasedwitha

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fattymeal)andthenrapidlyundergoesfirst-passmetabolisminthe
livertotheactivemetabolitealbendazolesulfoxide.
excretedintheurine.
Hasamiciilaleffectsinhydatiddisease,cysticercosis,ascariasis,
andhookworminfectionandovicidaleffectsinascariasis,

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ancylostomiasis,andtrichuriasis.

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81.Whichofthefollowingis/arenot5th
generationcephalosporin?
a)Cefoxitin
b)Cefoperazone

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c)Ceftolozane
d)Ceftaroline
e)Ceftabiprole
CorrectAnswer-A:B
Ans.A,Cefoxitin&B,Cefoperazone

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[Ref:KDT7/ep.26;Ketungp-779;Goodman&Gilman'sp.781;
Pharma241/ep.693]
First
Second
Third

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Fourth
Fifth
Cefuroxime
Cefoxitin
Cefotaxime

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Cephalothin Cefotetan
Cetizoxime
Ceftobiprole
Cefepime
Parenteral Cefazoline

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Cefmetazole Ceftriaxone
Ceftaroline
Cefpirome
Cephapirin
Cefamendole Ceftazidime

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Ceftolozane
Cefonicid,
Cefoperazone
ceforanide
Cefixime

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Cephalexin
Cefaclor
Cefpodoxime
Cephradine
Cefuroxime proxetil

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Oral
Cefadroxil
axetil
Cefdinir
Cephaloridine Cefprozil

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Ceftibuten,
Ceftamet

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82.Whichofthefollowingistrueabout
aminoglycosideassociatedacutekidney
injury?

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a)Seeninaround10-20%ofpatientstreatedwiththedrug
b)Mayoccurwithin1weekofinitiationoftreatment
c)Occuronlyafter3weeksoftreatment
d)Interstitialnephritisoccur
e)Usuallydevelopswithin72hoursofinitiationoftreatment

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CorrectAnswer-A:B
Ans.A,Seeninaround10-20%ofpatientstreatedwiththe
drug&B,Mayoccurwithin1weekofinitiationoftreatment
[Re/:KDf7e/dp.715;Katzungep.802]
Non-oliguricacutekidneyinjury(AKI)occursin10-30%ofpatients

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onaminoglycosidetherapy.
AKTtypicallymanifestsafter5-7daysoftherapy.
Nephrotoxicity:
Neomycinismostnephrotoxic,whilestreptomycinisleast
nephrotoxic.

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Nephrotoxicityisincreasedbyadvancedage,liverdisease,
hypokalemia,septicshock,concurrentuseofnephrotoxicdrugs
(amphotericinB,cisplatin,cyclosporine)andprolongedtherapy.

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83.Whichofthefollowingistrueabout
antifungaldrugs?

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a)Echinocandinshaveverylesssideeffects
b)Flucanazoleisfirstlinedrugforinvasiveaspergillosis
c)Oralfluconazolehas100%bioavailability
d)AmphotericinBisfungistatic
e)NephrotoxicityisdoselimitingsideeffectofamphotericinB

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CorrectAnswer-A:E
Ans.A,Echinocandinshaveverylesssideeffects&
E,NephrotoxicityisdoselimitingsideeffectofamphotericinB
[RefKDTzh/ep.787-95]
EchinocandinsarewelltoleratedwithmildGIsideeffects.

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Fluconazoleisnot1stlinedrugforaspergillosis.
Oralbioavailabilityoffluconazoleis94%.
Amphotericin-Bisfungicidalaswellasfungistatic
Themostimportantdoselimitingtoxicityisnephronicity.
Adverseeffectsincludeinfusionrelatedacutereactions(most

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common),nephrotoxicity,anemia,cNStoricityAnd,
hypomagnesemiaInfusionrelatedacutereactioncanbeprevented
bypremedicationslikecorticosteroidsandantihistamines.
Itismanifestedbyazotemia,reducedGFR,RTA,hypokalemia,and
hypomagnesemia.

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84.Drugsaffectingpurinesynthesis?
a)Azathioprine
b)Methotrexate
c)Fludarabine
d)6-Mercaptopurine

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e)Capecitabine
CorrectAnswer-A:B:C:D
Ans,A,AzathioprineB,MethotrexateC,Fludarabine&D,6-
Mercaptopurine
[Ref:KDT7h/ep.858;Katzungp.928,931;Goodman&Gilmin'sI

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tth/ep.1336,1346-48;SatoskarPharma24a'/ep.G29.]
Antimetabolites:
Drugsaffectintermediarymetabolismofproliferatingcells.
AllthesedrugsinterferewithnucleicacidsynthesisAct
on.S,phase.

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Purineantagonists=Mercaptopurine,Thioguanine,
Azathioprine,FludarabineAndCladribine.
Pyrimidineantagonists=S-Fluorouracil,cytosinearabinoside
(cytarabine),capecitabine,Gemcitabine.
Folateantagonist=Methotrexate,pemetrexed.

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Note:Tetrahydrofolateisrequiredforpurinesynthesisandits
formationisinhibitedbymethotrexate.
Methotrexateandpemetrexeddihydrofolatereductase(DHFRcse)
inhibitors.

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85.Methotrexateaffects?

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a)Purinesynthesis
b)Pyrimidinesynthesis
c)ConversionofDHFAtoTHFA
d)Polymerizationofmitotictubule
e)None

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CorrectAnswer-A:C
Ans.A,Purinesynthesis&C,ConversionofDHFAtoTHFA
Methotrexateandpemetrexeddihydrofolatereductase(DIlFRcse)
inhibitors.
ThesedrugsalsoinhiUitttrymiapatesynthaseanddenovopurine

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synthesis,whichcontributetomethotrexatetoxicity.

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86.LongactingInsulinis/are?
a)Lispro
b)Detemir
c)Glargine

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d)Isophane
e)Glulisine
CorrectAnswer-B:C
Ans.B,Detemir&C,Glargine
[Ref:KDTep-263:satashkarkhanna24e/ep'893]

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RapidActingInsulin=Insulinlispro,Insulinaspart,Insulinglulisine.
Shortacting=Regular(soluble)insulin,semilenteinsulin'
Intermediateacting=Insulinzincsuspension(Lente),Neutral
protaminehagedorn(isophaneinsulin)
Longacting=Protaminezincinsulin,Insulinglargine,Insulindetemir

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87.AmongACEinhibitors,whichofthe
followingis/areprodrug(s)-
a)Perindopril
b)Captopril
c)Lisinopril

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d)Ramipril
e)Enalapril
CorrectAnswer-A:D:E
Ans.A,PerindoprilD,Ramipril&E,Enalapril
[RefKDTF/ep'23,501]

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AllACEinhibitorsareprodrugsexceptcaptoprilandLisinopril.

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88.Whichofthefollowinganti-tumordrug
havehighriskofgonadotoxicity?
a)Dactinomycin
b)Cyclophosphamide

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c)Busulfan
d)Vinblastine
e)Ifosfamide
CorrectAnswer-B:C:E
Ans.B,CyclophosphamideC,Busulfan&E,Ifosfamide

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[ReFK.D-t.P.859;]
Allalkylatingagentsarehighlygonadotoxic.
HighAlkylatingagents=Cyclophosphamide,ifosfamide,busulfan,
chlorambucil,melphalan,procarbazine.
Medium=Carboplatin,doxorubicin

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Low=Vincaalkaloids(vincristine,vinblastine),methotrexate,
mercaptopurine,bleomycin,dactinomycin.

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89.Adrenalinecanbeusedin?
a)Bronchialasthma
b)Allergicdisorder

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c)Cardio-pulmonaryresuscitation
d)Anaphylaxis
e)Asanti-analgesicmedicine
CorrectAnswer-B:C:D
Ans.B,AllergicdisorderC,Cardio-pulmonaryresuscitation&

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D,Anaphylaxis
Adrenalineisthedrugofchoiceforanaphylaxis(anaphylacticshock)
->anallergichypersensitivityreaction(Type-lhypersensitivity).
1stlinedrugusedincardiopulmonaryresuscitation.

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90.Drug(s)causingQTintervalprolongation?

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a)Amiodarone
b)Cisapride
c)Calciumgluconate
d)Magnesiumtherapy
e)Ketoconazole

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CorrectAnswer-A:B
Ans.(A)Amiodarone&(B)Cisapride
[Ref:KDTVh/ep.528;Davison27d/ep.571]
DrugsthatprolongQ-Tinterval(havepotentialtoprecipitate
Torsadesdepointes)

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Antiarrhythmics=Quinidine,procainamide,disopyramide,
propafenone,amiodarone
Antimicrobials=Quinine,mefloquine,artemisinin,halofantrine,
sparfloxacin,gatifloxacin
Antihistamines=Terfenadine,astemizole,ebastine

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Antidepressants=Amitriptylineandothertricyclics
Antipsychotics=Thioridazine,risperidone
Prokinetic=Cisapride

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91.Whichofthefollowingdrugsisexcreted
mainlybykidney?

--- Content provided by FirstRanker.com ---

a)Tetracycline
b)Rifampicin
c)Digoxin
d)Penicillin
e)Lithium

--- Content provided by‌ FirstRanker.com ---

CorrectAnswer-A:C:D:E
Ans.(A)Tetracycline(C)Digoxin(D)Penicillin&(E)Lithium
[Ref:KDTp.695;Katzung13'h/ep,790]
Lithium=>95%renalexcret
Penicillin=Excretedbythekidney,10%byglomerularfiltrationand

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90%bytubularsecretion.
Digoxin=Primarilyexcretedbykidney
Tetracyclines=Primarilyexcretedinurine,exceptfordoxycycline.
Rifampicin=Excretedmainlyinbile,someinurine;Urineand
secretionsmaybecomeorange-red.

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92.Whichofthefollowingistruestatement(s)
aboutcodeine?
a)Usedasanti-tussiveagent
b)Analgesicpotencyisequivalenttomorphine
c)Causesrespiratorydepression

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d)Partlymetabolizedtomorphine
e)Completelymetabolizedtomorphine
CorrectAnswer-A:C:D
Ans.(A)Usedasanti-tussiveagent(C)Causesrespiratory
depression&(D)Partlymetabolizedtomorphine

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[Ref:KDT7/ep.474;Katzungljh/ep.545-49]
Codeine:
Codeineisapureopioidagonistwhichislesspotentthanmorphine
(1/l0sanalgesicaction).
Ithaspartialagonisticactivityonopioidreceptorswithalowceiling

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effects.
Partlyconvertedtomorphineinthebody.
Itisusedasantitussive(drugsforcough)andantidiarrhealdrugs
Ceusasamedegreeofrespiratorydepressionasmorphine.

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93.Allaretrueabouttamoxifenexcept:

--- Content provided by FirstRanker.com ---

a)Usedasadjuvanttherapyinestrogenreceptorpositivebreast
cancer
b)Noeffectonuterus
c)Pro-estrogeneffectonbone
d)Reduceschanceofosteoporosis

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e)Reducescoronaryarterydiseases
CorrectAnswer-B:E
Ans.(B)Noeffectonuterus(E)Reducescoronaryartery
diseases
[Ref:KDT7th/312-15;Katzung13th/713;Harrison19th/2498]

--- Content provided by FirstRanker.com ---

Tamoxifen:
Approvalfortheprimaryprophylaxisofbreastcancerinhighrisk
women.
Reducestherecurrencerateofbreastcancerinipsilateralaswellas
contralateralbreast.

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Associatedwithreducedriskofcancerinthecontralateralbreast.
Improvesthebonemassduetoantiresorptiveeffect.
Increasestheriskofthromboembolicevents.
Hypertglyceridaemia,deepveinthrombosis,ischemicheartdisease,
retinopathy&othercomplicationstobeobservedduringtamoxifen

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therapy.

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94.TrueaboutHyoscine:
a)Causemydriasis
b)Causemiosis
c)Usedformotionsickness

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d)BetterBBBpenetrationthanatropine
e)Centralnervoussystemdepressant
CorrectAnswer-A:C:D:E
Ans.(A)Causemydriasis(C)Usedformotionsickness
(D)BetterBBBpenetrationthanatropine(E)Centralnervous

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systemdepressant
Hyoscine(scopolamine):
Appliedtoeyestheyfreelypenetratecornea
HasbetterBBBpenetration
Shorterdurationofactionthanatropine.

--- Content provided by FirstRanker.com ---

Mosteffectivedrugformotionsickness
CNSdepressant.
Producesedationandamnesiaduringlabour(twilightsleep)
Causedefinitemydriasis&lossofaccommodation"
LiedetectorduringworldwarII

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95.Truestatement(s)aboutRutin:
a)Hasanti-fibrinolyticaction
b)Hasanti-plateletaction
c)Antioxidantproperty
d)Acitrusflavonoidglycosidefoundinmanyplantsincluding

--- Content provided by​ FirstRanker.com ---

buckwheat
e)None
CorrectAnswer-B:C:D
Ans.(B)Hasanti-plateletaction(C)Antioxidantproperty(D)A
citrusflavonoidglycosidefoundinmanyplantsincluding

--- Content provided by‌ FirstRanker.com ---

buckwheat
Rutin(Bioflavonoids):
Richestsourceisbuckwheat.
Plantglycosideclaimedtoreducecapillarybleeding.
Usedinadoseof60mgoralBD-TDSalongwithVit.Cwhichis

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believedtofacilitateitsaction(supportbloodcirculation,asan
antioxidant,afldtotreatallergies,yiruses,orarthritisandother
inflammatoryconditions).
Strengthenstheliningofthebloodvesselsthroughoutthebody.
Helpstreathemorrhoids,internalbleeding.

--- Content provided by​ FirstRanker.com ---

Helpspreventhemorrhagicstrokes.
Stoptheformationofabloodclot(thrombosis).
Veryeffectivewithbloodclotsbecauseittreatsandpreventclotsin
botharteriesandveins
Mostpotentlyanti-thrombotic.

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Anantioxidant.

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96.Side-effect(s)ofZoledronicacidis/areall
except:
a)Flu-likesymptoms
b)Osteonecrosisofthejaw

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c)Dizziness
d)Constipation
e)Renaltoxicity
CorrectAnswer-D
Ans.D.Constipation

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Zoledronate:
Flu-likesymptomsduetocytokinereleaseattendthei.vinfusion
Nausea,vomiting,bodyache,dizzinessarecommon
Renaltoxicityhasbeenencountered
OsteonecrosisofJawisararecomplicationofi.vhighdose

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97.Anti-microbialagentsactingonnucleic
acidareallexcept:
a)Acyclovir
b)Linezolid
c)Fluroquinolones

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d)Streptomycin
e)Rifampin
CorrectAnswer-B:D
Ans.(B)Linezolid(D)Streptomycin
[Ref:KDT7th/689-90]

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1. Inhibitcellwallsynthesis:Penicillins,Cephalosporins,Cycloserine,
Vancomycin,Bacitracin.
2. Causeleakagefromcellmembranes:Polypeptides-Polymyxins,
Colistin,Bacitracin.Polyenes-AmphotericinB,Nystatin,Hamycin
3. Inhibitproteinsynthesis:Tetracyclines,Chloramphenicol,

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Erythromycin,Clindamycin,linemlid,
4. Causemisreadingofm-kNAcodeandaffectpermeability:
Aminoglycosides-Streptomycin,Gentamicin,etc.
5. InhibitDNAgyrase:Fluoroquinolones-Ciprofloxacinandothers
6. InterferewithDNAfunction:Rifampin

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7. InterferewithDNAsynthesis:Acyclovir,Zidovudine
8. Interferewithintermediarymetabolism;Sulfonamides,Sulfones,
PAS,Trimethoprim,Pyrimethamine,Metronidazole

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98.CNSstimulantsare:
a)Cocaine

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b)Amphetamine
c)Cannabis
d)Dexamphetamine
e)MDMA(ecstasy)
CorrectAnswer-A:B:D:E

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Ans.(A)Cocaine(B)Amphetamine(D)Dexamphetamine
(E)MDMA(ecstasy)
[Ref,KDT7th/486,452.]
Psychotogenic(Hallucinogens)drugsareCannabis,LSD,
mescaline,endocannabinoid.

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CNSStimulant:
1. Convulsants:Strychnine,picrotoxin,bicuculline,pentyIenetetrazol
2. Analeptics:Doxapram
3. Psychostimulants:Amphetamine,Methylphenidate,atomoxetine,
modafinil,armodafinil,pemoline,cocaine&caffeine.

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99.Drugcontraindicatedinpregnancy:
a)Sulfonamide
b)ACEinhibitors
c)Phenytoin
d)Ciprofloxacin

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e)Furosemide
CorrectAnswer-B:C
Ans.(B)ACEinhibitors(C)Phenytoin
[Katzung10th/975]
ACEinhibitors-InAlltrimester,especiallysecondandthird-Renal

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damage.
Phenytoin-InAlltrimester-FetaIhYdantoinsYndrome
Thalidomide-Firsttrimester=Phocomelia(shortenedorabsent
longbonesofthelimbs)andmanyInternalmalformations

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100.Inwhichofthefollowingliverflukes,

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triclabendazoleis/areused:
a)Clonorchissinensis
b)Opisthorchisviverrini
c)Fasciolahepatica
d)Fasciolagigantica

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e)Opisthorchisfelineus
CorrectAnswer-C:D
Ans.(C)Fasciolahepatica(D)Fasciolagigantica
[Ref:Harriison19th/1428;I(DT7th/851]
Triclabendazoleishighlyeffectiveagainstadultsofthecommonliver

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fluke(Fasciolahepatica)aswellasallimmaturestages.
AlsoeffectiveagainstFasciolagiganticaandFascioloidesmagna.
Noefficacyagainstroundwormsortapeworms.

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101.Mechanismofactionofgabapentin
is/are:

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a)EnhancesGABArelease
b)AgonistatGABAAreceptor
c)ActonNMDAreceptor
d)ProlongationofNa+ChannelInactivation
e)Inhibitionofvoltage-gatedCa2+channels

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CorrectAnswer-A:E
Ans,.(A)EnhancesGABArelease(E)Inhibitionofvoltage-
gatedCa2+channels
[Ref:K.D.T7th/419-21;Katzung12th/41j;Harrison19th/2548,
2551-56]

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Gabapentin:
MOA:
ModifythesynapticornonsynapticreleaseofGABA.
AnincreaseinbrainGABAconcentrationisobservedinpatients
receivinggabapentin.

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GabapentinistransportedintothebrainbytheL-aminoacid
transporter.
Gabapentinbindsavidlytovoltage-gatedCa2+channels.
Gabapentinalsoactpresynapticallytodecreasethereleaseof
glutamate;thiseffectisprobablydependentonreducedPresynaptic

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entryofCa2+viavoltage-activatedchannels.

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102.Whichofthefollowingis/arefeaturesof
Triamcilonewithrespectto
hydrocortisone:
a)Florinatedatcarbonatom9

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b)Notusedinoralform
c)Mineralocorticoidactivitypresent
d)Morepotentthanhydrocortisone
e)Glucocorticoidactivityis5timesofhydrocortisone
CorrectAnswer-D:E

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Ans.(D)Morepotentthanhydrocortisone(E)Glucocorticoid
activityis5timesofhydrocortisone
[RefK.D.T7th/289;Katzung12th/700,703,712]
Triamcinolone:
SlightlymorePotentthanprednisolonebuthighlyselective

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glucocorticoid;4-i2mg/dayoral;5-40mgi.m,intraarticular
injection.
Alsousedtopically

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103.Whichofthefollowingis/aretrue
regardingmuscarianicactionexcept:

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a)Miosis
b)Detrusormusclecontraction
c)Dicylomineisantimuscuarnicdrugusedforsmoothmuscle
relaxation
d)CardiacmuscuranicreceptorsarepredominantlyM3type

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e)salivaryglandsecretion
CorrectAnswer-B:D
Ans.(B)Detrusormusclecontraction(D)Cardiacmuscuranic
receptorsarepredominantlyM3type
[RefKDT7th/100-103,117;Katzung12th/97-102]

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CardiacmuscarinicreceptorsarepredominantlyM2type&mediate
vagalbradycardia.
Dicyclomine:
AntagonistofM1&M3(smoothmuscle)-
MuscarinicActions

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Heart:
AttheA-Vnode&His-purkinjefibersrefractoryperiod(W)is
increased&conductionisslowed;PRinteryalinteases6partialto
completeA-Vblockmaybeproduced.
Eye:

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Contractionofcircularmuscleofirismiosis
Contractionoftheciliarymusclespasmofaccommodation,
increasedoutflowfacility,reductioninintraoculartension(especially
inglaucomatouspatients

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SmoothMuscle:

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Peristalsisinureterisincreased.
Detrusormusclecontractswhilethebladdertrigone&sphincter
relaxesvoidingofbladder.
Glands:
Secretionfromallparasympatheticallyinnervatedglandsis

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increasedviaM3&someM2receptors:sweating,salivation,
lacrimation,increasedtracheobronchial&gastricsecretion.

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104.Diseasemodifyingdrug(s)usedin
treatmentofrheumatoidarthritis:
a)Neproxen

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b)Nabumetone
c)Abatacept
d)Monoclonalantibodies
e)Methotrexate
CorrectAnswer-C:D:E

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Ans.(C)Abatacept(D)Monoclonalantibodies(E)Methotrexate
[RefK.D.T7tW211-12,871-72;Katzungt2th/642;Goodman&
Gilman\11th/1942]
DiseasemodifyingAntl-rheumatoiddrugs(DMARDs)
NonBiologicalDrugs

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Immunosuppressants:Methotrexate,Azathioprine,
Cyclosporine
Sulfasalazine
ChloroquineorHydroxychloroquine
Leflunomide

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Biologicalagents
TNF-ainhibitors:Etanercept,Wiximab,Adalimumab
IL-1antagonists:Anakinra

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105.Whichofthefollowingis/areteratogens:
a)Artemisinin

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b)Aminoglycoside
c)Carbamezapine
d)Retinoicacid
e)Phenytoin
CorrectAnswer-B:C:D:E

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Ans.(B)Aminoglycoside(C)Carbamezapine(D)Retinoicacid
(E)Phenytoin
[RefK.D.TTtlr/&g,8j1;Katzung10th/975;Katzung12th/1042-43;
G&G11th/;DruginPregnancy&LactationbyG.Briggs6th/339]
Teratogens:

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Quinine:Continuestobethedrugofchoiceforseverefalciparum
during1sttrimesterofpregnancy,becausesafetyofartemisininsis
notyetProven.
Artesunate:Useislimitedinsecond6thirdtrimestersofpregnancy
onlywhenotherdrugsarefoundresistant.

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Aminoglycosides:Avoidduringpregnancy:Riskoffoetal
ototoxicity.
ACEinhibitors:2.7foldhighermalformationrateinfetusexposed
forACEinhibitorsinthefirsttrimester..

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106.Desmopressinis/areusedin:

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a)Diabetesinsipidus
b)Esophagealvarices
c)HaemophiliaA
d)VonWillebranddisease
e)HemophilaB

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CorrectAnswer-A:C:D
Ans.(A)Diabetesinsipidus(C)HaemophiliaA(D)Von
Willebranddisease
[Ref.K.D.T7th/596-97,616;Katzung12th/616,674,677;G&G
1fir/784-86]

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Desmopressin:
SelectiveV2agonist.
Uses:
Diabetesinsipidus,bedwettinginchildren&nocturiainadults,renal
concentrationtest,Haemophilia&VonWillebranddisease.

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107.Levetiracetamiscommonlyusedfor:
a)Juvenilemyoclonicepilepsy
b)Absenceseizure
c)GeneralisedTonicclonicseizure
d)Complexpartialseizure

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e)ActthroughGABA
CorrectAnswer-A:C:D:E
Ans.(A)Juvenilemyoclonicepilepsy(C)GeneralisedTonic
clonicseizure(D)Complexpartialseizure(E)Actthrough
GABA

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[RefKD-T7thl420-421]
Levetiracetam:
TreatmentofGeneralizedtonic-chronicseizure&simplepartial
seizures.
TreatmentofComplexpartialseizures.

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Myoclonic&atonicseizures-unresponsivecase
Adjuvanttreatmentofpartialseizuresinadults&childrenforprimary
generalizedtonic-clonicseizure&forthemyoclonicseizuresof
juvenilemyoclonicepilepsy
Approvedasadjuvanttherapyforfocalonsetseizure.

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Approvedasadjuvanttherapyforprimarygeneralizedtonic-clonic

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108.Penicillinaseresistantpenicillinis/are:
a)Methicillin
b)Cloxacillin
c)Ampicillin

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d)Dicloxacillin
e)Vancomycin
CorrectAnswer-A:B:D
Ans.(A)Methicillin(B)Cloxacillin(D)Dicloxacillin
[Ref,K.D.T7th/721]

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Penicillinase-ResistantPenicillins:
Methicillin,cloxacillin,Dicloxacillin
Thesecongenershavesidechainsthatprotectthebeta-lactamring
fromattackbystaphylococcalpenicillinase.
Theironlyindicationisinfectionscausedbypenicillinaseproducing

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staphylococci,forwhichtheyaredrugofchoice,acceptinareas
wheremethicillinresistantstaph.Aureus(MRSA)hasbecome
prevalent

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109.Whichofthefollowingcondition
increasechanceofhyponatremiain

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patienttreatedwithantidepressant:
a)Oldage
b)Lowweight
c)Coldclimate
d)Obesity

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e)Femalesex
CorrectAnswer-A
Ans.(A)Oldage
[Ref.NirajAhuja7th/188.]
CasesofSSRl-associatedhyponatremia&thesyndromeof

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inappropriateantidiuretichormonehavebeenseeninsomepatients,
especiallythosewhoareolderortreatedwithdiuretics.

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110.TrueaboutJarisch-Hexheimerreaction:
a)Occurwithinhoursaftergivingpenicillin
b)Developonlyafter1weekofPenicillintherapy

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c)Aggravationofsignsandsymptomsofsyphilis
d)Itoccurduetoallergytopenicillin
e)Mostcommoninsecondarysyphilis
CorrectAnswer-A:C:E
Ans.(A)Occurwithinhoursaftergivingpenicillin

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(C)Aggravationofsignsandsymptomsofsyphilis(E)Most
commoninsecondarysyphilis
[Ref:K.D.f7th/720;CMDT201s/1460;Harison19th/1140;Neena
Khanna4th/206;G6G11th/1181;Ananthanarayan9th/377,384]
Jarisch-HerxheimerReaction:

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Penicillininjectedinasyphiliticpatient(particularlysecondary
syphilis)mayproduceshiveringfever,myalgia,exacerbationof
lesions,evenvascularcollapse
Mayoccurafterinstitutionofchloramphenicoltherapyforsyphilis,
brucellosis&typhoidfever.

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Thisisduetosuddenreleaseofspirochetallyticproducts&lastsfor
12-72hours
Itdoesnotrecur&doesnotneedinterruptionoftherapy
Aspirin&sedationaffordreliefofsymptoms

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111.Incomparisontohaloperidol,clozapine

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causes:
a)Weightgain
b)Agranulocytosis
c)Sedation
d)Severeextrapyramidalsymptoms

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e)Lesseliptogenicpotential
CorrectAnswer-A:B:C
Ans.(A)Weightgain(B)Agranulocytosis(C)Sedation
[RefK.D.T7th/'M1;Katzung12th/509]
Haloperidol:

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Producesfewerautonomiceffects,islessepileptogenic,doesnot
causeweightgain,jaundiceisrare
SevereextraPyramidalsyndrome.
Preferreddrugforacuteschizophrenia
Clozapine:

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Producesfewornoextrapyramidalsymptoms;tardivedyskinesiais
rare&prolactinleveldoesnotrise.
Quitesedativesedation.
Higherincidenceofagranulocytosis.
Metaboliccomplicationslikeweightgain,hyperlipidemia&

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precipitationofdiabetesisanothermajorlimitation.
Highdosescaninduceseizureseveninnon-epileptics.

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112.Forwhichofthefollowingdrugbacteria
acquiredrugresistancebyinactivation
ordegradationbyenzyme:

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a)Quninolones
b)Aminoglycosides
c)Vancomycin
d)Ampicillin
e)Chloramphenicol

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CorrectAnswer-A:E
Ans.(A)Quninolones(E)Chloramphenicol
[Ref:KD.T7th/692-93;Ihtzung12th/792,816]
Drugdestroying:
Theresistantmicrobeselaborateanenzymewhichinactivatesthe

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drug
Manyofaminoglycosides-resistantcoliformshavebeenfoundto
produceenzymeswhichadenylateacetatephosphorylatespecific
aminoglycosidesantibiotics.
ChloramphenicolacetyltransferaseisacquiredbyresistantE.coli,

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H.influenzae&S.tyPhi.

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113.Apersonwasonchemotherapyfor2
weekforsomemediastinaltumour.Now
hedevelopshighfrequencyhearingloss.
Mostprobablecauseofthisconditionis

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useof:
a)Cisplatin
b)Etoposite
c)Doxorubicin
d)Methotrexate

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e)None
CorrectAnswer-A
Ans.(A)Cisplatin
Ototoxicdrugs:
Cytotoxicdrugscausinghearinglossare-nitrogenmustard

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(mechlorethamine),cisplatin&carboplatin.
Cisplatin:
Tinnitus,deafness,sensoryneuropathy&hyperuricemiaareother
problem
Carboplatin:

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Nephrotoxicity,ototoxicity&neurotoxicityareIowascomparedto
cisplatin

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114.Whichofthefollowingsarefeatureof
benzodiazepinewithdrawalexcept:
a)Anxiety

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b)Increasedappetite
c)Hypersomnia
d)Baddreams
e)Tremor
CorrectAnswer-B:C

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Ans.(B)Increasedappetite(C)Hypersomnia
[RefK.D.T7th/406;NirajAhuja7th/51]
Benzodiazepinewithdrawal:
Withdrawalsymptomsaregenerallymild;maybemoreintensein
caseofultrarapideliminationdrugs

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Anxiety,insomnia,restlessness,malaise,lossofappetite,bad
dreamsisallthatoccursinmostcases
Agitation,Panicreaction,tremors&deliriumareoccasional;
convulsionsarerare
Characterizedbymarkedanxiety,irritability,tremors,insomnia,

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vomitingweakness,automatichyperactivitywithpostural
hypotension(tseizures
Depression,transientpsychoticepisode,suicidalideation,
perceptualdisturbances&rarelydeliriumhavealsobeenreportedin
withdrawalperiod

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115.Whichofthefollowingdrugismainly
excretedbykidney:
a)Tetracyclines
b)Doxycyclines
c)Ampicillin

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d)Acyclovir
e)Rifampicin
CorrectAnswer-A:C:D
Ans.(A)Tetracyclines(C)Ampicillin(D)Acyclovir
[Ref:K.D.T7th/735,721;Katzung12th/794]

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Ampicillin:Partlyexecutedinbile&reabsorbed-enterohepatic
circulationoccurs;primarychannelofexcretioniskidney.
Acyclovir:Primarilyexcretedunchangedinurine,bothby
glomerularfiltrationdttubularsecretion..
Tetracyclines:Primarilyexcretedinurinebyglomerularrtltration;

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dosehastobereducedinrenalfailure;doxycyclineisanexception.
Rifampicin:Metabolizedinlivertoanactivelyacetylated.metabolite
whichisexcretedmainlyinbile,someinurine.

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116.S/Eofclofaziamineincludes:
a)Icthyosis

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b)Thrombocytosis
c)Skinpigmentation
d)Gastrointestinaldisturbances
e)Weightgain
CorrectAnswer-A:C:D

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Ans.(A)Icthyosis(C)Skinpigmentation(D)Gastrointestinal
disturbances
Clofazimine:Sideeffects:
Ichthyosis
Pigmentation-Reddish-blackdiscolorationofskin,especiallyon

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exposedparts.
Discolorationofhair&bodysecretionsmayalsooccur.
Conjunctivalpigmentationmaycreatecosmeticproblem.
Gastrointestinalsideeffects.

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117.Fomepizolecanbeusedin:

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a)Methanolpoisoning
b)Organophosphoruspoisoning
c)Ethyleneglycolpoisoning
d)Barbituratepoisoning
e)None

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CorrectAnswer-A:C
Ans.(A)Methanolpoisoning(C)Ethyleneglycolpoisoning
[Ref:KDT7th/395-96;Katzung12th/398,400,1033]
Fomepizole:
Competitiveinhibitoroftheenzymealcoholdehydrogenase,foundin

--- Content provided by​ FirstRanker.com ---

theliver.
Thisenzymeplaysakeyroleinthemetabolismofethyleneglycol
andmethanol.
Fomepizoleismosteffectivewhengivensoonafteringestionof
ethyleneglycolormethanol.

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Delayingtheadministrationoffomepizoleallowsforthegeneration
ofharmfulmetabolites

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118.Notindicatedforanaerobiccolitis
treatment:
a)Metronidazole

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b)Aminoglycoside
c)Amikacin
d)Piperacillin-tazobactam
e)Imipenem
CorrectAnswer-B

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Ans.(B)Aminoglycoside
[Ref:KDT7th/838;Hanison19th/1101,18th/1338-39;Katzung
12th/904-05]
Treatmentofanaerobicintra-abdominalinfections:
Oral:

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Moxifloxacin400mgevery24hour
IV:
Moderatetomoderatelysevereinfections
Ertapenem1gevery24hours
Ceftriaxone1gevery24hours(orciprofloxacin400mgevery12

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hours,ifpenicillinallergic)plusmetronidazole500mgevery8hours
or
Tigecycline100mgoncefollowedby50mgevery12hoursor
Moxifloxacin400mgevery24hours
Severeinfections:

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imipenem,0.5gevery6-8hours;meropenem1gevery8hours;
doripenem0.5gevery1hour;piperacillin/tazobactam
4.5gevery8hours

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---

119.Whichofthefollowingdruginteractwith
Warfarin:

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a)ACEinhibitor
b)Azithromycin
c)Fluconazole
d)Aspirin
e)Benzodiazepine

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CorrectAnswer-C:D
Ans.(C)Fluconazole(D)Aspirin
[RefKDT7th/62i,503;Katzung12th/610]
DrugCausingEnhancedAnticoagulantActionofWarfarin:
Aspirin:inhibitplateletaggregationebcauseG.Ibleeding

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Nevercephalosporins(ceftriaxone,cefoperazone):Cause
hypoprothrombinemia
BroadSpectrumantibiotics:Inhibitgutflora6reducevit.Kproduction
Longactingsulfonamide,indomethacin,phenytoin&probenecid:
Displacewarfarinfromplasmaproteinbinding.

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Chloramphenicol,erythromycin,celecoxib,cimetidine,allopurinol,
amiodarone&metronidazole:Inhibitwarfarinmetabolism
Tolbutamide&phenytoin:Inhibitwarfarinmetabolism&viceversa.
Liquidparaffin(habitualuse):Reducevit.Kabsorption
DrugCausingReducedAnticoagulantActionofWarfarin:

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Barbiturates(butnotbenzodiazepines),carbamazepine,rifampin,&
griseofulvin:InducethemetabolismoforalAnticoagulant.
OralcontraceptiveIncreasebloodlevelsofclottingfactors

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120.Allofthefollowingistrueabout
hydroxyureaexcept:

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a)Causemyelosuppression
b)Oralbioavailabilityisveryless
c)UsedinCML
d)Actasradiosensitizer
e)Usedinsicklecellanaemia

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CorrectAnswer-B
Ans.B.Oralbioavailabilityisveryless
[Ref:KDT7th/868;Kntzung12th/582]
Hydroxyurea:
Hydroxyureaisananalogofureawhosemechanismofaction

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involvestheinhibitionofDNAsynthesisbyinhibitingtheenzyme
ribonucleotidereductase,resultingindepletionofdeoxynucleoside
triphosphatepools.
ThisagentexertsitseffectsintheSphaseofthecellcycle.
Nearly100%oralbioavailability.

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Mainlyusedinchronicmyelogenousleukemia,blastcrisisofacute
myeloidleukemia,psoriasis&sicklecellanaemia.
Myelosuppressionistheilose-limitingtoxicity.

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121.Whichofthefollowingis/aretrue
regardingplasmaconcentrationtime

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curveofadrug:
a)Peakconcentrationdeterminebioavailability
b)Intramuscularadministrationhavecurvedifferentfromoral
administration
c)Areaundercurvedeterminetherapeuticresponse

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d)Bioavailabilityofanorallyadministereddrugcanbecalculated
bycomparingtheareaundercurveafteroral&afteri.v.
administration
e)Changesintherateofabsorptionandextentofbioavailability
caninfluenceboththedurationofactionandtheeffectiveness

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ofthesametotaldoseofadrugadministeredindifferent
formulations
CorrectAnswer-B:D:E
Ans.(B)Intramuscularadministrationhavecurvedifferentfrom
oraladministration(D)Bioavailabilityofanorallyadministered

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drugcanbecalculatedbycomparingtheareaundercurveafter
oral&afteri.v.administration(E)Changesintherateof
absorptionandextentofbioavailabilitycaninfluenceboththe
durationofactionandtheeffectivenessofthesametotaldose
ofadrugadministeredindifferentformulations

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(Ref:KDT7th/16-17;Katzung12th/43-44)
Theareaunderthebloodconcentration-timecurve(areaunderthe
curve,orAUC)canbeusedtocalculatetheclearanceforfirst-order
elimination.

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usedasameasureofbioavailability.

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Bioavailabilityvariationassumespracticalsignificancefordrugswith
lowsafetymargin(iligoxin)orwheredosageneedsprecisecontrol
(oralhypoglycemics,oralhypocoagulants).

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122.Allaretrueabouthydrochlorothiazide
except:

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a)Causehyperglycemia
b)InhibitNa-Clsymport
c)Increasescalciumexcretioninurine
d)Causehyperuricaemia
e)Usedintreatmentofrenalstone

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CorrectAnswer-C
Ans.C.Increasescalciumexcretioninurine
[RefKDT7th/5%-86;Katzung12th/260-61,270]
Hydrochlorothiazide:
InhibitsNa+-Cl-symportpredominantlyintheDCT.

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EnhanceCa2+reabsorption&decreaseurinecalciumexcretion
(causeshypercalcemia).
Thiazidecausecarbohydrateintolerance&causepreciPitationof
diabetes
Toxicity:

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Hypokalemicmetabolicalkalosisandhyperuricemia
ImpairedCarbohydrateTolerance.

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123.APatientpresentedinemergencyroom
withseveremalaria.Hewasgiven
artusunateat0hr,12hr,24hr&then

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onceadaytill3day.Whichofthe
followingstatement(s)is/arecorrect
regardingfurthermanagementofthe
patient
a)Patientmaylaterswitchedtooraldrugifpatientabletotolerate

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b)Dextrosedripshouldbestarted
c)Artesunateshouldneverbegivensingly
d)Steriodisbeneficial
e)None
CorrectAnswer-A:B:C

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Ans.(A)Patientmaylaterswitchedtooraldrugifpatientableto
tolerate(B)Dextrosedripshouldbestarted(C)Artesunate
shouldneverbegivensingly
[Ref:KDT7th/819-21;Park23rd/262-67;Harrison19th/1379-81,
18th/1698-1705]

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Artemisininderivativesmustneverbegivenasmonotherapyfor
uncomplicatedmalaria.
Therapidlyactingdrugs,ifusedalone,canleadtothedevelopment
ofparasiteresistance
Whenthepatientisunconscious,thebloodglucoselevelshouldbe

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measuredevery4-6hrs.

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AllpatientsshouldreceiveacontinuousinFusionofdextrose,and
bloodconcentrationsideallyshouldbemaintainedabove4mmol/L.

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124.ATTdrugwithsignificantrenalexcretion
is/are:

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a)INH
b)Rifampicin
c)Pyrazinamide
d)Amikacin
e)Streptomycin

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CorrectAnswer-A:C:D:E
Ans.(A)INH(C)Pyrazinamide(D)Amikacin(E)Streptomycin
[RefKDT7th/767;Katzung12th/841]
Rifampin:
Itismetabolizedinthelivertoanactivedeacetylatedmetabolite

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whichisexcretedmainlyinbile,someinurine.
Urine&secretionsmaybecomeorange-red
INH:
Itisextensivelymetabolizedinliver;mostimportantpathwaybeing
N-acetylationbyNAT2.

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Theacetylatedmetaboliteisexcretedinurine
Pyrazinamide:
Extensivelymetabolizedinliver&excretedinurine.
Pyrazinamidemetabolitesarerenallycleared.
Aminoglycosides(streptomycin&amikacin)arenotmetabolized.

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125.Validdrugcombinationsare:
a)Sulfamethoxazole+trimethoprim
b)Penicillin+Tetracycline/chloramphenicol:Pneumococci
c)Piperacillin-Tazobactam
d)Enalapril-Hydrochlorothiazide

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e)Ibuprofen&serratiopeptidase
CorrectAnswer-A:C:D:E
Ans.(A)Sulfamethoxazole+trimethoprim(C)Piperacillin-
Tazobactam(D)Enalapril-Hydrochlorothiazide(E)Ibuprofen&
serratiopeptidase

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[RefKDT7th/698-99,725,61-62;Katzung12th/801]
Tazobactampharmacokineticsmatcheswithpiperacillinwithwhichit
hasbeencombinedforuseinsevereinfectionsLikeperitonitis,
pelvic/urinary/respiratoryinfectionscausedbybeta-lactamase
producingbacilli.

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ACEinhibitors/ARBsareparticularlysynergisticwithdiuretics;this
combinationisverygoodforpatientswithassociatedCHForLVH.
Serratiopeptidaseisaproteolyticenzyme(protease)producedby
enterobacterSerratiasp.BrandnameNildol-SP(400+15)is
combinationofSerratiopeptidase&Ibuprofen(RoyalSapphire

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RemediesTablet.

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126.Whichofthefollowingstatementabout
protonpumpinhibitorsis/aretrue
except:
a)Hit&rundrug

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b)Acidicmediumisessentialforactivity
c)ActonH+/K+ATPase
d)Formsanintegralcomponentofanti-H.pyloriregimens
e)Actbestinalkalinemedium
CorrectAnswer-E

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Ans.E.Actbestinalkalinemedium
[RefKDT7thBa,651-52;Katzung12th/1085-89]
Hit&rundrugs:
Effectslastmuchlongerthanthedrugitself),e.g.,reserpine,
guanethidine,MAOinhibitors,omeprazole.

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OneofthePPIsisanintegralcomponentofallanti-H.pylori
regimensalongwith2(tripledrug)or3(quadrupledrug)
antimicrobial.
SinceanacidicpHintheparietalcellacidcanaliculiisrequiredfor
drugactivation&sincefoodstimulateacidproduction,thesedrugs

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ideallyshouldbegivenabout30minutesbeforemeals.
Protonpumpinhibitorsareadministeredasinactiveprodrugs.

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127.Commonaction(s)ofepinephrine&
norepinephrineincludes:
a)Skinvasodilation

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b)Bronchialmusclecontraction
c)IncreasesystolicBP
d)IncreaseHR
e)Renalvasoconstriction
CorrectAnswer-C:E

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Ans.(C)IncreasesystolicBP(E)Renalvasoconstriction
[RefKDT7th/124-133;Gooilman&Gillmanllth/2z4-248;Ganong
25th/353-56]
Epinephrinecausebronchialmusclerelaxation(throughbeat-2
receptor)whereasnorepinephrinehasnoaetion(noactiononbeat-

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2.
Bothepinephrine&norepinEphrineincreasesrenalvascular
resistance&thusreducerenalbloodflow.

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128.Antibioticwhichactsthroughcellwall
inhibition:

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a)Penicillin
b)Daptomycin
c)Aminoglycoside
d)Cephalosporin
e)Imipenam

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CorrectAnswer-A:D
Ans.(A)Penicillin(D)Cephalosporin
[RefKDT7th/689-90;Katzungp803]
MechanismofActionofDrugs:
Inhibitcellwallsynthesis:Penicillins,Cephalosporins,Cycloserine,

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Vancomycin,Bacitracin.
Causeleakagefromcellmembranes:Polypeptides-Polymyxins,
Colistin,Bacitracin.Polyenes-AmphotericinB,Nystatin,Hamycin.
Inhibitproteinsynthesis:Tetracyclines,Chloramphenicol,
Erythromycin,Clinda-mycin,Linezolid.

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Causemisreadingofm-RNAcodeandaffectpermeability:
Aminoglycosides-Streptomycin,Gentamicin,etc.
InhibitDNAgyrase:Fluoroquinolones-Ciprofloxacinandothers.
InterferewithDNAfunction:Rifampin.
InterferewithDNAsynthesis:Acyclovir,Zidovudine.

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Interferewithintermediarymetabolism:Sulfonamides,Sulfones,
PAS,Trimethoprim,Pyrimethamine,Metronida-zole.

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129.TrueaboutamphotericinB:
a)Liposomalpreparationisavailable
b)Orallyabsorbed

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c)Usedonlyinintravenousform
d)Proteinsynthesisinhibitor
e)None
CorrectAnswer-A
Ans.A.Liposomalpreparationisavailable

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[Ref:KDT7th/787-89;Katzung12th/934,849-52,1066]
AMBisnotabsorbedorally,itcanbegivenorallyforintestinal
candidiasiswithoutsystemictoxicity.
Administeredi,v,assuspensionmadefromdeoxycholate(DOC),it
getswidelydistributedinthebody.

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Itcanbealsoadministeredtopicallyforvaginitis,otomycosis
LiposomalAMB:
Ithasbeenproducedtoimprovetolerabilityofi.v.infusion,reduceits
toxicity&achievetargeteddelivery.
ItdeliversAMBparticularlytoreticuloendothelialcellsinliver&

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spleen-especiallyvaluableforkalaazar&inImmunocompromised.

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130.Peripheralneuropathyis/arecausedby:
a)Vincristine
b)Sulfonamide
c)Amiodarone

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d)Paclitaxel
e)None
CorrectAnswer-A:C:D
Ans.(A)Vincristine(C)Amiodarone(D)Paclitaxel
[Ref:Harrison19th/2686-88,18th/3463-66;KDT7th/706]

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Sulfonamidenotmentionedinlistofdrugscausingneuropathies

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131.Whichoffollowingis/aretrueabout
metformin:
a)Causelacticacid
b)PPARyagonist

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c)ContraindicatedinRenalfailure
d)Causehypoglycemia
e)GIdisturbancesarecommonsideeffect
CorrectAnswer-A:C:E
Ans.(A)Causelacticacid(C)ContraindicatedinRenalfailure

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(E)GIdisturbancesarecommonsideeffect
[Ref.KDT7th/275-76;Katzung12th/757]
Metformin:
PPARyagonist(peroxisomeproliferator-activatedreceptorl)
Causelittleornohypoglycemia

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ReportedtoimprovelipidprofilesintypeIIDm(decreasedLDL).
Contraindicatedinrenaldisease,alcoholism,hepaticdisease,or
conditionspredisposingtotissueanoxia(e.g.,chronic
cardiopulmonarydysfunction),becauseofanincreasedriskoflactic
acidosis,inducedbybiguanidedrugsinthepresenceofthese

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diseases.

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132.Whichoffollowingstatementistrue
aboutcanagliflozin:
a)SGLT-2inhibitor
b)BlocksNa/glucosesymport.

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c)Causesglycosuria&polyuria
d)Increaseschanceofvaginalinfections
e)None
CorrectAnswer-A:C:D
Ans.(A)SGLT-2inhibitor(C)Causesglycosuria&polyuria

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(D)Increaseschanceofvaginalinfections
[RefKDT7th/270:http://tvww.diabetesincontrol.eom]
Canagliflozin:
Antidiabeticdrugusedtoimproveglycemiccontrolinpatientswith
type2diabetes.

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SGLT-2inhibitor.
?Sodium-glucoseco-transPorter-2(SGLT-2)inhibitorsareanew
groupoforalmedicationsusedfortreatingtype2diabetes
ProducesbeneficialeffectsonHDLcholesterolandsystolicblood
pressure,buttheseeffectsareoffsetbyincreasedLDLcholesterol.

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Vaginalyeastinfectionsandurinarytractinfectionsarethemost
commonsideeffects
Canagliflozinislesseffectiveinpatientswithmoderaterenalfailure
endprobablyineffectiveinsevererenalfailureandtype1diabetics

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133.WhichofthefollowingpairofGreceptor

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iscorrectlymatchedwithitsaction:
a)Gi-Activationofcalciumchannel
b)Gq-Tcytoplasmiccalcium
c)Gs-Openingofcalciumchannel
d)Go-Openingofpotassiumchannel

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e)Gt-Activationofpotassiumchannel
CorrectAnswer-B:C:D
Ans.B,Gq-TcytoplasmiccalciumC,Gs-Openingofcalcium
channel&D,Go-Openingofpotassiumchannel
[RefKDT7th/a5-49;Katzung31]

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GsopenCa2+channelsinmyocardium6skeletalmuscle,whileGi
&GoopenK+channelinheart&smoothmuscleasweIIasinhibit
neuronalCa2+channel
GReceptor:
Gs:Adenylylcyclaseactivation,Ca2+channelopening

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Gi:Adenylylcyclaseinhibition,K+channelopening
Go:Ca2+channelinhibition.
Gq:PhospholipaseCactivation

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134.WhichofthefollowingCLASPhuman
experiment:

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a)MaincenterfortheexperimentwasGeneva
b)MaincenterfortheexperimentwasTokoyo
c)MaincenterfortheexperimentwasinUnitedkingdom
d)Heparinlowdosegiven
e)Drugusedinexperimentsignificantlyreduceseclampsiain

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subjects
CorrectAnswer-C
Ans.C.MaincenterfortheexperimentwasinUnitedkingdom
[Ref;http:/www.researchgate.net;
httP://www.ncbi.nlm,nih.gov/pubmed/7905809]

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CLASPhumanexperiment:
Correspondenceto:CLASPCo-ordinatingCentre,Harkness
Building,RadcliffeInfirmary,OxfordOX26HE,UK-http://
www,researchgate.net
CLASP

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Theimpactofaspirinonproteinuricpreeclampsiaanditsfetal
sequelaeinCLASPwascertainlysmallerthaninsomeprevious
reviews.
Theresultsofavailabletrialsdonotsupportthewidespreadroutine
prophylacticortherapeuticuseofantiplatelettherapyinpregnancy

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amongallwomenjudgedtobeatriskofpre-eclampsiaorIUGR.
Overall,theuseofaspirinwasassociatedwithareductionofonly
12%intheincidenceofproteinuriapre-eclampsia,whichwasnot
significant.

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NorwasthereanysignificanteffectontheincidenceofIUGRorof

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stillbirthandneonataldeath.

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135.Mineralocorticoidreceptors
antagonist(s)is/are:
a)Spironolactone
b)Triamterene

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c)Epleroenone
d)Amiloride
e)Acetazolamide
CorrectAnswer-A:C
Ans.(A)Spironolactone&(C)Epleroenone

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[RefKDT.Tth/578;Katzung12th/261-62]
PotassiumSparingDiuretics
Aldosteroneantagonists:Spironolactone,eplerenone
InhibitorsofrenalepithelialNa+channel:Triamterene,Amiloride
MOA:

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Actbydirectpharmacologicantagonismofmineralocorticoid
receptors(spironolactone,eplerenone)orbyinhibitionofNatinflux
throughionchannelsintheluminalmembrane(amiloride,
triamterene).

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136.TNF-ainhibitorsare:

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a)Bevacizumab
b)Ranibizumab
c)Adalimumab
d)Infliximab
e)Etanercept

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CorrectAnswer-A:B:D
Ans.(A)Bevacizumab(B)Ranibizumab(D)Infliximab
TNFalpha-inhibitor:Etanercept,infliximab,certolizumah,
golimumab,&Adalimumab.
MOA:

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BindsTNF-alpha,aproinflammatorycytokine.
BlockingTNF-alphafrombindingtoTNFreceptorsoninflammatory
cellsurfacesresultsinsuppressionofdownstreaminflammatory
cytokinessuchasIL-1&IL-6andadhesionmoleculesinvolvedin
leukocyteactivationandmigration.

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Anincreasedriskoflymphomaiscommontoeachoftheseagents.

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137.UnwantedinteractionsofMAOinhibitors
occurwith:
a)Levodopa
b)Hydrochlorothiazide

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c)Reserpine
d)Pethidine
e)None
CorrectAnswer-A:C:D
Ans.A,LevodopaC,Reserpine&D,Pethidine

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NonSelectiveMAOInhibitors:Interactions:
Cheesereaction-
Varietiesofcheese,beer,wine,pickledmeat&fish,yeastextract
containlargequantitiesoftyramine,dopaetc.
InMAOinhibitedpatientscausehypertensivecrisis&

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cerebrovascularaccidents.
Cold&coughremedies-Ephedrine.
Reserpine,guanethidine,tricyclicantidepressants
Levodopa:
Excitement&hypertension.

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Antiparkinsoniananticholinergics:
Hallucinations&symptomssimilartothoseofatropinepoisoning
Barbiturates,alcohol,opioids,antihistamines:
Actionsofthesedrugisintensified&prolonged.Respirationmay
fail..

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Pethidine:
Highfever,sweating,excitation,delirium,convulsions&severe

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respiratorydepression.
Note:
HydrochlorothiazidedruginteractionsnotincludeMAO-Inhibitors

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138.Trueaboutdoxorubicin:
a)Antineoplasticdrug
b)Alkylatingagent
c)TopoisomeraseIIIinhibitor
d)Anthracyclineantibiotic

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e)Cardiotoxic
CorrectAnswer-A:D:E
Ans.(A)Antineoplasticdrug(D)Anthracyclineantibiotic
(E)Cardiotoxic
[RefKDT7th/867;Katzung13th/934-35]

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Doxorubicin:
Anthracyclineantibiotichavingantitumoractivity
Itintercalateb/wDNAstrands&blockDNAaswellasRNA
synthesis.
TheyarealsocapableofcausingbreaksinDNAstrandsby

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activatingtopoisomerase-2&generatingquininetypefreeradicals.
Cardiotoxicadverseeffect.

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139.Whichofthefollowingis/aretrueabout
Sulfonylureaexcept:
a)Increaseinsulinsecretion

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b)Causehypoglycemia
c)Causeweightloss
d)Disulfiram-likereactionafteralcoholintake
e)Safeinpregnancy
CorrectAnswer-C:E

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Ans.C,Causeweightloss&E,Safeinpregnancy
[RefKDT7th/270-73;Katzung12th/754-5]
Sulfonylureas:
Provokeabriskreleaseofinsulinfrompancreas.
Hypoglycemiaisthemostcommonproblem.

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MajorityofdiabeticsstartedonSUstendtogain1-3kg.
Flushing&disulfiram-likereactionafteralcoholoccurinsome
individualstakingSUs
Safetyduringpregnancyisnotestablished.

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140.Trueaboutdaptomycin:

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a)Causesdiarrheaasside-effect
b)Itisaglycopeptideantibiotic
c)Causemyopathy
d)Itcanbeusedorally
e)Excretionthroughkidney

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CorrectAnswer-C:D
Ans.(C)Causemyopathy(D)Itcanbeusedorally
[RefKatzung13th/783-85;Goodman&Gilman11th/1197-98:
Harrison19th/961]
Daptomycin:

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CycliclipopeptidefermentationproductofStreptomyces
roseosPorus.
Newly-approvedantibacterialagent,thefirstlipopeptideagenttobe
releasedontothemarket.
ItsspectrumofactivityislimitedtoGram-positiveorganisms,

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includinganumberofhighlyresistantspecies(MRSA,VISA,VRSA,
VRE)
MOA:
Precisemechanismofactionisnotknown,butifappearstobindto
anddepolarizethecellmembrane,causingPotassiumeffluxand

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rapidcelldeath.
Features:
Onlyadministeredintravenously.
Clearedrenally.
Approximately80%oftheadministereddoseisrecoveredinurine.

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Cancausemyopathy,andcreatinephosphokinaselevelsshouldbe

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monitored.

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141.Weightgainisnotseenwith:
a)Clozapine
b)Risperidone

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c)Olanzapine
d)SSRI
e)Zotepine
CorrectAnswer-D
Ans.(D)SSRI

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[RefKDT7th/aal,442;Katzung12d/512,509]
ClozapineMetaboliccomplications(Major)-Weightgain,
hyperlipidemia&precipitationofdiabetes.
Olanzapinecausesweightgain.
Risperidonecausesweightgain&incidenceofnewonsetdiabetes

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islessthanwithclompine
increasedappetite&weightgainisnoteilwithmostTCAs&
trazodone,butnotwithSSRIs,SNRIs&bupropion.
Zotepine:Weightgain,hyperglycemia&dyslipidemiaareLikelyas
withclozapine

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Quetiapine:Weightgain&riseinbloodsugarismoderate.
Aripiprazole:Littletendencytoweightgain.

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142.Whichofthefollowingis/aretrueabout
dobutamine:
a)Selective(32receptoragonist

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b)Tventricularfillingpressure
c)Halflifeisabout2min
d)Dopaminereceptoragonist
e)None
CorrectAnswer-C

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Ans.(C)Halflifeisabout2min
[R4KDf7th/134;Katzung12th/141-42,218,225;Goodman&
Gilman11th/251]
Dobutamine:
Derivativeofdopamine,butnotaDlotD2receptoragonist.

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Hasactiononalpha&betareceptorsalso.
Yet,onlyprominentactionofclinicallyemployeddosesisincreased
forceofcardiaccontraction&outPut,withoutsignificantchangein
heartrate,peripheralresistance&BP.
Consideredtobearelativelyselectivebeta-1agonist.

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Half-lifeofabout2minutes&onsetofactionisrapid.
UsedasaninotroPicagentinpumpfailureaccompanying
myocardialinfarction,cardiacsurgery&forshorttermmanagement
ofseverecongestiveheartfailure.

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143.DrugsactiveagainstMRSA:

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a)Vancomycin
b)Ceftriaxone
c)Linezolid
d)Piperacillin-tazobactam
e)Meropenam

--- Content provided by‌ FirstRanker.com ---

CorrectAnswer-A:C
Ans.(A)Vancomycin(C)Linezolid
[RefKDT7th/731,757,6th/700,708,732,7i4;G6G11th/1132;
Kntzung13th/779,781;Harrison19th/961-62.18th/2134]
MRSA:

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Vancomycinanddaptomycinarenowrecommendedasthedrugof
choiceforthetreatmentofMRSAinfections.
Imipenema,Dalfopristino/Quinpristin,Mupirocin,Teicoplaninaare
alsoeffectiveagainstMRSA
Ceftarolineisa5thgen.cephalosporinwithbactericidalactivity

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againstMRSA(includingstrainswithreducedsusceptibilityto
vancomycinanddaptomycin)-Approvedforuseinnosocomial
pneumoniasandforskinandsofttissueinfections.
Otherdrugsare-Linezolid,daptomycin,Quinupristin/dalfopristin.

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144.Whichofthefollowingis/aretrueabout

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phenytoin-
a)InactivationbyLiverenzyme
b)CausesVitB12deficiency
c)Causesthiaminedeficiency
d)Gumhypertrophyiscommonestside-effect

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e)InhibitorofCYP3A4/5
CorrectAnswer-A:D
Ans.(A)InactivationbyLiverenzyme(D)Gumhypertrophyis
commonestside-effect
[Ref:KDT7th/a13-15;Katzung13th/2100-N2;AtoZDrugFacts

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2003byDaildS.Tatro;Goodman6Gilman11th/335;Hanison
l9ttt/2554'18th/893,888]
Phenytoin:
MetabolizedinliverbyhydroxylationinvolvingCYP2C9&2C19as
wellasbyglucuronideconjugation.

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Megaloblasticanaemia:ltdecreasedfolateabsorption&increaseits
excretion.
ItinterfereswithmetabolicactivationofVitD&withcalcium
absorPtion/metabolism.
Gumhypertrophy:commonest(20%incidence)

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PotentinducerofCYP2C8/9,CYP3A4/5&someotherCYPs.
ItcompetitivelyinhibitsCYP2C9/19

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145.Apersonhasgiven0.175gmoral
digoxinwithbioavailabilty70%.The
amountofdrugreachinginsystemic

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circulationis:
a)0.175
b)0.175x0.7
c)0.175/7
d)0.175+0.7

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e)0.175+1/0.7
CorrectAnswer-B
Ans.(B)0.175x0.7
[RdKDT7th/16,515;Katzungt2th/43]
Amountofdrugreachinginsystemiccirculation=drugdosegivenx

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bioavailability
=0.175gmx70/100
=0.175gmx0.7

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146.TrueaboutPlacebo:
a)Itworksonlyinpsychiatricperson

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b)Responseisbothobjective&subjective
c)Effectalsoseeninnormalperson
d)Itisaninertsubstance
e)None
CorrectAnswer-B:C:D

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Ans.B,Responseisbothobjective&subjectiveC,Effectalso
seeninnormalperson&D,Itisaninertsubstance
[RefKDT7th/67;Katzung12th/72]
Placebo:
Aninertsubstancewhichisgiveninthegarbofamedicine.

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Workbypsychodynamicratherthanpharmacodynamicmeans&
oftenproducesresponsesequivalenttotheactivedrug
Placebodoinducesphysiologicalresponses,e.g.,theycanrelease
endorphinsinbrain-causinganalgesia.
Substancescommonlyusedasplaceboarelactosetablets/capsules

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&distilledwaterinjection.
Themanifestationofthisphenomenoninthesubjectistheplacebo
response(Latin,'Ishallplease')andmayinvolveobjective
physiologicandbiochemicalchangaaswellaschangesin
subjectivecomplaintsassociatedwiththedisease

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147.Trueaboutmorphine:
a)ActasantagonistonIAreceptorwithnoagonistaction
b)Activationinliver
c)Halflife4hr
d)Causemiosis

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e)Clearancetimeisaround20hr
CorrectAnswer-B:D:E
Ans.(B)Activationinliver(D)Causemiosis(E)Clearancetime
isaround20hr
[Ref:KDT7th/469-75;Katzung13th/531-44;Goodman&Gilman

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p62-66]
Morphine:
Primarilymetabolizedinliverbyglucuronideconjugation.
Morphine-6-glucuronideisanactivemetabolite(morepotentthan
morphineonpopioidrecePtors),whichcontributetoanalgesia.

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AnothermetabolitemorPhine-3-glucuronidehasneuroexcitatory
proPerty.
Plasmahalflifemorphineaverages2-3hours
Effectofaparenteraldoselasts4-6hours.
EliminationisalmostcomPletein24hours.

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MorphinestimulateEdingerWestphalnucleusof3rdnerveis
stimulatedproducingmiosis.
NomeiosisoccurontopicalaPPlicationofmorPhinetotheeye,
sincethisisacentralaction

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148.Treatmentofnocardiainfectionincludes:

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a)Ampicillin
b)Floroquinolones
c)Azithromycin
d)Cotrimoxazole
e)Amikacin

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CorrectAnswer-A:B:D:E
Ans.A,AmpicillinB,FloroquinolonesD,Cotrimoxazole&
E,Amikacin
[RefKDf7th/706,755;Hanisonlgth/1087]
Nocardiosis:

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SulfonamidesareofvalueintreatinginfectionsduetoNocardiagrp.
Sulfisoxazoleorsulfadiazinemaybegivenindosagaof6-8gdaily
andiscontinuedforseveralmonthsafteraIImanifestationshave
resolved.
administrationofasulfonamidewith2ndgen.antibiotic(ampicillin,

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erythromycin,ardstreptomycin)advised.
CoTrimoxazoleisusedinnocardiosis.

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