{"question": "The following adverse drug reaction seen in colonoscopy view is due to", "exp": "The picture shows Melanosis coli caused by Senna and cascara which are stimulant purgatives.bisacodyl usually cause hypokalemiaRef: KD Tripathi 7th ed pg 673", "cop": 1, "opa": "Cascara", "opb": "Bisacodyl", "opc": "Castor oil", "opd": "Loperamide", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "7a4a7e23-8b00-42c3-8fd0-b132e0ff0dc5", "choice_type": "single"} {"question": "Moclobemide is", "exp": "Moclobemide is a reversible, competitive, selective MAO-A inhibitor.", "cop": 3, "opa": "SSRI", "opb": "Antipsychotic drug", "opc": "MAO inhibitor", "opd": "Tricyclic antidepressant", "subject_name": "Pharmacology", "topic_name": null, "id": "022edd2f-f683-487a-bef2-2563a96cfa47", "choice_type": "single"} {"question": "Drug of choice for pregnant female suspected of having a baby with congenital adrenal hyperplasia", "exp": "Refer Goodman Gilman 12/e p 123 To suppress fetal androgen production effectively band consequent virilization Dexamethasone must be initiated before 10 weeks of gestation To treat congenital adrenal hyperplasia is baby hydrocoisone is used.", "cop": 1, "opa": "Dexamethasone", "opb": "Betamethasone", "opc": "Hydrocoisone", "opd": "Prednisolone", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "0bc67e92-c62b-4458-8966-4411a6fdad85", "choice_type": "single"} {"question": "Filgrastim is a.", "exp": "Filgrastim is a recombinant G-CSF. From medical pharmacology padmaja 4th edition Page no 333", "cop": 3, "opa": "T-cell stimulating factor", "opb": "GnRH analogue", "opc": "G-CSF", "opd": "GM-CSF", "subject_name": "Pharmacology", "topic_name": "Hematology", "id": "485db02f-e937-4dfe-a55d-92e7d7f82a94", "choice_type": "single"} {"question": "Buspirone acts on", "exp": "Buspirone:- * Buspirone is a 5HT1A paial agonist used as an anxiolytic. * It is also used in relief of pain and related anxiety of functional dyspepsia associated with Irritable Bowel Syndrome. * Buspirone (atypical anxiolytic), in contrast to conventional Benzodiazepine anti-anxiety drugs: [?] Have minimal abuse liability [?] No withdrawal reactions on abrupt discontinuation [?] Lesser impairment of psychomotor skills and function Adverse effects of Buspirone:- Tachycardia, nervousness, GI distress, parasthesias and dose dependent miosis. Ref:- Goodman & Gilman Pharmacological Basis of Therapeutics 13th Ed; Pg num:- 230", "cop": 1, "opa": "5HT1A", "opb": "5HT1B", "opc": "5HT2", "opd": "5HT3", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "d4bdbd9c-67ae-4543-9df6-337027a77a51", "choice_type": "single"} {"question": "Oprelvekin is a", "exp": "Oprelvekin is a IL - 11 analogue that stimulates thrombopoiesis used in thrombocytopenia due to chemotherapy.", "cop": 3, "opa": "IL - 1 analogue", "opb": "IL - 6 analogue", "opc": "IL - 11 analogue", "opd": "IL - 13 analogue", "subject_name": "Pharmacology", "topic_name": null, "id": "e18a9572-f19e-4fa5-afcf-14059cfe64be", "choice_type": "single"} {"question": "A patient presents with malignant hypehermia and metabolic acidosis. Immediate treatment should be staed with", "exp": "IV dantrolene (1mg/kg repeated if required) is the life saving drug in malignant hypehermia. Oxygen inhalation, treatment of acidosis and immediate cooling of body may also help. Ref: KD Tripathi 8th ed.", "cop": 1, "opa": "Intravenous Dantrolene", "opb": "Sodium bicarbonate", "opc": "Intravenous fluids", "opd": "Paracetamol", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "3f0d927a-460a-41be-874b-ba58aaa3fdf5", "choice_type": "single"} {"question": "Shivering is observed in the early pa of postoperative period is due to", "exp": "Halothane Post operative shivering and hypothermia is maximum with Halothane Pethidine is used for treatment of this condition Refer Ajay yadav 2/e p 61", "cop": 2, "opa": "Chloroform", "opb": "Halothane", "opc": "Truchloroethylene", "opd": "Ether", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "36eda334-6ed6-404b-86fb-2bc478f41623", "choice_type": "single"} {"question": "The antibiotic of choice in patients sensitive to penicillin is", "exp": null, "cop": 1, "opa": "Erythromycin", "opb": "Streptomycin", "opc": "Tetracycline", "opd": "Chloramphenicol", "subject_name": "Pharmacology", "topic_name": null, "id": "15292cb9-5b5f-4c70-ae74-3981d307ac43", "choice_type": "single"} {"question": "Drug of choice for Hypertensive emergency is", "exp": "IV Nicardipine is the drug of choice for hypertensive emergency followed by IV Clevidipine.\nThese are calcium channel blockers and β - blockers should be given along with them to prevent tachycardia.", "cop": 2, "opa": "IV Clevidipine", "opb": "IV Nicardipine", "opc": "IV Diltiazem", "opd": "IV Verapamil", "subject_name": "Pharmacology", "topic_name": null, "id": "f6e701d6-bf80-441d-a2eb-993f3d0ee152", "choice_type": "single"} {"question": "Warfarin acts by", "exp": "Ans. is 'a' i.e., Inhibition of Vitamin K epoxide reductase", "cop": 1, "opa": "Inhibition of Vitamin K epoxide reductase", "opb": "Inhibition of gamma glutamyl carboxylase", "opc": "Activation of Vitamin K epoxide reductase", "opd": "Activation of gamma glutamyl carboxylase", "subject_name": "Pharmacology", "topic_name": null, "id": "ac0d14a0-074e-4fdb-a149-c7cd2fe3d4fb", "choice_type": "single"} {"question": "Intranasal calcitonin is used for", "exp": "Calcitonin nasal spray is used together with calcium and vitamin D to treat bone loss in women with postmenopausal osteoporosis who have been postmenopause for at least 5 years. REF KD Tripathi 8th ed", "cop": 4, "opa": "Paget's disease", "opb": "MEN syndrome", "opc": "Hypercalcemia", "opd": "Osteoporosis-Post menopausal", "subject_name": "Pharmacology", "topic_name": "Immunomodulators", "id": "a0849057-5a53-4964-aa7c-e1f9b763cfa1", "choice_type": "single"} {"question": "Bremelanotide is a drug approved for treatment of", "exp": "Bremelanotide functions by activating the melanocoin receptors. It was shown to be effective in treating sexual dysfunction in both men (erectile dysfunction or impotence) and women (sexual arousal disorder). Unlike phosphodiesterase inhibitors like sildenafil, it does not act upon the vascular system, but directly increases sexual desire the nervous system. The primary target for ED will be patients non-responsive to PDE-5 inhibitors, with patients receiving bremelanotide either as a monotherapy or in combination with a PDE-5 inhibitor.", "cop": 1, "opa": "Erectile dysfunction", "opb": "Lower urinary tract symptoms", "opc": "Prostate Cancer", "opd": "Metastatic renal cancer", "subject_name": "Pharmacology", "topic_name": "Osteoporosis, Sex Hormones and OCPs", "id": "5eadcbc4-a3b9-4609-8ea0-8c808701d93f", "choice_type": "single"} {"question": "Selective Alpha 2 blocker is", "exp": "Yohimbine, idazoxan -selective alpha 2 blockers. Only two of them are present with no impoant clinical use. Ref: KD Tripathi.", "cop": 3, "opa": "Tizanidine", "opb": "Terazosin", "opc": "Yohimbine", "opd": "Dexmedetomidine", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "c3b701dc-b716-43aa-8323-76954192d6ee", "choice_type": "single"} {"question": "Urgent reversal of warfarin induced bleeding can be done by the administration of", "exp": "Fresh frozen plasma contains clotting factors . Hence given immediately in warfarin induced bleeding. From essential of medical pharmacology K D Tripati 7th edition Page no 620", "cop": 3, "opa": "Cryoprecipitate", "opb": "Platelet concentrates", "opc": "Fresh frozen plasma", "opd": "Packed red blood cells", "subject_name": "Pharmacology", "topic_name": "Hematology", "id": "6c2bcad9-25f9-4ae7-bfae-eb0735da8d1a", "choice_type": "single"} {"question": "Elagolix sodium was approved by FDA in July 2018 for", "exp": "Approved for trestment of endometiosis", "cop": 2, "opa": "Prostate cancer", "opb": "Pain of endometriosis", "opc": "Dysmenorrhea", "opd": "Non-Hodgkins lymphoma", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "8d30fcb5-4b0a-43d9-9d32-a6c5d5fd828a", "choice_type": "single"} {"question": "Cardiomyopathy is caused by", "exp": "Ref: Katzung 14th ed. pg. 964-65; KDTy 6th ed. pg. 826-27* Doxorubicin and daunorubicin are anti-tumor antibiotics. Activity of Daunorubicin is limited to acute leukemia while doxorubicin is effective in several solid tumors.# MOA: Cause breaks in DNA strands by activating topoisomerse II and generating quinolone type free radicals.# Doxrorubicin and daunorubicin both these antibiotics produce cardiotoxicity as a unique adverse effect.* Actinomycin D (Dactinomycin) It is a very potent antineoplastic drug, highly efficacious in Wilms' tumour and rhabdomyosarcoma# Prominent adverse effects are vomiting, stomatitis, diarrhoea, erythema and desquamation of skin, alopecia and bone marrow depression* Mitoxantrone: Recently introduced analogue of doxorubicin with lower cardiotoxicity, probably because it does not produce quinine type free radicals. Though cardiomyopathy can occur, major toxicity is marrow depression and mucosal inflammation.* Mitomycin C: This highly toxic drug is used only in resistant cancers of stomach, cervix, colon, rectum, bladder, etc# Bone marrow and GIT are the primary targets of toxicity.", "cop": 2, "opa": "Actinomycin D", "opb": "Doxorubicin", "opc": "Mitomycin C", "opd": "Mitoxantrone", "subject_name": "Pharmacology", "topic_name": "Anti-Cancer", "id": "9e3d87b5-0d19-41b9-8d24-a82a3f15a725", "choice_type": "single"} {"question": "The drug used for leishmaniasis treatment", "exp": "Sodium stibogluconate, is drug of choice in leishmaniasis. Meglumine antimoniate, Pentamidine, Amphotericin B, Miltefosine, Paromomycin are alternative drugs Basic and clinical pharmacology Katzung 13th edition pg 902", "cop": 3, "opa": "Pyrimethamine", "opb": "Albendazole", "opc": "Sodium stibogluconate", "opd": "Tinidazole", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "6887c803-6a1b-4bb6-80c1-4e4e53c56d79", "choice_type": "single"} {"question": "Ondonsetron is a potent", "exp": "Ondansetron, is a medication used to prevent nausea and vomiting caused by cancer chemotherapy, radiation therapy, or surgery. It is also useful in gastroenteritis. It has little effect on vomiting caused by motion sickness. Refer kDT 6/e p646", "cop": 1, "opa": "Anti emetic", "opb": "Anxiolytic", "opc": "Analgesic", "opd": "Anti depressants", "subject_name": "Pharmacology", "topic_name": "Autacoids", "id": "61f22826-59bd-41a3-a2e1-892819925659", "choice_type": "single"} {"question": "The drug that can cause hirsutism is", "exp": "Ans: a (Minoxidil)Ref: katzung 9 ed., Pg. 247Topical minoxidil is used for treating androgenic alopecia. The mechanism of action of minoxidil on hair follicles is unknownDrugs causing hirsutism- Minoxidil- Phenytoin- Cyclosporine- Diazoxide- Androgens- Oral contraceptives - containing progesterone- Penicillamine- Heavy metals- Acetazolamide", "cop": 1, "opa": "Minoxidil", "opb": "Cycloserine", "opc": "Valsartan", "opd": "Dactinomycin", "subject_name": "Pharmacology", "topic_name": "Adverse Drug Effect", "id": "4d15aa8b-871a-47cc-9b83-de28890a9fd1", "choice_type": "single"} {"question": "Gingival hypertrophy and hirsutism are the side effects of following Antiepileptic drug use", "exp": "(D) Diphenylhydantoin # Gum hypertrophy: Commonest (20% incidence), more in younger patients, can be minimized by maintaining oral hygiene.> Hirsutism, coarsening of facial features (troublesome in young girls), acne.# Adverse effects These are numerous; some occur at therapeutic plasma concentration after prolonged use, while others are manifestation or toxicity due to overdose.# At therapeutic levels> Gum hypertrophy: Commonest (20% incidence), more in younger patients, can be minimized by maintaining oral hygiene.> Hirsutism, coarsening of facial features (troublesome in young girls), acne.> Hypersensitivity reactions are--rashes, DLE, lymphadenopathy; neutropenia is rare but requires discontinuation of therapy.> Megaloblastic anaemia: phenytoin decreases folate absorption and increases its excretion.> Osteomalacia: phenytoin desensitizes target tissues to vitamin D and interferes with calcium metabolism.> It can inhibit insulin release and cause hyperglycaemia.> Used during pregnancy--can produce foetal hydantoin syndrome (hypoplastic phalanges, cleft palate, hare lip, microcephaly), which is probably caused by its areneoxide metabolite.", "cop": 4, "opa": "Diazepam", "opb": "Primidone", "opc": "Carbamazepine", "opd": "Diphenylhydantoin", "subject_name": "Pharmacology", "topic_name": "Miscellaneous (Pharmacology)", "id": "e9e11837-c054-4060-93e5-86116294b59c", "choice_type": "single"} {"question": "The dosage of Testosterone dosage is", "exp": "(A) 100 mg/week# First, oral agents really have no place in hormone therapy in men.> There is a first pass effect after absorption into the portal system that allows the liver to metabolize the drug, leading to a very small amount of hormone entering the circulation. Injectable agents are more often used for replacement therapy.> The testosterone esters in these compounds are put in depot injections that leach hormone out over a period of weeks.> The average dosage is 100 mg per week.", "cop": 1, "opa": "100 mg/week", "opb": "200 mg/week", "opc": "150 mg/week", "opd": "300 mg/week", "subject_name": "Pharmacology", "topic_name": "Miscellaneous (Pharmacology)", "id": "e14c7212-a74f-4a68-8eb6-dfd1571bf71b", "choice_type": "single"} {"question": "Mechanism of action of Abatacept is ( REPAEAT)", "exp": "Abatacept is a soluble fusion protein that consists of the extracellular domain of human cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) linked to the modified Fc (hinge, CH2, and CH3 domains) poion of human immunoglobulin G1 (IgG1). Abatacept is produced by recombinant DNA technology in a mammalian cell expression system. The drug has activity as a selective costimulation modulator with inhibitory activity on T lymphocytes. It is used in the treatment of Rheumatoid ahritis. Ordinarily, full T cell activation requires 1) binding of the T cell receptor to the antigen-MHC complex on the antigen presenting cell (APC) and 2) a costimulatory signal provided by the binding of the T cell's CD28 protein to the B7 protein on the APC. Abatacept, which contains a high-affinity binding site for B7, works by binding to the B7 protein on APCs and preventing them from delivering the costimulatory signal to T cells, thus preventing the full activation of T cells. Abatacept is the basis for the second-generation belatacept currently being tested in clinical trials. In organ transplantation, it is intended to provide extended graft survival while limiting the toxicity generated by standard immune-suppressing regimens such as calcineurin inhibitors (eg, ciclosporin). Ref: katzung 12th ed.", "cop": 3, "opa": "IL-1 inhibitor", "opb": "TNF-alpha inhibitor", "opc": "T cell inhibitor", "opd": "Calcineurin inhibitors", "subject_name": "Pharmacology", "topic_name": "Immunomodulators", "id": "8f6dd2c9-9725-485f-b120-e6e4ba743962", "choice_type": "single"} {"question": "Broad spectrum antihelminthic", "exp": null, "cop": 2, "opa": "Niclosamide", "opb": "Albendazole", "opc": "Mebendazole", "opd": "Pyrantal pamoate", "subject_name": "Pharmacology", "topic_name": null, "id": "ade5f419-4961-4da5-9568-65aa784e0390", "choice_type": "single"} {"question": "drug directly acting on blood vessels is", "exp": "Hydralazine is used with or without other medications to treat high blood pressure. Lowering high blood pressure helps prevent strokes, hea attacks, and kidney problems.Hydralazine is called a vasodilator. It works by relaxing blood vessels so blood can flow through the body more easily. Refer kDT 6/e p547", "cop": 1, "opa": "Hydralizine", "opb": "Verapamil", "opc": "Propranolol", "opd": "Methyldopa", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "221d25eb-8745-4300-9e44-e6e2abaf76d3", "choice_type": "single"} {"question": "Mechanism of action of colchicine in acute gout is", "exp": "Colchicine used in acute gout inhibits beta-tubulin protein and prevents granulocyte migration.", "cop": 1, "opa": "Prevention of granulocyte migration", "opb": "Inhibition of leukotriene synthesis", "opc": "Inhibition of uric acid formation", "opd": "Inhibition of purine metabolism", "subject_name": "Pharmacology", "topic_name": null, "id": "63bc8781-3c96-4e7e-914f-084ffd81b262", "choice_type": "single"} {"question": "The drug used in Alzheimer's disease is", "exp": "Tacrine was not discontinued due to hepatotoxicity Donepezil, gallatamine, rivastigmine can be used which are lipid soluble and can cross BBB easily Pyridostigmine and neostigmine are quaernary amines which do not cross BBB hence not used in Alzheimers Ref: KDT 6th ed pg 104", "cop": 2, "opa": "Tacrine", "opb": "Rivastigmine", "opc": "Pyridostigmine", "opd": "Neostigmine", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "6070aad5-6714-4e3b-9e38-61a9de4c8de9", "choice_type": "single"} {"question": "Drug of choice in Acute migraine is", "exp": "(Sumatriptan) (170-17l-KDT6th) (523-LP 3rd)Triptans (Sumatriptan, naratriptan, eletriptan, almotriptan, zolmitriptan)* \"Triptans rapidly and effectively abort or markedly reduce the severity of migraine headaches in about 80% of patients\"* Sumatriptan is an effective and better tolerated than ergotamine* Somatriptan is the first selective 5HT 1B/1D receptor agonist\"Propranol is drug of choice for prophylaxis in migraine\"", "cop": 2, "opa": "Ergotamine", "opb": "Sumatriptan", "opc": "Dihydroergotamine", "opd": "Propranol", "subject_name": "Pharmacology", "topic_name": "C.N.S", "id": "45b9cc9b-e66a-424f-b47d-9cc2e9874fa5", "choice_type": "single"} {"question": "If a drug is given through skin, maximum percutaneous absorption of given drug is from", "exp": "Posterior auricularOrder of percutaneous absorption of drug applied topically:Posterior auricular > Scrotum > Scalp > Forearm > Plantar surface Ref: katzung 12th ed.", "cop": 1, "opa": "Posterior auricular", "opb": "Scalp", "opc": "Scrotum", "opd": "Plantar surface", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "daa88d56-8f6c-44d5-a556-dde0fa0d0e6e", "choice_type": "single"} {"question": "Radiopharmaceutical used for liver scan is", "exp": "A radio active subtance called radio pharmaceutical is formed or radio active tracer is formed by addition of a radioactive atom to a moleclue absorbed by a normal liver tissue.", "cop": 1, "opa": "Technetium 99m sulphur colloid", "opb": "Tc99m mebrofenin", "opc": "Tc-99m MIBI", "opd": "Tc99m DTPA", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "aff84389-be1d-47dd-8b59-437fac07600c", "choice_type": "single"} {"question": "Wof is a monoclonal anti CD20 antibody used in treating NHL", "exp": "Rituximab It is a chimerized MAb. Mech of action:- It binds to the CD20 B-cell antigen expressed on the surface of B-lymphocytes and B-cell lymphomas. Rituximab binding to the antigen promotes apoptosis through transmembrane signalling as well as by ADCC and CDC mechanisms. Uses:- It is indicated in B-cell lymphoma, non-Hodgkin lymphoma and chronic lymphocytic leukaemia. Adverse effects:- are infusion reactions consisting of chills, fever, uicarial rashes, pruritus, dyspnoea and hypotension. Severity of the reaction varies, and is also related to rate of infusion. Pretreatment with antihistaminics dampens the reaction. Ref:- kd tripathi;pg num:-872", "cop": 4, "opa": "Cyclophosphomide", "opb": "Transtuzumab", "opc": "Denosumab", "opd": "Rituximab", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "6e30760c-866a-42b6-98fd-d64fce122c2f", "choice_type": "single"} {"question": "Common side effect of colchicine among the following is", "exp": "Colchicine inhibits the polymerization of tubulin into microtubules. The disruption of the microtubules probably leads to defective intracellular movement of impoant proteins, nutrients, and waste products Common side effects of colchicine include bloating, abdominal cramps, lactose intolerance, and diarrhoea. They can be minimized by staing at a low dose and gradually advancing as tolerated, splitting the dose, use of simethicone for flatulence, and avoidance of dairy products. ref : Harrisons 20th ed", "cop": 4, "opa": "Neutropenia", "opb": "Asthma", "opc": "Fever", "opd": "Diarrhea", "subject_name": "Pharmacology", "topic_name": "Other topics and Adverse effects", "id": "8cda239e-4db8-455b-83b1-d4c27fe78ac6", "choice_type": "single"} {"question": "Acetazolamide is", "exp": "Carbonic anhydrase inhibitor act by non-competitive but reversible inhibition of the enzyme. Examples include acetazolamide,dorazolamide and brinzolamide.", "cop": 2, "opa": "Competitive and reversible carbonic anhydrase inhibitor", "opb": "Non-competitive and reversible carbonic anhydrase inhibitor", "opc": "Competitive and irreversible carbonic anhydrase inhibitor", "opd": "Non-competitive and irreversible carbonic anhydrase inhibitor", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "8dd2c049-3ed7-4c25-a1f1-6e53a499659e", "choice_type": "single"} {"question": "Nesiritide is broken down by", "exp": "Nesiritide is a brain natriuretic (BNP) analog broken by neutral endopeptidase (NEP).Sacubitril is a drug inhibits NEP. Used now a days in ccf.Ref: Katzung 11th ed .pg 303", "cop": 1, "opa": "Endopeptidase", "opb": "Angiotensin conveing enzyme", "opc": "Vasopeptidase", "opd": "Amidase", "subject_name": "Pharmacology", "topic_name": "Other topics and Adverse effects", "id": "179eca30-fe73-4900-9b6d-2e28c744d143", "choice_type": "single"} {"question": "GABA Reuptake is inhibited by", "exp": "Reuptake is inhibited by tiagabine as shown in the picture", "cop": 1, "opa": "Tiagabine", "opb": "Topiramate", "opc": "Felbamate", "opd": "Perampanel", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "9f775529-8541-4cf2-8027-e4aaf3840979", "choice_type": "single"} {"question": "Drug of choice for Liddle syndrome", "exp": "Liddle syndrome is charcterized by increased ENaC channels and Amiloride is a ENaC blocker, which can be used for this condition.", "cop": 3, "opa": "Acetazolamide", "opb": "Furosemide", "opc": "Amiloride", "opd": "Spironolactone", "subject_name": "Pharmacology", "topic_name": null, "id": "a9140920-3366-4a87-b848-2f3ad7bfab3d", "choice_type": "single"} {"question": "Neuroleptic malignant syndrome is caused by", "exp": "Ans. c (Haloperidol). (Ref. Harrison, Internal Medicine 18th/Table 16-1)Malignant neuroleptic syndrome (MNS)# is a rare dose-related adverse effect of neuroleptics characterised by marked rigidity, immobility, tremors, fever, fluctuating BP and HR, semiconsciousness and myoglobin in blood.# Drugs causing MNS are Phenothiazines; butyrophenones, including haloperidol and bromperidol; fluoxetine; loxapine; tricyclic dibenzodiazepines; metoclopramide; domperidone; thiothixene; molindone; withdrawal of dopaminergic agents.# Drug of choice for Rx of MNS is Dantrolene. (MH 2006); However, bromocryptine may also be of use.", "cop": 3, "opa": "Carbamazepine", "opb": "Clonazepam", "opc": "Haloperidol", "opd": "Fluoxetine", "subject_name": "Pharmacology", "topic_name": "C.N.S", "id": "bf8cc469-b448-4a25-9084-abef8a118321", "choice_type": "single"} {"question": "The following antibiotic accentuates the neuromuscular blockade produced by pancuronium", "exp": "DRUG INTERACTIONS Antibiotics:- Aminoglycoside antibiotics (streptomycin) reduce Ach release from prejunctional nerve endings by competing with Ca2+. They interfere with mobilization of ACh containing vesicles from a central location to near the terminal membrane, and have a weak stabilizing action on the postjunctional membrane. In clinically used doses, they do not by themselves produce muscle relaxation, but potentiate competitive blockers. Tetracyclines (by chelating Ca2+), polypeptide antibiotics, clindamycin and lincomycin also synergise with competitive blockers. Ref:- kd tripathi; pg num:-354", "cop": 1, "opa": "Streptomycin", "opb": "Penicillin", "opc": "Chloramphenicol", "opd": "Erythromycin", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "9d2c0fd0-096d-4494-9118-05851254db1a", "choice_type": "single"} {"question": "Anaesthetic having epileptogenic potential is", "exp": "Sevoflurane Enflurane Isoflurane Have epileptic potentials Refer Katzung 11/e p 432L", "cop": 2, "opa": "Desflurane", "opb": "Sevoflurane", "opc": "Ether", "opd": "Halothane", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "4867991f-d3d2-478b-bd51-25e546bd8212", "choice_type": "single"} {"question": "Ipratropium bromide is used for", "exp": null, "cop": 3, "opa": "renal colic", "opb": "Organophosphorus poisoning", "opc": "Bronchial asthma", "opd": "miosis", "subject_name": "Pharmacology", "topic_name": null, "id": "77a325f8-f0c1-4f34-b4b2-2c0328e40eda", "choice_type": "single"} {"question": "Caudal Anesthesia is produced by introduction of local Anesthetic solution into", "exp": null, "cop": 4, "opa": "Subarachnoid space", "opb": "Peridural space", "opc": "Lower part of the subarachnoid space", "opd": "Sacral canal through the sacral hiatus", "subject_name": "Pharmacology", "topic_name": null, "id": "8815ca11-4a2e-4f54-b051-b71fa379307a", "choice_type": "single"} {"question": "Drug of choice for neurogenic diabetes insipidus", "exp": "Desmopressin is used to treat neurogenic diabetes insipidus, bedwetting, hemophilia A, von Willebrand disease it acts as an agonist to vasopressin receptor or ADH receptor- produce antidiuresis- less urine production-used in DI, bedwetting, vasoconstriction - used in esophageal varices and produces vwf- used in von Willebrand disease ref KD Tripathi 8th ed", "cop": 3, "opa": "Vasopressin", "opb": "Terlipressin", "opc": "Desmopressin", "opd": "Pralipressin", "subject_name": "Pharmacology", "topic_name": "Kidney", "id": "c91799d3-9837-4a4c-8e4d-e2b2976d8e7f", "choice_type": "single"} {"question": "Drug used for smoking cessation", "exp": "Varenicline * Varenicline - paial agonist at alpha 3 beta 4, alpha 4 beta 2 & alpha 6 beta 2 subtypes of nAChRs and agonist at alpha 7 nicotinic Acetyl Choline Receptors. Block rewarding propeies of nicotine, alcohol and drugs of abuse. Ref:- Goodman & Gilman Pharmacological Basis of Therapeutics 13th Ed; Pg num:- 430", "cop": 1, "opa": "Varenicline", "opb": "Nalmefene", "opc": "Gabapentin", "opd": "Acamprosate", "subject_name": "Pharmacology", "topic_name": "Other topics and Adverse effects", "id": "736a7631-7bd5-46aa-9865-aec5a00cb7a7", "choice_type": "single"} {"question": "In patient of hypeension, metoprolol and verapamil are given together. This combination can result in", "exp": "Beta blocker (metoprolol) and non-DHP CCBs (verapamil) block SA node and AV node. Both combined can cause severe bradycardia and AV block. Drugs causing Torsades' de pointes include: Quinidine, Procainamide, Cisapride, Astemizole, Terfenadine etc.", "cop": 2, "opa": "Atrial fibrillation", "opb": "Bradycardia", "opc": "Torsades' de pointes", "opd": "Tachycardia", "subject_name": "Pharmacology", "topic_name": "Hypeension, Arrhythmias, Dyslipidemia", "id": "26c5b6b7-80f0-4658-ad9d-089f48b66240", "choice_type": "single"} {"question": "Calculate Km", "exp": null, "cop": 2, "opa": "3", "opb": "4", "opc": "5", "opd": "6", "subject_name": "Pharmacology", "topic_name": null, "id": "712ef483-4e87-4710-b762-6d4a76c0e396", "choice_type": "single"} {"question": "NMDA blocker used as antitussive is", "exp": "Dextromethorphan is a NMDA blocker which is a less potent antitussive. Side effects include addiction liability & hallucination.", "cop": 2, "opa": "Pholcodeine", "opb": "Dextromethorphan", "opc": "Diphenhydramine", "opd": "Aprepitant", "subject_name": "Pharmacology", "topic_name": null, "id": "fac3997f-b730-4291-be40-a2b51a6f5559", "choice_type": "single"} {"question": "Azidothymidine (Zidovudine), commonest side effect is", "exp": "Ans. is 'd' i.e., Macrocytic anaemia \"The most common adverse effect of zidovudine is myelosuppression, resulting in macrocytic anemia (1-4%) or neutropenia (2-8%)\". So most common side effect of zidovudine is neutropenia (2-8%) followed by macrocytic anemia (1-4%). Other side effects are - nausea, anorexia, headache, insomnia, abdominal pain, myalgia, malaise, fatigue, myopathy, lactic acidosis, hepatomegaly with steatosis, convulsions and encephalopathy.", "cop": 4, "opa": "Hyperuricemia", "opb": "Pancreatitis", "opc": "Peripheral neuropathy", "opd": "Macrocytic anaemia", "subject_name": "Pharmacology", "topic_name": null, "id": "f881fc31-cf7d-41d9-81dc-5c418b67e132", "choice_type": "single"} {"question": "Vecuronium acts on", "exp": "Vecuronium is a non-depolarizing neuromuscular blocking agent.\nIt acts on the nicotinic receptor at neuromuscular junctions and blocks the depolarization by inhibiting Na+ channels.", "cop": 2, "opa": "Cerebral cortex", "opb": "Myoneural junction", "opc": "Muscle fibres", "opd": "Spinal cord", "subject_name": "Pharmacology", "topic_name": null, "id": "cab13441-2f3d-4004-a6a7-d8edc9fc87ae", "choice_type": "single"} {"question": "Oaubain acts by inhibiting", "exp": "Ouabain is a cardiac glycoside and in lower doses, can be used medically to treat hypotension and some arrhythmias. It acts by inhibiting the Na/K-ATPase, also known as the sodium-potassium ion pump Refer kDT 6/e p496", "cop": 4, "opa": "Adenyl cyclase", "opb": "Ca+ chanells", "opc": "H+K+ ATPase", "opd": "Na+K+ATPase", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "90264bdd-2034-440e-893f-10d94e02f586", "choice_type": "single"} {"question": "An agent of choice in acute hypercalcemia due to malignancy is", "exp": "Calcitonin is the fastest acting followed by I.V bisphosphonates. hyperccalcimia in malignancy is mainly seen in tumors secreting Parathyroid hormone related peptide PTHrP. Ref: CMDT pg 801 2010 ed.", "cop": 1, "opa": "Calcitonin", "opb": "Cholecalciferol", "opc": "Teriperatide", "opd": "Zolendronate", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "dcdb8161-9d36-4818-90ba-fb3857b6f372", "choice_type": "single"} {"question": "Cochlear implant used in NOT RELATED ENT", "exp": ".", "cop": 1, "opa": "Sensorineural deafness", "opb": "Conductive deafness", "opc": "Mixed deafness", "opd": "Absent pinna", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "bf2487c7-b98d-43ce-9652-bfe1ccf0417c", "choice_type": "single"} {"question": "Anti androgen use in hea failure is", "exp": "Spironolactone is a potassium-sparing diuretic (water pill) that prevents your body from absorbing too much salt and keeps your potassium levels from getting too low. Spironolactone is used to treat hea failure, high blood pressure (hypeension), or hypokalemia (low potassium levels in the blood). Refer kDT 7/e p 514", "cop": 3, "opa": "Carvedilol", "opb": "Sampatrilat", "opc": "Spiranolactone", "opd": "Abiraterone", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "a4d80a64-e315-4090-b4a9-44ff6d87bf9b", "choice_type": "single"} {"question": "Maximum rise in Prolactin levels is seen with(2018)", "exp": "Risperidone is more potent D2 blocker than clozapine; extrapyramidal side effects are less only at low doses (<6 mg/day). Prolactin levels rise dispropoionately during risperidone therapy, but it is less epileptogenic than clozapine. Ref:- KD tripathi; pg num:- 441", "cop": 3, "opa": "Clozapine", "opb": "Olanzapine", "opc": "Risperidone", "opd": "Ziprasidone", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "f9dde4da-f254-41e8-a996-fc63ee4d0d70", "choice_type": "single"} {"question": "Antiemetic effect of Metoclopromide is mainly due to its action as", "exp": "Antiemetic effect of Metoclopramide is because of D2 antagonism > 5HT3 antagonism.\nProkinetic effect is due to 5HT4 agonism.", "cop": 2, "opa": "5HT3 antagonist", "opb": "D2 antagonist", "opc": "M3 antagonist", "opd": "5HT4 agonist", "subject_name": "Pharmacology", "topic_name": null, "id": "b63f45ba-6614-4ddf-8b9b-fe938bf66187", "choice_type": "single"} {"question": "Reslizumab used in bronchial asthma is a monoclonal antibody against", "exp": "Mepolizumab & Reslizumab are monoclonal antibodies against IL-5 used in bronchial asthma, which act by inhibiting recruitment of eosinophils.", "cop": 4, "opa": "IL-2", "opb": "IL-3", "opc": "IL-4", "opd": "IL-5", "subject_name": "Pharmacology", "topic_name": null, "id": "cd1538a4-63c5-4060-89b9-6a0412969870", "choice_type": "single"} {"question": "Digibind is used to", "exp": "DIGIBIND (digoxin immune fab) , Digoxin Fab (Ovine), is indicated for treatment of potentially life-threatening digoxin intoxication.3 Although designed specifically to treat life-threatening digoxin overdose, it has also been used successfully to treat life-threatening digitoxin overdose.3 Since human experience is limited and the consequences of repeated exposures are unknown, DIGIBIND (digoxin immune fab) is not indicated for milder cases of digitalis . Refer kDT 6/e p499", "cop": 3, "opa": "Potentiate the action of Digoxin", "opb": "Decrease the metabolism of Digoxin", "opc": "Treate Digoxin toxicity", "opd": "Rapidly digitalize the patients", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "36fe0be7-364f-4864-81cf-a6492f14701a", "choice_type": "single"} {"question": "Clostridium difficile diarrhoea is most commonly associated with", "exp": "Clostridium difficile diarrhea is a super-infection also called Pseudomembranous colitis. Mc cause is 3rd generation Cephalosporins Other causes include Clindamycin, Aminopenicillins (Ampicillin and Amoxycillin), and Fluoroquinolones. DOC for treatment of PMC is oral Vancomycin now. Stool transplant can also be done. MAB against toxin of C.difficile : Bezlotoxumab.", "cop": 1, "opa": "Aminopenicillins", "opb": "Fluoroquinolones", "opc": "Macrolides", "opd": "Carbapenems", "subject_name": "Pharmacology", "topic_name": "Cell Wall Synthesis Inhibitors", "id": "b7ffa479-464c-4ff0-8414-60522ebbb193", "choice_type": "single"} {"question": "The longest acting antihistaminic is", "exp": "Terfenadine is a prodrug broken down to fexofenadine.so long duration of action followed by astemizole Ref: Goodman Gillman 12th ed.Pg 924.", "cop": 1, "opa": "Terfenadine", "opb": "Astemizole", "opc": "Fexofenadine", "opd": "Cetrizine", "subject_name": "Pharmacology", "topic_name": "Kidney", "id": "22f4c9d3-cd9e-46fa-a858-c5c15e48006f", "choice_type": "single"} {"question": "Best uterine relaxation is seen with", "exp": "Refer Katzung 10/e p 405 Halogentaed inhalational anesthestic agents like Halothane are powerful tocolytic agents Halothane is anaesthetic of choice for internal version and manual removal of placenta", "cop": 4, "opa": "Chloroform", "opb": "Nitrous oxide", "opc": "Ether", "opd": "Halothane", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "71c5f3c5-11ad-4b31-9801-235430127e17", "choice_type": "single"} {"question": "Nitrates are contraindicated with", "exp": "Sildenafil & Tadalafil are the PDE-5 inhibitors which are contrainidicated with Nitrates to prevent severe hypotension.", "cop": 4, "opa": "Sulphonylureas", "opb": "Immunomodulators", "opc": "SSRI's", "opd": "PDE-5 inhibitors", "subject_name": "Pharmacology", "topic_name": null, "id": "dcb4e06e-4461-4dc4-846d-cc2f2eb86f85", "choice_type": "single"} {"question": "Ivabridine is indicated in the management of", "exp": "Refer kDT 6/e p 55,katzung 11e p203 Ivabradine is a bradycardia drug. It selectively blocks if sodium channel blocker and reduce hea rate by inhibiting the hyperpolarization activated sodium channel in the SA node. No other significant hemodynamic effects has been noted. It reduces and then attacked similar to Calcium channel blocker and beta blockers", "cop": 2, "opa": "PSVT", "opb": "Angina pectoris", "opc": "Cardiomyopathy", "opd": "Irritable bowel syndrome", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "369feed3-a8cf-49da-bfe2-52f245d89573", "choice_type": "single"} {"question": "The HIV fusion inhibitor, enfuvirtide, acts at the site", "exp": null, "cop": 2, "opa": "Gp 120", "opb": "Gp 41", "opc": "P24", "opd": "CXCR4", "subject_name": "Pharmacology", "topic_name": null, "id": "3818c243-8b73-45dd-bdf3-9bf85786353e", "choice_type": "single"} {"question": "The byproduct of GABA is", "exp": "It is clear from this picture that GABA metabolite is succinate.", "cop": 4, "opa": "Glutamate", "opb": "Aspaate", "opc": "Glycine", "opd": "Succinate", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "e074eff2-acd5-4ec8-bab2-b07366d04cbc", "choice_type": "single"} {"question": "Sodium nitroprusside acts by activation of", "exp": "Nitroprusside generates NO that relaxes the vascular smooth muscle by activating Guanylate cyclase Refer kDT 6/e p548", "cop": 1, "opa": "Guanylate cyclase", "opb": "K+ chanells", "opc": "Ca++ chanells", "opd": "Cyclic AMP", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "238b20cf-0473-4e1d-b7e0-efeca600f987", "choice_type": "single"} {"question": "Most common mechanism for transfer of resistance in staphylococcus aureus", "exp": "Refer Goodman Gilman 11/e p 1098 Transduction is paicularly impoant in transfer of resistance among staphylococci Multidrug resistant is transferred by conjugation", "cop": 2, "opa": "Conjugation", "opb": "Transduction", "opc": "Transformation", "opd": "Mutation", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "f0551e0b-6f36-4f53-b9d7-3701802e8208", "choice_type": "single"} {"question": "Beta blockers are not indicated in", "exp": "Ref: HL Sharma 3rd ed pg no: 193 Beta blockers are not used in CCF except metoprolol and carvedilol due to their antioxidant propeies they are used only in chronic CHF not in acute in acute CCF or CHF, diuretics , digoxin are used", "cop": 1, "opa": "Acute CHF", "opb": "Hypeension", "opc": "Chronic CHF", "opd": "Arrhythmia", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "03910027-a73d-47b7-94d1-6695eb5389a5", "choice_type": "single"} {"question": "A patient present to emergency with pinpoint pupil, salivation, lacrimation, tremors and red tears. Plasma cholinesterase level was 30% of normal . Most probable diagnosis is", "exp": "Refer katzung 12e p110 These are characteristic feature of anticholinesterase(organophosphorous and carbamates) poisoning features of organophosphate poisoning muscarinic symptoms: pinpoint pupil, salivation, lacrimation ,urination,defecation,gastrointestinal distress, vomiting, bronchospasm, bradycardia nicotinic symptoms: fasciculations and fibrillation of muscle, tachycardia and tachypnea CNS symptoms :Tremors, giddiness, ataxia and coma red tears: due to accumulation ofporphyrin in the lacrimal glands", "cop": 1, "opa": "Organophosphate poisoning", "opb": "Datura poisoning", "opc": "Opioid poisoning", "opd": "Pontine haemorrhage", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "73d0db0b-eb6d-4353-b7f6-aa1e82e50f9c", "choice_type": "single"} {"question": "The drug used to treat dry mouth in cancer chemotherapy is", "exp": "Cevimeline increase salivary secretions and has a specific use in Sjogren's and xerostomia It is a parasympathomimitic and muscarinic agonist with paicular actions on M1 and M3 receptors. Ref: HL Sharma.3rd ed. Pg 138", "cop": 3, "opa": "Oxotremorine", "opb": "Methacholine", "opc": "Cevimeline", "opd": "Pilocarpine", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "810503e4-238c-4bbe-9f31-de9bcf1cdb92", "choice_type": "single"} {"question": "Hand and foot syndrome can be caused by", "exp": "5 FU, capecitabine and liposomal doxorubucin can cause hand and foot syndrome Generally this disease affects infants and children Adults with immunodeficiency can also be affected Refer Katzung 10th/889", "cop": 3, "opa": "Cisplatin", "opb": "Vincristine", "opc": "Capecitabine", "opd": "Mitomycin -C", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "b3c371b7-7e0e-4a63-ba4b-83224ee6a7a3", "choice_type": "single"} {"question": "Riociguat is used for", "exp": "Used for Chronic-thromboembolic pulmonary hypeension (CTEPH) and Pulmonary aerial hypeension (PAH) It is a stimulator of soluble guanylate cyclase (sGC). Ref: KD Tripathi 7th ed", "cop": 1, "opa": "Pulmonary hypeension", "opb": "Myocarditis", "opc": "Atrial fibrillation", "opd": "Stroke", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "cd5246c4-e8a2-4719-97e8-c7907af8d5e5", "choice_type": "single"} {"question": "Anesthetic agent with vasoconstrictor is contraindicated in", "exp": "Refer Katzung 11/e p446 Vasoconstrictors are contraindicated if LAs are used for organs with end aeries like tips of fingers, toes, nose, pinnacle, and penis due to risk of ischemia and necrosis", "cop": 1, "opa": "Digital block", "opb": "Spinal block", "opc": "Epidural block", "opd": "Regional anesthesia", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "e84b3f21-c9a3-4dca-b756-922045bdbd44", "choice_type": "single"} {"question": "Infant mortality rate is defined as", "exp": "(A) Number of infant deaths per 1000 live birth # Infant mortality rate is the ratio of deaths under 1 year of age in a given year to the total number of live births in the same year; usually expressed as a rate per 1000 live births.> It is one of the most universally accepted indicators of health status not only of infants, but also of whole population and of the socioeconomic conditions under which they live.> In addition, the infant mortality rate is a sensitive indicator of the availability, utilization and effectiveness of health care, particularly perinatal care.", "cop": 1, "opa": "Number of infant deaths per 1000 live birth", "opb": "Number of infant deaths per 1000 of total birth", "opc": "umber of infant deaths per 1000 of mid year population", "opd": "Number of infant deaths per 1 lakh of mid year population.", "subject_name": "Pharmacology", "topic_name": "Miscellaneous (Pharmacology)", "id": "08348292-9873-492b-96f8-c84418454ba5", "choice_type": "single"} {"question": "The following ADR is caused by", "exp": "The picture is showing lid retraction which is an ADR of apraclonidine. It is an analogue of clonidine. Ref: KDT 6th ed pg 146-147", "cop": 2, "opa": "Pilocarpine", "opb": "Apraclonidine", "opc": "Brimonidine", "opd": "Latanoprost", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "cd222200-14b9-4d4b-beed-b1a251fb690c", "choice_type": "single"} {"question": "Mechanism of action of Ezetimibe is", "exp": "Ezetimibe inhibits NPC1L1 (Niemann Pick C1 Like1) protein present in intestinal epithelial cells that aids cholesterol absorption.", "cop": 3, "opa": "Interferes with absorption of bile acids", "opb": "Inhibits CETP", "opc": "Interferes with absorption of cholesterol by inhibiting NPC1L1", "opd": "Inhibitor of PPAR - α", "subject_name": "Pharmacology", "topic_name": null, "id": "55510bc4-6c47-4c7f-9650-589309668be4", "choice_type": "single"} {"question": "Calcium channel blocker used in subarachnoid hemorrhage", "exp": "Nimodipine is a cerbroselective calcium channel blocker used in SAH.Ref: KD Tripathi 6th ed pg 532", "cop": 3, "opa": "Nefidipine", "opb": "Nicardipine", "opc": "Nimodipine", "opd": "Nitrendepine", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "d058a9a0-96cd-443a-84cc-99d097abed78", "choice_type": "single"} {"question": "Arrange the following drugs according to their half life in increasing order1. Amiodarone2. Adenosine3. Esmolol4. Omeprazole", "exp": "Ans. AExplanation:* Amiodarone is longest acting anti-arrhythmic drug. Its half life is more than 3 weeks.* Adenosine is shortest acting anti-arrhythmic drug having half life less than 10 seconds.* Esmolol is an ultra short acting beta blocker. It is metabolized by pseudocholinesterase and thus has half life less than 5 minutes.* Omeprazole has half life of 1 -2 hours but works for 24 hours due to irreversible inhibition of proton pump.* Thus, the sequence isAdenosine < Esmolol < Omeprazole < Amiodarone", "cop": 1, "opa": "2, 3, 4, 1", "opb": "2, 3, 1, 4", "opc": "3, 2, 4, 1", "opd": "2, 4, 2, 1", "subject_name": "Pharmacology", "topic_name": "Miscellaneous (Pharmacology)", "id": "b97abce6-29c1-419a-9883-7e9b8fab064a", "choice_type": "single"} {"question": "Exogenous adrenaline is metabolized by", "exp": "Endogenous adrenaline action is terminated mainly by reuptake whereas exogenous agent is metabolized by COMT and MAO.", "cop": 3, "opa": "Acetyltransferase", "opb": "Reuptake", "opc": "COMT", "opd": "AchE", "subject_name": "Pharmacology", "topic_name": null, "id": "c44430fb-66ec-4542-8827-8225eb532271", "choice_type": "single"} {"question": "The drug preferred to stop the growth of prostate in a 70 year old male with Benign hyperplasia of prostate is", "exp": "Ref: Katzung 14th ed. pg. 1085* Most of the actions of testosterone are mediated by its conversion to DHT by 5-alpha reductase. Important amongst these are growth of prostate, male pattern baldness and hirsutism in females.* Finasteride and dutasteride are 5-alpha reductase inhibitors useful in the treatment of BPH, male pattern baldness and hirsutism by reducing the production of DHT.Note: Flutamide and Nilutamide act as antagonists of androgen receptors. These are useful for the treatment of prostatic carcinoma. Flutamide can cause gynaecomastia and reversible liver damage.", "cop": 3, "opa": "Spironolactone", "opb": "Ketoconazole", "opc": "Finasteride", "opd": "Flutamide", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "e33655d1-7e40-478d-9452-9307495d07db", "choice_type": "single"} {"question": "Antidote for paracetamol poisoning is", "exp": "Paracetamol - has only antipyretic and analgesic activity. It does not possess anti-inflammatory activity as it is believed to be inactivated by the free oxygen radicals generated at site of inflammation. Metabolite of PCM | Acts on TRPV receptor (Vanilloid Receptor) Analgesic action of it may be mediated by this receptor PCM has antidote i.e. N-Acetylcysteine", "cop": 1, "opa": "N- acetylcysteine", "opb": "Sodium bicarbonate", "opc": "BAL", "opd": "EDTA", "subject_name": "Pharmacology", "topic_name": "NSAIDs, Gout and Rheumatoid Ahritis", "id": "00aecdab-fdac-42ea-ba5e-8cabdab5eb82", "choice_type": "single"} {"question": "LHRH analogue used in breast cancer is", "exp": "GnRH agonists: Goserelin, buserelin, nafarelin, triptorelin, leuprolide GnRH antagonists: cetrorelix, abarelix, degarelix ref KD Tripathi 8th ed", "cop": 3, "opa": "Cetrorelix", "opb": "Anastrozole", "opc": "Leuprolide", "opd": "Tamoxifen", "subject_name": "Pharmacology", "topic_name": "Autacoids", "id": "0663e4f4-fbcc-4ec5-b4c1-a3fdd2adb0b5", "choice_type": "single"} {"question": "The therapeutic efficiency of antihypeensive drugs is blunted by NSAIDs because they", "exp": "PG E2 and PGI2 cause renal vasodilatation, natriuresis and increased water clearance due to inhibition of the action of ADH. Loop diuretics act paly by increasing the stimulation of cox. therefore NSAIDs attenuate the diabetic action of these drugs. Refer kDT 6/e p708", "cop": 4, "opa": "Cause of sodium excretion", "opb": "Increase the clearance of anti Hypeensive drugs", "opc": "Decrease the absorption of antihypeensive drugs", "opd": "Decrease the synthesis of Vascular prostacyclin", "subject_name": "Pharmacology", "topic_name": "Autacoids", "id": "1523849a-0a6c-4347-ae35-6d9b0996833f", "choice_type": "single"} {"question": "Drug used in aneliorative test for Myasthenia gravis is", "exp": "Drug used in amellorative test (tensilon test) for myasthena gavis is edrophonium. It is a cholinergic drug and can be used for diagnosis of myasthenia gravis becaise of its sho duration of action (10-30 min) Ref-KDT 6/e p104", "cop": 2, "opa": "Physostigmine", "opb": "Edrophonium", "opc": "Tacrine", "opd": "Pyridostigmine", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "17154490-2b69-40f1-a648-b51c0f03979c", "choice_type": "single"} {"question": "Leukotriene receptor antagonist used for bronchial asthama is", "exp": "Examples for leukotriene receptor antagonist are Montelukast and Zafirlukast ESSENTIALS OF MEDICAL PHARMACOLOGY 8TH EDITON Page No :222", "cop": 1, "opa": "Zafirlukast", "opb": "Zileuton", "opc": "Cromolyn Sodium", "opd": "Aminophylline", "subject_name": "Pharmacology", "topic_name": "Respiratory system", "id": "1b059bd2-20df-4b23-bdc6-21b5fb27e678", "choice_type": "single"} {"question": "β blocker with intrinsic sympathomimetic activity", "exp": "β blockers with intrinsic sympathomimetic activity have partial agonistic action on β1 receptors thus causing lesser bradycardia.\nEx: Acebutalol, Celiprolol, Cartelol, Pindolol, Penbutolol, Labetalol.", "cop": 3, "opa": "Propanalol", "opb": "Carvedilol", "opc": "Acebutolol", "opd": "Atenolol", "subject_name": "Pharmacology", "topic_name": null, "id": "f0a725d0-061a-4110-a44e-8d4e41e90c65", "choice_type": "single"} {"question": "Vitamin K is involved in the post translational modification of", "exp": "Refer Katzung 11/e p 595 Vitamin K causes gamma carboxylation of glutamate reduces in many clotting factors that result in their activation", "cop": 1, "opa": "Glutamate", "opb": "Aspaate", "opc": "Glycine", "opd": "GABA", "subject_name": "Pharmacology", "topic_name": "Respiratory system", "id": "29671dd8-a42b-401e-a831-ade026608bde", "choice_type": "single"} {"question": "Cardiac arrhythmias are most commonly seen during administration of", "exp": null, "cop": 2, "opa": "Thiopental", "opb": "Halothane", "opc": "Ethyl Ether", "opd": "Nitrous oxide", "subject_name": "Pharmacology", "topic_name": null, "id": "0dae9323-0a37-4823-9ab1-ca1f36465e8e", "choice_type": "single"} {"question": "Hemorrhagic cystitis is caused by", "exp": "Refer Katzung 11/e p500 It is a prodrug and is activated BBy hepatic biotransformation to aldophosphamade. One of the degradation products is acrolein that is responsible for hemorrhagic cystitis", "cop": 1, "opa": "Cyclophosphamide", "opb": "6 mercaptounrine", "opc": "5 flurouracil", "opd": "Busulfan", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "3536443e-a980-4334-88af-dab9413edf75", "choice_type": "single"} {"question": "Treatment for male pattern alopecia includes", "exp": "Finasteride and dutasteride are 5 alpha reductase inhibitors; inhibit the formation of Dihydrotestosterone. So they are used in alopecia and also in BPH. Minoxidil also used in treatment. Fulvestrant is a SERD selective estrogen down regulator Ref: KD tripathi , 8th ed", "cop": 1, "opa": "Finasteride", "opb": "Potassium channel blocker", "opc": "Fulvestrant", "opd": "Dexamethasone", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "ac84e3ea-f62e-4f0c-bd7a-689ac2a0379b", "choice_type": "single"} {"question": "The only reliable symptom of hypoglycemia in a patient on beta blocker therapy is", "exp": "* All the symptoms of hypoglycemia are blocked by beta blockers except sweating as it has cholinergic innervation * Beta blockers (non selective) are contraindicated in : ABSOLUTE C/I Pheochromocytoma Decompensated hea failure symptomatic bradycardia AV block Asthma RELATIVE C/I Peripheral vascular disease", "cop": 2, "opa": "Tremor", "opb": "Sweating", "opc": "Tachycardia", "opd": "Palpitations", "subject_name": "Pharmacology", "topic_name": "Sympathetic System", "id": "1ba6892b-c757-420a-9221-7cbd5e0b3ff7", "choice_type": "single"} {"question": "Drug monitoring is required for the following", "exp": "(A) Lithium# Lithium is generally taken with food, although its absorption is not markedly affected by the presence of food.> Doses vary widely and are adjusted based on measurements of the levels of lithium in the blood.> Early in therapy, dose adjustments are made as often as every 5 to 7 days to establish the correct dose.> Patients with kidney diseases excrete less lithium from the body and, therefore, require lower doses.", "cop": 1, "opa": "Lithium", "opb": "Paracetamol", "opc": "Ampicillin", "opd": "Olanzapine", "subject_name": "Pharmacology", "topic_name": "Miscellaneous (Pharmacology)", "id": "a30e69ea-0bc8-430d-b0a9-5731266ae7ac", "choice_type": "single"} {"question": "Digoxin toxicity is aggravated by", "exp": "Ref-KDT 6/e p499 Oxygen toxicity is a agravated by Hypokalemia and hypercalcemia", "cop": 1, "opa": "Hyperkalemia", "opb": "Hyperkalemia", "opc": "Hypermagnesemia", "opd": "Hypocalcemia", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "e0e835be-cfc8-4700-9a76-b3267e26beb6", "choice_type": "single"} {"question": "Edrophonium test is helpful in diagnosing", "exp": "Ref: HL Sharma 3rd ed pg no: 142 edrophonium is very sho acting which helps in differentiating myasthenia and cholinergic crisis", "cop": 2, "opa": "Marcus gunn jaw winking ptosis", "opb": "myasthenia gravis", "opc": "Blepharophismosis syndrome", "opd": "parkinson's", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "85580af5-f283-44ca-90e4-c83d70951995", "choice_type": "single"} {"question": "Drug therapy used in treatment of Wernicke's encephalopathy", "exp": "(C) Thiamine # Thiamin deficiency can result in three distinct syndromes:> A chronic peripheral neuritis, beriberi, which may or may not be associated with heart failure and edema; acute pernicious (fulminating) beriberi (shoshin beriberi), in which heart failure and metabolic abnormalities predominate, without peripheral neuritis; and Wernicke's encephalopathy with Korsakoff's psychosis, which is associated especially with alcohol and drug abuse.> Therapeutic uses of Thiamine: most neurological symptoms in chronic alcoholics are due to thiamine deficiency -peripheral neuritis Wernick's encephalopathy, Korskoffs psychosis: give 100 mg/day paranterally.", "cop": 3, "opa": "Diazepam", "opb": "Disulfiram", "opc": "Thiamine", "opd": "Cyanocobalamin", "subject_name": "Pharmacology", "topic_name": "Miscellaneous (Pharmacology)", "id": "8415f51e-0fa1-4efc-804a-9a3f02242fd8", "choice_type": "single"} {"question": "DOC for Listeria monocytogenes", "exp": "Aminopenicillins Ampicillin It is active against all organisms sensitive to PnG. In addition, many gram-negative bacilli, e.g. H. influenzae, E. coli, Proteus, Salmonella Shigella and Helicobacter pylori are inhibited. Ampicillin is more active than PnG for Strep. viridans, enterococci and Listeria monocytogenes; equally active for pneumococci, gonococci and meningococci (penicillin-resistant strains are resistant to ampicillin as well); but less active against other gram-positive cocci. Ref:- kd tripathi; pg num:-722", "cop": 3, "opa": "Penicillin G", "opb": "Nitrofurantoin", "opc": "Ampicillin", "opd": "Ofloxacin", "subject_name": "Pharmacology", "topic_name": "Antibiotics", "id": "922e3802-d32f-40a8-8c08-82910187116d", "choice_type": "single"} {"question": "The dose of a drug required to produce a specified effect in 50% of the population is", "exp": null, "cop": 4, "opa": "Ld50", "opb": "Td50", "opc": "Md50", "opd": "Ed50", "subject_name": "Pharmacology", "topic_name": null, "id": "9acdf33e-66b9-4097-b683-e5a12b3fe7ba", "choice_type": "single"} {"question": "Shoest acting mydriatic and cycloplegic drug is", "exp": "Tropicamide is the shoest acting mydriatic ANTICHOLINERGIC DRUGS FOR EYE Atropine, homatropine, cyclopentolate and tropicamide are used as mydriatic and cycloplegic agents. Mydriatic action is useful in fundus examination whereas cycloplegic action allows correct assessment of refractive error Pain in iridocyclitis occur due to spasm of ciliary muscle which can be relieved due to cycloplegic action. Atropine has very long duration of action (3-5 days) in the eye Tropicamide is the shoest acting mydriatic. Anticholinergic agents are contra-indicated in glaucoma.", "cop": 3, "opa": "Hyoscine", "opb": "Homatropine", "opc": "Tropicamide", "opd": "Cyclopentolate", "subject_name": "Pharmacology", "topic_name": "Parasympathetic System & Glaucoma", "id": "5d744376-044b-44ae-bef1-f6de6589950b", "choice_type": "single"} {"question": "The mechanism of action of valproic acid is", "exp": null, "cop": 4, "opa": "Inhibition of Na+ channel inactivation", "opb": "Inhibition of GABA", "opc": "Opening of K+ channels", "opd": "Inhibition of 'T' type Ca+2 current", "subject_name": "Pharmacology", "topic_name": null, "id": "a689cca6-2f14-4b05-98b4-f1c171d885f0", "choice_type": "single"} {"question": "Drugs used for remodeling of hea in congestive hea failure is", "exp": "Refer kDT 7/e 520 Blockade of RAS by angiotensin-conveing enzyme inhibitors or angiotensin II type 1 receptor antagonists attenuates the ventricular dysfunction, but the effects of individual drugs in reducing the morbidity and moality in CHF patients are variable.", "cop": 3, "opa": "Beta blockers", "opb": "ACE inhibitor", "opc": "Digoxin", "opd": "Aldesterone antagonist", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "8f49b336-844a-4768-a8d3-741039a48013", "choice_type": "single"} {"question": "The main source of production of relaxin is", "exp": "The main source of production of relaxin is the corpus luteum of the ovary but pa of it may also be produced by the placenta and decidua. Ref: KD Tripathi 8th ed.", "cop": 1, "opa": "Ovary", "opb": "Placenta", "opc": "Decidua", "opd": "Adrenals", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "2680ad6d-d8da-4319-8c90-043122f37220", "choice_type": "single"} {"question": "The following ADR is seen with", "exp": "The picture shows gingival hyperplasia caused by phenytoin Ref: KDT 7th ed Pg: 417-422", "cop": 1, "opa": "Phenytoin", "opb": "Valproate", "opc": "Barbiturate", "opd": "Carbamazepine", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "c5f52eec-e050-4451-a903-2404df804a7a", "choice_type": "single"} {"question": "DOTS is a community based treatment and care strategy for", "exp": null, "cop": 3, "opa": "Filaria", "opb": "Leprosy", "opc": "Tuberculosis", "opd": "Malaria", "subject_name": "Pharmacology", "topic_name": null, "id": "d7a38a54-5526-4860-82e2-a28b34d1e094", "choice_type": "single"} {"question": "Action of angiotensin 11 includes", "exp": "Refer kDT 6/e p 481 The renin-angiotensin system (RAS) plays an impoant role in the regulation of blood pressure. Angiotensin II is the principal effector hormone in the RAS, causing vasoconstriction and increased sodium and water retention, leading to increased blood pressure", "cop": 1, "opa": "Systemic vasodilatation", "opb": "Systemic vasoconstriction", "opc": "Renal vasodilatation", "opd": "Reabsorption of sodium ions in proximal renal tubule", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "33e7faca-3f28-46a4-b605-27fd930629df", "choice_type": "single"} {"question": "A patient comes 6 hours after consuming morphine and presents with pin point pupils and respiratory depression. T 1/2 of morphine is 3 hours and volume of distribution (Vd) is 200 L. Current plasma concentration of morphine is 0.5 mg/L. Calculate the initial morphine dose consumed by the person.", "exp": "* Volume of distribution means how much amount of plasma is required to accommodate the whole drug, if the plasma concentration remains constant. Current plasma concentration is 0.5 mg/L means* 1 litre contains 0.5 mg of morphine So, Vd of 200 L means* 200 litre contain 0.5 x 200=100 mg So now total amount of morphine present in the body is 100 mg. This is the amount present in body after 2 half lives (half life is 3 hours and patient presented after 6 hours)* T1/2 = 3 hrsAfter 1 t1/2 drug remaining in body is 50 % of initial. After 2 t1/2 drug remaining in body is 25 % of initial If initial amount of morphine in body is x mg so, 100 = 25% of x S0, x = 400 mg So the drug present in body initially is 400 mg", "cop": 2, "opa": "100 mg", "opb": "400 mg", "opc": "10 mg", "opd": "50 mg", "subject_name": "Pharmacology", "topic_name": "Pharmacokinetics", "id": "cb202d79-91d5-43cb-a3cc-61d68999256e", "choice_type": "single"} {"question": "A patient on Aspirin will have increasing in", "exp": "Antiplatelet drugs like asprin and clopidogrel prolong the bleeding time Anticoagulant drugs prolong the clotting time Drugs interfering with extrinsic pathway like Warfare in prolonged the PT Drugs interfering with intrinsic pathway like heparin prolong the aPTT. Thrombin time is prolonged in cases of afibrinoginemia and dysfibrinogenemia. Refer kDT 6/e p609", "cop": 1, "opa": "Bleeding time", "opb": "Clotting time", "opc": "Prothrombin time", "opd": "Activated paial thromboplastin time", "subject_name": "Pharmacology", "topic_name": "Autacoids", "id": "0e6d613c-d515-468e-859c-922469b28225", "choice_type": "single"} {"question": "Haemodialysis is not useful in", "exp": "Dialysis is mainly done for poisoning due to: Methanol Lithium Aspirin Dabigatran Dialysis is not useful in: A- Amphetamines V: Verapamil O- Opioids, OPC I: Imipramine D- Digoxin Dialysis: Diazepam", "cop": 1, "opa": "Digoxin", "opb": "Methanol", "opc": "Lithium", "opd": "Salicylates", "subject_name": "Pharmacology", "topic_name": "Hypeension, Arrhythmias, Dyslipidemia", "id": "cdf5b7ae-650b-426f-b4b9-0da63d6e55ae", "choice_type": "single"} {"question": "Mode of contraception that should be avoided in epilepsy is", "exp": "Antiepileptic drugs such as phenytoin,carbamazepine,phenobarbitone are enzyme inducers which when used with oral contraceptives can cause its failure. (Ref.Essentials of medical pharmacology TD Tripathi 7th edition Page no.326)", "cop": 1, "opa": "Oral contraceptive pills", "opb": "Condoms", "opc": "Intrauterine contraceptive devises", "opd": "Post-coital pills", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "2e59fff8-5693-4a5a-9ea7-02773abcfabc", "choice_type": "single"} {"question": "Antidiabetic drug that does not cause weight gain is", "exp": "Metformin: Can cause megaloblastic anaemia and lactic acidosis. Risk of lactic acidosis increases in kidney and liver disease thus contraindicated in these patients. It causes maximum decrease in HbA1c Do not cause hypoglycaemia. Do not cause weight gain. DOC for type II diabetes mellitus. Pioglitazone: Metabolized by CYP2C8 and CYP3A4 to active metabolites, the risk of bladder cancer appears to be cumulatively increased with high doses. Tolbutamide and glipizide: sulfonylureas which tend to increase weight", "cop": 1, "opa": "Metformin", "opb": "Tolbutamide", "opc": "Pioglitazone", "opd": "Glipizide", "subject_name": "Pharmacology", "topic_name": "Pancreas", "id": "d64cc018-853a-4447-b062-8efad2f67d1e", "choice_type": "single"} {"question": "Drug of choice for acute PSVT", "exp": "Adenosine is used for acute termination of PSVT Verapamil and esmolol are used as an alternate 2nd choice of drugsRef: Katzung 11th ed pg 243", "cop": 2, "opa": "Esmolol", "opb": "Adenosine", "opc": "Digoxin", "opd": "Verapamil", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "cd637f59-03b3-4e28-8722-58467930dbae", "choice_type": "single"} {"question": "Oligospermia caused by aEUR'", "exp": "Methotrexate \"Transient but reversible oligospermia has been repoed in males receiving high dose methotrexate for cancer chemotherapy\". Defective oogenesis or spermatogenesis \"Occurs in methotrexate therapy\"", "cop": 1, "opa": "Methotrexate", "opb": "Hydroxychloroquine", "opc": "Leflunomide", "opd": "D-peniollamine", "subject_name": "Pharmacology", "topic_name": null, "id": "b153edbc-e294-4491-bb50-2d116f81041b", "choice_type": "single"} {"question": "PFOR inhibitor used in angina", "exp": "Trimetazidine, ranolazine is paial fatty acid oxidation inhibitors used in angina as they prevent free radicle formation and decrease myocardial oxygen demand. Ref: HL Sharma 3rd ed.", "cop": 2, "opa": "Nifedipine", "opb": "Trimetazidine", "opc": "Atenolol", "opd": "Fasudil", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "320dba2e-0b2a-4a98-b390-e4272316dd3d", "choice_type": "single"} {"question": "A psychiatric patient taking medication develops a tremor, thyroid enlargement and leucocytosis. Drug implicated is", "exp": "Tremor is one of the most common adverse effects of lithium treatment, and it occurs with therapeutic doses.Lithium probably decreases thyroid function in most patients exposed to the drug,Leukocytosis is always present during lithium treatment, probably reflecting a direct effect on leukopoiesis rather than mobilization from the marginal pool.Polydipsia and polyuria, Edema are other adverse effectsReference: Katzung Pharmacology; 12th edition; Page no: 517", "cop": 3, "opa": "Clomipramine", "opb": "Haloperidol", "opc": "Lithium", "opd": "Olanzapine", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "b19df3d0-3e9c-4346-b8fe-2e27dd0c51b5", "choice_type": "single"} {"question": "Prostaglandin used in the treatment of peptic ulcer is", "exp": "Ans) b (Misoprosotol) Kef: KDT 6th ed p. 629Misoprostol is the prostaglandin analogue used in the treatment of peptic ulcer.DRUGS USED IN PEPTIC ULCER1) H2 antagonists-ranitidine, cimetidine, famotidine roxatidine and nizatidine.Nizatidine has little first-pass metabolism and a bioavailability of al-most 100%. Famotidine is the most potent among them.2) Proton pump inhibitors (PPIs)- omeprazole, lansoprazole, rabeprazole, pantoprazole, and esomeprazole. They are the most effective drugs in GERD.3) Mucosal protective agents-sucralfate, colloidal bismuth compounds4) Prostaglandin analogs-misoprostol5) Antacids6) Anticholinergics-Pirenzipine, propantheline7) Anti-H.pylori drugs -Amoxicillin, clarothromycin, metronidazole, tinidazole, tetracycline.", "cop": 2, "opa": "Carboprost", "opb": "Misoprostol", "opc": "Dinoprost", "opd": "Latanoprost", "subject_name": "Pharmacology", "topic_name": "Prostaglandins", "id": "0a723bc2-c3dd-430a-814d-85fffead627e", "choice_type": "single"} {"question": "Most potent proton pump inhibitor is", "exp": "Lansoprazole is the most potent proton pump inhibitor.", "cop": 4, "opa": "Omeprazole", "opb": "Rabeprazole", "opc": "Esomeprazole", "opd": "Lansoprazole", "subject_name": "Pharmacology", "topic_name": null, "id": "12210170-dfa4-432c-871c-dbca9de69b7b", "choice_type": "single"} {"question": "Drug of choice for Hypeension in eclampsia is", "exp": "Refer kDT 7/e p 573 The drug of choice to treat and preventeclampsia is magnesium sulfate. Familiarity with second-line medications phenytoin and diazepam/lorazepam is required for cases in which magnesium sulfate may be contraindicated (eg, myasthenia gravis) or ineffective.", "cop": 1, "opa": "Magnesium Sulphate", "opb": "Nifedipine", "opc": "Hydralizine", "opd": "Labetolol", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "0e34d59c-43ff-4d51-9233-5d75bb08c002", "choice_type": "single"} {"question": "Sodium 2 mercapto ethane sulfonate is used as a protective agent is", "exp": "Refer KDT 6/e p833 Sodium 2 mercapto ethane sulfonic acid is used to amelioreae the hemorrhagic cystitis caused by cycloohosphamide and Ifosfamide", "cop": 2, "opa": "Radiotherapy", "opb": "Cancer chemotherapy", "opc": "Lithotripsy", "opd": "Hepatic encephalopathy", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "1943c9a9-c8de-48da-a2b7-146a7cd69f49", "choice_type": "single"} {"question": "Intranasal spray of budesonide is indicated in", "exp": "Budesonide A nonhalogenated glucocoicoid with high topical: systemic activity ratio (greater first pass metabolism). Small fraction that is absorbed is rapidly metabolized; less systemic effects, uses:- 1) Asthma 2). Allergic rhinitis 3) prophylaxis and treatment of seasonal and perennial allergic or vasomotor rhinitis, nasal polyposis side effects:- Nasal irritation, sneezing, itching of throat and dryness may occur, especially in the beginning. Ref:- kd tripathi;pg num:- 231", "cop": 3, "opa": "Acute sinusitis", "opb": "Common cold", "opc": "Perennial vasomotor rhinitis", "opd": "Epistaxis", "subject_name": "Pharmacology", "topic_name": "Respiratory system", "id": "cb4cf849-c00c-4441-9e0e-ee3a55f5ec54", "choice_type": "single"} {"question": "Opioid induced constipation is treated by", "exp": "Alvimopan, Naloxegal & Methyl naltrexone are peripherally acting opioid antagonists used to treat opioid induced constipation & paralytic ileus.", "cop": 3, "opa": "Loperamide", "opb": "Biperiden", "opc": "Alvimopan", "opd": "Naltrexone", "subject_name": "Pharmacology", "topic_name": null, "id": "5fb1f637-4197-401f-9a3e-c2c0b9357df3", "choice_type": "single"} {"question": "Drug used for bleeding GI varices", "exp": "Ans. is'c'i.e., TerlipressinTerlipressin (analogue vasopressin) is considered the vasoactive agent of choice for acute variceal bleeding.Other drugs used are somatostatin and its analogue octreotide.", "cop": 3, "opa": "Demeclocycline", "opb": "Desmopressin", "opc": "Terlipressin", "opd": "Leuprolide", "subject_name": "Pharmacology", "topic_name": null, "id": "92dc2e20-1c71-4db1-8d7b-73239e9734b5", "choice_type": "single"} {"question": "Plazomicin was approved by FDA recently for", "exp": "it is ia new or nect generation aminoglycoside i.e neo glycoside, bactericidal in nature ,inhibiting the protein syunthesis, acting on both gram negetive and positive bacteria.", "cop": 2, "opa": "I", "opb": "UTI", "opc": "Cl difficale", "opd": "Chicken pox", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "6f33ff9c-04e7-46f9-882c-47360ea71db8", "choice_type": "single"} {"question": "Methyl xanthines acts on", "exp": "(Adenosine receptors) (202-3-KDT) (220-KDT 6th)Mechanism of action of Methylxanthines - Three distinct cellular actions(a) Release of Ca++ from sarcoplasmic reticulum especially in skeletal and cardiac muscle.(b) Inhibition of phosphodiesterase which degrades cyclic nucleotides intracellularly.ATPorGTPAdenylcyclase------------guanylcyclasecAMPorcGMPPhosphodiesterase--------------------Inhibited by Theophylline5 AMPor5 GMP(c) ** Blockade of adenosine receptors: adenosine acts as a local mediator in CNS, CVS and other organs- contracts smooth muscles, especially bronchial, dilates cerebral blood vessels, depresses cardiac pacemaker and inhibits gastric secretion. Methylxanthines produces opposite effects.", "cop": 2, "opa": "Histamine receptors", "opb": "Adenosine receptors", "opc": "Mast cells", "opd": "Cholinergic receptors", "subject_name": "Pharmacology", "topic_name": "Asthma", "id": "5925014d-c6a4-47e8-a580-68fefdc68152", "choice_type": "single"} {"question": "Ibuprofen is contraindicated in", "exp": null, "cop": 2, "opa": "Patients having fever", "opb": "Patients having asthma", "opc": "Patients having amoebic dysentery", "opd": "Patients having bronchitis", "subject_name": "Pharmacology", "topic_name": null, "id": "6914a646-c061-4ceb-a9bc-1a02c166fafb", "choice_type": "single"} {"question": "Pharmacovigilance is done for monitoring aEUR'", "exp": "Drug safety Pharmacovigilance is defined as \"All methods of assessment and prevention of adverse drug reactions\". National pharmacovigilance program (India) 2004 India's drugs control depament within the ministry of health and family welfare initiated the establishment of a nationwide network to build a comprehensive phannacovigilance data system in 2004. The national pharmacovigilance programme for India is sponsored by World Health Organization (WHO) and is funded by the World Bank. The national pharmacovigilance programme is based on the recommendations made in WHO document titled \"safety monitoring of medicinal products - Guidelines for setting up and running (I pharmacovigilance centre\". The programme paicularly solicits repos of:- All \"adverse events\" suspected to have been caused by new drugs and drugs of current interest (list to be published by CDSCO from time to time). All suspected drug interactions. Reactions to any other drugs which are suspected of significantly affecting a patient's management including reactions suspected of causing:- - Death - Life threatening - Hospitalisation (initial or prolonged) - Disability (significant persistent or permanent) - Congenital anomaly - Required intervention to prevent permanent impairment or damage", "cop": 3, "opa": "Drug price", "opb": "Unethical practices", "opc": "Drug safety", "opd": "Pharmacology students", "subject_name": "Pharmacology", "topic_name": null, "id": "c8293bc0-7ef2-420e-8119-0977978356db", "choice_type": "single"} {"question": "Proteasome inhibition is seen with", "exp": "It is a proteasome inhibitor - an anticancer drugBoezomib was first approved for use in relapsing or refractory multiple myeloma and is now widely used in the first-line treatment of multiple myeloma. This agent is thought to exe its main cytotoxic effects through inhibition of the 26 S proteasome, which results in down-regulation of the nuclear factor kappa B (NF-kB) signaling pathway. Of note,inhibition of NF-kB has been shown to restore chemosensitivity.Ref: Sharma and Sharma 3rd ed/pg 871; Katzung; 13th edition; Page no: 971", "cop": 3, "opa": "Fludarabine", "opb": "Thioguanine", "opc": "Boezomib", "opd": "Rivaroxiban", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "21153c9b-4336-479e-9a3f-3c6db1b617ac", "choice_type": "single"} {"question": "Acetylcholinesterase inhibitors are not used in", "exp": "Carbamate and OP compounds are acetylcholinesterases. Oximes are used in op poisioning where as in carbamates poisioning oximes are not effective. Ref: KDT 6th ed pg 105", "cop": 2, "opa": "Anticholinergic poisoning", "opb": "Carbamate poisoning", "opc": "Cobra bite", "opd": "Glaucoma", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "c29c5879-3c24-4c77-a264-4fe138d628e7", "choice_type": "single"} {"question": "Heparin does not cause", "exp": "Heparin doesnot cause factor V inhibition whereas it causes all the other three. From medical pharmacology padmaja 4th edition Page no 335", "cop": 2, "opa": "Osteoporasis", "opb": "Factor V inhibition", "opc": "Thrombocytopenia", "opd": "Prolongation of a PTT", "subject_name": "Pharmacology", "topic_name": "Hematology", "id": "aedcfcfa-f1fa-4f7f-a890-8f5b6e445334", "choice_type": "single"} {"question": "Drug of choice for plasmodium vivax is", "exp": "Chloroquine Chloroquine remains the treatment of choice for clinical cure and suppressive prophylaxis of all types of malaria, except that caused by resistant P.falciparum. In sho time visitors to chloroquine-sensitive endemic areas, suppressive dose should be staed 1 week before and continued for 4 weeks after returning REF : katzung pharmacology : 14th ed", "cop": 2, "opa": "Mefloquine", "opb": "Chloroquine", "opc": "Aesunate", "opd": "Aesunate", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "66ef7199-bc77-45f3-86ac-e770bbf38d40", "choice_type": "single"} {"question": "Duration of treatment for multibacillary and paucibacillary leprosy is", "exp": "Multibacillary (MB) leprosyFor adults, the standard regimen is Rifampicin: 600 mg once a month Dapsone: 100 mg daily Clofazimine: 300 mg once a month and 50 mg daily Duration= 12 months.Paucibacillary (PB) leprosyFor adults, the standard regimen is Rifampicin: 600 mg once a month Dapsone: 100 mg daily Duration= six monthsSingle Skin Lesion Paucibacillary leprosyFor adults, the standard regimen is a single dose of Rifampicin: 600 mg Ofloxacin: 400 mg Minocycline: 100 mg", "cop": 3, "opa": "24 months and 12 months", "opb": "6 months and 12 months", "opc": "12 months and 6 months", "opd": "12 months and 24 months", "subject_name": "Pharmacology", "topic_name": "Antibiotics", "id": "9baa35e8-da16-4fd3-9e58-eb2f7d32c9e4", "choice_type": "single"} {"question": "Tetracycline with highest anti leprotic propey", "exp": "Minocyline is a tetracycline group given in cases where clozamine is not tolerated minocycline is given in such cases 100mg per day in such cases. Ref: KDT 6/E P753", "cop": 1, "opa": "Minocycline", "opb": "Doxycycline", "opc": "Demeclocycline", "opd": "Oxyteacycline", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "d6e70c2c-bb7f-41fc-aea0-cff55bf0efd0", "choice_type": "single"} {"question": "Surfactant deficiency occurs in NOT RELATED", "exp": ".", "cop": 1, "opa": "Infant of diabetic mother", "opb": "Meconium aspiration syndrome", "opc": "Transient tachypnea of newborn", "opd": "Bronchopulmonary dysplasia", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "8c9e90e4-2ff2-45d6-bfd1-254f2bd2ff97", "choice_type": "single"} {"question": "FDA approved drug for HIV is", "exp": "Ibalizumab was approved by FDA in 2018 for the treatment of HIVRef: Rigidity > Hypokinesia# Peripheral actions - responsible for treatment of sialorrhea# Started at low dose and gradually increased", "cop": 1, "opa": "Trihexyphenidyl", "opb": "Pramipexole", "opc": "Amantadine", "opd": "Selegiline", "subject_name": "Pharmacology", "topic_name": "C.N.S", "id": "7062bb04-18c1-4a38-9c0a-20af8bf4a585", "choice_type": "single"} {"question": "Drug that does not follow nonlinear dose dependent saturation kinetics", "exp": "(A) Paracetamol # Nonlinear Pharmacokinetics> Nonlinearity in pharmacokinetics (i.e., changes in such parameters as clearance, volume of distribution, and half-life as a function of dose or concentration of drug) usually is due to saturation of either protein binding, hepatic metabolism, or active renal transport of the drug.", "cop": 1, "opa": "Paracetamol", "opb": "Salicylates", "opc": "Phenytoin", "opd": "Ethanol", "subject_name": "Pharmacology", "topic_name": "Miscellaneous (Pharmacology)", "id": "188d3826-5416-4fdb-8320-49d2d2a2eb7d", "choice_type": "single"} {"question": "Effects mediated by H1 histamine receptor include", "exp": "The H1 receptor is a histamine receptorbelonging to the family of rhodopsin-like G-protein-coupled receptors.This receptor is activated by the biogenic amine histamine. It is expressed in smooth muscles, on vascular endothelial cells, in the hea, and in the central nervous system. Refer kDT 7/162", "cop": 3, "opa": "Inhibition of gastric acid secretion", "opb": "Induction of hepatic cytochrome P450 enzyme", "opc": "Maintaince of a wakeful state", "opd": "Vasoconstriction of aerioles", "subject_name": "Pharmacology", "topic_name": "Autacoids", "id": "2736ce0f-7e46-4938-95fb-fa07bc16dcf0", "choice_type": "single"} {"question": "Drug of choice for absence seizures is", "exp": "Ethosuximide and valproate are equally efficacious, but the latter i:more commonly used because it would als, prevent kindling and emergence of GTCS Valproate is clearly superior in mixed absence and GTCS, which is more common than pure absence seizures. REF KD TRIPATHI 8TH ED.", "cop": 1, "opa": "Valproate", "opb": "Phenytoin", "opc": "Diazepam", "opd": "Ethosuximide", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "f1e64832-a847-4c87-b758-3c04dc08148d", "choice_type": "single"} {"question": "Paial agonist can antagonise the effects of a full agonist because it has", "exp": "Agonists:- Have both affinity and maximal intrin-sic activity. Competitive antagonists :- Have affinity but no intrinsic activity. Paial agonists:- Have affinity and submaximal intrinsic activity. Inverse agonists:- Have affinity but intrinsic activity with a minus sign (IA between 0 and -1). Ref:- kd tripathi; pg num:-41,42", "cop": 1, "opa": "High affinity but low intrinsic activity", "opb": "No affinity and low intrinsic activity", "opc": "Low affinity but high intrinsic activity", "opd": "High affinity but no intrinsic activity", "subject_name": "Pharmacology", "topic_name": "General pharmacology", "id": "c714750a-7b15-4136-ae29-ebcdd087bfe1", "choice_type": "single"} {"question": "Ankle edema caused by calcium channel blockers is prevented by", "exp": "Calcium channel blockers can lead to ankle edema caused by precapillary dilation of vessels.\nACE inhibitors or Angiotensin Receptor Blockers can Prevent the edema by causing postcapillary dilation of vessels.", "cop": 4, "opa": "Propanalol", "opb": "Adrenaline", "opc": "Ropinirole", "opd": "ACE inhibitors", "subject_name": "Pharmacology", "topic_name": null, "id": "a81d14a4-f916-4b78-b476-b641b199600d", "choice_type": "single"} {"question": "Fastest and briefest action occurs in", "exp": "(Tropicamide): (118-KDT 7th edition)TROPICAMIDE - has quickest (20-40 min) and briefest (3-6 hours) action but is a relatively unreliable cycloplgic* It is satisfactory for refraction testing in adults and as a short acting mydriatic for fundoscopy* The mydriatic action can be augmented by combining with phenylephrine", "cop": 3, "opa": "Atropine", "opb": "Homatropine", "opc": "Tropicamide", "opd": "Cyclopentolate", "subject_name": "Pharmacology", "topic_name": "A.N.S.", "id": "335fa6c5-f7d5-43fa-9a0e-a69b4454c660", "choice_type": "single"} {"question": "Mechanism of action of aspirin as antiplatelet drug is it's inhibitory action on", "exp": "Refer KDT 7th /629 By inhibiting cyclooxygenase enzyme, aspirin initially decreses6 the level of both prostacyclins and TXA2 Howevr6 after some time prostacyclins synthesis resumes due to presence big nulcues in endothelium where'ass TXA2 remain depressed because platelets are enucleated", "cop": 3, "opa": "Prostacyclins", "opb": "PGF-2 alpha", "opc": "Thromboxane A2", "opd": "Phospholipase C", "subject_name": "Pharmacology", "topic_name": "Respiratory system", "id": "8a124b21-3e97-4544-b251-ba012a46b433", "choice_type": "single"} {"question": "Insulin release due to K+ closure is seen with", "exp": "Glinides acts by the closure of potassium channels like sulphonylureas REF KD TRIpathi 8th ed", "cop": 1, "opa": "Nateglinide", "opb": "Acarbose", "opc": "Exenatide", "opd": "Sitagliptin", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "998cab99-efbb-436d-85a3-2426ae1b41f9", "choice_type": "single"} {"question": "Complications of inhalational steroids use include", "exp": "Adverse effects Hoarseness of voice, dysphonia, sore throat, asymptomatic or symptomatic oropharyngeal candidiasis are the most common side effects. These can be minimized by the use of a spacer, gargling after every dose (to wash off the drug deposited on oral and pharyngeal mucosa) and prevented as well as treated by topical nystatin/clotrimazole. Patients who are to be switched over from oral steroid should receive inhaled steroid in addition for 1-2 weeks before oral steroid is tapered (Peak effect of inhaled steroid is seen after 4-7 days of instituting inhaled steroids and benefit persists for a few weeks after discontinuation), Otherwise steroid with-drawal may manifest (precipitation of asthma, muscular pain, lassitude, depression, hypotension). This confirms lack of systemic activity of inhaled steroids (at doses < 600 ug/day). Systemic effects of long-term inhaled glucocoicoids are clinically relevant only at doses > 600 ug/day. The significant ones are--mood changes, osteoporosis, growth retardation in children, bruising, petechiae, hyperglycaemia and pituitary-adrenal suppression; several repos of adrenal crisis have appeared, especially in children, during stress. Ref:- kd tripathi; pg num:-230,231", "cop": 2, "opa": "Cushing's syndrome", "opb": "Oral candidiasis", "opc": "Decreased ACTH", "opd": "Systemic complications", "subject_name": "Pharmacology", "topic_name": "Respiratory system", "id": "158768a3-b928-4d95-b3d0-31c2130fc50a", "choice_type": "single"} {"question": "Wof bones is affected more with glucocoicoid induced osteoporosis", "exp": "Adverse effects:- Osteoporosis Especially involving veebrae and other flat spongy bones. Compression fractures of veebrae and spontaneous fracture of long bones can occur, especially in the elderly. Radiological evidence of osteoporosis is an indication for withdrawal of coicoid therapy. Coicosteroid induced osteoporosis can be prevented/arrested by calcium supplements + vit D, and by estrogen/raloxifene or androgen replacement therapy in females and males respectively. However, bisphosphonates are the most effective drugs. Avascular necrosis of head of femur, humerus, or knee joint is an occasional abrupt onset complication of high dose coicosteroid therapy. Ref:- kd tripathi; pg num:-293", "cop": 4, "opa": "Humerus", "opb": "Femur", "opc": "Radius", "opd": "veebra", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "9ac791bf-d8b6-4e82-9912-dd5df2d2cad4", "choice_type": "single"} {"question": "Most potent mineralocoicoid is", "exp": "Aldosterone is the most potent mineralocoicoid. Not used clinically because of the low oral bioavailability. most potent synthetic or man made is- fludrocoisone- having more mineralocoicoid activity (REF.Essential of medical pharmacology K D TRIPATHI 6 Edition, Page No - 282)", "cop": 1, "opa": "Aldosterone", "opb": "DOCA", "opc": "Fludrocoeisone", "opd": "Triamcinolone", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "17eb85b1-2fe6-47d3-b6fe-e53aa19d2c03", "choice_type": "single"} {"question": "Gemtuzumab ozogamycin is a monoclonal antibody against", "exp": "It is a monoclonal antibody against CD33, used for CD33+ve AML.", "cop": 2, "opa": "CD 30", "opb": "CD 33", "opc": "CD 45", "opd": "CD 79a", "subject_name": "Pharmacology", "topic_name": null, "id": "7d2b689a-4c58-46aa-b21b-83d70f86ab01", "choice_type": "single"} {"question": "Digitalis has positive ionotropic effect by the viue of its effects on", "exp": "Effects of digitalis on cell biochemistry: sodium pumpinhibition. It is now generally agreed that Na+-K+ adenosine triphosphatase (ATPase), a transpo enzyme derived from the sarcolemmal sodium pump, is the primary site at which digitalis exes its effects on the myocardial cell. Refer kDT 6/e p497", "cop": 1, "opa": "Na+K+ ATPase pump", "opb": "Na glucose channels", "opc": "H+ K+ ATPase pump", "opd": "Calcium pump", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "c946ea95-0f9e-4edb-b75d-4c61ff718ab1", "choice_type": "single"} {"question": "Longest acting statin is", "exp": "Among statins, shoest acting is simvastatin and longest acting is rosuvastatinRef: KD Tripathi 7thed.Pg: 637", "cop": 3, "opa": "Simvastatin", "opb": "Pravastatin", "opc": "Rosuvastatin", "opd": "Lovastatin", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "bdf6ed13-917d-4ecb-8dd0-2189639b18e0", "choice_type": "single"} {"question": "The drug of choice in digitalis induced ventricular arrhythmia is", "exp": "Refer CMDT 2010/364 Administration of intravenous lignocaineinfusion is indicated as an adjunctive intervention in patients with severe acute pain eg during and post laparotomy, following major trauma or burns and for acute cancer pain flares or neuropathic (nerve memory) pain [such as deafferentation/postamputation pain or from acute ...", "cop": 1, "opa": "IV Lignocaine", "opb": "Phenytoin", "opc": "Quinidine", "opd": "Procainamide", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "9d8f9ee8-225c-4d98-a890-e59e2f835146", "choice_type": "single"} {"question": "Topical antibiotic of choice for MRSA", "exp": "Ans: C. MupirocinMethicillin resistance staphylococcus aureus (MRSA):Also be referred to as multi-drug resktant staphylococcus aureus or oxacillin resistant staphylococcus aureus (ORSA).Vancomycin is the systemic DOC for MRSAMupirocin is topical antibiotic of choice.Other topical effective drug are fusidic acid and retapamulin.", "cop": 3, "opa": "Mafenide", "opb": "Silver sulfadiazine", "opc": "Mupirocin", "opd": "Butenafine", "subject_name": "Pharmacology", "topic_name": null, "id": "bf226199-c400-4a26-9323-67c835e2d3ef", "choice_type": "single"} {"question": "Most impoant dose limiting toxicity of cancer chemotherapy is", "exp": "Depression of bone marrow is usually the most significant dose limiting toxicity with cancer chemotherapy Refer CMDT 2010/1499", "cop": 3, "opa": "Gastronomy toxicity", "opb": "Neurotoxiciity", "opc": "Bone marrow suppression", "opd": "Nephrotoxicity", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "e2459d77-c30e-4fcd-82f2-981de4d5957c", "choice_type": "single"} {"question": "Wof are anti diabetic agents that acts by increasing insulin sensitivity, and so should be euglycemics", "exp": "Thiazolidinedione (PPARg agonist) Pioglitazone:- Only one thiazolidinedione Pioglitazone is currently available. Mech of action:- This class of oral antidiabetic drugs are selective agonists for the nuclear peroxisome proliferator-activated receptor g (PPARg) which is expressed mainly in fat cells, but also in muscle and some other cells. It enhances the transcription of several insulin responsive genes. Glitazones tend to reverse insulin resistance by enhancing GLUT4 expression and translocation. Entry of glucose into muscle and fat is improved. Hepatic gluconeo- genesis is also suppressed. Activation of genes regulating fatty acid metabolism and lipogenesis in adipose tissue contributes to the insulin sensitizing action. Lipolysis and plasma fatty acid levels are reduced. Adipocyte turnover and differentiation is accelerated by glitazones. Thus, fatty tissue is a major site of their action. Improved glycaemic control results inlowering of circulating HbA1C and insulin levels in type 2 DM patients. Pioglitazone, in addition, lowers serum triglyceride level and raises HDL level without much change in LDL level, probably because it acts on PPARa as well to induce expression of reverse cholesterol transpoer and some apoproteins. Monotherapy with glitazones is not associated with hypoglycaemic episodes. Ref:- kd tripathi; pg num:-276,277", "cop": 2, "opa": "Phenformin", "opb": "Pioglitazone", "opc": "Sitagliptin", "opd": "Liraglutide", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "ef3dd9e9-66a4-479f-aeed-f4a525f9c1f8", "choice_type": "single"} {"question": "35 year old man was found unconscious. Examination revealed bilateral constricted pupil, bradycardia, excessive sweating and secretion. most likely causes", "exp": "Refer kDT 7/e p 110,111 Signs and Symptoms Muscarinic signs (SLUDGE) salivation, lacrimation, urination, diaphoresis, gastrointestinal upset, emesis and progressing to bronchospasm, bronchorrhea, blurred vision, bradycardia or tachycardia, hypotension, confusion, and shock. Nicotinic effects Skeletal muscle initially exhibits fasciculation (involuntary irregular, violent muscle contractions) followed by the inability to repolarize cell membranes resulting in weakness and paralysis. Severe reactions can lead to ventilatory failure and death (cholinergic crisis).", "cop": 3, "opa": "Opium poisoning", "opb": "Acute alcohol intoxication", "opc": "Organophosphorus poisoning", "opd": "Pontine haemorrhage", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "0d6ee12f-d90b-411b-ad77-fc7e6377094c", "choice_type": "single"} {"question": "Beta blockers are contraindicated in", "exp": null, "cop": 3, "opa": "Angina pectoris", "opb": "Cardiac arrhythmia", "opc": "Cardiac failure", "opd": "Myocardial infarction", "subject_name": "Pharmacology", "topic_name": null, "id": "f9ea5792-8a93-4d35-bac1-ca1fb536a1a4", "choice_type": "single"} {"question": "Niacin must be used in diabetics cautiously because", "exp": "Niacin can result in Insulin resistance and lead to hyperglycemia. Hence, it must be used cautiously in Diabetics.", "cop": 2, "opa": "It causes hypoglycemia", "opb": "It impairs Insulin sensitivity", "opc": "Increases metabolism of oral hypoglycemic agents", "opd": "It increases skin thickness", "subject_name": "Pharmacology", "topic_name": null, "id": "f63cdeff-50b3-45cc-afc8-5ece470c098d", "choice_type": "single"} {"question": "Combination of sulfamethoxazole and trimethoprim is synergistic due to", "exp": null, "cop": 2, "opa": "Enhanced entry into bacteria", "opb": "Sequential blockade in folate metabolism", "opc": "Inhibition of drug inactivation enzymes", "opd": "Inhibition of drug efflux", "subject_name": "Pharmacology", "topic_name": null, "id": "5bff2188-2b4e-4f0c-ac36-1d3d3264df7c", "choice_type": "single"} {"question": "Dysfunctional uterine bleeding (DUB) is seen in", "exp": "The term DUB is used for menorrhagia in the absence of any structural abnormality, pelvic pathology or evidence of extra-genital cause for bleeding or endocrine disorder. Metropathia haemorrhagic is a specialized form of DUB. Continuous uterine bleed is the most constant symptom and may be preceded by amenorrhoea of about 8-10 weeks duration. ref katzung 12th ed. Bleeding is always painless and anovulatory. Thick polypoidal endometrium and a cystic follicle are present in one ovary.", "cop": 3, "opa": "Polycystic ovarian disease", "opb": "Endometrial tuberculosis", "opc": "Metropathia haemorrhagica", "opd": "Multiple fibroids", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "a6f039cd-bfa9-47d1-ac56-c44b78c43b4f", "choice_type": "single"} {"question": "Two regarding use of Bromocriptine for suppression of lactation includes", "exp": "Refer KDT 6/e p236 For suppression of lactation D2 agonists like Bromocriptine can be used In hyoerprolactinemia these are given for long periods Metoclopromide being a D2 antogonist will stop the action of Bromocriptine Adverse effects of Bromocriptine include nausea, vomiting, postural hypotension, digital vasospasm and CNS effects like hallucinations ,psychosis", "cop": 2, "opa": "It can cause deep vein thrombosis", "opb": "It can cause hypotension", "opc": "Metaclopramide potentiates the action of Bromocriptine", "opd": "It is given for 1 week only", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "21304ba2-a5d2-438a-9945-72342a6b2226", "choice_type": "single"} {"question": "sho acting acting beta 2 agonist", "exp": "sho-acting beta2 agonists- salbutamol., terbutaline, pirbuterol long-acting- salmeterol, formoterol, clenbuterol ref kd Tripathi 8th ed", "cop": 3, "opa": "Formoterol", "opb": "Isoprenaline", "opc": "Salbutamol", "opd": "salmeterol", "subject_name": "Pharmacology", "topic_name": "Respiratory system", "id": "372e2a07-8eb6-4190-98a9-b126c038eba3", "choice_type": "single"} {"question": "Vascular dermal necrosis is seen with", "exp": "Vascular dermal necrosis occurs due to warfarin Cutaneous necrosis with reduced activity of protein C sometimes occurs during the first weeks of therapy. Rarely, the same process causes frank infarction of the breast, fatty tissues, intestine, and extremitiesKatzung 12e pg: 610", "cop": 1, "opa": "Warfarin", "opb": "Hirudin", "opc": "Dabigatran", "opd": "Rivaroxiban", "subject_name": "Pharmacology", "topic_name": "Hematology", "id": "c7202fae-fdb7-4d28-a593-393ce032e92a", "choice_type": "single"} {"question": "Patisiran was approved by FDA recently for", "exp": "It is a double stranded small interfering ribose neuclic acid ( si RNA) formulated in the form of a lipid complex. used in the treatment of polyneuropathy", "cop": 4, "opa": "Filariasis", "opb": "Peripheral Neuropathy", "opc": "Neuropathy of diabetes", "opd": "Neuropathy of amyloidosis", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "82a028d1-ce52-42e7-849e-8a01e63c154b", "choice_type": "single"} {"question": "The most potent topical coicosteroid is", "exp": "Ans. is `d' i.e., Clobetasol propionate", "cop": 4, "opa": "Betamethasone valerate", "opb": "Triamcinolone acetonide", "opc": "Hydrocoisone acetate", "opd": "Clobetasol propionate", "subject_name": "Pharmacology", "topic_name": null, "id": "5e840484-1fc5-4267-a5f0-56b8ef74e2dc", "choice_type": "single"} {"question": "In staphylococci, plasmids encoding beta lactamase are transmitted by", "exp": "Ref Goodman Gilman 11/e p 1133 Beta lactamase are encoded by plasmids that can be transferred with the help of bacteriophage in staphylococci and by transformation in pneumococci", "cop": 2, "opa": "Conjugation", "opb": "Transduction", "opc": "Transposon", "opd": "Transformation", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "8dd199ee-2bf1-40aa-a424-9d079136d019", "choice_type": "single"} {"question": "The drug contraindicated in variant angina is", "exp": "Beta blockers are contraindicated invariant or vasospastic angina as they produce vasoconstriction by blocking beta 2 receptors which produce vasodilatation Also, the unopposed action of alpha receptor activation can l.t vasoconstriction. Ref: Katzung 13th ed Pg: 203-206", "cop": 3, "opa": "Aspirin", "opb": "GTN", "opc": "Propranolol", "opd": "Nicorandil", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "a52f4366-024b-4c5d-8657-968ce879d6ef", "choice_type": "single"} {"question": "Propranolol is contraindicated in diabetes mellitus because it", "exp": "Ref; KD Tripathi pharmacology 7th edition (page no; 146) Propranolol delays recovery from hypoglycemia due to insulin and oral antidiabetics. It masks the warning signs of hypoglycaemia mediated through sympathetic stimulation (tachycardia, tremor).", "cop": 3, "opa": "Causes hyperglycemia", "opb": "uses seizures", "opc": "Masks the hypoglycemic symptoms", "opd": "Causes hypotension", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "a37339f0-88a9-4a21-8832-4bfcd2d31eae", "choice_type": "single"} {"question": "Drug inhibiting granulocyte migration is", "exp": "Colchicine * Colchicine, an anti gout medication exes its pharmacological action by hindering granulocyte migration in gouty inflammation. * Colchicine is indicated in the intercritical periods for prolonged prophylaxis against acute attacks of gout. * Mechanism of Colchicine in Acute Gout is illustrated below: Ref:- Goodman & Gilman Pharmacological Basis of Therapeutics 13th Ed; Pg num:- 702-3", "cop": 1, "opa": "Colchicine", "opb": "Montelukast", "opc": "Cromoglycate", "opd": "Felbamate", "subject_name": "Pharmacology", "topic_name": "Autacoids", "id": "0185e7e8-3115-442d-a411-e84a1f4d5f35", "choice_type": "single"} {"question": "The following drug inhibits histamine release", "exp": "Ketotifen, nedocromil are mast cell stabilizers inhibiting the release of histamine.remaining all options given are histamine releasersRef: KD Tripathi 7th ed pg 229", "cop": 4, "opa": "D tubocurare", "opb": "Morphine", "opc": "Suxamethonium", "opd": "Ketotifin", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "cf3220b8-4a97-48c0-8345-d0666984d8e9", "choice_type": "single"} {"question": "Safe diuretic in renal dysfunction is", "exp": "Loop diuretics are safe in renal dysfunction, liver cirrhosis and CCFRef: KDT 7THed Pg 581", "cop": 2, "opa": "Mannitol", "opb": "Bumetinide", "opc": "Chlohalidone", "opd": "Acetazolamide", "subject_name": "Pharmacology", "topic_name": "Kidney", "id": "388ac38b-7698-4bbb-9954-95e3d6f3f6b4", "choice_type": "single"} {"question": "New indication of tolvaptan as approved by FDA recently", "exp": "Tolvaptan is a vasopressin antagonist used for SIADH Now approved for PCKD Ref : HH Sharma 3rd ed.", "cop": 4, "opa": "Phenylketonuria", "opb": "Pancreatic tumours", "opc": "Polycystic ovarian disease", "opd": "Polycystic kidney disease", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "fcf1fbda-7f65-4997-8ada-1d4f47e2967a", "choice_type": "single"} {"question": "Longest acting insulin is", "exp": "(Protamine zinc insulin) (259-KDT 6th)Types of Insulin Preparations and Insulin analogues1. Rapid acting- Insulin lispro, Insulin aspart, Insulin glulisine2. Short acting- Regular (soluble) insuline3. Intermediate acting- Insulin zinc suspension or Lente, Neutral protamine hagedorm (NPH) or Isophane insulin4. Long acting- Protamine zinc insulin (PZI), Insulin glargine", "cop": 4, "opa": "Global zinc suspension", "opb": "Insulin- zinc suspension", "opc": "Neutral protamine hagedorm (NPH)", "opd": "Protamine- zinc insulin", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "1b228e7f-39fe-4ae1-be1b-d907b8deb64a", "choice_type": "single"} {"question": "DOC for Extrapulmonary cryptococcal infection without CNS involvement is", "exp": "Cryptococcal infection with meningitis: DOC IS Amphotericin B with flucytosine,Extrapulmonary without CNS involvement: DOC is fluconazole Ref: Harrison 18th ed/.Pg 1650.", "cop": 4, "opa": "Amphotericin B", "opb": "Flucytosine", "opc": "Azoles", "opd": "Fluconazole", "subject_name": "Pharmacology", "topic_name": "Antibiotics", "id": "2c6e8613-70ba-4040-9c81-16800a1098b3", "choice_type": "single"} {"question": "Amphotericin B has the following unwanted effects", "exp": "Renal impairment occurs in nearly all patients treated with clinically significantdoses of amphotericin.. varying degree of anaemia due to reduced erythropoietin production by damaged renal tubular cellsBasic and clinical pharmacology Katzung 13th edition pg 828", "cop": 2, "opa": "Psychosis", "opb": "Renal impairment, anaemia", "opc": "Hypeension, cardiac arrhythmia", "opd": "Bone marrow toxicity", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "001f01e5-0072-401b-a5da-f9b65e2ef06f", "choice_type": "single"} {"question": "Abatacept is a", "exp": "Abatacept is a fusion protein consisting of CTLA4 and the Fc poion of IgG1. It inhibits T cell activation by competitively inhibiting the costimulation of T cells that results from an interaction of T cell-expressed CD28 and CD80/86 expressed by antigen-presenting cells. It can be used with or without methotrexate, although its efficacy is greater as cotherapy with methotrexate. It has a positive effect on signs and symptoms of RA and also retards progressive bone damage.", "cop": 4, "opa": "IL1 antagonist", "opb": "INFa neutralizing drug", "opc": "Immunosuppressent", "opd": "Fusion protein", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "7b118a4b-1b76-4481-870b-8960a77dc133", "choice_type": "single"} {"question": "Drug used for acute severe asthma is", "exp": "Magnesium produce broncho dilatationRef:Harrison 17th ed Pg 1605", "cop": 1, "opa": "MGS04", "opb": "Cromolyn sodium", "opc": "Anti leukotriene", "opd": "Cyclosporine", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "92f300a7-7421-47b5-a86c-8f69459a66d6", "choice_type": "single"} {"question": "Leucovorin is used to decrease the toxicity of", "exp": "Ref: Katzung 10th/887; KDT 6/e 823 Toxicity of methotrexate can be reversed by the administration of 5-formyltetrahydrofolate (leucovorin or citrovorum factor). Folic acid in the diet is in dihydrofolate form. It is ineffective in reversing methotrexate toxicity.", "cop": 1, "opa": "Methotrexate", "opb": "6-Mercaptopurine", "opc": "Thio-TEPA", "opd": "Cytosine arabinoside", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "fdb3d9f7-eae9-4bb7-896f-ad2ff84d5be9", "choice_type": "single"} {"question": "Cannabinoids are approved by USFDA in June 2018 for new use of", "exp": "cannabinoids are obatained naturally, semi aynthetic or synthetic in nature. the anti epileptic activity of cannabinoids is proved and approved for use in US by USFDA. Ref: www.ncbi.nlm.nih.gov/pmc/aicles/5767492.", "cop": 1, "opa": "Epilepsy", "opb": "UTI", "opc": "TB", "opd": "Chicken pox", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "585eae8d-e836-4209-9676-53357bb67c71", "choice_type": "single"} {"question": "A reasonable explanation for the therapeutic effects of ibuprofen or naproxen in primary dysmenorrhea is that these drugs", "exp": "PGE, and PGF2a both increase in primary dysmenorrhea, and the therapeutic effects of NSAIDs appear to be due to inhibition of the synthesis of these prostaglandins. Both ibuprofen and naproxen are nonselective COX inhibitors that can inhibit the synthesis of prostacyclin (PGI2 ). NSAIDs do not inhibit phospholipase A2 , and they do not decrease leukotrienes.", "cop": 1, "opa": "|PGE, and PGF2a", "opb": "selectively inhibit COX 2", "opc": "|LTB,", "opd": "inhibit PLA2", "subject_name": "Pharmacology", "topic_name": "General Pharmacology", "id": "6d454fe9-a3d6-417f-9681-0b52fc08f0e7", "choice_type": "single"} {"question": "Drug of choice for imminent eclampsia is", "exp": "Labetalol and alpha-methyldopa are safe in pregnancy.Labetol is rapid acting and used in hypeensive emergencies.MgSO4 prophylaxis is used in imminent eclampsia and eclampsia.Ref: KDT 7th ed P 573", "cop": 3, "opa": "Hydralazine", "opb": "Labetolol", "opc": "MgSO4", "opd": "Methyldopa", "subject_name": "Pharmacology", "topic_name": "Kidney", "id": "28e88cfa-1a1c-448b-b91e-51e8c1f0b2a9", "choice_type": "single"} {"question": "The physical half life of radioactive iodine 131 is", "exp": "RADIOACTIVE IODINE The stable isotope of iodine is 127I. Its radioactive isotope of medicinal impoance is: 131I physical half-life of iodine 131 is 8 days. Mech of action:- 131I emits X-rays as well as b paicles. latter are utilized for their destructive effect on thyroid cells. 131I is concentrated by thyroid, incorporated in colloid--emits radiation from within the follicles. The b paicles penetrate only 0.5-2 mm of tissue. The thyroid follicular cells are affected from within, undergo pyknosis and necrosis followed by fibrosis when a sufficiently large dose has been administered, without damage to neighbouring tissues. Ref:- kd tripathi; pg num:-255", "cop": 2, "opa": "8 hours", "opb": "8 days", "opc": "16 days", "opd": "60 days", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "7342c21d-9422-474f-818c-336b9fa484af", "choice_type": "single"} {"question": "Gender specific adverse effect of valproate is", "exp": "Long term use of valproate in young girl is associated with higher incidence of polycystic ovarian disease and menstrual irregularities. REf KD Tripathi 8th ed.", "cop": 4, "opa": "Weight gain", "opb": "Tremors", "opc": "Alopecia", "opd": "Polycystic ovarian disease", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "569a564c-7bc4-4bd9-83e6-29c6b2305262", "choice_type": "single"} {"question": "Discolouration of the teeth seen in following intake", "exp": "[A) (Tetracycline) (672 - KDT 5th) (714-KDT 6th)* Tetracyclines have chelating property. Calcium- tetracycline chelate gets deposited in developing teeth and bone Given from mid pregnancy to 5 months to extra uterine life the decidous teeth are affected brown discolouration of teeth, more susceptible to carries. Tetracyclines gives between 3 months to 6 years of age affect permanent anterior dentition. Repeated course are more damaging* Prevention of discolouration of permanent front teeth requires that tetracyclines be avoided from the last 2months of pregnancy to 4 years and of other teeth to 8 years of age (or 12 years if the third molar are valued)* Prolonged tetracyclines therapy can also stain the finger nails at all ages.", "cop": 1, "opa": "Tetracyclines", "opb": "Chloramphenicol", "opc": "Minocycline", "opd": "Lymecycline", "subject_name": "Pharmacology", "topic_name": "Anti Microbial", "id": "64c86057-76ce-473e-99dd-b6a071736866", "choice_type": "single"} {"question": "Leukotriene antagonist is used as", "exp": "Ans. is 'b' i.e., Anti asthmatic Drugs used in asthmaBronchodilatorsDrugs reducing inflammation Leukotriene antagonistsMast cell stabilizers CorticosteroidsAnti-IgE antibodya)B2Sympathomimetics* Montelukast* Zafirlukast* Sodium cromoglycate* Ketotifena)Systemic* Hydrocortisone* Prednisolone* Omalizumab* Salbutamol* Bambuteral* Formoterol* Terbutaline* Salmeterol* Ephedrineb)Inhalation* Beclomethasome* Budesonide* Fluticasone* Flunisolide* Ciclesonideb)Methylxanthines* Theophylline* Doxophylline* Aminophyllinec)Anticholinergics* Ipratropium* Tiopratropium* Selective PGE4 inhibitors are under clinical trial as antiasthma drugs. These are cilomilast, roflumilast and tofimilast.", "cop": 2, "opa": "Anti neoplastic", "opb": "Anti asthmatic", "opc": "Anti inflammatory", "opd": "Tocolytic", "subject_name": "Pharmacology", "topic_name": "Asthma", "id": "f7a30f7f-6cc4-4bad-bf14-934ab140a639", "choice_type": "single"} {"question": "Anti CD20 is", "exp": "anti cd20 mabs: KD Tripathi 8th ed", "cop": 4, "opa": "Alemtuzumab", "opb": "Bevacizumab", "opc": "Gemtuzumab", "opd": "Tositumomab", "subject_name": "Pharmacology", "topic_name": "Immunomodulators", "id": "371197bc-fb61-4bcf-9f93-0dc953dedfbb", "choice_type": "single"} {"question": "Haemorrhagic cystitis is caused by", "exp": "Ans. is 'a' i.e., Cyclophosphamide Hemorrhagic cystic is most commonly associated with cyclophosphamide (seen in 5-10 % of patients).In Harrison drugs causing hemorrhagic cystitis have been listed and this also includes Busulphan.Still, I prefer cyclophosphamide as the answer because none of the pharmacology books (This even includes Goodman & Gilman) mention hemorrhagic cystitis as an adverse effect of Busulfan.More question on this topic: -Hemorrhagic cystitis has been attributed to cyclophosphamide because of the presence of acrolein.Adequate hydration and intravenous injection of MESNA (Sodium 2-mercaptoethane sulfonate) minimize this problem.", "cop": 1, "opa": "Cyclophosphamide", "opb": "Busulphan", "opc": "Prednisolone", "opd": "Melphalan", "subject_name": "Pharmacology", "topic_name": "Adverse Drug Effect", "id": "abfc22bf-6df0-42ec-afc3-bfdad80b82b9", "choice_type": "single"} {"question": "NADPH actions in RBC are a/e", "exp": "ATP is not produced by NADPH. ATP is produced by reducing equivalents like NADH, FADH2. W When NADH and other reducing equivalents transfer their electrons through Electron transpo chain in the Mitochondrial inner membrane and generate proton motive force which brings about the ATP synthesis by the ATP synthase complex. Both nicotinamide adenine dinucleotide (NAD+) or nicotinamide adenine dinucleotide phosphate (NADP+) are co-factors of vitamin niacin used by dehydrogenases. However NAD-linked dehydrogenases catalyse oxido-reduction reactions in the oxidative pathways of metabolism, paicularly in glycolysis, in the citric acid cycle and in the respiratory chain of mitochondria.", "cop": 1, "opa": "Produce ATP", "opb": "Stabilizes the membrane", "opc": "Reductive biosynthesis", "opd": "GP6D deficiency causes decreased synthesis of NADPH", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "b2c39998-87ad-43b9-9b61-746127a347d1", "choice_type": "single"} {"question": "Abciximab is", "exp": "Ans. b (Gp IIb/IIIa antibody) (Ref. KDT 6th/ Table 112-1)- Abciximab is antiplatelet drug which is Gp Ilb/IIIa antagonist.GPIIb/ IIIa AntagonistsFeatureAbciximabEptifibatideTirofibanDescriptionFab fragment of humanized mouse monoclonal antibodyCyclical KGD-containing heptapeptideNonpeptidic RGD mimeticSpecific for GPIIb/IIIaNoYesYesPlasma half-lifeShort (min)Long (2.5 h)Long (2.0 h)Platelet-bound half-lifeLong (days)Short (sec)Short (sec)Renal clearanceNoYesYes- Other Antithrombotic Drugs are: ANTITHROMBOTIC DRUGS: | ||||Antiplatelet drugsAnticoagulantsDirect thrombin inhibitorsFibrinolytics*Aspirin/*Heparin*Argatroban*Streptokinase*Thienopyridines*LMWH*Lepirudin* Anistreplase(clopidogrel&ticlopidine),*Fondaparinux,*Bivalirudin* rt-PA (alteplase)*Dipyridimole, and*Warfarin * Tenecteplase*GPIIb/llla antagonists.(warfarin is only available oral anticoag)* Reteplase*Desmoteplase* AlfimepraseLMWH and Fondaparinux, ComparisonFeaturesLMWHFondaparinuxNumber of saccharide units15-175Catalysis of factor Xa inhibitionYesYesCatalysis of thrombin inhibitionYesNoBioavailability after subcutaneous administration (%)90100Plasma half-life (h)417Renal excretionYesYesInduces release of tissue factor pathway inhibitorYesNoNeutralized by protamine sulfatePartiallyNoHirudin, Bivalirudinand Argatroban, Comparison. HirudinBivalirudinArgatrobanMolecular mass70001980527Interaction Site with thrombinActive site and exosite 1Active site and exosite 1Active siteRenal clearanceYesNoNoHepatic metabolismNoNoYesPlasma half-life (min)602545", "cop": 2, "opa": "Antithrombin III inhibitor", "opb": "Gp IIb/IIIa antibody", "opc": "Alanine analogue", "opd": "P2YAC Purine receptor antagonist", "subject_name": "Pharmacology", "topic_name": "Hematology", "id": "a2ad551a-a8cd-46e9-8278-e039c3f4e6fc", "choice_type": "single"} {"question": "\"Eutectic mixture\" is", "exp": "Eutectic mixture is topical applied to skin and mucous membrane and only superficial area is anesthelized, combination of 2.5% lignocanie & 2.5% prilocaine lowers each others melting point & is used as Eutectic mixture.", "cop": 3, "opa": "5% Lignocaine + 5% prilocaine", "opb": "2.5% Bupivacaine + 2.5 % Prilocaine", "opc": "2.5% lignocaine + 2.5 % prilocaine", "opd": "1% Lignocaine + 1% Prilocaine", "subject_name": "Pharmacology", "topic_name": null, "id": "3fab16ab-7c0e-457a-a4f4-f29ad1b22a72", "choice_type": "single"} {"question": "Renin antagonist is", "exp": "Direct renin antagonists are aliskiren, remikiren - could be used for HTN in the future- new drugs aliskiren- oral, remikiren- IV side effects- hypotension, hyperkalemia REF KD Tripathi 8th ed", "cop": 3, "opa": "Losaan", "opb": "Benazepril", "opc": "Remikiren", "opd": "Imidapril", "subject_name": "Pharmacology", "topic_name": "Kidney", "id": "18748c0d-adcd-4ee5-9a14-a478ad3c9352", "choice_type": "single"} {"question": "Mechanism of action of Theophylline in bronchial asthma", "exp": "Refer Katzung 11/e p 345 Theophylline is used in bronchial asthma. It's mechanise of action is Inhibition of phosphodiestesrase paicularly PDE-4 Antagonism of adenosine receptors Enhancement for histone deacetylation", "cop": 1, "opa": "Phosphodiestesrase 4 inhibition", "opb": "Beta 2 agonism", "opc": "Antichoinergic action", "opd": "Inhibition of mucociliary clearance", "subject_name": "Pharmacology", "topic_name": "Respiratory system", "id": "71c7aead-9de4-4981-8fa2-89a7b19ddd62", "choice_type": "single"} {"question": "Hyperuricemia is seen with", "exp": "Chlorthiazide is a thiazide diuretic which can lead to hyper uricema, as Thiazide diuretics competitively inhibit excretion of uric acid.", "cop": 2, "opa": "Acetazolamide", "opb": "Chlorthiazide", "opc": "Mannitol", "opd": "Triamterene", "subject_name": "Pharmacology", "topic_name": null, "id": "c5e522c0-e441-4f2c-869b-0a0a8eed067f", "choice_type": "single"} {"question": "Low doses of aspirin prolong bleeding time by selec tively inhibiting synthesis of the following mediator in the platelets", "exp": "Antiplatelet aggregation:- Mech of action:- Aspirin inhibits COX irreversibly and thus inhibits synthesis of PGs. NSAIDs inhibit synthesis of both proaggregatory (TXA2- synthesized in platelets) and anti- aggregatory (PGI2- synthesized by endothelium) prostanoids, but effect on platelet TXA2 predominates . At therapeutic doses most NSAIDs inhibit platelet aggregation, bleeding time is prolonged. Therefore aspirin exes anti- thrombotic effect for several days. Risk of surgical and anticoagulant associated bleeding is enhanced. These drugs should be stopped a week before any elective major surgeries to reduce the risk of bleeding. Ref:- kd tripathi; pg num:-194", "cop": 1, "opa": "Thromboxane A2", "opb": "5-Hydroxytryptamine", "opc": "Platelet activating factor", "opd": "Prostacyclin", "subject_name": "Pharmacology", "topic_name": "Autacoids", "id": "6a16f586-637f-4570-a8b4-5ea10e299ea2", "choice_type": "single"} {"question": "Wof alkylating agent is known to cause disulfiram like reaction", "exp": "Procarbazine It is a weak MAO inhibitor; It produces sedation and other CNS effects, and can interact with foods and drugs. Alcohol causes hot flushing and a disulfiram-like reaction in patients taking procarbazine. Males may suffer sterility. Vomiting, leucopenia, thrombocytopenia are the prominent toxicities. Ref:- kd tripathi; pg num:-861", "cop": 2, "opa": "Melphalan", "opb": "Procarbazine", "opc": "Carmustine", "opd": "Ifosfamide", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "1b9f758e-0009-4bb3-a047-fdfd9243562b", "choice_type": "single"} {"question": "A 55 year old drug addict from California presents with euphoria, altered time perception, and conjuctival injection. There is impairment of judgment. Most likely cause is addiction from substance", "exp": "Marijuana", "cop": 1, "opa": "Marijuana", "opb": "Cocaine", "opc": "Phencyclidine", "opd": "Benzodiazepine", "subject_name": "Pharmacology", "topic_name": null, "id": "e7acff2b-3a37-47cd-9fc0-9360943cc105", "choice_type": "single"} {"question": "The most likely drug to be effective in diseases caused by cestodes and trematodes is", "exp": "Praziquantel is the drug of choice for treatment of all fluke (trematode) infections and most tapeworm (cestode) infections. Its antihelminthic action derives from an increase in membrane permeability to Ca, which results in contraction, followed by paralysis, of worm musculature. Mebendazole also has antihelminthic activity, but it is restricted to the nematodes. The other drugs listed are antiprotozoals.", "cop": 4, "opa": "chloroquine", "opb": "mebendazole", "opc": "metronidazole", "opd": "praziquantel", "subject_name": "Pharmacology", "topic_name": "Anti Microbial", "id": "901f9462-3d54-4e5e-92df-2e34b50617b4", "choice_type": "single"} {"question": "Intravenous inducing agent with maximum plasma protein binding", "exp": "Ans. is 'd' i.e., Propofol Intravenous inducing agent Protien binding (%) Thiopental 85% Methhexital 85% Propofol 98% Etomidate 75% Ketamine 12%", "cop": 4, "opa": "Thiopental", "opb": "Ketamine", "opc": "Etomidate", "opd": "Propofol", "subject_name": "Pharmacology", "topic_name": null, "id": "a0f7c68d-838b-402c-95c5-a05a2a89fe55", "choice_type": "single"} {"question": "Arrhythmias refractory to the treatment of lignocaine can be treated by", "exp": "Katzung 11e p 241. Amiodarone is an antiarrhythmic medication used to treat and prevent a number of types of irregular heabeats. This includes ventricular tachycardia, ventricular fibrillation, and wide complex tachycardia, as well as atrial fibrillation and paroxysmal supraventricular tachycardia.", "cop": 3, "opa": "Sotalol", "opb": "Diltiazem", "opc": "Amiodarone", "opd": "Quinidine", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "ac26ccf2-9fb2-4728-861f-d03a7198ea20", "choice_type": "single"} {"question": "DOC for acute attack of asthma in patients on Beta blockers", "exp": "Respiratory airway has beta adrenergic receptors(beta 2 receptors). Beta 2 agonists cause bronchodilatation, and beta 2 blockers cause bronchoconstriction. ipratropium bromide:- Atropine like drugs cause bronchodilatation by blocking M3 receptor mediated cholinergic constrictor tone; act primarily in the larger airways which receive vagal innervation. Ipratropium bromideis a sho acting (duration 4-6 hours) inhaled anticholinergic bronchodilator, while tiotropium bromide is long acting (duration 24 hours). They are the bronchodilators of choice in COPD. Ref:- kd tripathi;pg num:- 227,228", "cop": 3, "opa": "Salbutamol", "opb": "Theophylline", "opc": "Ipratropium bomide", "opd": "Chlorpheniramine", "subject_name": "Pharmacology", "topic_name": "Respiratory system", "id": "1617e406-8982-46d5-b12b-349d2833dd10", "choice_type": "single"} {"question": "The presence of a drug on left side in the Log DRC tells about its", "exp": "Dose Response Curve (DRC) - Hyperbola shape Log Dose Response Curve ( log DRC )- Sigmoid shape Three impoant Parameters a) Potency- Potency tells which drug produces more effect on lower dose. Left side graph is of more potent drug as compared to right side graph b) Efficacy- Efficacy tells maximum effect of a drug. It is seen from height of DRC. c) Slope- Slope tells the safety of the drug as more is the slope less is the safety. Quantal DRC - It tells about effect of drug in population Therapeutic index (TI) of a drug = LD50 / ED50 - TI is index of measure of safety.", "cop": 1, "opa": "Potency", "opb": "Safety", "opc": "Efficacy", "opd": "Therapeutic index", "subject_name": "Pharmacology", "topic_name": "Pharmacodynamics", "id": "20f97ff9-21be-42c8-aa11-2e5c4452917c", "choice_type": "single"} {"question": "\"Phantom calyx/ Amputed calyx\" on IVU is feature of", "exp": ".", "cop": 1, "opa": "Tuberculosis", "opb": "Hydronephrosis", "opc": "Bilharziasis", "opd": "UPJ obstruction", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "f7d5cf98-0fc6-4d3a-9e31-53df286d7b0a", "choice_type": "single"} {"question": "Duration of action of flumazenil is", "exp": "Duration of action of flumazenil is 30-60min. So the best answer seems to be 30min The onset of action is about 1 to 2 minutes; 80% response is seen within the first 3 minutes. Peak effect is 6 to 10 minutes after administration.Duration range is from 19 minutes to 50 minutes as it depends on the dose was given and benzodiazepine plasma concentrations Ref: Goodman and Gilman 13th ed.", "cop": 4, "opa": "5minute", "opb": "10minute", "opc": "20minute", "opd": "30minute", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "dd374811-c60e-4944-aefe-ba2f8520d831", "choice_type": "single"} {"question": "Selective alpha 2 agonist is", "exp": "Ref: HL Sharma 3rd ed pg no:180 Clonidine, methyldopa, tizanidine, relminidine are central alpha 2 agonists", "cop": 1, "opa": "Tizanidine", "opb": "Prazosin", "opc": "Adrenaline", "opd": "Propanolol", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "08023fbb-22fc-476f-bafe-2ef4ae7b2525", "choice_type": "single"} {"question": "Chelating agent used in chronic thalassemia major for iron overload", "exp": "Defepreninone is oral chelating agent used for chronic use. Whereas desferioxamine is an iron chelator given IV .EDTA is a chelating agent used in blood banks. Ref: KDT 6/e p868", "cop": 3, "opa": "Oral desferroxamine", "opb": "EDTA", "opc": "Deferiprone", "opd": "IV Deferoxamine", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "fe012b1c-35ea-4ecd-a210-ff33737b16c6", "choice_type": "single"} {"question": "Mechanism of action of sodium nitrate in cyanide poisoning is", "exp": "Sodium nitroprusside contain 1 Iron molecule coordinated to five cyanide molecules and one molecule of nitric oxide Prolonged use of Sodium nitroprusside may cause cyanide poisoning Detoxification occurs when cyanide and methamoglobin combines to form cyanomethamoglobin. Amyl nitrate and sodium nitrates enhance the oxidation of hemoglobin to methamoglobin, ensuring reliable mechanism of detoxification Refer kDT 6/e p 527", "cop": 1, "opa": "Produces methamoglobinemia", "opb": "Increased blood flow to liver", "opc": "Increased blood flow to hea", "opd": "Increased blood flow to kidney", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "3f2f0ec1-2575-4bee-9ace-2a492ba2f8bd", "choice_type": "single"} {"question": "shortest acting mydriatic", "exp": "Ans. (b) Tropicamide", "cop": 2, "opa": "Atropine", "opb": "Tropicamide", "opc": "Homatropine", "opd": "Cyclopentolate", "subject_name": "Pharmacology", "topic_name": "A.N.S.", "id": "95d4083b-b6a8-4a29-9c41-5bfe3afeb598", "choice_type": "single"} {"question": "Side effect of halothane countered by atropine is", "exp": "Halothane usually causes sinus or nodal bradycardia which is reversed by atropine. Ref katzung 12th ed.", "cop": 1, "opa": "Bradycardia", "opb": "Hypotension", "opc": "Hypehermia", "opd": "Constipation", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "52c69478-9887-4971-bfdc-4df1b0cea186", "choice_type": "single"} {"question": "Free water clearance is decreased by", "exp": "Flurosemide is a drug which act on both coex and medulla. It acts on the ascending limb of loop of Henle which has both coical and medullary components.Thus,furosemide can block positive as well as negative free water clearance. Vincristine increases the secretion of the harmone ADH and thus decreases positive free water clearance. Chlorpropamide sensitizes the kidney to ADH action.Thus it may decrease the positive free water clearance and in some patients may results in hyponatremia and water intoxication. Most probably the question should have been framed as \"All of the following blocks free water clearance,except\" But if you have to choose one answer,go for furosemide as it will always block free water clearance where as other drugs will cause them occasionally as it is their adverse effect.", "cop": 4, "opa": "Vincristine", "opb": "Vinblastine", "opc": "Chlorpropamide", "opd": "Furosemide", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "69e531c1-f559-44ab-8763-40d0dcbe46dd", "choice_type": "single"} {"question": "Drug causing ocular hypotension with apnea in an infant is", "exp": "Brimonidine lowers IOP and causes CNS depression in new born babies and can result in apnea, so it is contraindicated in such patients. Ocular adverse effects of anti-glaucoma drugs DRUG ADVERSE EFFECT Miotics (Pilocarpine) Cataract Stenosis of nasolacrimal system PGF2 analogs (Latanoprost) Heterochromia iridis, Growth of eyelashes, Cystoid Macular Edema Apraclonidine Lid retraction Brimonidine CNS depression and apnea in newborn Adrenaline Conjunctival pigmentation", "cop": 2, "opa": "Latanoprost", "opb": "Brimonidine", "opc": "Timolol", "opd": "Acetazolamide", "subject_name": "Pharmacology", "topic_name": "Parasympathetic System & Glaucoma", "id": "27c9dd83-e385-4678-bc6c-bd862336d9c3", "choice_type": "single"} {"question": "Aspirin is contraindicated in children suffering from influenza or similar viral infection because of increased risk of", "exp": "An association has been noted between salicylate therapy and 'Reye's syndrome', a rare form of hepatic encephalopathy seen in children having viral (varicella, influenza) infection. Ref:- kd tripathi; pg num:-197", "cop": 4, "opa": "Fanconi syndrome", "opb": "Thrombocytopenia", "opc": "Gastric bleeding", "opd": "Reye's syndrome", "subject_name": "Pharmacology", "topic_name": "Autacoids", "id": "e9157ba5-bbea-411c-9927-cfde7da2af16", "choice_type": "single"} {"question": "Mechanism of action of methadone is", "exp": "Ans. is 'a' i.e., Opioid receptor agonist Methadone* Methadone is opioid receptor agonist.* Most important feature is high oral: parenteral activity ratio (1:2) and firm binding to tissue protein.* It relieves cancer and neuropathic pain not responding to morphine.* Abuse potential is less than morphine.* It also blocks NMDA receptors and uptake of monoamines.* It is the drug of choice for substitution therapy of opioid dependence.* 1 mg of methadone can be substituted for 4 mg of morphine.* Methadone is less hypnotic than morphine (sedative action is less intense).", "cop": 1, "opa": "Opioid receptor agonist", "opb": "Opioid receptor partial agonist", "opc": "Opioid receptor antagonist", "opd": "Opioid receptor inverse agonist", "subject_name": "Pharmacology", "topic_name": "C.N.S", "id": "58070d26-0a43-4c2b-86d6-80d29bb39cfc", "choice_type": "single"} {"question": "The drug of choice for treatment of thyrotoxicosis during pregnancy is", "exp": "Refer KDT 6 /e p 250 Propylthiouracil does not cross placenta and us therefore The drug of choice in first trimester pregnancy", "cop": 3, "opa": "Iodine therapy", "opb": "Carbimazole", "opc": "Propylthiouracil", "opd": "Methimazole", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "1d3d7abf-36bb-453d-9609-a701d1aead52", "choice_type": "single"} {"question": "Ketanserine is", "exp": "5-HT2A antagonistsEdit Antagonists of the 5-HT2A receptor are sometimes used as atypical antipsychotics(contrast with typical antipsychotics, which are purely dopamine antagonists). They include: Cyproheptadine blocks 5-HT2A, H1 and is a mild anticholinergic. Methysergide is a 5-HT2A antagonist and nonselective 5-HT1 receptor blocker. It causes retroperitoneal fibrosis and mediastinal fibrosis. Quetiapine blocks 5-HT2A, 5-HT1A, dopamine receptors D1 and D2, histamine receptor H1, and A1 adrenoreceptors. 5-HT2A/2C antagonistsEdit Ketanserin Antihypeensive. Blocks 5-HT2A, 5-HT2C and Alpha 1 (A1) adrenoreceptors. Risperidone antipsychotic Trazodone antidepressant Clozapine antipsychotic. Blocks 5-HT2A, 5-HT2C and D4 receptors. Nefazodone acts primarily as a potent 5-HT2A antagonist. Refer kDT 6/e p167", "cop": 2, "opa": "5HT 1b antagonist", "opb": "5HT2 antagonist", "opc": "5HT 1a agonist", "opd": "5HT 1d antagonist", "subject_name": "Pharmacology", "topic_name": "Autacoids", "id": "c96b1155-aa94-43d5-8a2c-4e899ec00180", "choice_type": "single"} {"question": "Drug of choice for Insulinoma is", "exp": "Diazoxide is K+ channel opener, which is drug of choice for Insulinoma. It was used for hypertensive emergency but can lead to severe hypotension.", "cop": 3, "opa": "Glucagon", "opb": "Sodium nitroprusside", "opc": "Diazoxide", "opd": "Mecasermin", "subject_name": "Pharmacology", "topic_name": null, "id": "75711498-139c-4f28-a1ab-61f3aa2a564a", "choice_type": "single"} {"question": "The most significant effect of ACE inhibition is", "exp": "Refer kDT 6/e p 484 Sho acting ACE inhibitors like captopril main result in postural hypotension.ACE Inhibitors do not affect serum calcium level", "cop": 1, "opa": "Hypotention", "opb": "Hypeension", "opc": "Hypocalcemia", "opd": "Hypercalcemia", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "8e31560d-425b-45fe-9a57-ea590bbb7ae9", "choice_type": "single"} {"question": "Methemoglobinemia is a complication following the administration of", "exp": null, "cop": 3, "opa": "Lignocaine", "opb": "Lignocaine", "opc": "Prilocaine", "opd": "Procaine", "subject_name": "Pharmacology", "topic_name": null, "id": "c3357a81-a36a-4f75-86dd-5b405e8d741b", "choice_type": "single"} {"question": "Drug given in OPC poisoning is", "exp": "Ans. is 'b' i.e., Atropine * Atropine is considered to be a first line drug for treatment of OPC poisoning.* It is highly effective in counteracting the muscarinic symptoms and higher doses counteract the central effects.* 2 mg i.v. repeated every 10 minutes till dryness of mouth or other signs of atropinization appear.* It does not reverse peripheral muscular paralysis which is the nicotinic effect.", "cop": 2, "opa": "Hyoscine", "opb": "Atropine", "opc": "Propanthelene", "opd": "Physostigmine", "subject_name": "Pharmacology", "topic_name": "A.N.S.", "id": "bdc65e2e-4964-4b41-beba-ae0e2f68643a", "choice_type": "single"} {"question": "INH induced peripheral neuropathy results from deficiency of vitamin", "exp": "Pyridoxine (vitamin B6) is admistered for the prevention as well as treatment of Isoniazid induced peripheral neuropathy Ref KDT 6/e p741", "cop": 4, "opa": "B1", "opb": "B2", "opc": "B12", "opd": "B6", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "2b17679f-9750-4a67-a179-e9a50da1955b", "choice_type": "single"} {"question": "Prolactin is inhibited by", "exp": "(A) Dopamine# PITUITARY PROLACTIN secretion is regulated by endocrine neurons in the hypothalamus, the most important ones being the neurosecretory tuberoinfundibulum neurons of the arcuate nucleus, which secrete dopamine to act on the D2 receptors of lactotrophs, causing inhibition of prolactin secretion. Thyrotropin-releasing factor has a stimulatory effect on prolactin release.", "cop": 1, "opa": "Dopamine", "opb": "Neurophysin", "opc": "Sertonin", "opd": "Glutamate", "subject_name": "Pharmacology", "topic_name": "Miscellaneous (Pharmacology)", "id": "aad47bcb-d0d5-435f-b6ba-3580923f25f3", "choice_type": "single"} {"question": "Most common side effect of calcium channel blockers is", "exp": "Calcium channel blockers: Most common side effect is headache CCB cause flushing, headache, angioedema, reflex tachycardia. Verapamil, diltiazem- both vasodilation and decrease in hea rate Nifedipine, clevidipine - only vasodilation but increase in hea rate. Avoid in angina.", "cop": 4, "opa": "Nausea", "opb": "Constipation", "opc": "Postural hypotension", "opd": "Headache", "subject_name": "Pharmacology", "topic_name": "Hypeension, Arrhythmias, Dyslipidemia", "id": "223f8ff1-3684-4738-bb2f-91df1946b261", "choice_type": "single"} {"question": "Tranexaemic acid is a specific antidote of", "exp": "ANTIFIBRINOLYTIC DRUGS Tranexamic acid:- It binds to the lysine binding site on plasminogen and prevents its combination with fibrin leading to fibrinolysis. It is preferred for prevention/control of excessive bleeding due to: * Fibrinolytic drugs. * Cardio-pulmonary bypass surgery. * Tonsillectomy, prostatic surgery, tooth extraction in haemophiliacs. * Menorrhagia, especially due to IUCD. * Recurrent epistaxis, hyphema due to ocular trauma, peptic ulcer. side effects:- Nausea and diarrhoea. Thromboembolic events, disturbed colour vision and allergic reactions are infrequent. Thrombophlebitis of injected vein can occur. Ref:- kd tripathi; pg num:-628,629", "cop": 1, "opa": "Fibrinolytic drugs", "opb": "Heparin", "opc": "Barbiturates", "opd": "Organophosphates", "subject_name": "Pharmacology", "topic_name": "Hematology", "id": "d677cd78-693b-413a-aa38-28bba03d48d1", "choice_type": "single"} {"question": "A single cell within a culture of freshly isolated cardiac muscle cells is injected with a fluorescent dye that cannot cross cell membranes. Within minutes, several adjacent cells become fluorescent. The most likely explanation for this observation is the presence of", "exp": "Gap junctions are pores composed of paired connexons that allow the passage of ions, nucleotides, and other small molecules between cells. Ref: katzung 12 th ed.", "cop": 1, "opa": "Gap junctions", "opb": "IP3 receptors", "opc": "Transverse tubules", "opd": "Desmosomes", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "ccc7bb9e-b1d8-466e-97a5-177fb8262481", "choice_type": "single"} {"question": "Drug of choice for Neutropenia due to cancer chemotherapy is", "exp": "ANSWER: (C) FilgrastimREF: KDT 6TH edition, page 833, internet resourcesSee APPENDIX-37 below \"ANTICANCER DRUGS TOXIC AMELIORATION\" APPENDIX - 37Classification of Cancer Chemotherapy Agents:GroupSubgroups & AgentsAcute ToxicityDelayed ToxicityUsesAlkylatingAgentsNitrogen Mustard Alkylation of DNA at N7 &06 position of Guanine -DNA crosslinking I; b/n 2 strands - prevents duplication(1) Mechiorethamine(First anticancer drug)CINV-chemo induced nausea vomiting (4hr- 48hrs)MyelosuppressionMyelosuppression (delayed type-onset = 7d, Nadir = 10-14d, reco%rerv = 21-28d)AlopeciaMOPP-HodgkinslymphomaAA are commonly used in chronic leukemia(2) Cyclophosphamide1CP - 4hydroxyCP -aldophosphamide- Acrolein (toxic) & phosphamide mustard (active)]CINVMyelosuppression(CP>Ifo)Myelosuppression (CP>Ifo) Alopecia, SIADHHemorrhagic cystitis (Ifo>CP)Sec cancer-transitional cell cancer of bladderWagner'sgranulomatosis DOC CMF-Breast, small cell lung ca Broad spectrumAA are nonphase specific(3) Ifosfamide 4hydroxy ifosfamide (active)CINVMyelosuppression(CP>Ifo)Myelosuppression(CP>Ifo)AlopeciaHemorrhagic cystitis (Ifo>CP)Broad spectrum Lung, breast, ovary, sarcoma, testis, germ cell tumorAA causes secondary leukemia in 4-5 years(4) Melphanamino acid derivative ofmechloretamineCINVMyelosuppressionMyelosuppression No alopeciaMultiple myeloma DOCCan replace C in CMF (5) ChlorambucilMyelosuppression CINV is rareMyelosuppression No alopeciaCLL, Hodgkin's Nitrosoureas(lipophilic-crosses BBB) Nitrosoureas causes delayedMyelosuppression (onset-15d, Nadir-4wks, recovery-6wks) (1) Carmustine (BCNU- bis chloro nitroso urea)CINV (severe-2hrs)Myelosuppression, male infertility,Pulmonary fibrosisBrain tumors DOC(Glioblastomamultiforme.Astrocytoma,Medulloblastoma) (2) Lomustine (CCNU)CINV (severe-2hrs)Myelosuppression Interstitial lung diseasedo (3) Semustine (methyl CCNU)CINV (severe-2hrs)Myelosuppressiondo (4) Streptozocin (methylation of protein & nucleic acid)CINV (severe-2 hrs)No MyelosuppressionPancreatic islet cell tumorCarcinoid tumor Alkyl Sulfonates(Intra strand cross linking of DNA by 2 N7 Guanine) BUSULFAN {Dealkylating agent)Hyperuricemia(MC)Sterility, gynecomastia, seizures, Skin pigmentation, Adrenal insufficiency Pulmonary fibrosis (specific)CM L-DOC until imatinibConditioning of BM transplant Ethyl Enimines Thiotepa(Organophosphorous)CINVMyelosuppressionSeldom used nowNon ClassicalAlkylatingAgentsTriazenes Acts on RNA &Protein synthesis not/ mild DNADacarbazine (Active- methyl carbonium ion)CINV-severePermanent sterility Myelos uppre ssion (early/classical)MAID-sarcoma, ABVD-Hodgkins Malignant melanoma (most active agent) Procarbazine (autoxidize spontaneously, Active- Azoprocarbazine, crosses BBB)CINV, MAO inhibitor Disulfiram like reactionMyelosuppression,DermatitisLeukenogenic,teratogenicMOPP-Hodgkin'sPCV-Glioblastoma AltretamineCINV-severe HypotensionNeuro toxic NephrotoxicRefractory ovarian cancerAlkylating Like AgentsPlatinum Compounds 1st gen platinum Inactivated by aluminumCisplatinCINV (most emitogenic)Hypo Mg, K, Ca sec to hypo Mg)Myelosuppression N ephrotoxicity, Ototoxicity Secondary leukemiaCMF-Solidmalignancies2nc generation platinum, Cross resistance- cisplatinCarboplatinCINV (cis>carbo)Myelosuppression(carbo>ds)No nephrotoxicityLess potent than cisplatin (1:4) GemCarco-Iung cancer3rd generation platinum No cross resistanceOxaliplatinPSN pathy (reversible hand & foot, temp loss)Neurotoxicity (dose limiting)No nephrotoxicity PSN pathyflrreversible, hand, foot, leg, arm, temp loss, propio loss)FOLFOX- colon cancerCis/carboplatin resistance AntimetabolitesFolate Antagonists S phase specificMethotrexate HepatotoxicityMyelosuppressionMucositisChoriocarcinoma DOC, ALL, Osteosarcoma. RA, ectopic Myasthenia, psoriasis, meningeal leukemia (intrathecal route)Inhibits DMA syn thesisPemetrexed : Mesothelioma, nonsmall cell lungNo acute toxicidesPurine Analogue Commonly used in acute leukemias6 THIO Guanine MyelosuppressionHepatotoxicityAdult acute leukemia 6 Mercapto Purine Myelosupp ression, hepatotoxicityChildhood acute leukemia Fludrabine Myelosuppression, Flu like symptom (fever, myalgia, arthralgia) Cladribine Myelosuppression, Nephrotoxic, ClXVHairy cell leukemia Pentostatin NephrotoxicHairy cell leukemia Pyrimidine Analogue 5 Fluorouracil (5-FU) GI upset-diarrhea (MC) Hand foot syndrome, CINVMyelosuppression, neurotoxicity Cerebellar ataxia Cytrabine Stomatitis, CINV, Cerebellar ataxia MyelosuppressionAML Capecitabine CINV, Diarrhea, Hand foot syndrome Myelosupp ression (<5FU)Metastatic breast cancer, Metastatic colorectal cancer Gamecitabine CINV, Myelosuppression (dose limiting)Pancreatic cancer DOC Bladder & Nonsmall cell lung CaAntibioticsAnthracyclinsTopoisomerase 2 inhibitor (me)Quinone Free radical injury & intercalation b/n DNA strandsMembrane binding (responsible for cardiotoxicity) Doxorubicin (Adriamycin)CINV, AlopeciaMyelosuppression (dose limiting, neutropenia >th rombocytopenia) Cardiotoxicity(cardiomy opathy, CHF)Radiation recall Hand foot syndromeBroad spectrum Solid tumors & sarcomas (rhabdo/ leiomyosarcoma, Kaposi sarcoma) DaunorubcinCl MV, AlopeciaMyelosuppression, cardiotoxicity, radiation recallNarrow spectrum AML Idarubcin (synthetic Daunorubicin analogue)CINV, Alopecia, Red urine (not hematuria)Myelosuppression, cardiotoxicity, radiation recallAML (more efficacious than daunorubicin) MitoxantroneCINV, Bluish discoloration of nailsMyelosuppression (dose limiting)Lower cardiotoxicity? Other Antibiotics Bleomycin(Glyco peptide Antibiotic) Free radical injury - ds- ss DMA breaks, have both DNA & Fe binding domainAllergic reaction HypotensionPulmonary fibrosis (dose limiting)Mucocutaneous toxicity? Marrow sparingHL, NHL, SCC Malignant pleural effusionAscitis (sclerosing agent) Mitomycin- CActs as alkylating agentCINVHemolytic uremic syndrome. Pulmonary- fibrosis, 8th nerve damageRadiosensitizer- DOC, SCC Dactinomycin Inhibits all forms of DMA dependent RMA synthesis, r-RNA most sensitiveCINVMyelosupp ression Alopecia Radiation recallPediatric tumors (Ewing's, witm's, Rhabdomyosarcoma) Radiosensitizer ActinomycinCINVDesquamationMyelosuppressionAlopeciaPediatric tumors (Ewing's, wilm's, Rhab domyosarcoma) Radiosensitizer PlicamycinCINV EnzymeL-ASPARGINASE (inhibits protein synthesis of tumor cell by depletion of L-Aspargine)Anaphylaxis/ hyper sensitivity- fever, chills, rash, urticaria (brochospasm, hypotension if severe)Hypercoagulable state Pancreatitis, Hepatotoxicity Marrow sparing, no alopeciaALLIneffective in solid tumors(normal cells spared)Plant DerivedVinca AlkaloidsM phase specificInhibits tubulin polymerizationMitotic inhibitors VincristineAlopeciaPSNpathySIADH, Marrow sparingLymphosarcoma, wilm's, Ewing's Remission of childhood acute leukemia. VinblastineAlopecia (Vc >Vb)PSNpathy (Vc >Vb) MyelosuppressionHodgkin s, testicular carcinoma EpipodophylotoxinsTopoisomerase 2 inhibitor Etopside (VP-16)CINV, HypotensionMyelosuppression, early onset secondary leukemia (1-3 years) alopecia Teniposide (VP-26) TaxansM phase specificEnhance tubulin polymerizationSpindle poison PaclitaxelHypersensitivityPSNpathy (stocking glove type) Myelosuppression,Cisplatin resistance Relapse &resistant breast/ovary ca Docetaxel (more potent)HypersensitivityMyelosuppression, PSNpathy (is less frequent)Cisplatin resistance, Relapse-resistant br/ovary ca CamptothecinTopoisomerase 1 inhibitorss DNA breaks TopothecanCINVMyelosuppression (dose limiting) Irinothecan (active = SN-38)CINV, Cholinergic syndrome (SLUDGE) including early diarrhea-24hrsMyelosuppression, cholinergic syndrome (SLUDGE) including late diarrhea 3-10d (dose limiting)Advanced colorectal ca- DOCMiscellaneousArsenic Trioxide (degradation of PM LI & RARa protein)Headache, lightheadednessCINVCardiotoxicity (QT prolongation, arrhythmias), Myelosuppression Syndrome-fever, fluid retention, wt gain, rashAPL-induction in tretinoin relapse and refractoryHydroxyurea has 100% oral bioavailabilityHydroxyurea (inhibits ribonucleotide reductase - inhibits DMA synthesis)CINVMyelosuppression (dose limiting)HyperpigmentationCMLAML-blast crisis Imatinib (Bcr-Abl Tyrosine kinase inhibitor)CINVFluid retention, Ankle & perioral edemaCML-chronic phase GIST with Ckit tyrosine kinase Dasatinib & Nilotinib (novel agents- TK inhibitors) CML- imatinibresistance/intoleranceAnticancer Drug Toxicities:MYELOSUPPRESSIONAll except Asparginase, Vincristine, BleomycinCARDIOTONICAnthracyclins, arsenic trioxideNEPHROTOXICPlatinum compounds (cisplatin>carboplatin>oxaliplatin)PULMONARY FIBROSISBleomycin. Busulfan, CarmustinePERIPHERAL NEUROPATHYGxaliplatin, vincristine Taxans (stoking & glove type)HAEMORRHAGIC CYSTITISCyclophosphamide, IfosfamideHAND FOOT SYNDROME5FU, Capecitabine, DoxorubicinCEREBELLAR ATAXIAPyrimidine analogs like Cytrabine & 5FUSIADHCyclophosphamide, VincristineSECONDARY LEUKEMIAAll alkylating agents & alkylating like agents (in 4-5 years) E topside (in 1-3 years)STERLITYAlkylating agentsDISULFIRAM LIKE REACTIONProcarbazineCHOLINERGIC SYNDROMEIrinitecanRADIATION RECALL SYNDROMEAnthracydinsAnticancer Drugs Toxic Amelioration:ToxicityMeasuresMethotrexateFolinic acidAlkalization of urine (Mtz is weak acid & reabsorbed in acidic urine)Hemorrhagic cystitis (cyclophosphamide, ifosfamide)ME SNA (2 mercapto ethyl sulfonyl sodium) systemic ACETYLCYSTEINE irrigation of bladderHigh fluid intakeFrequent voidingCINV (Cytotoxic drug induced nausea Stvomiting )Ondansetron (5HT3 Antagonist)Cytotoxic drug induced MucositisPabfermin (human recombinant keratinocyte growth factor)TUMOR LYSIS SYNDROME (hyperkalemia, hypophosphatemia, hyperuricemia, hypemricosuria, hypocalcaemia, acute renal failure)prophylactic ALLOPURINOL (xanthine oxidase inhibitor)alternatively RASBURICASE (urkase)Aggressive hydrationHigh urine outputAlkalization of urine not recommended/controversialDiuresis is reserved for well hydrated patientsHEMODIALYSIS (if above fails) MYE LOS OPPRESSIONFor AnemiaERYTHROPOIETIN (recombinant)For NeutropeniaFILGRASTIM- Granulocyte colony-stimulating factor (G-CSF) analogSARGRAMOSTTM - Recombinant granulocyte macrophage colony stimulating factor (GM-CSF)For ThrombocytopeniaOPRELVEKIN (IL-11)BONE MARROW TRANSPLANT (for extreme suppression)CANCER CACHEXIATHALIDOMIDECYTOPROTECTION of normal tissueAMIFOSTINE= WTR-2721=prodrug(active = free thiol=WR-1065. activation normal tissue)USES=cispIatin based chemotherapy & radiation therapyAnthracyclins induced CARDIOTOXICITYDEXRAZOXAXE (ICRF-187) Iron chelating agent Cardio protective agent, derivative of EDTA", "cop": 3, "opa": "Vitamin B-12", "opb": "IL 11", "opc": "Filgrastim", "opd": "Erythropoietin", "subject_name": "Pharmacology", "topic_name": "Anti-Neoplastic Agents", "id": "f493ce4a-1b2c-4778-a153-e3dc6ac42848", "choice_type": "single"} {"question": "In Lepra reaction, drug useful is", "exp": "Refer KDT 6/e p752 Anti inflammatory drugs are used in Lepra reaction Steroids ,Clofazimine and thalidomide can be used", "cop": 2, "opa": "Penicillin", "opb": "Clofazamine", "opc": "Dapsone", "opd": "Rifamipicin", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "ef67f057-df6e-419d-a72f-90846d2c2d0a", "choice_type": "single"} {"question": "Tildrakizumab was approved by FDA in 2018 for", "exp": "Tildrakizumab was approved by FDA in 2018 to treat adults with moderate-to-severe plaque psoriasis who are candidates for systemic therapy or phototherapy", "cop": 4, "opa": "Cystic fibrosis", "opb": "Migraine", "opc": "Hypeension", "opd": "Psoriasis", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "3694c473-a8a5-4790-9b68-37f9bcb70e22", "choice_type": "single"} {"question": "Oral Factor Xa Inhibitor is", "exp": "Factor Xa inhibitors * Oral Direct Factor Xa (Stua-Prower factor) Inhibitors are Rivaroxaban, Apixaban, Betrixaban and Edoxaban * Rivaroxaban inhibits free and clot associated Factor Xa AE reducing !rombin generation AE suppressing Platelet aggregation and Fibrin formation. * Other options: * Dabigatran etexilate is an Oral Direct Factor IIa (Thrombin) Inhibitor * Fondaparinux is a parenteral synthetic Heparin derivative anticoagulant * Bivalirudin is a parenteral Hirudin-based Thrombin Inhibitor. * Salient features of Rivaroxaban: Ref:- Goodman & Gilman's the pharmacological basis of therapeutics 13th Edition; Pg num:- 594.", "cop": 4, "opa": "Dabigatran etexilate", "opb": "Fondaparinux", "opc": "Bivalirudin", "opd": "Rivaroxaban", "subject_name": "Pharmacology", "topic_name": "Hematology", "id": "9e36f14c-c95f-49c0-bd24-9e121a13f153", "choice_type": "single"} {"question": "Arrange the following drugs according to their half life in increasing order 1. Amiodarone 2. Adenosine 3. Esmolol 4. Omeprazole", "exp": "Amiodarone is longest acting anti-arhythmic drug. Its half life is more than 3 weeks. Adenosine is shoest acting anti-arrhythmic drug having half life less than 10 seconds. Esmolol is an ultra sho acting beta blocker. It is metabolized by pseudocholinesterase and thus has half life less than 5 minutes. Omeprazole has half life of 1-2 hours but works for 24 hours due to irreversible inhibition of proton pump. Thus, the sequence is Adenosine < Esmolol < Omeprazole < Amiodarone", "cop": 4, "opa": "1-2-4-3", "opb": "2-3-1-4", "opc": "4-3-1-2", "opd": "2-3-4-1", "subject_name": "Pharmacology", "topic_name": "Hypeension, Arrhythmias, Dyslipidemia", "id": "8e2cc24c-7b7d-47de-b773-055e39566f6d", "choice_type": "single"} {"question": "The surfactant is produced by", "exp": "The smaller type II pneumocytes are often more numerous than type I pneumocytes, and they contribute less than 10% of the surface area.Their cytoplasm contains numerous characteristic secretory lamellar bodies. Ultrastructurally, the lamellar bodies are comprised of concentric whorls of the phospholipid-rich membrane, the precursors of alveolar surfactant. “Surfactant is stored in lamellar bodies and secreted in the form of tubular myelinby type II pneumocytes.", "cop": 2, "opa": "Type I Pneumocytes", "opb": "Type II Pneumocytes", "opc": "Alveolar macrophages", "opd": "Clara cells", "subject_name": "Pharmacology", "topic_name": null, "id": "3ce81b7a-d347-40c6-8bd3-45ec3e3db146", "choice_type": "single"} {"question": "Tramadol is", "exp": "Ans. d (Opioid analgesic). (Ref. KD Tripathi, Pharmacology/6th. 453)# Tramadol is synthetic centrally acting opioid analgesic having modest affinity for ji receptors.# Unlike other opioids, it inhibits reuptake of NA and 5-HT and thus activates monoaminergic spinal inhibition of pain.# Its oral bioavailability is good and it has minimal hemodynamic effects and hence safer in patients with compromised CVS function.# It is indicated for medium intensity short lasting pain due to diagnostic procedures, injury, surgery, etc as well as for chronic cancer pain.", "cop": 4, "opa": "Antiflatulent", "opb": "Antireflux drug", "opc": "Beta-blocker", "opd": "Opioid analgesic", "subject_name": "Pharmacology", "topic_name": "C.N.S", "id": "b0d8e08d-51dc-422a-ad70-a3e0595b4e7f", "choice_type": "single"} {"question": "Bisphosphonates act by", "exp": "Bisphosphonates (BPNs) are analogues of pyrophosphate: carbon atom replacing oxygen in the P-0-P skeleton. They inhibit bone resorption by inhibiting osteoclast function- useful to prevent osteoporosis in addition to metabolic bone diseases and hypercalcaemia. (REF.Essentials of Pharmacology TD TRIPATHI 6th EDITION page no 333)", "cop": 3, "opa": "Increasing the osteoid formation", "opb": "Increasing the mineralization of osteoid", "opc": "Decreasing the osteoclast mediated resorption of bone", "opd": "Decreasing the parathyroid hormone secretion", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "83abaee5-b489-44b3-8615-8276cdeeacc0", "choice_type": "single"} {"question": "Causes of reduced bioavailability of a drug includes", "exp": "When the metabolism of a drug is high during its passage from the site of absorption into the systemic circulation, the rate, and extent of absorption of that drug decreases. absorption- amount of drug reaching the systemic circulation from the site of administration (Ref.Essentials of medical pharmacology TD Tripathi 7th edition page no.16,27)", "cop": 1, "opa": "High first pass metabolism", "opb": "Increased absorption", "opc": "IV drug administration", "opd": "High lipid solubility", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "547bbe6f-6b25-4205-9307-84e6a79f1467", "choice_type": "single"} {"question": "60 yr old lady with RA is considered for infliximab therapy tests to be done are", "exp": "TNF alpha inhibitors can cause reactivation of latent TB. Othr drugs in TNF alpha inhibitors are adalimumab, golimumab. Ref: Katzung 11/e p633", "cop": 4, "opa": "LFT", "opb": "PPD skin test", "opc": "PFT", "opd": "Visual exam", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "09af4751-3c4f-4fdb-a6ea-f185fb85bafb", "choice_type": "single"} {"question": "Mannitol is used in the management of", "exp": "Mannitol * Mannitol, an osmotic diuretic is a drug preferred in reduction of acutely raised intraocular pressure due to Acute Congestive Glaucoma. * Other agents used to relieve raised Intraocular Pressure (IOP) are: Glycerin, Hypeonic saline and Acetazolamide. * Sho term management measures to decrease IOP - needed in acute glaucoma attacks or pre/post ocular surgical procedures are met by Glycerin and Mannitol. * In an acute attack of glaucoma, associated symptoms of nausea and emesis - deter the use of oral agents (like glycerin) - in such instances, IV Mannitol or Acetazolamide are preferred. Therapeutic Indications of Mannitol: - By IV route: - * Treatment of dialysis disequilibrium syndrome * Reduction of IOP in acute glaucoma and during periopeaive periods of ocular surgeries. * To reduce intracranial tension associated with cerebral edema and CNS mass lesions. * For treatment and prevention of acute kidney injury * Enhance urinary excretion of Salicylates, Barbiturates, Bromides and Lithium following their overdose. By oral inhalation:- To diagnose bronchial hyperreactivity. Transurethral irrigation:- To prevent hemolysis during urological procedures. Use of Mannitol is contraindicated in:- CongestiveCardiac Failure, Pulmonary Edema, Renal Failure and in patients with active cranial bleeding. Ref:- Goodman & Gilman Pharmacological Basis of Therapeutics 13th Ed; Pg num:-1267", "cop": 1, "opa": "Acute Congestive Glaucoma", "opb": "Congestive Cardiac Failure", "opc": "Pulmonary edema", "opd": "Acute Renal Failure", "subject_name": "Pharmacology", "topic_name": "Kidney", "id": "a00a9cb5-c852-43db-9398-2a6aec24ba82", "choice_type": "single"} {"question": "Major neurotransmitter released at end organ effectors of the sympathetic division of autonomic nervous system", "exp": "Refer katzung 10e p76,kdt 6/e 116 Neurotransmitter secreted at the end organ effects of sympathetic system is mostly nor adrenaline (except hair follicles and sweat glands, where it is Acetylcholinesterase) where as it is acetylcholine in parasympathetic system", "cop": 2, "opa": "Adrenaline", "opb": "Nor adrenaline", "opc": "Dopamine", "opd": "Acetylcholine", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "19e04d8e-9b04-480f-ace8-134ff570a4d5", "choice_type": "single"} {"question": "Coasting effect is seen with", "exp": "Platinum compounds can result in Coasting effect. It is the term used to describe the sensory loss seen even after the cessation of chemotherapy.", "cop": 3, "opa": "Nitrogen mustards", "opb": "Methotrexate", "opc": "Platinum compounds", "opd": "Dacarbazine", "subject_name": "Pharmacology", "topic_name": null, "id": "af3331ff-413d-44fa-9b33-9a3a3f6e55ea", "choice_type": "single"} {"question": "Quindine is used to treat", "exp": null, "cop": 3, "opa": "Hypertension", "opb": "Angina pectoris", "opc": "Atrial fibrillation", "opd": "Congestive heart failure", "subject_name": "Pharmacology", "topic_name": null, "id": "c89b7a75-f6e1-40c2-8acd-dd7cbc13f1c5", "choice_type": "single"} {"question": "Antidote of datura poisoning is", "exp": "Datura is atropine .antidote is physostigmine because it is a teiary amine which can cross BBB and neutralize central effects produced by atropine Ref: KDT 6th ed pg 101-102", "cop": 3, "opa": "Neostigmine", "opb": "Pyridostigmine", "opc": "Physostigmine", "opd": "Atropine", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "01322dbe-71d2-4de2-9191-65f1dae6a05c", "choice_type": "single"} {"question": "Dabigatran toxicity is treated by", "exp": "Idarucizumab is a monoclonal antibody used to treat Dabigatran toxicity.", "cop": 3, "opa": "Protamine sulphate", "opb": "Andexanet alfa", "opc": "Idarucizumab", "opd": "Argatroban", "subject_name": "Pharmacology", "topic_name": null, "id": "5f051b0f-e12d-4727-8cff-0efea3d29f0b", "choice_type": "single"} {"question": "Beta blocker used safely in hepatic disease is", "exp": "Ans) a (Esmolol) Ref: Gondmun & Gilman 11thedition KDT 6th ed p.139, Katzung edEsmolol has a half-life of about 8 minutes and it contains an ester linkage, and it is hydrolyzed rapidly by esterases in erythrocytes. The half-life of the carboxylic acid metabolite of esmolol is far longer and is about 4 hours which accumulates during prolonged infusion of esmolol which is excreted in the urine. Soit can be safely given in liver diseasesBisoprolol is well absorbed following oral administration with bioavailability of -90%. It is eliminated by renal excretion (50%) and liver metabolism to pharmacologically inactive metabolites (50%).CarvedilolCarvedilol is a third-generation b receptor antagonist that has a unique pharmacological profile. It blocks bl, b2, and al receptors similarly to labetalol, but also has antioxidant and antiproliferative effects. It has membrane-stabilizing activity but it lacks intrinsic sympathomimetic activity. Carvedilol produces vasodilation.It is thought that the additional properties (e.g., antioxidant and antiproliferative effects) contribute to the beneficial effects seen in treating congestive heart failure. Carvedilol does not increase b receptor density and is not associated with high levels of inverse agonist activity. Carvedilol is rapidly absorbed following oral administration, with peak plasma concentrations occurring in 1 to 2 hours. It is highly lipophilic and thus is extensively distributed into extravascular tissues. It is >95% protein bound and is extensively metabolized in the liver, predominantly by CYP2D6 and CYP2C9. No significant changes in the pharmacokinetics of carvedilol were seen in elderly patients with hypertension, and no change in dosage is needed in patients with moderate-to- severe rend insufficiencyBETA BLOCKERSCardioselective (betal) beta blockersMetoprolol, Acebutalol, Atenolol. Bisoprolol ,Esmolol, Betaxolol, Celiprolol, and NebivololNon selective beta blockersPropranolol ,SotalolTimolol, Pindolol, Labetalol, Carvedilol, Medroxolol, Bucindolol and Levubunonol.Beta blocker with intrinsic sympathomimetic activityDilevalolPindololAcebutalolLabetalolCarteololOxyprenololAlprenololPenbutalol Non selective blocker betal + beta2 + alphaK - Crazy Buss Die in Medicine Lab)CarvedilolBucindololLabetolol,DilevalolMedroxalol, IMPORTANT POINTS REGARDING BETA BLOCKERSPropranalol has highest degree of membrane stabilizing action. Nadolol is longest acting beta blocker (t 1/2 -14-24 hrs) and Esmolol is the shortest acting.(t 1/2 2-10 minutes)Propranolol has poor oral bioavailability. Pindolol and Penbutolol have approx 100% bioavailabilityHepatic elimination - propranolol, metoprolol and labetalol. Renal elimination - atenololbeta blockers not crossing CNS -Atenolol, Nadolol and Sotalol (mnemonic: ANS will not cross CNS)Pindolol has intrinsic sympathomimetic activity. Butoxamine is a beta 2 selective blocker.Carvedilol is a non-selective beta blocker showing anti-oxidant property and alpha 1 receptor antagonism.Labetolol, Medroxalol, and Bucindolol also shows alpha 1 receptor blocking activity.Propranalol has highest degree of membrane stabilizing actionNadolol is longest acting beta blocker (t Y=2-14-24 hrs) and Esmolol is the shortest acting.(t Y=2 -10 minutes)Propranolol has poor oral bioavailability. Pindolol and Penbutolol have approx 100% bioavailability Propranolol and Metoprolol are extensively metabolized in the liver, with little unchanged drug appearing in the urine.USES1) Hypertension -They are one of the first choice drugs used in treat ment of hypertension.2) Angina pectoris- Beta-blockers reduces the frequency of anginal episodes and improves exercise tolerance in many patients with angina3) Cardiac arrhythmias- Beta antagonists are often effective in the treatment of both supraventricular and ventricular arrhythmias.4) Myocardial infarction- beta antagonists are strongly indicated in the acute phase of a myocardial infarction. In this setting, relative contraindications include bradycardia, hypotension, moderate or severe left ventricular failure, shock, heart block, and active airways disease5) Congestive heart failure - drugs used are bisoprolol, metoprolol & carvedilol (BMC)6) Dissecting aortic aneurysm7) Pheochromocytoma8) Thyrotoxicosis - controls the sympathetic symptoms without affecting thyroid status.9) Migraine - Propranolol is the most effective drag for prophylaxis of migraine10) Anxiety,11) Essential tremor12) Glaucoma13) HOCM- drags used are beta blockers and calcium channel blockers14) Portal hypertensionAdverse effectsCentral nervous system effects include sedation, sleep disturbances, and depressionWorsens pre existing asthma and COPD Worsening of peripheral vascular diseaseBeta-receptor blockade depresses myocardial contractility and excitability, caution must be exercised in starting a beta receptor antagonist in patients with compensated heart failureBeta blockers may interact with the calcium antagonist verapamil causing severe hypotension, bradycardia, heart failure, and cardiac conduction abnormalities.Exacerbates variant (prinzmetal's) angina.The incidence of hypoglycemic episodes in diabetics that are exacerbated. They also can cause impaired carbohydrate tolerance Plasma lipid profile is altered. Total triglycerides and LDL cholesterol tend to increase while HDL cholesterol decreases.", "cop": 1, "opa": "Esmolol", "opb": "Betaxolol", "opc": "Bisoprolol", "opd": "Carvedilol", "subject_name": "Pharmacology", "topic_name": "A.N.S.", "id": "0b8d8d93-bd49-4bbf-af70-dc868c34a373", "choice_type": "single"} {"question": "The following drugs are avoided with warfarin", "exp": null, "cop": 3, "opa": "Antacids", "opb": "Benzodiazepine", "opc": "Nsaid's like Ibuprofen", "opd": "Codeine, dihydrocodeine, paracetmol", "subject_name": "Pharmacology", "topic_name": null, "id": "272ca69e-7979-4b10-aff3-9390f6932594", "choice_type": "single"} {"question": "Arrange the following opioids according to their potency (most potent first) a. Fentanyl b. Sufentanil c. Morphine d. Pethidine", "exp": "a. Fentanyl group of opioids are most potent opioids. Among these most potent is Sufentanil (approx 1000 times more potent than morphine) . The sequence of potency from high to low in this group is Sufentanil > Fentanyl > Alfentanil. b. Pethidine is 10 times less potent than morphine", "cop": 2, "opa": "a,d,c,b", "opb": "b,a,c,d", "opc": "a,d,b,c", "opd": "b,c,d,a", "subject_name": "Pharmacology", "topic_name": "Opioids and Alcohols", "id": "396b6f93-ae19-4ec6-8f40-6d17f6f1d941", "choice_type": "single"} {"question": "Increase in cAMP is caused by", "exp": "Ref:- kd tripathi; pg num:-48", "cop": 3, "opa": "a (Alpha) receptor", "opb": "Somatostatin", "opc": "b (Beta) receptor", "opd": "Acetylcholine", "subject_name": "Pharmacology", "topic_name": "General pharmacology", "id": "d2ad6393-038e-4f82-81c6-35ef1697e564", "choice_type": "single"} {"question": "Pseudocholinesterase is synthesized by", "exp": "Pseudocholinesterase which metabolizes succinylcholine is synthesized by liver and is present in plasma. True cholinesterase which metabolizes acetylcholine is synthesized by muscle end plate. Ref: KD Tripathi 8th ed.", "cop": 1, "opa": "Liver", "opb": "Plasma", "opc": "Muscle end plate", "opd": "Nerve ending", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "b7495466-d23f-4582-a6ee-d617fc00cf42", "choice_type": "single"} {"question": "Anticancer drug also used in RA, produces acrolein in urine that leads to hemorrhagic cystitis", "exp": "Cyclophosphamide IMPOANT POINTS ON HEMORRHAGIC CYSTITIS: Drugs causing: Cyclophosphamide Ifosfamide Metabolite responsible: Acrolein - In Cyclophosphamide Chloracetaldehyde - In Ifosfamide Treatment: Mesna. Nitrogen mustards: 1. Cyclophosphamide: Powerful vesicant Prodrug - Activated by hepatic biotransformation to aldophosphamide. Acrolein - One of its degradation products. Responsible for hemorrhagic cystitis - Characteristic adverse effect. Use: DOC for Wegener's granulomatosis. Adverse effects: Hemorrhagic cystitis (Characteristic) - Treated by mercapto ethane sulfonic acid (mesna). May cause cardiac dysfunction, pulmonary toxicity & syndrome of inappropriate ADH secretion. 2. Ifosfamide: Produces chloracetaldehyde & acrolein as metabolites. Adverse effects: HIGHER risk of neurotoxicity & hemorrhagic cystitis. Chloracetaldehyde - Responsible for nephrotoxic.", "cop": 1, "opa": "Cyclophosphamide", "opb": "Busulfan", "opc": "Procarbazine", "opd": "Mesna", "subject_name": "Pharmacology", "topic_name": null, "id": "c2a03ce1-bcc1-4152-9f7b-bbf0ff9845c4", "choice_type": "single"} {"question": "Omalizumab is used for", "exp": "Ans. (c) Asthma", "cop": 3, "opa": "Ulcerative colitis", "opb": "Crohn disease", "opc": "Asthma", "opd": "Psoriatic arthritis", "subject_name": "Pharmacology", "topic_name": "Asthma", "id": "ad82e961-76a1-45fa-9501-68cdce6ed4e0", "choice_type": "single"} {"question": "The following drug is", "exp": "The picture shows the drug inhibiting the release of acetylcholine into synapse.so it is either botulinum or beta bungaro toxin Ref: KD Tripathi 6th ed pg 94", "cop": 3, "opa": "Hemicholinium", "opb": "Vesamicol", "opc": "Botulinum toxin", "opd": "Metyrosine", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "c615f66b-200e-4042-b61a-526c0cacdb05", "choice_type": "single"} {"question": "Wof is a limiting adverse effect of ACE inhibitors", "exp": "Adverse effects:- By reducing aldosterone levels, ACE inhibitors decrease K + excretion in the distal nephron leading to hyperkalemia. Hyperkalaemia: more likely in patients with impaired renal function and in those taking K+ sparing diuretics, NSAIDs. Ref:- kd tripathi; pg num:-495,502", "cop": 4, "opa": "Acidosis", "opb": "Hypernatremia", "opc": "Hypokalemia", "opd": "Hyperkalemia", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "895dbd83-a327-4e35-820b-b7860b7dc726", "choice_type": "single"} {"question": "Ipilimumab is a", "exp": "Ipilimumab and Tremelimumab are CTLA4 inhibitors used in BRAF -ve malignant melanoma.", "cop": 3, "opa": "Anti CD30 Monoclonal Antibody", "opb": "PDL1 receptor inhibitor", "opc": "CTLA4 inhibitor", "opd": "PTPN22 inhibitor", "subject_name": "Pharmacology", "topic_name": null, "id": "2d04adf8-1e96-427a-859a-91f41e0c56d7", "choice_type": "single"} {"question": "Melanosis coli is caused by", "exp": "Senna and cascara are anthraquinone derivatives, which are used as stimulant purgatives. On chronic use they can lead to melanosis coli.", "cop": 2, "opa": "Bisacodyl", "opb": "Senna", "opc": "Magnesium sulphate", "opd": "Lactulose", "subject_name": "Pharmacology", "topic_name": null, "id": "9e95a8ef-f8ef-4c2c-a3f8-daee233271ec", "choice_type": "single"} {"question": "Longest actin statin is", "exp": "Ans. (d) Rosuvastatin", "cop": 4, "opa": "Simavastatin", "opb": "Lovastatin", "opc": "Atorvastatin", "opd": "Rosuvastatin", "subject_name": "Pharmacology", "topic_name": "Hypolipidemic", "id": "15971c5e-5ef1-4a3a-a188-d48eb055946f", "choice_type": "single"} {"question": "Therapeutic index of a drug is indicative of", "exp": "Ans: A (Measure of safety)Ref: Thripathi 5 ed. Pg. 46Therapeutic index is a measure of drug safety.Therapeutic index (TD)It is the ratio of the dose that produces toxicity to the dose that produces a clinically desired or effective response. A large value indicates that there is a wide margin between doses that are effective and doses that are toxic.TD = TD50/ED50 TD50 is the dose that produces a toxic effect in half the population.ED 50 is the dose that produces a desired effect in half the population.", "cop": 1, "opa": "Measure of safety", "opb": "Measure of adverse effect", "opc": "Dose range across which the drug can be safely administered", "opd": "Measure of efficacy", "subject_name": "Pharmacology", "topic_name": "General Pharmacology", "id": "6cdf89a4-9d52-4067-9387-b723f420a2e0", "choice_type": "single"} {"question": "In Ampicilline & Amoxycilline, Amoxycilline is better due to", "exp": "(Better bioavailability in taken with foods) (700-701-KDT 6th)AMOXYCILLINE - is close congener of ampicillin (but not a pro drug) similar to it in all respects EXCEPT* Oral absorption is better, food does not interfere with absorption; higher and more sustained blood levels are produced* Incidence of diarrhoea is lower* It is less active against Shigella and H. influenza.", "cop": 1, "opa": "Better bioavailobility in taken with foods", "opb": "Lesser bioavailability in taken with foods", "opc": "Incidence of diarrhoea is higher", "opd": "More active against Shigella and H. influenza", "subject_name": "Pharmacology", "topic_name": "Anti Microbial", "id": "fd036bb0-a1b6-4ac2-b54c-7f98a27300b2", "choice_type": "single"} {"question": "Alpha blocker used as anti hypertensive agent", "exp": null, "cop": 2, "opa": "Alpha methyl DOPA", "opb": "Prazosin", "opc": "Clonidine", "opd": "Propranolol", "subject_name": "Pharmacology", "topic_name": null, "id": "201482fb-ad89-4aa9-bc4f-306b4ad43514", "choice_type": "single"} {"question": "Km is", "exp": "Km is that concentration of substrate at which velocity of reaction is Vmax /2 (half of the maximum)\nIt corresponds to X-axis and denotes potency.", "cop": 2, "opa": "Substrate concentration at which the velocity of reaction is maximum", "opb": "Substrate concentration at which velocity of reaction is half of the maximum", "opc": "Corresponds to Y-axis", "opd": "Denotes efficacy", "subject_name": "Pharmacology", "topic_name": null, "id": "4705d939-43a3-4cd2-8572-4e33b3cded37", "choice_type": "single"} {"question": "Drug of choice for central diabetes insipidus is", "exp": "Desmopressin (dDAVP):- This synthetic peptide is a selective V2 agonist; but has negligible vasoconstrictor activity. It is also longer acting because enzymatic degradation is slow; t 1/2 1-2 hours; duration of action 8-12 hours. Desmopressin is the preparation of choice for all V2 receptor related indications. The intranasal route is preferred, though bioavailability is only 10-20%. Uses :- Based on V2 actions (Desmopressin is the drug of choice). 1. Diabetes insipidus DI of pituitary origin (neurogenic) is the most impoant indication for vasopressin. It is ineffective in renal (nephrogenic) DI, since kidney is unresponsive to ADH. Life- long therapy is required, except in some cases of head injury or neurosurgery, where DI occurs transiently. The dose of desmopressin is individualized by measuring 24 hour urine volume. It can be used in transient DI and to differentiate neurogenic from nephrogenic DI--urine volume is reduced and its osmolarity increased if DI is due to deficiency of ADH, but not when it is due to unresponsiveness of kidney to ADH. Ref:- kd tripathi; pg num:-596,597", "cop": 4, "opa": "Leuprolide", "opb": "Insulin", "opc": "Thiazide diuretics", "opd": "Desmopressin", "subject_name": "Pharmacology", "topic_name": "Kidney", "id": "d79190ee-0051-4c32-ae9d-c23ca754c04f", "choice_type": "single"} {"question": "Drug of choice in drug induced parkinsonism is", "exp": "(Benzhexol) (421-KDT 6th)* Trihexyphenidyl (Benzhexol) is most commonly used drug in drug induced Parkinsonism* \"Anticholinergics are the only drugs effective in drug (phenothiazine) induced parkinsonism \"Drug used in Alzheimer's disease Acetylcholinesterase inhibitors - donepezil, galentamine, rivastigmine, tacrine NMDA receptor antagonists - Memantine", "cop": 2, "opa": "Levodopa", "opb": "Benzhexol", "opc": "Selegilline", "opd": "Amantadine", "subject_name": "Pharmacology", "topic_name": "C.N.S", "id": "798a1b23-9833-4d50-b504-07b9d60ab083", "choice_type": "single"} {"question": "Drug of choice in a patient with severe complicated falciparum malaria is", "exp": null, "cop": 3, "opa": "Chloroquine", "opb": "Quinine", "opc": "Artesunate", "opd": "Artemether", "subject_name": "Pharmacology", "topic_name": null, "id": "81c150d3-a71c-4b19-be55-2371b4e4dcde", "choice_type": "single"} {"question": "The most impoant drug in the psychosis is", "exp": "Thioridazine is a typical antipsychotic drug.used in schizophrenia,acute psychosis Ref: Katzung 13th ed. Pg 493.", "cop": 2, "opa": "Thiopentone", "opb": "Thioridazine", "opc": "Theophylline", "opd": "Thiocolchiside", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "88ea3a9f-26cd-4104-b29d-8e3a08add92b", "choice_type": "single"} {"question": "The beneficial effect of drug neostigmine in the treatment of Myasthenia gravis is due to the action", "exp": null, "cop": 2, "opa": "It produces more acetylcholine", "opb": "It inhibits the action of cholinesterase", "opc": "It produces more acetylcholine receptors", "opd": "It increases the action of cholinesterase", "subject_name": "Pharmacology", "topic_name": null, "id": "02355c58-b676-4e06-88a0-81e14afa5f5c", "choice_type": "single"} {"question": "Wof sulfonylureas is used in treatment of neurogenic diabetes Insipidus", "exp": "Chlorpropamide:- is one of the first SUs which has been discontinued because of long duration of action (> 2 days) and frequent hypoglycaemia. Side effects:- It was also prone to cause dilutional hyponatraemia (by sensitizing kidney to ADH action- used in treating central DI), cholestatic jaundice and alcohol flush(disulfiram like reaction). Ref:- kd tripathi; pg num:-273", "cop": 3, "opa": "Nateglinide", "opb": "Tolbutamide", "opc": "Chlorpropamide", "opd": "Glipizide", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "291abb0b-5a09-4369-aacf-5df63ac36655", "choice_type": "single"} {"question": "Reflex bronchoconstriction is most likely to occur with the following form of inhaled antiasthma medication", "exp": "Dry powder inhalers are poable devices in which the capsule (rotacap) containing the drug is punctured/cut across and the powder is aerosolized by the inspiratory air flow of the patient. It requires high velocity inspiration which children, elderly and the very sick may not be capable of. Complications The dry powder is also more likely to irritate the air passage producing cough and bronchoconstriction. Ref:- kd tripathi;pg num :-232", "cop": 2, "opa": "Metered dose spray of drug in solution", "opb": "Dry powder rotacap", "opc": "Nebuliser", "opd": "Nebuliser with spacer", "subject_name": "Pharmacology", "topic_name": "Respiratory system", "id": "ba4bd514-966e-43ad-8961-e6e34df62d06", "choice_type": "single"} {"question": "Most common cause of Death in high income nations includes", "exp": "(B) Ischemic Heart Disease # ISCHEMIC HEART DISEASE is the cause of 25 to 30% of deaths in most industrilised countries.> WHO has drawn attention to the fact that Coronary Heart Disease (CHD) is our modern epidemic, i.e., a disease that effects populations, not an unavoidable attribute of aging.> CHD may manifest itself in many presentations -1. Angina pectoris of effort, 2. Myocardial infarction, 3. Irregularities of the Heart, 4. Cardiac failure and 5. Sudden Death.> CHD is assuming serious dimension in developing countries.> CHD is expected to be the single most important cause of death in India by the year 2015.", "cop": 2, "opa": "Unipolar depression", "opb": "Ischemic Heart Disease", "opc": "Alcohol", "opd": "Cerebro Vascular Accident", "subject_name": "Pharmacology", "topic_name": "Miscellaneous (Pharmacology)", "id": "d288b6ce-c2f7-4805-a743-4b5adf83ad94", "choice_type": "single"} {"question": "Long acting dopamine agonist is", "exp": "Bromocriptine has greater action on D2 receptors. Cabergoline is more potent and longer acting than bromocriptine. ERGOT-DERIVED DOPAMINE AGONISTS Examples of this type of dopamine agonist are bromocriptine, pergolide, lisuride, and the long acting ergoline, cabergoline. (REF.Essential of medical pharmacology K D TRIPATHI 6 Edition, Page No - 237)", "cop": 3, "opa": "Bromocriptine", "opb": "Lisuride", "opc": "Cabergoline", "opd": "Apomorphine", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "a55b173d-1287-4ef8-bcae-262ff8aa9ca7", "choice_type": "single"} {"question": "Hea rate is decreased by", "exp": "ref; KD Tripathi Pharmacology 6th edition (page no;136) Propranolol is a beta blocker which decreases hea rate, force of contraction (at relatively higher doses) and cardiac output (c.o.). beta blocker inhibits adrenergic responses mediated through the beta receptors. Isoprenaline,Dobutamine,Dopamine are adrenergic drugs , which are cardiac stimulators so increases hea rate", "cop": 1, "opa": "Propanolol", "opb": "Isoprenaline", "opc": "Dopamine", "opd": "Dobutamine", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "3f2f6124-98fa-461a-b0c8-9eaaaf534314", "choice_type": "single"} {"question": "Drug of choice for ventricular arrhythmia due to myocardial infarction is", "exp": "Refer kDT 6/e p 519 Drug of choice for ventricular arrhythmias with myocardial infarction is lignocaine Drug of choice for supraventricular arrhythmia after myocardial infection is beta blockers cardiac function is adequate", "cop": 3, "opa": "Quinidine", "opb": "Amiodarone", "opc": "Xylocaine", "opd": "Diphenylhydantoin", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "407b777e-b8f5-4c3c-b7e3-a95896225948", "choice_type": "single"} {"question": "Extrapyramidal side effects are common in", "exp": "Antipsychotic medications commonly produce extrapyramidal symptoms as side effects. The extrapyramidal symptomsinclude acute dyskinesias and dystonic reactions, tardive dyskinesia, Parkinsonism, akinesia, akathisia, and neuroleptic malignant syndrome. Ref: KD tripathi 8th ed.", "cop": 4, "opa": "Anti depressants", "opb": "Anti epileptics", "opc": "Anti maniacs", "opd": "Anti psychotics", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "2d6983a7-9904-4368-9ce6-01cac77645b9", "choice_type": "single"} {"question": "Aliskiren is", "exp": "(Renin/ Angiotensin antagonist): (508.562- KDT 7th edition)ALISKIREN is a nonpeptide which binds selectively to the catalytic site of renin and competitively blocks the access of angiotensinogen to this site - Ang I is not produced and the chain of renin angiotension system is interrupted while the concentration of renin in plasma is increased by feed back, the plasma renin activity is decreased. Ang I and Ang II level fall.* Bradvkinin Antagonist * HOE 140 (Icatibant) selective b2 antagonist* FR173657* Aldosterone antagonist* Spironolactone, Eplerenone* Canrenone, Potassium canrenoate***", "cop": 2, "opa": "Aldosteron antagonists", "opb": "Renin/Angiotensin antagonist", "opc": "Bradykinin analogue", "opd": "Prostacyclin analogue", "subject_name": "Pharmacology", "topic_name": "C.V.S", "id": "48dd30ad-ad91-49fd-baad-efdc33d10136", "choice_type": "single"} {"question": "Gynaecomastia is caused by", "exp": "Ans. is c i.e., Spironolactone Causes of Gynecomastia* Digitalis* Spironolactone* Ethionamide* Ketoconazole* Estrogens* Calcium antagonists* INH* Griseofulvin* Reserpine* Methyldopa* Cimetidine* Phenytoin* Cyproterone acetate* Flutamide* Clomiphene* GoserelinGynecomastia occurs as a result of imbalance between estrogens which stimulate breast tissue and androgens which counteract these effects.The gynecomastia causing drugs can be categorized into :The first type are drugs that act exactly like estrogens, such as diethylstilbestrol, birth control pills, digitalis, and estrogen containing cosmetics.The second type is drugs that enhance endogenous estrogen formation such as gonadotropins and clomiphene.The third type is drugs that inhibit testosterone synthesis and action such as spironolactone, ketoconazole, metronidazole and cimetidine.The final type is drugs that act by unknown mechanisms such as isoniazid, methyldopa, captopril, tricyclic antidepressants, diazepam and heroin.Also know,Testosterone also causes Gynecomastia", "cop": 3, "opa": "Clomiphene citrate", "opb": "Tamoxifen", "opc": "Spironolactone", "opd": "Testosterone", "subject_name": "Pharmacology", "topic_name": "Adverse Drug Effect", "id": "c480c4cb-90c5-4fa5-97d0-221f82ee4601", "choice_type": "single"} {"question": "Oral complication of Cyclosporin is", "exp": "Adverse effects Cyclosporin is nephrotoxic--the major limitation, and impairs liver function. Other adverse effects are sustained rise in BP, precipitation of diabetes, anorexia, lethargy, hyperkalaemia, hyperuricaemia, oppounistic infections, hirsutism, gum hyperplasia, tremor and seizures. Ref:- kd tripathi; pg num:-880,881", "cop": 3, "opa": "Oral thrush", "opb": "Leukoplakia", "opc": "Gingival hyperplasia", "opd": "Squamous cell carcinoma", "subject_name": "Pharmacology", "topic_name": "Immunomodulators", "id": "ca75ca7c-56b4-4b42-a6dc-e4d8a18f5253", "choice_type": "single"} {"question": "Roxithromycin is", "exp": null, "cop": 1, "opa": "A long acting macrolide", "opb": "Short action quinolone", "opc": "Short acting macrolide", "opd": "Long acting polypeptide", "subject_name": "Pharmacology", "topic_name": null, "id": "1742f7b7-a03c-4dcd-b42d-0f3d55a3302f", "choice_type": "single"} {"question": "Mechanism of action of exenatide in diabetes mellitus is", "exp": "Exenatide is a Glucagon like peptide analogue which is approved as an injectable, adjunctive therapy in persons with type 2 DM Saxagliptin -> DPP4 inhibitor which inhibit the metabolism of GLP-1, therefore increase insulin. Canagliflozin, Dapagliflozin, Empagliflozin, Eugliflozin etc. Drugs-inhibit SGLT-2 -Inhibit glucose reabsorption, -result in glucosuria Pramlintide - amylin analogue - Given subcutaneously", "cop": 1, "opa": "It is analogue of GLP released from gut and increase glucose dependant insulin secretion", "opb": "It is DPP-4 inhibitor and result in decreased breakdown of GLP", "opc": "It inhibits SGLT-2 and cause glucosuria", "opd": "It is amylin analogue and decrease glucagon", "subject_name": "Pharmacology", "topic_name": "FMGE 2019", "id": "9bc1741f-a75f-41c8-973a-a45e96bda4e7", "choice_type": "single"} {"question": "Dopamine agonist used in diabetes", "exp": "Bromocriptine and cabergoline are dopamine agonists but bromocriptine usage in type 2 diabetes is approved.It has an interesting mechanism of action by inhibiting the dopamine dip that causes in early morning leading to hyperglycemia. Ref: Goodman and Gillman 13th ed", "cop": 2, "opa": "Metformin", "opb": "Bromocriptine", "opc": "Cabergoline", "opd": "Vanadium salts", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "1aa45a13-94ca-4936-bde2-46b5527e91ee", "choice_type": "single"} {"question": "Dystrophic calcification is seen in (NOT RELATED)", "exp": ".", "cop": 4, "opa": "Milk alkali syndrome", "opb": "Atheromatous plaque", "opc": "Hyperparathyroidism", "opd": "Vitamin A intoxication", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "65c84c0e-99be-4e74-9b87-2c73f26b74f0", "choice_type": "single"} {"question": "Drug of choice for Bupivacaine induced cardiac arrythmia", "exp": "Bretylium is a class III Antiarrythmic used to treat Bupivacaine induced ventricular tachycardia.", "cop": 3, "opa": "Amiodarone", "opb": "Procainamide", "opc": "Bretylium", "opd": "Flecainide", "subject_name": "Pharmacology", "topic_name": null, "id": "3ad5b6f1-0144-4eb6-9a87-b6367e8b957b", "choice_type": "single"} {"question": "Anticholinesterases with effect on CNS is", "exp": "Refer kDT 6/e p 101 Because it enhances the transmission of acetylcholine signals in the brain and cancross the blood-brain barrier,physostigmine salicylate is used to treat anticholinergic poisoning (that is, poisoning by substances that interfere with the transmission of acetylcholine signaling, such as atropine, scopolamine,", "cop": 3, "opa": "Neostigmine", "opb": "Pyridostigmine", "opc": "Physostigmine", "opd": "Edrophonium", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "4ac27792-53d8-44f5-981a-e7a57b417546", "choice_type": "single"} {"question": "Drug used in the treatment of steroid resistant ulcerative colitiis", "exp": null, "cop": 2, "opa": "Azathioprine", "opb": "Cyclosporine", "opc": "5ASA", "opd": "Racecadotril", "subject_name": "Pharmacology", "topic_name": null, "id": "bebd36d3-4166-4c74-b4c2-fd2cd4bf7cd7", "choice_type": "single"} {"question": "Drug efficacy refers to", "exp": null, "cop": 2, "opa": "Range of diseases in which the drug is beneficial", "opb": "Maximal intensity of response that can be produced by the drug", "opc": "The therapeutic dose range of the drug", "opd": "The therapeutic index of the drug", "subject_name": "Pharmacology", "topic_name": null, "id": "749b3122-0d50-4619-8ae6-1162477e3935", "choice_type": "single"} {"question": "The drug of choice for treatment of meningococcal meningitis is", "exp": "Ans. b. CeftriaxoneRef: Goodman Gilman 13th E/PI 035Ceftriaxone is the drug of choice for treatment of meningitis caused by H. influenza, N. meningitidis (meningococcal meningitis) and S. pneumoniae.Ampicillin is the drug of choice for treatment of meningitis caused by L. monocytogenes.Meningitis seen in post neurosurgery or penetrating head trauma patients caused by staphylococcus, Propionibacterium, pseudomonas or acinetobacter is treated by meropenem+vancomycin.Note: For prophylaxis of meningococcal meningitis (contacts or mass chemoprophylaxis) ciprofloxacin is the drug of choice. Ceftriaxone though us the best drug for prophylaxis is not the drug of choice as it is a parenteral drug.", "cop": 2, "opa": "Piperacillin", "opb": "Ceftriaxone", "opc": "Ampicillin", "opd": "Meropenem", "subject_name": "Pharmacology", "topic_name": "Anti Microbial", "id": "d653240c-9ab4-412a-80a6-3a4643993d78", "choice_type": "single"} {"question": "Fellypressin is a", "exp": null, "cop": 2, "opa": "Vaso dilator", "opb": "Vaso constrictor", "opc": "Neuroleptic drug", "opd": "Anti coagulant", "subject_name": "Pharmacology", "topic_name": null, "id": "bf93b708-a3ee-490e-8d6e-df4f8a2a8439", "choice_type": "single"} {"question": "The selective β1 receptor agonist is", "exp": null, "cop": 1, "opa": "Dobutamine", "opb": "Dopamine", "opc": "Atenolol", "opd": "Salbutamol", "subject_name": "Pharmacology", "topic_name": null, "id": "d7b2c112-c31b-428c-abd0-a0b4ca8f588e", "choice_type": "single"} {"question": "Ebstein anamoly is caused by usage of wof", "exp": "Lithium In take by mother during pregnancy leads to Ebstein anomaly in fetus. Teratogenicity It refers to the capacity of a drug to cause foetal abnormalities when administered to the pregnant mother. The placenta does not constitute a strict barrier, and any drug can cross it to a greater or lesser extent. The embryo is one of the most dynamic biological systems and in contrast to adults, drug effects are often irreversible. The thalidomide disaster (1958-61) resulting in thousands of babies born with phocomelia (seal like limbs). Drugs can affect the foetus at 3 stages-- (i) Feilization and implantation-- conception to 17 days--failure of pregnancy which often goes unnoticed. (ii) Organogenesis-- 18 to 55 days of gestation--most vulnerable period, deformities are produced. (iii) Growth and development-- 56 days onwards-- developmental and functional abnormalities can occur, e.g. ACE inhibitors can cause hypoplasia of organs, especially of lungs and kidneys; NSAIDs may induce premature closure of ductus aeriosus; androgens and progestins cause masculanization of female foetus, antithyroid drugs and lithium cause foetal goiter. Ref:- kd tripathi; pg num:-89", "cop": 2, "opa": "Phenytoin", "opb": "Lithium", "opc": "Warfarin", "opd": "Enalapril", "subject_name": "Pharmacology", "topic_name": "General pharmacology", "id": "5a5cc639-47f8-4ccb-9d37-4e433ec9803a", "choice_type": "single"} {"question": "Majority of drugs are transported across the membrane by", "exp": null, "cop": 1, "opa": "Passive diffusion", "opb": "Active transport", "opc": "Facilitated transport", "opd": "Filtration", "subject_name": "Pharmacology", "topic_name": null, "id": "2541bc86-6b65-4c5f-854a-291886f46ae5", "choice_type": "single"} {"question": "The neuromuscular blocker that does not need reversal of action by neostigmine at the end of the operation is", "exp": "Mivacurium:- It is the shoest acting competitive blocker; does not need reversal. Dose and speed of injection related transient cutaneous flushing can occur due to histamine release. Fall in BP is possible, but change in HR is minimal. It is metabolized rapidly by plasma cholinesterases. Prolonged paralysis can occur in pseudocholinesterase deficiency, but this can be reversed by neostigmine. Ref:- kd tripathi; pg num:-354", "cop": 3, "opa": "Pipecuronium", "opb": "d-Tubocurarine", "opc": "Mivacurium", "opd": "Doxacurium", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "4828f36d-42e7-41f8-a8a2-90602804e383", "choice_type": "single"} {"question": "A partial agonist at acetylcholine nicotinic receptors that can be used in smoking cessation programs is", "exp": null, "cop": 2, "opa": "Acamprosate", "opb": "Varenicline", "opc": "Buprenorphine", "opd": "Nalbuphine", "subject_name": "Pharmacology", "topic_name": null, "id": "cd19c7e9-b44c-4d90-b956-a8131a0c6190", "choice_type": "single"} {"question": "The schematic diagram is depicting some features of autonomic and somatic nervous systems. The neurotransmitter at site 'F' is", "exp": "Acetylcholine (ACh) is the primary transmitter at ANS ganglia and at the somatic neuromuscular junction .Katzung Pharmacology 12th edition Pg: 80", "cop": 1, "opa": "Acetylcholine", "opb": "Norepinephrine", "opc": "Dopamine", "opd": "Epinephrine", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "a0efcd8b-4c21-492c-b2e2-fd570a4fc003", "choice_type": "single"} {"question": "Pembrolizumab is", "exp": "Pembrolizumab and Nevolumab are monoclonal antibodies against PDL1 receptor used in BRAF -ve malignant melanoma.", "cop": 2, "opa": "CTLA4 inhibitor", "opb": "Monoclonal antibody against PDL1 receptor", "opc": "Monoclonal antibody against PD1 ligand", "opd": "Monochonal antibody against CDK416", "subject_name": "Pharmacology", "topic_name": null, "id": "6e2a3f32-b626-40bf-99f9-a484270d10ce", "choice_type": "single"} {"question": "Broad spectrum antifungal agent is", "exp": "(Ketoconazole) (762-KDT 6th)* Ketoconazole - It is the first orally effective broad spectrum antifungal drug useful in both dermatophytosis and deep mycosis a major advance* Terbinafine - is the drug of choice for treating dermatophytoses and especially, oncychomycoses (fungal infections of nails)* It is better tolerated, requires shorter duration of therapy, and is more effective than either itraconazole or griseofulvin (4.10 - Pharmacology - Lippincott's 3rd) Rifampicin decreases blood levels & cimetidine increases blood levels of terbinafine", "cop": 3, "opa": "Econazole", "opb": "Miconazole", "opc": "Ketoconazole", "opd": "Clotrimazole", "subject_name": "Pharmacology", "topic_name": "Anti Microbial", "id": "ffbd88ab-68e9-46d3-bd8a-f609bbcf95fd", "choice_type": "single"} {"question": "Cardiotoxicity is the side effect of", "exp": "Ans. is 'c' i.e., Rubidomycin Anthracycline induced cardiotoxicity* Rubidomycin and doxorubicin are the anthracycline anti - tumor antibiotics* They have cardiotoxicity as a adverse effect.* This can manifest either acutely with ECG changes, arrhythmias and hypotension, which are reversible, or be delayed like CHF.* CHF is due to cardiomyopathy and may be fatal.* To prevent the chances of anthracycline induced cardiomyopathy, antioxidants like dexrazone can be used.", "cop": 3, "opa": "Bleomycin", "opb": "Topotecan", "opc": "Rubidomycin", "opd": "Procarbazine", "subject_name": "Pharmacology", "topic_name": "Anti-Cancer", "id": "e98c3402-2432-4516-bd86-1925e5484754", "choice_type": "single"} {"question": "Potassium Iodide given for cough acts as", "exp": "Potassium Iodide is an expectorant that increases bronchial secretion either directly by irritating bronchial glands or indirectly by causing gastric irritation.", "cop": 2, "opa": "Central antitussive", "opb": "Expectorant", "opc": "Peripheral antitussive", "opd": "Mucolytic", "subject_name": "Pharmacology", "topic_name": null, "id": "f278e2e5-9680-4bcc-b6ec-c0ac310a0e4a", "choice_type": "single"} {"question": "Thrombolytics can provide relative morality reduction in the treatment of acute myocardial infarction if patient comes within", "exp": "Thrombolytic drugs should be given within 12 hours after onset of acute MI and within 3 hours of acute stroke Refer Harrison 18/e p2027", "cop": 2, "opa": "6 hrs", "opb": "12 hrs", "opc": "18 hrs", "opd": "24 hrs", "subject_name": "Pharmacology", "topic_name": "Hematology", "id": "b884f99f-bfb1-4c31-ab35-4e4164649563", "choice_type": "single"} {"question": "Pulmonary fibrosis is a side effect of", "exp": "Ans. is 'c' i.e., Bleomycin Pulmonary infiltrates are seen with 3 of the given options - Methotrexate Bleomycin CyclophosphamidePulmonary fibrosis is seen with two of the given optionsBleomycin (Page 1395 G & G 10th/e)Cyclophosphamide (page 1430 G & G 10th/e)I have gone for Bleomycin because pulmonary involvement is most common with Bleomycin.\"The most serious adverse reaction to Bleomycin is pulmonary toxicity, which begins with dry, cough, fine rales, and diffuse basilar infiltrates on x-ray and may progress to life threatening pulmonary fibrosis\"", "cop": 3, "opa": "Methotrexate", "opb": "Vincristine", "opc": "Bleomycin", "opd": "Cyclophosphamide", "subject_name": "Pharmacology", "topic_name": "Anti-Neoplastic Agents", "id": "9b3a1f2a-931e-4876-90a4-08d2f6c4f043", "choice_type": "single"} {"question": "Thiazides can cause", "exp": "Anti hypeensive agents like thiazides and -blockers can cause impotence. It is maximum with thiazides among anti-hypeensive drugs and is thought to be due to volume depletion.", "cop": 4, "opa": "Hyperkalemic paralysis", "opb": "Hypouricemia", "opc": "Hypolipidemia", "opd": "Impotence", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "f5e0a817-186f-411b-b279-ffe1f799bfa6", "choice_type": "single"} {"question": "Drug of choice for Hairy cell leukemia", "exp": "Cladribine is a purine analogue, which is  DOC for Hairy cell leukemia.", "cop": 3, "opa": "Methotrexate", "opb": "Gemcitabine", "opc": "Cladribine", "opd": "Decitabine", "subject_name": "Pharmacology", "topic_name": null, "id": "7d887bc4-619f-4b11-a235-c29044e6140c", "choice_type": "single"} {"question": "Anti arrhythmic drug is", "exp": "Refer kDT 7/e p 529 Phentolamine is a synthetic imidazoline with alpha-adrenergic antagonist activity. As a competitive alpha-adrenergic antagonist, phentolamine binds to alpha-1 and alpha-2 receptors, resulting in a decrease in peripheral vascular resistance and vasodilatation. Phenobarbital belongs to a class of drugs known as barbiturate anticonvulsants/hypnotics. Pentamidine is an antimicrobial medication used to treat African trypanosomiasis, leishmaniasis, babesiosis, and to prevent and treat pneumocystis pneumonia in people with poor immune function", "cop": 3, "opa": "Phentolamine", "opb": "Phenobarbitone", "opc": "Procainamide", "opd": "Pentamidine", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "fb520cde-9554-4433-9001-aea93e2f2c0b", "choice_type": "single"} {"question": "Low molecular weight heparin inhibits", "exp": "Prophylaxis of neural tube defects require treatment with folic acid.\nMethotrexate toxicity can be prevented by 5′-formyltetrahydrofolate (folinic acid).\nPernicious anemia requires the therapy with vitamin B12\nAnemia associated with chronic renal failure is treated with erythropoietin.", "cop": 2, "opa": "Factor Xa", "opb": "Factor Xa and II a", "opc": "Factor II a", "opd": "Factors II, VII, IX and X", "subject_name": "Pharmacology", "topic_name": null, "id": "f3a53351-c89f-41eb-a5be-e4fe88b2fa56", "choice_type": "single"} {"question": "Status epilepticus Drug of choice is", "exp": "LORAZEPAM iv is considered as the firset drug to be given followed by phenytoin. Ref: KD Tripathi 8th ed.", "cop": 1, "opa": "Benzodiazepine", "opb": "Valproate", "opc": "Barbiturate", "opd": "Ethosuximide", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "4beebb49-613f-4d55-9bbc-98b88699c3f1", "choice_type": "single"} {"question": "The mechanism of action of Apixaban is", "exp": "(B) Factor Xa inhibitor[?]APIXABAN is an oral anticoagulant and a highly selective direct inhibitor of factor Xa with rapid onset of action.oUsed to decrease the risk of venous thromboses, systemic embolization and stroke in patients with atrial fibrillation, and lower the risk of deep vein thrombosis and pulmonary embolus after knee or hip replacement surgery.oApixaban has been linked to a low rate of serum aminotransferase elevations during therapy and to rare instances of clinically apparent liver injury.oIt does not require routine laboratory monitoring in the majority of patients except in special situations such as serious bleeding into critical organs, potential overdose, emergency surgery.oOther new oral anticoagulants include edoxaban, betrixaban oDirect X2 inhibitoroAnticoagulant for treatment & prophylaxis of venous thromboembolic events", "cop": 2, "opa": "Direct thrombin inhibitor", "opb": "Factor Xa inhibitor", "opc": "Antithrombin 3 activator", "opd": "Vitamin K antagonist", "subject_name": "Pharmacology", "topic_name": "Hematology", "id": "5efd3faa-de13-402f-b04d-5cf8f6fa6532", "choice_type": "single"} {"question": "Progesterone is added to estrogens in H to achieve wof effects", "exp": "Hormone replacement therapy (H) In nonhysterectomised postmenopausal women estrogen therapy is supplemented with a progestin for 10-12 days each month to counteract the risk of inducing endometrial carcinoma. Ref:- kd tripathi; pg num:-318", "cop": 2, "opa": "Decrease the estrogen action on the breast", "opb": "Decrease the occurrence of endometrial cancers", "opc": "Increase the effectiveness of the estrogens", "opd": "Inhibit bone resorption", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "59c75220-9b11-48e3-afb7-684f88ec8d33", "choice_type": "single"} {"question": "Mechanism of action of Levetiracetam is", "exp": "Levetiracetam blocks SV2A which is a synaptic vesicular protein & inhibits release of excitatory neurotransmitters.", "cop": 1, "opa": "Blocking SV2A protein", "opb": "Inhibiting reuptake of GABA", "opc": "Inhibiting GABA transaminase enzyme", "opd": "Calcium channel blocker", "subject_name": "Pharmacology", "topic_name": null, "id": "a0db7a30-caeb-47ec-8670-92ff0f76a400", "choice_type": "single"} {"question": "First drug of choice for acute pulmonary edema is", "exp": "Ans. is 'a' i.e., Furosemide o Loop diuretics (Furosemide) is the DOC for acute pulmonary edema.o In acute left ventricular failure and pulmonary edema, furosemide has benefical effect because of venodilatory action (not because of diuretic action).o Intravenous furosemide causes promt increase in systemic venous capacitance and decreases left ventricular filling pressure even before the diuretic action becomes apparent.", "cop": 1, "opa": "Furosemide", "opb": "Morphine", "opc": "Aminophyline", "opd": "Oxygen", "subject_name": "Pharmacology", "topic_name": null, "id": "5458cac8-6111-4269-9f27-46adb3f6d166", "choice_type": "single"} {"question": "Longest acting insulin", "exp": "Degludec is the longest acting insulin.it acts for 42hrs so it can be given even once every alternate day. Other long-acting which acts for 24 hrs is glargine, detemir. They are insulin analogues. Ref: KD Tripathi 8th ed.", "cop": 1, "opa": "Degludec", "opb": "Aspa", "opc": "Regular insulin", "opd": "Glargine insulin", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "55acb643-2348-40ea-8030-3317b6a92920", "choice_type": "single"} {"question": "Longest acting oral sulphonamide is", "exp": "Sulphadoxine is the longest acting orally absorbable drug. Mafenide is a topical drug.sulphadiazine and sulfacetamide are sho-acting oral drugsRef: KD Tripathi 6th ed .pg: 684", "cop": 1, "opa": "Sulphadoxine", "opb": "Sulphadiazine", "opc": "Sulphacetamide", "opd": "Mafenide", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "675c4561-fff5-4dae-bd8f-9348f9cdb7c3", "choice_type": "single"} {"question": "One of the following activities is not meditated through beta 2 adrenergic receptor", "exp": "Beta-agonist produce smooth muscle relaxation, bronchodilation, vasodilatation and uterine stimulation through beta 2 receptors. Also, Beta 3 receptors are located on adipocytes, not beta 2 beta 1- hea From medical pharmacology Padmaja 4th edition page no 101,105", "cop": 1, "opa": "Stimulation of lipolysis", "opb": "Increased hepatic gluconeogenesis", "opc": "Increased muscle gluconeogenesis", "opd": "Smooth muscle relaxation", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "31c4360d-403e-4b97-a78b-7f356a8aeab6", "choice_type": "single"} {"question": "Fexofenadine is metabolic product of", "exp": "Terfenadine acts as a peripherally-selectiveantihistamine, or antagonist of the histamine H1 receptor. It is a prodrug, generally completely metabolized to the active form fexofenadine in the liver by the enzyme cytochrome P450 3A4. Due to its near complete metabolism by the liver immediately after leaving the gut, terfenadine normally is not measurable in the plasma. Terfenadine itself, however, is cardiotoxic at higher doses, while its major active metabolite is not. Refer kDT 6/e p158", "cop": 4, "opa": "Loratidine", "opb": "Astemizole", "opc": "Cetrizine", "opd": "Terfenadine", "subject_name": "Pharmacology", "topic_name": "Autacoids", "id": "10899191-b02f-4355-b84a-27ae091ce065", "choice_type": "single"} {"question": "Drug of choice for the following condition is (endoscopic view)", "exp": "The picture shows esophageal candidiasis for which azoles are used.fluconozole is preferred due to better safety profile than ketoconazole .clotrimazole, nystatin is topical antifungal drugsRef: KD Tripathi 6th ed pg 761", "cop": 4, "opa": "Ketoconazole", "opb": "Clotrimazole", "opc": "Nystatin", "opd": "Fluconozole", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "05cf57aa-868c-4eba-96a0-db61efd74f6b", "choice_type": "single"} {"question": "Drug of choice for Late East African Trypanosomiasis", "exp": "Early east African trypanosomiasis : Suramine\nLate east African trypanosomiasis : Melarsoprol\nAmerican trypanosomiasis : Benznidazole", "cop": 3, "opa": "Pentamidine", "opb": "Suramine", "opc": "Melarsoprol", "opd": "Nifurtimox", "subject_name": "Pharmacology", "topic_name": null, "id": "6c8b275b-574c-43a4-a251-bb834c22830d", "choice_type": "single"} {"question": "The primary mechanism of action of local anesthetics is", "exp": "The primary mechanism of action of local anaesthetics is the blockade of voltage-gated sodium channels Ref: Katzung 13e pg:443", "cop": 1, "opa": "Blockade of voltage-gated sodium channels", "opb": "Stimulation of voltage-gated N-type calcium channels", "opc": "Activation of ligand-gated potassium channels", "opd": "Blockade the GABA-gated chloride channels", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "051e1a66-fd21-455d-9a05-227406cf8873", "choice_type": "single"} {"question": "Many signaling pathways involve the generation of inositol trisphosphate (IP3) and diacylglycerol (DAG). These molecules", "exp": "IP3 DAG are secondary messengers derived from PIP2 they are present in the cell membrane where IP2 crosses the cell membrane and DAG doesnot. Ref: KD Tripathi 8th ed.", "cop": 3, "opa": "Are first messengers", "opb": "Activate phospholipase C", "opc": "Are derived from PIP2", "opd": "Can't activate calcium calmodulin-dependent protein kinases directly or indirectly", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "86798aef-0077-456c-9dff-aab8372048d2", "choice_type": "single"} {"question": "Bronchodilator in COPD", "exp": "Ans. is 'a' i.e., Anticholinergics Anticholinergic bronchodilators Anticholinergic acts on receptors located mainly in the larger central airways (Contrast sympathomimetics whose primary site of action is peripheral bronchioles). Parasympathetic tone is the major reversible factor in COPD. Anticholinergics are more effective than sympathomimetics. Ipratropium and tiotropium are anticholinergic bronchodilators. Tiotropium is longer acting than ipratropium. Inhaled ipratropium / tiotropium are bronchodilators of choice in COPD.", "cop": 1, "opa": "Anticholinergics", "opb": "Antiadrenergic", "opc": "Cholinergic", "opd": "Alfa agonists", "subject_name": "Pharmacology", "topic_name": null, "id": "67ea4352-123c-46df-85be-d592de43a68a", "choice_type": "single"} {"question": "Ethosuximide can be used for the treatment of", "exp": "The only indication for ethosuximide is absence ccizures; in that also it has been superseded by valproate. ::ON: 20-30 mg/kg/day; ZARONTIN 250 mg/5 ml yr. Ref: KD TRIPATHI 8th ed.", "cop": 2, "opa": "Generalized tonic clonic seizure", "opb": "Absence seizures", "opc": "Complex seizures", "opd": "Myoclonic seizures", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "91053974-39f8-459e-9114-ecbb82b6de29", "choice_type": "single"} {"question": "Best treatment of severe digitalis toxicity is", "exp": "The primary treatment of digoxin toxicity is digoxin immune fab, which is an antibody made up of anti-digoxin immunoglobulinfragments. This antidote has been shown to be highly effective in treating life-threatening signs of digoxin toxicity such as hyperkalemia, hemodynamic instability, and arrhythmias. Fab dose can be determined by two different methods. First method is based on the amount of digoxin ingested whereas the second method is based on the serum digoxin concentration and the weight of the person. Other treatment that may be used to treat life-threatening arrhythmias until Fab is acquired are magnesium, phenytoin, and lidocaine. Magnesium suppresses digoxin-induced ventricular arrhythmias while phenytoin and lidocaine suppresses digoxin-induced ventricular automaticity and delay afterdepolarizations without depressing AV conduction. In the case of an abnormally slow hea rate (bradyarrhythmias), Atropine, catecholamines (isoprenaline or salbutamol), and/or temporary cardiac pacing can be used Refer kDT 6/e p499", "cop": 4, "opa": "Potassium supplements", "opb": "Diphenyl hydantoin", "opc": "Quinidine", "opd": "Fab fragments of digitalis antibody", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "81e61f89-e281-46a5-87d1-be624f9c9335", "choice_type": "single"} {"question": "Flumazenilis", "exp": "(Benzodiazepine antagonist) (399-KDT6th)* Flumazenil - Benzodiazepine antagonistUses - (i) To reverse BZD anaesthesia (ii) BZD overdose* Melatonin receptor agonist - Ramelteon", "cop": 1, "opa": "Benzodiazepine antagonist", "opb": "Benzodiazepine agonist", "opc": "Melatonin receptor agonist", "opd": "GABA analogue", "subject_name": "Pharmacology", "topic_name": "C.N.S", "id": "31e32235-2dde-407a-a700-452375a323cc", "choice_type": "single"} {"question": "Inverse agonist of BZD", "exp": "beta carboline is an inverse agonist of BDZ .", "cop": 1, "opa": "Beta-carboline", "opb": "Bicuculine", "opc": "Baclofen", "opd": "Diazepam", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "f6107c47-9c06-4814-bd8e-541a5e70c3fd", "choice_type": "single"} {"question": "Drug treatment for tardive dyskinesia is", "exp": "Tardive dyskinesia is late symptom which appears on treatment with typical antipsychotic like haloperidol. It occurs due to D2 receptor supersensitivity. Treatment of choice is valbenazine - Ropinirole is used for Restless leg syndrome - Tetrabenazine is drug used in Huntington's chorea - Biperidin is used in drug induced Parkinsonism.", "cop": 1, "opa": "Valbenazine", "opb": "Ropinirole", "opc": "Tetrabenazine", "opd": "Biperiden", "subject_name": "Pharmacology", "topic_name": "Psychiatric Illness", "id": "80f11647-fd48-48f7-a6c6-3296d80841d9", "choice_type": "single"} {"question": "The microsomal enzyme involved in the metabolism of omeprazole is", "exp": "Omeprazole and clopidogrel are mainly metabolized by CYP2C19.Other drugs metabolized by this enzyme are anti anxiety drugs like diazeoam. Induced by drugs rifampicin and barbituates. Ref: KATZUNG; 13th ed / Page: 80", "cop": 2, "opa": "CYP 2A", "opb": "CYP 2C19", "opc": "CYP 2C8", "opd": "CYP 2B", "subject_name": "Pharmacology", "topic_name": "General pharmacology", "id": "27df7cf8-f170-47ba-affe-ccff97dd3fd7", "choice_type": "single"} {"question": "Local anesthetic action is a result of blockade of the movement of wof channels", "exp": "LOCAL ANAESTHETICS MECHANISM OF ACTION The LAs block nerve conduction by decreasing the entry of Na+ ions during upstroke of action potential (AP). As the concentration of the LA is increased, the rate of rise of AP and maximum depolarization decreases causing slowing of conduction. Finally, local depolarization fails to reach the threshold potential and conduction block ensues. The LAs interact with a receptor situated within the voltage sensitive Na+ channel and raise the threshold of channel opening: Na+ permeability fails to increase in response to an impulse or stimulus. Impulse conduction is interrupted when the Na+ channels over a critical length of the fibre (2-3 nodes of Ranvier in case of myelinated fibres) are blocked. Ref:- kd tripathi; pg num:-361", "cop": 2, "opa": "Chloride", "opb": "Sodium", "opc": "Potassium", "opd": "Calcium", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "e4405a08-da20-4973-912c-844267b940d7", "choice_type": "single"} {"question": "Concurrent administration of tetracyclines is most likely to impair the action of", "exp": null, "cop": 4, "opa": "Lincomycin", "opb": "Chloramphenicol", "opc": "Erythromycin", "opd": "Penicillin", "subject_name": "Pharmacology", "topic_name": null, "id": "82faccba-1ea9-4ee8-ac0a-4c364348992f", "choice_type": "single"} {"question": "Sialogouges are", "exp": null, "cop": 1, "opa": "Increases salivary secretions", "opb": "Decreases salivary secretions", "opc": "Indicator dye for sialography", "opd": "Medication for over function", "subject_name": "Pharmacology", "topic_name": null, "id": "03467deb-69c8-4cd7-b9bc-9a5b3cb7a598", "choice_type": "single"} {"question": "Heparin induced thrombocytopenia is due to antibodies against", "exp": "Antibodies against platelet factor-4 (PF-4) causes aggregation of platelets and thrombosis, thus leads to thrombocytopenia.", "cop": 4, "opa": "PF - 1", "opb": "PF - 2", "opc": "PF - 3", "opd": "PF - 4", "subject_name": "Pharmacology", "topic_name": null, "id": "e2d194b0-cb28-4ed3-ade0-ab9a1e91806b", "choice_type": "single"} {"question": "Vorapaxar acts by inhibiting", "exp": "Vorapaxar inhibits Protease Activated Receptor 1 (PAR1) which is a thrombin receptor and thus can be used as a antiplatelet drug in M.I", "cop": 3, "opa": "GPIIa / IIIb", "opb": "P2Y12 receptor", "opc": "PAR - 1", "opd": "Antithrombin - 3", "subject_name": "Pharmacology", "topic_name": null, "id": "6d43fbe8-aba0-4297-9a41-8a79d5abc337", "choice_type": "single"} {"question": "Reflex tachycardia is most likely to occur after the systemic administration of", "exp": "Although used primarily via inhalation for asthma, systemic effects of albuterol include vasodilation due to its b2 receptor activation. This can result in a decrease in PVR and mean BP, which elicits a reflex tachycardia. Methoxamine and phenylephrine are a- receptor activators causing vasoconstriction, which would result in reflex bradycardia. Ganglion blockers (trimethaphan) prevent autonomic reflexes, and a reflex increase in heart rate could not occur in the presence of a beta blocker (propranolol).", "cop": 1, "opa": "albuterol", "opb": "methoxamine", "opc": "phenylephrine", "opd": "propranolol", "subject_name": "Pharmacology", "topic_name": "A.N.S.", "id": "17f9b2f8-7f4e-46fd-8910-178b25d44603", "choice_type": "single"} {"question": "Drug useful in breast cancer is", "exp": "Medications Estrogen modulator, Chemotherapy, Hormone based chemotherapy, and Bone health", "cop": 1, "opa": "Tamoxifen", "opb": "Cyprotenene", "opc": "Testosterone", "opd": "Chlorambucil", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "b98a3c6c-8089-47ea-9847-8ad54c2e7af4", "choice_type": "single"} {"question": "Mogamulizumab was approved by FDA recently for", "exp": "Recently approved for non hodgkins lymphoma.", "cop": 4, "opa": "Prostate cancer", "opb": "Breast cancer", "opc": "Hodgkins lymphoma", "opd": "Non-Hodgkins lymphoma", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "9baf2159-e9a4-4ead-895a-b996aff76b52", "choice_type": "single"} {"question": "Depression is not a side effect of", "exp": "Answer is option4, flupenthisol. The antidepressive and anxiolytic efficacy of flupenthixol has been investigated in numerous controlled and open trials involving patients with endogenous, reactive as well as senile depressions. When administered at a mean daily single or multiple dose of 1-2 mg, flupenthixol proved to be a very effective and well-tolerated antidepressant. As opposed to some of the currently available antidepressants, flupenthixol has a rapid onset of action which is often displayed within the first 2-3 days following its application. Ref:", "cop": 4, "opa": "Propanolol", "opb": "Oral contraceptives", "opc": "Reserpine", "opd": "Flupenthixol", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "50cb0de0-10bf-4040-adbe-047f0ab6fbad", "choice_type": "single"} {"question": "Sildenafil should not be used in", "exp": "Sildenafil inhibits PDE-5 and prevents Nitric oxide (NO) degradation. Increased NO results in vasodilation. It should not be used in patients taking vosodilators as it can lead to sudden hypotension.", "cop": 2, "opa": "Diabetics", "opb": "Patients on vasodilator therapy", "opc": "Pulmonary hypertension", "opd": "Erectile dysfunction", "subject_name": "Pharmacology", "topic_name": null, "id": "05c19855-310d-43fb-9a83-09765ba18fe4", "choice_type": "single"} {"question": "Constipation is a possible side effect of drugs taken by the oral route, but it is highly unlikely to occur with the use of", "exp": "Docusate is a stool-softening laxative that facilitates mixing of oil and water via its surfactant properties. Drugs that have muscarinic blocking effects, like scopolamine and the antihistamines diphenhydramine and promethazine, tend to cause constipation by decreasing GI motility. Loperamide is an opioid derivative, with no analgesic activity, used in the treatment of diarrheal states.", "cop": 2, "opa": "diphenhydramine", "opb": "docusate", "opc": "promethazine", "opd": "loperamide", "subject_name": "Pharmacology", "topic_name": "General Pharmacology", "id": "e42769f2-05fe-4da1-8842-9b2dd0a54a18", "choice_type": "single"} {"question": "Probencide interacts with", "exp": "Interaction of probeecid Competitively blocks active transpo of organic acids at all sites especially renal tubules. it inhibits excretion of penicillin or ampicellin and increases its blood level It also inhibits urinary excretion of cephalosporins, sulfonamides, methotrexates and indomethacin. It enables tubular secretion of nitrofurantoin Salicylates, pyrazinamide and ethambutol inhibit uricosuric action of probeecid It inhibits biliary excretion of rifampicin Refer kDT 6/e p209", "cop": 2, "opa": "Streptomycin", "opb": "Ampicillin", "opc": "Vancomycin", "opd": "Erythromycin", "subject_name": "Pharmacology", "topic_name": "Autacoids", "id": "59e2315f-7439-4f37-8342-3ee6d87b05c6", "choice_type": "single"} {"question": "Urination in the human subject is decreased by", "exp": "ANTICHOLINERGIC DRUGS (Muscarinic receptor antagonists, Atropinic, Parasympatholytic) Smooth muscles:- All visceral smooth muscles that receive parasympathetic motor innervation are relaxed by atropine (M3 blockade). Tone and amplitude of contractions of stomach and intestine are reduced; the passage of chyme is slowed--constipation may occur, spasm may be relieved. Atropine has relaxant action on ureter and Urinary bladder; urinary retention can occur in older males with prostatic hyperophy. However,this relaxant action can be beneficial for increasing bladder capacity and controlling detrusor hyperreflexia in neurogenic bladder/enuresis. Ref:- kd tripathi; pg num:-114,115", "cop": 4, "opa": "Nicotinic agonists", "opb": "AChase inhibitors", "opc": "muscarinic agonists", "opd": "muscarinic antagonists", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "a6d73ebf-f9fc-4d17-a59d-d184ac64c8f2", "choice_type": "single"} {"question": "Tadalafil inhibits", "exp": "Tadalafil & Sildenafil inhibits Phosphodiesterase - 5 (PDE -5) and increase cGMP, They are used in pulmonary hypertension & erectile dysfunction.", "cop": 3, "opa": "PDE - 3", "opb": "PDE - 4", "opc": "PDE - 5", "opd": "PDE - 6", "subject_name": "Pharmacology", "topic_name": null, "id": "e67beafc-19c5-4dc8-adf4-003eb52067f2", "choice_type": "single"} {"question": "Imatinib is used in the treatment of", "exp": "Imatinib is used in the treatment of certain types of leukemia and gastrointestinal stromal tumors (GIST). \nThis medication is also used to treat dermatofibrosarcoma protuberans, a type of skin tumor. Imatinib is a biologic drug, also known as targeted therapy.", "cop": 4, "opa": "Chronic myelomonocytic leukemia", "opb": "Myelodysplastic syndrome", "opc": "Acute lymphoblastic leukemia", "opd": "Gastrointestinal stromal tumors", "subject_name": "Pharmacology", "topic_name": null, "id": "f4237d88-6841-439b-898a-84d37bbf9fba", "choice_type": "single"} {"question": "Quinidine exes action on hea by", "exp": "Refer katzung 11e p 237 * Mechanism of action Like all other class I antiarrhythmic agents, quinidine primarily works by blocking the fast inward sodium current (INa). ... The effect of blocking the fast inward sodium current causes the phase 0 depolarization of the cardiac action potential to decrease (decreased Vmax).", "cop": 2, "opa": "Ca+ Channel blocker", "opb": "Kt Channel blocker", "opc": "Na+ Channel opener", "opd": "Cl+ Channel opener", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "4c00e498-9483-4d46-90e1-05db764595c1", "choice_type": "single"} {"question": "Bulls eye retinopathy is seen in", "exp": "Refer Kanski clinical ophthalmology 6/e p842-843 Chloroquine can cause Bulls eye retinopathy. The risk of retinotoxicity increases significantly with cumulative dose of more than 300 g.it is rare if duration is less than than one year", "cop": 1, "opa": "Chloroquine", "opb": "Methanol", "opc": "Ethambutol", "opd": "Steroids", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "68b92cc6-540a-4563-b552-ac5d69073bb1", "choice_type": "single"} {"question": "Opioid agonist are ALE aEUR'", "exp": "Ketamine", "cop": 3, "opa": "Morphine", "opb": "Codeine", "opc": "Ketamine", "opd": "Methadone", "subject_name": "Pharmacology", "topic_name": null, "id": "d02d6a95-02d4-4597-900c-3181ae17980d", "choice_type": "single"} {"question": "The activation of muscarinic receptors in bronchiolar smooth muscle is associated with", "exp": "M3 receptors:- Visceral smooth muscle contraction and glandular secretions are elicited through M3 receptors, which also mediate vasodilatation through EDRF release. The muscarinic receptors are G-protein coupled receptors having the characteristic 7 membrane traversing amino acid sequences. The M1 and M3 (also M5) subtypes function through Gq protein and activate membrane bound phospholipase C (PLc)--generating inositol trisphosphate (IP3) and diacyl-glycerol (DAG) which in turn release Ca2+ intracellularly-- cause depolarization, glandular secretion, raise smooth muscle tone and release NO (from endothelium). They also activate phospholipase A2 resulting in enhanced synthesis and release of prostaglandins and leucotrienes in ceain tissues. Ref:- kd tripathi; pg num:-101,102", "cop": 1, "opa": "Increase in IP3 and DAG", "opb": "Inhibition of protein kinase C", "opc": "Activation of adenylyl cyclase", "opd": "Opening of Na + /K +cation channels", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "63fb511c-ffda-4763-83c8-fa4b4c390311", "choice_type": "single"} {"question": "Effect of atropine on eye is", "exp": "Parasympatholytics like atropine produce passive mydriasis due to blockade of m3 receptors. sympathomimetics produce active mydriasis due to contraction of dilator papillae Ref: Katzung 11th ed pg 117", "cop": 2, "opa": "Active mydriasis", "opb": "Passive mydriasis", "opc": "Miosis", "opd": "Pin point pupil", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "ca8c7c2e-df00-4adc-8eab-79847bcfe53e", "choice_type": "single"} {"question": "The positive inotropic effect of digitalyzers is due to invitation of Na+/K+ ATPase pump in cardiac muscle cell membrane leading to", "exp": "Ref-Goodman and Gillman 12/e p802,803 The positive inotropic effect of digitalis is due to inhibition of Na+/K+ ATPase pump in cardiac muscle cell membrane leading to decreased activity of Na+/Ca++ exchanger causing decrease the influx of sodium and decreased efflux of CA++ in the sarcolemma", "cop": 1, "opa": "Decrease the activity of Na+/Ca+ exchanger causing decrease the influx of sodium and decreased efflux of Ca++ in the sarcolemma", "opb": "Decreased efflux of Na+ leading to less negative resting membrane potential and opening of voltage gated Ca+ + channels on the T tubules", "opc": "Increased intracellular Na+ causing increased efflux of any place and increase the influx of Ca + + through Na+/ Ca + + exchanges in sarcolemma", "opd": "Increased intracellular Na+ decreasing the activity of Ca + + pump in the sarcoplasmic reticulum", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "5007ba16-4a50-4da7-a156-6ee4cc831606", "choice_type": "single"} {"question": "Pirenzepine is used for", "exp": "Pirenzepine & Telenzepine are M1 antagonists used for peptic ulcer disease.", "cop": 1, "opa": "Peptic ulcer", "opb": "Motion sickness", "opc": "Constipation", "opd": "Bronchial asthma", "subject_name": "Pharmacology", "topic_name": null, "id": "71dd22dc-77d5-4765-ae3e-aba5ca213597", "choice_type": "single"} {"question": "The following can be used to antagonise the action of heparin in case of overdose", "exp": "HEPARIN ANTAGONIST Protamine sulfate Given i.v. it neutralises heparin weight for weight, i.e. 1 mg is needed for every 100 U of heparin. For the treatment of heparin induced bleeding, due consideration must be given to the amount of heparin that may have been degraded by the patient's body in the mean time. However, it is needed infrequently because the action of heparin disappears by itself in a few hours, and whole blood transfusion is needed to replenish the loss when bleeding occurs. Protamine is more commonly used when heparin action needs to be terminated rapidly, e.g. after cardiac or vascular surgery. Ref:- kd tripathi; pg num:-620", "cop": 4, "opa": "Heparan sulfate", "opb": "Dextran sulfate", "opc": "Ancrod", "opd": "Protamine sulfate", "subject_name": "Pharmacology", "topic_name": "Hematology", "id": "c0911f53-c0b7-4240-a823-1b2675744bfd", "choice_type": "single"} {"question": "DOC for acute attack of Hereditary angioneurotic edema", "exp": "Medication C1 inhibitor concentrate (Plasma-derived) (Berine, Berine P, Cinryze. Recombinant C1 inhibitor Conestat alfa (Ruconest, Rhucin). Bradykinin Bzreceptor antagonist Icatibant (Firazyr). Kallikrein inhibitor Ecallantide (Kalbitor) REF : katzung pharmacology : 14th ed", "cop": 2, "opa": "Danazol", "opb": "Cl, inhibitor concentrate", "opc": "Icatibant", "opd": "Methylprednisolone", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "ef8a8295-cecc-4df3-959a-f16cbe81ed6f", "choice_type": "single"} {"question": "Red man syndrome is seen with", "exp": "Ans. (b) Vancomycin", "cop": 2, "opa": "Lincomycin", "opb": "Vancomycin", "opc": "Linezolide", "opd": "Carbanicilliase", "subject_name": "Pharmacology", "topic_name": "Adverse Drug Effect", "id": "6948d174-267e-490e-9f42-a9cb97c6dd19", "choice_type": "single"} {"question": "Secukinumab is", "exp": "Ustekinumab (anti-IL-12/23) and secukinumab (anti-IL-17) monoclonal antibodies have shown promising efficacy in clinical trials, but have not yet been approved for use in Ankylosing Spondylitis. Reference: Harrison&;s Principles of Internal Medicine; kd tripathi 9th ed", "cop": 3, "opa": "Anti IL 1", "opb": "Anti IL 6", "opc": "Anti IL 17", "opd": "Anti IL 23", "subject_name": "Pharmacology", "topic_name": "General pharmacology", "id": "a07c31a4-f22f-4c62-b780-dd7a54929f49", "choice_type": "single"} {"question": "The antiviral drug recommended for treatment of Herpes Zoster infection of Trigeminal nerve\ndistribution in an immunocompromised host is", "exp": null, "cop": 3, "opa": "Fomivirsen", "opb": "Vidarabin", "opc": "Famciclovir", "opd": "Entecavir", "subject_name": "Pharmacology", "topic_name": null, "id": "126451fa-6f10-4146-be75-04f31db75383", "choice_type": "single"} {"question": "Most potent cycloplegic among the following", "exp": null, "cop": 3, "opa": "Tropicamide", "opb": "Cyclopentolate", "opc": "Atropine", "opd": "Umeclidinum", "subject_name": "Pharmacology", "topic_name": null, "id": "6f3db3b7-d814-41b6-98a1-c740fd1ebc08", "choice_type": "single"} {"question": "Low Vd means", "exp": "The volume of distribution (V) relates the amount of drug in the body to the concentration of drug (C) in blood or plasmaVd = amount of drug in body/concentration of drug (C)Drugs with low volumes of distribution have much lower concentrations in extravascular tissue than in the vascular compament.Katzung Pharmacology 12th edition Pg: 38", "cop": 2, "opa": "The drug has low half life", "opb": "The drug does not accumulate in tissues", "opc": "The drug has low bioavailability", "opd": "The drug has weak plasma protein binding", "subject_name": "Pharmacology", "topic_name": "General pharmacology", "id": "bcd28813-a1dc-492e-b93d-74b2f4afe802", "choice_type": "single"} {"question": "Carbapenem with maximum seizure risk is", "exp": "* Imipenem is a Carbapenem group of Beta-Lactam antibiotic with highest propensity to induce seizures compared to the other Carbapenem congeners. * Seizure is noted in 1.5% patients receiving Imipenen. Seizure risk is increased in patients receiving high doses in the presence of renal insufficiency and CNS lesions. Ref:- Goodman & Gilman Pharmacological Basis of Therapeutics 13th Ed; Pg num:- 1035", "cop": 2, "opa": "Doripenem", "opb": "Imipenem", "opc": "Eapenem", "opd": "Meropenem", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "5dc8c675-2f3f-4065-88ee-b7b5cf17395a", "choice_type": "single"} {"question": "Multiple drug resistance is transferred through", "exp": "Refer KDT 6/e p 671 Multiple drug resistance is transferred through Pladmids Mostly by conjugation", "cop": 3, "opa": "Transduction", "opb": "Transformation", "opc": "Conjugation", "opd": "Mutation", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "664c234c-fd8d-4bdf-93ab-b91a8ab4c420", "choice_type": "single"} {"question": "Topical Antifungal agent in candidiasis is", "exp": null, "cop": 1, "opa": "Clotrimazole", "opb": "Clotrimoxazole", "opc": "Ornidazole", "opd": "Propranolol", "subject_name": "Pharmacology", "topic_name": null, "id": "2470a521-0889-4e78-9210-83f0b4c881d3", "choice_type": "single"} {"question": "One of the following is a prodrug", "exp": "Ans. is 'a' i.e. Enalapril Remember, * The end result of drug metabolism is usually the abolition of activity of the drugs and conversion of drug from lipid soluble to water soluble compounds but sometimes the drug may be converted from its inactive form to active form.ProdrugsFew drugs are inactive as such and need conversion in the body to one or more active metabolites. Such a drug is called a prodrug.The prodrug may offer advantage over the active form in being more stable, having better bioavailability or other desirable pharmaco-kinetic properties or less side effects and toxicity.ProdrugActive form* LevodopaDopamine* EnalaprilEnalaprilat* S-methyldopaa methyl norepinephrine* DipivefrinEpinephrine* SulindacSulfide metabolites* Hydrazide MAO inhibitorsHydrazine derivatives* ProguanilProguanil Triazine* PrednisonePrednisolone* BacampicillinAmpicillin* Sulfasalazine5 Aminosalicylic acid* CyclophosphamideAldophosphamide, Phosphoramide mustard* FluorouracilFluoruridine monophosphate* MercaptopurineMethyl mercaptopurine ribonucleotide", "cop": 1, "opa": "Enalapril", "opb": "Neostigmine", "opc": "Esmolol", "opd": "Captopril", "subject_name": "Pharmacology", "topic_name": "Pharmacokinetics", "id": "8c1c506b-ad57-46db-a03c-84e20a7ff6b9", "choice_type": "single"} {"question": "The major clinical use of Nimodipine is in", "exp": "Refer kDT 6/e p532 subarachnoid hemorrhage USES: Nimodipine is used to decrease problems due to a ceain type of bleeding in the brain (subarachnoid hemorrhage-SAH).Nimodipine is called a calcium channel blocker. The body naturally responds to bleeding by narrowing the blood vessel to slow blood flow.", "cop": 3, "opa": "Hypeension", "opb": "Angina pectoris", "opc": "Sub arachnoid haemorrhage", "opd": "Raynouds phenomenon", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "f1865f8c-0fe1-4782-b8f8-dc77fc0e9300", "choice_type": "single"} {"question": "Mechanism of action of sildenafil is", "exp": "Ans. is 'c' i.e., Inhibits PDE 5 * Sildenafil (Viagra) acts to increase cGMP by inhibiting its breakdown by phosphodiesterase isoform 5 (PDE-5).", "cop": 3, "opa": "Inhibits PDE 2", "opb": "Inhibits PDE 4", "opc": "Inhibits PDE 5", "opd": "Inhibits PDE 3", "subject_name": "Pharmacology", "topic_name": "Miscellaneous (Pharmacology)", "id": "13002cb8-942b-42bd-98b0-a85886c94c07", "choice_type": "single"} {"question": "Therapeutic index indicates", "exp": null, "cop": 3, "opa": "Drug toxicity", "opb": "Drug potency", "opc": "Drug safety", "opd": "Drug's lethal effect", "subject_name": "Pharmacology", "topic_name": null, "id": "a7d2d71a-4e9e-4955-8263-01954e6e6adb", "choice_type": "single"} {"question": "Baricitinib was approved by FDA recently for", "exp": "barcitinib is a janus kinase inhibitoe JAK . Ihibits the activity of JAK 1 and JAK 2 enzymes interfering with JAK STAT pathway.", "cop": 2, "opa": "Osteo ahritis", "opb": "R ahritis", "opc": "Cl difficale", "opd": "Gout", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "71ae5fae-6fff-498b-abc4-8ac19177c38b", "choice_type": "single"} {"question": "Anaesthetic that has a smooth induction is", "exp": "Refer Katzung 10/e 404 KDT 6/e p372 Halothane and Sevoflurane have smooth induction So these are preferred agents for anaesthesia in children", "cop": 4, "opa": "Diehyl ether", "opb": "Isoflurane", "opc": "N2O", "opd": "Halothane", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "5f2de3aa-c006-4757-ab6a-c606d420d572", "choice_type": "single"} {"question": "Drug is absorbed rapidly in the following form", "exp": null, "cop": 1, "opa": "Aqueous solution", "opb": "suspension", "opc": "Oily solution", "opd": "solid form", "subject_name": "Pharmacology", "topic_name": null, "id": "b9c79852-b1a3-4cf6-9c75-ba451a2d5876", "choice_type": "single"} {"question": "Green frothy vaginal discharge is produced by", "exp": "Ans. is 'c' i.e., Trichomonas vaginalis Trichomoniasis - It is a sexually transmitted disease It is almost entirely a disease of child-bearing age The vaginal discharge is frothy, slightly green in colour and profuse.There are multiple punctate strawberry spots on the vaginal vault and portio vaginalis of cervix.Diagnosis : Culture is 98% reliableT/T : Metronidazole 200 mg T.D.S. for 7 days", "cop": 3, "opa": "Herpes simplex", "opb": "Candida albicans", "opc": "Trichomonas vaginalis", "opd": "Normal vaginal flora", "subject_name": "Pharmacology", "topic_name": "Anti Microbial", "id": "f3a4c546-ee67-4743-88fa-93c57a6622e6", "choice_type": "single"} {"question": "Loading drug of dose primaraly depends on", "exp": "Loading dose; This is a single or few quickly repeated doses given in the beginning to attain target concentration rapidly. Loading dose =Target Cp * V /F Cp-concentration, V - the volume of distribution, F-oral bioavailabilityThus, the loading dose is governed only by V and not by Clearance or t1/2 Ref ; KD Tripathi Pharmacology 7th edition (page no;33)", "cop": 1, "opa": "Volume of distribution", "opb": "Clearance", "opc": "Rate of administration", "opd": "Half life", "subject_name": "Pharmacology", "topic_name": "General pharmacology", "id": "97bccc99-7bc6-452b-aea0-7772f39f9d22", "choice_type": "single"} {"question": "The plane of surgical anesthesia during ether anesthesia is defined as", "exp": "Refer KDT 7th/373 The plane of surgical anesthesia during ether anesthesia is defined as from onset of regular respiration to cesssation of spontaneous breathing", "cop": 3, "opa": "Loss of consciousness", "opb": "Loss of consciousness to the onset of spontaneous respiration", "opc": "From onset of regular respiration to cessation of spontaneous breathing", "opd": "Absence of reflexes", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "9b805c1f-078b-4f74-9d8d-035d62ecfd0d", "choice_type": "single"} {"question": "Eltrombopag is a", "exp": "Eltrombopag is a thrombopoietin analogue used in ITP, but carries the risk of hepatotoxicity.\nLustrombopag & Avatrombopag are other thrombopoietin analogues used to prevent bleeding in patients of liver disease.", "cop": 3, "opa": "Erythropoietin analogue", "opb": "Erythropoietin receptor agonist", "opc": "Thrombopoietin analogue", "opd": "GMCSF analogue", "subject_name": "Pharmacology", "topic_name": null, "id": "2be89eae-c77a-4a86-bd6f-e9724c97f80f", "choice_type": "single"} {"question": "Omeprazole is a", "exp": null, "cop": 2, "opa": "Antihistamine", "opb": "Proton pump inhibitor", "opc": "Ulcer protective", "opd": "Ulcer healing drug", "subject_name": "Pharmacology", "topic_name": null, "id": "d1a0afd3-2c44-473d-81d0-fe7c6b1369c1", "choice_type": "single"} {"question": "Cilastatin is given in combination with Imipenem because", "exp": "* Cilastatin is a renal dipeptidase (or dehydropeptidase) enzyme inhibitor, used in conjunction with Imipenem antibiotic to prevent degradation of Imipenem by the renal tubular dipeptidase. * Imipenem is a carbapenem class of Beta-Lactam antibiotic. It has poor absorption following oral administration. Given IV, the drug is rapidly catabolized by the dipeptidase enzyme expressed by the brush border cells of proximal tubules in kidney. * Both Imipenem and Cilastatin have identical pharmacokinetic profile - so ideal for combination. * Following concurrent administration, Imipenem degradation is blocked significantly, biovailability and duration of action is enhanced, around 70% active drug is recovered from urine (When Imipenem is used alone, only about 5.5-42.5% of unchanged drug is recovered from urine). Ref:- Goodman & Gilman Pharmacological Basis of Therapeutics 13th Ed; Pg num:- 1035", "cop": 1, "opa": "Cilastatin prevents degradation of Imipenem in kidney", "opb": "Cilastatin increases absorption of Imipenem", "opc": "Inhibits the enzymes that digest Imipenem in stomach", "opd": "Reduces side effects of Imipenem", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "a5b4ad35-6ce3-4aa8-a0d1-39c8d9a64d62", "choice_type": "single"} {"question": "Most common Digoxin induced arrythmia is", "exp": "Ventricular bigeminy is the most common arrythmia induced by Digoxin.", "cop": 3, "opa": "Ventricular Fibrillation", "opb": "Atrial flutter", "opc": "Ventricular bigeminy", "opd": "Ventricular premature beats", "subject_name": "Pharmacology", "topic_name": null, "id": "593df22c-b47c-4d7b-8bd3-67ef69c59f7e", "choice_type": "single"} {"question": "Ibuprofen acts on", "exp": "(Cyclo-oxygenase pathway) (157, 176-KDT) (184-KDT 6th)Biosynthesis of prostaglandins (PG) and LeukotrienesIBUPROFEN - Propionic acid derivative. All inhibits PG synthesis, naproxen being most potent. They inhibit platelet aggregation and prolong bleeding time.A. Non selective COX inhibitors (Conventional NSAIDS)1. Salicylates - Aspirin, Diflunisol2. Pyrazolone derivative - Phenylbutazone, Oxyphenbutazone3. Indole derivative - Indomethacin, Sulindac4. Propionic acid derivatives - Ibuprofen, Naproxen, Ketoprofen, Flurbiprofen5. Anthranilic acid derivative - Mephenamic acid6. Aryl-acetic acid derivatives - Diclofenac7. Oxicam-derivatives - Piroxicam, Tenoxicam8. Pyrrolo-pyrrole derivative - KetorolacB. Preferential COX-2 inhibitors - Nimesulide, Meloxicam, NabumetoneC. Selective COX inhibitors - Celecoxib, Rofecoxib, Veldecoxib, Etoricoxib", "cop": 2, "opa": "Lipoxygenase pathway", "opb": "Cyclo-oxygenase pathway", "opc": "Kinine system", "opd": "Serotonin synthesis", "subject_name": "Pharmacology", "topic_name": "Prostaglandins", "id": "67a91c69-2849-4a9b-af2e-f383e9612fbf", "choice_type": "single"} {"question": "Dilator pupillae is supplied by", "exp": "ref : A K Khurana ophthalmology 6th edition (page no:7) Ganong 23/e p261,265 dilator pupillae muscle is supplied by the sympathetic fibers from the carotid plexus which enter the Gasserian ganglion of 5th cranial nerves. ultimately reach the muscle along with long ciliary branches of nasociliary nerves (ophthalmic division 5th CN)", "cop": 2, "opa": "postganglionic parasympathetic from Edingerwest phal nucleas", "opb": "Postganglioninc sympathetic from cervical sympathetic chain", "opc": "Third cranial nerve", "opd": "Sympathatic fibres of fronto-orbital branch of trigeminal nerve", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "ccd550e8-d4b2-4bb2-b2d3-3398a0dccd63", "choice_type": "single"} {"question": "New vaginal ring used to prevent pregnancy for an entire year", "exp": "It is a ring shaped non biodegradable , flexible, white opaque system contain a estrogrn n progesterone ative compounds.", "cop": 1, "opa": "Segesterone acetate", "opb": "Desogestrel", "opc": "Norgestimate", "opd": "Levonorgestrel", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "8f1e0d60-06ed-40b2-8bbe-a35ee2082931", "choice_type": "single"} {"question": "ATT most commonly implicated in causing peripheral neuropathy is", "exp": "INH Peripheral neuritis and a variety of neurological manifestations Paraesthesia Numbness Mental disturbances Rarely convulsions Refer KDT 6/e p741", "cop": 3, "opa": "Rifampicin", "opb": "Pyrazinamide", "opc": "INH", "opd": "Ethambutol", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "2aeb0c98-4f36-4663-9704-92ba7091867c", "choice_type": "single"} {"question": "Lactic acidosis is a side effect of", "exp": "(B) Metformin # LACTIC ACIDOSIS: occurs when the rate of production of lactic acid from pyruvate in muscle, skin, brain & erythrocytes exceeds the rate of removal by liver & kidney.# Causes of Lactic Acidosis:# Group A (Due to poor tissue perfusion)> Shock from any cause, Respiratory failure, Severe anaemia, Mitochondrial enzyme inhibitor (Cyanide or CO)# Group B (Due to aerobic disorder)> Diabetes mellitus; Hepatic failure; Renal failure; Severe infection (cholera, malaria)> Malignancies; Seizures> Drugs (biguanides such as metformin, salicylates, isoniazid, sorbitol, AZT analogues, fructose)> Toxins (ethanol, methanol), Congenital enzyme defect", "cop": 2, "opa": "Chlorothiazide", "opb": "Metformin", "opc": "Cyclosporine", "opd": "Pentamidine", "subject_name": "Pharmacology", "topic_name": "Miscellaneous (Pharmacology)", "id": "4303ca51-83ff-48b1-b426-97246f310a5e", "choice_type": "single"} {"question": "Sustained neutropenia is seen with", "exp": "Refer Goodman Gilman 11/e p1330 KDT 6/e p822. Myrelosuppression leading to neutropenia ,thrombocytopenia and anemia is seen is seen with most of the anticancer drugs The characterstic features of Myelosuprresion produced by carmustine", "cop": 3, "opa": "Vinbalstine", "opb": "Cisplatin", "opc": "Carmustine", "opd": "Cycloohosphamide", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "133e0943-deea-471f-bf69-db7d277cc89b", "choice_type": "single"} {"question": "Maximum dose of lignocaine given with adrenaline for infiltration anesthesia is", "exp": "Refer Goodman Gilman 12/e p576 For normal healthy adults, the individual maximum recommended dose of lignocaine HCI with epinephrine should not exceed 7mg/kg of body weight and in general it is recommended that the maximum total dose not exceed 500mg When used without epinephrine the maximum individual dose should not exceed 4.5 mg/kg of body weight and in general it is recommended that the maximum total dose not exceed 300mg", "cop": 3, "opa": "3 my /kg", "opb": "5mg/kg", "opc": "7mg/kg", "opd": "10 mg/kg", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "500f5f13-c1db-4dbc-8d09-3d806aa4cc71", "choice_type": "single"} {"question": "Drug not used for Pseudomembranous colitis", "exp": "All except streptogramins are used. Drug of choice for pseudomembranous colitis is metronidazole,in resistant cases vancomycin given orally. Fidaxomycin is newer class of macrolide type of antibiotic used specially for PMC Ref:KDT 6/e p799", "cop": 4, "opa": "Metronidazole", "opb": "Vancomycin", "opc": "Fidaxomycin", "opd": "Streptogramins", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "d39d5666-ddc7-4ac6-928f-8bbb6ea122bf", "choice_type": "single"} {"question": "Drug A, has Bioavailabity of 80% volume of distribution is 10 L, Calculate the loading dose to be given to achieve plasma concentration of 0.6 mg/L", "exp": null, "cop": 3, "opa": "0.75 mg", "opb": "0.48 mg", "opc": "7.5 mg", "opd": "48 mg", "subject_name": "Pharmacology", "topic_name": null, "id": "151de014-6d9c-4caf-bdff-e96f214ac8d8", "choice_type": "single"} {"question": "Fastest acting proton pump inhibitor is", "exp": "Rabeprazole is the fastest acting proton pump inhibitor.", "cop": 1, "opa": "Rabeprazole", "opb": "Lansoprazole", "opc": "Tenatoprazole", "opd": "Esomeprazole", "subject_name": "Pharmacology", "topic_name": null, "id": "5b463000-f1b7-47ee-b37f-c012349d49f3", "choice_type": "single"} {"question": "The mechanism of action of local anesthetics is that they act on Na+ channels in their", "exp": "The mechanism of action of local anesthetic is by blockade of sodium channels in their activated state. Local anesthetic drugs interfere with excitation and conduction by action potentials in the nervous system and in the hea by blockade of the voltage-gated Na channel. Drug affinity varies with gating state of the channel. The drugs show low affinity at slow excitation rates, but high affinity when the channels are opened and inactivated during action potentials at high frequency, as they are during pain or during a cardiac arrhythmia. The drugs are thought to access their binding site in the inner pore by passage through the membrane and entry through the inner pore vestibule. There have been three major developments in the last decade that greatly increase our understanding of their mechanism of action. Firstly, amino acid residues critical to drug binding have been located by mutagenesis, and it is possible to develop a molecular model of the drug binding site. Secondly, a path for drug access directly from the outside has been characterized in the cardiac isoform of the channel. Thirdly, the hypothesis that high affinity binding stabilizes the fast inactivated conformation of the channel has been challenged. Rather, the drug may stabilize a slow inactivated state and immobilize the voltage sensor in domain III in its activated outward position. The combination of mutational study of the cloned Na channels and patch clamp offers the oppounity to understand the detailed molecular mechanism of drug action and to resolve drug structure-function. From Tripati 7th edition. Page no 362, figure 26.2", "cop": 1, "opa": "Activated state", "opb": "Inactivated state", "opc": "Resting state", "opd": "Any state", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "0b07f87b-31fd-4e6e-a7bf-c6bc2e1880f5", "choice_type": "single"} {"question": "Most serious side effect of valproate is", "exp": "Ans. is 'a' i.e., Fulminant hepatits Valproate Valproate acts by multiple mechanism : Prolongation of inactivated Na* channel. Inhibition of T type Ca' current. Inhibition of degradation of GABA by GABA transminase - facilitation of GABA mediated Cl- channel opening. Its most serious adverse effect is fulminant hepatitis especially in children below 3 years. Used during pregnancy, it has produced spina bifida and other neural tube defects. Uses (other than epilepsy) --> mania & bipolar illness, prophylaxis of migraine, trigeminal neuralgia, tardive dyskinesia. Adverse effect of Valproate Neurological - Ataxia, sedation,tremor Systemic- Hepatotoxicity, thromobocytopenia,GI irritation, weight gain, transient alopecia, hyperammonemia, pancreatitis,coagulation disorder.", "cop": 1, "opa": "Fulminant hepatits", "opb": "Spina bifida", "opc": "Weight gain", "opd": "Thrombocytopenia", "subject_name": "Pharmacology", "topic_name": null, "id": "df3030ca-d110-4d43-b9e2-391dd56069da", "choice_type": "single"} {"question": "Provisional sho antiretroviral regime given in the peripaum period reduces the risk of veical transmission by", "exp": "Most transmission of HN occurs during pregnancy and bih, breastfeeding may account for 5-15% of infants becoming infected after delivery Studies have demonstrated that truncated regimens of zidovudine alone or with Lamivudine given to mother during last few weeks of pregnancy or even during labour & delivery & to the infant for a week or less reduced transmission to infant by 50% compared to placebo. rEF : katzung 12 th ed.", "cop": 2, "opa": "35%", "opb": "50%", "opc": "65%", "opd": "75%", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "c7669689-a937-4a0e-870a-aef1103e4b3d", "choice_type": "single"} {"question": "The following antiarrhythmic drug has the most prominent anticholinergic action", "exp": "Disopyramide It is a quinidine like Class IA drug that has prominent cardiac depressant and anticholinergic actions, but no a adrenergic blocking propey. Disopyramide usually has no effect on sinus rate because of opposing direct depressant and antivagal actions. Ref:- kd tripathi; pg num:-530", "cop": 3, "opa": "Quinidine", "opb": "Lignocaine", "opc": "Disopyramide", "opd": "Procainamide", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "1f4c75b3-46a3-4b9f-a3ad-6ae61985fca1", "choice_type": "single"} {"question": "Renal lesion in chronic use of lithium is", "exp": "(C) Chronic interstitial nephritis # \"Nephrogenic Diabetes Insipidus and Other Renal Adverse Effects> Polydipsia and polyuria are common but reversible concomitants of lithium treatment, occurring at therapeutic serum concentrations. The principal physiologic lesion involved is loss of responsiveness to antidiuretic hormone (nephrogenic diabetes insipidus). Lithium-induced diabetes insipidus is resistant to vasopressin but responds to amiloride.> Extensive literature has accumulated concerning other forms of renal dysfunction during long-term lithium therapy, including chronic interstitial nephritis and minimal-change glomerulopathy with nephrotic syndrome. Some instances of decreased glomerular filtration rate have been encountered but no instances of marked azotemia or renal failure.> Patients receiving lithium should avoid dehydration and the associated increased concentration of lithium in urine. Periodic tests of renal concentrating ability should be performed to detect changes.\"", "cop": 3, "opa": "Acute tubular necrosis", "opb": "Membranous glomerulopathy", "opc": "Chronic interstitial nephritis", "opd": "Crystal formation", "subject_name": "Pharmacology", "topic_name": "Miscellaneous (Pharmacology)", "id": "ab006848-7878-46a8-8135-274cabc7ca09", "choice_type": "single"} {"question": "Bacteria implicated in dental caries", "exp": "Ans. is 'a' i.e., streptococcus mutans Viridans streptococci is implicated in causing Dental caries.Various species of viridans streptococci are -S. Salivarius S. Mitis S. Sanguis S. MutansThese bacterias are a part of normal flora of the mouth.They can cause bacteremias through minor trauma such as eating, brushing md flossing, these bacteremias can then cause endocarditis.", "cop": 1, "opa": "Streptococcus mutans", "opb": "Pneumococci", "opc": "Streptococcus pyogenes", "opd": "Staphylococcus aureus", "subject_name": "Pharmacology", "topic_name": "Anti Microbial", "id": "3ff935f0-9ad0-4966-9e30-0afb3d33c13b", "choice_type": "single"} {"question": "Quinidine belongs to class antiarrhythmic drug is", "exp": "i.e. (class I): (510-17-KDT 6th) (367-68-MDT-l1)ANTIARRHYTHMIC DRUGSClass Ia Sodium channel blockers* Depress phase O depolarization* Slow conduction, prolong repolarization Drugs* Quinidine, Procainamide, Disopyramide, MoricizineClass Ib * Shorten repolarization Drugs* Lidocaine, MexiletineClass IC * Depress phase O repolarization, slow conduction* Propafenone is a week calcium channel blocker and b-blockers and prolongs action potential and refractionariness Drugs* Flecainide, PropafenoneClass II b-blockers* Slow AV conduction Drugs* Esmolol, Propanolol, MetoprololClass III * Prolong action potential* Prolong repolarization and ERP Drug* Amiodarone, Bretylium (also class II) Dofetilide, Ibutilide, Dronedarone, SotalolClass IV Calcium Channel blockers Drugs* Verapamil, diltiazem", "cop": 1, "opa": "Class I", "opb": "Class II", "opc": "Class III", "opd": "Class IV", "subject_name": "Pharmacology", "topic_name": "C.V.S", "id": "de49b56c-3184-4cb2-8bc4-5f77b7626a86", "choice_type": "single"} {"question": "Less sedating antiemetic used in motion sickness and veigo", "exp": "Meclizine and cyclizine are often used in preventing motion sickness and for sho-term treatment of veigo because they are less sedating than diphenhydramine and promethazine. Promethazine also causes antiemetic activity and is available as a suppository or for injection. Chlorpheniramine and brompheniramine, which are less sedating than diphenhydramine and promethazine, are often used alone or in combination with decongestants for allergies and colds. Cyproheptadine has antiserotonin activiry and may be useful in treating patients with carcinoid tUmor, where it blocks the effects of serotonin and histamine on smooth muscle. Aztemizole, loratadine, and terfenadine are nonsedating antihistamines that do not cross the blood-brain barrier. Ref: katzung 12th ed.", "cop": 4, "opa": "Cyproheptadine", "opb": "Chlorpheniramine", "opc": "Promethazine", "opd": "Meclizine", "subject_name": "Pharmacology", "topic_name": "Gastrointestinal tract", "id": "23ed5c15-c4cc-4a55-826b-b525f22024a0", "choice_type": "single"} {"question": "'Lock and Key model' of enzyme action was proposed by", "exp": "Lock and key hypothesis By emil Fischer Active site is rigid Substrate has complimentary shape Demerits: 1. Rigid active site in reversible reaction. 2. Stabilization of transition state Ref: G n G 13th ed.", "cop": 1, "opa": "Emil Fisher", "opb": "Daniel Koshland", "opc": "Lenor Michaelis", "opd": "Maud Menten", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "9de11b35-e243-4114-a5ef-f2d5b20dea6e", "choice_type": "single"} {"question": "Nootropic drug", "exp": "Ans. d (Piracetam). (Ref. KD Tripathi, Pharmacology, 4th ed., 481)CEREBROACTIVE DRUGS (COGNITION ENHANCERS)1NootropicPiracetam2Metabolic enhancerDihydrergotaxine,Nicergoline,Piribedil3Cholinergic activatorTacrine4Vasoactive cerebral protectorsPyritinol, Ginko biloba.Educational Points:DRUGUsed in Rx of:Newer cholinesterase inhibitors (Donepezil, Revastigmine, Galantamine) & Mementine (NMDA antagonist)Alzheimer's diseaseRiluzoleAmyotropic lateral sclerosisD2 receptor blockers (Chlorpromazine, haloperidol)Huntington's choreab-IFN, Glatiramer & NatalizumabMultiple sclerosisTemozolomide, an orally administered alkylating agent, has replaced nitrosureas, including carmustine (BCNU) and lomustine (CCNU), as the most widely used chemotherapeutic agent for :High-grade gliomas.", "cop": 4, "opa": "Rivastigmine", "opb": "Tacrine", "opc": "Amantadine", "opd": "Piracetam", "subject_name": "Pharmacology", "topic_name": "C.N.S", "id": "d2f32a18-5fc9-4aff-9a3d-38196247bec0", "choice_type": "single"} {"question": "Drug S is most like", "exp": "The effects of Drug S are changed by treatment with the beta blocker, but not by the alpha blocker (choices A, C, and D are ruled out). Terbutaline is beta2 selective and would not increase heart rate directly. Drug S is isoproterenol.", "cop": 2, "opa": "Epinephrine", "opb": "Isoproterenol", "opc": "Norepinephrine", "opd": "Phenylephrine", "subject_name": "Pharmacology", "topic_name": "A.N.S.", "id": "56740c08-09ae-4f08-bf66-f8b3433c432c", "choice_type": "single"} {"question": "Drugs causing afterload reduction is", "exp": "Along with oxygen, medicationsassisting with symptom relief include: (1) diuretics, which reduceedema by reduction of blood volume and venous pressures; (2) vasodilators, for preload andafterload reduction; (3) digoxin, which can cause a small increase in cardiac output; (4) inotropic agents, which help to restore Refer katzung 11e p 219", "cop": 2, "opa": "Digoxin", "opb": "Captopril", "opc": "Dobutamine", "opd": "Furosemide", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "3f3de409-8df9-43b1-b978-552619170f73", "choice_type": "single"} {"question": "Pain in early labor is transmitted through", "exp": ".", "cop": 1, "opa": "T11 - T12", "opb": "L2 - L3", "opc": "L4 - L5", "opd": "S2 - S3", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "f9af56a0-a213-4966-bfbe-fb49f2ab8541", "choice_type": "single"} {"question": "Menadione (Vitamin K3)", "exp": "Menadione is fat-soluble synthetic vitamin K3. It can cause hemolysis in G-6-PD deficient individuals. In severe hepatic disease, large doses of menadione can further depress liver function. Menadione is not used to prevent haemorrhagic disease of the newborn as it can cause kernicterus, instead phytonadione is used. Phytonadione is also the drug of choice to overcome the toxic effects of warfarin as it acts rapidly.", "cop": 1, "opa": "Can cause hemolysis in a patient with G-6-PD deficiency", "opb": "Is the preparation of choice to antagonize the effect of warfarin overdose", "opc": "Is useful to prevent hemorrhagic disease of the newborn", "opd": "Is given in large doses in patients with severe liver disease", "subject_name": "Pharmacology", "topic_name": null, "id": "f5058efa-0e26-430d-a2e6-adf645565a3c", "choice_type": "single"} {"question": "Tricyclic antidepressants", "exp": "In addition to blocking reuptake of NE and 5HT, pharmacodynamic actions of the tricyclic antidepressants include block of peripheral adrenergic and muscarinic receptors--the former resulting in postural hypotension and the latter, via mydriasis, exacerbating glaucoma. TCAs block the uptake of guanethidine into sympathetic nerve endings, decreasing its antihypertensive effects, and they may cause arrhythmias in overdose. They have no effect on the absorption of levodopa.", "cop": 3, "opa": "increase the antihypertensive effect of guanethidine", "opb": "have anticonvulsant activity", "opc": "should not be used in patients with glaucoma", "opd": "may increase oral absorption of levodopa", "subject_name": "Pharmacology", "topic_name": "C.N.S", "id": "628532d9-158b-4fec-8bac-a460da6e1d40", "choice_type": "single"} {"question": "For Arsenic poisoning Antidote is", "exp": null, "cop": 4, "opa": "Penicillamine", "opb": "E.D.T.A", "opc": "Desferrixamine", "opd": "B.A.L", "subject_name": "Pharmacology", "topic_name": null, "id": "87a73d6c-2fdd-49db-b332-6897fdec100f", "choice_type": "single"} {"question": "Name the drug used for this procedure", "exp": "Tolazoline is an alpha blocker used in peripheral aeriography as it produces vasodilatation and has more selective action on peripheral vessels. Refr: KD Tripathi 8th ed.", "cop": 4, "opa": "Metoprolol", "opb": "Atenolol", "opc": "Phenoxybenzamine", "opd": "Tolazoline", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "6b8c932c-10a1-4800-816c-7990dce327e3", "choice_type": "single"} {"question": "A patient came to the casualty with acute bronchial asthma after treatment for glaucoma .the probable drug maybe", "exp": "Timolol is a non selective Beta blocker and can precipitate acute attacks of asthama in a suitable individual blockade of Beta 2 receptors. Betaxolol is a cardioselective Beta blocker and this less likely to cause this adverse effect Ref-KDT 6/e p139", "cop": 1, "opa": "Timolol", "opb": "Betaxolol", "opc": "Latanoprost", "opd": "Anticholinesterase", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "cca97821-9e80-4e51-ac2f-a77079835c82", "choice_type": "single"} {"question": "Pilocarpine reduce the intraocular pressure in person with closed angle glaucoma by", "exp": "Refer kDT 7/e p 156 It has also been used in the treatment of chronic open-angle glaucoma and acute angle-closure glaucoma It acts on a subtype of muscarinic receptor (M3) found on the iris sphincter muscle, causing the muscle to contract -resulting in pupil constriction (miosis). Pilocarpine also acts on the ciliary muscleand causes it to contract. When the ciliary muscle contracts, it opens the trabecular meshwork through increased tension on the scleral spur. This action facilitates the rate that aqueous humor leaves the eye to decrease intraocular pressure", "cop": 3, "opa": "Reducing aqueous humour secretion", "opb": "Contacting iris spincter muscle", "opc": "Increasing aqueous humour outflow", "opd": "Relaxin ciliary muscle", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "eb77de2e-b112-48a9-a06f-17f6eb732342", "choice_type": "single"} {"question": "Beta blockers used in CHF is", "exp": "[D) (Carvedilol): (523-KDT7th edition)CARVEDILQL is a Betaj + Beta2 + Alpha! adrenoceptor blocker produces vasodilatation due to Alpha 1 blockade as well as calcium channel blockade and has antioxidant property. It has been used in hypertension and is the Beta blocker especially employed as cardioprotective in CHF (151-KDT7th)* b1 blockers mainly (metoprolol, bisoprolol, nebivolol) in mild to moderate CHF treated with ACE inhibitor + diuretic digitalis* There is no place for b blockers in decompensated patients. b blockers should be stopped during an episode of acute heart failure and recommended at lower doses followed by uptitration after compensation is restored", "cop": 4, "opa": "Timolol", "opb": "Atenolol", "opc": "Acebutalol", "opd": "Carvedilol", "subject_name": "Pharmacology", "topic_name": "C.V.S", "id": "049cd2e7-7397-4294-9dc6-6e3fc3efdd19", "choice_type": "single"} {"question": "Oral incretin analogue", "exp": "GLP analogues are usually given by SC route but now recently oral analogue was prepared-semaglutide. Ref: Ktzung 12 th ed.", "cop": 1, "opa": "Semaglutide", "opb": "Dulaglutide", "opc": "Exenatide", "opd": "Liraglutide", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "8e3a40bd-15b6-4a5f-8813-07bbb83cd090", "choice_type": "single"} {"question": "Indications of somatostatin include", "exp": "GH Inhibitors Somatostatin Mech of action:- This- 14 amino acid peptide inhibits the secretion of GH, prolactin and TSH by pituitary; insulin and glucagon by pancreas, and of almost all gastrointestinal secretions including that of gastrin and HCl. Side effects:- The g.i.t action produces steatorrhoea, diarrhoea, hypochlorhydria, dyspepsia and nausea as side effect. Uses:- 1) Somatostatin constrict splanchnic, hepatic and renal blood vessels. The decreased g.i. mucosal blood flow can be utilized for controlling bleeding esophageal varices and bleeding peptic ulcer, but octreotide is preffered now due to longer duration of action. 2) it's antisecretory action is beneficial in pancreatic, biliary or intestinal fistulae; can also be used to reduce complications after pancreatic surgery. 3) it also has adjuvant value in diabetic ketoacidosis (by inhibiting glucagon and GH secretion). 4) somatostatin in acromegaly. 5) insulinoma, glucaganoma. Ref:- kd tripathi; pg num:-237", "cop": 2, "opa": "Zollinger Ellison syndrome", "opb": "Bleeding esophageal varices", "opc": "Steatorrhoea", "opd": "Macroprolactinoma", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "df7ced86-3b38-4693-8f90-725109a455f3", "choice_type": "single"} {"question": "The following antitussive is present in opium but has no analgesic or addicting propeies", "exp": "Noscapine (Narcotine):- An opium alkaloid of the benzoisoquinoline series. Mech of action:- It depresses cough but has no narcotic, analgesic or dependence inducing propeies. It is nearly equipotent antitussive as codeine, especially useful in spasmodic cough. side effects:- Headache and nausea avoided r contraindication:- It release histamine and produce bronchoconstriction in asthmatics. Ref:- kd tripathi; pg num:- 220", "cop": 3, "opa": "Codeine", "opb": "Pholcodeine", "opc": "Noscapine", "opd": "Ethylmorphine", "subject_name": "Pharmacology", "topic_name": "Respiratory system", "id": "212454ca-0953-452a-94cd-9658766c2dd6", "choice_type": "single"} {"question": "Aldosterone exes action on", "exp": "Aldosterone acts on the late DT and CD cells by combining with an intracellular mineralocoicoid receptor - induces the formation of' aldosterone-induced proteins' (AlPs) which promote Na+ reabsorption by a number of mechanisms and K+ secretion. Aldosterone (AL) penetrates the cell from the interstitial side and combines with the mineralocoicoid receptor (MR). The complex translocates to the nucleus-promotes gene mediated mRNA synthesis. The mRNA then directs the synthesis of aldosterone-induced proteins (Alps). The AlPs activates Na+ channel, translocate Na+ channels from cytosolic site to the luminal membrane and Na+K+ATPase of the basolateral membrane, increase ATP production by mitochondria. All these changes promote Na+ reabsorption-more K+vand H+ is secreted indirectly ( Essentials of Medical Pharmacology, K.D Tripathi,6tth edition, page 570 )", "cop": 4, "opa": "Proximal tubule", "opb": "Early Distal tubules", "opc": "Loop of Henle", "opd": "Collecting duct", "subject_name": "Pharmacology", "topic_name": "Kidney", "id": "2e6c57ef-8e86-4ca5-9272-1df098f94d52", "choice_type": "single"} {"question": "Treatment of choice in a patient big acute pulmonary embolism with right ventricular hypokinesia and a compromised cardiac output but normal blood pressure is", "exp": "Ref KDT 6 /e p606 Anticoagulants are the most mainstay for the treatment of pulmonary embolism Thrombolytic therapy is indicated bin massive pulmonary embolism with hemodymica instability and in hemodymically stable patients but with compromised right ventricular function", "cop": 1, "opa": "Thrombolytic agent", "opb": "Low molecular weight heparin", "opc": "IV filters", "opd": "Warfarin", "subject_name": "Pharmacology", "topic_name": "Hematology", "id": "aa64cc79-3c76-40e3-b970-2b518681976d", "choice_type": "single"} {"question": "A patient of schizophrenia was staed on haloperidol 5 mg. Next day, he presented with uprolling of eyes. Complete neurological examination revealed no spasticity or any other abnormality. Visual acuity and opthalmoscopic findings are normal. Most likely diagnosis is", "exp": "Acute muscular dystonias Bizarre muscle spasms, mostly involving lingua-facial muscles -grimacing, tongue thrusting, toicollis, locked jaw; occurs within a few hours of a single dose or at the most in the first week of therapy. It is more common in children below 10 years and in girls, paicularly after parenteral administration; overall incidence is 2%. It lasts for one to few hours and then resolves spontaneously. One of the central anticholinergics, promethazine or hydroxyzine injected i.m. clears the reaction within 10-15 min. REF KD TRIPATHHI 8TH ED.", "cop": 2, "opa": "Akathisia", "opb": "Acute dystonia", "opc": "Seizure", "opd": "Tardive dyskinesia", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "627930de-efff-4d8e-8f5c-6cd91c42dabe", "choice_type": "single"} {"question": "Quinidine exes its action on the hea by", "exp": "It is d-isomer quinidine is used as an antiarrhythmic drug. Quinidine blocks myocardial Na channels. Class 1a group of drugs- quinidine, procainamide, disopyramide Ib: Lidocaine, phenytoin Ic-encainide, flecainide Ref: KD tripathi 8th ed.", "cop": 2, "opa": "Ca2+ channel blockade", "opb": "Na+ channel blockade", "opc": "K+ channel opening", "opd": "Cl- channel opening", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "75628e87-c633-4d6b-8c8e-68916fd44ff4", "choice_type": "single"} {"question": "Clopidogrel is an", "exp": null, "cop": 3, "opa": "Anti hypertensive", "opb": "Antidiabetic", "opc": "Antiplatelet", "opd": "Anticoagulant", "subject_name": "Pharmacology", "topic_name": null, "id": "3b0a6985-f3ee-49b3-b055-7e7f7c25ecfb", "choice_type": "single"} {"question": "D Tubocurarine acts by", "exp": "Refer Katzung 10/e p 429 D-Tubocurarine is a skeletal muscle relaxant that acts by competitive inhibition of NM receptors at neuron muscular junction", "cop": 1, "opa": "Inhibiting nicotinic receptors at myoneural junction", "opb": "Inhibiting nicotinic receptors at autonomic ganglion", "opc": "Producing depolarising block", "opd": "By inhibiting re-uptake of acetyl choline", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "88c34357-7eac-4b07-a681-3274cbf087d0", "choice_type": "single"} {"question": "Ivabradine is used in the treatment of", "exp": "Ivabradine-direct acting bradycardiac agent is used in angina and in rare cases- CCF As it decreases myocardial oxygen demand. Ref. HH Sharma 3rd ed.", "cop": 2, "opa": "Ventricular arrhythmia", "opb": "Angina", "opc": "Atrial arrhythmia", "opd": "Hypeension", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "456f463b-ec9a-4b92-8363-f87ecebc77a1", "choice_type": "single"} {"question": "Dialysis is not indicated in toxicity of", "exp": "Refer kDT 6/e p 499 Indications for Dialysis: A Mnemonic And Explanation Severe fluid overload. Refractory hypeension. Uncontrollable hyperkalemia. Nausea, vomiting, poor appetite, gastritis with hemorrhage. Lethargy, malaise, somnolence, stupor, coma, delirium, asterixis, tremor, seizures, Pericarditis (risk of hemorrhage or tamponade)", "cop": 4, "opa": "Lithium", "opb": "Methanol", "opc": "Salicylates", "opd": "Digitalis", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "86cb795c-cb60-412b-87ff-0a0509802b0e", "choice_type": "single"} {"question": "Sucralfate", "exp": "Ans. is 'c' i.e., Is ulcer protective Sucralfateo Sucralfate is an ulcer protective agent. It preferentially and strongly adheres to the ulcer base, specially duodenal, and acts as a physical barrier preventing acid, pepsin and bile from coming in contact with the ulcer base. However, this protective action is attributed to sucralfate because of certain properties which are achieved only in acidic medium:Acidic medium gives it a viscous consistency, alsoIt polymerises at pH < 4 by cross linkages of molecule assuming sticky gel like consistency,o It is this viscous and gel like properties that are responsible for its action.o When antacids are given concurrently they raise the pH of gastric secretion and this interferes with the very basic mechanism of action of sucralfate (requires pH < 4) and thus makes them ineffective.", "cop": 3, "opa": "Reduces gastric acid secretion", "opb": "Neutralises gastric acid", "opc": "Is ulcer protective", "opd": "Isanti H. pylori drug", "subject_name": "Pharmacology", "topic_name": "Anti-Ulcer", "id": "9961f270-bee1-4db4-b49a-f557af80d656", "choice_type": "single"} {"question": "Ezetimibe acts by", "exp": "Refer kDT 6/e p 618 Ezetimibe is an intestinal cholesterol absorption inhibits and is combined with statins", "cop": 2, "opa": "Enhancing excretion of bile acids", "opb": "Decreasing absorption of cholesterol", "opc": "Inhibiting HMG CoA reductase", "opd": "Inhibiting intracellular lipase", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "8f7fce83-bae2-45c7-b467-2daa3c73c6a4", "choice_type": "single"} {"question": "Norepinephrine action at the synaptic cleft is terminated by", "exp": null, "cop": 3, "opa": "Metabolism by COMT", "opb": "Metabolism by MAO", "opc": "Reuptake", "opd": "Metabolism by acetylcholinesterase", "subject_name": "Pharmacology", "topic_name": null, "id": "bcb74dd7-174b-44c9-aca3-0cb7a4124ca2", "choice_type": "single"} {"question": "\"Monday disease\" is seen with", "exp": "Isosorbide Mononitrate is a venodilator, which is associated with Monday disease, where nitrate industry workers gets dizziness & hypotension on Monday, but symptoms disappear by the weekend because of down regulation of enzymes.", "cop": 3, "opa": "Calcium channel blockers", "opb": "Benzodiazepines", "opc": "Isosorbide Mono nitrate", "opd": "Chlorpromozine", "subject_name": "Pharmacology", "topic_name": null, "id": "8145aae9-e0e0-4bdd-9a92-cdba8c4a0dd3", "choice_type": "single"} {"question": "One of the longer acting analogue among uterine stimulants", "exp": "Carbetocin is a newer longer acting analogue of oxytocin . Now a days oxytocin use is reduced and this newer acting analogue is being used. Ref: katzung 12th ed, endocrinology.", "cop": 2, "opa": "Di hydro ergotamine", "opb": "Carbetocin", "opc": "Atosiban", "opd": "Magnesium salts", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "b3d081d4-b51c-4563-9aae-f1324c0ce1a5", "choice_type": "single"} {"question": "Drugs that are highly bound to albumin", "exp": "Plasma protein binding 1) Highly plasma protein bound drugs are largely restricted to the vascular compament because protein bound drug does not cross membranes,thus they tend to have smaller volumes of distribution. 2)High degree of protein binding generally makes the drug long acting, because bound fraction is not available for metabolism or excretion, unless it is actively extracted by liver or by kidney tubules. 3) One drug can bind to many sites on the albumin molecule. Conversely, more than one drug can bind to the same site. This can give rise to displacement interactions among drugs bound to the same site(s). The drug bound with higher affinity will displace that bound with lower affinity. Some clinically impoant displacement interactions are: * Aspirin displaces sulfonylureas. * Indomethacin, phenytoin displace warfarin. Ref:- kd tripathi; pg num:-19,20", "cop": 4, "opa": "Effectively cross the BBB", "opb": "Have a large Volume of distribution", "opc": "Are easily filtered at the glomerulus", "opd": "Can undergo competition with other drugs for albumin binding sites", "subject_name": "Pharmacology", "topic_name": "General pharmacology", "id": "6f65f4c2-2184-4d4f-8707-e51f1e20ad49", "choice_type": "single"} {"question": "Phase II in a clinical drug trial is", "exp": "Ans. is 'b' i.e., Therapeutic exploration and dose ranging Summary of clinical tarilsPhaseNameConducted onBlinding and controlPurposeIHuman pharmacology and safetyHealthy volunteers (20-100)OPEN LABEL (No bliniding)* To know maximum tolerable dose (MTD).* Safety and tolerability.IITherapeutic exploratory100-150Patients (homogenous population)Single blindControlled* To establish therapeutic efficacy.* Dose ranging and ceiling effect.IIITherapeutic confirmatoryUpto 5000 patients from several centres (heterogenous population)Double blindRandomizedControlled* To confirm therapeutic efficacy.* To establish the value of drug in relation to existing therapy.IVPost marketing surveillanceLarge number of patients being treated by practicing physicians * To konwn rare and long-term adverse effects* Special groups like children, pregnancy etc can be tested.", "cop": 2, "opa": "Human pharmacology and safety", "opb": "Therapeutic exploration and dose ranging", "opc": "Therapeutic comparison", "opd": "Post marketing surveillance.", "subject_name": "Pharmacology", "topic_name": "General Pharmacology", "id": "7afa8207-698a-4517-a08b-bd532e4b2cf4", "choice_type": "single"} {"question": "A new diuretic is being studied in human volunteers. Compared with placebo, the new drug increases urine volume, decreases urinary Ca2+, increases body pH, and decreases serum K+. If this new drug has a similar mechanism of action to an established diuretic, it probably", "exp": "The effects described are typical of thiazide diuretics, which inhibit the Na/Cl cotransporter in the distal convoluted tubule. This action facilitates reabsorption of Ca2+, which is the basis for the use of thiazides in nephrolithiasis, and which can result in hypercalcemia. The increased load of Na+ in the collecting tubules leads to increased excretion of both K+ and Hi, so hypokalemia and alkalosis may occur.", "cop": 1, "opa": "blocks the NaCl cotransporter in the DCT", "opb": "blocks aldosterone receptors in the CT", "opc": "inhibits carbonic anhydrase in the PCT", "opd": "inhibits the Na/K/2Cl cotransporter in the TAL", "subject_name": "Pharmacology", "topic_name": "C.V.S", "id": "4687c088-cb08-4071-bccf-17e2ec0ffa1a", "choice_type": "single"} {"question": "High dose methotrexate is used for the treatment of(REPEAT)", "exp": "Ref: Harrison's 17th/612 Drugs used for osteosarcoma are: Doxorubicin Ifosfamide Cisplatin High dose methotrexate with leucovorin", "cop": 1, "opa": "Osteosarcoma", "opb": "Rhabdomyosarcoma", "opc": "Retinoblastoma", "opd": "Ewing's sarcoma", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "c4252db8-a8d7-41b2-bcf0-e36e298e3bdf", "choice_type": "single"} {"question": "Escitalopram is a", "exp": "(A) Selective serotonin reuptake inhibitor # Mechanism of action of Escitalopram: Highly potent blockade of serotonin reuptake transport mechanism S CT without its inactive R-enantiomer.> Selective serotonin reuptake inhibitors: include Citalopram, Escitalopram, Fluoxetine, Fluvoxamine, Paroxetine, Sertraline, Venlafaxine. Norepinephrine uptake inhibitors: Amitriptyline, Clomipramine, Doxepin, Imipramine, Desipramine.Trimipramine, Amoxapine, Maprotiline, Nortryptalline, protyptalline. Atypical Antideppressants: Amoxapine. Atomoxetin, Maprotiline, Trazodone and Bupropion, Venlafaxine, Mirtazapine, Nefazodone, and Duloxetine. MAO Inhibitors: Tranylcypromineto phenelzine, Selegiline", "cop": 1, "opa": "Selective serotonin reuptake inhibitor.", "opb": "Nonspecific norepinephrine uptake inhibitor", "opc": "Atypical Antideppressants", "opd": "MAO Inhibitors", "subject_name": "Pharmacology", "topic_name": "C.N.S", "id": "17a96743-9f59-4617-ba50-19a1d0a7d49d", "choice_type": "single"} {"question": "Dry skin seen due to excess dosage of datura is due to", "exp": "One of the anticholinergic effects is dry skin due to absence of sweating due to blockade of m3 receptors on sweat glands Datura is nothing but atropine-anticholinergic drug Ref: KDT 6th ed pg 114-116", "cop": 2, "opa": "Vasodilatation", "opb": "Absence of sweating", "opc": "Central action", "opd": "Change in BMR", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "fe35e59a-6a23-48cd-9d49-d4c76b732c25", "choice_type": "single"} {"question": "Wof agents is often combined with local anesthetics to prevent its systemic distribution from the site of injection", "exp": "Addition of a vasoconstrictor, e.g. adrenaline (1:50,000 to 1:200,000): * Prolongs duration of action of LAs by decreasing their rate of removal from the local site into the circulation: contact time of the LA with the nerve fibre is prolonged. * Enhances the intensity of nerve block. * Reduces systemic toxicity of LAs: rate of absorption is reduced and metabolism keeps the plasma concentration lower. * Provides a more bloodless field for surgery. * Increases the chances of subsequent local tissue edema and necrosis as well as delays wound healing by reducing oxygen supply and enhancing oxygen consumption in the affected area. Ref:- kd tripathi; pg num:-363", "cop": 3, "opa": "Acetylcholine", "opb": "Dopamine", "opc": "Epinephrine", "opd": "g-Aminobutyric acid (GABA)", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "c374ddb9-594c-4ebc-82a4-c47e69bcf76a", "choice_type": "single"} {"question": "Epalrestat is used in", "exp": "It is a aldose reductase inhibitor. Thereby it prevent conversion of glucose in to sorbitol. Sorbitol act like a tissue toxin & is responsible for many of the complica on of diabetes. So Epalrestat is use as a drug to prevent the complica on of diabetes. But it does not reduce the blood sugar level.", "cop": 4, "opa": "Hypeension", "opb": "Hyperlipidemia", "opc": "HIV", "opd": "Diabetes", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "443b0936-1c78-4eed-8c4e-a31e907fedc3", "choice_type": "single"} {"question": "Thiopentone is fast acting inducing agent because of", "exp": "Thiopentone is fast acting because of its high lipid solubility.\nAnd action of this drug terminates very quickly because of rapid redistribution.", "cop": 4, "opa": "Rapid redistribution", "opb": "Increased clearance", "opc": "Metabolized in plasma", "opd": "High lipid solubility", "subject_name": "Pharmacology", "topic_name": null, "id": "011dca7f-6bd8-490a-a2ce-a41dca2a43ec", "choice_type": "single"} {"question": "The compound obtained from the following plant is used in", "exp": "The picture shows datura from which atropine is obtained. It is used in iritis, iridocyclitis and digoxin induced bradycardia as it increases hea rate. Contraindicated in glaucoma as it produces mydriasis and decreased sweating-hyperpyrexiaRef: Goodman Gillman 12th ed pg 234", "cop": 4, "opa": "Glaucoma", "opb": "Tachycardia", "opc": "Hyperpyrexia", "opd": "Iridocyclitis", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "41aa8ad5-6585-40d1-b322-293b793263cc", "choice_type": "single"} {"question": "Trisodium phosphonoformate (foscarnet) is a potent antiviral agent for treating herpes simplex infections. It works by affecting", "exp": "Trisodium phosphonoformate (foscarnet) inhibits herpes simplex virus (HSV) replication. Foscarnet is a potent inhibitor of HSV-induced DNA polymerase, and has little effect on known cellular DNA polymerases. Herpesvirus mutants resistant to the drug arise easily. To a lesser extent, foscarnet also appears to inhibit the polymerase of hepatitis B virus and retroviruses. Combinations of antivirals, including foscarnet, are currently prescribed to increase the clinical usefulness of the drugs..", "cop": 2, "opa": "The viral RNA polymerase", "opb": "The viral DNA polymerase", "opc": "The viral reverse transcriptase", "opd": "The host-cellular DNA polymerase", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "205b69e8-b57c-48ef-85d2-b8390e51c2ac", "choice_type": "single"} {"question": "Maximum glucocoicoid activity is seen with", "exp": "Fludrocoisone has max mineralocoicoid activity.Triamcinolone, dexa, and betamethasone are having pure glucocoicoid activity. Methylprednisolone is having 5 times more glucocoicoid activity than prednisolone. Ref: KDT 7th ed P:289", "cop": 4, "opa": "Fludrocoisone", "opb": "Prednisolone", "opc": "Methyprednisolone", "opd": "Triamcenolone", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "0ad39957-d466-4e18-9970-23b2025ceae2", "choice_type": "single"} {"question": "An 80 kg patient brought to casualty in shock. Dopamine needs to be started at 10 μg/ kg / min. A 5 ml vial contains 200mg of dopamine. Two vials are diluted to solution of 250ml with the help of normal saline. Calculate drops per minute required to be administered if 1 ml = 16 drops", "exp": "5 ml vial : 200 mg 2 vials : 400 mg\n2 vials in a solution of 250 ml\n→ Each ml contains : 400mg /250ml = 1.6mg\n16 drops: 16 mg 1drop: 0.1 mg.\nDose of dopamine need to be started: 10 μg / kg / min\nDose of dopamine for 80 kg: 800 μg / min\nDose of dopamine for 80 kg: 0.8 mg / min\n(1drop : 0.1 mg)\nDrops required per minute : 8 drops.", "cop": 1, "opa": "8", "opb": "16", "opc": "24", "opd": "32", "subject_name": "Pharmacology", "topic_name": null, "id": "821669d7-a9cf-47a2-b522-55c1afdbda6b", "choice_type": "single"} {"question": "Volume of distribution of drug is given by", "exp": "Apparent volume of distribution (Vd); Presuming that the body behaves as a single homogeneous compament with volume V into which drug gets immediately and uniformly distributedvd =dose administered i.v./ plasma concentration volume of distribution is the theoretical volume that would be necessary to contain the total amount of an administered drug at the same concentration that it is observed in the blood plasma. Ref -KD Tripathi Pharmacology 7th edition (page no;17)", "cop": 1, "opa": "Vd=Dose administrated i.v./Plasma concentration", "opb": "Vd=Maximum tolerated dose/Dose administered i.v.", "opc": "Vd=Dose administered i.v./Total lipid solubility", "opd": "Vd=t 1/2/Dose Administered i.v.", "subject_name": "Pharmacology", "topic_name": "General pharmacology", "id": "3a817231-d9ce-4b58-975c-9bccdbe40c30", "choice_type": "single"} {"question": "Most characteristic arrhythmia seen with Digoxin toxicity is", "exp": "Atrial tachycardia (because of increase intracellular calcium levels) and AV nodal blockade (because of parasympathomimetic activity) is the most characteristic arrhythmia seen with Digoxin toxicity.\nBut Ventricular bigeminy is the most common arrythmia seen with Digoxin toxicity.", "cop": 3, "opa": "Ventricular Extrasystoles", "opb": "Ventricular bigemini", "opc": "Atrial tachycardia with AV nodal block", "opd": "Atrial flutter", "subject_name": "Pharmacology", "topic_name": null, "id": "31f78e60-285f-4f4d-a72d-4999e2214b24", "choice_type": "single"} {"question": "A drug having narrow therapeutic range is", "exp": "Therapeutic range is bounded by the dose which produces a minimal therapeutic effect and the dose which produces a maximal acceptable adverse effect.\nExample of the narrow therapeutic range are lithium, Phenytoin.", "cop": 1, "opa": "Lithium", "opb": "Sertraline", "opc": "Reboxetine", "opd": "Dothiepin", "subject_name": "Pharmacology", "topic_name": null, "id": "3c7dbf53-ea02-4669-9461-592ef6ddb55f", "choice_type": "single"} {"question": "AIDS is a disease of the immune system primarily affecting", "exp": null, "cop": 4, "opa": "Granulocytes", "opb": "Immunoglobulins", "opc": "Opsonins", "opd": "T Lymphocytes", "subject_name": "Pharmacology", "topic_name": null, "id": "863e35b4-3e4d-46ca-b67e-52eca281a0bb", "choice_type": "single"} {"question": "For a 23 old pregnant female having severe sensitivity to amoxicillin, drug used to treat gonorrhoea in a single dose should be", "exp": "(Ref: Katzung 10/e p719,762) Ceftriaxone is contraindicated in patients having severe allergy to penicillins. Tetracyclines are noty effectyive against gonorrhoea. Although ciprofloxacin is effective as a single dose treatment of gonorrhoea but it is contraindicated in pregnancy. Spectinomycin can be given as single dose treatment of PPNG.", "cop": 1, "opa": "Ceftriaxone", "opb": "Clindamycin", "opc": "Ciprofloxacin", "opd": "Spectinomycin", "subject_name": "Pharmacology", "topic_name": "Other topics and Adverse effects", "id": "c686fe74-d884-41e9-93fc-0fbcad19985d", "choice_type": "single"} {"question": "Heparin inhibits Xa by", "exp": "Heparin contains pentasaccharide unit that activates Antithrombin III & inhibits factor Xa (Thus it is a indirect thrombin inhibitor).\nUnfractionised heparin also contains a heteropolysaccharide unit that inhibits factor II a.\nLMWH lacks this heteropolysacchoride unit and therefore inhibitors factor Xa only.", "cop": 2, "opa": "Blocking vitamin K mediated activation of Xa", "opb": "Activating Antithrombin III", "opc": "Direct breakdown of Xa", "opd": "Blocking P2 Y12 receptor of ADP", "subject_name": "Pharmacology", "topic_name": null, "id": "173d0f3c-84a7-4c58-a298-41a1fde943ee", "choice_type": "single"} {"question": "The best stimulator of Vasopressin includes", "exp": "(D) Hypertonicity > Main stimulus for secretion of vasopressin is increased osmolality of plasma.> Reduced volume of extracellular fluid also has this effect, but is a less sensitive mechanism.> Serum osmolarity/osmolality is affected by vasopressin due to its role in keeping proper electrolytic balance in the blood stream.> mproper balance can lead to dehydration, alkalosis, acidosis or other life-threatening changes. The hormone ADH is partly responsible for this process by controlling the amount of water the body retains from the kidney when filtering the blood stream.# Vasopressin has three main effects:> Increasing the water permeability of distal convoluted tubule & collecting duct cells in the kidney, thus allowing water reabsorption & excretion of more concentrated urine, i.e., antidiuresis. This occurs through increased transcription and insertion of water channels (Aquaporin-2) into the apical membrane of distal convoluted tubule and collecting duct epithelial cells. Aquaporins allow water to move down their osmotic gradient and out of the nephron, increasing the amount of water re-absorbed from the filtrate (forming urine) back into the bloodstream. This effect is mediated by V2 receptors. Vasopressin also increases the concentration of calcium in the collecting duct cells, by episodic release from intracellular stores. Vasopressin, acting through cAMP, also increases transcription of the aquaporin-2 gene, thus increasing the total number of aquaporin-2 molecules in collecting duct cells.> Increasing permeability of the inner medullary portion of the collecting duct to urea by regulating the cell surface expression of urea transporters, which facilitates its reabsorption into the medullary interstitium as it travels down the concentration gradient created by removing water from the connecting tubule, cortical collecting duct, and outer medullary collecting duct.> Acute increase of sodium absorption across the ascending loop of Henle. This adds to the countercurrent multiplication which aids in proper water reabsorption later in the distal tubule and collecting duct.# Drug Stimulators of Vasopressin secretion: Vincristine, cyclophosphamide, tricyclic antidepressants, nicotine, epinephrine, and high doses of morphine. Lithium, which inhibits the renal effects of vasopressin, also enhances vasopressin secretion. Inhibitors of vasopressin secretion: Ethanol, phenytoin, low doses of morphine, glucocorticoids, fluphenazine, haloperidol, promethazine, oxilorphan, and butorphanol. Carbamazepine has a renal action to produce antidiuresis in patients with central diabetes insipidus but actually inhibits vasopressin secretion by a central action.", "cop": 4, "opa": "Decreased K+", "opb": "Increased K+", "opc": "Hypotonicity", "opd": "Hypertonicity", "subject_name": "Pharmacology", "topic_name": "Miscellaneous (Pharmacology)", "id": "111f11a5-5421-457d-9a5c-1ed15681a49a", "choice_type": "single"} {"question": "Hydrochlorothiazide works by inhibiting", "exp": "Thiazide diuretics: Inhibits Na-Cl- sympoer in early DCT acts on distal tubule Includes- chlorothiazide, indapamide Decreases Na+, K+, Mg2+, H+ Increases glucose, uric acid, lipid Increase in calcium - used in osteoporosis Name Site of action Example Mechanism Loop diuretics Thick ascending limb of Loop of Henle Furosemide, Torsemide Na-K-2Cl sympoer inhibition Carbonic anhydrase inhibitors PCT Acetazolamide, Dorzolamide, Brinzolamide Carbonic anhydrase inhibition Thiazides DCT Hydrochlorothiazide, Chlohalidone Na-Cl sympoer inhibition Osmotic diuretics Non-specific Mannitol By osmotic effect Epithelial sodium channel blockers Collecting duct Amiloride, Triamterene eNa channel blockade Aldosterone antagonists Collecting duct Spironolactone, Eplerenone Antagonism of aldosterone receptors", "cop": 2, "opa": "Na+ CI pump in late DCT", "opb": "Na+ CI pump in early DCT", "opc": "Na+ K+ 2CT pump in descending limb of loop of Henle", "opd": "Na+K+2CT pump in ascending limb of loop of Henle", "subject_name": "Pharmacology", "topic_name": "FMGE 2019", "id": "1a96c922-010b-4139-a6ca-e9b8b44430d7", "choice_type": "single"} {"question": "The drug of choice for treatment of typhoid is", "exp": null, "cop": 3, "opa": "Tetracycline", "opb": "Metronidazole", "opc": "Ciprofloxacin", "opd": "Cefotaxime", "subject_name": "Pharmacology", "topic_name": null, "id": "0a979477-020e-491b-8554-773bb84301ea", "choice_type": "single"} {"question": "Hand, foot mouth syndrome is caused by ~", "exp": "Ans. is 'c' i.e., 5FU Hand foot syndromeo Hand foot syndrome is a form erythromyelalgia manifested as tingling, numbness, pain, erythma, swelling and increased pigmentation of hands and feet,o Two most common drugs causing 'Hand foot' syndrome are:Capecitabine (most common)5-FU (2nd most common)Drugs causing 'Hand foot' syndromeCommonly associated drugso Capecitabineo Surafenibo Cytarabino 5-FUo Doxorubicin (liposomo!)Rarely associated drugso Cisplatino Cyclophosphamideo Docetaxelo Daunorubicino Etoposideo Hydroxyureao Methotrexateo Mitotaneo 6-MPo Suramino Paclitaxel", "cop": 3, "opa": "Cisplatin", "opb": "Methotrexate", "opc": "5 FU", "opd": "Metvcergide", "subject_name": "Pharmacology", "topic_name": "Anti-Neoplastic Agents", "id": "8772284f-8ae5-4868-8ab6-5d3777790ead", "choice_type": "single"} {"question": "Zileuton is a", "exp": "Zileuton is an orally active inhibitor of 5-lipoxygenase, and thus inhibits leukotrienes (LTB4, LTC4, LTD4, and LTE4) formation, used for the maintenance treatment of asthma. Ref: KD Tripathi 8th ed", "cop": 1, "opa": "5 lipooxygenase inhibitor", "opb": "TXA2 inhibitor", "opc": "Leukoteriene receptor antagonist", "opd": "Prostaglandin synthesis inhibitor", "subject_name": "Pharmacology", "topic_name": "Autacoids", "id": "8b586a5b-e40a-4623-8da0-c2298889afe2", "choice_type": "single"} {"question": "The most impoant factor governing absorption of a drug from intact skin is", "exp": "Lipid solubility is an impoant factor governing the absorption through skinRef: KDT 6/e , pg 15", "cop": 3, "opa": "Molecular weight of the drug", "opb": "Site of application", "opc": "Lipid solubility of the drug", "opd": "Nature of the base used in the formulation", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "354bfb2c-4a8f-4897-ad80-c0fff4c3ddce", "choice_type": "single"} {"question": "Svere myopathy commonly is a side effect of", "exp": "ESSENTIALS of medical PHARMOCOLOGY SEVENTH EDITION KD TRIPATHI Page :636,637 Impoant statins are :lovastatin Simvastain, pravastatin, rosuvastatin etc Rosuvastatin This is the latest and the most potent statin (10 mg rosuvastatin :::::. 20 mg atorvastatin), with a plasma tlh. of 18-24 hours. Greater LDL-CH reduction can be obtained in severe hypercholesterolaemia; paly due to its longer persistence in the plasma. In patients with raised TG levels, rosuvastatin raises HDL-CH by 15--20% (greater rise than other statins). Dose: Sta with 5 mg OD, increase if needed upto 20 mg/ day, (max 40 mg/ day) ROSUV AS, ROSYN 5, 10, 20 mg tabs. Adverse effects All statins are remarkably well tolerated; overall incidence of side effects not differing from placebo. Notable side effects are: * Headache, nausea, bowel upset, rashes. * Sleep disturbances (probably more with lipophilic drugs). * Rise in serum transaminase can occur, but liver damage is rare. * Muscle tenderness and rise in CPK levels occurs infrequently. Myopathy is the only serious reaction, but is rare ( < 1 per 1000). Few fatalities due to rhabdomyolysis are on record. Myopathy is more common when nicotinic acid/ gemfibrozil or CYP3A4 inhibitor- ketoconazole I erythromycin/ cyclosporine I HIV protease inhibitor is given concurrently. Gemfibrozil inhibits the hepatic uptake of statins by the organic anion traspoer OATP2.it must not be given to pregnant ladies. Uesd in primary hyperlipipidemias.", "cop": 1, "opa": "Rosuvastatin", "opb": "Nicotinic acid", "opc": "Ezetimibe", "opd": "Colesevelam", "subject_name": "Pharmacology", "topic_name": "Other topics and Adverse effects", "id": "6f796142-482f-4156-9811-61f55dd7b2e0", "choice_type": "single"} {"question": "Spironolactone should not be given with", "exp": "Sprinolanctone is a potassium sparing diurectic It doesn't excrete potassium - increasing potassium levels in the blood ACE IN. also increases potassium levels in the blood Hence the combination is contraindicated Ref: KD Tripathi 8th ed", "cop": 3, "opa": "Chlohiazide", "opb": "Beta blockers", "opc": "ACE inhibitors", "opd": "Amlodipine", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "d306ea3d-13dc-4985-8642-a60135919464", "choice_type": "single"} {"question": "Sacubitril is a/an", "exp": "(B) Neuro-endopeptidase inhibitor[?]Sacubitril is a pro-drug used in combination with valsartan to reduce the risk of cardiovascular events in patients with chronic heart failure (NYHA Class II-IV) and reduced ejection fraction.oIt acts by inhibiting neprilysin (neutral endopeptidase) which is responsible for the degradation of atrial and brain natriuretic peptide.oANP & BNP are released under atrial and ventricle stress, which activate downstream receptors leading to vasodilation, natriuresis and diuresis.oInhibition of neprilysin leads to reduced breakdown and increased concentration of endogenous natriuretic peptides in addition to increased levels of vasoconstricting hormones such as angiotensin II.oIt is given in combination with valsartan which is an aangitensin receptor blocker, resulting in a decrease in vascular resistance and blood pressure.oMost common adverse reactions (>=5%) are hypotension, hyperkalemia, cough, dizziness, & renal failure.oCardiovascular & renal effects of sacubitril is a result of the increased levels of peptides that are normally degraded by neprilysin. PHARMACOKINETICS OF SACUBITRIL* ClassAntiotensin-receptor nepilysin inhibitor* ForumulationSacubitril/valsatran-24/26mg,49/51mg,97/103mg tablets* RouteOral* Tmax0.5 hrs (Sacubitril); 2 hours (LBQ657)*; 1.5 hrs (Valsartan)* EliminationSacubitril (52-68% urine 37-48% feces; Valsartan (-13% urine; 86% feces)* Half-life1.4 hrs (sacubitril); 11.5 hrs (LBQ657)*; 9.9 hrs (valsartan)* Active metabolite of sacubitril.[?]VALSARTANois mainly used for treatment of high blood pressure, congestive heart failure, & to increase the chances of living longer after a heart attack. It is an angiotensin II receptor antagonistoSACUBITRILoSacubitril blocks the activity of an enzyme called neprilysin. When neprilysin is active, it breaks down helpful peptides Sacubitril inhibits nepnlysin so peptide levels can go up. These peptides help relax blood vessels & decrease sodium and fluid in the body.[?]ACE inhibitoroAn angiotensin-converting-enzyme inhibitor (ACE inhibitor) is used primarily for the treatment of hypertension (elevated blood pressure) and congestive heart failure.[?]Renin inhibitorsoRenin inhibitors are used primarily in treatment of essential hypertension (high blood pressure).oThese drugs inhibit the first and rate-limiting step of the renin-angiotensin-aldosterone system (RAAS), namely the conversion of angiotensinogen to angiotensin[?]Angiotensin receptor antagonist: Angiotensin II receptor blockers (ARBs) are medications that block the action of angiotensin II by preventing angiotensin II from binding to angiotensin II receptors on muscles surrounding blood vessels", "cop": 2, "opa": "ACE inhibitor", "opb": "Neutral endopeptidase inhibitor", "opc": "Renin inhibitor", "opd": "Angiotensin receptor antagonist", "subject_name": "Pharmacology", "topic_name": "ACE Inhibitors", "id": "f01017cc-885f-4356-9d4b-95372d5d04d1", "choice_type": "single"} {"question": "Crofelemer is a", "exp": "Crofelemer blocks CFTR and chloride channels and is approved for relieving symptoms of diarrhoea is AIDS patients on antiretroviral therapy.", "cop": 2, "opa": "Chloride channel activator", "opb": "CFTR blocker", "opc": "Somatostatin antagonist", "opd": "Guanylate cyclase agonist", "subject_name": "Pharmacology", "topic_name": null, "id": "86eb8a26-eb48-403a-a41f-370dc8cc9dd4", "choice_type": "single"} {"question": "Therapeutic drug monitoring is done for;", "exp": "Therapeutic drug monitoring is adjustment of dose of the drug according to its plasma concentration. It is required for A Aminoglycosides (e.g. gentamicin) Drug Digitalis Possessing Phenytoin (anti-epileptics) Low Lithium Therapeutic Tricyclic antidepressants Index Immunomodulators (e.g. cyclosporine) Criteria for doing TDM Low therapeutic index When therapeutic response cannot be easily measured Inconsistent pharmacokinetics of the drug.", "cop": 1, "opa": "Phenytoin", "opb": "Heparin", "opc": "Aspirin", "opd": "Metformin", "subject_name": "Pharmacology", "topic_name": "FMGE 2019", "id": "b7289445-e3bd-4782-baf8-e69dacf1accb", "choice_type": "single"} {"question": "An anesthetic agent with boiling temperature more than 75 C is", "exp": "Refer Anesthesiology by Longnecker 2008/777 Boiling point of methoxyflurane is 104,7 degree Celsius whereas other flurrinated anesthetics have boiling point between 50 C and 60 C", "cop": 4, "opa": "Ether", "opb": "Halothane", "opc": "Cyclopropane", "opd": "Methoxyflurane", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "65408e88-2c5d-4a4e-9306-16c386ba94eb", "choice_type": "single"} {"question": "Voriconazole is not effective against", "exp": "Mucormycosis Voriconazole Voriconazole is recent systemic antifungal agent belonging to the azole chemical .family. It is a broad spectrum azole that has been approved for t/t by F.D.A. in 2002. As with other triazoles voriconazole impairs the biosynthesis of ergosterols by inhibiting the p450 enzyme 14a sterol demethylase. Voriconazole is administered by i.v. and oral routes. It is formulated as lyophilized powder ,for solution for i.v. infusion as well as tablets and powder for suspension for oral administration. Uses of Voriconazole Varoconazole is a broad spectrum azole. It can be used in all diseases where azoles are effective. It is especially used for ? Invasive aspergillosisQ In patients with invasive aspergillosis, initial therapy with voriconazole led to better responses and improved survival and resulted in.fewer side effects than the standard approach of initial therapy with amphotericin B. Emerging fungal pathogensQ Voriconazole is used in the primary treatment of amphotericin B and fluconazole resistant fungal infections e.g., Fusarium, Scendosporium. Patients with neutropenia and feverQ Pts with neutropenia and fever are often treated empirically with AMB or liposomal AMB to prevent invasive fungal infections. Voriconazole is a suitable alternative to AMB preparation for empirical antifungal therapy in patients with neutropenia and persistent fever. Those with Fluconazole resistant candida infection Voriconazole is a broad spectrum antifungal showing in vitro activity against candida species uncluding fluconazole resistant candida albicans2 and candida krusei2. Some impoant adverse effect of Voriconazole : ? Teratogenecity - Voriconazole is teratogenic in animals and contraindicated in pregnancy (class 0) QTc prolongation and arrhythmias - Voriconazole like some other azoles causes a prolongation of the QTc intervals which can become significant in patient with other risk factors for Torsades-de-points.", "cop": 2, "opa": "Aspergillosis", "opb": "Mucormyocosis", "opc": "Candida albicans", "opd": "Candida tropicalis", "subject_name": "Pharmacology", "topic_name": null, "id": "8cd5848d-67f9-470d-a441-002593d66378", "choice_type": "single"} {"question": "Potassium iodide is useful in the treatment of", "exp": "Cutaneous and lymphocutaneous sporotrichosis have historically been treated with saturated solution of potassium iodide (SSKI). Although relatively inexpensive, SSKI is poorly tolerated by many patients because of frequent adverse effects. The orally available azole antifungals are the drugs of choice for cutaneous or lymphocutaneous sporotrichosis in developed nations. Ketoconazole has been used but is less effective than itraconazole or fluconazole; thus, ketoconazole is no longer indicated. Fluconazole is less effective than itraconazole. Itraconazole is the drug of choice for all types of sporotrichosis but CNS and disseminated sporotrichosis.Terbinafine has been demonstrated to be effective in the treatment of lymphocutaneous sporotrichosis, but no comparative data with itraconazole therapy exist. REFERANCE:emedicine.medscape.com", "cop": 1, "opa": "Sporotrichosis", "opb": "Impetigo", "opc": "Viral was", "opd": "Dermatitis herpetiformis", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "ea9aeda3-746a-4ddb-b6be-c303fc6b04de", "choice_type": "single"} {"question": "Muscle relaxant of choice in liver disease is", "exp": "Refer Katzung 11/e p456 Atracurium and cis-Atracurium are degraded spontaneously by Hoffman's elimination These don't require liver or kidney for elimination and thus are muscle relaxant of choice in a patient with renal and hepatic dysfunction", "cop": 1, "opa": "Atracurium", "opb": "Pipecuronium", "opc": "Rocuronium", "opd": "Vecuronium", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "a57c343f-aa49-49d5-8dc3-26c018701b90", "choice_type": "single"} {"question": "Use of tiotropium is contraindicated in", "exp": "Refer katzung 10e 117,kdt 6/e 113 Ipratropium and tiotropium are anti muscarinic drugs used for the treatment of bronchial asthma and COPD by inhalational route Anti muscarinic drugs are contraindicated in patients with Glaucoma especially angle closure glaucoma History of BPH", "cop": 3, "opa": "Bronchial asthma", "opb": "Hypeension", "opc": "Urinary retention", "opd": "Peptic ulcer disease", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "ded2afde-b908-41f5-9ebf-d45ef2834987", "choice_type": "single"} {"question": "Calicitonin causes hypocalcemia by", "exp": "Refer KDT 6/e p 330 Calcitonin inhibits bone resorption by direct action on osteoclasts Calcitonin recetpors are present on osteoclasts It also inhibits proximal tubular calcium and and phosphate reabsorption by direct action on kidney However hypocalcemia which occurs overrides the direct action by decreasing the total Ca2+ filtered at the Glomerulus", "cop": 1, "opa": "Inhibiting bone resorption", "opb": "Promoting osteolysis", "opc": "Decreasing renal tubular reabsorption of calcium", "opd": "Decreasing absorption of phosphorus", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "99c8788c-f7a6-4fe0-9ddb-58086d964040", "choice_type": "single"} {"question": "Systemic vascular resistance is twice that of normal, treatment should be", "exp": "Increase in systemic vascular resistance means vasoconstriction, this is a vasodilator drugs like nitroprusside is given. Adrenaline and noradrenaline act as vasopressors whereas isoprenaline increases systolic blood pressure by acting on hea Refer kDT 7/e p567", "cop": 3, "opa": "Adrenaline", "opb": "Nor adrenaline", "opc": "Sodium nitroprusside", "opd": "Isoprenaline", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "67a40cc7-adc6-43f9-a7b3-7afd26986cfc", "choice_type": "single"} {"question": "Racemic mixture of two enantiomers with different pharmacokinetic pharmacodynamic propeies is seen in", "exp": "Refer Goodman and Gilman 11e p836 Verapamil is present as a racemic mixture of R and S verapamil. S verapamil has more stronger negative dromotropic action and higher first pass metabolism than R verapamil", "cop": 3, "opa": "Digoxin", "opb": "Dilantin", "opc": "Verapamil", "opd": "Octreotide", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "b0263001-feab-415c-8a4a-2c9949e84a6f", "choice_type": "single"} {"question": "Muscle relaxant of choice in renal and hepatic failure Is", "exp": "Cis-Atracurium is an isomer of Atracurium. It undergoes inactivation in plasma by spontaneous non enzymatic degradation(Hoffman elimination) in addition to that by cholinesterases. Consequently it's duration of action is not altered in patients with hepatic or renal insufficiency.. All the other given drugs don't undergo Hoffman elimination. From KD Tripati 7th edition Page no 253", "cop": 1, "opa": "Cis-atracurium", "opb": "Vecuronium", "opc": "Rocuronium", "opd": "Rapacuronium", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "05b9b9a0-1cbc-488e-a0a9-8a87ae3a60f9", "choice_type": "single"} {"question": "A 2 years old child without fever develops bone pain, vomiting, and features of increased intracranial pressure following excessive meditation. The drug most likely to be responsible for this is;", "exp": "Vitamin A is stored in the liver, deficiency symptoms appear only after long-term deprivation, but vit A deficiency is quite prevalent, especially among infants and children in developing countries. Manifestations are • Xerosis (dryness) of the eye, 'Bitot's spots', keratomalacia (softening of the cornea), corneal opacities, night blindness (nyctalopia) progressing to total blindness. • Dry and rough skin with papules (Phrynoderma), hyperkeratinization, atrophy of sweat glands. • Keratinization of bronchopulmonary epithelium increased susceptibility to infection. • Unhealthy gastrointestinal mucosa, diarrhoea. • Increased tendency to urinary stone formation due to the shedding of ureteric epithelial lining which acts as a nidus. • Sterility due to faulty spermatogenesis, etc", "cop": 2, "opa": "Vitamin D", "opb": "Vitamin A", "opc": "Phenothiazine", "opd": "Phenytoin", "subject_name": "Pharmacology", "topic_name": null, "id": "68b1853e-6f8f-419c-a7c4-3ecd01cbb08b", "choice_type": "single"} {"question": "Anaesthetic agent causing pain on intravenous administration", "exp": "Refer Katzung 12th/431 Propofol is highly lipid soluble It's solution is made in oil(oliy liquid employed as 1 percnt emulsion) Thus it is painful on injection", "cop": 2, "opa": "Thiopentone", "opb": "Propofol", "opc": "Ketamine", "opd": "Midazolam", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "0270e8bf-0cbf-4ad5-9745-b0d3c13f7192", "choice_type": "single"} {"question": "Wof agent is used to prevent hemorrhagic cystitis caused by cyclophosphamide and ifosfamide", "exp": "To prevent hemorrhagic cystitis mesna is routinely given with the drugs. Mesna is a -SH compound that is excreted in urine--binds and inactivates the vasicotoxic metabolites(Acrolein) of ifosfamide and cyclophosphamide. Ref:- kd tripathi; pg num:-860", "cop": 3, "opa": "Busulfan", "opb": "Carmustine", "opc": "Mesna", "opd": "Niacin", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "6cab2569-a6c8-4d8c-9a68-d7ea2896f987", "choice_type": "single"} {"question": "Lovastatin acts by inhibiting", "exp": "Ans. a (HMGCoA reductase). (Ref. Harrison Medicine I6th/I43I, 2168, 2296, table 335-6)HMG-CoA REDUCTASE INHIBITORS# HMG-CoA reductase is the rate-limiting step in cholesterol biosynthesis.# By inhibiting cholesterol biosynthesis, HMG-CoA reductase inhibitors (statins) lead to -- increased hepatic LDL receptor activity and accelerated clearance of circulating LDL, resulting in a dose-dependent reduction in plasma LDL-C.# HMG-CoA reductase inhibitors are the drug class of choice for LDL-C reduction.# They also reduce plasma triglycerides in a dose-dependent fashion, which is proportional to their LDL-C lowering effects .# They have a modest HDL-raising effect (5 to 10%), and this effect is not dose-dependent.# HMG-CoA reductase inhibitors are well tolerated and can be taken in tablet form once a day.# Potential Side Effects include:Dyspepsia,- Headaches,- Fatigue,- Muscle or joint pains- Severe myopathy- Rhabdomyolysis (rarely).- Hepatitis# The risk of myopathy is increased by the presence of renal insufficiency and by coadministration of drugs that interfere with the metabolism of HMG-CoA reductase inhibitors, such as erythromycin and related antibiotics, antifungal agents, immunosuppressive drugs, and fibric acid derivatives.# Serum CPK levels do not need to be monitored on a routine basis as an elevated CPK in the absence of symptoms does not predict the development of myopathy and does not necessarily suggest the need for discontinuing the drug.DRUGS USED FOR THE TREATMENT OF HYPERLIPIDEMIADrugMajor indicationsMechanismCommon side effectsHMG-CoA reductase inhibitors (statins)Elevated (LDL)|Cholesterol synthesis;|LDL receptors,| hepatic VLDLProductionMyalgias, arthralgias, DyspepsiaBile acid sequestrantsElevated triglycerides| Bile acid excretion and| LDL receptorsBloating, constipation.Nicotinic acidElevated LDL, |HDL,Elevated TG|VLDL hepatic synthesis and | HDL.Cutaneous flushing;GI upset;Elevated glucose, uric acid, levels and liver function tests.Fibric acid derivatesElevated remnants| LPL, |VLDLDyspepsia myalgia; gall stones.", "cop": 1, "opa": "HMGCoA reductase", "opb": "HMGCoA synthetase", "opc": "17- Hydroxyalse", "opd": "Bile-acid synthetase", "subject_name": "Pharmacology", "topic_name": "Hypolipidemic", "id": "d5924ecb-5758-4980-95d5-e9f9404121a6", "choice_type": "single"} {"question": "The drug of choice in scleroderma induced hypeensive crisis is", "exp": "Refer kDT 7/e p 505 Blood pressure control is the mainstay of therapy in sclerodermarenal crisis. ... An ACE inhibitor is the agent of choice, leading to an improvement in blood pressure in up to 90% of patients by reversing the angiotensin II-inducedvasoconstriction.", "cop": 1, "opa": "ACE inhibitor", "opb": "Thiazides", "opc": "Beta blockers", "opd": "Sodium nitroprusside", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "754db08b-7009-4be8-bbbe-898ff63dba53", "choice_type": "single"} {"question": "Drug of choice for post menopausal osteoporosis is", "exp": "Drug used in osteoporosis Inhibit resorption:Bisphosphonates (drug of choice), Denosumab, calcitonin, estrogen, SERMS, gallium nitrate. Stimulate formation: Teriparatide (PTH analogue), calcium, calcitriol, fluorides. Both actions: Strontium ranelate.", "cop": 2, "opa": "Estrogen", "opb": "Bisphosphonates", "opc": "Teriparatide", "opd": "Thyroxine", "subject_name": "Pharmacology", "topic_name": "NEET Jan 2020", "id": "3447d428-6630-4526-a637-520c8776c80b", "choice_type": "single"} {"question": "Brinzolamide is", "exp": "Carbonic anhydrase (CAse) is an enzyme which catalyses the reversible reaction H2O + CO2 - H2C03 Hence, Carbonic anhydrase functions in CO2 and HC03 transpo and in H+ ion secretion. Carbonic anhydrase inhibitors act by non-competitive but reversible inhibition of the enzyme -Decreases the production of aqueous humor from ciliary body epithelium. Ex: Acetazolamide, dorzolamide and Brinzolamide.", "cop": 2, "opa": "Competitive and reversible carbonic anhydrase inhibitor", "opb": "Non-competitive and reversible carbonic anhydrase inhibitor", "opc": "Competitive and irreversible carbonic anhydrase inhibitor", "opd": "Non-competitive and irreversible carbonic anhydrase inhibitor", "subject_name": "Pharmacology", "topic_name": "Sympathetic System", "id": "0bf3127c-d51f-485d-973e-d3fd0846d133", "choice_type": "single"} {"question": "Drug of choice for late cisplatin induced vomiting is", "exp": "Anti - Emetic Drugs:- - Neurokinin antagonist (NK1antagonist / Substance-P antagonist) Aprepitant Fosaprepitant Rolapitant Netupitant - These are drug of choice for delayed vomiting due to chemotherapy", "cop": 3, "opa": "Omeprazole", "opb": "Granisetron", "opc": "Aprepitant", "opd": "Dexamethasone", "subject_name": "Pharmacology", "topic_name": "Gastro-Intestinal Tract", "id": "bbd02411-7e68-4665-85bc-0b68962b033a", "choice_type": "single"} {"question": "The drug not used in acute asthma is", "exp": "Refer KDT 6/e p 222 Only bronchodilator drugs are useful for the treatment of acute attack of asthma Beta 2 agonists eg salbutomol, terbutaline. Antichokinergics eg Iprqtropoum, tiotropium Methylxanthine eg Theophylline", "cop": 3, "opa": "Salbutomol", "opb": "Ipratropium", "opc": "Montelukast", "opd": "Hydrocoisone", "subject_name": "Pharmacology", "topic_name": "Respiratory system", "id": "0f203f3e-a0ca-4b52-8efb-cf903ed16e31", "choice_type": "single"} {"question": "Muscle relaxant of choice in a patient with serum bilirubin 6mg/dl and serum creatinine of 4.5mg/dl", "exp": "Refer KDT 7th, /353 Atracurium is eliminated by Hoffman's elimination. It means it neither require liver for metabolism nor kidney for excretion. It's molecules spontaneously reaarnge to make it reactivity. Thus it safest muscle relaxed in a patient on a patient with liver and kidney disease", "cop": 2, "opa": "Vecuronium", "opb": "Atracurium", "opc": "Pancuronium", "opd": "Mivacurium", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "bf286ff8-2318-402a-9a3d-85dc824ba58b", "choice_type": "single"} {"question": "Tyramine acts by", "exp": "C i.e. Release norepinephrine Tyramine, ephedrine & amphetamine (TEA) augment autonomic activity by releasing norepinephrineQ from endings of post-ganglionic neurons. Stnne drugs and toxins affecting Autonomic activity /IP Site of Action Compounds That Augment Autonomic Activity Compounds That Depress Autonomic Activity Sympathetic and parasympathetic ganglia * Stimulate postganglionic neurons - Nicotine - Low concentrations of acetylcholine * Inhibit acetylcholinesterase - DFP (diisopropyl fluorophosphate) - Physostigmine (Eserine) - Neostigmine (Prostigmin) - Parathion * Block conduction - Hexamethonium (C-6) - Mecamylamine (inversine) - Pentolinium - Trimethaphan (Arfonad) - High concentration of acetylcholine Endings of postganglionic noradrenergic neurons * Release norepinephrine - Tyramine - Ephedrine - Amphetamine * Block norepinephrine synthesis - Metyrosine (Demser) * Interfere with norepinephrine storage - Reserpine - Guanethidine (Ismelin) * Prevent norepinephrine release - Bretylim (Bretylol) - Guanethidine (Ismelin) * Form false transmitters - Methyldopa (Aldomet) Muscarinic receptors Atropine, scopolamine a adrenergic receptors * Stimulate alreceptors - Methoxamine (Vasoxyl) - Phenylephrine (Neo-Synephrine) * Block a receptors - Phenoxybenzamine (Dibenzyline) - Phentolamine (Regitine) - Prazosin (Minipress) (block al) - Yohimbine (blocks a2) b adrenergic receptors * Stimulate 13 receptors - Isoproterenol (Isuprel) * Block $ receptors - Propranolol (Inderal) and others (blocks 01 - Atenolol (Tnormin) and others (blocks 01) Butoxamine (blocks 02) C i.e. Release norepinephrine", "cop": 3, "opa": "Inhibit acetylcholinesterase", "opb": "Stimulate co receptor", "opc": "Release norepinephrine", "opd": "Stimulate 13 receptor", "subject_name": "Pharmacology", "topic_name": null, "id": "234562f7-310e-425a-a1a7-0cee3c345d79", "choice_type": "single"} {"question": "Aspirin is contraindicated in", "exp": "B. i.e. (Peptic Ulcer) (190- KDT 6th)* Aspirin is contra indicated in1. Peptic ulcer, bleeding tendencies2. Viral infection in children (Develop Reys syndrome)3. Warfarin*** Aspirin is avoided in1. Chronic liver disease2. Diabetes3. Breast feeding mothers4. Avoid high dose in G-6PD deficient individuals**Aspirin should be stopped 1 week before elective surgery ***.* Salicylism (tinnitus, and hearing difficulty, dizziness, headache and confusion) develops on high doses of aspirin intake* Aspirin is one of the worst for causing gastric irritation* Low doses of aspirin also decreases the incidence of transient ischaemic attacks* Analgesic effect of Aspirin is due to Inhibit prostaglandin synthesis (cyclo- oxygenase decreases)**", "cop": 2, "opa": "Rheumatoid arthritis", "opb": "Peptic ulcer", "opc": "Unstable angina", "opd": "Myalgia", "subject_name": "Pharmacology", "topic_name": "Miscellaneous (Pharmacology)", "id": "20b64991-01b1-44c8-8a2f-25f1964ff41d", "choice_type": "single"} {"question": "Amylin analog among the following is", "exp": "Pramlintide, a synthetic analog of amylin, is an injectable antihyperglycemic agent that modulates postprandial glucose levels and is approved for preprandial use in persons with type 1 and type 2 diabetes. It is administered in addition to insulin in those who are unable to achieve their target postprandial blood sugar levels.Pramlintide suppresses glucagon release undetermined mechanisms, delays gastric emptying, and has central nervous system mediated anorectic effects.Ref: Katzung; 13th edition; Page no: 760", "cop": 4, "opa": "Sitagliptin", "opb": "Liraglutide", "opc": "Nateglinide", "opd": "Pramlintide", "subject_name": "Pharmacology", "topic_name": "Immunomodulators", "id": "dbd028d5-86a8-44ab-bdbe-c84e3ad7b31b", "choice_type": "single"} {"question": "Variation in sensitivity of response to increasing doses of the drug in different individuals can be obtained from", "exp": "Quantal DRC When the response is an 'all or none' phenomenon (e.g. antiemetic drug stopping the vomiting or not), the y-axis (response axis) shows the number of person responding and X-axis shows the plasma concentration. It thus shows that how many person respond to a paicular dose of the drug. It is used to calculate ED50 and LD50. Median Effective Dose (ED50): It is the dose that will produce the desired response in half of the (50%)recipients. More is ED50, lower is the potency and vice a versa. Median Lethal Dose (LD50): It is the dose that will result in death of 50% of the animals receiving the drug. More is LD50, safer is the drug. Therapeutic Index (T.I.): It is a measure of the safety of a drug. It is calculated as a ratio of LD50 to ED50. Drugs having high T.I. are safer whereas those having low T.I. are more likely to be toxic.", "cop": 2, "opa": "Graded DRC", "opb": "Quantal DRC", "opc": "Potency", "opd": "Efficacy", "subject_name": "Pharmacology", "topic_name": "Pharmacodynamics", "id": "3df4d810-8ab9-4269-bc39-8ee5b75dca91", "choice_type": "single"} {"question": "A patient presents with malignant hyperthermia and metabolic acidosis. Immediate treatment should be started with", "exp": null, "cop": 1, "opa": "Intravenous Dantrolene", "opb": "Sodium bicarbonate", "opc": "Intravenous fluids", "opd": "Paracetamol", "subject_name": "Pharmacology", "topic_name": null, "id": "14e137b3-3d70-407b-bb34-456f6ab532bf", "choice_type": "single"} {"question": "Drug causing impaired taste is", "exp": "antibiotics, such as ACE inhibitors like ESSENTIALS of medical PHARMACOLOGY SIXTH EDITION-KD TRIPATHI Page:688,689", "cop": 1, "opa": "metronidazole", "opb": "losaan", "opc": "paracetamol", "opd": "aspirin", "subject_name": "Pharmacology", "topic_name": "Other topics and Adverse effects", "id": "14bc1395-5cdc-4ef9-b87f-53693c97c7ef", "choice_type": "single"} {"question": "Antidote for opioid poisoning;", "exp": "Naloxone is an opioid antagonist given intravenously. It blocks mu, kappa and delta receptors. It is the DOC for opioid toxicity. is given parenterally (ineffective orally) and is a very sho acting drug. Pethidine (Meperidine)- fully agonist at opiod receptors Flumazenil-Flumazenil is specific antidote for benzodiazepines. Physostigmine - it is a lipid soluble anticholinesterase. It is the specific antidote for poisoning with belladonna.", "cop": 1, "opa": "Naloxone", "opb": "Pethidine", "opc": "Flumazenil", "opd": "Physostigmine", "subject_name": "Pharmacology", "topic_name": "FMGE 2019", "id": "c66d8a95-52a5-479c-8815-9021dbc56f84", "choice_type": "single"} {"question": "Colourblindess is caused by", "exp": "Ans. b (Ethambutol). (Ref. Katzung 12th/Chapter 47)Hypersensitivity to ethambutol is rare. The most common serious adverse event is retrobulbar neuritis, resulting in loss of visual acuity and red-green color blindness. This dose-related adverse effect is more likely to occur at dosages of 25 mg/kg/d continued for several months. At 15 mg/kg/d or less, visual disturbances are very rare. Periodic visual acuity testing is desirable if the 25 mg/kg/d dosage is used. Ethambutol is relatively contraindicated in children too young to permit assessment of visual acuity and red-green color discrimination.Drugs causing color vision alterationDrugs causing cataractDrugs causing retinopathyBarbituratesBusulfanChloroquineDigoxin (yellow vision)SteroidPhenothiazidesEthambutol (red-green blindness)PhenothiazidesDEC (anti-filarial)Sildenafil citrate (blue-green blindness)Miotics Thioridazone, thiazidesGold SulfonamidesChloroquine SYSTEMIC DRUGS:ADVERSE OCULAR EFFECTSOxygen> Retinopathy of prematurity.0Digitalis> Disturbances of color vision (yellow vision), scotomas, photopsia.Quinidine> Optic neuritis (rare).Thiazides> Xanthopsia (yellow vision), myopia.Carbonic anhydrase inhibitors> Ocular hypotony, transient myopia.Amiodarone> Corneal deposits.Anticholinergic agents> Risk of angle closure glaucoma due to mydriasis. Blurring of vision due to cycloplegia.Barbiturates> Extraocular muscle palsies with diplopia, ptosis, cortical blindness.Chloral hydrate> Diplopia, ptosis, miosis.Phenothiazines> Deposits of pigment in conjunctiva, cornea, lens and retina. Oculogyric crises.Amphetamines> Widening of palpebral fissure. Dilation of pupil, paralysis of ciliary muscle with loss of accommodation.Monoamine oxidase (MAO) inhibitors> Nystagmus, extraocular muscle palsies, optic atrophy.Tricyclic agents> Dilation of pupil (risk of angle closure glaucoma)0, cycloplegia.Phenytoin> Nystagmus, diplopia,0 ptosis, slight blurring of vision (rare).Neostigmine> Nystagmus, miosis.Morphine> Miosis.Haloperidol> Capsular cataract.Lithium carbonate> Exophthalmos, oculogyric crisis.Diazepam> Nystagmus.Corticosteroids> Cataract (posterior subcapsular), local immunologic suppression, causing susceptibility to viral (herpes simplex), bacterial, and fungal infections; steroid induced glaucomaFemale sex hormones> Retinal artery occlusion, retinal vein occlusion, papilledema, ocular palsies with diplopia, nystagmus, optic neuropathy, retinal vasculitis, scotomas, migraine, mydriasis and cycloplegia, and macular edema.Chloramphenicol> Optic neuritis and atrophy.Rifabutin> Uveitis.Streptomycin> Optic neuritis.Tetracycline> Pseudotumor cerebri, transient myopiaChloroquine> Macular changes, central scotomas, pigmentary degeneration of the retina, chloroquine keratopathy, ocular palsies, ptosis, ERG depression.lodochlorhydroxyquin> Optic atrophy.Sulfonamides> Stevens Johnson syndrome.Ethambutol> Optic neuritis and atrophy.Isoniazid> Optic neuritis and atrophy/ color blindness.Gold salts> Deposits in the cornea and conjunctiva.Lead> Optic atrophy, papilledema, ocular palsies.Penicillamine> Ocular pemphigoid, optic neuritis, ocular myasthenia.Chlorpropamide> Transient change in refractive error, diplopia, Stevens Johnson syndrome.Vitamin A> Papilledema, retinal hemorrhages, loss of eyebrows and eyelashes, nystagmus, diplopia, blurring of vision.Vitamin D> Band shaped keratopathy.Salicylates> Nystagmus, retinal hemorrhages, cortical blindness (rare).Indomethacin> Corneal deposits.Phenylbutazone> Retinal hemorrhages", "cop": 2, "opa": "Chloroquine", "opb": "Ethambutol", "opc": "Digitails", "opd": "PZM", "subject_name": "Pharmacology", "topic_name": "Adverse Drug Effect", "id": "6ff1a625-c5ab-47de-96ee-985c0ee44528", "choice_type": "single"} {"question": "Steady state plasma concentration obtained after a dosage regimen depends on", "exp": "Factors on which steady state depends:* Half life of drug, it is obtained after 4-5 half lives.* Frequency of administration i.e. more frequently we give, lesser is the variation between peak and trough at steady state.* Dosing rate i.e. more the dosing rate , more will be the concentration of drug in plasma. Note: Read the question carefully. If the question is asked, time to reach steady state plasma concentration depends upon?, then answer would he half life. But if they ask how much plasma concentration is obtained at steady state, it depends upon dosing rate.", "cop": 2, "opa": "Duration of action of the drug", "opb": "Dosing rate", "opc": "Half life of a drug", "opd": "Dosage interval", "subject_name": "Pharmacology", "topic_name": "Pharmacokinetics", "id": "fb42b5f7-ed23-4b48-b63a-c700266e99a8", "choice_type": "single"} {"question": "Drug of choice in treatment of partial complex seizures", "exp": "Ans. a (Carbamazepine). (Ref. Harrison, Internal Medicine, 16th ed., 1848)Type of seizurePrimary generalized tonic clonic seizurePartial complex seizuresAbsence seizureAtypical absence;Myoclonic; Atonic* First line treatmentValproic acidCarbamazepineEthosuximideValproic acidPhenytoin Valproic acid Valproic acid Lamotrigine * Valproate is broad spectrum anti-epileptic.", "cop": 1, "opa": "Carbamazepine", "opb": "Sodium valproate", "opc": "Ethosuximide", "opd": "Phenytoin", "subject_name": "Pharmacology", "topic_name": "C.N.S", "id": "c95875c1-d0ec-41c4-b1d2-68822348903f", "choice_type": "single"} {"question": "Drug of choice for primary syphilis is", "exp": "Ans. b (Benzathine penicillin). (Ref. Pharmacology KD Tripathi 5th/657, 673, 688; Harrison's Medicine 16th/980)Rx of SyphilisEarly & latent syphilisLate syphilis1.2 MU Procaine penicillin x 10 daysOR2.4 MU benzathine penicillin 1-3 weeklyBenzathine penicillin2.4 MU weekly for 4 weeksDrug used for treatment of syphilis# Penicillin# Erythromycin# Tetracycline# Cephalosporins.", "cop": 2, "opa": "Ampicillin", "opb": "Benzathine penicillin", "opc": "Erythromycin", "opd": "Tetracycline", "subject_name": "Pharmacology", "topic_name": "Anti Microbial", "id": "5df78bd0-9c6a-43ce-aa62-0ffee9b3c12c", "choice_type": "single"} {"question": "Digoxin increases cardiac contractility by directly engaging in wof", "exp": "Mechanism of action:- Digoxin increases force of cardiac contraction by a direct action independent of innervation. It selectively binds to extracellular face of the membrane associated Na+K+ ATPase of myocardial fibres and inhibitis this enzyme. Inhibition of this cation pump results in progressive accumulation of Na+ intracellularly. This indirectly results in intracellular Ca2+ accumulation. During depolarization Ca2+ ions enter the cell driven by the steep Ca2+ gradient through voltage sensitive L type Ca2+ channels. This triggers release of larger amount of Ca2+ stored in sarcoplasmic reticulum (SR) through Ryanodine calcium channel 2 (RYR2) - cytosolic Ca2+ increases transiently (calcium transients) - triggers contraction by activating troponin C on myofibrils. Ref:- kd tripathi; pg num:-514", "cop": 4, "opa": "Inhibiting myocardial Na + /Ca 2+ -ATPase", "opb": "Activating L-type Ca 2+ channels", "opc": "Inhibiting cardiac phosphodiesterase", "opd": "Inhibiting myocardial Na + /K + -ATPase", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "4665c308-c0dd-43da-9ba3-e2e7878e8bdc", "choice_type": "single"} {"question": "Local anesthetics act by blocking", "exp": "Local anesthetics are weak bases that peneterate cell membrane in unionized form and within the cell membrane in ionized form they block voltage gated Na+ Channels.", "cop": 3, "opa": "Na+ channels from outer side", "opb": "K+ channels from outer side", "opc": "Na+ channels from inner side", "opd": "K+ channels from inner side", "subject_name": "Pharmacology", "topic_name": null, "id": "3c9d0e5f-68db-4994-8076-ed6d67cb0e65", "choice_type": "single"} {"question": "QY prolongation can be caused by", "exp": null, "cop": 2, "opa": "Lithium", "opb": "Quinidine", "opc": "Adenosine", "opd": "Magnesium", "subject_name": "Pharmacology", "topic_name": null, "id": "90ba76b6-f120-4d0a-9bd9-2fa96b23827c", "choice_type": "single"} {"question": "The following anticancer drug has high emetogenic potential", "exp": "PLATINUM COORDINATION COMPLEXES Cisplatin Mech of action:- It is hydrolysed intracellularly to produce a highly reactive moiety which causes cross linking of DNA. The oured site is N7 of guanine residue. Adverse effects:- It is a highly emetic drug. Antiemetics are routinely administered before infusing it. The most impoant toxicity is renal impairment which is dependent on total dose administered. Renal toxicity can be reduced by maintaining good hydration. Tinnitus,deafness, sensory neuropathy and hyperuricaemia are other problems. Ref:- kd tripathi; pg num:-861", "cop": 4, "opa": "Chlorambucil", "opb": "Vincristine", "opc": "6-Mercaptopurine", "opd": "Cisplatin", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "7ed5d889-fd10-4080-9e91-5adb45a0b4df", "choice_type": "single"} {"question": "The drug of choice for paroxysmal supraventricular tachycardia", "exp": "Refer kDT 6/e p 519 Adenosine is a sho-actingmedication that is commonly used as a first-line drug to treat PSVT. Other treatment options for other atrial tachycardias include calcium channel blockers, beta blockers, digoxin, and amiodarone.", "cop": 1, "opa": "Verapamil", "opb": "Digitalis", "opc": "Quinidine", "opd": "Diphynylhydantoin", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "99573ac7-cecf-43d0-b5a2-1e864246ce69", "choice_type": "single"} {"question": "The tissues most sensitive to atropine are", "exp": "Atropine is highly selective for muscarinic receptors. Its potency at nicotinic receptors is much lower, and actions at nonmuscarinic receptors are generally undetectable clinically.The effectiveness of antimuscarinic drugs varies with the tissue and with the source of agonist. In most tissues, antimuscarinic agents block exogenously administered cholinoceptor agonists more effectively than endogenously released acetylcholine.Tissues most sensitive to atropine are the salivary, bronchial, and sweat glands.Secretion of acid by the gastric parietal cells is the least sensitive. Katzung 13e pg: 122", "cop": 1, "opa": "The salivary, bronchial and sweat glands", "opb": "The gastric parietal cells", "opc": "Smooth muscle and autonomic effectors", "opd": "The hea", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "e47e7e6f-5ce1-4ed2-85ee-fab32e92a9a4", "choice_type": "single"} {"question": "Drug of choice for pregnancy induced hypeension is", "exp": "Alpha methyldopa is a drug of choice for pregnancy induced hypeension. However these days labetalol is preferred for this case of indication. Refer Goodman and Gilman 12e p773 Katzung 12e p176", "cop": 1, "opa": "Methuldopa", "opb": "Atenolol", "opc": "Nitroprusside", "opd": "Enalapril", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "ee405bf2-ad0c-477d-a265-6ce191896cd6", "choice_type": "single"} {"question": "Displacement is the defensive mechanism for (NOT REALTED)", "exp": "In Phobia patient has fear of something which then is replaced by generalized fear of so many things.", "cop": 1, "opa": "Phobia", "opb": "Depression", "opc": "Persecutory delusions", "opd": "Delusions of grandiosity", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "b3bddc18-ca0d-4b31-84ca-0a1b8acdec58", "choice_type": "single"} {"question": "AZT, DD1, HAART are combination of three drugs are used in AIDS acts by", "exp": "(Nucleoside reverse transcriptase inhibitors) (770-KDT 6th)* Nucleoside reverse transcriptase inhibitors (NRTIs) -Zidovudine (AZT), Didanosine (ddl) Stavudine (d4T) Lamivudine (3TC) abacavir(ABC)Single- stranded viral RNA||Virus directed reverse transcriptase(Inhibited by zidovudine triphosphate)Double - stranded viral DNA* Non nucleoside reverse transcriptase inhibitors (NNRTIs)Nevirapine (NVP) Efavirenz (EFV) Delavirdine* Protease inhibitors - Ritonavir, Indinavir, Nelfinavir, Saquinavir* Fusion inhibitor - Enfuvirtide (binding to HIV envelope glycoprotein (grp 41) and preventing fusion of viral and cellular membranes", "cop": 2, "opa": "Inhibitory effects on viral DNA", "opb": "Nucleoside reverse transcriptase inhibitors", "opc": "Inhibit the synthesis of group 24", "opd": "P53 anti- apoptotic molecule synthesis", "subject_name": "Pharmacology", "topic_name": "Anti Microbial", "id": "60809271-a872-4c7b-b66f-9b2d2f338d34", "choice_type": "single"} {"question": "In Bact. fragilis infection drug of choice is", "exp": "C. i.e. (Clindamycin) (731 - KDT 6th)* CLINDAMYCIN. Potent lincosamide antibioticIt inhibits most gram positive cocci, C. diphtheriae, Nocardia Actinomyces, Toxoplasma* High activity against a variety of anaerobes especially Bact.fragilis*** AZITHROMYCIN - more active than other macrolides against H. influenzae* High activity is exerted on respiratory pathogens- Mycoplasma, Chla. pneumonia, Legionella, Moraxella and on others like Campylobacter, Ch. trachomatis, H. ducreyi, Calymm. granulomatis, N. gonorrhoeae.CLARITHROMYCIN - More active against sensitive strains of gram - positive cocci, Moraxella, Legionella. Mycopneumoniae and Helicobacter- pylori.", "cop": 3, "opa": "Azithromycin", "opb": "Gentamicin", "opc": "Clindamycin", "opd": "Aztreonam", "subject_name": "Pharmacology", "topic_name": "Anti Microbial", "id": "c01360f7-2603-4a1d-a71a-dd2c459ee9ee", "choice_type": "single"} {"question": "Lactation is suppressed by", "exp": "Ans. is'c'i.e., ApomorphineRef : Clinical Pharmacology 3'd/e p. 799Impoant drugs inhibiting lactation are : -DopamineBromocriptineCabergolineApomorphine", "cop": 3, "opa": "Metaclopramide", "opb": "Opioids", "opc": "Apomorphine", "opd": "Haloperidol", "subject_name": "Pharmacology", "topic_name": null, "id": "a9a3f39f-498b-4bfa-b4ce-20b0996b4ee4", "choice_type": "single"} {"question": "One of the following is not a 5HT receptors on antagonist", "exp": "Lanreotide is a medication used in the management of acromegaly and symptoms caused by neuroendocrine tumors, most notably carcinoid syndrome. It is a long-acting analogue of somatostatin, like octreotide Refer kDT 6/e p166", "cop": 2, "opa": "Ketanserine", "opb": "Lanreotide", "opc": "Methylsergide", "opd": "Tropisetron", "subject_name": "Pharmacology", "topic_name": "Autacoids", "id": "4c2ba909-e02a-4a0b-b961-458336960be3", "choice_type": "single"} {"question": "Most teratogenic in pregnancy", "exp": "Valproate is the most teratogenic, phenytoin also isn't safe. Phenobarbitone, lamotrigine, topiramate are relatively safe drugs but 4mg folic acid is required per day. Ref: KD Tripathi 8th ed.", "cop": 2, "opa": "Phenytoin", "opb": "Valproate", "opc": "Barbiturate", "opd": "Ethosuximide", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "4537a3b3-80d0-40ea-b854-f79adc170116", "choice_type": "single"} {"question": "Omalizumab is", "exp": "ANTI-IgE ANTIBODY Omalizumab It is a humanized monoclonal antibody against IgE. Administered s.c., Mech of action:- It neutralizes free IgE in circulation without activating mast cells and other inflammatory cells. On antigen challenge, little IgE is available bound to the mast cell surface receptors (FceR1) to trigger mediator release and cause bronchoconstriction. In severe extrinsic asthma, omalizumab has been found to reduce exacerbations and steroid requirement. No benefit has been noted in nonallergic asthma. Ref:- kd tripathi; pg num:-231", "cop": 2, "opa": "Interleukin 2 receptor blocker", "opb": "Anti IgE antibody", "opc": "Anti IgM antibody", "opd": "Leukotriene receptor blocker", "subject_name": "Pharmacology", "topic_name": "Respiratory system", "id": "a0e62781-6eda-47e8-ae91-89da2930ff73", "choice_type": "single"} {"question": "A child presents with bladder exstrophy and chronic renal failure. The muscle relaxant of choice to be used during surgery if exstrophy in this child is", "exp": "Refer Ref Katzung 11/e p453 Atracurium is eliminated by Hoffman's elimination I. e, it does not require liver of kidney, it is the muscle relaxant of choice in hepatic and renal failure", "cop": 1, "opa": "Atracurium", "opb": "Mivacurium", "opc": "Pancuronium", "opd": "Rocuronium", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "1c2254e3-5996-4afb-af0b-b27c008d3122", "choice_type": "single"} {"question": "DOC for belladona poisoning", "exp": "Physostigmine is an anticholinesterase & chemically it is a tertiary amine which can cross BBB.\nIt is DOC for Belladona, Datura & Atropine poisoning.", "cop": 2, "opa": "Neostigmine", "opb": "Physostigmine", "opc": "Pyridostigmine", "opd": "Edrophonium", "subject_name": "Pharmacology", "topic_name": null, "id": "c5a62ee8-8342-4e0c-8ecc-9e8dab207fdd", "choice_type": "single"} {"question": "Coarse tremors, polyuria and hypothyroidism are adverse effects of", "exp": "Bipolar Disorder - Drug of Choice (in general)- Lithium - Drug of Choice (In pregnancy)-Atypical Antipsychotic drugs Lithium L - Leucocyte I - Increase T - Tremors (most common) H - Hypothyroidism I - Increase U - Urine M- Mother (Avoided in pregnancy as it causes Ebstein anomaly in baby i.e. Congenital tricuspid atresia)", "cop": 1, "opa": "Lithium", "opb": "Haloperidol", "opc": "Imipramine", "opd": "Valproate", "subject_name": "Pharmacology", "topic_name": "Psychiatric Illness", "id": "eafc49e6-c82b-45f8-8f1b-5c8970e2b9e4", "choice_type": "single"} {"question": "OCP should not be used with", "exp": "Rifatnpicin See Nov 09 Obs & Gynae", "cop": 1, "opa": "Rifampicin", "opb": "1NH", "opc": "Streptomycin", "opd": "Pyrazinamide", "subject_name": "Pharmacology", "topic_name": null, "id": "f9e4b064-b7bb-4b11-b74a-66a7782cef67", "choice_type": "single"} {"question": "High anticholinergic propey is present in the following antihistaminic agent", "exp": null, "cop": 2, "opa": "Astemizole", "opb": "Diphenhydramine", "opc": "Terfenadine", "opd": "Fexofenadine", "subject_name": "Pharmacology", "topic_name": "Autacoids", "id": "d72567e2-443d-4a05-83f8-96dee6a80ba3", "choice_type": "single"} {"question": "The following cytotoxic drug acts by inhibiting depoly merization of tubulin and thus producing abnormal arrays of microtubules", "exp": "Taxanes mechanism of action:- It binds to b-tubulin and enhances its polymerization. The microtubules are stabilized and their depolymerization is prevented. This stability results in inhibition of normal dynamic reorganization of the microtubule network that is essential for interphase and mitotic functions. Adverse effects:- Reversible myelosuppression (mainly granulocytopenia) and 'stocking and glove' neuropathy. Nausea, chest pain, ahralgia, myalgia, mucositis and edema. Ref :- kd tripathi; pg num:-865,866", "cop": 2, "opa": "Vinblastine", "opb": "Paclitaxel", "opc": "Etoposide", "opd": "Mitoxantrone", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "fd24dad9-8f75-4367-ae63-03a6a28a133d", "choice_type": "single"} {"question": "DOC for Neisseria gonorrhea infection is", "exp": "Ans. is 'a' i.e., Ceftriaxone Recommended Rx of Gonococcal infection (Penicillinase producing NG):* Gonococcal infection of cervix, urethra, pharynx, rectum# First line - Ceftriaxone, ciprofloxacin, ofloxacin.# Alternatives - Spectinomycin, ceftizoxime, cefotetan.* Gonococcal conjuctivitis and ophthalmia neonatorum - Ceftriaxone.* Disseminated gonoccal infection (Gonococcal arthritis)# Patient tolerant to b-lactam drugs - ceftriaxone, cefotaxime, ceftizoxim.# Patient allergic to b-lactam drugs - ciprofloxacin, ofloxacin, spectinomycin.# Continuation therapy - Ciprofloxacin, ofloxacin, levofloxacin.* Gonococcal epididymitis - ceftriaxone followed by doxycycline.DOC for gonorrhea is ceftriaxone", "cop": 1, "opa": "Ceftriaxone", "opb": "Ciprofloxacin", "opc": "Kanamycin", "opd": "Cefaclor", "subject_name": "Pharmacology", "topic_name": "Anti Microbial", "id": "dfb16a96-294b-4521-a7cd-23c19c136017", "choice_type": "single"} {"question": "Detoxication of drugs is controlled by", "exp": "Cytochrome p450 enzymes are microsomal enzymes that are involved in phase I metabolism of many drugs,\nMost of the drugs are metabolized by CYP 3 A4 isoform. Drug metabolizing enzymes The drug-metabolizing enzymes are divided into two types :\n1. Microsomal These are located on smooth endoplasmic reticulum primarily in the liver, also in kidney, intestinal mucosa and lungs.\nExamples are monooxygenase, cytochrome P450, glucuronyl transferase.\nThey catalyze most of the oxidation, reduction, hydrolysis and glucuronide conjugation.\nThey are inducible by drugs, diet and other agencies.\n2. Nonmicrosomal These are present in the cytoplasm and mitochondria of hepatic cells as well as in other tissues including plasma.\nExamples are flavoprotein oxidase, esterases, amidases and conjugases.\nThey catalyze some oxidation and reduction, many hydrolysis and all conjugation except glucuronidation.\nThey are not inducible but many show genetic polymorphism (acetyltransferase, pseudocholinesterase)", "cop": 2, "opa": "Cytochrome", "opb": "Cytochrome p450", "opc": "Cytochrome", "opd": "Cytochrome A", "subject_name": "Pharmacology", "topic_name": null, "id": "a758633d-31ef-4d24-8f46-205c1ec490af", "choice_type": "single"} {"question": "The drug approved for obesity treatment along with Phentermine is", "exp": "Topiramate causes weight loss. Recently it was approved for obesity treatment along with Phentermine.This drug is an extended release or controlled release preparation.Phenteramine is an non adrenergic sympathomimetic and topiramate anti seizure and antimigrate drug available in FDC known as Qsymia.Ref: H.L.Sharma; 3rd ed.; pg 925", "cop": 1, "opa": "Topiramate", "opb": "Sibutramine", "opc": "Fenfluramine", "opd": "Lorcaserin", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "81db9139-f44f-4e89-86cf-80f45b0c0714", "choice_type": "single"} {"question": "A bactericidal drug would be preferred over a bacteriostatic drug in a patient with", "exp": "Bactericidal drugs kill the bacteria whereas bacteriostatic drugs only inhibits bacterial growth. Bacteriostatic activity is adequate for the treatment of most infections ,bactericidal activity nay be necessary for cure in patients with altered immune system like neutropenia ,HIV and other immunosuppressive conditions Refer KDT 6/e p686", "cop": 1, "opa": "Neutropenia", "opb": "Cirrhosis", "opc": "Pneumonia", "opd": "Hea disease", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "0d26a742-786e-4ce6-9c7e-1a974df8dfdc", "choice_type": "single"} {"question": "Apremilast is", "exp": "Ustekinumab, a monoclonal antibody to the shared IL-23/IL-12p40 subunit, is an efficacious treatment for psoriasis and has shown promise in Psoriatic ahritis in clinical trials. Other newer drugs that have shown efficacy for both psoriasis and PsA include the anti-IL-17 pathway agents, such as secukinumab and brodalumab, and an oral phosphodiesterase-4 inhibitor, apremilast. Data on the oral Jak inhibitor, tofacitinib, has been very limited but promising. Ref: Harrison&;s Principles of Internal Medicine; 20th ed KD TRIPATHI 9th ed", "cop": 2, "opa": "PDE 3 inhibitor", "opb": "PDE 4 inhibitor", "opc": "PDE 5 inhibitor", "opd": "PDE 6 inhibitor", "subject_name": "Pharmacology", "topic_name": "Immunomodulators", "id": "a2c691c3-0d1a-48bf-8466-4197c1be377b", "choice_type": "single"} {"question": "Select the diuretic that is most effective in acute congestive glaucoma", "exp": "Angle closure (narrow angle, acute congestive) glaucoma It occurs in individuals with a narrow iridocorneal angle and shallow anterior chamber. The i.o.t.remains normal until an attack is precipitated, usually by mydriasis. The i.o.t. rises rapidly to very high values (40-60 mmHg). It is an emergent condition with marked congestion of eyes and severe headache. Treatment:- 1. Hypeonic mannitol (20%) 1.5-2 g/kg or glycerol (10%): infused i.v. decongest the eye by osmotic action. 2. Acetazolamide:- 0.5 g i.v. followed by oral twice daily is staed concurrently. 3. Miotic:- Once the i.o.t. stas falling due to the above i.v. therapy, pilocarpine 1-4% is instilled every 10 min initially and then at longer intervals. Contraction of sphincter pupillae changes the direction of forces in the iris tolessen its contact with the lens and spreads the iris mass centrally - pupillary block is removed and iridocorneal angle is freed. 4. Topical b blocker:- Timolol 0.5% is instilled 12 hourly in addition. 5. Apraclonidine (1%)/latanoprost 0.005% instillation may be added. Drugs are used only to terminate the attack of angle closure glaucoma. Definitive treatment is surgical or laser iridotomy. Ref:- kd tripathi; pg num:-155,156,157", "cop": 4, "opa": "Furosemide", "opb": "Amiloride", "opc": "Indapamide", "opd": "Mannitol", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "31d3c98b-cd7d-4b9a-9c9a-92dfe5a6abf9", "choice_type": "single"} {"question": "Clomiphene acts to induce ovulation by wof mechanisms", "exp": "Antiestrogens Clomiphene citrate:- It binds to both ERa and ERb and acts as a pure estrogen antagonist.it induces Gn secretion in women by blocking estrogenic feedback inhibition of pituitary. The amount of LH/FSH released at each secretory pulse is increased. In response, the ovaries enlarge and ovulation occurs if the ovaries are responsive to Gn. Adverse effects:- Polycystic ovaries, multiple pregnancy, hot flushes, gastric upset, veigo, allergic dermatitis. Risk of ovarian tumour may be increased. Ref:- kd tripathi; pg num:-312", "cop": 1, "opa": "Diminishing ER-mediated negative feedback at the pituitary", "opb": "Increasing the action of ER a in the ovary", "opc": "Increasing the action of ER a in the hypothalamus", "opd": "Increasing the amount of ER a", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "2025ba05-5066-4af7-9195-caf31d7fa7fd", "choice_type": "single"} {"question": "Site of action of levetiracetam is", "exp": "Levetiracetam acts on SV2A", "cop": 4, "opa": "GAT", "opb": "AMPA", "opc": "NMDA", "opd": "SV2A", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "e652efc4-23b9-4ef6-9a28-dfdb988d3187", "choice_type": "single"} {"question": "Therapeutic plasma level of the digoxin is", "exp": "Ref-KDT 6/e p497 Digitoxin digoxin Therapeutic plasma concentration 15-30ng/ml 0.5-1.4 ng/ml Toxic plasma concentraton >35 ng/ml >2.5 ng/ml", "cop": 2, "opa": "0.1-0.3 ng/ml", "opb": "0.8-1.5 ng/ml", "opc": "1.2-2 ng/ml", "opd": "More than 2.4 ng/ml", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "d78ee234-1849-47ce-9d01-59016575b145", "choice_type": "single"} {"question": "Children are more susceptible than adults to the following action of atropine", "exp": "PHARMACOLOGICAL ACTIONS (Atropine as prototype) Body temperature:- Rise in body temperature occurs at higher doses. It is due to both inhibition of sweating as well as stimulation of temperature regulating centre in the hypothalamus. Children are highly susceptible to atropine fever. Ref:- kd tripathi; pg num:-115", "cop": 3, "opa": "Cycloplegic", "opb": "Gastric antisecretory", "opc": "Central excitant and hypehermic", "opd": "Tachycardia", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "f31effa4-48b0-48ad-8e28-711359bb837f", "choice_type": "single"} {"question": "Vigabatrin is used for the treatment of", "exp": "Sabril (vigabatrin) is an anti-epileptic medication, also called an anticonvulsant,used in combination with other medications to treat complex paial seizures in adults and adolescents who are at least 16 years old. Ref: KD Tripathi 8th ed.", "cop": 2, "opa": "GTCS", "opb": "Infantile spasms", "opc": "Myoclonic epilepsy", "opd": "Paial seizures", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "41865542-2c0e-4ded-a0c5-6774f9a23d39", "choice_type": "single"} {"question": "Cinacalcet acts by", "exp": "Cinacalect is a calcimimetic drug. It resembles calcium and activates calcium sensing receptor(CaSR) present on parathyriod gland and decreases parathormone secretion.", "cop": 3, "opa": "Inhibiting RANK - ligand", "opb": "Activating osteoblasts", "opc": "decreasing parathormone secretion", "opd": "Increasing vitamin D", "subject_name": "Pharmacology", "topic_name": null, "id": "8bd6866a-656c-4f6c-919c-b6183d772f48", "choice_type": "single"} {"question": "Calcium channel blocker agent used in treatment of hypeension are", "exp": "Nifedipine and amilodipine like calcium channel blockers can be used for hypeension. Calcium channel blockers are prescription medications that relax blood vessels and increase the supply of blood and oxygen to the heawhile also reducing the hea's workload. Examples of calcium channel blockers include: Amlodipine (Norvasc) Bepridil (Vascor) Diltiazem (Cardizem, Cardizem CD, Cardizem SR, Dilacor XR, Diltia XT, Tiazac) Felodipine (Plendil) Nicardipine (Cardene, Cardene SR) Nifedipine (Adalat, Adalat CC, Procardia, Procardia XL) Nisoldipine, (Sular) Verapamil (Calan, Calan SR, Covera-HS, Isoptin, Isoptin SR, Verelan, Verelan PM) Refer kDT 6/e p543", "cop": 4, "opa": "Prazosin", "opb": "Lidoflazin", "opc": "Captopril", "opd": "Nifedipine", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "5d029375-8038-4764-8ab1-02418db12918", "choice_type": "single"} {"question": "Anticholinergic drug useful in treatment of peptic ulcer disease is", "exp": "Peptic Ulcer Disease 1) Drug inhibiting the M1 receptor - Pirenzepine 2) Drug blocking the H2 receptor - Cimetidine - Ranitidine 3) Prostaglandin - Misoprostol - It is chemically PGE1 but work like PGE2 4) Proton pump inhibitors: - Omeprazole - Esomeprazole - Pantoprazole - Lansoprazole - Rabeprazole", "cop": 4, "opa": "Cimetidine", "opb": "Misoprostol", "opc": "Omeprazole", "opd": "Pirenzipine", "subject_name": "Pharmacology", "topic_name": "Gastro-Intestinal Tract", "id": "a65387fe-97b2-472d-9245-18d5d351e7f2", "choice_type": "single"} {"question": "Less gastrointestinal bleed is seen in the following NSAID.", "exp": null, "cop": 3, "opa": "Meloxicam", "opb": "Naproxen", "opc": "COX2 specific inhibitors", "opd": "Ibuprofen", "subject_name": "Pharmacology", "topic_name": null, "id": "e17588a3-0194-45e5-8235-b55dfd09dfdc", "choice_type": "single"} {"question": "Agent used for eliciting diagnostic differentiation of Myasthenia Gravis from Cholinergic crisis is", "exp": "Edrophonium test * Edrophonium test is used to distinguish between Myasthenic crisis of autoimmune Myasthenia Gravis and Cholinergic crisis. * Edrophonium is a sho acting reversible non-carbamate Acetylcholinesterase inhibitor (indirectly acting cholinomimetic). * It is based on the scientific rationale that muscular weakness of myasthenic crisis (caused by inadequate cholinergic stimulation) dramatically improves on administration of Edrophonium. * In Cholinergic crisis - caused by overeatment with anticholinesterases --> resulting in muscle weakness by induction of persistent depolarization, fuher administration of Edrophonium causes drastic worsening of muscle weakness. Ref:- Goodman & Gilman Pharmacological Basis of Therapeutics 13th Ed; Pg num:- 172", "cop": 3, "opa": "Neostigmine", "opb": "Ecothiophate", "opc": "Edrophonium", "opd": "Ambenonium", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "4509c547-d019-4992-95b2-45b2229ef9a4", "choice_type": "single"} {"question": "Drug used for cobra bite is", "exp": "In cobra bite, there is Neuromuscular paralysis. Neostigmine increase acetylcholine metabolism at synapse so that more ach is available to act on NM receptors producing muscle contraction physostigmine may have unnecessary central side effects Ref: KDT 6th ed pg 102", "cop": 1, "opa": "Neostigmine", "opb": "Atropine", "opc": "Adrenaline", "opd": "Physostigmine", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "70813299-a705-4034-8ef0-33c71f3f4304", "choice_type": "single"} {"question": "Treatment of choice for prinzmetal's angina", "exp": "Ans. is 'a' i.e., Nitroglycerine Treatment of variant angina Prinzmetal's variant angina is due to spasm of coronary vessels. The drugs which dilate the coronary vessels, are the main treatment of Prinzmental's angina. Drugs are : Nitrates Calcium channel blockers (verapamil, diltiazem) Nitroglycerin is considered the drug of choice for the patient with variant angina. Prazosin a selective a-blocker may also be used because it prevents a mediated vasospasm. ii-blocker's are contraindicated because they cause constriction of coronary aery due to unopposed a mediated vasoconstriction. Prevention of variant angina In contrast Nitrates are not used for the prevention of variant angina because of delevelopment of tolerance. CCBs are the DOC for prevention.", "cop": 1, "opa": "Nitroglycerine", "opb": "CCBs", "opc": "P-blockers", "opd": "Prazosin", "subject_name": "Pharmacology", "topic_name": null, "id": "71110ece-2b1e-45f5-b070-6f63153a3265", "choice_type": "single"} {"question": "The drug affecting the trabecular outflow in Glaucoma", "exp": "Miotics like pilocarpine reduce intraocular tension by increasing the trabecular outflowBeta-blockers reduce production of aqueous humor by acting on the ciliary bodyBrimonidine and prostaglandin analogs increase uveoscleral outflow Ref: Katzung 12th ed. pg: 161", "cop": 3, "opa": "Timolol", "opb": "Acetazolamide", "opc": "Pilocarpine", "opd": "Brimonidine", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "40af8112-af0c-4da3-96d2-332dd2c0c554", "choice_type": "single"} {"question": "Drug of choice for Paroxysmal Supraventricular Tachycardia", "exp": "Ref: Katzung 14lh ed. pg. 246; KD Tripathi, 6th ed. pg. 509 & 518* Paroxysmal supraventricular tachycardia (PSVT) is sudden onset episodes of atrial tachycardia (rate 150-200/min) with 1:1 atrioventricular conduction* An attack of PSVT can be terminated by i.v. injection of verapamil, diltiazem, esmolol or digoxin; but most cardiologists now prefer adenosine.* Adenosine has a very short t1/2 in blood ( 10sec)* Almost complete elimination occurs in a single passage through coronary circulation.", "cop": 2, "opa": "Digitalis", "opb": "Adenosine", "opc": "Adrenaline", "opd": "Verapamil", "subject_name": "Pharmacology", "topic_name": "C.V.S", "id": "0058d3dd-0b56-4991-b314-deb10ef98d92", "choice_type": "single"} {"question": "Most common side effect of levodopa", "exp": "Ans) b (Nausea vomiting) Ref: Katzung 11th editionWhen levodopa is given without a peripheral decarboxylase inhibitor, anorexia and nausea and vomiting occur in about 80% of patients.These adverse effects can be minimized by taking the drug in divided doses, with or immediately after meals, and by increasing the total daily dose very slowly; antacids taken 30-60 minutes before levodopa may also be beneficial. The vomiting has been attributed to stimulation of the chemoreceptor trigger zone located in the brain stem but outside the blood-brain barrier. Fortunately, tolerance to this emetic effect develops in many patients. Antiemetics such as phenothiazines should be avoided because they reduce the antiparkinsonism effects of levodopa and may exacerbate the disease.", "cop": 2, "opa": "Diarrhoea", "opb": "Nausea vomiting", "opc": "Tremor", "opd": "Rash", "subject_name": "Pharmacology", "topic_name": "C.N.S", "id": "36d933dd-3eae-460b-bd07-e1d3b1633924", "choice_type": "single"} {"question": "A patient with ruptured spleen is taken for laparotomy. His blood pressure is 80/50 and hea rate is 125/min.Induction agent of choice for this patient is", "exp": "Refer Goodman Gilman 12/e p 538-539 Ketamine increases all pressures Blood pressure.. Intracranial tension Introcular pressure In the body ****it is therefore intravenous anesthetic of choice for shock", "cop": 3, "opa": "Sodium thiopentone", "opb": "Fentanyl", "opc": "Ketamine", "opd": "Halothane", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "429f7950-8de6-47e1-85bf-676c1e9022b9", "choice_type": "single"} {"question": "The pathological state that alerts the volume of distribution of many drugs is", "exp": null, "cop": 3, "opa": "Septicemia", "opb": "Duodenal ulcers", "opc": "Congestive heart failure", "opd": "Hypertension", "subject_name": "Pharmacology", "topic_name": null, "id": "4a63e9d0-b606-4fef-a6f7-b7790ed713c0", "choice_type": "single"} {"question": "Ethambutol causes", "exp": "Refer Katzung 10/e p774 KDT 6/e p 742 Ethambutol causes retobulbar neuritis It can result in red green colour blindness", "cop": 1, "opa": "Retro bulbar neuritis", "opb": "Deafness", "opc": "Red urine", "opd": "Peripheral neuritis", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "5372f5ff-529c-4573-8a6f-bdc17382ca4d", "choice_type": "single"} {"question": "a peptide that causes increased capillary permeability and edema is", "exp": "Although both histamine as well as bradykinin can cause edema and increase in permeability, histamine is an amine, whereas bradykinin is a peptide. Refer KDT 6/e p490", "cop": 3, "opa": "Histamine", "opb": "Angiotensin 11", "opc": "Bradykinin", "opd": "Renin", "subject_name": "Pharmacology", "topic_name": "Autacoids", "id": "26a6bca6-637e-45b0-9ae7-4d1571e9c1e4", "choice_type": "single"} {"question": "Drug causing gynecomastia is", "exp": "Impoant drugs causing gynaecomastia are: D-Digitalis I-Isoniazid S-Spironolactone C-Cimetidine O-Oestrogens", "cop": 1, "opa": "Spironolactone", "opb": "Rifampicin", "opc": "Penicillin", "opd": "Bumetanide", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "d7cd5139-4b20-4a40-ad55-4fb8e0c5bc28", "choice_type": "single"} {"question": "Juvenile myoclonic epilepsy is worsened by", "exp": "Phenytoin & Carbomazepine can worsen absence & myoclonic seizures.", "cop": 3, "opa": "Lamotrigine", "opb": "Levetiracetam", "opc": "Phenytoin", "opd": "Zonisamide", "subject_name": "Pharmacology", "topic_name": null, "id": "75d0c93c-1122-46d4-842d-c7c519093638", "choice_type": "single"} {"question": "Shivering\" is observed in the early pa of postoperative period due to", "exp": "Postoperative shivering (halothane shakes) and hypothermia is maximum with halothane among inhalational anesthetics. It can be used to sta or maintain anaesthesia. One of its benefits is that it does not increase the production of saliva, which can be paicularly useful in those who are difficult to intubate", "cop": 2, "opa": "Chloroform", "opb": "Halothane", "opc": "Trichloroethylene", "opd": "Ether", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "72851095-b074-4906-a336-abc25704c53b", "choice_type": "single"} {"question": "The most significant adverse effect of ACE inhibition is", "exp": "On initiation of therapy ACE inhibitors may cause significant hypotension -first dose phenomenon. Hence treatment should be staed with small doses and if patients are on diuretic it is temporarily stopped. Hyperkalemia is another side effect. Ref: KD tripathi 8th ed Page no 129", "cop": 1, "opa": "Hypotension", "opb": "Hypeension", "opc": "Hypocalcemia", "opd": "Hypercalcemia", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "ea5818a5-ba38-4ce6-88ce-d5f796357e3a", "choice_type": "single"} {"question": "Aldosterone antagonists are not useful in the treatment of", "exp": "Aldosterone antagonists cause gynaecomastia as an adverse effect.", "cop": 3, "opa": "Hypeension", "opb": "Congestive hea failure", "opc": "Gynaecomastia", "opd": "Hirsutism", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "1a9a4824-fb63-426c-bb6a-27471acb627f", "choice_type": "single"} {"question": "Time taken for digitalization is", "exp": "Digitization is the process of changing from analog to digital form\" Refer kDT 6/e p497", "cop": 3, "opa": "36 hours", "opb": "12 hours", "opc": "5day", "opd": "10 day", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "90e66013-61fe-487e-9e15-df9256af807e", "choice_type": "single"} {"question": "Variation in drug responsiveness to a paicular dose of the drug in different individuals can be obtained from", "exp": "* Drug response to the same drug used in same doses in a population varies based on many factors governing pharmacodynamic variability (like age, genetics, co- morbid condition, concomitant medication, etc) operant in that subset of population under study. * This pharmacodynamic variability in a population is analyzed using a Quantal Dose Response Curve * Quantal Dose Response relationship is an \"all or none\" plot traced based on response elicited to varying dose of drug administered to a population. * Therapeutic Index of a drug is determined based on data plots from Quantal Dose Response Curves. * Median Effective Dose (ED50) is the dose of a drug required to produce a specified effect in 50% of the population. * In preclinical studies, the Median Lethal Dose (LD50) is determined in experimental animals - the dose that produced moality of 50% of animal group used in testing. * Therapeutic Index is determined as a ratio of LD50/ED50 - provides the safety margin of a drug. The wider the Lethal DRC is spaced away from the Therapeutic effect DRC --> Drug has a wide safety margin. Ref:- Goodman & Gilman's Pharmacological basis of Therapeutics 13th Ed; Pg Num:- 36", "cop": 1, "opa": "Quantal Dose Response Curve", "opb": "Efficacy", "opc": "Potency", "opd": "Graded Dose Response Curve", "subject_name": "Pharmacology", "topic_name": "General pharmacology", "id": "d0b3043a-9749-44ec-9d8b-3bb652cd0984", "choice_type": "single"} {"question": "The drug that is NOT useful in congestive hea failure", "exp": "Adrenaline, also known as epinephrine, is a hormone, neurotransmitter, and medication. Adrenaline is normally produced by both the adrenal glands and ceain neurons. It plays an impoant role in the fight-or-flight response by increasing blood flow to muscles, output of the hea, pupil dilation response, and blood sugar level. It does this by binding to alpha and beta receptors. It is found in many animals and some single cell organisms Refer kDT 6/e p493", "cop": 1, "opa": "Adrenaline", "opb": "Digoxin", "opc": "Hydrachlohiazide", "opd": "Enalapril", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "1839bf09-051a-450a-815b-f83b932f3f6b", "choice_type": "single"} {"question": "Tildrakizumab was approved in March 2018 for", "exp": "Tildrakizumab was designed to block interleukin-23, a cytokine that plays an impoant role in managing the immune system and autoimmune disease. It is approved for the treatment of moderate-to-severe plaque psoriasis.Ref:", "cop": 1, "opa": "Psoriasis", "opb": "HIV", "opc": "Rheumatoid ahritis", "opd": "Hepatitis C", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "c6335c7a-9758-4582-88f4-325deb571cfa", "choice_type": "single"} {"question": "A 29yr old women comes to clinic because of heat intolerance, excess sweating, thinning of hair. She had family H/O of autoimmune disease, she is 8 wks pregnant and has had no other issues during pregnancy. Medical H/O includes hypehyroidism. Lab studies are positive for thyroid stimulating immunoglobulin. Wof drug is most appropriate for treatment", "exp": "This is a case of Grave's disease, which results in thyrotoxicosis. Inhibit hormone synthesis (Antithyroid drugs) Includes Propylthiouracil, Methimazole, Carbimazole. Mech of action:- Antithyroid drugs bind to the thyroid peroxidase and prevent oxidation of iodide/ iodotyrosyl residues, thereby; (i) Inhibit iodination of tyrosine residues in thyroglobulin (ii) Inhibit coupling of iodotyrosine residues to form T3 and T4. Ref:- kd tripathi; pg num:- 252,253", "cop": 2, "opa": "Methimazole", "opb": "Propylthiouracil", "opc": "Radioactive iodine", "opd": "Oxytocin", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "4dd091a7-5165-41bc-9897-e7aa93ad113f", "choice_type": "single"} {"question": "Zidovudine and didanosine used in HAART act by", "exp": "These drugs act by Nucleoside reverse transcriptase inhibition", "cop": 2, "opa": "Inhibitory effects on viral DNA", "opb": "Nucleoside reverse transcriptase inhibition", "opc": "Inhibit the synthesis of gp41", "opd": "Protease inhibition", "subject_name": "Pharmacology", "topic_name": null, "id": "1b31d82f-ce0f-4271-83bd-9ef90cdaaa3b", "choice_type": "single"} {"question": "Drug of choice for MRSA is", "exp": "(B) Vancomycin > Drugs used in the treatment of MRSA: Vancomycin, Linezolid, Teicoplanin, Cotrimoxazole, Oxacillin, Rifampicin", "cop": 2, "opa": "Streptogramin", "opb": "Vancomycin", "opc": "Quinupristin", "opd": "Linezolid", "subject_name": "Pharmacology", "topic_name": "Miscellaneous (Pharmacology)", "id": "267d3e5d-5c3c-4685-97f5-91b21e355858", "choice_type": "single"} {"question": "Best antihypeensive drug in pulmonary hypeension is", "exp": "Among the given drugs only to drugs that is bosentan and amilodipine are indicated in pulmonary hypeension. Calcium channel blockers like amlodipine are indicated only in those patient who are positive for intravenous vasodilator challenge (less than 5% patient ). The patient is negative then endothelin drugs are indicated like ok Bosenton. Refer Harrison 19e p1659", "cop": 1, "opa": "Bosenton", "opb": "Amlodipine", "opc": "Furosemide", "opd": "Digoxin", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "80f00d78-ca5c-4f0c-9e7e-ed6106e220fa", "choice_type": "single"} {"question": "Calcium carbonate is used for", "exp": "Ref: Katzung's, 14th ed. pg. 1089* This medication is used to treat symptoms caused by too much stomach acid such as heartburn, upset stomach, or indigestion.* It is an antacid that works by lowering the amount of acid in the stomach.* It can also be used in renal osteodystrophy with hyperphosphatemia, hypocalcemia and osteoporosis like conditions.* It can cause metabolic alkalosis (Milk-alkali syndrome)", "cop": 1, "opa": "Antacid", "opb": "Renal stone", "opc": "Metabolic alkalosis", "opd": "Renal failure", "subject_name": "Pharmacology", "topic_name": "G.I.T", "id": "8a82bdd3-f4ab-4997-970a-7c6d7bc1b3e2", "choice_type": "single"} {"question": "Drug of choice for central precocious puberty in girls", "exp": null, "cop": 1, "opa": "GnRH analogue", "opb": "Danazol", "opc": "Cyproterone acetate", "opd": "Medroxy progesterone acetate", "subject_name": "Pharmacology", "topic_name": null, "id": "480c569f-58b8-4e3d-900d-b3c63ebeb527", "choice_type": "single"} {"question": "Lipid lowering drug that significantly decreases lipoprotein A", "exp": "Refer katzung 11e p 613 While one group of drugs, statins, lowerscholesterol, the other group, fibrates, is known to take care of fatty acids and triglycerides. In addition, other drugs, such as ezetimibe, colesevelam, torcetrapib, avasimibe, implitapide, and niacin are also being considered to manage hyperlipidemia.", "cop": 4, "opa": "Fenofibrate", "opb": "Gemfibrozil", "opc": "Rosuvastatin", "opd": "Nicotonic acid", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "183e799d-742d-4d67-bfe2-fbfb7d8e04c0", "choice_type": "single"} {"question": "Drug of choice for acute severe migraine is", "exp": "Acute migraine is a general term for migraines that aren't diagnosed as chronic. Another name for this type is episodic migraine.People who have episodic migraines have headachesup to 14 days a month. Thus, people with episodic migraines have fewerheadaches a month than people with chronic ones. Triptans are drugs of choice for severe migranes along with NSAIDs . Ref: KD Tripathi 8th ed.", "cop": 3, "opa": "NSAID", "opb": "Beta blockers", "opc": "Sumatriptan", "opd": "Caffeine", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "9a45de3a-f341-4f0f-9509-bb5c895961d5", "choice_type": "single"} {"question": "Anesthetic not painful on Intravenous administration is", "exp": "Ketamine:- * Ketamine on intravenous administration is absolutely devoid of pain at injection site. * Ketamine is a NMDA antagonist intravenous general anesthetic agent - that induces a characteristic cataleptic state called \"Dissociative Anesthesia\" - a state of induced dissociation from onself and surrounding. * Dissociative anesthesia is due to selective interruption of association pathways in the neocoex and thalamus --> characteristic somato-sensory blockade, a combination of Catalepsy +Catatonia+ Analgesia+ Amnesia (without complete loss of consciousness like other general anesthetics) Ref:- Goodman & Gilman Pharmacological Basis of Therapeutics 13th Ed; Pg num:- 391", "cop": 4, "opa": "Methohexital", "opb": "Etomidate", "opc": "Propofol", "opd": "Ketamine", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "911d3056-4385-4e61-9734-735e784ecefc", "choice_type": "single"} {"question": "The postmarketing trial comes under", "exp": "There are 4 phases of a clinical trial. Once the drug is released into market pharmacovigilance is done - comes under phase 4 of drug trial to asses the safety, cost effectiveness of the drug once marketed Ref: K.D.Tripati.7th ed. Pg 82-83", "cop": 4, "opa": "Phase 1 clinical trial", "opb": "Preclinical trial", "opc": "Phase 3 clinical trial", "opd": "Phase 4 clinical trial", "subject_name": "Pharmacology", "topic_name": "General pharmacology", "id": "f6d5364f-40a1-4ce8-8070-c22653c5b8f0", "choice_type": "single"} {"question": "The most preferred acute emetic for emesis induced by anticancer drugs is", "exp": null, "cop": 1, "opa": "Ondensetron", "opb": "Metaclopromide", "opc": "Chlorpromazine", "opd": "Dicyclomine", "subject_name": "Pharmacology", "topic_name": null, "id": "2cfe144d-a929-4a8c-991c-2de2892e5651", "choice_type": "single"} {"question": "Two drugs with opposite action on different receptors is", "exp": "physiological antagonism- functional antagonism - 2 drugs binding to two diff receptors, produces opp effects in same physiological system physical antagonism - by viue of physical propeies - opp to each other- charcoal helps in adsorption in alkaloid poisoning pharmacological anatagonism- competitive and non-competitive types Refer kDT 6/e ,katzung 12e", "cop": 4, "opa": "Physical antagonism", "opb": "Competitive antagonism", "opc": "Non competitive antagonism", "opd": "Physiological antagonism", "subject_name": "Pharmacology", "topic_name": "General pharmacology", "id": "01054d6d-5170-42da-89fb-7719d955dcc8", "choice_type": "single"} {"question": "Lid retraction is caused by", "exp": "Apraclonidine is sympathomimetic agent used in open angle glaucoma. It decreases aqueous secretion. It can result in upper lid retraction as an adverse effect It can also result in ocular allergy( less likely with brimonidine) Both apraclonidine and brimonidine can cause CNS depression and Apnea in neonates under contraindicated in the children less than 2 years of age Refer drug facts and comparisons 2006/2257", "cop": 4, "opa": "Bimatoprost", "opb": "Lantanoprost", "opc": "Brimonidine", "opd": "Apraclonidine", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "3ff733f5-5928-429f-ab26-f04bd85685f9", "choice_type": "single"} {"question": "The most potent diuretic amongst the following is", "exp": null, "cop": 1, "opa": "Bumetanide", "opb": "Furosemide", "opc": "Torsemide", "opd": "Ethacrynic acid", "subject_name": "Pharmacology", "topic_name": null, "id": "6ada4842-9e66-42cd-b803-25b6adc46ab3", "choice_type": "single"} {"question": "NSAID Drug induced edema is due to", "exp": "(A) Increased hydrostatic pressure# EDEMA> Causes due to increase hydrostatic pressure (due to enchanced renal salt & water): Congestive heart failure; Acute enphritis; Nephrotic syndrome; Chronic renal disease; Cirrhosis liver; Hypothyroidism. Drug induced fluid retention (E.g NSAID use)\\ Idiopathic or cyclical edema.> Edema due to decreased oncotic pressure (due to low serum albumin): Neprhotic syndrome; Cirrhosis liver; Malnutrition.> Edema due to inherent defects in edema preventing mechanisms (seen in face and neck/upper half of body): Prolonged Trendelenberg's position; Edema seen with 'weightlessness (space travel)'.> Lymphedema: Edema due to increased capillary permeability; Angioderma; Vasodilators, e.g. amlodepine; xPostural edema; Inflammatory edema.", "cop": 1, "opa": "Increased hydrostatic pressure", "opb": "Protein losing enteropathy", "opc": "Endothelial damage due to IL-2", "opd": "Low oncotic pressure", "subject_name": "Pharmacology", "topic_name": "Miscellaneous (Pharmacology)", "id": "82559ab6-9444-44ab-aada-29643612ad25", "choice_type": "single"} {"question": "Denileukin diftitox is used in", "exp": "It is a immunotoxin that binds to IL - 2.", "cop": 3, "opa": "Breast carcinoma", "opb": "AML", "opc": "Cutaneous T cell lymphoma", "opd": "Burkitt's lymphoma", "subject_name": "Pharmacology", "topic_name": null, "id": "f0bfdcb8-3e2a-49d3-8d93-4c27fa94a689", "choice_type": "single"} {"question": "A patient with NHL is staed on CHOP regimen. Wof agents is most likely to be protective against the toxicity of doxorubicin", "exp": "DOXORUBICIN It is an anthracycline antibiotic having anti- tumour activity. Mech of action :- It intercalates between DNA strands and block DNA as well as RNA synthesis. They are also capable of causing breaks in DNA strands by activating topoisomerase-2 and generating quinone type free radicals. As such, they have mutagenic and carcinogenic potential. Maximum action is exeed at S phase, but toxicity is usually exhibited in G2 phase. Adverse effects:- It produces cardiotoxicity as a unique adverse effect. This can manifest either acutely within 2-3 days, causing ECG changes, arrhythmias and hypotension, all of which are reversible; or be delayed--congestive hea failure (related to the total dose administered). CHF is due to cardiomyopathy and may be fatal. Marrow depression, alopecia, stomatitis, vomiting and local tissue damage (on extravasation) are other adverse effects. Urine may be coloured red The anthracycline antibiotics (doxorubicin, etc.) produce cumulative total dose related cardiotoxicity (usually at doses >300 mg/m2). Dexrazoxane is an iron chelating agent when infused i.v. before doxorubicin has been found to reduce risk of such toxicity. However, it may also compromise the anticancer efficacy of doxorubicin. Ref :- kd tripathi;pg num:-867,876", "cop": 4, "opa": "Amifostine", "opb": "Leucovorin", "opc": "Vitamin C", "opd": "Dexrazoxane", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "3bcfcce3-730e-4191-a6b5-1ad085dc24be", "choice_type": "single"} {"question": "Mechanism of Mianserin", "exp": "Mianserin is an atypical antidepressant that acts by inhibiting α - adrenergic, H1 & certain serotonin receptors.", "cop": 1, "opa": "Inhibitis α - adrenergic, H1 & some type of 5 - HT receptors", "opb": "Inhibits α - adrenergic, H2 & some type of 5-HT receptors", "opc": "Inhibitis β - adrenergic, H1 & some type of 5 - HT receptors", "opd": "Inhibits α adrenergic & H1 receptors.", "subject_name": "Pharmacology", "topic_name": null, "id": "8a2177b8-8435-4420-9154-c9cc983dfe82", "choice_type": "single"} {"question": "In low dose aspirin acts on", "exp": "Refer KDT 6 /e p 609 Aspirin acts by inhibiting the enzyme cyclooxygenase", "cop": 1, "opa": "Cyclooxygenase", "opb": "Thromboxane A2 syntahse", "opc": "PGI2 synthase", "opd": "Lipooxyngenase", "subject_name": "Pharmacology", "topic_name": "Respiratory system", "id": "0679a5ab-65a8-4e69-9503-702dc949b23e", "choice_type": "single"} {"question": "Secretory immunoglobulin is", "exp": null, "cop": 2, "opa": "IgG", "opb": "IgA", "opc": "IgM", "opd": "IgE", "subject_name": "Pharmacology", "topic_name": null, "id": "20d538d0-496a-4c16-b70b-cc50e8ea4406", "choice_type": "single"} {"question": "Anti inflamatory action of coicosteroids is due to blocking of", "exp": "Breakdown of phospholipids cause the release of phospholipase A2 from the cell membrane Coicosteroid helps in induction of lipocoins in macrophages. Lipocoins inhibits phospholipase A2. This lead to decreased production of prostaglandins, Leukotriens.Thus pro inflammatory mediators are reduced. (REF.Essential of medical pharmacology K D TRIPATHI 6 Edition, Page No - 279)", "cop": 4, "opa": "15 lipoxygenase", "opb": "Prostaglandin synthetase", "opc": "Thromboxane synthetase", "opd": "Breakdown of phospholipids", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "f2f40dd5-7f8a-4e9b-929c-83433dd6032f", "choice_type": "single"} {"question": "Drug of choice for the following worm infection is", "exp": "The picture shows whipworm (Whip is shown clearly) for which the drug of choice is albendazoleRef: KD Tripati 6th ed Pg 810", "cop": 2, "opa": "Mebendazole", "opb": "Albendazole", "opc": "Ivermectin", "opd": "Diethylcarbamazine", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "3904ebc2-df9c-4cb3-927c-441c6230096a", "choice_type": "single"} {"question": "Least teratogenic antiepileptic drug in pregnancy is;", "exp": "Anti-epileptic with highest risk of teratogenicity - Valproate - causes neural tube defects Anti-epileptic with lowest risk of teratogenicity- Lamotrigine >Levetiracetam", "cop": 4, "opa": "Valproate", "opb": "Phenytoin", "opc": "Carbamazepine", "opd": "Levetiracetam", "subject_name": "Pharmacology", "topic_name": "FMGE 2019", "id": "cae1d27d-60bf-4e06-9dce-04ae5ee221f2", "choice_type": "single"} {"question": "Sweating as a result of excretion is mediated through", "exp": "Refer kDT 7/e p 93 Most aeries and veins in the body are innervated by sympathetic adrenergic nerves, which release norepinephrine (NE) as a neurotransmitter. Some blood vessels are innervated by parasympathetic cholinergic orsympathetic cholinergic nerves, both of which release acetylcholine (ACh) as their primary neurotransmitter.", "cop": 4, "opa": "Adrenal harmone", "opb": "Sympathetic adrenergic", "opc": "Parasympathetic cholinergic", "opd": "Sympathetic cholinergic", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "5cc0e710-452e-4aff-8e7d-aab810ff71ac", "choice_type": "single"} {"question": "Patient complaints of muscle weakness. It was rivers on administration of neostigmine because", "exp": "(Ref: Katzung 11/e p105) Neostigmine acts by inhibiting the enzyme acetylcholinesterase. This enzyme is involved in degradation of ACh,consequently neostigmine inereases the synaptic level of ACh. Muscle weakness can be improved by stimulation of NM receptors at muscle end plate due to increased ACh.", "cop": 4, "opa": "It blocks action of acetylcholine", "opb": "It interferes with the action of monoamine oxidase", "opc": "It interferes with the action of carbonic anhydrase", "opd": "Interferes with the action of Acetyl chlolinesterase", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "090dd0f7-c0f5-44f5-9562-2c891efc1947", "choice_type": "single"} {"question": "The following drug is given in pulsatile manner", "exp": "GNRH agonists are given both in Pulsatile and continuous manner. GNRH antagonists are usually given in continuous manner. Goserelin is GNRH agonist. Abarelix is GNRH antagonist.Ref: Goodman Gillman 12th ed.Pg:1121", "cop": 3, "opa": "Octreotide", "opb": "Abarelix", "opc": "Goserelin", "opd": "Aspirin", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "dd0d26f9-90dd-40d1-af35-0aa4184a6acc", "choice_type": "single"} {"question": "As compared to unfractionated heparin, low molecular weight heparins", "exp": "Low molecular weight heparin has higher subcutaneous bioavailability. Lab monitoring is not required unlike heparin. LMWH has lower risk of osteoporosis and lower incidence of thrombocytopenia. From medical pharmacology padmaja 4th edition Page no 337, 339", "cop": 1, "opa": "Are absorbed more uniformly when given subcutaneously", "opb": "Require more frequent laboratory monitoring", "opc": "Cannot be given to patients with heparin induced thrombocytopenia", "opd": "Predispose to a higher risk of osteopenia", "subject_name": "Pharmacology", "topic_name": "Hematology", "id": "42c5020d-6eb1-4869-ae07-99b7727b7022", "choice_type": "single"} {"question": "Aspirin acts by", "exp": "(A) Cyclo oxygenase pathway # ASPIRIN prduces its antithrombotic effect by irreversibly acetylating and inhibiting platelet cyclo-oxygenase (COX)-1, a critical enzyme in the biosynthesis of thromboxane A2. At high doses, aspirin also inhibits COX-2, an inducible COX isoform found in endothelial cells and inflammatory cells.> Analgesic action of aspirin is mainly due to obstructing of peripheral pain receptors and prevention of prostaglandin mediated sensitization of nerve endings.> Aspirin & some NSAIDs blocked PG generation by inhibiting cyclooxygenase (COX) enzyme.> Aspirin, even in small doses, irreversibly inhibit TXA2 synthesis> Aspirin resets the hypothalamic thermostat & rapidly reduces fever by promoting heat loss but does not decrease heat production", "cop": 1, "opa": "Cyclo oxygenase pathway", "opb": "Lipo oxygenase pathway", "opc": "Membrane phospholipases", "opd": "Cyclic AMP", "subject_name": "Pharmacology", "topic_name": "C.N.S", "id": "ca6afe6e-0649-4857-8156-42c12325b5d4", "choice_type": "single"} {"question": "Severe myopathy commonly is a side effect of", "exp": null, "cop": 1, "opa": "Rosuvastatin", "opb": "Nicotinic acid", "opc": "Ezetimibe", "opd": "Colesevelam", "subject_name": "Pharmacology", "topic_name": null, "id": "ec9bcf18-3611-4548-8e19-46e0f188c43f", "choice_type": "single"} {"question": "b2 agonist with a long duration of action is", "exp": "A new generation of long-acting b2- selective agonists includes salmeterol (a paial agonist) and formoterol (a full agonist). Both drugs are potent selective b2 agonists that achieve their long duration of action (12 hours or more) as a result of high lipid solubility. These drugs appear to interact with inhaled coicosteroids to improve asthma control. Because they have no anti-inflammatory action, they are not recommended as monotherapy for asthma. An ultra-long-acting b agonist, indacaterol, is currently approved in Europe. It needs to be taken only once a day but is used only for the treatment of chronic obstructive pulmonary disease (COPD). Data on its efficacy and safety in the management of asthma are lacking. Reference: Katzung Pharmacology; 13th edition; Chapter 20; Drugs Used in Asthma", "cop": 3, "opa": "Salbutamol", "opb": "Terbutaline", "opc": "Salmeterol", "opd": "Albuterol", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "64d6c543-22c3-49c2-9b93-e100259d85ca", "choice_type": "single"} {"question": "Bone resorption is enhanced by", "exp": "Bone resorption is increased by prostaglandin E2. Increased PGE2 stimulates binding of RANK ligand to RANK- stimulating osteoclast-causing resorption (REF.Essential of medical pharmacology K D TRIPATHI 6 Edition, Page No - 325)", "cop": 3, "opa": "PGD2", "opb": "PDF2", "opc": "PGE2", "opd": "PGI2", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "5532cf1f-6dc0-4607-b8ae-31b5d0c13a1b", "choice_type": "single"} {"question": "Blockade of vasomotor reversal(Re reversal) is seen with", "exp": "Vasomotor re-reversal means only rise in BP is seen with adrenaline because of administration of beta blocker. Fall in BP is neutralized by beta blocker Ref: Katzung 12th ed.", "cop": 1, "opa": "Atenolol", "opb": "Nor adrenaline", "opc": "Dopamine", "opd": "Epinephrine", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "d0addecc-9b40-4a97-a88c-e94ad258f2be", "choice_type": "single"} {"question": "Thiopentone is absolutely contraindicated in", "exp": "(Porphyria): (381 -- KDT 7th edition; 536- Goodman 12th7or variegate)Thiopentone can precipitate acut intermittent or variegate porphyria in susceptible individuals therefore contraindicated. The abnormal synthesis of protoporphyrin (important in hemoglobin production) results in excess porphobilinogen. Barbiturates induce amino levulinic acid synthase, an enzyme responsible for phosphobilinogen synthesis, This leads to excessive porphobilinogen levels and can precipitate acute porphyric crises, that are manifested by severe abdominal pain, nausea, vomiting, psychiatric disorders and neurologic abnormalities", "cop": 1, "opa": "Porphyria", "opb": "Moribund patients", "opc": "Increased intracranial pressure", "opd": "Meningitis", "subject_name": "Pharmacology", "topic_name": "Anaesthesia", "id": "e1a6bd20-0da6-47b4-9f16-bca48ed0f609", "choice_type": "single"} {"question": "Thalidomide used for multiple myeloma is", "exp": "Refer Katzung 10th/919 Thalidomide used for morning sickness but later withdrawn due to teratogenic effects It is not extensively metabolized by microsomal enzymes It is now used for multiple myeloma It can also result in constipation ,peripheral neuropathy", "cop": 2, "opa": "Assosciated with diarrhea", "opb": "Characterised by enantiomeric interconvesions", "opc": "Metabolized extensively by hepatic CYP system", "opd": "Safe for use in pregnant female's", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "09488ff6-997c-46cf-8348-992b33cfab9e", "choice_type": "single"} {"question": "An anxiolytic, not interacting with GABAergic system and used in generalized anxiety is", "exp": null, "cop": 3, "opa": "Alprazolam", "opb": "Diazepam", "opc": "Buspiron", "opd": "Phenobarbital", "subject_name": "Pharmacology", "topic_name": null, "id": "1c543b42-6a95-4332-b347-4ff8a0583d88", "choice_type": "single"} {"question": "The most potent Narcotic Analgesic is", "exp": "(B) Buprenorphine", "cop": 2, "opa": "Morphine", "opb": "Buprenorphine", "opc": "Codeine", "opd": "Pentazocine", "subject_name": "Pharmacology", "topic_name": "C.N.S", "id": "38e03a34-9492-4770-bbb6-ad1b59b9ee30", "choice_type": "single"} {"question": "Oral therapy of choice in MRSA skin infection is", "exp": "Ans. is 'b' i.e., Clindamycin", "cop": 2, "opa": "Dicloxacillin", "opb": "Clindamycin", "opc": "Quinupristin", "opd": "Dalfopristin", "subject_name": "Pharmacology", "topic_name": null, "id": "6a29578e-86ef-44c7-b9e6-629afa94c3c2", "choice_type": "single"} {"question": "Shoest acting benzodiazepine is", "exp": "Ans. is 'c' i.e., Triazolam", "cop": 3, "opa": "Flurazepam", "opb": "Alprazolam", "opc": "Triazolam", "opd": "Diazepam", "subject_name": "Pharmacology", "topic_name": null, "id": "4bad68d0-8c78-43c4-a1e0-b567b60d1d8d", "choice_type": "single"} {"question": "Drug of choice for Clostridium difficile infection is", "exp": "Drugs used for Clostridium difficile infection are DOC is oral Vancomycin Alternatives are metronidazole and fidoxamicin Monoclonal antibody against Clostridium toxin is bezlotoxumab.", "cop": 1, "opa": "Vancomycin", "opb": "Metronidazole", "opc": "Ceftriaxone", "opd": "Clindamycin", "subject_name": "Pharmacology", "topic_name": "Cell Wall Synthesis Inhibitors", "id": "4711d93d-df81-4193-a6c4-6f1e5051af8b", "choice_type": "single"} {"question": "Montelukast is", "exp": "Montelukast and zafirlukast is selective antagonists of the CysLT1 receptor for leukotrienes. Competetively inhibit the bronchoconstictor effects of leukotrienes. Basic and clinical pharmacology Katzung 13th edition pg 324", "cop": 1, "opa": "Selective antagonists of leukotrienes receptor", "opb": "Lipooxygenase inhibitor", "opc": "H1 antagonist", "opd": "H3 antagonist", "subject_name": "Pharmacology", "topic_name": "Respiratory system", "id": "9760cc02-628a-47f5-af02-fc9ede58a71c", "choice_type": "single"} {"question": "Pain is caused by injection of", "exp": "Ans. is 'd' i.e., Thiopentone Thiopentone is an ultrashort acting Barbiturate.It is usually given intravenously to achieve rapid induction of anaesthesia.Inadvertent intra-arterial injection or extravasation of Thiopentone leads to thrombosis and necrosis. This produces intense pain.", "cop": 4, "opa": "Ketamine", "opb": "Methohexitone", "opc": "Di-isopropyl alcohol", "opd": "Thiopentone", "subject_name": "Pharmacology", "topic_name": "Adverse Drug Effect", "id": "2a61dd7e-9edb-4cd0-b3dc-cd1e3a5db7a2", "choice_type": "single"} {"question": "INH induced neuropathy is treated with", "exp": null, "cop": 2, "opa": "Thiamine", "opb": "Pyridoxine", "opc": "Niacin", "opd": "Riboflavin", "subject_name": "Pharmacology", "topic_name": null, "id": "3b5dbd14-6150-4279-a72f-366177887fad", "choice_type": "single"} {"question": "Wet pillow syndrome is caused by", "exp": "Clozapine carries the side effect of sialorrhoea, termed as \"Wet pillow syndrome\".", "cop": 4, "opa": "Risperidone", "opb": "Haloperidol", "opc": "Aripiprazole", "opd": "Clozapine", "subject_name": "Pharmacology", "topic_name": null, "id": "8ce68c2c-6117-4911-b6e4-6accf47bd849", "choice_type": "single"} {"question": "Catalase negative member of the family Enterobacteriaceae is (NOT RELATED)", "exp": "The general finding that members of the family enterobacteriaceae produce catalase has impoant exceptions in Shigella dysenteriae serotype 1 and a few strains of Shigella flexneri (mostly in serotype 4a) which are catalase negative.", "cop": 3, "opa": "Salmonella typhi", "opb": "Proteus vulgaris", "opc": "Shigella dysenteriae serotype 1", "opd": "Escherichia coli", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "f563cf4e-942a-46f1-acd7-759d0d8f8b0d", "choice_type": "single"} {"question": "Mechanism of action of oximes is", "exp": "Oximes are acetylcholinesterase reactivators which are used in OP poisoning, not in carbamate poisoning Ref: KDT 6th ed pg 105", "cop": 2, "opa": "Inhibiting cholinergic receptors", "opb": "Reactivating cholinesterase", "opc": "Inhibiting cholinesterase", "opd": "Reactivating cholinergic receptors", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "ddb2864f-fcdf-4410-b96f-c98ae75768cf", "choice_type": "single"} {"question": "Buprenorphine acts by following mechanism", "exp": null, "cop": 3, "opa": "Mu receptor antagonist", "opb": "Kappa receptor antagonist", "opc": "Mu receptor partial agonist", "opd": "Kappa receptor partial agonist", "subject_name": "Pharmacology", "topic_name": null, "id": "d8641ba2-5116-4f3f-9ec8-a5ab023a199a", "choice_type": "single"} {"question": "Ocular effects that include mydriasis and fixed far vision are characteristic of", "exp": "Mydriasis and fixed far vision can be due to either muscarinic receptor antagonists or ganglionic blockade. Because no M blockers are listed, the correct answer is mecamylamine. Alpha agonists (phenylephrine) have no effects on the focus of the eye. The cholinesterase inhibitor (neostigmine) and alpha blocker (phentolamine) cause miosis. Ocular effects of the beta blocker (timolol) are restricted to decreased formation of aqueous humor by the ciliary epithelium.", "cop": 1, "opa": "mecamylamine", "opb": "neostigmine", "opc": "phentolamine", "opd": "phenylephrine", "subject_name": "Pharmacology", "topic_name": "A.N.S.", "id": "a266755f-eac4-461a-8eef-1073ad969736", "choice_type": "single"} {"question": "spider nevi, dilatation of blood vessels is due to", "exp": "Ref Wikipedia A spider angioma as a nevus araneus, spider nevus, vascular spider ,spider telangiectasia is type of telangiectasia found slightly beneath the skin surface The central red dot is the dilated aeriole and the red spider legs are small veins carrying away the freely flowing blood. The dilation is caused by increased estrogen levels in the blood", "cop": 2, "opa": "Testosterone", "opb": "Estrogen", "opc": "Hepatotoxins", "opd": "FSH", "subject_name": "Pharmacology", "topic_name": "Kidney", "id": "102e45ac-18ef-407e-846a-65025469e897", "choice_type": "single"} {"question": "Ibalizumab was approved by FDA in 2018 April for ( REPEAT)", "exp": "Ibalizumab was approved for HIV in 2018 Ibalizumab belongs to a new class of HIV drugs called post-attachment inhibitors. Post-attachment inhibitors work by attaching to CD4 receptor on the surface of the immune cells. When ibalizumab attaches to the CD4 receptor, HIV cannot attach to, enter, or infect the cell.", "cop": 1, "opa": "HIV", "opb": "TB", "opc": "Leprosy", "opd": "Malaria", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "c4783296-c045-4d8e-80b3-db729917da3b", "choice_type": "single"} {"question": "The electrical potential difference necessary for a single ion to be at equilibrium across a membrane is best described by the (NOT RELATED)", "exp": ".", "cop": 4, "opa": "Goldman equation", "opb": "Van't Hoff equation", "opc": "Fick's law", "opd": "Nernst equation", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "6a175624-4210-47ef-9aeb-e67b1abd7667", "choice_type": "single"} {"question": "Following analgesic combination should be avoided", "exp": null, "cop": 4, "opa": "Aspirin and Codeine", "opb": "Paracetamol and Dextropropoxyphene", "opc": "Ibuprofen and Paracetamol", "opd": "Ibuprofen and Diclofenac", "subject_name": "Pharmacology", "topic_name": null, "id": "bdd1d7bd-f9c1-44e0-880c-f36f32407954", "choice_type": "single"} {"question": "A patient complains of muscle weakness it was reversed on administration of neostigmine, because", "exp": "Refer katzung 11e p 105 neostigmine acts by inhibiting the enzyme acetylcholinesteresis This enzyme is involved in the degradation of acetylcholine, consequential neostigmine increases the synaptic level of acetylcholine. Muscle weakness can be improved with the stimulation of Nm receptors at muscle endplate due to increase the acetylcholine", "cop": 4, "opa": "It blocks the action of acetylcholine", "opb": "It interfere with the action of monoamine oxidase", "opc": "It interfere with the action of carbonic anhydrase", "opd": "It interfere with action of acetylcholine esterases", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "20083af4-29d6-4267-9dfc-ac6ccc7db1ff", "choice_type": "single"} {"question": "Iodine content in amiodarone is", "exp": "Amiodarone contains around 37% of iodine This iodine content is repsonsible for thyroid disorders, corneal microdeposts and pulmnary fibrosis of amiodarone amiodarone is a class 3 agent Ref: KD Tripathi 8th ed", "cop": 2, "opa": "10-20%", "opb": "20-40%", "opc": "40-60%", "opd": "60-80%", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "d40613d1-f635-43c9-b58f-5c4302c5feaa", "choice_type": "single"} {"question": "Cyclosporine acts by inhibiting the proliferation of", "exp": "Ans. is 'b' i.e., IL2 Cyclosporine enters target cells and bind to cyclophilin (an immunophilin). This cyclosporine-cyclophilin complex inactivates calcineurin IL-2 trascripitan and proliferation of T cells.", "cop": 2, "opa": "ILl", "opb": "IL2", "opc": "IL6", "opd": "Macrophages", "subject_name": "Pharmacology", "topic_name": null, "id": "12532d6a-cd04-417e-b387-409cfa208e43", "choice_type": "single"} {"question": "Amitryptyline is a", "exp": null, "cop": 3, "opa": "Antibiotic", "opb": "Sedative", "opc": "Tricyclic antidepressant", "opd": "Diuretic", "subject_name": "Pharmacology", "topic_name": null, "id": "b6cd0982-4142-45ad-80f5-23e527225131", "choice_type": "single"} {"question": "ATT contraindicated in pregnant women", "exp": "Ref: KDT, 6th ed. pg. 743-44* Streptomycin has been assigned to pregnancy category D by the FDA.* Streptomycin crosses the placenta; reported cord concentrations have been equal to or less than the mothers serum concentration.* There are reports of fetal eighth cranial nerve damage with subsequent bilateral deafness. Most authorities, including the Centers for Disease Control and the American Thoracic Society, discourage the use of streptomycin during pregnancy due to the risk of fetal ototoxicity.* Note: Streptomycin is no longer an ATT drug", "cop": 3, "opa": "Isoniazid", "opb": "Rifampicin", "opc": "Streptomycin", "opd": "Ethambutol", "subject_name": "Pharmacology", "topic_name": "Anti Microbial", "id": "6efaff41-9fcf-4554-ac13-07a769e1fbae", "choice_type": "single"} {"question": "Metoclopramide", "exp": "metoclopramide incerase peristalsis ,no significant action on colonic motility ESSENTIALS OF MEDICAL PHARMACOLOGY SEVENTH EDITION KD TRIPARHI PG NO.664", "cop": 4, "opa": "Inhibit cholinergic smooth muscle stimulation in the gastrointestinal tract", "opb": "Decrease lower esophageal sphincter pressure", "opc": "Stimulate D2 receptor", "opd": "No significant action on colonic motility", "subject_name": "Pharmacology", "topic_name": "Gastrointestinal tract", "id": "3247a4f3-2a19-478c-962b-332f59d7dcbd", "choice_type": "single"} {"question": "Longest acting erythro poietin analogue is", "exp": "Darbo poietin is the longest acting erythropoietin analogue.\nEpoietin α & Epoietin β are other erythropoietin analogues.\nRomiplostim is a thromboplastin analogue.", "cop": 3, "opa": "Epoietin α", "opb": "Epoietin β", "opc": "Darbo poietin", "opd": "Romiplostim", "subject_name": "Pharmacology", "topic_name": null, "id": "bc7142b9-7e79-4334-8792-b2d309a7f680", "choice_type": "single"} {"question": "Buspirone is an", "exp": "(B) Anti anxiolitic> Buspirone is an anxiolytic psychoactive drug of the azapirone chemical class, and is primarily used to treat generalized anxiety disorder (GAD).", "cop": 2, "opa": "Anti psychotic", "opb": "Anti anxiolitic", "opc": "Anti depressant", "opd": "Anti hypertensive", "subject_name": "Pharmacology", "topic_name": "Miscellaneous (Pharmacology)", "id": "4ba94750-06f2-4d66-851a-34d80cb8aa73", "choice_type": "single"} {"question": "1st dose hypotension is commonly seen with", "exp": "Alpha blockers produce 1st dose hypotension. also seen with ACE inhibitors. hence there are to be given when the patient is in supine position and asked to be taken care not to stand immediately so preffered to be given at night. Ref: KD Tripathi 8th ed.", "cop": 2, "opa": "Yohimbine", "opb": "Prazosin", "opc": "Atenolol", "opd": "Methyldopa", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "99c2d076-514f-43dd-83b7-753215e2578a", "choice_type": "single"} {"question": "BNP is regarded by", "exp": "Inhibition of the neutral endopeptidase (NEPinh) had been investigated as a potential novel therapeutic approach because of its ability to increase the plasma concentrations of the natriuretic peptides (NPs). Indeed, the NPs have potent natriuretic and vasodilator propeies, inhibit the activity of the renin-angiotensin-aldosterone system, lower sympathetic drive, and have antiproliferative and antihyperophic effects Refer katzung 11e p303", "cop": 1, "opa": "Neutral endopeptidases", "opb": "Elastase", "opc": "Omapatrilat", "opd": "ACE", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "f9f644dc-2e0d-4f6b-8100-04e90f23c20b", "choice_type": "single"} {"question": "Sumatriptan is contraindicated in", "exp": "Ans: D (Peripheral vascular disease) Ref: Goodman & Gilman s The Pharmacological Basis of Tin . aeutics, 12th ed. 2011, Pg 346. 348Explanation:Sumatriptan is a 5HTIBID. agonist used in treatment of migraine. All triptans are effective in the treatment of acute migraine.The available triptans include sumatriptan, naratriptan. rizatriptan, frovatriptan, zolmitriptan and eletriptan.All triptans are contraindicated in:Ischemic or vasospastic coronary artery diseaseHistory of stroke or transient ischemic attacksCerebrovascular diseasePeripheral vascular diseaseHemiplegic ! basilar migrainesIschemic bowel diseasesUncontrolled hypertensionWithin 2 weeks of MOA inhibitor administrationHence the answer to the above question is peripheral vascular disease.In addition, naratriptan is contraindicated in severe hepatic and renal impairment while eletriptan is contraindicated in hepatic disease.Ergot alkaloids which are also used in migraine as that of triptans are contraindicated in:PregnancyPeripheral vascular diseaseCoronary artery diseaseHypertensionImpaired hepatic or renal functionSepsisWithin 24 hrs of triptan administration", "cop": 4, "opa": "Asthma", "opb": "DM", "opc": "Sepsis", "opd": "Peripheral vascular disease", "subject_name": "Pharmacology", "topic_name": "Anti Histaminics", "id": "abda5ea5-ca07-4d0b-a762-99cf79d1d32d", "choice_type": "single"} {"question": "X in the graph represents", "exp": "Therapeutic index : LD50/ED50 Therapeutic window Range of steady-state concentrations of drug that provides therapeutic efficacy with minimal toxicity Therapeutic efficacy: Ability of a drug to activate a receptor and generate a clinical response is Therapeutic efficacy Therapeutic dose: Dose of a drug required to have a clinical response", "cop": 3, "opa": "Therapeutic index", "opb": "Therapeutic dose", "opc": "Therapeutic window", "opd": "Therapeutic efficacy", "subject_name": "Pharmacology", "topic_name": "Pharmacodynamics", "id": "f2ec9119-f005-4471-ab60-e84a9c78a78f", "choice_type": "single"} {"question": "Drug used in ameliorative test for myasthenia gravis is", "exp": ".", "cop": 2, "opa": "d-TC", "opb": "Edrophonium", "opc": "Pyridostigmine", "opd": "Tacrine", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "4d8a8eba-8ddc-4adf-9546-56ae2ad89ae4", "choice_type": "single"} {"question": "MDR gene acts by aEUR'", "exp": "Causes efflux of drug A major problem in cancer chemotherapy is development of cellular drug resistance. These are of two types:- (i) Primary resistance When there is absence of response to drug on first exposure e.g. Malignant melanoma, Renal cell cancer and brain cancer. The presence of inherent drug resistance is thought to be associated with genomic instability that gave rise io the cancer. (ii) Acquired resistance In these cases the cancers were initially drug sensitive and became drug resistant, later on in the course of therapy. It can be :- Single drug resistance Cancer is resistant to a single drug and is based on change in genetic apparatus of a given tumour cell. Multi drug resistance Resistance develops to a variety of anticancer drugs. It is associated with increased expression of a normal gene --)MDR1 gene. MDRI gene encodes for P-glycoprotein Pcgp). P glycoprotein is a protective mechanism possessed by normal cells. Pgp is an ATP dependent membrane efflux pump. Its function is to expel a variety of foreign molecules including antitumour drugs from the cell. Long lived cells such as the haemopoietic stern cells, cells on excretory surfaces such as biliarr hepatocytes, proximal renal tubules and intestinal cells and the cells of the blood- brain barrier, all have high expression of Pgp. The MDR phenomenon illustrates how tumour cells adapt and enhance normal cell mechanism to deal with the effects of chemotherapy and how repeated cycles of chemotherapy select out a population of cells which have developed adaptive survival mechanism e.g. in myeloma where MDR proteins are rare at diagnosis but common at progression.", "cop": 3, "opa": "Block drug activation", "opb": "Block intracellular DNA synthesis", "opc": "Cause efflux of drug", "opd": "DNA repair inhibition", "subject_name": "Pharmacology", "topic_name": null, "id": "54c0a09b-9a99-44df-968b-962005618320", "choice_type": "single"} {"question": "Anaesthesia contraindicated In volvulus of gut is", "exp": "Nitrous oxide displaces nitrogen in air filled cavities and while doing so it enters the cavities faster that is even before nitrogen escapes. This results in expansion of such cavities leading to pnemothorax and air embolus.Hence nitrous oxide should be avoided in such patients. From padmaja 4th edition Page no 191", "cop": 2, "opa": "Halothane", "opb": "Nitrous oxide", "opc": "Ketamine", "opd": "Pancuronium", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "2d494e8b-fd39-4ffe-85bd-f7cfed90b3b4", "choice_type": "single"} {"question": "Rifampin kills tubercle bacilli by", "exp": "Rifampin (Rifampicin, R) Mech of action:- Rifampin interrupts RNA synthesis by binding to b subunit of mycobacterial DNA-dependent RNA polymerase (encoded by rpoB gene) and blocking its polymerizing function. Pharmacokinetics:- It is well absorbed orally, (bioavailability is ~ 70%), but food decreases absorption; rifampin is to be taken in empty stomach. It is widely distributed in the body: penetrates intracellularly, enters tubercular cavities, caseous masses and placenta. Though it crosses meninges, it is largely pumped out from CNS by P-glycoprotein. It is metabolized in liver to an active deacetylated metabolite which is excreted mainly in bile, some in urine also, t 1/2 of rifampin is variable (2-5 hours). Rifampin resistance:- It is nearly always due to mutation in the rpoB gene reducing its affinity for the drug. No cross resistance with any other antitubercular drug, except rifampin congeners, has been noted. uses of rifampin :- 1. Leprosy, Tuberculosis 2. Prophylaxis of Meningococcal and H. influenzae meningitis and carrier state. 3. Second/third choice drug for MRSA, diphtheroids and Legionella infections. 4. Combination of doxycycline and rifampin is the first line therapy of brucellosis. Ref:- kd tripathi; pg num:-768", "cop": 3, "opa": "Inhibiting mycobacterial DNA synthesis", "opb": "Inhibiting synthesis of mycolic acids in mycobacteria", "opc": "Binding to mycobacterial DNA dependent RNA polymerase", "opd": "Damaging mycobacterial mitochondria", "subject_name": "Pharmacology", "topic_name": "Antibiotics", "id": "315d1e2d-eabd-476c-b85c-b1fdc6bf955f", "choice_type": "single"} {"question": "Ullipristal acetate is", "exp": "Refer Harrinson 19/e p 2391 Ullipristal is a selective progesterone receptor modulator like mifepristone It is used as an emergency contraceptive that can be used within 120 hours of unprotected intercourse", "cop": 4, "opa": "GnRH agonist", "opb": "Androgen antagonist", "opc": "Selective estrogen receptor modulator", "opd": "Selective progesterone receptor modulator", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "5fdff69d-d98d-471d-a3cb-2a4897768adf", "choice_type": "single"} {"question": "Arrange the drug in decreasing order of antiplatelet potency a. Clopidogrel b. Prasugrel c. Aspirin d. Abciximab", "exp": "Order of potency -Abciximab > Prasugrel >Clopidogrel > Aspirin", "cop": 3, "opa": "b>d>c>a", "opb": "c>d>a>b", "opc": "d>b>a>c", "opd": "a>d>c>b", "subject_name": "Pharmacology", "topic_name": "Hematology", "id": "37f0bd80-a021-40bd-9b83-8e33d733af08", "choice_type": "single"} {"question": "Cyclosporine is active against", "exp": "Ans. is 'a' i.e., CD4+ Lymphocyte Cyclosporine acts on cell mediated immunity It profoundly and selectively inhibitsT Lymphocyte proliferation (CD4+ Cells)IL-2 and other cytokine proliferationResponse of inducer T cells to IL-1It does not has any effect on suppressor cells.", "cop": 1, "opa": "CD4+ lymphocyte", "opb": "CD8+ lymphocyte", "opc": "CD 14+ lymphocyte", "opd": "B lymphocyte", "subject_name": "Pharmacology", "topic_name": "Immunomodulator", "id": "5a5cc6ba-827b-4780-bd13-648be89d2af7", "choice_type": "single"} {"question": "Neostigmine differs from Pilocarpine in having effects on", "exp": "Pilocarpine is a muscarinic receptor agonist so it doesn't have effects on skeletal muscle (NM). Neostigmine, on the other hand, has indirect actions on both muscarinic and nicotinic receptors.Ref: Katzung Pharmacology; 13th edition", "cop": 4, "opa": "Bowel motility", "opb": "Hea rate", "opc": "Salivary glands", "opd": "Skeletal muscle", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "2a48e3cd-98d6-4a74-a0c7-0f2b1d32b382", "choice_type": "single"} {"question": "Oral sacubitril is approved for the treatment of", "exp": "Sacubitril is given in combination with valsaan for hea failure. Sacubitril is a prodrug that is activated to sacubitrilat (LBQ657) by de-ethylation esterases. Sacubitrilat inhibits the enzyme neprilysin, which is responsible for the degradation of atrial and brain natriuretic peptide, two blood pressure-lowering peptides that work mainly by reducing blood volume. In addition, neprilysin degrades a variety of peptides including bradykinin, an inflammatory mediator exeing a potent vasodilatory action. Ref: KK Sharma 3rd ed.", "cop": 1, "opa": "Congestive cardiac failure", "opb": "IBS with diarrhea predominance", "opc": "Unstable angina", "opd": "Vitamin K deficiency", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "20a8e7ee-4e90-4548-8570-cf08a586363c", "choice_type": "single"} {"question": "Glucagon acts via", "exp": "Ans. (a) cAMP* G-protein receptor for glucagon is Gs which acts via| Adenylyl cyclase causing |cAMP.G Proteins and Their Receptors and EffectorsG ProteinReceptors for:Effector/ Signaling PathwayGt1, Gt2Photons (rhodopsin and color opsins in retinal rod and cone cells)|cGMP phosphodiesterase- |cGMP (phototransduction)G5b-Adrenergic amines, glucagon, histamine, serotonin, and many other hormones|Adenylyl cyclase- |campGi1' Gi2' Gi3a2-Adrenergic amines, acetylcholine (muscarinic), opioids, serotonin, and many othersSeveral, including:| Adenylyl cyclase - |cAMPOpen cardiac K+ channels- | heart rateG5b-Adrenergic amines, glucagon, histamine, serotonin, and many other hormones|Adenylyl cyclase-- |cAMPGolfOdorants (olfactory epithelium)|Adenylyl cyclase- |cAMPGqAcetylcholine (muscarinic), bombesin, serotonin (5-HT1C), and many others|Phospholipase C- |IP3, diacylglycerol, cytoplasmic Ca2+", "cop": 1, "opa": "cAMP", "opb": "cGMP", "opc": "Cytoplasmic Ca+", "opd": "Intracellular K+", "subject_name": "Pharmacology", "topic_name": "Pharmacodynamics", "id": "5820eae4-1668-4c5b-899b-19b82c9d0bc6", "choice_type": "single"} {"question": "Tetrabenazine acts by inhibiting", "exp": "Tetrabenazine: Inhibit VMAT 2(vesicular monoamine transpoer), which transpo dopamine and norepinephrine into adrenergic vesicle in nerve ending. Use for treatment of chorea in Huntington and tardive dyskinesia. In above figure: Pharmacologic strategies for dopaminergic therapy of Parkinson's disease. Drugs and their effects are indicated (see text). MAO, monoamine oxidase; COMT, catechol-O-methyltransferase; DOPAC, dihydroxyphenylacetic acid; L-DOPA, levodopa; 3-OMD, 3-O-methydopa; 3-MT, 3-methoxytramine.", "cop": 2, "opa": "MAO-B", "opb": "Vesicular monoamine transpoer", "opc": "Dopamine D2 receptors", "opd": "COMT", "subject_name": "Pharmacology", "topic_name": "JIPMER 2017", "id": "404be195-b477-46fa-83b4-63d059d7f9bc", "choice_type": "single"} {"question": "The mechanism of action of Sodium nitroprusside is", "exp": "Sodium nitroprusside acts by releasing nitric oxide(NO). This stimulate guanylate cyclase and results in the elevation of cGMP, which are vasodilators. Refer kDT 6/e p549", "cop": 2, "opa": "Increased cAMP", "opb": "Stimulation of guanylate cyclase", "opc": "Calcium channel blockers", "opd": "Potassium channel blocker", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "38cc27c4-9c61-422c-b59d-274e10ccfa0d", "choice_type": "single"} {"question": "Vigabatrin acts by", "exp": "Mechanism of Action: Vigabatrin is an irreversible inhibitor of GABA aminotransferase (GABA-T), the enzyme responsible for the degradation of GABA. It may also inhibit the vesicular GABA transpoer. Vigabatrin produces a sustained increase in the extracellular concentration of GABA in the brain. This leads to some desensitization of synaptic GABA A receptors but prolonged activation of nonsynaptic GABA A receptors that provide tonic inhibition. A decrease in brain glutamine synthetase activity is probably secondary to the increased GABA concentrations. Vigabatrin is useful in the treatment of paial seizures and infantile spasms Reference: Katzung Pharmacology; 13th edition; Chapter 24; Antiseizure drugs", "cop": 2, "opa": "GABA-Antagonism", "opb": "GABA-Agonism", "opc": "NMDA-Antagonism", "opd": "Carbonic anhydrase activity", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "0993a67e-3b43-4274-8835-b111020ce31a", "choice_type": "single"} {"question": "Glyceryl trinitrate route of administration", "exp": "GTN is usually given by SL route .kept under the tongue and can be spit it out when sufficient pain relief is obtained.SL-1st pass metabolism can be bypassed. Ref: KD Tripathi 8th ed.", "cop": 4, "opa": "Oral", "opb": "Submucosal", "opc": "Rectal", "opd": "Sublingual", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "a7e884da-93f0-4733-99dc-842aee3396ef", "choice_type": "single"} {"question": "Drug NOT used in pulmonary hypeension aEUR'", "exp": "alpha blockers Pulmonary hypeension General management Diuretic therapy may be useful as it relieves pulmonary edema. Anticoagulant therapy is advocated for all patients. Specific management Calcium channel blockers Patients who have substantial reductions in pulmonary aerial pressure in response to sho acting vasodilators at the time of cardiac catheterization should he initially treated with calcium channel blockers. Endothelin receptor antagonist Bostenan is a non-selective endothelium receptor antagonist, is an approved t/t ,for patients who are NYHA .functional classes III and IV. Phosphodiesterase-5 inhibitors Slidenafil is used for patients who are NYHA functional classes II and Prostacyclins Iloprost is a prostacyclin analogue used in PAH patients who are NYHA functional classes III and IV. Pulmonary circulation is unique in that it accommodates a blood flow that is almost equal to that of all the other organs of body but still maintains low pressure. The factors responsible for low pressure in pulmonary circulation (even with large volume of blood) are:- - Larger diameter of pulmonary vessels due to thin wall of pulmonary aery and aerioles. - Greater compliance (distensibility) of pulmonary vessels. numoral factors responsible for maintaining pulmonary circulation:? Normally NO causes vosodilation and proliferation of smooth muscles by r in the conc. of cGMP --) this increases the diameter of pulmonary vessels. causes vosodilation and decreased proliferation of smooth muscles by increasing the conc. of cAMPincrease in the diameter of pulmonary vessels. Prostaglandin also decreases coagulation. Endothelin causes vasoconstriction and increase smooth muscle proliferation si lumen of pulmonary vessels. - Normally the vasodilators and antiprolifeave effects of NO and PGI7 dominate In Pulmonary hypeension There is l production of NO (and cGMP) and PGI2 (and cAMP), t vasoconstriction and proliferation of smooth muscles, st lumen of pulmonary vessel. Decreased production of PGI2 also causes increased coagulation. There is T production of endothelin, /vasoconstriction and smooth muscle proliferation, .1 lumen. Drug therapy in puhnonan, hypeension is targetted at these growth factor pathways which are involved in the pathogenesis of pulmonary hypeension: Endothelium receptor antagonist Bostenan is an endothelin receptor antagonist. It prevents endothelin mediated contraction of vessels. Phosphodiesterase-5 inhibitors Nitric oxide mediates its action through increasing cGMP concentration. Increased cGMP relaxes the vessels. cGMP is degraded by an enzyme phosphodiesterase-5 (PDE-5). - Slidenafanil is a phosphodiesterase 5 inhibitor. It reduces the degradation of cGMP, thus causing vascular relaxation and reducing pulmonary hypeension. Prostacyclins In pulmonary hypeension, the level of prostacycline is reduced. This causes pulmonary constriction as prostacyclin causes dilatation of pulmonary vessels.", "cop": 3, "opa": "Calcium channel blocker", "opb": "Endothelin receptor antagonist", "opc": "Alpha blocker", "opd": "Prostacyclin", "subject_name": "Pharmacology", "topic_name": null, "id": "f85bcc43-2469-4556-9301-616c1d489fd2", "choice_type": "single"} {"question": "Most unpleasant side effect of salbutamol is", "exp": "Ans. a (Tremors.) (Ref: KD Tripathi, Pharmacology, 4th ed., 125, 237)Salbutamol is highly selective beta, agonist used to treat attacks of asthma.Its side effects are:# Tremors (unpleasant, dose-related).- Palpitations# Restlessness- Ankle edema# Nervousness- Throat irritation", "cop": 1, "opa": "Tremors", "opb": "Hypertension", "opc": "Rhinorrhoea", "opd": "Headache", "subject_name": "Pharmacology", "topic_name": "Asthma", "id": "170c2b89-7729-48a6-91a6-eee9ff6f7abe", "choice_type": "single"} {"question": "Higher auditory centre determines", "exp": "Sound localization is markedly disrupted by lesions of the auditory coex.", "cop": 3, "opa": "Sound frequency", "opb": "Loudness", "opc": "Sound localization", "opd": "Speech determination", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "3e37828f-d60e-4236-9509-885336564ce2", "choice_type": "single"} {"question": "Digoxin is not indicated in", "exp": "Digitalis is an agent that is indicated when hea is not able to pump the blood adequately. Higher output Failure is seen in conditions like anaemia and thyrotoxicosis in which hea is already contracting vigorously. Cardiac glycoside,thus are not indicated in high output failure Refer kDT 6/e p502", "cop": 3, "opa": "Atrial flutter", "opb": "Atrial fibrillation", "opc": "High output failure", "opd": "PSVT", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "b1c0ff0b-2f9e-4b07-8207-4b87e63d9e5b", "choice_type": "single"} {"question": "A pregnant woman with the recent onset of urinary frequency, urgency and dysuria, and evidence of bacteriuria should be treated with", "exp": "Tetracyclines may cause staining of fetal teeth when given during pregnancy. Trimethoprim-sulfamethoxazole may cause neonatal jaundice when administered late in pregnancy because sulfonamides may displace bilirubin from plasma proteins. Fluoroquinolones, such as ciprofloxacin and norfloxacin, are best avoided in pregnancy because of their potential to cause ahropathy in the fetus caused by damage to cailage. The 13-lactam antibiotics, including penicillin's such as ampicillin and various oral cephalosporin's, may be safely administered to pregnant women. First- or second-generation cephalosporins are usually preferred because of their antimicrobial spectrum..", "cop": 4, "opa": "Ciprofloxacin", "opb": "Norfloxacin", "opc": "Trimethoprim-sulfamethoxazole", "opd": "Cephalexin", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "118c2e6c-fec6-4b89-8c8d-e22b11fe4a01", "choice_type": "single"} {"question": "Mechanism of action of Aspirin", "exp": "Ans. (b) Inhibit TXA2 formationRef KDT 6th ed. / 609; Katzung 9th ed. / 446Thromboxane helps in platelet aggregation.* TXA2 formation is suppressed at very low doses of aspirin.* Aspirin blocks thromboxane formation by inhibiting COX activity by enzyme COX1 and TX- synthase irreversibly.", "cop": 2, "opa": "Inhibit PGI2 formation", "opb": "Inhibit TXA2 formation", "opc": "Stimulate TXA2 formation", "opd": "Stimulate platelet aggregation", "subject_name": "Pharmacology", "topic_name": "Antiplatelets and Fibrinolytics", "id": "bcb1495a-1c10-4078-b5f7-ebb128e27d3a", "choice_type": "single"} {"question": "Out of two anticholinesterases, drug 'X' is a teiary amine while drug 'Y' is a quaernary ammonium compound. Then", "exp": "Drug X is physostigmine and Drug Y is neostigmine. Physostigmine:- It is rapidly absorbed from g.i.t. and parenteral sites. Applied to the eye, it penetrates cornea freely. It crosses blood-brain barrier and is disposed after hydrolysis by ChE. Neostigmine and congeners:- These are poorly absorbed orally; oral dose is 20-30 times higher than parenteral dose. They do not effectively penetrate cornea or cross blood-brain barrier. They are paially hydrolysed and paially excreted unchanged in urine. Ref:- kd tripathi; pg num:-107,108", "cop": 4, "opa": "Drug 'X' is likely to be more potent than 'Y'", "opb": "Drug 'Y' will produce CNS effects", "opc": "Drug 'Y' will be completely metabolized in the body", "opd": "Drug 'X' will be more suitable to be used as a miotic", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "b0a79382-ef2e-4142-b2ed-68dbaa281a0b", "choice_type": "single"} {"question": "Monoclonal antibody used in cancer is", "exp": "Rituximab is a monoclonal antibody against CD20. It is used for treatment of: - Non-Hodgkin lymphoma Chronic lymphoid leukemia Rheumatoid ahritis SLE Auto-immune hemolytic anemia Idiopathic thrombocytopenic purpura OTHER OPTION: Cisplatin is most emetogenic anticancer drug - DOC- esophageal or gastric cancer 5-fluorouracil is a pyrimidine analog and inhibit DNA synthesis by competing with DNA polymerase. Methotrexate is a dihydro folic acid reductase inhibitor. It decreases the formation of DNA.", "cop": 1, "opa": "Rituximab", "opb": "Cisplatin", "opc": "5-fluorouracil", "opd": "Methotrexate.", "subject_name": "Pharmacology", "topic_name": "FMGE 2019", "id": "72e57a54-decf-41b9-9230-08b097ad3637", "choice_type": "single"} {"question": "Bleomycin toxcity is characterized by destructionof aEUR'", "exp": "Type I Pneumocytes {Ref: Fishman's pulmonary disease and disorders 4/e p 1069; Devito Oncology 8/e p 2673] Neomycin is well known to cause pulmonary toxicity. -The incidence of Neomycin induced pulmonary toxicity is 5% for a total cumulative dose of 450 units and 15%.for higher dosages. - Bleomycin is concentrated preferentially in the lung and is inactivated by hydrolase enzyme. This enzyme is relatively deficient in lung tissue. - This may explain relative sensitivity of Neomycin to lung tissue Pathological features of Neomycin toxicity i) Early endothelial cell damage ii) Destruction of type I pneumocytesdeg iii) Migration of type 11 pneumocytes into alveolar spaces inducing interstitial changes Type 1 epithelial _cells are more vulnerable to Neomycin toxicity and are destroyed by bleonlycin2 -Following destruction of tope 1 pneumocytes repair is characterized by hyperplasia and dysplasia of type 11 pneumocytes - Fibroblast proliferation with subsequent pulmonary fibrosis is probably the basis for irreversible changes induced by Neomycin. Also know Histopathology of lung in Neomycin toxicity Endothelial cell edema and Webbing Necrosis of type 1 pneumocytes Hyperplasia and metaplasia of type Il pneumocytes Inflammatory infiltrate with PMN Proliferation of fibroblast and fibrosis", "cop": 2, "opa": ">Endothelial cells", "opb": ">Type I pneumocytes", "opc": ">Type II pneumocyutes", "opd": ">Alveolar macrophages", "subject_name": "Pharmacology", "topic_name": null, "id": "4bf9ab9c-2d63-4c4c-8461-6affaa4e5891", "choice_type": "single"} {"question": "Drug not causing enzyme inhibition is", "exp": "Ans. is 'a' i.e., Phenobarbitone Drugs that induce microsomal enzymes* Phenobarbitone* Carbamezepine* Phenytoin* Omeprazole* Rifampin* Clofibrate* Glucocorticoids* Meprobamate* Isoniazid* Ritonavir* Chloral hydrate* Glutethimide* Phenylbutazone* Chronic alcohol intake* Griseofulvin* Cigarette smoking* DDT* Cyclophosphamide Drugs that inhibit drug metabolizing enzymes* Allopurinol* Diltiazem* Omeprazole* Amiodarone* Erythromycin* Propoxyphene* Clarithromycin* Isoniazid* Chloramphenicol* Cimetidine* Phenylbutazone* Quinidine* Ketoconazole* Metronidazole* Itraconazole* Disulfiram* Ciprofloxacin* Verapamil* Sulfonamides* MAO inhibitors", "cop": 1, "opa": "Phenobarbitone", "opb": "Omeprazole", "opc": "Disulfiram", "opd": "Diltiazem", "subject_name": "Pharmacology", "topic_name": "General Pharmacology", "id": "1bf553d2-263d-46e7-9374-8cb278003dfd", "choice_type": "single"} {"question": "Find therapeutic index of drug from the information given below in the graph", "exp": "TI = LD50/ED50 TI = 128 mg/8 mg = 16", "cop": 4, "opa": "128", "opb": "1024", "opc": "8", "opd": "16", "subject_name": "Pharmacology", "topic_name": "FMGE 2019", "id": "4e6f3949-2418-41aa-8797-3618ba03e6e5", "choice_type": "single"} {"question": "Total dose of Levonorgestrel for emergency contraception", "exp": "Refer KDT 7tg/e Pg 322 Levonorgestrel 0.75mg two doses 12 hours apa or 1.5mg single dose should be taken within 72 hrs of unprotected intercourse for emergency contraception", "cop": 1, "opa": "1.5mg single pill", "opb": "1.5 mg pill", "opc": "7.5 mg single pills", "opd": "O. 25 mg two pills", "subject_name": "Pharmacology", "topic_name": "Kidney", "id": "6f1fd2fe-af8e-4335-be2b-a8953ee6ddbd", "choice_type": "single"} {"question": "A drug that blocks the hea rate effect of a slow intravenous infusion of Phenylephrine is", "exp": ".", "cop": 3, "opa": "Atenolol", "opb": "Prazosin", "opc": "Atropine", "opd": "Propranolol", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "0516c31d-1a76-4521-8df1-ab0aef55adff", "choice_type": "single"} {"question": "Drug of choice for ventricular premature beats(VPB) with digitalis toxicity is", "exp": "Digoxin remains a very useful agent for chronic atrial fibrillation or for the ectopic beats associated with hea failure. But when rapid control of the ventricular rate is required to arrhythmias such as atrial fibrillation, atrial flutter, or paroxysmal atrial tachycardia, a slow infusion of verapamil is the agent of choice. In general, verapamil may be added to digoxin or given intravenously while a digoxin effect is awaited, unless there is digitalis toxicity. In digitalis toxicity, lignocaine remains the agent of choice for ventricular arrhythmias, and is given in the same doses as for acute myocardial infarction; phenytoin is used for digitalis-arrhythmias with A-V block. Verapamil may be infused very cautiously for digitalis-induced supraventricular tachyarrhythmias. The use of oral agents such as quinidine, disopyramide and mexilitene for chronic prophylaxis of ventricular ectopic beats is of doubtful effectiveness, unless the ectopic activity is symptomatic. Serious ventricular arrhythmias may be induced by quinidine and disopyramide. Beta-blockade is especially useful for ectopic beats associated with anxiety, or when arrhythmias are associated with angina of effo or hypeension. As always, major contraindications to the use of beta-blockade include cardiomegaly, hea failure or asthma", "cop": 1, "opa": "Diphenylhydantoin", "opb": "Quinidine", "opc": "Amiodarone", "opd": "Verapamil", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "23ed0007-9e37-455f-a6eb-2e269f840c66", "choice_type": "single"} {"question": "Best treatment for kawasaki's disease is", "exp": "Kawasaki disease: IVIG is given within the first 10 days of illness. Concomitant aspirin should be staed until the patient is afebrile If fever persist beyond 36 hours after the initial IVIG infusion, a new dose of IVIG should be given if no other source of fever is found. Methylprednisolone should follow if the disease persists after the second IVIG administration. Fuher options for refractory cases include TNF blockers (infliximab), cyclophosphamide, methotrexate, and plasmapheresis.", "cop": 2, "opa": "Aspirin", "opb": "I.V. immunoglobulins", "opc": "Coicosteroids", "opd": "Methotrexate", "subject_name": "Pharmacology", "topic_name": "Targeted Anticancer Drugs and Immunosuppressants", "id": "6e19decb-d1d3-4d0a-b694-b4c28a0dc6c9", "choice_type": "single"} {"question": "GnRH analogue used In hormonal treatment of carcinoma of prostate Is", "exp": "Goserelin is a long acting GnRH agonist. It is used in the treatment of prostate cancer. nilutamide is also used in prostate cancer but it is anti androgen not a GNRH analogue finatseride is 5 alpha reductase inhibitor cyproterone- anti androgen with progestational propeies (REF.Essential of medical pharmacology K D TRIPATHI 6 Edition, Page No - 239)", "cop": 1, "opa": "Goserelin", "opb": "Nilutamide", "opc": "Cyproterone acetate", "opd": "Finasteride", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "ac43e39d-28a3-4255-bb1f-bdc4185e3f1f", "choice_type": "single"} {"question": "Most common side efiect of mifepristone", "exp": "Mifepristone (RU 485) It is a 19 norsteroid with potent antiprogestational and significant antiglucocoicoid and antiandrogenic actitity.It is used in termination of pregnancy, cervical ripening postcoital contraceptive, once a month contraceptive, in induction of labour and to treat cushing's syndrome.Commonly repoed side afects include vaginal bleeding, cramping, nausea, vomiting, diarrhea, dizziness, back pain & tenderness.", "cop": 3, "opa": "Fever", "opb": "Headache", "opc": "Diarrhea", "opd": "Rash", "subject_name": "Pharmacology", "topic_name": null, "id": "34d69014-6506-4a39-88eb-bf4e74682d0e", "choice_type": "single"} {"question": "The drug of choice for prevention of seizures in a patient with severe preeclampsia is", "exp": "given by i.v. infusion, it has been used for long to control convulsions and to reduce BP in toxaemia of pregnancy. As per WHO, it is the drug of choice for prevention and treatment of seizures in preeclampsia and eclampsia Ref: KD Tripathih 8th ed. page 333", "cop": 2, "opa": "Phenytoin", "opb": "Magnesium sulphate", "opc": "Diazepam", "opd": "Nidedipine", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "dbee4d73-cd0b-4a60-a493-6c2d75f7d543", "choice_type": "single"} {"question": "Recombinant form of a hormone used in osteoporosis is", "exp": "Recombinant form of PTH used in osteoporosis for both mineralization and preventing demineralization of bone.Ref: CMDT 2018/1173", "cop": 4, "opa": "Zolendronate", "opb": "Ibandronate", "opc": "Strontium ranelate", "opd": "Teriparatide", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "9bd2a1e0-be2e-4ae1-8408-baa842d6be5e", "choice_type": "single"} {"question": "Sequence of clinical trials is", "exp": "(FDA-NDA-Post marketing survillance)", "cop": 4, "opa": "NDA -FDA-NDA", "opb": "FDA--NDA-FDA", "opc": "FDA-Marketing-NDA", "opd": "FDA-NDA-Post marketing surveillance", "subject_name": "Pharmacology", "topic_name": "General Pharmacology", "id": "b2699530-8315-4a18-894f-f2511f3c936e", "choice_type": "single"} {"question": "Nitrates are not used in", "exp": "Renal colic The main pharmacological action of Nitrates Nitroglycerine relaxes all types of smooth muscle irrespective of the state of the preexisting muscle tone. The most prominent action is exeed on the vascular smooth muscle. - Apa .from vascular smooth muscle nitrates also cause relaxation of the smooth muscles of the bronchi, gastrointestinal tract (including biliary system) and genitourinary tract. Nitrates are rapidly denitrated in the smooth muscle to release nitric oxide which activates cytosolic guanyl cyclase which in turn increases CGMP that leads to vasodilation Effect of nitrate on cardiovascular system Enzymes activates Nitrates --4 NO --> Gyanylcyclase 1' CGMP Vasodilation Nitrates cause relaxation of all the components of vascular system from large aeries to veins, aerioles and capillaries. Veins respond at the lowest concentrations and aeries at slightly higher one (Veins express greater amount of the enzyme that generates NO )from organic nitrates). The primary direct result of an effective dose of nitroglycerine is marked relaxation of veins with increased venous capacitance and decreased ventricular preload. This leads to reduction in pulmonary vascular pressure and hea size. Effect of nitrates on coronary circulation '* In normal subjects without coronary disease - Nitroglycerine can induce a significant if transient increase in total coronary blood flow. In patients with angina due to atherosclerosis - There is no evidence that total coronary .flow is increased in patients with angina due to atherosclerotic obstructive coronary aery disease. However, in these patients - Nitrates cause redistribution of coronary blood flow from normal to ischemic regions which may play role in therapeutic effect. There are two types of vessels in coronary circulation :Larger conducting aeries They run epicardially and send perforating branches to deeper tissue. Smaller resistance vessels These are the perforating branches of larger conducting aeries. These aerioles supply blood to endocardium. If there is ischemia in any region of endocardium the perforating vessels of those region are dilated due to autoregulation (hypoxia causes vasodilation). Nitrates preferentially dilates larger conducting vessels. This pattern of action ours more blood flow towards the ischaemic zone as the smaller endocardial vessels are already dilated as a result of hypoxia / ischaemia. Nitrates in hea failure Nitrates afford relief by causing venous pooling of blood. - Nitrates reduce venous return (preload) decreases end diastolic volume -4 improvement in left ventricular function by Laplace law regression of pulmonary congestion. Nitrates are used in cyanide poisoning Cyanide poisoning results from complexing of cytochrome iron by the CV ion. - Methemoglobin has a very affinity for CN ion. - Methemoglobin combines with CN to form cyamnethemoglobin which is rapidly excreted by the body. It is a well known fact that Nitrates generate generate Methemoglobin when they combine with Hb. - Thus administration of nitrates will generate large amount of methemoglobin. - Due to its high offinity.for cyanide, methemoglobin combines with cyanide .forming cyanmethemoglobin. - This will regenerate active cytochrome. - However this may again dissociate to release cyanide. - The cynamethemoglobin can be fuher detoxified by the intravenous administration of sodium thiosulfate. This results in formation of thiocyanate ion a less toxic ion that is readily excreted. Biliary colic Esophageal spasm Sublingual GIN promptly relieves pain. Nitrates taken before a meal facilitate feeding in esophageal achalasia by reducing esophageal tone. Also remember these impoant propeies of Nitrates. Oral availability of Nitrates is low The liver contains a high capacity organic nitrate reductase that removes nitrate groups in a stepwise _fashion from the parent molecule and ultimately inactivates the drug. Therefore oral bioavailability of the traditional organic nitrates e.g. nitroglycerine and isosorbidedinitrate is very low. For this reason sublingual route is preferred for nitrates. Nitroglycerine and isosorbide dintrate are both absorbed effectively by this route and reach therapeutic blood levels within a few minutes. Nitrates develop tolerance With continued exposure smooth muscles develop tolerance to nitrates. The mechanism by which tolerance develops are not completely understood. As noted above diminished release of nitric oxide resulting from depletion of tissue thiol compounds may be paly responsible ,for tolerance to nitrates. Some student argue that cyanide poisoning should be the answer because nitrites not nitrates are used in cyanide poisoning but we are not convinced. All the standard books group them together and do not differentiate between nitrates or nitrites. More so Nitrates have'nt found wide clinical use in Renal colic - None of the standard text books mention use of nitrates in renal colic. - Both Goodman Gilman and KDT says that unlike its consistent effect on muscles of biliary tract, the action of nitrates on ureteric muscles is variable therefore it has not found application in renal colic. - None of the studies and research papers convincingly state that nitrates should be used in renal colic. Nitrates have been anecdotally used only in uruguay to treat renal colic. A trial was conducted based on this but it did'nt come out with conclusive results. - It states that large trials and studies should be undeaken before nitrates before nitrates use is begun clinically.", "cop": 3, "opa": "CCF", "opb": "Esophageal spasm", "opc": "Renal Colic", "opd": "Cyanide poisoning", "subject_name": "Pharmacology", "topic_name": null, "id": "7ce2dcb0-8de4-47b7-9d96-e9bbfb0fc3ce", "choice_type": "single"} {"question": "Antihypertensive not contraindicated in pregnancy", "exp": "Ans. is 'b' i.e. Labetalol Drugs used for the t/t of Hypertensive pregnancy B etter M other C are D uring H ypertensive P regnancy Beta blockers (labetalol, atenolol) Methyl dopa (.D.O.C. in pregnancy) Clonidine Dihydropyridine CCB's (discontinue before labour as they weaken uterine contractions) Hydralazine (D.O.C in hypertensive emergency) Prazosin Antihypertensives to be avoided during pregnancy Diuretics Tends to reduce blood volume - accentuate uteroplacental perfusion deficit (of toxemia) - increased risk of foetal wastage, placental infarcts, miscarriage, still birth. ACE inhibitors, AT1 antagonists Risk of foetal damage, growth retardation. Reserpine Suicidal depression in mother, nasal obstruction, deranged respiratory and temperature control in the new bom. Nonselective b blockers Propranolol has been implicated to cause low birth weight decreased placental size, neonatal bradycardia and hypoglycemia. Sodium Nitroprusside Contraindicated in eclampsia Pregnancy hypertension There is a lack of good clinical trial evidence, on which to base recommendations of one agent over another. Instead, drug usage reflects longevity of use without obvious harm to the fetus. Hence methyldopa is still the drug of choice for many obstetricians. Calcium channel blockers (especially nifedipine) are common second line drugs. Parenteral hydralazine is reserved for emergency reduction of blood pressure in late pregnancy, preferably in combination a b blocker to avoid unpleasant tachycardia (labetalol and atenolol) are often effective and probably the drug of choice in the third trimester. There is anecdotal evidence to suggest growth retardation with b blockade used in first and second trimester. Diuretics reduce the chance of developing preeclampsia but are avoided in pre-eclampsia itself because these patients, already have a contracted circulatory volume. Spironolactone is a diuretic which is avoided in pregnancy because of its antiandrogenic effect on fetus. ACE inhibitors (and by implication angiotensin AT1receptor antagonist) are absolutely contraindicated during pregnancy where they cause fetal death, typically midtrimester (they can be prescribed during first trimester) Note : There is no evidence that ACE inhibitors - or any of the commonly used antihypertensive drugs are teratogenic and women who become pregnant while receiving these should be reassured but should, of course, then discontinue the ACE inhibitor or AT1receptor antagonist.", "cop": 2, "opa": "Spironolactone", "opb": "Labetalol", "opc": "Sodium Nitroprusside", "opd": "ACE inhibitor", "subject_name": "Pharmacology", "topic_name": "C.V.S", "id": "ab1f7181-4428-4ddc-81d7-2a9bca31b424", "choice_type": "single"} {"question": "Moxidectin was approved by FDA recently for", "exp": "moxidectin is a macro cyclic lactone which is similar to ivermectin.it binds to the glutamate gated chloride channels leading to increased permeability and hyperpolarization and muscle paralysis. Ref: www.fda.gov.in", "cop": 2, "opa": "Filariasis", "opb": "Onchocerca volvulus", "opc": "Hypeension", "opd": "Scabies", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "16ee489c-b43f-4dee-a96a-4cbd2c71a7ec", "choice_type": "single"} {"question": "The following laxative lowers blood ammonia level in hepatic encephalopathy", "exp": "Lactulose:- It is a semisynthetic disaccharide of fructose and lactose which is neither digested nor absorbed in the small intestine--retains water. Fuher, it is broken down in the colon by bacteria to osmotically more active products. In a dose of 10 g BD taken with plenty of water, it produces soft formed stools in 1-3 days. Flatulence and flatus is common, cramps occur in few. In patients with hepatic encephalopathy, lactulose causes reduction of blood NH3 concentration by 25-50%. The breakdown products of lactulose are acidic--lower the pH of stools. Ammonia produced by bacteria in colon is conveed to ionized NH4 + salts that are not absorbed. Ref:- kd tripathi; pg num:-676", "cop": 2, "opa": "Bisacodyl", "opb": "Lactulose", "opc": "Magnesium sulfate", "opd": "Liquid paraffin", "subject_name": "Pharmacology", "topic_name": "Gastrointestinal tract", "id": "e73cbd9b-803d-4dce-b354-3eeca3023fbd", "choice_type": "single"} {"question": "Anti Leprotic drug useful for lepra reactions", "exp": "Lepra reactions occur due to hypersensitivity reaction to dapsone.Two types are known type 1 lepra reaction is treated usingcoicosteroids and clofazamine and type 2 with Clofazamine - an anti-inflammatory drug apa from thalidomide and coicosteroids, chloroquine,aspirin,cholchicine. Ref: KD Tripathi 8th ed.", "cop": 4, "opa": "Dapsone", "opb": "Rifampicin", "opc": "Minocycline", "opd": "Clofazamine", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "e9572eb1-37e4-4287-a65e-eba269d6b0a4", "choice_type": "single"} {"question": "Azaserine inhibits", "exp": "In de novo synthesis of purine nucleotides, there are 10 steps.The 4th step (addition of N3) is catalysed by the enzyme Formyl glycinamide ribonucleotide amidotransferase.This enzyme is inhibited by azaserine, an anticancer drug.", "cop": 3, "opa": "Glycinamide ribonucleotide synthetase", "opb": "Glycinamide ribonucleotide transformylase", "opc": "Formyl glycinamide ribonucleotide amidotransferase", "opd": "Inosine monophosphate synthase", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "0242f754-6820-4885-8b67-3a11b8ffa7d4", "choice_type": "single"} {"question": "Beta blockers are antiarrhythmic agents of class", "exp": "Refer kDT 6/e p 511 The five main classes in the Vaughan Williams classification of antiarrhythmic agents are: Class I agents interfere with the sodium (Na+) channel. Class II agents are anti-sympathetic nervous system agents. ... Class III agents affect potassium (K+) efflux. Class IV agents affect calcium channels and the AV node.", "cop": 2, "opa": "1", "opb": "11", "opc": "111", "opd": "1V", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "ac6a5f48-66d6-4c63-8faa-361c97c9f68a", "choice_type": "single"} {"question": "Most cardiotoxic local anaesthetic agent", "exp": "Bupivacaine is more prone to prolong QTc interval and induce ventricular tachycardia or cardiac depression should not bbe used for intravenous regional analgesia (Bier's). Levobupivacaine is equally potent but less cardiotoxic and less prone to cause seizures then bupivacaine. Ref Katziung 12th ed", "cop": 1, "opa": "Bupivacaine", "opb": "Ropivacaine", "opc": "Dibucaine", "opd": "Levobupivacaine", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "37e4cece-eca1-46fc-a2e6-801bcecd4a4b", "choice_type": "single"} {"question": "Narcotic overdose can be antagonized by", "exp": null, "cop": 3, "opa": "Diphenhydramine", "opb": "Atropine", "opc": "Naloxane", "opd": "Nalorphine", "subject_name": "Pharmacology", "topic_name": null, "id": "b3038faa-8f83-4755-9c88-1e29de6ddcc0", "choice_type": "single"} {"question": "Digoxin action is not affected in", "exp": "Ref-KDT 5/e p463 Digoxin is eliminated mainly excretion through kidney. Dose of big ox and therefore does not require adjustment in hepatic failure where as it has to be reduced in renal failure", "cop": 1, "opa": "Hepatic disease", "opb": "Electrolyte disturbances", "opc": "Renal failure", "opd": "MI", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "a68b072a-399e-4a0f-ad48-107e05ca7021", "choice_type": "single"} {"question": "Methicilline resistance staph aureus NOT responds to", "exp": "(Oxacillin): (721-KDT 7th edition 396, 1070, 2069, 2135 - Harrison 18th)Oxacilline (Not marketed in India)CLOXACILLIN / DICLOXAC1LLIN - is highly penicellinase as well as acid resistant.More active than methicilline against penicillinase producing Staph but not against MRS AMethicilline resistant staph, aureus (MRSA) - These are insensitive to all penicillin- resistant penicillins (Methiciline, Cloxacilline, Dicloxacilline) and to Beta lactams as well as as to erythromycin, aminoglycosides, tetracyclines etc.* Drug of choice for these organism is vancomycin / linezolid but ciprofloxacin can also be used, Rifampin, Imipenem (362 - Lippintott's 4th)* Quinopristin / dalfopristin, Daptomycin and Linezolid are currently for the treatment of vancomycin resistant organism (370- Lippencott 4th)* Lincosamide antibiotics - Clindamycin, Lincomycin* Current recommendation for the treatment of community acquired MRSA. Atopic dermatitis is - Trimethoprim / sulfamethoxazole, minocycline-doxycycline or clindamycin (396- Harrison's 18th)Antibiotics for the treatment of osteomyelitis (1075 H 18th)* Methicilline susceptible Staph.aureus* Oxacilline or nafcilline* Cephalosporins* Clindamycin* Methiciline resistant S.aureus* Vancomycin* Daptomycin* Linezolid", "cop": 3, "opa": "Aminoglycosides", "opb": "Lincosamide", "opc": "Oxacilli", "opd": "Vancomycin", "subject_name": "Pharmacology", "topic_name": "Anti Microbial", "id": "25849985-f66a-4252-bd0f-801244d9033b", "choice_type": "single"} {"question": "Filgrastim is used for the treatment of", "exp": "Refer Katzung 11/e p 580-581 Filgrstim (G-CSF) and sargramostim(GM-CSF) are used to prevent or treat chemotherapy induced neutropenia Erythropoietin is used to treat anemia assosciated with chronic renal failure and cancer chemotherapy", "cop": 1, "opa": "Neutropenia", "opb": "Anemia", "opc": "Polycythemia", "opd": "Neutrophilia", "subject_name": "Pharmacology", "topic_name": "Respiratory system", "id": "0fc61b40-68e4-4307-97e5-2faafeed6b97", "choice_type": "single"} {"question": "Anaemia produced by phenytoin", "exp": "Megaloblastic as it causes mild folic acid deficiency. Ref: KD Tripathi 8th ed.,", "cop": 3, "opa": "Iron deficiency", "opb": "No anaemia", "opc": "Megaloblastic", "opd": "Sickle cell", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "f8c6cce5-fc4e-44e9-8e64-a52e975c58d3", "choice_type": "single"} {"question": "Most emetogenic drug is aEUR'", "exp": "Cisplatin; 'c' i.e., High dose cyclophosphamide The most common side effect of chemotherapy administration is nausea and vomiting. Antineoplastic agents may vary in their capacity to cause nausea and vomiting.", "cop": 1, "opa": "Cisplatin", "opb": "Carboplatin", "opc": "High dose cyclophosphamide", "opd": "High dose methotrexate", "subject_name": "Pharmacology", "topic_name": null, "id": "dfcc91d2-653b-4105-bdcb-b939834a8f49", "choice_type": "single"} {"question": "The percentage of drug remaining in the plasma after 3 half life is", "exp": "HALF-LIFE of drug : * The time taken for its plasma concentration to be reduced to half of its original value 1st t1/2 50% 2nd t1/2 (50+25) 75% 3rd t1/2 (50+25+12.5) 87.5% 4th t1/2 (50+25+12.5+6.25) 93.75% So Remaining is 100 - 87.5% = 12. 5% Note : Nearly complete drug elimination occurs in 4-5 half lives. Drugs eliminated by First order kinetics Zero order kinetics t 1/2 remains constant because V and CL do not change with dose. t 1/2 increases with dose CL progressively decreases as dose is increased t1/2= 0.693 x Vd/ CL", "cop": 4, "opa": "6.25%", "opb": "12%", "opc": "6%", "opd": "12.50%", "subject_name": "Pharmacology", "topic_name": "Pharmacokinetics", "id": "6239a6a0-c5c4-4d8a-8c26-013de24710a2", "choice_type": "single"} {"question": "A patient came to the casualty with acute bronchial asthma after treatment of glaucoma. The probable drug may be", "exp": "Timolol is a non selective β blocker (act on β1& β2 ). β2 blocking effect of Timolol cause blockage of dilator β2 receptor so it can precipitate asthma. Whereas Betaxolol is cardioselective beta blocker that acts only on β2  receptor.", "cop": 1, "opa": "Timolol", "opb": "Betaxolol", "opc": "Latanoprost", "opd": "Anticholinesterase", "subject_name": "Pharmacology", "topic_name": null, "id": "eb278717-b522-4278-9cc4-c4f820855cbb", "choice_type": "single"} {"question": "Cough is an adverse reaction seen with intake of", "exp": "Refer kDT 6/e p984 ACE inhibitor cause adverse reaction like cough. The CAPTOPRIL mnemonic can be used to remember the side effects of ACE inhibitors: cough, angioedema, potassium changes, taste change, hyp-O-tension, pregnancy changes, rash, increased renin, and lower angiotensin II. Another side effect is hyperkalemia.", "cop": 3, "opa": "Thiazide", "opb": "Nifedipine", "opc": "Enalapril", "opd": "Prazosin", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "25109b14-5144-4ca5-ba3e-cc93c695119c", "choice_type": "single"} {"question": "ACE inhibitors are contraindicated in", "exp": "Refer kDT 6/e p 484 Angiotensin-conveing enzyme inhibitors (ACEIs) are contraindicated in patients with bilateral renal aery stenosis due to risk of azotemia resulting from preferential efferent aeriolar vasodilation in the renal glomerulus due to inhibition of angiotensin II.", "cop": 4, "opa": "Diabetes mellitus", "opb": "Hypeension in age old patient", "opc": "Scleroderma", "opd": "Bilateral renal aery stenosis", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "6fa57232-44b4-4605-91a2-5aa0f610f450", "choice_type": "single"} {"question": "Tolerance is seen in", "exp": "Tolerance and withdrawal symptoms are seen in physical dependence", "cop": 4, "opa": "Hypochondriasis", "opb": "Obsessive complusive disorder", "opc": "Psychogenic dependence", "opd": "Physiological dependence", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "e81b6a5b-1eaf-4af4-b819-f67973c36b82", "choice_type": "single"} {"question": "Potassium channel opener with anti anginal activity is", "exp": "Refer katzung 11e p 158 Nicorandil is a vasodilatory drug used to treat angina. Angina is chest pain that results from episodes of transient myocardial ischemia. This can be caused by diseases such as atherosclerosis, coronary aery disease and aoic stenosis. Angina commonly arises from vasospasm of the coronary aeries.", "cop": 1, "opa": "Nicorandil", "opb": "Dipyramidole", "opc": "Trimetazidine", "opd": "Oxyphedrine", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "a884c24a-ae0b-4b19-af26-34b6ce0f242e", "choice_type": "single"} {"question": "Glyceryl trinitrate is given by sublingual route, because it has", "exp": "Glyceryl trinitrate (GTN) has high first pass metabolism. So preferred route is sublingual to bypass the metabolism liver Advantage of sublingual route Fast acting No first pass metabolism Self administration is possible After action drug can be spitted out", "cop": 2, "opa": "High absorption", "opb": "High first pass metabolism", "opc": "Low volume of distribution", "opd": "High plasma protein bound", "subject_name": "Pharmacology", "topic_name": "CHF, Angina Pectoris and Myocardial Infarction", "id": "1601e940-fb14-4852-aeb2-64c5f3ebb9ad", "choice_type": "single"} {"question": "Colesevelam is a", "exp": "It is a bile acid sequestrantIt bind bile acids but mechanism of glucose lowering not known.", "cop": 3, "opa": "HMG Co enzyme inhibitor", "opb": "Insulin secretogogue", "opc": "Bile acid sequestrant", "opd": "Alpha glucosidase inhibitor", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "11099834-8a2c-47b1-9cd8-2851196aa250", "choice_type": "single"} {"question": "Tim dependent killing and prolonged post antibiotic effect is seen with", "exp": "Ref Katzung 13th/879 Long post antibiotic effect is shown by most of the drugs against gram positive bacteria but few drugs have long PAE against gram negative bacteria Clindamycin and erythromycin are static6 drugs that exhibit time dependent inhibitory activity Fluroquinolone follow concentratn dependent killing", "cop": 2, "opa": "Fluoroquinolone", "opb": "Beta lactams", "opc": "Clindamycin", "opd": "Erythromycin", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "6f729201-beab-4486-b2b4-49f98c2d50c7", "choice_type": "single"} {"question": "Voricanazole is not effective against", "exp": "Refer Harrison 17th/1243 Voricanazole is drug of choice for treatment of Aspergillosis. It can also be used for Candida species Mucormycosis is treated by Amphotercin B.Posaconazole can also be used", "cop": 2, "opa": "Candida albicans", "opb": "Mucormycosis", "opc": "Candida tropicalis", "opd": "Aspergillosis", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "d40f0b62-2580-474e-9d43-35d9ea790567", "choice_type": "single"} {"question": "Xylometazoline nasal drops given before nasotracheal intubation to", "exp": null, "cop": 1, "opa": "Vasoconstriction of nasal mucosa", "opb": "Dilatation of orifices", "opc": "Decrease secretion", "opd": "Dilation of posterior", "subject_name": "Pharmacology", "topic_name": null, "id": "4d9e6613-0c17-40aa-88e5-0cabdad79ba2", "choice_type": "single"} {"question": "Drug used in irritable bowel syndrome with constipation is", "exp": "-Lubiprostone acts by stimulating Cl- channel opening in the intestine, increasing liquid secretion in gut and decreasing transit time, therefore used for chronic constipation. -It has also been approved for constipation dominant irritable bowel syndrome in women. -Irritable bowel syndrome is a condition characterized by abdominal pain, bloating and altered bowel habits (diarrhea or constipation) For diarrhea dominant IBS, drugs that can be used are Loperamide or diphenoxylate New kappa opioid receptor antagonist- Fedotozine Reserpine analog - Mebeverine 5 HT3 antagonist - Alosetron (also reduces pain) Clonidine (also reduces distension induced pain ) For constipation dominant IBS, drugs effective are 5 HT4 agonists (tegaserod, prucalopride) Loxiglumide Lubiprostone Plecanatide", "cop": 1, "opa": "Lubiprostone", "opb": "Loperamide", "opc": "Alosetron", "opd": "Clonidine", "subject_name": "Pharmacology", "topic_name": "Gastro-Intestinal Tract", "id": "e5f159bf-3ec9-4ba9-8c0e-de8ff0df4fed", "choice_type": "single"} {"question": "Wof is long acting NSAID", "exp": "ENOLIC ACID DERIVATIVES (Oxicams) Piroxicam:- It is a long-acting potent NSAID with anti-inflammatory potency similar to indomethacin and good analgesic-antipyretic action. It is a nonselective, reversible inhibitor of COX; lowers PG concentration in synol fluid and inhibits platelet aggregation--prolonging bleeding time. In addition, it decreases the production of IgM rheumatoid factor and leucocyte chemotaxis. Pharmacokinetics:- It is rapidly and completely absorbed: 99% plasma protein bound; largely metabolized in liver by hydroxylation and glucuronide conjugation; excreted in urine and bile; enterohepatic cycling occurs. Plasma t 1/2 is long nearly 2 days. (Due to enterohepatic circulation). Ref:- kd tripathi;pg num:-201", "cop": 4, "opa": "Aspirin", "opb": "Ibuprofen", "opc": "Diclofenac", "opd": "Piroxicam", "subject_name": "Pharmacology", "topic_name": "Autacoids", "id": "fac1a18c-30b2-4e6d-a0bb-037cac235af6", "choice_type": "single"} {"question": "For drugs with first order kinetics the time required to achieve steady state levels can be predicted from", "exp": "Ans. is 'b' i.e., Half-life Steady stateplasma concentration After 5 t1/2, nearly complete drug is eliminated from the body o If a constant dose of drug is repeated before 5 V/2, the concentration in blood will be higher, because some remnant of the previous dose will be present in the body. o So, when a drug is infused at a constant rate the plasma concentration rises until a state is reached at which the rate of administration of drug to the body is exactly equal to the rate of elimination. o This is called the steady state ---> when it is attained the amount of drug in the body remains constant i.e. the plasma concentration is on a plateau ---> plateau principal of drug accumulation. o If a drug is administered by a constant rate the time to reach steady state depends only on the t1/2. o With passage of each V/2 period of time, the plasma concentration rises by half the difference between the current concentration and the ultimate steady state (100%) concentration. o For all practical purposes, after 5 t1/2 the amount of drug in the body will be constant and the plasma concentration will be at a plateau. o For example, if a drug with t1/2 4 hours and plasma concentration 100 mg/ml is given at a constant rate ie every 4 hrs. 1st dose --> at 0 hrs 2nd dose --> at 4 hrs 3rd dose at 8 hrs 4th dose --> at 12 hrs-------------------- so on. o After 4 hrs (1 t1/2) the drug concentration --> 50 mg/ml. o After 8 hrs (2 t1/2) 75 mg/ml (50 of 1 st dose + 25 of 2\" dose) o After 12 hrs (3 t'/2) --> 87.5 mg/ml (50 of 3\" dose + 25 of 2\" dose + 12.5 of 1' dose) o After 16 hrs (4 t1/2) --> 93.75 (50 of 4th dose + 25 of 3rd dose + 12.5 of 2' dose + 6.25 of 1\" dose) o After 20 hrs (5 t1/2) --> 96.875 (50 of 5th dose + 25 of 4th dose + 12.5 of 3rd dose + 6.25 of 2' dose + 3.125 of V dose) o After 24 hrs (6 t1/2) --> 96.875 (50 of 6th dose + 25 of 5th dose + 12.5 of 4th dose + 6.25 fo 3rd dose + 3.125 of 2' dose + nil from 1st dose, after 5 t1/2 nearly complete drug elimination occurs & first dose is eliminated after 5 VA). o So, after 5 t1/2 plasma concentration will be constant.", "cop": 2, "opa": "Volume of distribution", "opb": "Half life", "opc": "Clearance", "opd": "Loading dose", "subject_name": "Pharmacology", "topic_name": null, "id": "ad499731-f02a-469c-9d1a-71631afe0207", "choice_type": "single"} {"question": "INH can be used safely in the presence of", "exp": "ReferKDT 6/e p740 INH causes hepatitis Peripheral neuritis Neurological manifestations *****its toxic metabolites accumulates in the presence of renal failure so we are left with last option, coronary aery disease, which is our answer of exclusion", "cop": 4, "opa": "Jaundice", "opb": "Chronic renal failure", "opc": "Epilepsy", "opd": "Coronary aery disease", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "87f2207c-4d7e-4d79-b41c-9e4379e3d9b4", "choice_type": "single"} {"question": "Most common cause of neonatal seizures is not related", "exp": ".", "cop": 2, "opa": "Sepsis", "opb": "Hypoxic ischemic encephalopathy", "opc": "Bacterial meningitis", "opd": "Hypoglycemia", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "2466bf08-27b9-4c97-a727-3f19e05d675a", "choice_type": "single"} {"question": "Iron is most commonly absorbed from", "exp": "Refer Katzung 11/e p 571 Maximum iron absorption occurs in duodenum and proximal jejunum Vitamin B12 is absorbed in distal ileum whereas folic acid is absorbed in proximal jejunum", "cop": 1, "opa": "Duodenum and upper jejunum", "opb": "Lower jejunum", "opc": "Stomach", "opd": "Ileum", "subject_name": "Pharmacology", "topic_name": "Respiratory system", "id": "eabe9437-5ec2-4134-8705-1ceb0f07b575", "choice_type": "single"} {"question": "Drug contraindicated in bilateral renal aery stenosis", "exp": "Refer kDT 6/e p 484 Renal aery stenosis is thenarrowing of one of the renal aeries, most often caused by atherosclerosis or fibromuscular dysplasia. This narrowing of therenal aery can impede blood flow to the target kidney, resulting in renovascular hypeension - a secondary type of high blood pressure. Angiotensin-conveing enzyme inhibitors (ACEIs) arecontraindicated in patients withbilateral renal aery stenosis due to risk of azotemia resulting from preferential efferent aeriolar vasodilation in the renal glomerulus due to inhibition of angiotensin II.", "cop": 3, "opa": "Propanolol", "opb": "Guanethidine", "opc": "Captopril", "opd": "Amilodipine", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "2188c702-1201-4d51-a23d-f79f255f3652", "choice_type": "single"} {"question": "Grey baby syndrome is caused by", "exp": "Amikacin - nephrotoxicity, ototoxicity and neuromuscular blockade Tetracycline - nephrotoxicity when given along with diuretics, phototoxicity, , affect dentition and bones in young children, Fanconi syndrome and Renal tubular acidosis. Vancomycin - red man syndrome Chloramphenicol- grey baby syndrome,nephrotoxicity,ototoxicity.", "cop": 4, "opa": "Amikacin", "opb": "Tetracycline", "opc": "Vancomycin", "opd": "Chloramphenicol", "subject_name": "Pharmacology", "topic_name": "Protein Synthesis Inhibitors", "id": "36f37718-f3ba-4dcb-8299-497b88378df0", "choice_type": "single"} {"question": "Nitrous oxide is carried in the blood stream by", "exp": null, "cop": 3, "opa": "Haemoglobin", "opb": "White blood cells", "opc": "Red Blood cells", "opd": "Serum", "subject_name": "Pharmacology", "topic_name": null, "id": "35157d9c-019a-4680-b363-5c9d09e4103d", "choice_type": "single"} {"question": "Eclampsia seizures drug of choice", "exp": "Eclampsia in pregnancy can be treated by magnesium sulphate. It is given by i.m route with the monitoring of reflexes mainly the patellar refex Ref: Katzung 12th ed.", "cop": 3, "opa": "Diazepam", "opb": "Phenytoin", "opc": "Magnesium", "opd": "Barbiturate", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "ee69ed6d-04cc-46e0-829d-a839fd56cdcf", "choice_type": "single"} {"question": "Tolvaptan is used for", "exp": "Tolvaptan:- * Tolvaptan is a selective Vasopressin V2 receptor antagonist indicated in treatment of euvolaemic or hypervolaemic hyponatremia (Na+ < 125mEq/L or clinically symptomatic hyponatraemia, in spite of fluid restrictive corrective measures), including patients with Syndrome of Inappropriate ADH Secretion and Hea Failure. * Bater and Schwaz criteria defines SIADH as follows: Ref:- Goodman & Gilman's Pharmacological basis of Therapeutics 13th Ed; Pg Num:- 466", "cop": 4, "opa": "Von Willebrand Disease", "opb": "Catecholamine resistant Shock", "opc": "Central DI", "opd": "SIADH", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "05d2367e-55d6-44f6-8cf1-8f7ace1e4856", "choice_type": "single"} {"question": "A female presents with placenta pre with active bleeding and blood pressure of 80/50 MM Hg and pulse rate of 140 bpm. The choice of anesthesia for emergency cesarean section of this female is", "exp": "Refer Williams Obstetrics 24th/e p 518 The patient is presenting with shock, so spinal anesthesia can't be used Among the general anesthetics, Ketamine is drug of choice for induction in patients with low blood pressure", "cop": 2, "opa": "General anesthesia with intravenous propofol", "opb": "General anesthesia with intravenous Ketamine", "opc": "Spinal anesthesia", "opd": "Epidural anesthesia", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "e52de523-965c-4fda-9d35-98dd4aab9aaf", "choice_type": "single"} {"question": "Digoxin toxicity is aggrevated by", "exp": "Hypokalemia is usually observed with chronic toxicity or in patients taking diuretics; it reduces the rate of Na+/K+ ATPase pump turnover and exacerbates pump inhibition due to digitalis. Hyperkalemia is the usual electrolyte abnormality precipitated by digoxin toxicity, primarily in the acute setting Refer kDT 6/e p499", "cop": 1, "opa": "Hypokalemia", "opb": "Hyperkalemia", "opc": "Hypermagnesimaia", "opd": "Hypocalcemia", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "149616ec-c147-4dae-8ae4-7b466b7717cd", "choice_type": "single"} {"question": "Basiliximab is a monoclonal antibody against", "exp": "(A) IL-2 receptor[?]IL-2 is a type of cytokine signaling molecule in the immune system that regulates the activities of white blood cells (leukocytes, often lymphocytes) that are responsible for immunity.oBasiliximab is a chimeric murine monoclonal antibody acts as IL-2 antagonist used to prevent organ rejection in kidney transplant.oMOA: Basiliximab binds with high-affinity to the alpha-subunit (CD25) of IL-2 receptor. This inhibits IL-2 binding, which inhibits T-cell activation and prevents an immune response in organ transplantation.oUses:-Indicated for prophylaxis of acute organ rejection in renal transplant patients and also as a part of an immunosuppressive regimen along with glucocorticoids and cyclosporine.Adverse effects - Anaphylactic reactions & opportunistic infections.Daclizumab: humanized lgG1 chimeric monoclonal antibody.Has a somewhat lower affinity but a longer t1/2 (20 days) than Basiliximab (7 days) MONOCLONAL ANTIBODIESAntibodyType1 TargetIndicationAbciximabChimeric1 Inhibition of Gp lib/IIIaCardiovascular diseaseAdalimumabHumanffInhibition of TNF-alfa signalingSeveral autoimmune disordersAlamtuzumabHumanized1 CD52CLLBasiliximabummericIL-2 receptor (CD25)Transplant rejectionBevacizumabHumanized1 Vascular endothelial GFColorectal cancer, macular degenerationDaclizumabHumanizedIL-2 receptor (CD25)Transplant rejectionEuclizumabHumanizedComplement system protein C5Paroxysmal nocturnal hemoglobinuria4 fefalizumabHumanizedCD11aPsoriasisGemtuzumabHumanizedCD33Acute myelogenous leukemiaInfliximabChimericInhibition of TNF-alfa signalingSeveral autoimmune disordersMuromonab-CD3MurineT cell CD3 receptorTransplant rejectionNatalizumabHumanized Multiple sclerosis and Crohn's diseaseOmalizumabHumanisedIG EAllergy related asthmaRitixumabChimericCD20 Non hodgekin's lymphomaTrastuzumabHumanizedErbB2Breast cancer", "cop": 1, "opa": "IL-2 receptor", "opb": "CD 20 %", "opc": "TNF alpha", "opd": "IL-6", "subject_name": "Pharmacology", "topic_name": "Immunomodulator", "id": "2c0c8603-fcab-4a7f-9126-09f5351fa7f7", "choice_type": "single"} {"question": "Drug distribution is inversely propoional to", "exp": "The extent of distribution of a drug depends on its lipid solubility, ionization at physiological pH, the extent of binding to plasma and tissue proteins, differences in regional blood flow. If PPB is high VD is low, PPB is inversly propoional to vd drugs with low vd usually have high ppb ref; KD Tripathi pharmacology 6th edition (page no;18)", "cop": 1, "opa": "Plasma protein binding", "opb": "Lipid Solubility", "opc": "fat layer in the body", "opd": "structure of drug", "subject_name": "Pharmacology", "topic_name": "General pharmacology", "id": "fa214456-a770-4005-bef8-d72c0a78d884", "choice_type": "single"} {"question": "Arrange the insulin in order of their duration of action (shoest first and longest last) a. NPH b. Glargine c. Detemir d. Degludec", "exp": "Duration of action of insulin : a40h)", "cop": 2, "opa": "d It is very useful for removing ethanol, methanol, ethylene glycol, chloral hydrate, lithium, trivalent arsenic, acetaminophen, bromides, phenobarbital, bromides, salicylates, fluoride, sodium chlorate, digitalis, methaqualone, boric acid and thiocyanates.", "cop": 2, "opa": "Barbiturates", "opb": "Diazepam", "opc": "Salicylate", "opd": "Methanol", "subject_name": "Pharmacology", "topic_name": "Miscellaneous (Pharmacology)", "id": "d6c6099c-e08f-494d-945a-aba6ff44a745", "choice_type": "single"} {"question": "A patient on treatment for leukemia, develops chest pain, pulmonary infiltrates and pleural effusion. The likely cause is", "exp": "Ans. (D) Tretinoin(Ref: Katzung 10th/899; KDT 8th/e p928)Tretinoin causes chest pain, pleuritis, pulmonary infiltrates and pleural effusion. It is a known human teratogen. Daunorubicin and doxorubicin cause cardiotoxicity manifested as arrhythmias and CHF.", "cop": 4, "opa": "Daunorubicin", "opb": "Hydroxyurea", "opc": "Cytarabine", "opd": "Tretinoin", "subject_name": "Pharmacology", "topic_name": "Chemotherapy: General Principles", "id": "b45d5aab-6be2-4577-a534-ae15660b72ee", "choice_type": "single"} {"question": "Drug of choice for treatment of infestation due to Onchocerca volvolus is", "exp": "DOC for all nematode including their larvae: ALBENDAZOL Exception:- FILARIA: DEC - STRONGYLOIDES, ONCHOCERCA: IVERMECTIN", "cop": 2, "opa": "Albendazole", "opb": "Ivermectin", "opc": "Praziquantal", "opd": "Suramin", "subject_name": "Pharmacology", "topic_name": "Anti-Parasitic Drugs", "id": "2bba099a-6e7f-4616-9af1-51794820cb45", "choice_type": "single"} {"question": "Dose of Carbetocin for post paum hemorrhage", "exp": "Refer Goodman Gilman 12th/1851 Carbetocin is along acting Oxytocin that us useful to prevent post pay hemorrhage given intramuscularly or intravenously in a dose of 100 microorgam", "cop": 1, "opa": "100 microgram intramuscular", "opb": "50 microorgam Inravenous", "opc": "150 microgram intravenous", "opd": "200 microgram intramuscular", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "c39803d4-d603-4cc3-9278-dc84abcc514e", "choice_type": "single"} {"question": "Forced Alkaline diuresis is useful in the poisoning of", "exp": "Barbiturates Forced alkaline diuresis increses the excreation of some drugs in urine and is used in treatment of drug overdose or treatment of poisioning by these drugs.Sodium bicarbonate is used.Other drugs where it is used as treatment are salicylates,cocaine,amphetamine. Ref: K.D.Tripati.7th Ed., Pg: 29", "cop": 2, "opa": "Lead", "opb": "Barbiturates", "opc": "Morphine", "opd": "Iron", "subject_name": "Pharmacology", "topic_name": "General pharmacology", "id": "179a59ee-09bf-4dd4-9133-11a5a01f2a00", "choice_type": "single"} {"question": "In leprosy, the best bactericidal agent is", "exp": "Refer KDT 6/e p753. Best and the fastest acting drug for leprosy is Rifamipicin Clofazimine and Dapsone are bacteriostatic agents", "cop": 3, "opa": "Clofazimine", "opb": "Dapsone", "opc": "Rifamipicin", "opd": "Ethionamide", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "d6d4f94a-af4e-4bc8-8089-d4ac7c0297e9", "choice_type": "single"} {"question": "Wof chemotherapeutic drugs inhibit the polymerization of microtubules but is not associated with causing bone marrow supression", "exp": "Vinca alkaloids Mech of action:- These are mitotic inhibitors, bind to microtubular protein--'tubulin', prevent its polymerization and assembly of microtubules, cause disruption of mitotic spindle and interfere with cytoskeletal function. The chromosomes fail to move apa during mitosis: metaphase arrest occurs. They are cell cycle specific and act in the mitotic phase. Vincristine (oncovin):- Uses:- It is a rapidly acting drug, very useful for inducing remission in childhood acute lymphoblastic leukaemia, but is not good for maintenance therapy. Other indications are acute myeloid leukaemia, Hodgkin's disease, Wilms' tumour, Ewing's sarcoma, neuroblastoma and carcinoma lung. Adverse effects:- peripheral neuropathy and alopecia. It also causes ataxia, nerve palsies, autonomic dysfunction (postural hypotension, paralytic ileus, urinary retention) and seizures. Bone marrow depression is minimal, but syndrome of inappropriate secretion of ADH (SIADH) can occur. Ref:- kd tripathi; pg num:-865", "cop": 2, "opa": "Cisplatin", "opb": "Vincristine", "opc": "Vinblastine", "opd": "5 FU", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "3c8a98fe-eb7a-4527-8334-95274f4bcf75", "choice_type": "single"} {"question": "Most effective treatment for severe malaria is", "exp": "Refer Harrison 19th/1699-1701 Drug for choice for severe or complicated malaria is aesunate .For more6 details see text", "cop": 1, "opa": "Aesunate", "opb": "Chloroquine", "opc": "Quinine", "opd": "Primaquine", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "1672a766-01db-42cf-a057-7e54902389af", "choice_type": "single"} {"question": "The alpha 2 agonist used in glaucoma is", "exp": "Ref: KD Tripathi pharmacology 7th edition (page.no: 153) a2 agonist used for glaucoma is Brimonidine, Apraclonidine. Drugs used for glaucoma - b blocker; Timolol,Betaxolol PG analogue ; Latanoprost ,Bimatoprost Carbonic anhydrase inhibitors ; acetazolamide ,Dorzolamide Miotics; Pilocarpine", "cop": 3, "opa": "Guanacare", "opb": "Guanabenz", "opc": "Brimonidine", "opd": "Tizanidine", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "5f44e153-650d-43cf-ad3e-d5baf805650a", "choice_type": "single"} {"question": "The following is not an immunomodulator", "exp": "Cycloserine is an antibiotic. Remaining all are immune-modulators which are calcineurin inhibitors.Ref: Katzung 13th ed Pg 1135", "cop": 3, "opa": "Tacrolimus", "opb": "Cyclosporin", "opc": "Cylcoserin", "opd": "Sirolimus", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "01fd93a3-d0b5-4e37-aaed-9a9b851d81ca", "choice_type": "single"} {"question": "An anxiolytic benzodiazepine that has additional antidepressant propey is", "exp": "Anti-anxiety benzodiazepines are D: Diazepam O: Oxazepam C: Chlordiazepoxide L: Lorazepam A: Alprazolam -- Chlordiazepoxide is benzodiazepine of choice for alcohol withdrawal. -- Lorazepam has high risk of causing amnesia. It is the only benzodiazepine recommended by intramuscular route. -- Alprazolam has additional mood elevating action. It is paicularly useful in anxiety associated with depression.", "cop": 1, "opa": "Alprazolam", "opb": "Oxazepam", "opc": "Lorazepam", "opd": "Chlordiazepoxide", "subject_name": "Pharmacology", "topic_name": "Sedative-Hypnotics and Parkinsonism", "id": "e18767b9-f9e6-440a-8441-4aa731319b1f", "choice_type": "single"} {"question": "Atorvastatin is used as an anti dyslipidemic drug. These drugs inhibit their target enzyme by", "exp": "Atorvastatin: Anti dyslipidemic drug Inhibits HMG COA reductase competitively. Propeies of Atorvastatin: - Antioxidant propey. High efficacy, most commonly used statin capable of lowering LDH by 55-60 % Longer plasma t 1/2 14 - 18 hrs. Competitive Non competitive 1. Antagonist bind with same site as substrate (active site) 2. Antagonist resembles chemically with the substrate 3. Km increase 1. Binds to another site called allosteric site 2. Does not resemble 3. Vmax decrease", "cop": 1, "opa": "Competitive inhibition", "opb": "Non-competitive inhibition", "opc": "Uncompetitive inhibition", "opd": "Irreversible inhibition", "subject_name": "Pharmacology", "topic_name": "Hypeension, Arrhythmias, Dyslipidemia", "id": "5494f693-b5b9-4fef-8ce8-bfda994f29b6", "choice_type": "single"} {"question": "Buprenorphine is partial agonist of", "exp": "Ans. is 'a' i.e., Mu (m) receptor BuprenorphineReceptor p(mu) - Partial agonistK (kappa) - Antagonist (moderate) d (delta) - Also know -Buprenorphine produces ceiling effect", "cop": 1, "opa": "Mu (u) receptor", "opb": "Delta (d) receptor", "opc": "Kappa (k) receptor", "opd": "Sigma (s) receptor", "subject_name": "Pharmacology", "topic_name": "C.N.S", "id": "529f1f4f-909e-49cf-8cde-672264326a4f", "choice_type": "single"} {"question": "Drug remaining in body after 3 half lives is", "exp": "Half-life- time taken by the drug to become half of its earlier concentration it takes 5-6 half-lives for a drug to almost get eliminated from the body Ref: KD Tripathi 8th ed", "cop": 1, "opa": "12.50%", "opb": "75%", "opc": "87.50%", "opd": "94%", "subject_name": "Pharmacology", "topic_name": "General pharmacology", "id": "3ec0a72a-b335-4165-b9ef-83619aee3ec7", "choice_type": "single"} {"question": "One of the obvious consequences of alchol (ethanol), ingestion in many individuals is facial flushing and increased heart rate triggered off by alcohol getting metabolized to", "exp": null, "cop": 2, "opa": "Formaldehyde", "opb": "Acetaldehyde", "opc": "Propanaldehyde", "opd": "Butanaldehyde", "subject_name": "Pharmacology", "topic_name": null, "id": "1fc0d679-d192-43d8-8428-1a4f5b822961", "choice_type": "single"} {"question": "Drugs highly bound to albumin", "exp": null, "cop": 1, "opa": "NSAID'S", "opb": "Lidocaine", "opc": "Beta blockers", "opd": "Verapamil", "subject_name": "Pharmacology", "topic_name": null, "id": "cdbcfca8-0a8c-460f-aa9c-c972efcf837f", "choice_type": "single"} {"question": "Antiinflammatory action of steroid is due to inhibition of", "exp": "Ans. is'c' i.e., Phospholipase A2(Ref: KDT Vh/e p. 286)Glucocoicoids interfere at several steps in the inflammatory response but the most impoant overall mechanism appears to be limitation of recruitment of inflammatory cells at the local site and production of proinflammatory mediators like PCs. LTs. PAF through inhibition of phospholipase A2", "cop": 3, "opa": "Cyclooygenase", "opb": "Lipooxygenase", "opc": "Phospholipase A2", "opd": "Myeloperoxidase", "subject_name": "Pharmacology", "topic_name": null, "id": "7b84d3bc-70e7-47f5-b3ac-1b9563c4d393", "choice_type": "single"} {"question": "Muscle rigidity due to opiods is becasue of their effect on aEUR'", "exp": "When used as an anaesthetic opioids may caue muscle rigidity. - Opioid induced rigidity is characterized by increased muscle tone progressing at times to severe stiffness. - When the rigidity increases and involves thoracic and abdominal muscle, it may impair ventilation. - Rigidity of the abdominal and/or thoracic muscles was thought to underlie opioid induced impairment of spontaneous or controlled ventilation. The precise mechanism by which opioids can cause muscular rigidity is not clearly understood. Muscle rigidity is not due to direct action on muscle fibres because it can be decreased or prevented by pretreatment with muscle relaxants. In addition, opioid induced muscle rigidity is not associated with increase in creatinine kinase a .finding suggesting that little or no muscle damage occurs during this period. - Opioids do not have any significant effect on neuromuscular conduction and result in only minimal depression of monosynaptic reflexes associated with muscle stretch receptors. - Some investigators have suggested that opioids produce rigidity by altering dopamine concentrations within the striatum.s of the brain. Rigidity may occur due to the result of stimulation of GABA ergic interneurons which can be blocked by lesion in the striatum. Continuous research and data seems to indicate that the main mechanism responsible for opioid induced muscle rigidity is stimulation of it receptors. - Opioids appear to produce their physiological effects by.binding to at least three types of opioid receptors the mu (p), delta (8) and Kappa (x) receptors. - Muscle rigidity occurs after administration of supra analgesic doses of potent p preferring opioids. - The present data demonstrates that whereas systemic opiate induced muscle rigidity is primarily due to the activation of central mu receptors, supraspinal delta and kapp receptors may attenuate this effect. Anaesthesia review by Michelle Bowman Howard states (p134) -All opioids given in high doses may cause muscular rigidity. It is most likely related to I.i receptors in the caudate nucleus. It is more commonly seen with Fentanyl.", "cop": 1, "opa": ">mu", "opb": ">kappa", "opc": "Sigma", "opd": ">delta", "subject_name": "Pharmacology", "topic_name": null, "id": "be5db063-d2b8-41d8-8fcf-393b53852b53", "choice_type": "single"} {"question": "The following drug is a synthetic choline ester (REPEAT)", "exp": "Remaining all are naturally obtained from plants-alkaloids-the word ends with ''ine'' Ref: KDT 7th ed pg 101", "cop": 4, "opa": "Nicotine", "opb": "Pilocarpine", "opc": "Arecoline", "opd": "Carbachol", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "1c60930c-ba2a-43c5-a71e-6175bf82c946", "choice_type": "single"} {"question": "Antiparkinsonian drug activating D2 receptors directly", "exp": "Direct D2 activators are bromcriptine , pergolide,pramipexole,ropinirole. ENtcapone and tolcapone are COMT inhibitors and selegiline is a MAO inbibitor used in PD.In PD there is decrease of dopamine in the substansia nigra. Ref:KDT 6/e p419", "cop": 1, "opa": "Pramipixole", "opb": "Entacapone", "opc": "Benserazide", "opd": "Selegiline", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "4202a3b2-8c62-45f4-a44d-a06266b3cfda", "choice_type": "single"} {"question": "Most common dose limiting toxicity of chemotherapeutic agent", "exp": "Myelosuppression \"Myelosuppression with depression of both antibody and cell mediated immunity is the single most impoant dose limiting factor with cytotoxic agents and carries life threatening consequences\". Repeated blood monitoring is essential and transfusion of red cells and platelets may be necessary. Cell growth factors e.g. the natural (granulocyte colony stimulating factor (filgrastim) are available to protect against or resolve neutropenia.", "cop": 1, "opa": "Myelosuppression", "opb": "G.I. toxicity", "opc": "Neurotoxicity", "opd": "Alopecia", "subject_name": "Pharmacology", "topic_name": null, "id": "1ee0c4cb-3cf7-498c-a229-19afed850e0e", "choice_type": "single"} {"question": "The site of action of the furosemide is", "exp": "Furosemide is a loop diuretic and this group of drugs act on thick ascending limb of loop of Henle", "cop": 1, "opa": "Thick ascending limb of loop of Henle", "opb": "Descending limb of loop of Henle", "opc": "Proximal convoluted tubule", "opd": "Distal convoluted tubule", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "efebd1dd-7fc7-4db2-826a-e221efdb9ba3", "choice_type": "single"} {"question": "The following monoclonal antibody is used in senile dementia", "exp": "The picture shows monoclonal antibody against beta-amyloid- bapineuzumab -new drug for alzhemier'sdisease.''neu'' in bapineuzumab indicates neuroprotectiveRef:HL and KK Sharma 3rd ed pg 548", "cop": 3, "opa": "Abciximab", "opb": "Ceolizumab", "opc": "Bapineuzumab", "opd": "Vedolizumab", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "9ddad556-7e0d-40c3-b7df-62152335a33c", "choice_type": "single"} {"question": "Digoxin can accumulate to toxic level in patient with", "exp": "Refer kDT 7/e 497 Digoxin incompletely distributes across the placental barrier. Most of the digoxin is eliminated unchanged by the kidneys. ... Renal failure also decreases the clearance of digoxin, and may cause accumulation to toxic levels if dosage is not adapted thoroughly.", "cop": 1, "opa": "Renal insufficiency", "opb": "Chronic hepatitis", "opc": "Advanced cirrhosis", "opd": "Chronic pancreatitis", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "e2296452-0c0f-4cb4-af31-f3814c408add", "choice_type": "single"} {"question": "Drug inhibiting release of Ach at myoneural junction is", "exp": "Ans) a ( Botulinum toxin) Ref Goodman & Gilman 11th ed, KDT 5th ed page 76Two toxins interfere with cholinergic transmission by affecting release. Boutilinum toxin inhibit release, while black widow spider toxin induces massive release and depletion. The site on the presynaptic nerve terminal for block of ACh release by botulinum toxin; death usually results from respiratory paralysis unless patients with respiratory failure receive artificial ventilation.Injected locally, botulinum toxin type A is used in the treatment of certain ophthalmological conditions associated with spasms of ocular muscles (e.g., strabismus and blepharospasm) and for a wide variety of unlabeled uses ranging from treatment of muscle dystonias and palsy to cosmetic erasure of facial lines and wrinklesHemicholinium, a synthetic compound, blocks the transport system by which choline accumulates in the terminals of cholinergic fibers, thus limiting the synthesis of the ACh store available for release.Vesamicol blocks the transport of ACh into its storage vesicles, preventing its release.", "cop": 1, "opa": "Botulinum toxin", "opb": "Hemicholinum", "opc": "Atropine", "opd": "Vesamicol", "subject_name": "Pharmacology", "topic_name": "A.N.S.", "id": "6e0f3164-bdf3-4de8-b9b7-32f5b4a82867", "choice_type": "single"} {"question": "Action of alpha 2 and b1 receptors on adenyl cyclase", "exp": "Beta receptors are GsPCR -so increase adenyl cyclase activity.alpha 1 -g1 pcr,alpha 2 GiPCR-decrease adenyl cyclase activity Ref: KD Tripathi 8th ed.", "cop": 4, "opa": "Stimulate; Stimulate", "opb": "Stimulate; Inhibit", "opc": "Inhibit; Inhibit", "opd": "Inhibit; Stimulate", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "0b74c868-434b-4a47-9be1-8edb403f9a6f", "choice_type": "single"} {"question": "Aspirin is avoided in children with influenza infection because of association of", "exp": null, "cop": 1, "opa": "Reye's syndrome", "opb": "Nausea", "opc": "Diarrhoea", "opd": "Acid-base imbalance", "subject_name": "Pharmacology", "topic_name": null, "id": "49183444-8614-4cc8-a15a-4ef86d4ece46", "choice_type": "single"} {"question": "Carmustine is a", "exp": null, "cop": 3, "opa": "Anti metabolite", "opb": "Nitrogen mustards", "opc": "Nitrosoureas", "opd": "Taxanes", "subject_name": "Pharmacology", "topic_name": null, "id": "040ab334-45e1-47d5-a438-025a3251c4f1", "choice_type": "single"} {"question": "Toxic dose of lithium", "exp": "Lithium toxicity, also known as lithium overdose and lithium poisoning, is the condition of having too much lithium in the blood. This condition also happens in persons that are taking lithium in which the lithium levels are affected by drug interactions in the body. Ref: KD Tripathi 8th ed.", "cop": 3, "opa": "o.6 mEq/L", "opb": "1.2 mEq/L", "opc": "2.0 mEq/L", "opd": "6 years. Half the dose in paediatric contacts less than 6 years. * Apa from Chemoprophylaxis, Immunization of the Contacts of Diphtheria patients is based on their vaccination status. Diphtheria antitoxin vaccine is given to contacts if their vaccination status is unceain or questionable. Ref:- Harrisons Principles of Internal Medicine 20th Ed; Pg Num:- 1098", "cop": 4, "opa": "Cloxacillin", "opb": "Ciprofloxacin", "opc": "Rifampicin", "opd": "Erythromycin", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "98cbc117-02d3-4135-a88b-e5084dc6f442", "choice_type": "single"} {"question": "General anaesthetic most likely to cause bronchodilation is", "exp": null, "cop": 2, "opa": "Thiopentone", "opb": "Ketamine", "opc": "Propofol", "opd": "Fentanyl", "subject_name": "Pharmacology", "topic_name": null, "id": "929eb584-78d3-4865-81de-4b530a5f56f9", "choice_type": "single"} {"question": "Drug effective in Tardive dyskinesia", "exp": "Ans. is 'd' i.e., Terabenazine o There is currently no satisfactory treatment for tardive dyskinesia other than discontinuation of drugo Terabenazine (TBZ) is currently considered as a first line and most effective medication for treatment of persistent and disabling tardive dyskinesia. Reserpine is an alternative to terabenazine.Read following information (from www.ncbi.nlm.nih.gov)The dopamine-depleting drugs reserpine and TBZ inhibit vesicular monoamine transporter (VMAT) at the presynaptic membrane of the nerve terminal; thus exposing monoamines to monoamine oxidase, which results in depletion of the synaptic pool of monoamines. Reserpine has slow onset and a prolonged duration of action that should be taken into consideration while changing the dose. It blocks both types of VMAT: VMAT1 found peripherally and VMAT2 present in CNS. TBZ has quicker onset and shorter duration of effect. It selectively inhibits VMAT2 and therefore does not have peripheral catecholamine depleting side effects, such as orthostatic hypotension and gastrointestinal side effects. TBZ is currently considered a first-line agent and the most effetive medication to treat persistent and disabling TD.", "cop": 4, "opa": "Central anticholinergic", "opb": "Dantroline", "opc": "Succinylcholine", "opd": "Terabenazine", "subject_name": "Pharmacology", "topic_name": "Anti-Psychotic", "id": "80b72da9-2dc4-49ec-8e02-7a35e3333249", "choice_type": "single"} {"question": "Antidiabetic used safely in renal failure", "exp": "Ans. is 'd' i.e., Rosigtitazone", "cop": 4, "opa": "Metformin", "opb": "Glimeperide", "opc": "Glibenclamide", "opd": "Rosiglitazone", "subject_name": "Pharmacology", "topic_name": null, "id": "cffcc32d-42e2-4fb0-852b-cdca81886964", "choice_type": "single"} {"question": "Drug of choice for termination paroxysmal Supraventricular tachycardia is", "exp": "Refer kDT 7/e p536 Adenosine is a sho-actingmedication that is commonly used as a first-line drug to treat PSVT. Other treatment options for other atrial tachycardias include calcium channel blockers, beta blockers, digoxin, and amiodarone.", "cop": 3, "opa": "Calcium channel blockers", "opb": "Beta blockers", "opc": "Adenosine", "opd": "Digitalis", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "f9e78b76-90d4-4777-b921-bb493ab07a54", "choice_type": "single"} {"question": "Cerebellar toxicity is seen with", "exp": "Refer Katzung 11/e p945 Cytarabine causes cerebellar ataxia", "cop": 2, "opa": "Cisplatin", "opb": "Cytarabine", "opc": "Bleomycin", "opd": "Actinomycin D", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "ae70a3e6-7a32-41a9-b1aa-8b67ce040b6c", "choice_type": "single"} {"question": "H1N1 influenza prophylaxis", "exp": "Ans. a. OseltamivirRef: Goodman Gilman 12th E/P1114Drug of Choice for Treatment of InfluenzaInfluenza A and BOseltamivir resistant influenza A and BOral Oseltamivir 75 mg BD for 5 daysInhalational Zanamivir 75 mg OD for 7 daysDrug of Choice for Prophylaxis of InfluenzaInfluenza A and BOseltamivir resistant influenza A and BOral Oseltamivir 10 mg BD 5 daysInhalational Zanamivir 10 mg OD 7 days", "cop": 1, "opa": "Oseltamivir", "opb": "Zanamivir", "opc": "Amantadine", "opd": "Rimantadine", "subject_name": "Pharmacology", "topic_name": "Anti Microbial", "id": "be722566-f885-4d64-8e4b-58f439b1c9bf", "choice_type": "single"} {"question": "Alpha methyldopa primarily used for", "exp": "Methyldopa was primarily used in the past but is now used widely for pregnancy induced hypeension. Refer katzung 11e p173", "cop": 1, "opa": "Pregnancy induced hypeension", "opb": "Renovascular hypeension", "opc": "First line agent in hypeension", "opd": "Refractory hypeension", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "4ff035e3-f116-4b92-b214-d6579ee9988b", "choice_type": "single"} {"question": "Drug causing Addison's disease is", "exp": "Addison's disease, also known as primary adrenal insufficiency and hypocoisolism, is a long-term endocrine disorder in which the adrenal glands do not produce enough steroid hormones A dose dependent decrease in serum hydrocoisone due to synthesis inhibition is noted with the use of ketoconazole. others-mitotane, metyrapone, aminoglutethimide, etomidate (REF.Essential of medical pharmacology K D TRIPATHI 6 Edition, Page No - 763)", "cop": 1, "opa": "Ketoconazole", "opb": "Aminoglutethimide", "opc": "Cyclosporine", "opd": "Glucocoicoids", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "d693d182-b2c0-4d32-b0ae-ff6b9108e94a", "choice_type": "single"} {"question": "The beta blocker with alpha blocking action", "exp": "Ans) a (Carvedilol) Ref Goodman&Gilman 11th ed.KDT 7th ed, Katzung 11th edCarvedilol is a third-generation beta receptor antagonist that has a unique pharmacological profile.It blocks beta1, beta2, and alphatreceptors similarly to labetalol, but also has antioxidant and anti- proliferative effects.It has membrane-stabilizing activity but it lacks intrinsic sympathomimetic activity.Carvedilol produces vasodilation.It is thought that the additional properties (e.g., antioxidant and antiproliferative effects) contribute to the beneficial effects seen in treating congestive heart failure.Carvedilol does not increase beta receptor density and is not associated with high levels of inverse agonist activity.BETA BLOCKERSCardioselective (betal) beta blockersMetoprololBetaxololAtenololCeliprololBisoprololNebivolol.Esmolol Non selective beta blockersPropranolol ,Sotalol,Timolol, Pindolol, Labetalol, Carvedilol, Medroxolol, Bucindolol and Levubunonol.- Pindolol has intrinsic sympathomimetic activity.- Butoxamine is a beta 2 selective blocker.- Carvedilol is a non-selective beta blocker showing anti-oxidant property and alpha 1 receptor antagonism.- Labetolol, Medroxalol, and Bucindolol also shows alpha 1 receptor blocking activity.Propranalol has highest degree of membrane stabilizing actionNadolol is longest acting beta blocker (t Vi -14-24 hrs) andEsmolol is the shortest acting.(t Vi -10 minutes)Propranolol has poor oral bioavailability.Pindolol and Penbutolol have approx 100% bioavailabilityPropranolol and Metoprolol are extensively metabolized in the liver, with little unchanged drug appearing in the urine.", "cop": 1, "opa": "Carvedilol", "opb": "b)Atenolol", "opc": "pindolol", "opd": "Nadolol", "subject_name": "Pharmacology", "topic_name": "A.N.S.", "id": "55d84a3f-20d0-4337-9ffb-cd0ba2ec45ce", "choice_type": "single"} {"question": "A 50 year old male presents with malignant hypeension. the drug of choices", "exp": "It is a first choice drug for malignant hypeension Refer kDT 11e p185", "cop": 1, "opa": "Sodium nitroprusside", "opb": "Sublingual nifedipine", "opc": "Furosemide", "opd": "Enalapril", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "b2777bc5-a5ef-45ba-951f-41fb8d973a1f", "choice_type": "single"} {"question": "Fluconazole differs from ketoconazole in the following aspect", "exp": "Fluconazole is a preferred agent because it has\n\nVery good oral absorption.\nMaximum CNS penetration. (therefore effective in cryptococcal meningitis).\nNo inhibitory action on microsomal enzymes.\nNo anti-androgenic property.", "cop": 4, "opa": "It is not active by the oral route", "opb": "It is a more potent inhibitor of drug metabolism", "opc": "It is not effective in cryptococcal meningitis", "opd": "It is unlikely to produce anti-androgenic side effects", "subject_name": "Pharmacology", "topic_name": null, "id": "40238194-6dbe-4aed-96fd-146f0be584ee", "choice_type": "single"} {"question": "Nitroglycerine is used in Angina pectoris. The mechanism of action is primarily a", "exp": "(Post capillary venodilator): (540 KDT 7th edition)NITRATES (GTN, Nitroglycerine)* Most prominent action is exerted on vascular smooth muscleNitrates dilate veins more than arteries|Peripheral pooling of blood|Decreased venous return (ie preload on heart is reduced)|End diastolic size and pressure are reduced|Decreased cardiac work* Nitroglycerine are used sublingually because terminates first pass metabolism* *** Nitroglycerine is effective when retained sublingually because it is non-ionic and has very high lipid solubility (22-Goodman)", "cop": 2, "opa": "Arteriolar dilator", "opb": "Post capillary venodilator", "opc": "Increase oxygen myocardial demand", "opd": "Decrease myocardial work load", "subject_name": "Pharmacology", "topic_name": "C.V.S", "id": "210e0489-c3c3-4001-b985-0f0a7adefdf4", "choice_type": "single"} {"question": "In Addison's disease drug to be given is", "exp": "Refer KDT 6/e p 283 In chronic adrenal insufficiency or Addinsons disease, hydrocoisone given orally IA the drug of choice Hydrocoisone is a glucocoicoid with maximum mineralocoicoid action", "cop": 1, "opa": "Hydrocoisone", "opb": "Betamethasone", "opc": "Prednisolone", "opd": "DOCA", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "26d6682f-51d5-4099-8df9-e28524717ad3", "choice_type": "single"} {"question": "A 40 year old woman was on chemotherapy for 6 months for Ovarian carcinoma. Now she presented with a progressive bilateral Sensorineural hearing loss. The Drug responsible for this includes", "exp": "(A) Cisplatin# Platinum-containing chemotherapeutic agents, including cisplatin and carboplatin, are associated with cochleotoxicity characterized by high-frequency hearing loss and tinnitus.> Ototoxicity is less frequently seen with the related compound oxaliplatin.", "cop": 1, "opa": "Cisplatin", "opb": "Doxorubicin", "opc": "Cyclophosphamide", "opd": "Paclitaxel", "subject_name": "Pharmacology", "topic_name": "Miscellaneous (Pharmacology)", "id": "2f10d5fd-5193-41e0-a664-bcecceb07fd8", "choice_type": "single"} {"question": "Roflumilast is a", "exp": "Roflumilast is a PDE-4 inhibitor that inhibits degradation of cAMP and lead to bronchodilation.", "cop": 2, "opa": "PDE-3 inhibitor", "opb": "PDE-4 inhibitor", "opc": "PDE-5 inhibitor", "opd": "Leucotriene receptor antagonist", "subject_name": "Pharmacology", "topic_name": null, "id": "51452140-7daa-46e5-bc25-5ae707a24d6e", "choice_type": "single"} {"question": "DOC for infantile spasms", "exp": "ACTH is the drug of choice for infantile spasms and vigabatrin is DOC for infantile spasms with tuberous sclerosis. Ref: KD Tripathi 8th ed.", "cop": 1, "opa": "ACTH", "opb": "Phenytoin", "opc": "Phenobarbitone", "opd": "Carbamazepine", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "51700821-26b7-4577-97a2-c23af4598571", "choice_type": "single"} {"question": "Vasopressin antagonist acts on", "exp": "Vaspression receptors(V2) are present on principal cells of inner medullary collecting tubule. The antagonist like Conivaptan and Tolvaptan may be used in conditions like SIADH and CHF.", "cop": 4, "opa": "Proximal convoluted tubule", "opb": "Distal convoluted tubule", "opc": "Coical collecting tubule", "opd": "Medullary collecting duct", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "58ef6d80-fc28-4ca1-8724-7027a54b578f", "choice_type": "single"} {"question": "Drugs to be avoided in Hyperophic obstructive cardiomyopathy is", "exp": "stepwise antihypeensive therapy effectively controlled both obstructive HCM symptoms and hypeension. ... Avoid digitalis, because glycosides are contraindicated except in patients with uncontrolled atrial fibrillation. Refer kDT 7/e p517", "cop": 4, "opa": "Amiodarone", "opb": "Verapamil", "opc": "Beta blockers", "opd": "Digoxin", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "219939ec-03af-410d-b0a8-26f91ad54053", "choice_type": "single"} {"question": "Anti TNF is not used in aEUR'", "exp": "RA with Hepatitis B??? We are still not sure of the answer. Anti TNF-a drugs can be used in all of the conditions mentioned in the question. Anti TNF a the therapy in Hepatitis B For the treatment of HBV, Anti TNF- atherapy showed cases of fulminant HBV reactivation. But any HBV reactivation was treated success fully with lamivudine therapy, thus it was concluded that physicians should consider antiviral therapy in patients with HBV (with or without active viral replication) and initiated treatment should continue for 3-6 months after stopping anti TNF- therapy. Both published British society of Rheumatology guidelines and British society of Gastroenterology guidelines concludes:- Successful treatment of active RA with anti TNF a in patients chronically infected with HBV is possible and can be safe. Our findings together with those of others, suggest that chronic HBV infection need not preclude therapy with anti TNF a where clinically indicated but an individualized approach is required including careful counseling, collaboration with colleagues in gastroenterology and intensive monitoring. HIV and anti TNF- a therapy As of now there are only eight patients treated with HIV and Rheumatoid disease. Retrospective series of eight patients suggests that treatment with anti TNF- a therapy can be used in HIV patients without advanced disease with associated rheumatic diseases. HCV and anti TNF-- cc therapy Anti TNF- a therapy is safe in patients with HCV and Rheumatoid ahritis. In a study involving 31 patients with RA with concomitant HCV infection, TNF a blocker seemed to be safe provided there is close monitoring of clinical virological data. Pulmonary fibrosis and anti TNF- a therapy Anti TNF-a therapy is considered safe in patients with Rheumatoid ahritis and pulmonary fibrosis. In some cases pulmonary. fibrosis seems to have improved with anti-TNF- atherapy.", "cop": 2, "opa": "RA with HIV", "opb": "RA with Hepatitis B", "opc": "RA with HCV", "opd": "RA with pulmonary fibrosis", "subject_name": "Pharmacology", "topic_name": null, "id": "f7e5d78e-8c7b-4acb-989e-9aff47271f45", "choice_type": "single"} {"question": "Mechanism of action of pralidoxime is", "exp": "Refer kDT 6/e p105, katzung 12e p116 pralidoxime and diacetyl monoxime Arey cholinesterase Re generator compounds used for organophosphorus poisoning", "cop": 4, "opa": "Stimulation ofACh receptor", "opb": "Inhibition of breakdown ofACh", "opc": "Blockade of ACh receptors", "opd": "Reactivation of AChE enzyme", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "ae68de21-52a3-4d42-9652-79392b1d3890", "choice_type": "single"} {"question": "Drug of choice for ventricular arrhythmias induced by bupivacaine", "exp": "Bupivacaine has got high cardiotoxic potential. Treatment for ventricular arrhythmia produced by bupivacaine is bretylium.", "cop": 1, "opa": "Bretylium tosylate", "opb": "Lignocaine", "opc": "Nifedipine", "opd": "Verapamil", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "6a17121c-700a-4ca0-bae6-0cd31455ec2a", "choice_type": "single"} {"question": "Quinolone antibiotics inhibit bacterial growth by affecting", "exp": "Quinolones block bacterial DNA synthesis by inhibiting DNA gyrase. This introduces negative superhelical turns into duplex DNA, thereby maintaining the negative superhelical tension of the bacterial chromosome during DNA replication. Ciprofloxacin and norfloxacin are active against a broad range of organisms that cause infections of the lower respiratory tract, intestinal tract, urinary tract and soft tissues. The original form, nalidixic acid, is useful only for urinary tract infections. Rifampin directly inhibits bacterial RNA polymerase. The reverse transcriptase of human immunodeficiency virus is inhibited by azidothymidine (AZT). Penicillins and cephalosporins are transpeptidase enzymes that function in the final stages of cell wall synthesis. They are inactivated by f3-lactamase enzymes, which break a single bond in the f3-lactam ring of these antibiotics. Nonclinical useful drugs such as mitomycin C and actinomycin D can directly interfere with DNA polymerase activity, but they are useful only as biochemical tools in experiments.", "cop": 4, "opa": "Reverse transcriptase", "opb": "RNA polymerase", "opc": "DNA polymerase", "opd": "DNA gyrase", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "3bc4706e-d5f9-448b-afd5-6fc31090732b", "choice_type": "single"} {"question": "Oral anticoagulants given to pregnant women cause", "exp": "Contradi's syndrome (Skeletal and facial anomalies optic atrophy, microcephaly, chondrodysplasia punctate. Warfarin given in early pregnancy increases bih defects, specially skeletal abnormality foetal warfarin syndrome - hypoplasia of nose, eye socket hand bones, growth retardation. Given later in pregnancy - it can cause CNS defects, foetal haemorrhage, foetal death and accentuates neonatal hypoprothrombinemia Ref: Katzung 12 th ed.", "cop": 2, "opa": "Long bones limb defect", "opb": "Craniofacial malformation", "opc": "CVS malformation", "opd": "Costochondro dysplasia", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "01b3afc6-89f6-44cb-ac2d-a7e1ad507e80", "choice_type": "single"} {"question": "Drugs of the choice for central diabetes insipidus is", "exp": "*Desmopressin is treatment of choice for central diabetes insipidus. *It acts selectively at V2 receptors to increase urine concentration and decrease urine flow in a dosedependent Manner. *It is also more resistant to degradation than AVP and has a three- to fourfold longer duration of action. *Desmopressin can be given by IV or SC injection,nasal inhalation,or oral tablet.", "cop": 1, "opa": "Desmopressin", "opb": "Leuprolide", "opc": "Thiazide diuretics", "opd": "Insulin", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "6a988479-ee04-42ba-8ced-76f6dfd88038", "choice_type": "single"} {"question": "Hyperprolactinemia is a side effect of", "exp": null, "cop": 4, "opa": "Bromocriptine", "opb": "Levodopa", "opc": "Amantadine", "opd": "Metoclopramide", "subject_name": "Pharmacology", "topic_name": null, "id": "a3a998b8-6ea2-4f20-beaa-84d95b3e96ef", "choice_type": "single"} {"question": "Methotrexate resistance occurs by", "exp": "Overproduction of DHFR Mechanism of action of methotrexate Methotrexate enter the cell by reduced folate carrier Once inside the cell methotrexate is polyglutamylated. The polyglutamylated.forms of methotrexate are potent inhibitors of dihydrofolate reductase The polyglutamased.forms of methotrexate are conveed back to monoglutamate .form in lysosomes by the glytamyl hydrolase and is subsequently effluxed from the cell Methotrexate resistance can occur through any of the following five mechanism Decreased entry into the cell due to impaired transpo Decreased retention as a consequence of lack of pohyglutammate formation An increase in DHFR An altered mutated DHFR that binds less avidly than the normal enzyme to the drug. Increased level of lysosomal enzyme 2 glutamyl hydrolase that hydrolyse methotrexate polyglutamates Decreased transpo A common mechanism of methotrexate resistance is reduced.folale transpo carrier The decreased transpo is common mechanism to methotrexate resistance in relapsed ALL. Impaired Polyglutammation The polyglutammated.forms of methotrexate inhibits dihydrofolate reductase. The intracellular content of polyglutammate derivatives of methotrexate is controlled by a balance between folypolyglutamate synthetase and glutamyl hydrolase activity. Folypolyglutamate synthetase produces polyglutammate while A glutamyl hydrolase conves its bact to monoglutamate form A lower content of methotrexate polyglutamate could he due to decreased synthesis or an increased catabolism of methotrexate polyglutamates by A glutamate hydrolase. Increased DHFR The main mechanism of action of methotrexate is inhibition of the enzyme DHFR. - Methotrexate is a tight binding inhibitor of DHFR and the concentration of methotrexate required to achieve enzyme activity increases in direct propoion to the amount of enzyme in target cells. - If is now well established that an impoant mechanism of resistance of cells to methotrexate is an increase in DHFR production due to amphification of the DHFR gene Mutation in DHFR Mutation is DHFR genes may be responsible .for methotrexate resistance. Mutation in DHFR causes production of altered forms of DHFR that have decreased affinity.for the inhibitor.", "cop": 2, "opa": "Depletion of folate", "opb": "Overproduction of DHFR", "opc": "Deficiency of thymidylate synthase", "opd": "Deficiency of thiamine kinase", "subject_name": "Pharmacology", "topic_name": null, "id": "e2536ddc-d5b1-4026-9037-ecab07370f22", "choice_type": "single"} {"question": "Dose of levonorgestrol for contraception is", "exp": "Levonorgestrol should be given as 0.75 mg 2 doses 12 hours apart or 1.5 mg single dose within 72 hours of unprotected sexual intercourse.", "cop": 2, "opa": "0.75 mg single dose", "opb": "1.5 mg single dose", "opc": "1.5 mg double dose", "opd": "7.5 mg single dose", "subject_name": "Pharmacology", "topic_name": null, "id": "d6fa435e-8bd2-4b98-9875-8b07187aadfe", "choice_type": "single"} {"question": "First line of drug for angle closure glaucoma is", "exp": "Ref: HL Sharma 3rd ed pg no:140 For acute angle-closure glaucoma, the best option is acetazolamide oral or IV for chronic glaucoma, DOC is phf2 alpha analogs like latanoprost", "cop": 1, "opa": "Acetazolamide", "opb": "Physostigmine", "opc": "Brimonidine", "opd": "Atropine", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "6654b367-a096-4b14-b2c1-b0cf56538ee0", "choice_type": "single"} {"question": "Drug of choice for medical treatment of hydatid cyst of liver is", "exp": "Ans. d (Albendazole). (Ref. Harrison, Medicine, 18th /Table 208-1)Albendazole is a broad spectrum, single dose anti-helminthic drug.Used in treatment of:Ascariasis, hookworm, tapeworm, enterobius, strongylodoisis, trichuris infestations.# Trichinosis# Neurocysticercosis (DOC), however it should not be used in ocular cysticercosis as blindness can occur due to reaction.# Hydatid disease (DOC)--MH 2006.Q# FilariasisALBENDAZOLEUsed in Parasitic Infection(s)Adverse EffectsMajor Drug-InteractionsAscariasis, clonorchiasis, cutaneous larva migrans, cysticercosis, echinococcosis, enterobiasis, eosinophilic enterocolitis, gnathostomiasis, hookworm, lymphatic filariasis, microsporidiosis, strongyloidiasis, trichinellosis, trichostrongyliasis, trichuriasis, visceral larva migrans.Nausea, vomiting, abdominal pain, headache, reversible alopecia, elevated aminotransferases. Rare: leukopenia,rashDexamethasone, praziquantel: plasma level of albendazole sulfoxide increased by ~50%", "cop": 4, "opa": "Praziquantel", "opb": "Thiabendazole", "opc": "Ivermectin", "opd": "Albendazole", "subject_name": "Pharmacology", "topic_name": "Anti Microbial", "id": "8e56c84d-a7a2-4cea-83ff-d9455f22aa1d", "choice_type": "single"} {"question": "Penicillins are NOT effective against", "exp": null, "cop": 4, "opa": "Gram positive cocci", "opb": "Gram negative cocci", "opc": "Gram positive bacilli", "opd": "Gram negative bacilli", "subject_name": "Pharmacology", "topic_name": null, "id": "78c7caa1-8c91-4bfb-99f4-91cd7d8077e6", "choice_type": "single"} {"question": "FDA approved the use of modafinil as an adjunct in", "exp": "For obstructive sleep apnea the treatment of choice: Continuous positive airway pressure.Adjunct: Modafinil which is a sympathomimetic agonist for alpha and beta receptors.Ref:", "cop": 1, "opa": "Sleep apnea", "opb": "Narcolepsy", "opc": "Depression with lethargy", "opd": "Tourette's syndrome", "subject_name": "Pharmacology", "topic_name": "Respiratory system", "id": "a5cc8765-fc40-4231-836d-295e3290e8e2", "choice_type": "single"} {"question": "Pyronaridine is", "exp": "Refer KDT 6/e p796 Pyronaridine is an anti malarial agent related to amodoaquine .It is highly effective against chloroquine resistant and falciparum Malaria. Currently it is being evaluated in combination with aesunate", "cop": 1, "opa": "Antimalarial", "opb": "Anti-HIV", "opc": "Anti fungal", "opd": "Antibacterial", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "439e08a2-f8ea-41de-93ba-f2b3a28800b1", "choice_type": "single"} {"question": "Mechanism of action of Tubocurarine is", "exp": "Tubocurarine is a non depolarizing muscle relaxant that competitively blocks action of Acetylcholine on its receptors.", "cop": 3, "opa": "Cholinesterase inhibitor", "opb": "Cause membrane depolarisation", "opc": "Competitive antagonist of acetylcholine receptor", "opd": "Inhibit opening of chloride channels", "subject_name": "Pharmacology", "topic_name": null, "id": "499ee636-e78e-4200-9cf6-614704a3f536", "choice_type": "single"} {"question": "Arrange the following drugs according to increasing volume of distribution. 1. Haloperidol 2. Gentamicin 3. Heparin 4. Chloroquine", "exp": "* Chloroquine has highest volume of distribution. It is concentrated in liver and retina. * Heparin is high molecular weight compound and thus not able to cross most membranes. It has low Vd. * Gentamicin again cannot cross many membranes because of polar nature and thus has low Vd. * Haloperidol is a drug working in CNS. So, it must be able to cross other membranes also resulting in high Vd. Thus the sequence is Chloroquine > Haloperidol > Gentamicin > Heparin", "cop": 2, "opa": "3-2-4-1", "opb": "3-2-1-4", "opc": "2-3-4-1", "opd": "2-1-3-4", "subject_name": "Pharmacology", "topic_name": "Pharmacokinetics", "id": "7d52bb13-cce5-42fb-8ca1-afca426604fb", "choice_type": "single"} {"question": "Treatment agent for scarlet fever is", "exp": "Ans. is 'a' i.e., Penicillin Treatment : Immediate hospitalization and isolation of the patient is indicated. Penicillin is the treatment of choice.", "cop": 1, "opa": "Penicillin", "opb": "Ciprofloxacin", "opc": "Erythromycin", "opd": "Chloramphenicol", "subject_name": "Pharmacology", "topic_name": null, "id": "8afabd5e-9510-481d-bb9e-a8490414b91d", "choice_type": "single"} {"question": "The following receptor has an intrinsic ion channel", "exp": "GABA -BDZ receptor is an ion channel receptor , has an intrinsic Cl ion channel opening when a agonist binds to it and causes increase in frequency of channel opening and causes hyperpolarization. KDT 6/ e pg 42", "cop": 4, "opa": "Histamine H1 receptor", "opb": "Histamine H2 receptor", "opc": "Adrenergic alfa receptor", "opd": "GABA-benzodiazepine receptor", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "ea75b3c4-f4fb-45da-90cf-aa363fec6187", "choice_type": "single"} {"question": "Buspirone is used as a/an", "exp": "Busiprinone, is a medication primarily used to treat anxiety disorders, paicularly generalized anxiety disorder. Benefits suppo its sho term use. It is not useful for psychosis. It is taken by mouth, and it may take up to four weeks for an effect Ref KD Tripati 8th ed.", "cop": 1, "opa": "Anxiolytic", "opb": "Sedative", "opc": "Muscle relaxant", "opd": "Anticonvulsant", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "98d0c218-3466-4de1-a9d3-9b72778bbda2", "choice_type": "single"} {"question": "Radical curve for plasmodium vivax used", "exp": "B. i.e. (Primaquine) (784 - KDT 6th)* Drug of choice for radical cure of vivax an ovale malaria is - Primaquine**Commonly used therapeutic options for the Treatment and Prevention of malaria (421-Lippincott,s 3rd)1. All plasmodium species except chloroquine resistant P. falciparum- Chloroquine2. Chloroquine resistant P. falciparum- Quinine + Pyrimethamine - sulfadoxineORDoxycyclineORClindamycinAlternate Mefloquine3. Prevention of relapse P. Vivax and P. ovale only- Primaquine4. Prevention of malaria(i) Chloroquine sensitive geographic areas - Chloroquine(ii) Chloroquine resistant geographic areas - Mefloquine(iii) Pregnancy - Chloroquine** or Mefloquine", "cop": 2, "opa": "Chloroquine", "opb": "Primaquine", "opc": "Mefloquinine", "opd": "Quinine", "subject_name": "Pharmacology", "topic_name": "Anti Microbial", "id": "81d057e9-f66b-424b-b0a8-2feb81d3927d", "choice_type": "single"} {"question": "Fluconazole is used for the treatment of", "exp": null, "cop": 3, "opa": "Pemphigus", "opb": "Herpes simplex", "opc": "Candidiasis", "opd": "Syphilis", "subject_name": "Pharmacology", "topic_name": null, "id": "a1ddf903-89b3-4d80-b843-82533ccd2847", "choice_type": "single"} {"question": "Antidote of heparin is", "exp": "Ans. is 'b' i.e., Protamine sulfate Protamine sulfate* It is a strongly basic, low molecular weight protein obtained from the sperm of certain fish.* Given i. v. it neutralizes heparin weight for weight, i.e., 1 mg is needed for every 100 U of heparin.* It is needed only when the heparin action needs to be terminated rapidly, e.g., after cardiac or vascular surgery.* In absence of heparin, protamine itself acts as a weak anticoagulant by interacting with platelets and fibrinogen.", "cop": 2, "opa": "CaNaEDTA", "opb": "Protamine sulfate", "opc": "Deferiprone", "opd": "d - penicillamine", "subject_name": "Pharmacology", "topic_name": "Hematology", "id": "ce481105-86d2-4b8b-9cc0-da168431a342", "choice_type": "single"} {"question": "The drug used to stop the growth of prostate in a 70 year old male with Benign hyperplasia of prostate is", "exp": "Ans. (c) FinasterideRef. Pharmacology Gobittd Sparsh /135Most of the actions of testosterone are mediated by its conversion to DHT by 5-alpha reductase. Important amongst these are growth of prostate, male pattern baldness and hirsutism in females. Finasteride and dutasteride are 5- alpha reductase inhibitors useful in the treatment of BHP, male pattern baldness and hirsutism by reducing the production of DHT.Note: Flutamide and Nilutamide act as antagonists of androgen receptors. These are useful for the treatment of prostatic carcinoma. Flutamide can cause gynaecomastia and reversible liver damage.", "cop": 3, "opa": "Spironolactone", "opb": "Ketoconazole", "opc": "Finasteride", "opd": "Flutamide", "subject_name": "Pharmacology", "topic_name": "Anti-Neoplastic Agents", "id": "96f84d13-c3bd-410c-96d5-7e3f775b7c25", "choice_type": "single"} {"question": "A drug given at the loading dose of 20mg reaches plasma concentration of 0.5mg/L, If apparent volume of distribution is 40L, Calculate Bio availability of the drug", "exp": null, "cop": 4, "opa": "70%", "opb": "80%", "opc": "90%", "opd": "100%", "subject_name": "Pharmacology", "topic_name": null, "id": "9a8c946b-d704-4785-a2fb-4ca20ff47fd6", "choice_type": "single"} {"question": "Cholinomimetic is not used for", "exp": "Ans. b. Bradycardia Cholinomimetic is used for Open angle glaucoma, Cobra bite and Myasthenia gravis Uses of Cholinomimetic Diseases of eye: Glaucoma and accommodative esotropiadeg Gastrointestinal and urinary tract: Post-operative atonydeg, neurogenic bladderdeg Neuromuscular junction: Myasthenia gravisdeg, Curare induced neuromuscular paralysis Hea: Ceain atrial arrhythmiasdeg Atropine overdosesdeg Alzheimer's diseasedeg Cobra bitedeg: Neostigmine and endrophonium (Harrison 18/e p3570)", "cop": 2, "opa": "Open angle glaucoma", "opb": "Bradycardia", "opc": "Cobra bite", "opd": "Myasthenia gravis", "subject_name": "Pharmacology", "topic_name": null, "id": "bba17a14-04b2-44fa-8ea9-abeea0053c07", "choice_type": "single"} {"question": "Probenecid", "exp": "Does decrease the renal excretion of pencillin", "cop": 2, "opa": "Does not decrease the renal excretion of pencillin", "opb": "Does decrease the renal excretion of pencillin", "opc": "Has no effect", "opd": "At high doses increases and at low doses decreases", "subject_name": "Pharmacology", "topic_name": null, "id": "5d96046e-19c1-4abd-9044-a11ea8fd3ff4", "choice_type": "single"} {"question": "Benzyl peroxide acts in acne vulgaris by", "exp": "Benzyl peroxide has bacterio static propeies in addition to its action as a peeling agent. Ref; KD Tripathi 8th ed", "cop": 4, "opa": "Decreased sebumproduction", "opb": "Acts as oxidizing agent", "opc": "Reduces epithelial proliferation", "opd": "Decreasing bacterial count", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "bcc71bb8-ad5d-46a9-9cee-0dd149cb5f84", "choice_type": "single"} {"question": "Mechanism of action of Memantine includes", "exp": "(B) Glutaminergic action# MEMANTINE is a noncompetitive NMDA receptor antagonist first used as an anti-influenza agent.> Memantine acts on the glutamatergic system by blocking NMDA receptors and inhibiting their overstimulation by glutamate.> Memantine has been shown to be moderately efficacious in the treatment of moderate to severe Alzheimer's disease. Its effects in the initial stages of AD are unknown. Adverse events with memantine are infrequent and mild, including hallucinations, confusion, dizziness, headache and fatigue.", "cop": 2, "opa": "GABA nergic action", "opb": "Glutaminergic action", "opc": "Adrenergic action", "opd": "Dopaminergic act on", "subject_name": "Pharmacology", "topic_name": "C.N.S", "id": "c48a2555-bc3c-4667-aa7d-a4ba18ed47e3", "choice_type": "single"} {"question": "Alteplase differs from streptokinase as it", "exp": "Refer KDT 6/e p606 Fibrinolytics are the drugs which activate plasminogen to form plasmin and thus helps in lysis of thrombus These drugs can cause bleeding as the major adverse effect due to lysis of physiological thrombi as well as due to excessive amount of plasma generated in the circulation", "cop": 4, "opa": "Is longer acting", "opb": "Is derived from human kidney", "opc": "Is cheap", "opd": "Activates plasminogen bound to fibrin", "subject_name": "Pharmacology", "topic_name": "Hematology", "id": "bf70b08e-3203-448c-8d5a-375dc4a70f3a", "choice_type": "single"} {"question": "Esmolol is a sho acting b blocker because", "exp": "* Esmolol - Shoest acting b blocker * Nadolol - Longest acting b blocker * Esmolol is metabolized by pseudocholinesterase hence it is sho acting. * Drugs metabolized by pseudocholinesterase SUCCINYLCHOLINE ESMOLOL REMIFENTANIL", "cop": 2, "opa": "It has more plasma protein binding", "opb": "Its plasma hydrolysis by esterases is rapid", "opc": "It has high lipid solubility", "opd": "It has high oral bioavailability", "subject_name": "Pharmacology", "topic_name": "Sympathetic System", "id": "8980d523-e6f2-466e-9c57-04ffdb044b98", "choice_type": "single"} {"question": "Most emetogienic anticancer drugs (REAPEAT)", "exp": "Refer CMDT 2010/1508 Cisplantin. Cisplatin is the most emetogienic anticancer drugs", "cop": 1, "opa": "Cisplantin", "opb": "Carboplatin", "opc": "High dose cycloohosphamide", "opd": "High dose Methotrexate", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "cf0ca5be-bb98-45f9-a096-f05530de19dd", "choice_type": "single"} {"question": "Prodrug is", "exp": "(Levodopa) (20-KDT) (23-24-KDT 6th)PRODRUGACTIVE-FORMLevodopaDopamineEnalaprilEnalaprilata-methyldopaa methylnorepinephrineDipivefrineEpinephrineSulindacSulfide metaboliteHydrazide MAO inhibitorsHydrazine derivativesProguanilProguanil triazine PRODRUGACTIVE-FORMPrednisonePrednisoloneBecampicillinAmpicillinSulfasalazine5-Aminosalicyclic acidCyclophosphamideAldophosphamide, phosphoramide mustard, acroleinFluorouracilFluorouridine monophosphateMercaptopurineMethyl mercaptopurine ribonucleotide", "cop": 1, "opa": "Levodopa", "opb": "Amitryptiline", "opc": "Primidone", "opd": "Digitoxin", "subject_name": "Pharmacology", "topic_name": "General Pharmacology", "id": "c27ac1c5-0f87-41c5-a378-4f2b90ead89b", "choice_type": "single"} {"question": "Neostigmine does not able to cross blood brain barrier because of its", "exp": "Refer kDT 6/e p 101 Quaternary ammonium compounds are water soluble and thus cannot cross blood brain barrier. New Stickman is a quaernary derivative whereas physostigmine is a teiary amine", "cop": 4, "opa": "Primary structure", "opb": "Secondary structure", "opc": "Teiary structure", "opd": "Quaternary structure", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "9a3b2c78-c246-4b3c-87d9-c60cbc7c11a1", "choice_type": "single"} {"question": "Treatment of choice in ventricular fibrillation is", "exp": "Refer kDT 7/e 538 A class of medications called beta blockers is commonly used in people at risk of ventricular fibrillation or sudden cardiac arrest. Implantable cardioveer-defibrillator (ICD). After your condition stabilizes, your doctor is likely to recommend implantation of an ICD. ... The ICD constantly monitors your hea rhythm", "cop": 2, "opa": "Sotalol", "opb": "Cardioversion", "opc": "Ibutilide", "opd": "Adenosine", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "4b8a55ae-835f-4690-86dc-b20d81e2be63", "choice_type": "single"} {"question": "Daily dose of isoniazid in treatment of tuberculosis is", "exp": "DAILY DOSES OF ANTITUBERCULAR DRUGS: DRUG DOSE (mg/kg) H 5 R 10 Z 25 E 15 S 15", "cop": 1, "opa": "5 mg/kg body weight", "opb": "10 mg/kg body weight", "opc": "20 mg/kg body weight", "opd": "15 mg/kg body weight", "subject_name": "Pharmacology", "topic_name": "Mycobacterial Diseases (TB, Leprosy and MAC)", "id": "8f8a3100-fc78-4a65-83a5-8024e9eedb81", "choice_type": "single"} {"question": "Wof vitamin D preparations would be the most appropriate in a patient with poor renal function", "exp": "1-Hydroxylase activity must be adequate to produce 1,25(OH) 2 D 3. Calcitriol is the only choice that is already 1-hydroxylated. Ref:- kd tripathi; pg num:-341", "cop": 2, "opa": "Cholecalciferol", "opb": "Calcitriol", "opc": "Ergocalciferol", "opd": "Calcifediol", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "0cabafce-c35e-4cb1-853f-8f1449a072fb", "choice_type": "single"} {"question": "Verril's sign is seen in", "exp": null, "cop": 1, "opa": "Diazepam administration", "opb": "Digitalis toxicity", "opc": "Paget's disease", "opd": "Unconscious states", "subject_name": "Pharmacology", "topic_name": null, "id": "6880b295-e168-47e8-a771-4b791726cf7a", "choice_type": "single"} {"question": "Warfarin act by", "exp": null, "cop": 1, "opa": "Inhibiting the activation of vitamin K dependent factors", "opb": "Inhibiting thrombin indirectly through antithrombin III", "opc": "Directly inhibiting thrombin", "opd": "Inhibiting Gp IIb/IIIa", "subject_name": "Pharmacology", "topic_name": null, "id": "ee80bce5-b5c0-488e-9e1e-3057b6d47ba0", "choice_type": "single"} {"question": "ED50 is used for determining", "exp": "Ed 50 measures potency Ld 50 measures safety or fatality ed50- dose required to produce 50% of the maximum effect LD50- The dose that causes death in 50 percent of the subjects tested Pgno-54 K D Tripathi Seventh edition", "cop": 1, "opa": "Potency", "opb": "Efficacy", "opc": "Safety", "opd": "Toxicity", "subject_name": "Pharmacology", "topic_name": "General pharmacology", "id": "e952e7a3-8331-44e8-a2ef-f2c0fc569783", "choice_type": "single"} {"question": "Antidiabetic drug of choice for obese patients", "exp": "Ans. (a) MetforminRef KDT 6th ed. 1267# metformin* Metformin is an antidiabetic drug from biguanides category.* They improve lipid profile, hence considered as DOC for DM in obese patients.* MOA:# increase peripheral utilization of glucose# Inhibit hepatic gluconeogenesis* Metformin never causes hypoglycemia.* Another drug from Biguanides is Phenformin, which is withdrawn, because it causes lactic acidosis.* Sulfonylureas causes a brisk release of insulin from pancreas which stimulate the functional receptors for the intake of glucose.# they can cause hypoglycemia.# Preferred in thin patients with DM* Repaglinide has same MOA as sulfonylureas, but it is short acting.# Used to control sudden rise of glucose after meal.* Acarbose act by inhibiting G.I. absorption of sugar.# s/e: can cause osmotic diarrhea.Also Know* Safest sulfonylureas: Tolbutamide (safer in elderly also)* Remembered as: MOST- Metformin for Obese; Sulfonylureas for Thin.", "cop": 1, "opa": "Metformin", "opb": "Sulfonylureas", "opc": "Repaglinide", "opd": "Acarbose", "subject_name": "Pharmacology", "topic_name": "Anti Diabetes", "id": "67ad2261-f56f-4fc3-b282-c58c16b56202", "choice_type": "single"} {"question": "Central muscle relaxants act by", "exp": "Refer KDT 6/e p 348 Centrally acting muscle relaxants reduce skeletal muscle tone by a selective action in the cerebrospinal axis, without altering consciousness They selectively depress spinal and supraspinal polysynaptic reflexes Polysynaptic pathways in the ascending reticular formation which are involved in the maintenance of wakefullness", "cop": 3, "opa": "Decreasing muscle excitation", "opb": "Decreasing spinal polysynaptic reflexes", "opc": "Inhibiting spinal polysynaptic reflexes", "opd": "Decreasing nerve conduction", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "be79bb84-ec38-48d2-92ea-2da4eac0612d", "choice_type": "single"} {"question": "Major aim of phase 1 clinical trials is to know the", "exp": "Phase I trial is designed as a dose-escalation study to determine the maximum tolerable dosage (MTD), that is, the maximum dose associated with an acceptable level of dose-limiting toxicity. Phase 1 Clinical Trials: The drug is tested in healthy human volunteers (extremes of ages ; elderly and children are excluded). As the drug is not tested in the patients, so we cannot determine efficacy in this phase. This is mainly for finding the maximum tolerable dose of the drug. This is first in human study. Because anti-cancer drugs can produce unacceptable toxicity and we cannot expose healthy humans to such a toxicity, the phase-1 trials for anticancer drugs are done in the patients", "cop": 3, "opa": "Safety", "opb": "Efficacy", "opc": "Maximum Tolerable Dose", "opd": "Pharmacokinetics", "subject_name": "Pharmacology", "topic_name": "CLINICAL TRIALS, DRUG LABEL", "id": "5c985d2c-e69f-455a-b449-1b841b442372", "choice_type": "single"} {"question": "Post cardiac surgery delirium symptoms are worsened by", "exp": "Ans. b. AnticholinergicsRef: Goodman Gilman 13th E/P156Delirium is an acute change in cognition and attention characterized by alteration in consciousness and disorganized thinking.Since anticholinergics decrease cognition, delirium can be worsened by anticholinergics.Postoperative delirium is decreased by drugs likeAntipsychotics: HaloperidolDexmedetomidineBenzodiazepines: Midazolam", "cop": 2, "opa": "Antipsychotics", "opb": "Anticholinergics", "opc": "BZD", "opd": "Antihistaminics", "subject_name": "Pharmacology", "topic_name": "C.N.S", "id": "0dbbe012-1565-41d4-89d4-4bf3a4d4e176", "choice_type": "single"} {"question": "Increased prolactin is associated with aEUR'", "exp": "Increased estradial Prolactin is a polypeptide produced by the lactotrophs of the pituitary. It is responsible .for the initiation and maintenance of lactation. As with several pituitary hormones, prolactin is secreted in a circadian, fashion with the highest levels being attained during sleep and a nadir occurring between 10 am and noon. Prolactin is secreted in a pulsatile .fashion, the amplitude and frequency of which not only varies throughout the day but is also impacted upon by a variety of physiology stimuli i.e., suckling, stress and increased level of ovarian steroids primarily estrogens. \"The general view is that lactotrophs have spontaneously high secretary activity\". Therefore pituitary prolactin secretion is under a tonic and predominantly inhibitory control exeed by the hypothalamus. - Hypothalmus releases prolactin inhibitory factor (PIF) which inhibits prolactin release. - PIE is actually dopamine and it suppresses prolactin synthesis and secretion by means of D2 receptors. - These actions constitute the physiologic basis of therapeutic effect of dopamine agonists in hyperprolactinemia. Prolactin acts on the breast tissue where in the setting of estrogen priming, it stimulates lactation. Effect of physiological hormones on prolactin secretion Glucocoicoids seem to have an inhibitory role on PRL secretion. - These hormones stimulate the differentiation of somatotrophs but suppress that of lactotrophs. - Long-term elevation of the serum glucocoicoid levels by chronic administration of coicotrophin (ACTH) or hydrocoisone or by prolonged stress decreases PRL secretion. Estrogens and thyroid hormones have opposite effects on PRL synthesis and release. - \"Estrogen increases prolactin levelQ by acting at both pituitary and hypothalamic level\" - At pituitary level it increases prolactin secretion by controlling PRL gene expression and modifying its sensitivity to physiological stimuli. - At hypothalamic level it inhibits the activity of all three types of hypothalamic neuroendocrine dopaminergic neurone. - Low thyroxine (T4) and triiodothyronine (T3) levels increase TRH-induced PRL secretion, whereas high T4 and T3 levels inhibit PRL mRNA accumulation and release. An impoant point Increased estrogen causes hyperprolactinemia But Hyperprolactinemia causes decrease in estrogen Prolactin also acts at the hypothalamus to inhibit the secretion of gonadotropin releasing hormone (GnRH). - Inhibition of GnRH results in a decrease in the release of LH and FSH from the anterior pituitary. In females - This leads to decreased in estrogen and progesterone synthesis and secretion by the ovaries and a failure of ovarian .follicular maturation. In males - This leads to decrease in testicular production and synthesis of testosterone and a halt in spermatogenesis. Causes of hyperp rolactinemia Hypothalamic diseases Heavy metals and other chemical substances * Tumors (craniopharyngioma, meningioma, dysgerminoma, third * Manganese * Organic mercury ventricle tumor, cyst, glioma, harnaoma, and metastasis), * Lead * Cadmium * Infiltrative disease (sarcoidosis, tuberculosis, Langerhans's cell * Uranium * Arsenic histiocytosis, and eosinophilic granuloma). * Bari um * Cranial irradiation * Vascular abnormalities * Pseudotumor cerchri * Genetic syndromes (multiple endocrine neoplusia syndrome Carney complex, McCune-Albright syndrome). Pituitary diseases Neurogeic * Functioning and nonfunctioning * Chest wall lesions adenomas, MEN I * Spinal cord lesions * Empty sella sendrome * Breast stimulation * Lymphocytic hypophysitis * Physical or psycho? Primitive tumors (meningioma, germinoma, metastasis, and lymphoma) and metastasis infiltrative diseases (giant cell granuloma and sarcoidosis) logic stress Drugs Other * Neurolepticsdeg (phenothiazines, butyrophenones, and atypical * Hypothyroidism * Chronic renal failure antipsychotics). * Cirrhosis * Antidepressantsdeg (tricyclic and * Adrenal insufficiency tetracyclic antidepressants, MAO inhibitors, SSEIs and others). * Pseudocyesis * Antihypeensive medications (verapamil methyldopa, and reserpine). Gastrointestinal medications (metoclopramide, domperodone and H2 blockers). * Opiates, Cocaine, Estrogensdeg, Protease inhibitors", "cop": 4, "opa": "Increased FSH", "opb": "Increased libido", "opc": "Increased testosterone", "opd": "Increased estradiol", "subject_name": "Pharmacology", "topic_name": null, "id": "56e19551-b4cf-4244-b1d9-dbb1effd8925", "choice_type": "single"} {"question": "Drug of choice for prophylaxis of motion sickness is", "exp": "Doc for prophylaxis of motion sickness is - Hyoscine (scopolamine) If hyoscine is not given in the option them first generation Antihistaminics (Promethazine) Ondansetron -Doc for chemotherapy / radiotherapy induced vomiting. Metoclopramide- prokinetic drug Domperidone (prokinetic drug) - D2 receptor antagonist Drug of choice for levo dopa induced vomiting Both Metaclopromide and Domperidone are used for postoperative, drug and disease induced nausea & vomiting.", "cop": 1, "opa": "Scopolamine", "opb": "Ondansetron", "opc": "Metoclopramide", "opd": "Domperidone", "subject_name": "Pharmacology", "topic_name": "Parasympathetic System & Glaucoma", "id": "2af54a79-0b3e-4723-9e5c-4d6eedfa5148", "choice_type": "single"} {"question": "Alpha 1a selective blocker is", "exp": "Tamsulosin, silodosin are more selective alpha blockers in prostrate uhera.used for BPH. Ref: KD Tripathi 8th ed.", "cop": 1, "opa": "Tamsulosin", "opb": "Prazosin", "opc": "Yohimbine", "opd": "Idazoxan", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "603728da-2e77-463b-b431-d8b17202d62e", "choice_type": "single"} {"question": "Delamanid is used for the treatment of", "exp": "Delamanid is given to adults with multi-drug resistant (MDR) TB. It is the first in a new class of TB drugs called nitroimidazoles. other new drug in TB is Bedaquiline. Ref: KD Tripathi 8th ed.", "cop": 1, "opa": "Tuberculosis", "opb": "Leprosy", "opc": "Malaria", "opd": "Trypanosoma", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "cbb69e57-7dd5-46d8-9be6-7ef5e3afa9d1", "choice_type": "single"} {"question": "In terms of the ability of drugs like digoxin to increase cardiac contractility, their primary action on cardiac cells is", "exp": "Cardiac glycosides increase contractility by inhibiting the Na/K-ATPase pump, causing an increase in intracellular Na. This, in turn, increases intracellular Ca by slowing down Na/Ca exchange. The increase in intracellular Ca leads to its binding to the troponin-tropomyosin complex, causing an allosteric change and facilitating the interaction between actin and myosin.", "cop": 4, "opa": "activation of adenylyl cyclase", "opb": "inactivation of Na channels", "opc": "activation of the slow Ca channel", "opd": "inhibition of Na/K-ATPase", "subject_name": "Pharmacology", "topic_name": "C.V.S", "id": "519e86f2-db71-49c6-80f7-d7c7b261dffc", "choice_type": "single"} {"question": "A patient presented in emergency with tachycardia,hypehermia,bronchial dilation and constipation.The person is likely to be suffering from overdose of", "exp": "Ref:KD Tripathi pharmacology 7th edition (page.no: 114,115) Actions of Muscarinic antagonist (atropine) CNS stimulation CVS: the prominent effect is tachycardia by abbretes refractory period of AV node and facilitate AV conduction Gland; decrease salivary, tracheobronchial and lacrimatory secretion, gastric secretions Smooth muscle: decrease tone and contraction, bronchodilatation, constipation Eye; mydriasis by contraction of longitudinal ciliary muscle Rise in body temperature (hypehermia)", "cop": 1, "opa": "Atropine", "opb": "organophosphorus compound", "opc": "Mushroom", "opd": "Paracetamol", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "36e1e626-3b23-4b05-95d4-8e0b40de2ada", "choice_type": "single"} {"question": "Bromhexine acts by", "exp": "Bromhexine acts by depolymerisation of mucopolysaccarides and making the mucus less viscid and thus acts as a expectorant.", "cop": 3, "opa": "Central opiod agonism", "opb": "Muscarine receptor antagonism", "opc": "Depolymerisation of mucopolysaccharides", "opd": "MAO inhibitor", "subject_name": "Pharmacology", "topic_name": null, "id": "7f32a910-9d34-4c24-8c2f-c58c1a3789c1", "choice_type": "single"} {"question": "TNF (alpha inhibitors) used in rheumatoid arthritis is", "exp": "(Infliximab): (2/2- 683- 84 - KDT 7t)INFLIXIMAB - is a chimeral monoclonal antibody which binds and neutralizes TNF-alpha* TNF-alpha inhibitors mainly suppress macrophage and T-cell function; inflammatory changes in the joint regress and new erosions are slowed* Quicker response than non biologic DMARDs* Generally added to methotrexate* Susceptibility to opportunistic infection, including tuberculosis and pneumocystis pneumonia is increasedDisease modifying antirheumatic drugs (DMARDs)A. Nonbiological drugsB, Biological drugs1. Immunosuppressants - Methotrexate, Azathioprine, cyclosporine1TNF alpha inhibitors - Etanercept, Infliximab, Adalimumab2. Sulfasalazine 3. Chloroquine or Hydroxychloroquine2. IL-1 antagonist:- Anakinra4. Leflunomide Gold and penicillamine are obsolete DMARDs", "cop": 1, "opa": "Infliximab", "opb": "Rituximab", "opc": "D-penicillamine", "opd": "Cycloserine", "subject_name": "Pharmacology", "topic_name": "Immunomodulator", "id": "c2aa9624-ed6c-4183-b8f1-4d07286a76b3", "choice_type": "single"} {"question": "The drug of choice for schistosomiasis is", "exp": "Refer KDT6/e p435-436 Praziquental is the drug of choice for all trematode and cestode infestations except Fasciola hepatica bad hydatid disease", "cop": 3, "opa": "Albendazole", "opb": "Metronidazole", "opc": "Praziquental", "opd": "Triclabendazole", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "0d91b1ca-0a1e-4538-859a-cdfcc8096d47", "choice_type": "single"} {"question": "Mechanism of action of Ezetimibe", "exp": "Refer kDT 7/e p 641 Ezetimibe is a medication used to treat high blood cholesterol and ceain other lipid abnormalities. Generally it is used together with dietary changes and a statin. Alone, it is less preferred than a statin. It is taken by mouth. It is also available in the combination ezetimibe/simvastatin", "cop": 3, "opa": "Interfere with absorption of bile acids", "opb": "Interfere CETP", "opc": "Interfere with the absorption of cholesterol by inhibiting NPCIL1", "opd": "Inhibitor of PPAR alpha", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "f81d6a5c-6208-4bc3-9ad5-757043799dc2", "choice_type": "single"} {"question": "Wof glucocoicoid has significant (max) mineralocoicoid activity", "exp": "Hydrocoisone (coisol):- Acts rapidly but has sho duration of action. In addition to primary glucocoicoid, it has significant minera- locoicoid activity as well. Uses:- For Replacement therapy, Shock, status asthmaticus, acute adrenal insufficiency. Topically and as suspension for enema in ulcerative colitis. Ref:- kd tripathi;pg num:-288", "cop": 3, "opa": "Dexamethasone", "opb": "Triamcinolone", "opc": "Hydrocoisone", "opd": "Betamethasone", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "c5666366-acdb-4db0-a048-65890a10e248", "choice_type": "single"} {"question": "The following drug is used for", "exp": "The picture shows levonorgesterol 2 tablets to be used 12 hrs apa within 72hours for emergency contraceptionRef:Goodman Gillman 12th ed pg 1184", "cop": 1, "opa": "Emergency contraception", "opb": "Harmone replacement therapy", "opc": "Regular contraception", "opd": "Prostate cancer", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "2e7ce1dc-0374-404e-9399-ff12979cf0ff", "choice_type": "single"} {"question": "Nonselective reversible a receptor blocker among the following is", "exp": "Nonselective irreversible a receptor blocker Phenoxybenzamine Nonselective reversible a receptor blocker Phentolamine Selective a receptor blocker Prazosin Terazosin Doxazosin", "cop": 2, "opa": "Phenoxybenzamine", "opb": "Phentolamine", "opc": "Prazosin", "opd": "Terazosin", "subject_name": "Pharmacology", "topic_name": "Sympathetic System", "id": "84e478e3-6667-4bb1-b014-9d1e4e835d23", "choice_type": "single"} {"question": "A competitive antagonist is a substance that", "exp": "In the presence of a fixed concentration of agonist, increasing concentrations of a competitive antagonist progressively inhibit the agonist responseBasic and clinical pharmacology Katzung 13th edition pg 23", "cop": 2, "opa": "Interacts with receptors and produces submaximal effect", "opb": "Binds to the same receptor site and progressively inhibits the agonist response", "opc": "Binds to the nonspecific sites of tissue", "opd": "Binds to one receptor subtype as an agonist and to another as an antagonist", "subject_name": "Pharmacology", "topic_name": "General pharmacology", "id": "62c11404-c1e1-4aec-8cdc-7d6afef80512", "choice_type": "single"} {"question": "Drug of choice for akathesia caused by use of haloperidol is", "exp": "EPS Drug Of Choice Dystonia Benzhexol Akathisia Propranolol Parkinsonism Benzhexol Malignant neuroleptic syndrome Dantrolene Tardive dyskinesia Valbenazine", "cop": 1, "opa": "Propranolol", "opb": "Benzhexol", "opc": "Diazepam", "opd": "Levodopa", "subject_name": "Pharmacology", "topic_name": "Psychiatric Illness", "id": "8315157f-2e68-4cf6-bc51-01d093b657f8", "choice_type": "single"} {"question": "Hemorrhagic cystitis is caused by aEUR'", "exp": "Cyclophosphamide Hemorrhagic cystitis is commonly associated with Cyclophosphamide Cyclophocphamide is the most common cause of hemorrhagic cystitis. The drug Cyclophosphamide itself is not toxic. The drug toxicity is due to its hepatic conversion to the metabolite \"acrolein\" which is excreted in the urine and causes damage to the bladder mucosa - It is believed that urothelial damage occurs due to direct contact of the bladder wall with acrotein which causes edema, ulceration, neovascularisation, hemorrhage and necrosis - Thus patients receiving cyclophosphamide should always receive good hydration and a .foley's catheter is often placed to ensure immediate drainage of the bladder. The hemorrhagic cystitis caused by cyclophosphamide can be reduced in intensity or prevented by intravenous administration of \"MESNA\" -MESNA is a thiol compound. The .free (Thiol) groups of MESNA combine directly with double bond of acrolein of form a stable nontoxic compound. MESNA is given orallyQ. - Cyclophosphamide induced hemorrhagic cystitis appeare to be dose related and is most prevalent in patients who are dehydrated and those receiving intravenous cyclophosphamide.", "cop": 3, "opa": "Busulphan", "opb": "Cisplatin", "opc": "Cyclophosphamide", "opd": "Doxorubicin", "subject_name": "Pharmacology", "topic_name": null, "id": "8c62e588-708d-4c65-956c-0574530cdf0e", "choice_type": "single"} {"question": "Mechanism of action of theophylline in bronchial asthma is", "exp": "Mechanism of action of methylxanthines like theophylline, caffeine: (a) Release of Calcium from the sarcoplasmic reticulum, especially in skeletal and cardiac muscle. (b) Inhibition of phosphodiesterase3 and PDE4 which degrades cyclic nucleotides intracellularly. (c) Blockade of adenosine receptors: adenosine acts as a local mediator in CNS, CVS and other organs-contracts smooth muscles, especially bronchial; dilates cerebral blood vessels, depresses cardiac pacemaker and inhibits gastric secretion. Beta 2 agonism is also correct because Theophylline acts synergistic with beta 2 agonistsPharmacology and pharmacotherapeutics Satoskar 24th page no. 579 ESSENTIALS OF MEDICAL PHARMACOLOGY 7TH EDITION KD TRIPATHI Page No:225,226", "cop": 1, "opa": "Phosphodiestesterase 4 inhibition", "opb": "inhibit the release of mediators", "opc": "Anticholinergic action", "opd": "Inhibition of mucociliary clearance", "subject_name": "Pharmacology", "topic_name": "Respiratory system", "id": "3b6fba00-4143-4d3f-bc8e-3eb2b755c479", "choice_type": "single"} {"question": "Glucocoicoids act in inflammation mainly by", "exp": "Glucocoicoid helps in induction of lipocoins in macrophages. Lipocoins inhibits phospholipase A2 enzyme present in the cell membrane and thus lead to decrease production of prostaglandins, Leukotriens which are responsible for inflammation. (REF.Essential of medical pharmacology K D TRIPATHI 6 Edition, Page No - 279)", "cop": 3, "opa": "(downward arrow) Lipocoin", "opb": "increasing IL-2", "opc": "(upword arrow) Lipocoin", "opd": "increasing CRP", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "a16f9c69-491a-4e22-9370-5ad694103de0", "choice_type": "single"} {"question": "Laudanosine is a metabolite of", "exp": "Refer Miller 7/e p 880 Both Atracurium and cis-Atracurium are eliminated by Hoffman's elimination Atracurium is also metabolized by liver to some extent and result in production of a metabolite laudanosine that can cause CNS toxicity including seizures", "cop": 1, "opa": "Atracurium", "opb": "Cis Atracurium", "opc": "Pancuronium", "opd": "Vecuronium", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "5519636c-49a7-439e-8b1d-6591176b63bb", "choice_type": "single"} {"question": "Most common drug used for prophylaxis of migraine is", "exp": "Ref: HL Sharma 3rd ed Pg no: 191 beta blockers are the first line of choice for chronic migraine or migraine prophylaxis", "cop": 2, "opa": "Sumatriptan", "opb": "Propranolol", "opc": "Valproate", "opd": "Flunarizine", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "0afd34c4-7f6e-412b-850f-e19a5bfa4d2b", "choice_type": "single"} {"question": "Diagnosis of Myasthenia gravis done by using", "exp": "Refer kDT 6/e p 104 Myasthenia gravis can be differentiated from cholinergic crisis with the help of sho acting anticholinesterase agent,edrophonium. It improves the symptoms in Myasthenia gravis whereas was on the condition in case of cholinergic crisis. Neostigmine is used in the treatment of Myasthenia", "cop": 1, "opa": "Edrophonium", "opb": "Neostigmine", "opc": "Succinyl choline", "opd": "Atropine", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "b343f484-09c0-4f37-94b2-94c30b159966", "choice_type": "single"} {"question": "Conversion of norepinephrine to epinephrine occur by", "exp": "Synthesis of NA occurs in all adrenergic neurons while that of adrenaline occurs only in the adrenal medullary cells. It requires a high concentration of glucocoicoids reaching through the intra- adrenal poal circulation for induction of the methylating enzyme - N methyltransferase. From essential of medical pharmacology K D Tripati 7th edition Page no 124", "cop": 1, "opa": "Methylation", "opb": "Decarboxylation", "opc": "Oxidation", "opd": "Sulphation", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "3dfaa8f6-bc07-473e-ae95-6ebc11b6a1c9", "choice_type": "single"} {"question": "Enzyme inactivation is the main mode of resistance to", "exp": "Refer KDT 6/e p 720 Resistance to quinolone is due to altered DNA gyrase, to Rifampicin is due to mutation in gene rpo! Reducing it's ability for the target and for glycopeptides like vancomycin due to reduced affintiy6 for target site", "cop": 1, "opa": "Aminoglycosides", "opb": "Quinolone", "opc": "Rifampicin", "opd": "Glycopeptides", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "ca58e130-b223-4554-a433-57f562a8368a", "choice_type": "single"} {"question": "Intravenous anaesthetic metabolized by pseudo cholinesterase", "exp": "Propanidid is no more used in anaesthesia due to severe allergic reactions. It is metabolized by pseudocholinesterase.", "cop": 1, "opa": "Propanidid", "opb": "Althesin", "opc": "Eltanolone", "opd": "Clonidine", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "77b52b20-9ba2-46c3-8958-bb586d7c1122", "choice_type": "single"} {"question": "Anti IgE monoclonal antibody used in bronchial asthma is", "exp": "It is a humanized monoclonal antibody against IgE. Administered i.v. or s.c., it neutralizes free IgE in circulation without activating mast cells and other inflammatory cells.\nIn severe extrinsic asthma, omalizumab has been found to reduce exacerbations and steroid requirement.\nIt is very expensive; use is reserved for resistant asthma patients with positive skin tests or raised IgE levels who require frequent hospitalization.", "cop": 2, "opa": "Mepolizumab", "opb": "Omalizumab", "opc": "Keliximab", "opd": "Altrakincept", "subject_name": "Pharmacology", "topic_name": null, "id": "65d5d283-f65e-449d-b99f-9926c54a72bc", "choice_type": "single"} {"question": "The intrinsic potency as local anesthetic is the lowest in", "exp": null, "cop": 2, "opa": "Lidocaine", "opb": "Procaine", "opc": "Prilocaine", "opd": "Tetracaine", "subject_name": "Pharmacology", "topic_name": null, "id": "2020b516-6c10-49fd-9a4c-c76aa88315e5", "choice_type": "single"} {"question": "Drug contraindicated in absence seizures is", "exp": "Ans. is 'c' i.e., Tiagabine * Carbamazepine, vigabatrin, and tiagabine are contraindicated in the treatment of absence seizures, irrespective of cause and severity. This is based on clinical and experimental evidence. In particular, the GABA agonists vigabatrin and tiagabine are used to induce, not to treat, absence seizures and absence status epilepticus. Similarly, oxcarbazepine, phenytoin, phenobarbital, gabapentin, and pregabalin should not be used in the treatment of absence seizures because these medications may worsen absence seizures.", "cop": 3, "opa": "Lamotrigine", "opb": "Clonazepam", "opc": "Tiagabine", "opd": "Ethosuximide", "subject_name": "Pharmacology", "topic_name": "C.N.S", "id": "bba5be24-3e88-4fcb-8811-c7242aa1c53e", "choice_type": "single"} {"question": "Drug of choice for anaerobic infection is", "exp": "Ans. is 'b' i.e., Metronidazole * Metronidazole is a prototype nitroimidazole which has broad spectrum cidal activity against the anaerobic micro-organisms including giardia lamblia.* It doesn't affect the aerobic bacteria.* It is selectively toxic to anaerobic and micro-aerophilic micro-organisms.* In anerobic conditions, it produces highly cytotoxic nitro radical which is attenuated in aerobic environment.* It also induces mutagenesis and cause radiosensitization.* Aminoglycosides are active only against aerobes.* Amphotericin B is an anti-fungal agent.", "cop": 2, "opa": "Amphotericin B", "opb": "Metronidazole", "opc": "Aminoglycoside", "opd": "Macrolide", "subject_name": "Pharmacology", "topic_name": "Anti Microbial", "id": "c2c1a454-c497-4bfb-b401-514728761496", "choice_type": "single"} {"question": "Ciprofloxacin acts on", "exp": "Ans. is 'b' i.e., DNA gyrase Major mechanism of action of fluoroquinolone is inhibition of bacterial enzyme DNA gyrase.Recent evidence indicates that in gram positive bacterias, the major target is topoisomerase IV.So greater affinity for topoisomerase IV may confer higher potency against gram positive bacteria.", "cop": 2, "opa": "DNA histone proteins", "opb": "DNA gyrase", "opc": "Camp", "opd": "mRNA polymerase", "subject_name": "Pharmacology", "topic_name": "Anti Microbial", "id": "5590f956-9dd4-4f21-b61a-5a33ce9048b6", "choice_type": "single"} {"question": "The following angiotensin conveing enzyme inhibi tor can reduce cardiac contractility", "exp": "Lisinopril:- It is the lysine derivative of enalaprilat; does not require hydrolysis to become active ACE inhibitor. Pharmacokinetics:- Its oral absorption is slow (making first dose hypotension less likely) and incomplete, but unaffected by food. The duration of action is considerably longer, permitting single daily dose and ensuring uniform hypotensive action round the clock. A reduction in venous return, cardiac contractility and cardiac output has been noted after few weeks of lisinopril use. Ref:- kd tripathi; pg num:-503", "cop": 2, "opa": "Captopril", "opb": "Lisinopril", "opc": "Enalapril", "opd": "Perindopril", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "1c5ae3ac-31c2-46a3-9a5a-39d4e826001d", "choice_type": "single"} {"question": "A a1 selective adrenergic blocking agents used in benign prostatic hypertrophy is", "exp": "D. i.e. (Tamsulosin) (135- KDT 6th) (83- Lippincott's 3rd)* Prazosi, Terazosin, Doxazosin are useful in the treatment of hypertension. Tamsulosin is indicated for the treatment of benign prostatic hypertrophy (83- Lippincott's 3rd)* According to KDT all are used in BPH. but Tamsulosin is best answer of choice* TAMSULOSIN - is Uroselective aIA/ a1D blocker** better tolerated less side effects* Selective b1 antagonist is - Atenolol*** Selective b2 antagonist is - Butoxamine**", "cop": 4, "opa": "Prazosin", "opb": "Terazosin", "opc": "Doxazosin", "opd": "Tamsulosin", "subject_name": "Pharmacology", "topic_name": "A.N.S.", "id": "00813868-bbb7-4481-8319-32aa05b12203", "choice_type": "single"} {"question": "The most likely complication of prolonged use of nasal decongestant drops is", "exp": "NASAL DECONGESTANTS These are a agonists which on topical application as dilute solution (0.05-0.1%) produce local vasoconstriction. The imidazoline compounds-- naphazoline, xylometazoline and oxymetazoline are relatively selective a2 agonist (like clonidine). They have a longer duration of action (12 hours) than ephedrine. side effects:- They may cause initial stinging sensation (Especially naphazoline). Regular use of these agents for long periods should be avoided because mucosal ciliary function is impaired: atrophic rhinitis and anosmia can occur due to persistent vasoconstriction. They can be absorbed from the nose and produce systemic effects, mainly CNS depression and rise in BP. cautious use:- These drugs should be used cautiously in hypeensives and in those receiving MAO inhibitors. Ref:- kd tripathi; pg num:-136", "cop": 1, "opa": "Atrophic rhinitis", "opb": "Naso-pharyngeal moniliasis", "opc": "Hyperophy of nasal mucosa", "opd": "Blockage of eustachian tubes", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "3b5d559c-d451-476a-80c1-e97d39e49c99", "choice_type": "single"} {"question": "DSM265 is having promising trials in the treatment of", "exp": "DSM265 an inhibitor of dihydroorotate dehydrogenase is effective in single oral dose both in prophylaxis and treatment against P.falciparum. Proposed to give as a single dose. Ref:www.thelancet.comjournals.", "cop": 3, "opa": "Tuberculosis", "opb": "Leprosy", "opc": "Malaria", "opd": "Trypanosoma", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "3d168859-eebc-4590-94e6-102a4d8156e8", "choice_type": "single"} {"question": "The recommended time for prophylactic antibiotic is", "exp": "Antibiotic should be present in adequate concentration at the operative site before incision and through out the procedure Parenteral agents should be admistered during the interval beginning 60 minutes before incision", "cop": 1, "opa": "30 min prior to induction of anesthesia", "opb": "15 min after the initiation of surgery", "opc": "At the time of induction", "opd": "At the time of skin incision", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "b96db6bd-d3a7-4eb9-9b2f-c5b31eb7ca22", "choice_type": "single"} {"question": "A patient on treatment for leukemia develoPS chest pain pulmonary infiltrates and pleural effusion. The likely cause is", "exp": "Refer Katzung 10th,/899 Tretinoin causes chest pain, pleuritis, pulmonary infiltrates and pleural effusion. It is known human teratogen Daunorubicin and Doxorubicin cause cardiotoxicity manifested as arrhythmias and CHF", "cop": 4, "opa": "Daunorubicin", "opb": "Hydroxyurea", "opc": "Cytarabine", "opd": "Tretinoin", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "8bebc2b7-a43d-4cd3-a8a4-3180ab11250c", "choice_type": "single"} {"question": "Tegaserod is a", "exp": "Cisapride, Mosapride, Prucalopride and Tegaserod are 5HT4 agonists used as prokinetics in constipation.\nTegaserod is withdrawn from market because of increased risk of myocardial infarction & stroke.", "cop": 3, "opa": "5HT3 antagonist", "opb": "D2 antagonist", "opc": "5HT4 agonist", "opd": "NK1 antagonist", "subject_name": "Pharmacology", "topic_name": null, "id": "5ccf4654-c341-4b42-a7d3-1a604585998c", "choice_type": "single"} {"question": "Drug of choice for CML", "exp": "Ans. (a) Imitanib mesylate (Doc for CML & GIST - Imatinib Mesylate)Ref. KD Tripathi 6th Ed. / 828 & 832IMATINIB* It inhibits the tyrosine protein kinases in chronic myeloid leukaemia (CML) cells and and c-kit receptor found in gastrointestinal stromal tumour (GIST).* Adverse effects are fluid retention, edema, vomiting, abdominal pain, myalgia and liver damageDrugs of choice for some commonly asked malignanciesMalignancyFirst line drugsChronic Lymphatic leukaemiaFludarabineChronic Myeloid leukaemiaImatinibHairy cell leukemiaCLADRIBINEMultiple myelomaMelphalanChoriocarcinomaMethotrexateProstate carcinomaBicalutamide/Flutamide", "cop": 1, "opa": "Imitanib mesylate", "opb": "Fludarabine", "opc": "A1 trans retinoic acid (for AML 3)", "opd": "Methotrexate", "subject_name": "Pharmacology", "topic_name": "Anti-Neoplastic Agents", "id": "cd94bf39-da33-45df-99fe-90c88864229f", "choice_type": "single"} {"question": "The insulin preparation of choice in diabetic ketoacidosis is", "exp": "Diabetic ketoacidosis (Diabetic coma) Ketoacidosis of different grades generally occurs in insulin dependent diabetics. It is infrequent in type 2 DM. The most common precipitating cause is infection; others are trauma, stroke, pancreatitis, stressful conditions and inadequate doses of insulin Treatment of DKA:- 1. Insulin:- Regular insulin is used to rapidly correct the metabolic abnormalities. A bolus dose of 0.1-0.2 U/kg i.v. is followed by 0.1 U/kg/hr infusion; the rate is doubled if no significant fall in blood glucose occurs in 2 hr. Fall in blood glucose level by 10% per hour can be considered adequate response. Usually, within 4-6 hours blood glucose reaches 300 mg/dl. Then the rate of infusion is reduced to 2-3 U/hr. This is maintained till the patient becomes fully conscious and routine therapy with s.c. insulin is instituted. 2) I v. Fluids 3) kcl Ref:- kd tripathi; pg num:-267,268", "cop": 1, "opa": "Regular insulin", "opb": "Lente insulin", "opc": "Isophane insulin", "opd": "A 30:70 mixture of plain and isophane insulin", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "04766ecb-b7e4-49ba-b3cc-d972f0077de6", "choice_type": "single"} {"question": "Histamine blocker in stomach act through", "exp": "Histamine H2 blockersinhibit the action of histamine ongastric H2 receptors thereby decreasing gastric acidity. They were considered a breakthrough in the treatment of peptic ulcer disease when first introduced. Refer kDT 6/e 153", "cop": 4, "opa": "Decreasing cAMP in stomach", "opb": "Increasing cAMP in stomach", "opc": "Increasing IP3 in stomach", "opd": "Decreasing IP3 in stomach", "subject_name": "Pharmacology", "topic_name": "Autacoids", "id": "0f432ade-742d-47ea-a558-d7d43efb0255", "choice_type": "single"} {"question": "Nonselective beta adrenergic antagonist is", "exp": "Ans. is 'a' i.e., Nodalol", "cop": 1, "opa": "Nodalol", "opb": "Atenolol", "opc": "Bisoprolol", "opd": "Esmolol", "subject_name": "Pharmacology", "topic_name": null, "id": "5ed56bb1-f320-484f-9934-2901690fce72", "choice_type": "single"} {"question": "Maximum tachycardia is seen with", "exp": "Ans. is 'a' i.e., Nifedipine", "cop": 1, "opa": "Nifedipine", "opb": "Verapamil", "opc": "Propanolol", "opd": "Amlodipine", "subject_name": "Pharmacology", "topic_name": null, "id": "bb7eee71-8ca1-40af-85aa-dfea4a8c272e", "choice_type": "single"} {"question": "Orange urine and tears are adverse effect of", "exp": "A. i.e. (Rifampicin) (742- KDT6th) (398- Lipincott's 3rd* Urine of patients taking Nitrofurantoin becomes dark brown due to its metabolites* Systemic administration of phenol gives - green colour to urineDrugAdverse- effectsCommentsEthambutolOptic neuritis** with blurred vision, red- green color blindnessEstablish baseline visual acuity and color vision test monthlyIsoniazidHepatic enzyme elevation, hepatitis, peripheral neuropathy*** Take base line LFT measurement* Clinically significant interaction with phenytoin* and anifungal agents (azols)PyrazinamideNausea, hepatitis, hyperuricemia**, rash joint ache, gout (rare)Take base line LFT and uric acid measurementRifampinHepatitis, GI upset, flue- like syndrome,**Take baseline LFT and CBC count, Warn patients that urine and tears may turn red- orange in color**StreptomycinOtotoxicity, nephrotoxicity**Do base line audiography and renal function tests* Red Man's Syndrome is caused by vancomycin (Fever, Urticaria and Intense flushing)", "cop": 1, "opa": "Rifampicin", "opb": "Isoniazid", "opc": "Ethambutol", "opd": "Pyrazinamide", "subject_name": "Pharmacology", "topic_name": "Anti Microbial", "id": "358cc29b-cc5c-45b0-92a1-21255eb707bf", "choice_type": "single"} {"question": "Adult dose of Clozapine is", "exp": "(C) 300 mg# Clozapine:> Indicated for reducing risk of recurrent suicidal behavior in patients with Schizophrenia or Schizoaffective disorder in patients who are judged to be at chronic risk to re-experience suicidal behavior> Also indicated for treatment-resistant Schizophrenia in patients who fail to respond adequately to standard antipsychotic treatment 12.5 mg PO once daily or 12hr initially; increased daily in increments of 25-50 mg/day, if well tolerated, to achieve target dosage of 300-450 mg/day by end of 2 weeks> On occasion, may have to be increased to 600-900 mg/day to obtain acceptable response> Maintenance: Generally, patients who respond should continue maintenance treatment on their effective dose beyond the acute episode", "cop": 3, "opa": "150 mg", "opb": "250 mg", "opc": "300 mg", "opd": "500 mg", "subject_name": "Pharmacology", "topic_name": "Miscellaneous (Pharmacology)", "id": "3fd515dc-f200-432d-bb41-7dc69f007baa", "choice_type": "single"} {"question": "Glyceryl trinitrate is given by sublingual because of", "exp": "Refer kDT 6/e p 7 Main advantage of Sublingual route of drug administration is that liver is bypassed and drugs with high first pass metabolism are absorbed directly into systemic circulation", "cop": 2, "opa": "Sho t1/2 in plasma", "opb": "High hepatic first pass metabolism", "opc": "High bioavailability by oral route", "opd": "Extensive protein binding", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "db0eaf0c-74a7-4dae-862f-992b6d19b0f5", "choice_type": "single"} {"question": "Pulmonary fibrosis is seen with(REPEAT)", "exp": "Reference Katzung 11/e p953 Bleomycin is a marrow sparing drug But it causes pulmonary fibrosis and skin toxicity Another antineoplastic drug causing pulmonary fibrosis is busulfan", "cop": 1, "opa": "Bleomycin", "opb": "Cisplatin", "opc": "Methotrexate", "opd": "Actinomycin D", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "1b89f55e-bbf6-40b3-b6bc-dc01e87210c3", "choice_type": "single"} {"question": "An elderly hypeensive has diabetic mellitus and bilateral renal aery stenosis. the best management is", "exp": "Thiazides and beta blockers should be avoided in diabetes mellitus whereas ACE inhibitor should not be given to patient with bilateral renal aery stenosis therefore, Calcium channel blockers, like verapamil are the best given for the management of hypeension Refer kDT 6/e p484", "cop": 2, "opa": "Enalapril", "opb": "Verapamil", "opc": "Beta blockers", "opd": "Thiazide", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "2f6f116c-54e5-4f5f-ad50-6538845cddea", "choice_type": "single"} {"question": "Antimicrobial agent effective against ESBL producing microorgansims is", "exp": "(A) Beta lactam plus beta lactamase inhibitorAntimicrobial Agents that must not be reported as susceptibleOrganismESBL - producing K. pneumoniae, K oxytoca, E. coli & P mirabilis1st & 2nd generation cephalosporins, cephamycins & aminoglycosidesSalmonell spp., Shegella spp.Penicillins, beta lactam / beta lactamase inhibitor combinations, cephems & carbapenemsOxacillin - resistant Staphylococcus spp.Aminoglycosides (except high concentrations), cephalosporins, Clindamycin & trimethoprim sulfamethoxazoleEnterococcus spp.#Important resistance mechanisms to beta lactam antibiotics:Beta lactamase Resistance:Many bacteria produce enzymes that are capable of destroying the beta-lactam ring of penicillin, these enzymes are referred to as penicillinases or beta-lactamases and they make the bacteria that possess them resistant to many penicillins.Clavulanic acid is inhibits beta-lactamase enzymes, thereby increasing the longevity of beta-lactam antibiotics in the presence of penicillinase-producing bacteria.Clavamox is a combination of amoxicillin and clavulanate.Combination of the beta-lactamase inhibitor tazobactam and piperacillin.Summary of beta lactam / beta lactamase inhibitor on treatment of ESBL - producing organisms:Limited clinical information:Class A ESBLs are susceptible to clavulanate & tazobactam in vitro, nevertheless many producers are resistant to beta lactamase inhibitor due to:-Hyperproduction of the ESBLs - overwhelm inhibitor.-Co-production of inhibitor-resistant penicillinases (E.g., OXA-1) or AmpC enzyme.-Relative impermeability of the host strain.Beta-lactam/beta lactamase inhibitor should not be used not be used to treat serious infections with ESBL producing organisms.Beta lactamase inhibitors:Almost all have weak antibacterial activitiy.Important in combination with penicillins sensitive to beta lactamase degradation.Clavulanic acid is the first one of this class.Natural product from streptomyces.Has a powerful & irreversible inhibition of beta lactamase enzymes because it will covalently bind to two positions in the active site.Normally used in combination with amoxicillin & other beta lactamase sensitive penicillins.Extended Spectrum Beta Lactamase (ESBL):Enzymes that are produced by Gram negative bacteria.Confer resistance to Cephalosporins, Penicillins & Monobactam (Aztreonam) by opening the beta lactam ring inactivating the antibiotic.Cannot attack Cephamycins (cefoxitin, cefotetan) or the carbapenems (imipenem, meropenem, ertapenem, doripe- nem).Generally susceptible to beta-lactamase inhibitors (Tazobactam)Plasmid mediated TEM, SHV, CTX-M beta lactamases are the most common.Therapy for ESBL producing gram negative rods:Carbapenems: Imipenem, Macropenem, Doripenem, ErtapenemPiperacillin / Tazobactam - Tazobactam blocks beta lactamase action.Beta lactam / beta lactamase inhibitor on treatment of ESBL - producing organisms:Most ESBLs are susceptible to clavulanate & tazobactam in vitro.Nevertheless some ESBL producers are resistant to beta lactamase inhibitor due to:Hyperproduction of the ESBLs - overwhelm inhibitor.Co-production of inhibitor - resistent penicillinases or AmpC enzyme.Relative impermeability of the host strain.Beta lactam/beta lactamase inhibitor should not be used to treat serious infections with ESBL - producing organisms", "cop": 1, "opa": "Beta lactam plus beta lactamase inhibitor", "opb": "Ampicillin", "opc": "Ceftriaxone", "opd": "Aztreonam", "subject_name": "Pharmacology", "topic_name": "Anti Microbial", "id": "255a58fa-86a1-41a3-b64c-c7fc08b46305", "choice_type": "single"} {"question": "Vitamin def encountered with isoniazid is", "exp": "Pyridoxine deficiency is seen with high doses of isoniazedRef:Katzung 11th ed Pg: 825", "cop": 3, "opa": "Vit A", "opb": "Vit B9", "opc": "Vit BB6", "opd": "Vit B12", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "c37660f1-cb75-4f40-b57b-9cac3287ffb5", "choice_type": "single"} {"question": "Loading drug of dose primarily depends on", "exp": "Loading dose; This is a single or few quickly repeated doses given in the beginning to attain target concentration rapidly.\nLoading dose = Target Cp * V /F\nCp - concentration, V - volume of distribution, F - oral bioavailability\nThus, the loading dose is governed only by V and not by Clearance or t1/2", "cop": 1, "opa": "Volume of distribution", "opb": "Clearance", "opc": "Rate of administration", "opd": "Half life", "subject_name": "Pharmacology", "topic_name": null, "id": "183e75ee-7532-4c10-b570-89b607898b31", "choice_type": "single"} {"question": "Verapamil is contraindicated in", "exp": "Ans. b (Complete heart block). (Ref. KDT, Pharmacology, 4th ed., 530)# VERAPAMIL can accentuate conduction defects, hence contraindicated in II and III degree AV blocks and precipitates congestive heart failure in patients with pre-existing disease.# Cardiac arrest can occur in patients with sick sinus syndrome.CALCIUM CHANNEL ANTAGONISTSDrugIndicationContraindications/CautionsFrequent or peculiar side EffectsDihydropyridines:# Nifedipine XL# Amlodipine# Felodipine XL# Isradipine# NicardipineMild to moderate hypertensionHeart failure, 2nd or 3rd degree heart blockTachycardia, flushing, gastro- intestinal disturbances, hyperkalemia, edema,headache.Benzothiazepines:DeltiazemMild to moderate HypertensionHeart failure, 2nd or 3rd degree heart blockSame as amlodipine, except no tachycardia or edema, but can cause heart block, constipation, and liver dysfunction.Phenylalkylamine: VerapamilMild to moderate HypertensionHeart failure, 2nd or 3rd degree heart block.Nausea, Constipation and Bradycardia", "cop": 2, "opa": "Hypertension", "opb": "Complete heart block", "opc": "Paroxysmal supraventricular tachycardia", "opd": "Angina pectoris", "subject_name": "Pharmacology", "topic_name": "C.V.S", "id": "770e774f-d9fc-46e5-8c79-857c45503f02", "choice_type": "single"} {"question": "The most prominent toxic effect associated with acetaminophen use is", "exp": null, "cop": 3, "opa": "Respiratory alkalosis", "opb": "Haemorrhage", "opc": "Hepatic necrosis", "opd": "Gastric Ulceration", "subject_name": "Pharmacology", "topic_name": null, "id": "c89f3315-db72-42aa-8bfb-835c9fe59d3c", "choice_type": "single"} {"question": "Specific side effect of thalidomide is", "exp": "Ans. is 'c' i.e., Phacomelia Thalidomide* Thalidomide is an anxiolytic, antiemetic drug with antiinflammatory, cytokine modulatory property.* Thalidomide was introduced in 1958 for morning sickness and was found to be highly teratogenic resulting in thousand of babies with phocomelia (seal like limbs) and withdrawn in 1961.* Now it has come again in the market for use as an anticancer drug in multiple myeloma and melanoma.* Lenalidomide is its more potent and non-teratogenic derivative. Thalidomide most commonly causes sedation and constipation in cancer patients.* It can also cause peripheral sensory neuropathy.* Two enantiomers of thalidomide (R and S) are present but these are interconvertible in body, therefore racemic mixture is used.* Antiangiogenic action is responsible for antitumor activity.", "cop": 3, "opa": "Lymphopenia", "opb": "Lymphocytosis", "opc": "Phacomelia", "opd": "Optic neuritis", "subject_name": "Pharmacology", "topic_name": "Adverse Drug Effect", "id": "a358f204-067a-494e-842d-343626576ddc", "choice_type": "single"} {"question": "A 70 kg patient needs to be staed on nitroglycerine (NTG) infusion. A 5 ml ampoule contains 5 mg/ml NTG. One ampoule is added to normal saline and to make a total of 500 ml solution. Calculate the rate of infusion if NTG is required at a rate of 10 mcg/min. (1 micro drip = 60 drops/ml )", "exp": "Dose to be given = 10 mcg/min As, one ampoule (5 ml) is mixed with normal saline to make 500 ml volume, Means 500 ml of solution contains = 5*5 = 25 mg NTG = 25000 mcg NTG 25mg -----500ml 1mg----500/25 10mcg -10*10 -3-----0.2ml So, we need to infuse 0.2 ml/min of the solution As, 1 ml = 60 drops So, 0.2 ml = 60/1 * 0.2 = 12 drops So, we need to infuse 12 drops/min", "cop": 1, "opa": "12 drops/min", "opb": "14 drops/min", "opc": "15 drops/min", "opd": "16 drops/min", "subject_name": "Pharmacology", "topic_name": "Pharmacokinetics", "id": "ff76a738-7668-48ed-b8ef-2a4e83095d14", "choice_type": "single"} {"question": "Topical mitomycin C is used in the treatment of aEUR'", "exp": "Tracheal stenosis Management of tracheal stenosis The optimal treatment of tracheal stenosis remains undefined Traditionally tracheal stenosis has been managed by thoracic and otorhinolaryngology surgeons. Endoscopic procedures are usually performed as bridge to definitive surgical intervention. With the development of interventrical pulmonology field in the last 20 years definitive management of tracheal stenosis using minimally invasive endoscopic methods becomes a possibility. Endoscopic surgery has been shown to be useful especially in patients who are deemed high risk and too unwell for reconstructive surgery. One of the main drawbacks of endoscopic tit and surgery is the risk of recurrence of tracheal stenosis due to granulation and fibrotic tissue. Scar formation and restenosis is the main cause. Studies have shown that most of the recurrence of tracheal stenosis occurs within one to three months after the procedure and use of mitomycin C has been repoed in case studies to reduce the rate of recurrence. - Both in vitro and invivo mitomycin C has been proved to be a potent inhibitor of human fibroblasts at concentrations of .04 mg/L Topical mitomycin C is a useful adjunct in the management of sho concentric membranous stenosis which does not involve the cailage.", "cop": 3, "opa": ">Basal skull ca", "opb": ">Tracheal stenosis", "opc": ">Skull base osteomyelitis", "opd": ">Angiofibroma", "subject_name": "Pharmacology", "topic_name": null, "id": "6a18ec79-787b-4607-b446-a348081e6871", "choice_type": "single"} {"question": "Wof skeletal muscles is relaxed first by tubocurarine", "exp": "ACTIONS Skeletal muscles:- Intravenous injection of nondepolarizing blockers rapidly produces muscle weakness followed by flaccid paralysis. Small fast response muscles (fingers, extraocular) are affected first; paralysis spreads to hands, feet--arm, leg, neck, face--trunk--intercostal muscles--finally diaphragm: respiration stops. Recovery occurs in the reverse sequence; diaphragmatic contractions resume first. Ref:- kd tripathi; pg num:-350", "cop": 3, "opa": "Respiratory muscles", "opb": "Head and neck muscles", "opc": "Finger muscles", "opd": "Limb muscles", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "e2d9da9e-04c9-4d54-a5d3-41843e5305de", "choice_type": "single"} {"question": "Elimination after 4 half lives in first order Kinetics is", "exp": "Ans. is 'b' i.e., 93% Half life Elimination 1t%2 50% 2t'/2 75% 3 0/2 87.5% 41 93.75% 5 t'/ 96.875", "cop": 2, "opa": "84%", "opb": "93%", "opc": "80.50%", "opd": "4.75%", "subject_name": "Pharmacology", "topic_name": null, "id": "5b06347e-0194-4f80-9b78-9aa2c1ff7927", "choice_type": "single"} {"question": "Drug acting on V2 receptors and used in DI (REPEAT)", "exp": "Desmopressin is USED IN central DIREF:KDT7/e p597", "cop": 3, "opa": "Telypressin", "opb": "Vasopressin", "opc": "Desmopressin", "opd": "Pralispressin", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "5d111830-d9d5-4e2c-86a4-f6eb3579ddc8", "choice_type": "single"} {"question": "Cephalosporin that does not require dose reductionin patient with any degree of renal impairment is aEUR'", "exp": "Cefoperazone [Ref: Goodman Gilman 17thie 1147, 1148; Katzung 10 p. 7371 Remember: ? Most cephalosporins are excreted mainly by tubular secretion. But ceftriaxone and cefoperazone are excreted mainly in bile and no dose adjustment is required in renal insufficiecy. The other unique feature of cefriaxone is its long half life. Thus it can be injected O.D. or B.D. in serious infections. According to Goodman and Gilman \"All cephalosporins are excreted through kidney except celPiramide and cefoperazone which are excreted predominantly in the bile\". About ceftriaxone Goodman Gilman mentions. \"50% of this drug is excreted through urine while 50% of it is excreted through bile\". But Katzung differs from Goodman Gilman \"All cephalosporins are excreted through kidney except .for cefoperazone and ceftriaxone which are excreted mainly through the bilian' tract\". Antimicrobial Drugs that do not require dosage adjustment in Renal Failure Cephalosporins Antitubercular * Cefoperaczone * Rifampicin * Ceftriaxone Other (miscellaneous) * Cefopiramide * Clindamycin * Chloramphenicol * Metronidazole Macrolides * Amphoterecin B * Erythomycin * Linezolid * Clarithomycin * Quinupristin / Dalfopristin * Azithromycin * Nafcillin / Oxacillin Fluoroquinolones Tetracycline * Trovafloxacin * Doxycycline * Grepafloxacin * Minocycline Use of Antimicrobial Agents in the Presence of Renal Dysfunction (Anesthesiology by Longnecker, Newman, Zapol'(2007J/285 Containdicated in the presence of dosage Require Require dosage adjustment only with severe adj adjustment with renal failures: renal failure: moderate renal failure: * Tetracyclines (except doxycycline), * Carbenicillin, ticarcillin, * Ampicillin, * Isoniazid, * Nitrofurantoin, * Cefazolin, * Mezlacillin. * Ethambutol, * Cephaloridine, * Aminoglycosides, * Piperacillin * Meropenem, * Long-acting sulfonamides, * Vancomycin, * Cefoxitin, * Nalidixic acid, * Methenamine, * Irnipenem, * Cefotaxime, * Ciprofloxacin, * Paraaminosalicylic acid * Flucytosine, * Penicillin G, * 5- fluorocytosine, * Fluconazole * Ceftizoxime, * Ofloxacin, * Ceftazidime, * Levofloxacin, * Cefuroxime, * Norfloxacin, * Cefotetan, * Itraconazole * Trimethoprim? * Sulfamethoxazole,", "cop": 2, "opa": "Cefuroxime", "opb": "Cefoperazone", "opc": "Ceftazidime", "opd": "Cefotaxime", "subject_name": "Pharmacology", "topic_name": null, "id": "4a22bee8-44d3-44ad-b25f-22e7a10cf86c", "choice_type": "single"} {"question": "DOC for Cisplatin induced nausea & vomiting occuring within 24 hours is", "exp": "DOC for Cisplatin induced nausea & vomiting within 24 hours is Ondansetron.\nDOC for Cisplatin induced nausea & vomiting after 2days is Aprepitant.", "cop": 3, "opa": "Aprepitant", "opb": "Fosaprepitant", "opc": "Ondansetron", "opd": "Promethazine", "subject_name": "Pharmacology", "topic_name": null, "id": "55f7d887-51b7-4af8-a6d0-188ca50a6817", "choice_type": "single"} {"question": "Calculate the therapeutic index of the drug from given DRC.", "exp": "Therapeutic index is calculated as: TI = LD50/ED50 TI = 128 mg/6 mg = 21.3", "cop": 2, "opa": "8", "opb": "21", "opc": "128", "opd": "1024", "subject_name": "Pharmacology", "topic_name": "Pharmacodynamics", "id": "06c216e3-68bc-4ff9-92ca-f0ae7ea8aec7", "choice_type": "single"} {"question": "Hypokalemia is seen in therapy with", "exp": null, "cop": 1, "opa": "Digitalis", "opb": "Ibuprufen", "opc": "Corticosteroids", "opd": "Diazepam", "subject_name": "Pharmacology", "topic_name": null, "id": "2ddd6f57-fcbc-4c0e-aeac-98886e0ed801", "choice_type": "single"} {"question": "Ganer's duct is present in NOT RELATED GYN", "exp": "Broad ligament", "cop": 1, "opa": "Broad ligament", "opb": "Ovarian ligament", "opc": "Perineal membrane", "opd": "Separates medial pa of epididymis from testis", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "d2121544-d05c-4506-963d-5797c6a5ef38", "choice_type": "single"} {"question": "Drug used in unstable angina to prevent Myocardial infarction is", "exp": "Aspirin is an antiplatelet agent used mostly in unstable angina to prevent MI. Ref: KD Tripathi 8th ed.", "cop": 1, "opa": "Aspirin", "opb": "GTN", "opc": "Amlodipine", "opd": "Fasudil", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "c957e481-39ce-4300-a19f-58e1d47f5f87", "choice_type": "single"} {"question": "Theophylline therapeutic blood ranges", "exp": "(5-20) (221-KDT6th)* Therapeutic ranges 5-20 as shown in above figure* Theophylline has a narrow margin of safety. Dose dependent toxicity starts from upper part of therapeutic concentration", "cop": 4, "opa": "0-5", "opb": "10-May", "opc": "15-May", "opd": "20-May", "subject_name": "Pharmacology", "topic_name": "Asthma", "id": "0af56ae3-879c-4152-ae7d-d6ec699b06eb", "choice_type": "single"} {"question": "The second messengers cyclic AMP and cyclic GMP (REPEAT)", "exp": ".", "cop": 2, "opa": "Activate the same signal transduction pathways", "opb": "Are generated by the activation of cyclases", "opc": "Activate the same protein kinase", "opd": "Are impoant only in sensory transduction", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "5bcef734-e893-4d94-a25a-f8b3e4a5bc00", "choice_type": "single"} {"question": "Drug that does not cause sedation", "exp": null, "cop": 1, "opa": "Buspirone", "opb": "Nitrazepam", "opc": "Zopiclone", "opd": "Diazepam", "subject_name": "Pharmacology", "topic_name": null, "id": "609c0955-850d-40da-bee2-a0382121dad6", "choice_type": "single"} {"question": "Danaparoid is", "exp": "Danaparoid is a parenteral Xa inhibitor which is Drug of choice for \"Heparin induced thrombocytopenia\" in pregnant women as Argatroban is contraindicated.", "cop": 3, "opa": "Xa analog", "opb": "Oral Xa inhibitor", "opc": "Parenteral Xa inhibitor", "opd": "Oral Direct thrombin inhibitor.", "subject_name": "Pharmacology", "topic_name": null, "id": "af7845ca-dc84-41ae-a5de-4922b6b4e94b", "choice_type": "single"} {"question": "Quinine is obtained from CINCHONA", "exp": null, "cop": 2, "opa": "Root", "opb": "Bark", "opc": "Leaves", "opd": "Seed capsule", "subject_name": "Pharmacology", "topic_name": null, "id": "9153d442-2b19-40b2-a662-00bba4dbc9a3", "choice_type": "single"} {"question": "Is 70 year old man was administered penicillin intravenous within five minutes, he developed generalized uicaria, swelling of lips, hypotension and bronchospasm. the first choice is to administer", "exp": "Epinephrine (adrenaline) is a drug of choice for anaphylactic shock. it is given by subcutaneous or intramuscular route in a concentration of 1:1000. intravenous route is rarely used but at match but that much lower concentration(1:10,000) Refer kDT 6/e p128", "cop": 2, "opa": "Chlorpheneramine inj", "opb": "Epinephrine inj", "opc": "High dose hydrocoisone tablet", "opd": "Nebulized salbutamol", "subject_name": "Pharmacology", "topic_name": "Autacoids", "id": "149cb42b-439a-4da1-af12-a8f7fe5799b6", "choice_type": "single"} {"question": "Drug of choice for cheese reaction is", "exp": "Phentolamine is the drug of choice in CHEESE REACTION It is a rapidly acting alpha blocker with sho duration of action (in minutes). It is non selective alpha blocker therefore blocks both alpha 1 and 2 Non Selective a Blockers Selective a1 Blockers Irreversible - Phenoxybenzamine - Used for pheochromocytoma Reversible - Phentolamine, Tolazoline,ergotamine - DOC for cheese reaction and clonidine withdrawal Prazosin Terazosin Doxazosin Alfuzosin - These drugs are used for BHP and HTN. - Also used for scorpion sting", "cop": 2, "opa": "Prazosin", "opb": "Phentolamine", "opc": "Pentazocine", "opd": "Phenoxybenzamine", "subject_name": "Pharmacology", "topic_name": "Sympathetic System", "id": "0745a1a4-6a0f-426c-8f3e-78091d1a1142", "choice_type": "single"} {"question": "Drug of choice for hyperhidrosis is", "exp": "Darifenacin is considered as drug of choice for hyperhidrosis-excess sweating as it blocks m3 receptors on sweat glands Ref: KDT 6th ed pg 118", "cop": 3, "opa": "Phenylephrine", "opb": "Atropine", "opc": "Darifenacin", "opd": "Trospium", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "1212d005-5005-43dd-8e2e-3438afcefce7", "choice_type": "single"} {"question": "Nevirapine is", "exp": "NIs are - Zidovudine, Lamivudine, Stavudine, Didanosine, Zalcitabine Emtricitabine, Abacavir, Tenofovir PIs are - Saquinavir, Indinavir, Ritonavir, Nelfinavir, Amprenavir, Lopinavir and Amprenavir Fusion inhibitor - Enfuviide Ref: HL Sharma 3rd edition anti retroviral drugs.", "cop": 1, "opa": "Nonnucleoside reverse transcriptase inhibitor (NNI)", "opb": "Nucleoside reverse transcriptase inhibitor (NIs)", "opc": "Protease inhibitor (PI)", "opd": "Fusion inhibitor", "subject_name": "Pharmacology", "topic_name": "Immunomodulators", "id": "6ca3395e-003a-44db-b775-72f8701b1109", "choice_type": "single"} {"question": "In comparison to inhaled adrenergic agonists, the inhaled anticholinergics", "exp": null, "cop": 3, "opa": "are more affective in bronchial asthma", "opb": "are better suited for control of an attack of asthma", "opc": "produce slower response in bronchial asthma", "opd": "produce little benefit in chronic obstructive lung disease", "subject_name": "Pharmacology", "topic_name": null, "id": "2e8d700e-97c9-41be-8487-9a6fe141d495", "choice_type": "single"} {"question": "Cyclosporin is used an", "exp": null, "cop": 4, "opa": "Anticancer drug", "opb": "Antibiotic", "opc": "Antiarrythmic", "opd": "Immunosuppresant", "subject_name": "Pharmacology", "topic_name": null, "id": "7f2fbb13-1343-4607-8fa9-b9ec2443b82f", "choice_type": "single"} {"question": "Wich one of the following drugs does not produce central anticholinergic syndrome", "exp": "Ref: KD Tripathi pharmacology 7th edition (page.no: 111) Glycopyrrolate is a potent and rapidly acting antimuscarinic, lacking central effects. It is having a quaternary structure. so it doesn't cause the central anticholinergic syndrome. Atropine has both central and peripheral action. Tricyclic antidepressants, Antihistaminics have central anticholinergic effects", "cop": 2, "opa": "Atropine sulphate", "opb": "Glycopyrrolate", "opc": "Antihistaminics", "opd": "Tricyclic antidepressants", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "1e27cc74-7c6e-40aa-81fe-ac81e30699ac", "choice_type": "single"} {"question": "The dose of methyl prednisolone to be given in an acute spinal injury is", "exp": "(C) 30 mg/kg/body weight# STEROID THERAPY IN SPINAL CORD INJURY: Steroid have verified significant improvement in motor function and sensation in patients with complete or incomplete spinal cord injuries (SCIs) who were treated with high doses of methylprednisolone within 8 hours of injury. High doses of steroids or Tirilazad are thought to minimize the secondary effects of acute SCI.> 30-mg/kg bolus of methylprednisolone administered within 8 hours of injury, whereas the study evaluated methylprednisolone 5.4 mg/kg/h for 24 or 48 hours versus tirilazad 2.5 mg/kg q6h for 48 hours. (Tirilazad is a potent lipid preoxidation inhibitor.)> Between the 2 studies, it was determined that: (1) in patients treated earlier than 3 hours after injury, the administration of methyl- prednisolone for 24 hours was best; (2) in patients treated 3-8 hours after injury, the use of methylprednisolone for 48 hours was best; (3) Tirilazad was equivalent to methylprednisolone for 24 hours.> Both NASCIS studies evaluated the patients' neurologic status at baseline on enrollment into the study, at 6 weeks, and at 6 months and found absolutely no evidence suggests that giving the medication earlier (eg, in the first hour) provides more be nefit than giving it later (eg, between hours 7 and 8).> The authors concluded that there was only a benefit if methylprednisolone or tirilazad were given within 8 hours of injury.> Use of high-dose methylprednisolone in non-penetrating acute SCI had become the standard of care in North America.An increased incidence of infection and avascular necrosis has been documented.> Revised recommendations pertaining to steroid therapy in SCI:- The American College of Surgeons (ACS) has modified their advanced trauma life support (ACLS) guidelines to state that methylprednisolone is \"a recommended treatment\" rather than \"the recommended treatment.\" Updated guidelines issued in 2013 by the CNS and the American Association of Neurological Surgeons (AANS) recommend against the use of steroids early after an acute SCI. Guidelines recommend that methylprednisolone not be used for the treatment of acute SCI within the first 24-48 hours following injury. Previous standard was revised because of a lack of medical evidence supporting the benefits of steroids in clinical settings and evidence that high-dose steroids are associated with harmful adverse effects. Overall, the benefit from steroids is considered modest at best, but for patients with complete or incomplete quadriplegia, a small improvement in motor strength in one or more muscles can provide important functional gains. Administration of steroids remains an institutional and physician preference in spinal cord injury. Administration of high-dose steroids within 8 hours of injury for all patients with acute spinal cord injury is practiced by most physicians. Current recommendation is to treat all patients with spinal cord injury according to the local/regional protocol. If steroids are recommended, they should be initiated within 8 hours of injury with the following steroid protocol: Methylpred- nisolone 30 mg/kg bolus over 15 minutes and an infusion of methylprednisolone at 5.4 mg/kg/h for 23 hours beginning 45 minutes after the bolus.", "cop": 3, "opa": "15 mg/kg/body weight", "opb": "25 mg/kg/body weight", "opc": "30 mg/kg/body weight", "opd": "50 mg/kg/body weight", "subject_name": "Pharmacology", "topic_name": "Miscellaneous (Pharmacology)", "id": "0382a2af-b8f1-4c95-9eb8-9ffdd684c474", "choice_type": "single"} {"question": "Glycoprotein II b / III a receptor antagonists is", "exp": "(Abciximab) (573-KDT) (610-11-KDT 6th)Antiplatelet Drugs (Antithrombotic drugs)* Aspirin* Dipyridamole* Ticlopidine* Clopidogrel* * Glycoprotein lib /Ilia receptor antagonists - Abciximab, Eptifibatide and TirofibanAbciximab* Given along with aspirin + heparin during PTC A it has markedly reduced the incidence of restenosis, subsequent MI and death* Used in unstable angina and as adjuvant to coronary thrombolysis* Non antigenic, the main risk is haemorrhage. Thrombocytopenia is another complications.Antifibrinolvtics - EACA, Tranexaemic acid, Aprotinin", "cop": 2, "opa": "Clopidogrel", "opb": "Abeiximab", "opc": "Tranoxaemic-acid", "opd": "Ticlopidine", "subject_name": "Pharmacology", "topic_name": "Hematology", "id": "d2092992-012b-49e3-b22d-15ff0381db58", "choice_type": "single"} {"question": "Quinolones are not effective in the treatment of", "exp": null, "cop": 2, "opa": "Mycobacteria", "opb": "Treponema", "opc": "Haemophilus", "opd": "Salmonella", "subject_name": "Pharmacology", "topic_name": null, "id": "fea825a2-5bfc-4c7b-bdbe-081def09555c", "choice_type": "single"} {"question": "Carvedilol is an effective antihypeensive agent that, like propranolol, is capable of blocking beta receptors. An impoant difference between the two drugs is that carvedilol", "exp": "a + b ADRENERGIC BLOCKERS Includes Labetalol, Carvedilol. Carvedilol:- It is a b1 + b2 + a1 adrenoceptor blocker; produces vasodilatation due to a1 blockade as well as calcium channel blockade, and has antioxidant propey. It has been used in hypeension and is the b blocker especially employed as cardioprotective in CHF. Oral bioavailability of carvedilol is 30%. It is primarily metabolized and has a t 1/2 of 6-8 hrs. Ref:- kd tripathi; pg num:-151", "cop": 4, "opa": "is available only as eye drops", "opb": "has intrinsic sympathomimetic activity", "opc": "is a selective blocker of cardiac b1 receptors", "opd": "has a1 receptor blocking actions", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "7a21978e-14c1-4ea5-a25a-734c93e3f4a8", "choice_type": "single"} {"question": "Contraindications to use of Beta Blockers", "exp": "* Bronchial asthma is an absolute contraindication of non selective beta Blockers - as they induce bronchoconstriction by knocking off beta 2 mediated adrenergic bronchodilation. Ref:- Sharma's Principles of Pharmacology 3rd Ed; Pg No:- 191-2", "cop": 1, "opa": "Bronchial asthma", "opb": "Hypeension", "opc": "Tachycardia", "opd": "Glaucoma", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "3b31aaa4-5ac1-47d8-8416-6dc6f8a2fc08", "choice_type": "single"} {"question": "Laxative used in hepatic encephalopathy", "exp": "Ref: Goodman & Gillman 13th ed. P 928, 940USES OF LACTULOSE* Constipation caused by opioids* Idiopathic chronic constipation* Lactulose also used to treat hepatic encephalopathyLACTULOSE IN HEPATIC ENCEPHALOPATHY* Impaired liver function/severe liver disease are unable to detoxify the ammonia coming from colon which is produced by colonic bacterial metabolism of fecal urea.* The drop in luminal pH that accompanies hydrolysis to short-chain fatty acids in the colon results in \"trapping\" of the ammonia by its conversion to the polar ammonium ion.* Combined with the increase in colonic transit, this therapy significantly lowers circulating ammonia levels. The therapeutic goal in this condition is to give sufficient amounts of lactulose (usually 20-30g three to four times per day) to produce two to three soft stools a day with a pH of 5-5.5.", "cop": 1, "opa": "Lactulose", "opb": "Sodium picosulfate", "opc": "Lubiprostone", "opd": "Bisacodyl", "subject_name": "Pharmacology", "topic_name": "G.I.T", "id": "4315fe34-cb9a-4ae8-8cca-6fd8f609ba98", "choice_type": "single"} {"question": "Most important side effect of Amphotericin B is", "exp": "Ans. is 'b' i.e., Nephrotoxicity Important adverse effects of Amphotericin B:a) Acute reactions - occurs with each infusion and consists of chills, fever, aches and pain due to release of cytokines like TNF a, IL1 and IL6.b) Nephrotoxicity - It is the most important side effect which occurs uniformly and dose related and often manifests as azotemia, reduced GFR, acidosis, hypokalemia. It reverses slowly and often incompletely after stoppage of therapy.c) Anemia due to bone marrow depression which is largely reversible.d) CNS toxicity.", "cop": 2, "opa": "Fever and chills", "opb": "Nephrotoxicity", "opc": "Hyperkalemia", "opd": "Anaemia", "subject_name": "Pharmacology", "topic_name": "Anti Microbial", "id": "dc9be8b3-2470-4826-a7e9-57895ba683e7", "choice_type": "single"} {"question": "Drug used only for treatment of postprandial hyperglycemia is", "exp": "Alpha glucosidase inhibitors - effect on both prandial and post prandial sugar ,that act as competitive inhibitors of enzymes needed to digest carbohydrates Rapaglinide is used only for treatment of postprandial hyperglycemia Sulfonylureas is for maintenance of type 2 DIABETES MELLITUS Metformin is drug of choice for treatment of type 2 DIABETES MELLITUS", "cop": 2, "opa": "Alpha glucosidase inhibitors", "opb": "Rapaglinide", "opc": "Sulfonylureas", "opd": "Metformin", "subject_name": "Pharmacology", "topic_name": "Pancreas", "id": "1b55184c-f242-4a92-8d7d-73c9c8b21a60", "choice_type": "single"} {"question": "Drug not to be given in ishchemic hea disease", "exp": "Refer kDT 6/e p547 Isopreterenol is a beta adrenergic agonists and is contraindicated in ishchemic hea disease. As it can increase myocardial oxygen demand by causing tachycardia", "cop": 3, "opa": "Atenolol", "opb": "ACE inhibitor", "opc": "Isopreterenol", "opd": "Streptokinase", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "4adc2b68-447f-4114-b5c0-cc4af2d9d3f7", "choice_type": "single"} {"question": "Pulmonary fibrosis is the most common complication after treatment with", "exp": "Ans. is 'c' i.e., bleomycin This question has been repeated numerous times before so its well-known that Bleomycin causes Pulmonary fibrosisThe other important fact about Bleomycin is its mechanism of action.* It causes DNA chain scission and inhibits repair by intercalating between DNA strands*Other drugs causing pulmonary fibrosis areacyclovir*amiodarone*busulphan*cyclophosphamide*melphalan*methotrexate*methysergide*", "cop": 3, "opa": "6- mercaptopurine", "opb": "Vincristine", "opc": "Bleomycine", "opd": "Adriamycine", "subject_name": "Pharmacology", "topic_name": "Adverse Drug Effect", "id": "a8e1fa2a-8290-4c2c-a68e-641092d5d269", "choice_type": "single"} {"question": "Drug of choice for absent seizures", "exp": "Many children appear to have a genetic predisposition to absence seizures. In general, seizures are caused by abnormal electrical impulses from nerve cells (neurons) in the brain. Ref: KD Tripathi 8th ed.", "cop": 4, "opa": "Clonezapam", "opb": "Diazepam", "opc": "Phenytoin", "opd": "Valproate", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "bfca29b5-7ebf-42e3-bfc3-75117f4c10a0", "choice_type": "single"} {"question": "In spider nevi, dilatation of blood vessels is due to", "exp": "Nevus araneus, also known as spider angioma or spider nevus, is a common benign vascular lesion present in 10-15% of healthy adults and young children. They may appear as solitary or multiple lesions. In paicular, when multiple lesions are present, liver disease, estrogen therapy, and thyrotoxicosis should be considered. The name stems from its physical appearance, which is characterized by a central red aeriole, or punctum, representing the body of the spider, surrounded by a radial pattern of thin-walled capillaries, resembling legs", "cop": 2, "opa": "Testosterone", "opb": "Estrogen", "opc": "Hepatotoxins", "opd": "FSH", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "c6b51935-1b21-4ee1-8d35-3d34771e69d4", "choice_type": "single"} {"question": "Drug acting tyrosine kinase receptor is", "exp": "Drugs acting on tyrosinase kinase receptors - Prolactin Insulin Growth hormone TRH, TSH and MSH acts on GPCR receptors", "cop": 3, "opa": "TRH", "opb": "TSH", "opc": "Insulin", "opd": "MSH", "subject_name": "Pharmacology", "topic_name": "NEET Jan 2020", "id": "e5a622cc-0376-4f04-b487-22ca7155a291", "choice_type": "single"} {"question": "Pharmacogenetics is associated with", "exp": "The determinants of drug response, viz. transpoers, metabolizing enzymes, ion channels, receptors with their couplers and effectors are controlled genetically The study of the genetic basis for variability in drug response is called 'Pharmacogenetics'. Ref ;KD Tripathi Pharmacology 7th edition (page no;65)", "cop": 1, "opa": "individual variations in drug response due to gene variability", "opb": "Environmental influence", "opc": "Individual variability in oral absorption", "opd": "Different mechanism of actions in different individuals", "subject_name": "Pharmacology", "topic_name": "General pharmacology", "id": "cc532c33-334f-4492-b07c-7ebbd477abd2", "choice_type": "single"} {"question": "The Loop diuretic acts at", "exp": "(C) Ascending loop # Loop diuretics: are diuretics that act on the ascending loop of Henle in the kidney.> They are primarily used in medicine to treat hypertension and edema often due to congestive heart failure or renal insufficiency.# Mechanism of action:> Loop diuretics act on the Na+-K+-2CI' symporter (cotransporter) in the thick ascending limb of the loop of Henle to inhibit sodium & chloride reabsorption. This is achieved by competing for the Cl' binding site.> Because magnesium and calcium reabsorption in the thick ascending limb is dependent on sodium and chloride concentrations, loop diuretics also inhibit their reabsorption> By disrupting the reabsorption of these ions, loop diuretics prevent the urine from becoming concentrated and disrupt the generation of a hypertonic renal medulla", "cop": 3, "opa": "PCT", "opb": "DCT", "opc": "Ascending loop", "opd": "Descending loop", "subject_name": "Pharmacology", "topic_name": "Miscellaneous (Pharmacology)", "id": "2532d806-70f9-4268-b334-4f7fc8614702", "choice_type": "single"} {"question": "Not a side effect of cimitidine is", "exp": "Common side effects of Tagamet include: headache, dizziness, drowsiness, depression, agitation, breast swelling or tenderness (in men), joint or muscle pain, skin rash,", "cop": 3, "opa": "Impotence", "opb": "Gynaecomastia", "opc": "Atrophic gastritis", "opd": "Galactorrhea", "subject_name": "Pharmacology", "topic_name": "Kidney", "id": "893512b5-a752-468a-a339-d152ec427ac6", "choice_type": "single"} {"question": "Hyperkalemia is associated with", "exp": "Refer Harrison 17e 281 ACE inhibitor can cause hyperkalemia whereas amphotericin B and Thiazide (chlohalidone) cause hypokalemia", "cop": 1, "opa": "ACE inhibitor", "opb": "Chlohalidone", "opc": "Amphotericin B", "opd": "Amiodarone", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "e6612670-fc9a-422f-a97e-1f6498e0a177", "choice_type": "single"} {"question": "Ivabradine is indicated in the management of", "exp": "Ivabradine This 'pure' hea rate lowering antianginal drug has been introduced recently. mech of action:- The only significant action of ivabradine is blockade of cardiac pacemaker (sino-atrial) cell 'f' channels, which are 'funny' cation channels that open during early pa of slow diastolic (phase 4) depolarization. The resulting inward current (If) determines the slope of phase 4 depolarization. Selective blockade of If current by ivabradine results in hea rate reduction without any other electrophysiological or negative inotropic or negative lucitropic (slowing of myocardial relaxation) effect. Hea rate reduction decreases cardiac O2 demand and prolongation of diastole tends to improve myocardial perfusion (O2 supply). Accordingly, in clinical trials, ivabradine has been found to improve exercise tolerance in stable angina and reduce angina frequency. Indications:- Used in chronic stable angina in patients with sinus rhythm. Ref:- kd tripathi;pg num:-554", "cop": 3, "opa": "Congestive hea failure", "opb": "Cardiomyopathy", "opc": "Angina pectoris", "opd": "Irritable bowel syndrome", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "d11a20fb-9258-4e5f-9a91-087b2ec71d43", "choice_type": "single"} {"question": "The most impoant channel of elimination of digoxin is", "exp": "PHARMACOKINETICS Presence of food in stomach delays absorption of digoxin. The volume of distribution of digoxin is large. It is concentrated in the hea, skeletal muscle, liver and kidney. Digoxin is primarily excreted unchanged by the kidney: mainly by glomerular filtration; rate of excretion is altered parallel to creatinine clearance. Its t 1/2 is prolonged in elderly patients and in those with renal insufficiency: dose has to be reduced. Ref:- kd tripathi; pg num:-515,516", "cop": 2, "opa": "Hepatic metabolism", "opb": "Glomerular filtration", "opc": "Tubular secretion", "opd": "Excretion in bile", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "ac6646af-1ed9-4f37-8ca7-3b4267744b5c", "choice_type": "single"} {"question": "Apixaban is a new drug that acts by", "exp": "Rivaroxaban and Apixaban are newer oral anticoagulants that act by inhibiting factor Xa. Newer oral anticoagulants that are currently being asked in the exams are: Direct thrombin inhibitor- Dabigatran Direct factor Xa inhibitors Apixaban Rivaroxaban Edoxaban Betrixaban", "cop": 2, "opa": "Inhibiting TNF alpha", "opb": "Inhibiting coagulation factor Xa", "opc": "Inhibiting platelet aggregation", "opd": "Activating plasminogen", "subject_name": "Pharmacology", "topic_name": "Hematology", "id": "6741fb1f-da35-472b-b6e8-baf898663b9d", "choice_type": "single"} {"question": "Recently used topical NSAID for ophthalmic use", "exp": "Nepafenac is the newly launched Topical NSAID for ophthalmic use. Nepafenac is an NSAID, usually sold as an eye drop(0.1% solution). It is used to treat pain and inflammation associated with cataract surgery. It is used in the management of cystoids macular edema because of its good penetration into the posterior segment.", "cop": 2, "opa": "Indomethacin", "opb": "Nepafenac", "opc": "Flurbiprofen", "opd": "Oxyphenbutazone", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "e00f6471-2a86-4d48-8dee-ab7327cc653c", "choice_type": "single"} {"question": "Drug of choice for drug induced Parkinsonism is", "exp": "Condition Drug DOC for Parkinsonism Pramipexole/Ropinirole DOC for Drug induced Parkinsonism Benzhexol (Trihexiphenidyl) Most effective drug for Parkinsonism Levo-dopa + Carbidopa Gold standard drug for Parkinsonism Levo-dopa + Carbidopa Disease modifying drug in Parkinsonism Selegiline", "cop": 3, "opa": "Levodopa", "opb": "Benserazide", "opc": "Benzhexol", "opd": "Selegiline", "subject_name": "Pharmacology", "topic_name": "Sedative-Hypnotics and Parkinsonism", "id": "f1a9b7e4-3d98-4667-80a8-538d7390bf25", "choice_type": "single"} {"question": "The site of action of vasopressin antagonist in kidney", "exp": "V2 receptors are located on medullary collecting ducts. drugs acting on V2 receptor antagonists are vaptans like convivaptan and tolvaptan Ref: Goodman Gillman 12th ed pg 707", "cop": 1, "opa": "Medullary Collecting duct", "opb": "Coical collecting duct", "opc": "Proximal convoluted tubule", "opd": "Distal convoluted tubule", "subject_name": "Pharmacology", "topic_name": "Kidney", "id": "531249eb-0bcc-4d7b-9e42-ad77efc3d136", "choice_type": "single"} {"question": "The mechanism of action of haloperidol is the blockage of", "exp": "(C) Dopamine receptor # Haloperidol, Trifluperidol, Droperidol, Penfluridol are Butyrophenones and act as antipsychotic drugs.> All antipsychotic (except clozapine like) have potent dopamine D2 receptor blocking action.> So, it is clear that Haloperidol act by blocking dopamine receptor.> Uses of haloperidol are in acute schizophrenia, Huntington's disease.> Clozapine has significant 5-HT2 and at blocking action.> Dopaminergic blockade in basal ganglia cause extrapyramidal sign while that in CTZ is responsible for antiemel action.", "cop": 3, "opa": "Serotonin receptor", "opb": "GABA receptor", "opc": "Dopamine receptor", "opd": "Adrenergic receptor", "subject_name": "Pharmacology", "topic_name": "C.N.S", "id": "bb9bc4b9-338c-4596-af61-d50e2a99bd34", "choice_type": "single"} {"question": "Drug of choice for Huntington's chorea is", "exp": "Huntigton's chorea is characterized by dopaminergic overactivity and Tetrabenazine is a dopamine depleter which is the drug of choice for this condition.", "cop": 3, "opa": "Haloperidol", "opb": "Chlorpromazine", "opc": "Tetrabenazine", "opd": "Donepezil", "subject_name": "Pharmacology", "topic_name": null, "id": "089e67c6-1f35-4cb9-95c2-f0c1fe78dd6b", "choice_type": "single"} {"question": "Fluoroquinolone with highest oral bioavailability", "exp": "Fluoroquinolones:- * Gemifloxacin is a third generation fluoroquinolone having absolute oral bioavailability. * All third generation fluoroquinolones: Sparfloxacin, Gatifloxacin and Gemifloxacin have 100% oral biovailability. * Among the Fluoroquinolones, Norfloxacin has the least oral bioavailability. Ref:- HL & KK Sharma's Principles of Pharmacology 3rd Ed; Pg Num:- 724", "cop": 1, "opa": "Gemifloxacin", "opb": "Norfloxacin", "opc": "Ciprofloxacin", "opd": "Levofloxacin", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "3dfb4db7-65a3-4bfc-ac88-f1fd1310faf1", "choice_type": "single"} {"question": "Most common Cytochrome P450 involved in drug metabolism is", "exp": "Cytochrome P-450 (CYP) isoenzymes are grouped into families designated by numerals (1, 2, 3....; each having several sub-families designated by capita: letters (A, B, C. .... ), while individual isoenzymes are again allocated numerals (1, 2, 3 .... ). In human beings, only a few, members of three isoenzyme families (CYP 1, 2 and 3 carry out the metabolism of most of the drugs, The CYP isoenzyme: CYP3A4/5 Carryout biotransformation of largest number: (nearly 50%) of drugs. 20-30% of metabolism is done by the next common cyp2d6 In addition to liver, these isoforms are expressed in the intestine (responsible for the first-pass metabolism at this site) and kidney as well. Ref: KD Tripathi pharmacology 7th edition (page.no: 24)", "cop": 1, "opa": "CYP 3A4", "opb": "CYP 1AI", "opc": "CYP 2E1", "opd": "CYP 2D6", "subject_name": "Pharmacology", "topic_name": "General pharmacology", "id": "8f27f9da-0d6f-4bf7-8cdc-e72cd8882f7d", "choice_type": "single"} {"question": "The mydriatic drug with sho duration of action is", "exp": "Tropicamide, is a medication used to dilate the pupil and help with examination of the eye. Specifically it is used to help examine the back of the eye. It is applied as eye drops. Effects occur within 40 minutes and last for up to a day.", "cop": 2, "opa": "Cyclopentolate", "opb": "Tropicamide", "opc": "Homatropine", "opd": "Atropine", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "b7e03865-100d-4d18-a0d5-c777177f7590", "choice_type": "single"} {"question": "Vigabatrine is drug of choice for", "exp": "Ans. is'c'i.e., Infantile spasmRef: Harrison 18n/e p. 3262, 3266Vigabatrin is DOC for infantile spasm.", "cop": 3, "opa": "Febrile seizures", "opb": "Myoclonic epilepsy", "opc": "Infantile spasm", "opd": "Paial seizures", "subject_name": "Pharmacology", "topic_name": null, "id": "09b965bd-1759-4433-a5c8-c0fbce15d477", "choice_type": "single"} {"question": "Route of choice for analgesics in cancer patients", "exp": null, "cop": 1, "opa": "Oral", "opb": "IV", "opc": "Topical", "opd": "Sublingual", "subject_name": "Pharmacology", "topic_name": null, "id": "db89ffac-74e0-48f2-974f-b69f40bc5957", "choice_type": "single"} {"question": "Antagonist of Benzodiazepine is", "exp": "Ans. is 'd' i.e., Flumazenil Flumazenil is a benzodiazepine analogue which competes with BZD agonists as well as acts as inverse agonists for the BZD receptor and reverses their depressant or stimulant effects respectively.", "cop": 4, "opa": "Nalorphine", "opb": "Carbamazepine", "opc": "Naloxone", "opd": "Flumazenil", "subject_name": "Pharmacology", "topic_name": "C.N.S", "id": "8c64c1c5-3a3e-40c6-91a3-a643bd48ad8a", "choice_type": "single"} {"question": "Drug responsible for the below condition", "exp": "Thalidomide given to pregnant lady can lead to hypoplasia of limbs called as \"Phocomelia\".", "cop": 3, "opa": "Chlorpromazine", "opb": "Lithium", "opc": "Thalidomide", "opd": "Clofazimine", "subject_name": "Pharmacology", "topic_name": null, "id": "3cb676fa-5342-4d75-b631-479c834ffc82", "choice_type": "single"} {"question": "The major limitation in the use of clozapine for treatment of schizophrenia is", "exp": "Clozapine:- It is the first atypical anti- psychotic. It has only weak D2 blocking action, produces few/no extrapyramidal symptoms; tardive dyskinesia is rare and prolactin level does not rise. Both positive and negative symptoms of schizophrenia are improved and clozapine is the most effective drug in refractory schizophrenia, i.e. patients not responding to typical neuroleptics may respond to it. Pharmacokinetics:- Clozapine is metabolized by CYP1A2, CYP2C19 & CYP3A4 into active and inactive metabolites with an average t 1/2 of 12 hours. Adverse effects:- It's major limitation is higher incidence of agranulocytosis (0.8%) and other blood dyscrasias: weekly monitoring of leucocyte count is required. Metabolic complication like weight gain, hyperlipidemia and precipitation of diabetes is another major limilation. Ref:- kd tripathi; pg num:-441", "cop": 1, "opa": "Its potential to cause agranulocytosis", "opb": "High incidence of extrapyramidal side effects", "opc": "Production of hyperprolactinemia", "opd": "Its inability to benefit negative symptoms of schizophrenia", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "480f6ca3-591e-4b4e-94dc-93a595b90533", "choice_type": "single"} {"question": "Metastatic calcification is most commonly seen in (NOTRELATED)", "exp": ".", "cop": 4, "opa": "Cornea", "opb": "Extensor tendon", "opc": "Lungs", "opd": "Renal tubules", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "88a872f0-76a1-4d75-92ab-7215472cd2fe", "choice_type": "single"} {"question": "In Aspirin mechanism of action", "exp": "(B) Cyclooxygenase decreased # Aspirin acts by inhibiting cyclooxygenase enzyme, thereby inhibiting prostaglandin synthesis.> Leukotriens acts by inhibiting Lipooxygenase> Steroids acts by inhibiting phospholipase", "cop": 2, "opa": "Lipooxygenase decreased", "opb": "Cyclooxygenase decreased", "opc": "Phospholipase", "opd": "Increased Lipoxygenase", "subject_name": "Pharmacology", "topic_name": "Miscellaneous (Pharmacology)", "id": "8886afcd-25a8-45dd-a39e-53efd054d341", "choice_type": "single"} {"question": "Drug contraindicated in hyperiglyceridemia", "exp": "Bile acid binding resins like cholestyramine causes increase in triglycerides and are thus contraindicated in patients with hyperiglyceridemia due to risk of development of pancreatitis. Statins - decrease LDL and increase HDL Niacin - decrease LDL and triglyceride, maximum increase in HDL Fibrates - decrease triglyceride, decrease LDL.", "cop": 4, "opa": "Fibrates", "opb": "Simvastatin", "opc": "Niacin", "opd": "Cholestyramine", "subject_name": "Pharmacology", "topic_name": "Hypeension, Arrhythmias, Dyslipidemia", "id": "fe0a81e2-0291-4993-8ee7-1573bb3298cf", "choice_type": "single"} {"question": "The drug of choice for hypehyroidism in third trimester of pregnancy is;", "exp": "HYPEHYROIDISM IN PREGNANCY DOC for hypehyroidism in pregnancy is Propylthiouracil. DOC for hypehyroidism in first trimester of pregnancy is Propylthiouracil. DOC for hypehyroidism in 2nd and 3rd trimester of pregnancy is Carbimazole.", "cop": 1, "opa": "Carbimazole", "opb": "Propylthiouracil", "opc": "Sodium iodide", "opd": "Radioactive iodine", "subject_name": "Pharmacology", "topic_name": "FMGE 2019", "id": "33aec8c8-751f-4940-854f-2c3821c1ef84", "choice_type": "single"} {"question": "An Anti epileptic drug, but NOT a mood stabalizer includes", "exp": "(D) Leviracetam# VALPROIC ACID: Available in extended release form. This drug can be very irritating to the stomach, especially when taken as valproic acid. Liver function and CBC should be monitored.> Lamotrigine: Particularly effective for bipolar depression. Usual dose is 100-200 mg daily, which can be built up by 25 mg every 2 weeks. The patient should be monitored for signs and symptoms of Stevens-Johnson syndrome, a very rare but potentially fatal skin condition.> Carbamazepine: CBC should be monitored, as carbamazepine can lower white blood cell count. Therapeutic drug monitoring is required. Carbamazepine was approved by the US Food and Drug Administration as a bipolar disorder treatment in 2005, but had been widely used previously.> Oxcarbazepine: Oxcarbazepine is not FDA approved for bipolar disorder. Still, it appears to be effective in about one-half of patients with bipolar disorder and be well tolerated.> Other anticonvulsants, such as gabapentin and topiramate, also are mood stabilizers.", "cop": 4, "opa": "Topiramate", "opb": "Lamotrigine", "opc": "Sodium valproate", "opd": "Leviracetam", "subject_name": "Pharmacology", "topic_name": "C.N.S", "id": "92b3f0b9-5bc1-4be9-81df-ea53f82e8787", "choice_type": "single"} {"question": "Digitalis acts in atrial fibrillation by", "exp": "Ans. is 'a' i.e., Increase in A.V. node refractoriness Digitalis in arrhythma Digitalis is the drug of choice for controlling ventricular rate in atrial fibrillation (AF) with hea failure. Digitalis reduces the ventricular rate in AF by decreasing the number of impulses that are able to pass down the A-V node and bundle of His. It increases effective refractory period-ERP refractoriness) of A-V node by direct, vagomimetic and antiadrenergic action - the minimum interval between consecutive impulses that can successfully traverse the conducting tissue is increased. A degree of A-V block is naturally established in AF. Because of the relatively long ERP of A-V node, many atrial impulses impinge on it while it is still refractory; others falling early in the relative refractory period get extinguished by decremental conduction - These concealed impulses leave upper margin of A-V node refractory for a fuher period. Thus, any influence which increases atrial rate in AF (e.g. digitalis), by itself reduces ventricular rate.", "cop": 1, "opa": "Increasing AV node refractoriness", "opb": "Decreasing atrial contractility", "opc": "Inhibiting Na+ K+ ATPase pump", "opd": "Inhibiting Na+ H+ ATPase pump", "subject_name": "Pharmacology", "topic_name": null, "id": "7ba71964-992a-4d1e-b5c2-35077f8d93a4", "choice_type": "single"} {"question": "Drug of choice for NSAID induced peptic ulcer disease is", "exp": "Misoprostol is the most specific drug for NSAIDS induced peptic ulcer but it is not the drug of choice for any ulcer. DOC for all types of peptic ulcer including NSAIDs induced peptic ulcer are proton pump inhibitors.", "cop": 2, "opa": "Pirenzapine", "opb": "Omeprazole", "opc": "Cimetidine", "opd": "Misoprostol", "subject_name": "Pharmacology", "topic_name": "Gastro-Intestinal Tract", "id": "f4b60fb9-cb39-43fd-af1b-c547d1cfe989", "choice_type": "single"} {"question": "Beta blocker with intrinsic sympathomimetic activity is", "exp": "Beta blockers with intrinsic sympathomimetic activity are acebutolol, celiprolol, pindolol etc Ref: KD tripathi 8th ed.", "cop": 4, "opa": "Propranolol", "opb": "Atenolol", "opc": "Bisoprolol", "opd": "Celiprolol", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "6a22bd40-7b20-4772-8690-9573e2dd77bc", "choice_type": "single"} {"question": "Mechanism of action of benzodiazepine is", "exp": "Ans. is 'a' i.e., GABAA - BZD - Cl- channel stimulator Mechanism of action of benzodiazepines (BZDs)* Muscle relaxation is produced by action on medulla.* Ataxia is due to action on cerebellum.* BZDs acts on GABAA receptors.* GABAa receptor has 5 subunits a / b, b, a / g.* GABA binding site is on b. subunit, while BZDs binding site is on a / g subunit.* BZDs receptor increase the conductance of Cl channel.* BZDs do not themselves increase Cl conductance, i.e. they have only GABA facilitatory but no GABA mimetic action. (Barbiturates have both GABA facilitatory and GABA mimetic actions).Effect on CNS* In contrast to barbiturates, BZDs are not general depressant, but exert relatively selective anxiolytic, hypnotic, muscle relaxant and anticonvulsant effects.* The antianxiety action of BZDs is not dependent on their sedative property - with chronic administration relief of anxiety is maintained, but drowsiness wanes off due to development of tolerance.* Stage 2 sleep is increased, while REM, Stage 3 & 4 sleep are decreased.* Nitrazepam is the only benzodiazepine, which increases REM sleep.* Clonazepan and diazepam have more marked muscle relaxant property.* Clonazepam, diazepam, nitrazepam and flurazepam have more prominent anticonvulsant activity than other BZDs.* Diazepam (but not other BZDs) has analgesic action.* Diazepam produces short lasting coronary dilatation on i.v. injection.* Diazepam decreases nocturnal gastric secretion and prevents stress ulcers.", "cop": 1, "opa": "GABAA - BZD - Cl- channel stimulator", "opb": "GABAB - BZD - Cl- channel stimulator", "opc": "BZD receptor stimulator", "opd": "NMDA receptor stimulator", "subject_name": "Pharmacology", "topic_name": "C.N.S", "id": "82f832ca-8d87-4daa-b8de-c69b146e0e84", "choice_type": "single"} {"question": "Drug used in mild hemoplilia is", "exp": "DDAVP is an analogue of ADH. It acts on V2 receptors to cause increased release of factor VIII and vWF from the endothelium. Due to this propey, it can be used for the treatment of mild hemophilia.", "cop": 2, "opa": "Coicosteroids", "opb": "DDAVP", "opc": "Vitamin K", "opd": "Tranexamic acid", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "5a3d01a2-7fca-4222-a2eb-fb6aa3b29b2b", "choice_type": "single"} {"question": "Carbachol acts as", "exp": "M2 agonist: MethacholineM3 agonists: Carbachol, bethanecholRef: Katzung 12th Ed.Pg 100", "cop": 2, "opa": "Agonist for M2 receptors", "opb": "Agonist for M3 receptors", "opc": "Agonist for M1 receptors", "opd": "Antagonist for M3 receptors", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "56952167-d835-4a04-b2d5-93ed2a47fd05", "choice_type": "single"} {"question": "Toxicity of Oral Xa inhibitors are treated by", "exp": "Andexanite alfa is a Xa factor analogue used to treat poisoning of Oral Xa inhibitors like Epixaban, Rivaroxaban.", "cop": 2, "opa": "Protamine sulphate", "opb": "Andexanet alfa", "opc": "Idarucizumab", "opd": "Argatroban", "subject_name": "Pharmacology", "topic_name": null, "id": "f1cc0f7e-727e-4bbd-ba3d-09970e65e065", "choice_type": "single"} {"question": "Drug of choice for Polycystic ovarian disease is", "exp": "Refer CMDT 2014/744 Oral contraceptives are used for the treatment of mennstrul irregularity These are the drug of choice for PCOD PCOD is also known as Stein-Levanthal syndrome. Weight loss by regular exercise low glycemic index diet combined with insulin lowering drugs like metformin can restore feility in 85 percnt of females For females who don't respond to weight loss, metformin therapy may be helpful", "cop": 3, "opa": "Metformin", "opb": "Estrogen", "opc": "Estrogen and progesterone combination pill", "opd": "Dopamine antagonist", "subject_name": "Pharmacology", "topic_name": "Kidney", "id": "9a450f13-2fd1-46fa-b4f5-ede9c76deeef", "choice_type": "single"} {"question": "Anticancer macrolide is", "exp": "Tacrolimus, sirolimus, everolimus are macrocyclic lactones or macrolides.Ref: KK Sharma 2nd ed. Pg: 885", "cop": 1, "opa": "Sirolimus", "opb": "Cycloserine", "opc": "Roxythromycin", "opd": "Azithromycin", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "e6c5f0f0-d965-458e-b670-9396c397a575", "choice_type": "single"} {"question": "Drugs within the following groups react unourably with lithium", "exp": "Causes worsening of lithium toxicity and renal damage", "cop": 1, "opa": "ACE inhibitors", "opb": "Morphine", "opc": "Valproate", "opd": "Antipsychotics", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "fce0a6db-309c-46db-bd13-3550ab71486f", "choice_type": "single"} {"question": "Mechanism of action of the sulfonylureas is", "exp": "Ans. is 'a' i.e., K ATP channel blocker * Sulfonylurease provoke a brisk release of insulin from pancreas. They act on the so called \"Sulfonylurea receptors\" (SUR1) on pancreatic b-cell membrane - cause depolarization by reducing conductance of ATP sensitive K+ channels. This enhances influx of Ca+2 - degranulation. They do not cause hypoglycemia in pancreatectomized animals and type 1 diabetes (Presence of at least 30% of functional b-cells in essential for their action). A minor action reducing glucagon secretion by increasing insulin and somatostatin release has been demonstrated.", "cop": 1, "opa": "K+ ATP channel blocker", "opb": "Na ATP channel blocker", "opc": "Cl ATP channel blocker", "opd": "Ca ATP channel blocker.", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "8d7ab965-4d7f-4dc9-a4b4-44bbc7334175", "choice_type": "single"} {"question": "Combination of ampicillin and gentamicin is an example of", "exp": null, "cop": 2, "opa": "Indifference", "opb": "Synergy", "opc": "Antagonism", "opd": "Bacterial symbiosis", "subject_name": "Pharmacology", "topic_name": null, "id": "ad642376-6aac-4b2b-8567-8ad81ef39e10", "choice_type": "single"} {"question": "Least narcotic", "exp": "Papaverine The term narcotic was derived from the Greek word \"stupor\". At one time, the term referred to any drug that induced sleep, but then it became associated with \"opioids\". Now it is often used in legal context to refer to a variety of substances with abuse or addictive potential. Least potent narcotic does not mean opioid with least analgesic activity. - It means substance which has least addictive or abuse potential. \"Papaverine is an alkaloid originally extracted from opium but devoid of narcotic propeies\". - It is present in opium but is structurally unrelated to morphine. - It is a nonspecific phosphodiesterase inhibitor and its principal action is to relax smooth muscles throughout the body. It is occasionally injected into an area where local vasodilation is desired especially into and around aeries and veins to relieve spasm during vascular surgery and when setting up intravenous infusions. It is also used to treat male erectile dysfunction - It is self injected in corpora cavernosa sholy before intercourse.", "cop": 4, "opa": "Morphine", "opb": "Codeine", "opc": "Heroine", "opd": "Papaverine", "subject_name": "Pharmacology", "topic_name": null, "id": "867e6df6-adbe-490d-8afa-2b2d2333ecc4", "choice_type": "single"} {"question": "A young man is with known heroin addiction is brought in the emergency in unconscious state. On examination, the patient has decreased bowel sounds, depressed respiration and pin point pupil. The treatment of choice for this patient is", "exp": "IV Naloxone 0.1-0.4 mg . Dose repeated every 1-2 hour as naloxone is sho acting. As patient is unconscious drug cannot be given orally. Ref: KD Tripathi 8th ed.", "cop": 2, "opa": "Oral natrexone", "opb": "IV naloxone", "opc": "Oral diazepam", "opd": "Oral Buprenorphine", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "a0b8f507-36c4-4c41-bcdc-baac48844847", "choice_type": "single"} {"question": "Respiratory depression is seen with", "exp": null, "cop": 3, "opa": "Tranquilizers", "opb": "Non-barbiturates", "opc": "Synthetic narcotics", "opd": "Antidepressants", "subject_name": "Pharmacology", "topic_name": null, "id": "2f133a6d-67b6-4939-a9ad-586f55fc076b", "choice_type": "single"} {"question": "Receptors for thyroid hormones are", "exp": null, "cop": 3, "opa": "G protein coupled receptors", "opb": "Cytoplasmic receptors", "opc": "Nuclear receptors", "opd": "Tyrosine Kinase receptor", "subject_name": "Pharmacology", "topic_name": null, "id": "b90b38b6-b0ff-495a-83ae-32ba4395e67c", "choice_type": "single"} {"question": "Indomethacin reduce the diuretic action of furosemide by", "exp": "NSAIDS inhibit specifically PGE2, PGI2 synthesis in renal tubules effecting the hemodynamic changes done by Prostaglandins for water, sodium reabsorption Ref: katzung 12th ed, Autocoids.", "cop": 1, "opa": "Preventing prostaglandin mediated heamodynamic actions", "opb": "Blockade of furosemide action in loop of henle", "opc": "Enhancing water reabsorption in distal tubule", "opd": "Increasing aldosterone secretion", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "e0fd9112-f81c-4339-a929-ca5ad91c99a7", "choice_type": "single"} {"question": "Peripheral neuritis is a complication of", "exp": null, "cop": 1, "opa": "Isoniazid", "opb": "Ethambutol", "opc": "Rifampicin", "opd": "Pyrazinamide", "subject_name": "Pharmacology", "topic_name": null, "id": "aa2a0ec7-1390-4881-9cdf-89f780b277f2", "choice_type": "single"} {"question": "Terlipressin is preferred over vasopressine for esophageal varices because of", "exp": "Ans. is'c'i.e., Iess side effects Terlipresin is preferred over vasopressin because : -Fewer adverse effectsGreater convenience in use", "cop": 3, "opa": "Faster acting", "opb": "Not metabolized", "opc": "Less side effects", "opd": "More potent", "subject_name": "Pharmacology", "topic_name": null, "id": "3c285e95-ee76-495f-a9fa-1054ea1dcfce", "choice_type": "single"} {"question": "Drug not useful in hypeensive emergency is", "exp": "Refer kDT 6/e p554 Indapamide is thiazide like diuretics, having mild diuretic effect, not used in emergency situation Indapamide is a thiazide-like diuretic drug generally used in the treatment of hypeension, as well as decompensated hea failure. Combination preparations with perindopril", "cop": 2, "opa": "IV Hydralizine", "opb": "Indapamide", "opc": "Sublingual nifedipine", "opd": "Sodium nitroprusside", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "e9604d54-abc8-4ae3-a2bf-00a816c69ca7", "choice_type": "single"} {"question": "Perampanel is", "exp": "Perampanel is recently approved selective non-competitive antagonist of AMPA receptorwhich is used as add on therapy for paial seizure. Adverse effect of this drug is somnolence, weight gain Felbamate is NMDA inhibitor Barbiturates are GABA mimetic Ethosuximide , valproate inhibit the calcium channels.", "cop": 2, "opa": "NMDA antagonist", "opb": "AMPA antagonist", "opc": "GABA mimetic", "opd": "Calcium channel inhibition", "subject_name": "Pharmacology", "topic_name": "Epilepsy", "id": "348c475d-be5c-4ff7-9c46-817134582127", "choice_type": "single"} {"question": "Digoxin is contraindicated in(REPEAT)", "exp": "non selective beta blockers(propanolol)are the Agents of choice for hyperophic obstructive cardiomyopathy in hyperophic obstructive cardiomyopathy, the left ventricular outflow tract is narrowed during systole due to hyperophic septum.. obstraction is worsened by Factors increasing myocardial contractility-digitalis,sympathetic stimulation factors decreasing left ventricular filling-valsalva maneuver,peripheral vasodilators Refer kDT 6/e p143", "cop": 4, "opa": "Supraventricular tachycardia", "opb": "Atrial fibrillation", "opc": "Congestive hea failure", "opd": "Hyperophic obstructive cardiomyopathy", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "cd86e541-eb14-4440-90d4-07371a2fa7bc", "choice_type": "single"} {"question": "An aminoglycoside that is often combined with\npolymyxin and bacitracin for the treatment of\ntopical infection is", "exp": null, "cop": 4, "opa": "Gentamycin", "opb": "Tetracycline", "opc": "Aztreonam", "opd": "Neomycin", "subject_name": "Pharmacology", "topic_name": null, "id": "c80bfdd0-e7ff-4a8f-b798-871833e20b55", "choice_type": "single"} {"question": "Idiosyncracy is known as to have", "exp": null, "cop": 1, "opa": "Genetic component", "opb": "Psychological component", "opc": "Physiological component", "opd": "Nutritional component", "subject_name": "Pharmacology", "topic_name": null, "id": "604d35ec-4818-4b71-8e0c-15f88b38c381", "choice_type": "single"} {"question": "Drug of choice for syphilis during pregnancy is", "exp": "Ans. c (Benzathine penicillin). (Ref. KD Tripathi - 4th/ 741, 751; William's Obstetrics - 780)# Penicillin is DOC during pregnancy as it also protects the newborn from developing syphilis.# If patient is allergic to penicillin, desensitize the patient & give penicillin (not erythromycin).DOC for syphilisPenicillinAlternative to penicillinErythromycinDuring pregnancyDOC (even if patient is allergic to penicillin) is Penicillin. (Because erythromycin never protect baby from developing syphilis)", "cop": 3, "opa": "Ampicillin", "opb": "Erythromycin", "opc": "Benzathine penicillin", "opd": "Tetracyclines", "subject_name": "Pharmacology", "topic_name": "Anti Microbial", "id": "f08cbd4e-56ae-42d3-86cf-e43019e7e939", "choice_type": "single"} {"question": "Neuro adaptation to drug is same as", "exp": null, "cop": 1, "opa": "Physical dependence", "opb": "Psychological dependence", "opc": "Addiction", "opd": "Habituation", "subject_name": "Pharmacology", "topic_name": null, "id": "50bc3448-9358-416e-b48a-25c11ccd0d57", "choice_type": "single"} {"question": "Wof is the most likely explanation for multiple drug resistance to antibiotics that spreads from one type of bacteria to another", "exp": "Gene transfer (infectious resistance) The resistance causing gene is passed from one organism to the other; is called horizontal transfer of resistance. Rapid spread of resistance can occur by this mechanism and high level resistance to several antibiotics (multidrug resistance) can be acquired concurrently. Ref :- kd tripathi; pg num:-692", "cop": 2, "opa": "Adaptation", "opb": "Gene transfer", "opc": "Mutation", "opd": "Decreased bioavailability", "subject_name": "Pharmacology", "topic_name": "Antibiotics", "id": "a95fdee4-f417-4c39-9191-1a6d9f9e22d0", "choice_type": "single"} {"question": "Mechanism of action of sodium nitrite in cyanide poisoning", "exp": "Cyanide poisoning:- Nitrates generate methaemoglobin which has high affinity for cyanide radical and forms cyanomethaemoglobin. However, this may again dissociate to release cyanide. Therefore, sodium thiosulfate is given to form Sod. thiocyanate which is poorly dissociable and is excreted in urine. Cytochrome and other oxidative enzymes are thus protected from cyanide. Ref:- kd tripathi; pg num:-545", "cop": 2, "opa": "Increased blood flow to liver", "opb": "Produces methemoglobinemia", "opc": "Increased blood flow to kidney", "opd": "Increased blood flow to hea", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "443f4d8c-e212-4483-b032-77c5353d9989", "choice_type": "single"} {"question": "Use of anticoagulant is", "exp": "Ans. is'a'i.e., Venous thrombosisRef : Katzung /e p. 599; l$hle p. 554Prophylaxis for venous thrombus:Heparin (unfractionated, LMW, or fondaparinux) and oral anticoagulants (warfarin).", "cop": 1, "opa": "Venous thrombosis", "opb": "Aerial thrombosis", "opc": "Vitamin K toxicity", "opd": "Hea failure", "subject_name": "Pharmacology", "topic_name": null, "id": "aee9f684-1aa3-42f1-9f4e-f560eabacdc1", "choice_type": "single"} {"question": "Doc for Gille de la tourette's syndrome", "exp": "Haloperidol:- It is a potent antipsychotic with strong D2 receptor blocking activity. it produces few autonomic effects, is less epileptogenic, does not cause weight gain, jaundice is rare. Uses-- It is the preferred drug for acute schizophrenia, Huntington's disease and Gilles de la Tourette's syndrome. Pharmacokinetics It is metabolised by CYP3A4 and 2D6 both. Elimination t 1/2 averages 24 hours. Ref:- kd tripathi; pg num:-441", "cop": 2, "opa": "Chlorpromazine", "opb": "Haloperidol", "opc": "Olanzapine", "opd": "Risperidone", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "8a49278c-5f00-4eea-bbed-d2202ecea3d7", "choice_type": "single"} {"question": "MOA of oral hypoglycemic agent", "exp": "Ans. (b) Enhance glucose uptake by skeletal muscleRef.: KDT 6th ed. / 267OHA DrugsMechanism of actionMetformin and thiazolidinedi- ones* Inhibition of hepatic gluconeogenesis* Enhance glucose uptake in skeletal muscleSulfonylureas and ripaglindeStimulate insulin release from pancreasAcarboseDecrease absorption of glucose from intestine", "cop": 2, "opa": "Inhibit glucose uptake by skeletal muscle", "opb": "Enhance glucose uptake by skeletal muscle", "opc": "Stimulate glycogenolysis", "opd": "Stimulate gluconeogenesis", "subject_name": "Pharmacology", "topic_name": "Anti Diabetes", "id": "e84b9ad6-4396-4cfb-bccc-24960c8a12e4", "choice_type": "single"} {"question": "Alemtuzumab is antibody against", "exp": "Ans. is'd'i.e., CD-52", "cop": 4, "opa": "CD-20", "opb": "VEGF", "opc": "EGFR", "opd": "CD-52", "subject_name": "Pharmacology", "topic_name": null, "id": "d4e7006a-1e2d-488c-933e-89cffc30283b", "choice_type": "single"} {"question": "Emesis receptor is", "exp": "ANSWER: (C) 5HT3REF: Goodman Gillman manual of pharmacology and therapeutics 2008 edition, page 646Iheprocessofnauseaandvomiting appears to be coordinated by a central emesis center in the lateral reticular formation of the mid-brainstem adjacent to both the chemoreceptor trigger zone (CTZ) in the area postrema (AP) at the bottom of the fourth ventricle and the solitary tract nucleus (STN) of the vagus nerve.The lack of a blood-brain barrier allows the CTZ to monitor blood and cerebrospinal fluid constantly for toxic substances and to relay information to the emesis center to trigger nausea and vomitingThe CTZ has high concentrations of receptors for serotonin (5-HT3), dopamine (D2), and opioids, while the STN is rich in receptors for enkephalin, histamine, and ACh, and also contains 5-HT3 receptors.The most effective agents for chemotherapy-induced nausea and vomiting are the 5-HT3 antagonists and metoclopramidePharmacological view of emetic stimuli", "cop": 3, "opa": "5HT1", "opb": "5HT2", "opc": "5HT3", "opd": "5HT4", "subject_name": "Pharmacology", "topic_name": "G.I.T", "id": "5d8b4b3d-dd81-4110-b2da-e87843cdaad6", "choice_type": "single"} {"question": "Large bilateral painless effusions of the knees occurring in late congenital syphilis in patients between ages 8 to 18 are designated as", "exp": ".", "cop": 1, "opa": "Clutton's joints", "opb": "Ramsey's joints", "opc": "Charcot's joints", "opd": "Mercer's joints", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "59533540-4a51-4a7f-b76b-ffcfac5af0e9", "choice_type": "single"} {"question": "As compared to unfranctioned heparin, low molecular weight heparins", "exp": "Refer Katzung 10/e p 546 Unlike unfranctioned heparin, LMW heparins have more consistent SC bioavalilabilty and thus do not require monitoring Adverse effects of both type of heparins are similar Both are contraindicated in heparin induced thrombocytopenia", "cop": 1, "opa": "Are absorbed more uniformly when given subcutaneously", "opb": "Require more frequent laboratory monitoring", "opc": "Can be given to patients with heparin induced thrombocytopenia", "opd": "Predispose to higher risk of osteopenia", "subject_name": "Pharmacology", "topic_name": "Respiratory system", "id": "cd97be1d-7ae4-4c8f-9749-fab1c46e2728", "choice_type": "single"} {"question": "Mechanism of action of paxclitaxel is", "exp": "Refer Katzung 10th/893 Refer KDT 6/e p825 Taxanes act by increasing the polymerization of beta tubulin whereas vinca alkaloid cause inhibition of tubulin polymerization. Both of these drugs act by causing the disruption of mitosis and are active in M phase of cell cycle", "cop": 2, "opa": "Topisomaerse inhibition", "opb": "Increase the polymerization of tubulin", "opc": "Inhibits protein synthesis", "opd": "Alkylation of DNA", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "9a7ac26c-c844-46a7-a5b9-ff0aa14a357f", "choice_type": "single"} {"question": "Antibiotic that achieves high concentration in Hard tissue, because of its molecular size is", "exp": null, "cop": 3, "opa": "Ceftum", "opb": "Ciprofloxacin", "opc": "Clindamycin", "opd": "Erythromycin", "subject_name": "Pharmacology", "topic_name": null, "id": "1b41dfd7-3310-4889-9dac-bfec0b75ba58", "choice_type": "single"} {"question": "Drug used for drug induced parkinsonism", "exp": "Sodium valproate, used to treat epilepsy, and lithium, used in depression, both commonly cause tremor which may be mistaken for Parkinson's. Some repos have linked SSRI antidepressant drugs such as fluoxetine (Prozac) to drug-induced parkinsonism but hard evidence of causeand effect is unsubstantiated. Ref: KD T ripathi 8th ed.", "cop": 3, "opa": "Levodopa", "opb": "Carbidopa", "opc": "Benzhexol", "opd": "Amantidine", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "d14fc398-1f71-44d6-87c2-7717759d75b9", "choice_type": "single"} {"question": "Coronary vasodilatation is caused by", "exp": "Refer kDT 7/e p536 It serves as a metabolic coupler between oxygen consumption andcoronary blood flow. ... Parasympathetic stimulation of the hea (i.e., vagal nerve activation) elicits modest coronary vasodilation(due to the direct effects of released acetylcholine on the coronaries). In some types of blood vessels, there is evidence that adenosine producesvasodilation through increases in cGMP, which leads to inhibition of calcium entry into the cells as well as opening of potassium channels. Incardiac tissue, adenosine binds to type 1 (A1) receptors, which are coupled to Gi-proteins.", "cop": 1, "opa": "Adenosine", "opb": "Bradykinin", "opc": "Histamines", "opd": "Ergotamine", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "f9f165c6-efce-454d-b9d3-fed5d89640eb", "choice_type": "single"} {"question": "Drug of choice for prevention of NSAID induced peptic ulcer disease is", "exp": "Ans. is 'b' i.e., Proton pump inhibitors * PPI are the DOC for peptic ulcer (gastric or duodenal), GERD, ZE syndrome, prevention of aspiratory pneumonia and NSAID induced gastric / duodenal ulcers. Note - PGE1 analogue (Misoprostol) is specific drug for prevention and treatment of NSAID induced ulcer, but DOC is PPL", "cop": 2, "opa": "H2 receptor blockers", "opb": "Proton pump inhibitors", "opc": "Macrolide antibiotic", "opd": "Sucralfate", "subject_name": "Pharmacology", "topic_name": "G.I.T", "id": "4b4f2b6f-4d6b-4d07-a2d5-302d0d3bc2a9", "choice_type": "single"} {"question": "Latanoprost (PGF0 alf", "exp": "ANSWER: (D) GlaucomaREF: Goodman and Gillmans 11TH edition page 1103, http://en.udkipedia.org/wiki/Latanoprost \"Latanoprost ophthalmic solution is a topical medication used for controlling the progression of glaucoma or ocular hypertension by reducing intraocular pressure. It is a prostaglandin analogue (more specifically an analogue of Prostaglandin F2a)\"\"The PGF2a analogs consist of Latanoprost, travoprost, bimatoprost, and unoprostone. PGF2a analogs appear to lower IOP by facilitating aqueous outflow\" through the accessory uveoscleral outflow pathway. The mechanism by which this occurs is unclear\"", "cop": 4, "opa": "Maintenance of ductus arteriosus", "opb": "Pulmonary hypertension", "opc": "Gastric mucosal protection", "opd": "Glaucoma", "subject_name": "Pharmacology", "topic_name": "A.N.S.", "id": "a4172efb-f144-4fe8-a620-45413b5d8b81", "choice_type": "single"} {"question": "Histamine release is one of the common features with administration of", "exp": "histamine is released by atracurium , all skeletal musle relaxants release histamine other drugs releasing histamine are morphine,vancomycin etc. Ref: kd tRipathi 8th ed.", "cop": 1, "opa": "Atracurium", "opb": "Adrenaline", "opc": "Thiopentone", "opd": "Ketamine", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "4cca43d7-4de8-4c01-9e68-39aad581997e", "choice_type": "single"} {"question": "Wof is an immunosuppressant that acts by inhibiting mTOR and is non nephrotoxic", "exp": "mTOR INHIBITORS Sirolimus This new and potent immunosup-pressant is a macrolide antibiotic (like tacrolimus), which was earlier named Rapamycin. Mech of action:- It binds to immunophillin FKBP and the sirolimus-FKBP complex inhibits kinase called 'mammalian target of rapamycin' (mTOR). uses:- 1)For prophylaxis and therapy of graft rejection reaction, sirolimus can be used alone, but is generally combined with lower dose of cyclosporine/tacrolimus and/or coicosteroids and mycophenolate mofetil. It is paicularly suitable for patients developing renal toxicity with cyclosporine.( Sirolimus is non nephrotoxic). 2)sirolimus coated stents are being used to reduce the incidence of coronary aery restenosis, by inhibiting endothelial proliferation at the site. Adverse effects:- Significantly, sirolimus is not nephrotoxic, but it can suppress bone marrow, mainly causing thrombocytopenia. Rise in serum lipids is common. Other adverse effects are diarrhoea, liver damage and pneumonitis. Ref:- kd tripathi; pg num:-882", "cop": 3, "opa": "Azathioprine", "opb": "Tacrolimus", "opc": "Sirolimus", "opd": "Rapamycin", "subject_name": "Pharmacology", "topic_name": "Immunomodulators", "id": "946868d8-9927-4cc0-9f25-1fd9cf8f5418", "choice_type": "single"} {"question": "Physiological antagonism is found in", "exp": "ref ; KD Tripathi pharmacology 7th edition (page no; 58) Physiological/functional antagonism; The two drugs act on different receptors or by different mechanisms but have opposite ove effects on the same physiological function, i. e . have pharmacological effects in the opposite direction, e.g.Histamine and adrenaline on bronchial muscles and BP Hydrochlorothiazide and triamterene on urinary k+ excretion Glucagon and insulin on blood sugar level. Ref: KD Tripathi 8th ed", "cop": 4, "opa": "Isoprenaline and salbutamol", "opb": "Isoprenaline and adrenaline", "opc": "Isoprenaline and propanolol", "opd": "Adrenaline and histamine", "subject_name": "Pharmacology", "topic_name": "General pharmacology", "id": "a343013b-a0c9-4c0f-b819-7d5b52789717", "choice_type": "single"} {"question": "Drug of choice for treatment of chloroquine resistant falciparum Malaria is", "exp": "Among the given options quinine is the best answer. DOC for uncomplicated chloroquine resistant P. Falciparum Malaria Is ACT", "cop": 1, "opa": "Quinine", "opb": "Chloroquine", "opc": "Pyrimethamine", "opd": "Primaquine", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "9db44221-cc06-41d9-9190-0e755d1b6fd2", "choice_type": "single"} {"question": "Drug of choice for hypeension with hyperlipidemia is", "exp": "Thiazide diuretics and beta blockers produce unourable lipid profile.Hence prazosin which is an alpha blocker is prefered as it has no effect on lipid profile. Ref: KD Tripathi 8th ed.", "cop": 1, "opa": "Prazosin", "opb": "Atenolol", "opc": "Thiazide", "opd": "Propranolol", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "d8da2252-e697-4c7a-81fb-e13e2a9d62c0", "choice_type": "single"} {"question": "Post dural (spinal) puncture headache is due to", "exp": "(Seepage of CSF) (517 - Lee's 13th) (360-KDT 6th)* Post spinal headache is due to seepage of CSF: can be minimised by using smaller bore needle (KDT)* Typical location is bifrontal and / or occipital* It is more common in Young pregnant patients and with accidental dural puncture rate during epidural anaesthesia using Touhyneedle (60 - 80%) Reduced by introduction of size 25 G and 27 - G whitacre pencil point needles. Which replaced cutting needles* Paralysis of cranial nerve. All cranial nerves except 1st, 9, 10th can be involved after spinal Anaesthesia. Most commonly (90%) 6th nerve is involved (Because of the longest course of 6th nerve)", "cop": 1, "opa": "Seepage of CSF", "opb": "Fine needle", "opc": "Toxic effects of the drugs", "opd": "Traumatic damage to nerve roots", "subject_name": "Pharmacology", "topic_name": "Anaesthesia", "id": "89f2b9da-cbe5-4816-a4c2-7ac6b11e26d7", "choice_type": "single"} {"question": "Linaclotide is a", "exp": "Linaclotide is a Guanylate cyclase - C agonist that increases levels of cGMP and stimulates secretion of chloride & bicarbonate ions into the intestinal lumen. It is used in treatment of IBS with constipation.", "cop": 4, "opa": "Chloride channel activator", "opb": "CFTR blocker", "opc": "Somatostatin antagonist", "opd": "Guanylate cyclase agonist", "subject_name": "Pharmacology", "topic_name": null, "id": "86a598a6-7160-4ebe-8943-6b9d8642204a", "choice_type": "single"} {"question": "An antibiotic not acting on tubulin is", "exp": "ANSWER: (A) BleomycinREF: Goodman Gillman manual of pharmacology and therapeutics 2008 edition various pages, h ttp://e n. wikipe dia. org/wiki/ Spindle_poisonMitotic spindle poisons:These poisons disrupt cellular reproduction by affecting the protein threads which connect the centromere regions of chromosomes, known as spindles (tubulin).MebendazoleColchicineGriesofulvinVinca Alkaloids (vincristine, vinblastine)Paclitaxel (Taxans)", "cop": 1, "opa": "Bleomycin", "opb": "Colchicine", "opc": "Paclitaxel", "opd": "Vincristine", "subject_name": "Pharmacology", "topic_name": "Anti Microbial", "id": "0ab8fadc-2e9c-45c3-9389-f3dcc48c6904", "choice_type": "single"} {"question": "Antiarrhythmic drugs not causing torsade De points are", "exp": "Refer kDT 6/e 510 Torsedes de points is seen with potassium channel blocker (class 1 and class 3 antiarrhythmic drugs) Eg: beryllium, ibutilide,disopyramide, quinidine, procainamide", "cop": 4, "opa": "Quinidine", "opb": "Disopyramide", "opc": "Procainamide", "opd": "Lidocaine", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "242ca920-1729-4721-bced-e9d45c39baa8", "choice_type": "single"} {"question": "Drug of choice for essential tremors", "exp": "Ref: HL Sharma 3rd ed pg no:189 Nonselective beta blockers are used for essential tremors they occur due to contraction of skeletal muscles (beta 2 receptors) cardioselective beta blockers are not useful", "cop": 2, "opa": "Sotalol", "opb": "Propranolol", "opc": "Methylphenidate", "opd": "prazosin", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "67cc93ee-16f6-4bc9-9168-6aae263cb3f6", "choice_type": "single"} {"question": "Inhalational form of Insulin is", "exp": "Afrezza is the inhalational form of insulin used to treat post prandial hyperglycemia.", "cop": 2, "opa": "Lispro", "opb": "Afrezza", "opc": "Humulin", "opd": "Ultralente", "subject_name": "Pharmacology", "topic_name": null, "id": "42cc9322-108d-4aaa-84fb-549b3006346a", "choice_type": "single"} {"question": "Alkaline diuresis is done for treatment of poisoning due to", "exp": "Alkaline diuresis is useful for poisoning of acidic drugs as acidic drugs ionize in alkaline medium ionized drugs will get eliminated easily eg for acidic drugs- Barbiturates, benzodiazepines, tetracyclines, penicillins, sulphonamides, etc Ref: KD Tripathi pharmacology 7th edition (page.no: 81)", "cop": 3, "opa": "Morphine", "opb": "Amphetamine", "opc": "phenobarbitone", "opd": "Atropine", "subject_name": "Pharmacology", "topic_name": "General pharmacology", "id": "21bc15c4-b93f-4cb2-be12-1349fcb36f72", "choice_type": "single"} {"question": "Dobutamine is preferred over Dopamine in cardiogenic shock because of its effects related to", "exp": "Dobutamine is a catecholamine with b-1 and b-2 adrenergic agonist propeies which help improve myocardial contractility. In patients with cardiogenic shock due to decompensated hea failure,dobutamine decreases left ventricular end-diastolic pressure and raises blood pressure by increasing cardiac output. Refer kDT 7/e p 134", "cop": 2, "opa": "Better cardiac stimulation", "opb": "Less peripheral Vasoconstriction", "opc": "Lower risk of cardiac Arrythymia", "opd": "More CNs stimulation", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "9ae2bca6-a4a9-407f-a204-bcd7ae00f47c", "choice_type": "single"} {"question": "Bevacizumab is used in", "exp": "Bevacizumab is an anti-VEGF monoclonal antibody used in renal cell carcinoma.Ref: Goodman Gillman 12th ed; Pg 1739", "cop": 3, "opa": "Breast carcinoma", "opb": "Hepatic carcinoma", "opc": "Renal carcinoma", "opd": "Lung carcinoma", "subject_name": "Pharmacology", "topic_name": "Immunomodulators", "id": "4f9124b5-c204-4415-bc4d-f5ff0542fb53", "choice_type": "single"} {"question": "The drugs increasing trabecular outflow in glaucoma is", "exp": "Miotics like pilocarpine increase trabecular outflow in glaucoma Beta blockers and CA inhibitors decrease aqueous production PG analogues increase UV outflow Ref: KDT 6th ed pg 145", "cop": 3, "opa": "Beta-blockers", "opb": "CA inhibitors", "opc": "Miotics", "opd": "PG analogues", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "f8dc30d9-39fe-4ca7-85b4-32d3f9cc7120", "choice_type": "single"} {"question": "Drug commonly used in the treatment of iridocyclitis is", "exp": "Atropine is used in iridocyclitis to break adhesions in the uveal tract Ref: KDT 6th ed pg 116", "cop": 2, "opa": "Phenylephrine", "opb": "Atropine", "opc": "Darifenacin", "opd": "Solifenacin", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "3278b31a-bcd0-4a6f-b7fb-76d85610f521", "choice_type": "single"} {"question": "Drug H is most like", "exp": "The effects of Drug H are changed by treatment with either an alpha or beta blocker, so Drug H must have activity at both receptors (choices B, D, and E are ruled out). \"Reversal\" of a pressor effect can only occur if the drug has beta2 activity (choice C is ruled out). Drug H is epinephrine.", "cop": 1, "opa": "Epinephrine", "opb": "Isoproterenol", "opc": "Norepinephrine", "opd": "Phenylephrine", "subject_name": "Pharmacology", "topic_name": "A.N.S.", "id": "59f161c1-687e-4fd1-9c14-5749f92edea7", "choice_type": "single"} {"question": "Safest treatment for hyperthyroidism in pregnant women is", "exp": "Ans. d (Propylthiouracil). (Ref. Harrison, Internal Medicine, 18th ed.,/Chapter 40., KD Tripath 5th/232)Propylthiouracil:# During pregnancy thyroidectomy and I131 are contraindicated. With anti-thyroid drugs risk of foetal hypothyroidism and goiter are there.# However, low doses of propylthiouracil are preferred as it has greater protein binding, allowing less transfer to foetus. For the same reason it is preferred in nursing mothers also.HYPERTHYROIDISM IN PREGNANCYHyperthyroidism in pregnancy should be aggressively evaluated and treated. It is most commonly caused by Graves disease, but autonomously functioning nodules, gestational trophoblastic disease, thyroiditis, and hyperemesis gravidarum should also be considered. Methimazole crosses the placenta to a greater degree than propylthiouracil and has been associated with fetal aplasia cutis. However, propylthiouracil can be associated with liver failure. Some experts recommend propylthiouracil in the first trimester and methimazole thereafter. Radioiodine should not be used during pregnancy, either for scanning or treatment, because of effects on the fetal thyroid. In emergent circumstances, additional treatment with beta blockers and a saturated solution of potassium iodide may be necessary. Hyperthyroidism is most difficult to control in the first trimester of pregnancy and easiest to control in the third trimester.", "cop": 4, "opa": "Radioactive iodine", "opb": "Methimazole", "opc": "Carbimazole", "opd": "Propylthiouracil", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "441dfb2d-9404-42f3-bb40-3e4df579899c", "choice_type": "single"} {"question": "Floppy baby syndrome occurs due to fetal exposure to", "exp": "Adverse effects of lithium Nephrogenic Diabetes Insipidus Hypothyroidism ECG Changes Reversible elevation of T waves Fine Tremor(MC) Nausea , Loose Stools Leucocytosis Teratogenecity: Fetal Li+ exposure is associated with Neonatal goiter, CNS depression, Hypotonia (\"floppy baby\" syndrome) Ebstein's anamoly", "cop": 4, "opa": "Warfarin", "opb": "Valproate", "opc": "Phenytoin", "opd": "Lithium", "subject_name": "Pharmacology", "topic_name": "Psychiatric Illness", "id": "a6a385de-9273-47e3-b54e-a378cf25d8a8", "choice_type": "single"} {"question": "Radiation protector drug in clinical use among the following is", "exp": "Amifostine is used therapeutically to reduce the incidence of neutropenia-related fever and infection induced by DNA-binding chemotherapeutic agents including alkylating agents and platinum-containing agents . It is also used to decrease the cumulative nephrotoxicity associated with platinum-containing agents. Amifostine is also indicated to reduce the incidence of xerostomia in patients undergoing radiotherapy for head and neck cancerReference: Perez and Brady&;s textbook of radiation oncology; 6th edition", "cop": 1, "opa": "Amifostine", "opb": "Cisplatin", "opc": "Mesna", "opd": "Tirapazamine", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "41f2965c-fd9b-43ce-ac28-30d62d21372d", "choice_type": "single"} {"question": "Antiparkinson's drug known to cause cardiac valvular fibrosis is", "exp": "Pergolide, ergot derivative, directly stimulates both D1 and D2 receptors. It has been widely used for parkinsonism but is no longer available because its use has been associated with the development of valvular hea disease.Reference: Katzung Pharmacology; 13th edition; Chapter 28; Pharmacologic Management of Parkinsonism & Other Movement Disorders", "cop": 4, "opa": "Levodopa", "opb": "Ropinirole", "opc": "Pramipexole", "opd": "Pergolide", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "aafd05ba-1121-4f53-b1cf-44ec4c586daa", "choice_type": "single"} {"question": "Cloudy swelling is due to (not related)", "exp": ".", "cop": 1, "opa": "Accumulation of water intracellularly", "opb": "Lysozyme degeneration", "opc": "Fat accumulation intracellularly", "opd": "Glycogen accumulation", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "e94d26a7-d06d-4f08-83c2-68b575d31ba5", "choice_type": "single"} {"question": "Mechanism of action of transexaminic acid is", "exp": "Ans. is `d' i.e., Prevents fibrinolysis", "cop": 4, "opa": "Decrease vascular permeability", "opb": "Smooth muscle contraction", "opc": "Activates Plasmin formation", "opd": "Prevents fibrinolysis", "subject_name": "Pharmacology", "topic_name": null, "id": "ccf0e097-f39e-42e3-a168-f7e0397f1c02", "choice_type": "single"} {"question": "Omeprazol is used in the treatment of", "exp": null, "cop": 1, "opa": "Peptic Ulcer", "opb": "Amoebiasis", "opc": "Malaria", "opd": "Cholera", "subject_name": "Pharmacology", "topic_name": null, "id": "08f001a2-5384-4899-8c2a-39193449ad3c", "choice_type": "single"} {"question": "Thiazides do not produce", "exp": "Loop and thiazide diuretics cause loss of H+ ions in urine.body will be in metabolic alkalosis state .potassium sparing diuretics cause metabolic acidosis.Ref:Katzung 10th ed Pg 246", "cop": 2, "opa": "Hyperglycemia", "opb": "Acidosis", "opc": "Alkalosis", "opd": "Hyperlipidemia", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "21f8375f-62a9-432a-884b-e47f660513f3", "choice_type": "single"} {"question": "Trimetazidine acts by", "exp": "It  inhibits pFox enzyme and inhibits β - oxidation of fatty acids and increases glucose oxidation. Thus reduces the oxygen consumption & demand in an ischaemic cell.", "cop": 3, "opa": "Inhibiting Rhokinase", "opb": "Inhibits Molecular light chain kinase (MLCK) and increase cGMP", "opc": "Inhibits pFox enzyme and inhibits β - oxidation of Fatty acids", "opd": "Inhibits sodium channels and decreases funny current", "subject_name": "Pharmacology", "topic_name": null, "id": "ed26922b-ba58-4053-a1e6-69b6bd940139", "choice_type": "single"} {"question": "The antiulcer agent detaches and kills H. Pylori organism and prevent relapses is", "exp": null, "cop": 1, "opa": "Colloidal Bismuth", "opb": "Pirenzipine", "opc": "Misoprostol", "opd": "Sucralfate", "subject_name": "Pharmacology", "topic_name": null, "id": "b004ef65-f7ff-4578-bd30-127ad66680c3", "choice_type": "single"} {"question": "Fenoldapam is", "exp": "Fenoldopam is a agonist  at D1 & α2 receptor and used in hypertensive emergencies.", "cop": 3, "opa": "D1 agonist", "opb": "D1 α1 β1 agonist", "opc": "D1, α2 agonist", "opd": "D1 D2 agonist", "subject_name": "Pharmacology", "topic_name": null, "id": "fb8c6076-9dd0-401b-b791-578cbc098bbc", "choice_type": "single"} {"question": "Drug of choice for pregnant female suspected of having a baby with congenital adrenal hyperplasia is", "exp": "Dexamethasone is very potent and highly selective glucocoicoid to be staed before 10 weeks of gestation to suppress fetal androgen production effectively It has a long duration of action and cause marked pituitary-adrenal suppression. DOC for CAH is hydrocoisone but DOC for pregnant women having baby with CAH - dexamethasone REF.Essential of medical pharmacology K D TRIPATHI 6 Edition, Page No - 283", "cop": 1, "opa": "Dexamethasone", "opb": "Betamethasone", "opc": "Hydrocoisone", "opd": "Predinsolone", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "2cc8c4ee-0c00-4835-8157-34efb1927cf9", "choice_type": "single"} {"question": "Alprostadil is used for", "exp": "Ref: HL Sharma 3rd ed pg no: 370 alprostadil - PGE1 analog used for erectile dysfunction -produces vasodilatation if it is used for PDA, It could lead to ductus fragility and rupture", "cop": 1, "opa": "Erectile dysfunction", "opb": "Pulmonary hypeension", "opc": "PDA", "opd": "Critical limb ischemia", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "111eed2e-7014-41ec-9a73-ca8b5a08e7b1", "choice_type": "single"} {"question": "A patient with hypeension also suffers from essential tremor. Optimal treatment of the patient should include management with", "exp": "Essential Tremor is the commonest movement disorder. It can present in childhood but dramatically increases in prevalence over the age of 70 years. ET is characterized by a high-frequency tremor (6-10 Hz) that predominantly affects the upper extremities. The tremor most often manifest as a postural or action (kinetic) tremor and, in severe cases, can interfere with functions such as eating and drinking. It is typically bilateral and symmetric but may begin on one side and remain asymmetric. TREATMENTMany cases are mild and require no treatment other than reassurance. Beta blockers and primidone are the standard drug therapies for ET and help in about 50% of cases. Propranolol (20-120 mg daily, given in divided doses) is usually effective at relatively low doses, but higher doses may be effective in some patients. The drug is contraindicated in patients with bradycardia or asthma.Reference: Harrison&;s Principles of Internal Medicine; 19th edition; Chapter 449 Parkinson's Disease and Other Movement Disorders", "cop": 1, "opa": "Propranolol", "opb": "Clonidine", "opc": "Metoprolol", "opd": "Lidocaine", "subject_name": "Pharmacology", "topic_name": "Kidney", "id": "1f4243ce-6071-4f25-ba77-6399ba20bb31", "choice_type": "single"} {"question": "Renal stones are seen as a complication by using the following drug", "exp": "Side effects of zonisamide are metabolic acidosis, renal stones, somnolence, dizziness, headache, irritability and anorexia. REF; KD TRIPATHI 8TH ED.", "cop": 3, "opa": "Tiagabine", "opb": "Oxacarbamazepine", "opc": "Zonisamide", "opd": "Phenytoin", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "c1a54dde-7e66-4a5d-b643-ded9bd92b466", "choice_type": "single"} {"question": "'Diffusion hypoxia' is likely to occur only after use of nitrous oxide because it", "exp": "Nitrous oxide (N2O) N2O having low blood solubility rapidly diffuses into alveoli and dilutes the alveolar air, and PP of oxygen in alveoli is reduced. The resulting hypoxia, called diffusion hypoxia, is not of much consequence if cardiopulmonary reserve is normal, but may be dangerous if it is low. Diffusion hypoxia can be prevented by continuing 100% O2 inhalation for a few minutes after discontinuing N2O, instead of straight away switching over to air. Diffusion hypoxia is not significant with other , anaesthetics because they are administered at low concentrations (0.2-4%) and cannot dilute alveolar air by more than 1-2%. Ref:- kd tripathi; pg num:-376", "cop": 2, "opa": "It Is a respiratory depressant", "opb": "Has low blood solubility and is used in high concentration", "opc": "It Is a very potent anaesthetic", "opd": "Interferes with diffusion of oxygen into the tissues", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "42817281-04f9-4465-9895-afbc918d9a36", "choice_type": "single"} {"question": "A young man is with known heroin addiction is brought in the emergency in an unconscious state. On examination, the patient has decreased bowel sounds, depressed respiration and pinpoint pupil. The treatment of choice for this patient is", "exp": null, "cop": 2, "opa": "Oral naltrexone", "opb": "IV naloxone", "opc": "Oral diazepam", "opd": "Oral Buprenorphine", "subject_name": "Pharmacology", "topic_name": null, "id": "f3f8b758-ee8f-49f2-9a74-cf4bb920dbb2", "choice_type": "single"} {"question": "The drug recently approved to be used along with phenteramine in the management of obesity is", "exp": null, "cop": 3, "opa": "Lorcaserin", "opb": "Orlistat", "opc": "Topiramate", "opd": "Sibutramine", "subject_name": "Pharmacology", "topic_name": null, "id": "4ee5763a-5eba-4e25-936c-4321cd66b7ff", "choice_type": "single"} {"question": "Contraindications of beta blockers are", "exp": "Ref:KD Tripathi pharmacology 7th edition (page.no: 146) the beta blocker is contraindicated in asthma because of beta 2 blocking effect (beta 2 agonist cause bronchodilation). Uses of beta blockers are Hypeension, Myocardial infarction, Pheochromocytoma, Cardiac arrhythmias, Thyrotoxicosis, MIGRAINE, essential tremors etc", "cop": 1, "opa": "Asthma", "opb": "Myocardial infarction", "opc": "Hypeension", "opd": "Arrhythmia", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "a46b1766-c903-406e-a6ef-b6a3814dded8", "choice_type": "single"} {"question": "Afrezza is used to treat post prandial hyperglycemia available in color coded formulations yellow colour indicates", "exp": "Afrezza is inhalational form of insulin available in color coded forms\nBlue : 4IU\nGreen : 8IU\nYellow : 12IU", "cop": 3, "opa": "4IU", "opb": "8IU", "opc": "12IU", "opd": "16IU", "subject_name": "Pharmacology", "topic_name": null, "id": "e9201daf-9319-4030-8c6d-d458aa467d69", "choice_type": "single"} {"question": "Nephrotoxicity is seen with", "exp": "(B) Aminoglycoside DRUGS ASSOCIATED WITH ACUTE RENAL FAILUREPre-renalIntrinsicPost-renal* Diuretics* ACE inhibitors* ARBs* NSAIDs* Cyclosporine* Interferon* lnterleukin-2* Tacrolimus* Radiocontrast dye* Aminoglycosides* Foscarnet* Amphotericin B* Penicillins* Rifampin* Immunoglobulin* Methotrexate,* Lithium,* Tetraclines,* Phenytoin,* Cimetidine,* Cocaine,* Mannitol,* Statins,* Cidofovir,* Pentamidine,* Fluoroquinolones,* Allopurinol,* Cisplatin,* Cephalosporins,* Thiazide diuretics,* Ifosfamide,* Indinavir,* Gold,* Mesalamine* Indinavir* Acyclovir* Sulfonamides", "cop": 2, "opa": "Doxycycline", "opb": "Aminoglycoside", "opc": "Erythromycin", "opd": "Riafampicin", "subject_name": "Pharmacology", "topic_name": "Miscellaneous (Pharmacology)", "id": "49b3ffaf-f41c-42e4-935c-451579a635c4", "choice_type": "single"} {"question": "Most commonly used insulin for emergencies of diabetes like diabetes ketoacidosis", "exp": "Regular-actrapid insulin is most commonly used for DKA, Hyperosmolar coma. But the ultra long acting and ultra shio accting insulin are not preferred in emergency situations. other treatment for DKA is 0.9% normal saline , regular insulin I.V,management o f metabolic acidosis due to ketone bodies . Ref: Katzung 12 th ed.", "cop": 2, "opa": "Lispro", "opb": "Regular", "opc": "Aspa", "opd": "Glargine", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "8deaf2b4-06e6-4bb1-825d-9c614f3e9c61", "choice_type": "single"} {"question": "Disulfiram like reaction is seen with", "exp": "Chlorpropamide is a sulphonyl urea that causes Disulfiram like reaction and also dilutional hyponatremia.", "cop": 2, "opa": "Phenformin", "opb": "Chlorpropamide", "opc": "Glibenclamide", "opd": "Exenatide", "subject_name": "Pharmacology", "topic_name": null, "id": "c7e1fb8d-aecc-4717-a901-d4cda9ff06e6", "choice_type": "single"} {"question": "The following Potassium channel opener is used in angina", "exp": "Nicorandil, minoxidil, pinacidil are potassium channel openers used in angina which produce hyperpolarization. and causing the vasodilation and reducing the oxygen demand and increase the oxygen supply yo the infracted area. Ref: KD Tripathi 8th ed.", "cop": 1, "opa": "Nicorandil", "opb": "Hydralazine", "opc": "Fasudil", "opd": "Ranolazine", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "0a459354-c882-4662-8d3f-fd0534329f3d", "choice_type": "single"} {"question": "Selective Alpha 2a agonist is", "exp": "Clonidine, Tizanidine are selective alpha 2 agonists. But dexmedetomidine is more selective acting on Alpha 2a receptors-cause sedation. Used as pre-anesthetic medication. Ref: H.L. Sharma 3rd ed Pg:179", "cop": 4, "opa": "Tizanidine", "opb": "Terazosin", "opc": "Yohimbine", "opd": "Dexmedetomidine", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "2d5c47eb-e457-4521-a53e-9a5273d3b107", "choice_type": "single"} {"question": "Drug of choice for myoclonic seizures is", "exp": "Ans. is 'a' i.e., Valproic acid", "cop": 1, "opa": "Valproic acid", "opb": "Phenytoin", "opc": "Ethosuximide", "opd": "Carbamazepine", "subject_name": "Pharmacology", "topic_name": null, "id": "9b082cff-d729-4918-b317-70f1d4076776", "choice_type": "single"} {"question": "Sibutramine is indicated for", "exp": "Ref: HL Sharma 3rd ed pg no: 334 sibutramine is used for obesity as it decreases appetite rimonabant also could be used, but it is banned", "cop": 2, "opa": "Smoking cessation", "opb": "Obesity", "opc": "weight loss", "opd": "Mania", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "3dcf765d-0676-41a8-80b3-6afe2481d797", "choice_type": "single"} {"question": "Drug the choice for hyperthyroidism in first trimester of pregnancy is", "exp": "Propylthiouracil is the only thioamide which is least teratogenic and hence it is the drug of choice to hyperthyroidism in pregnancy and lactation.", "cop": 2, "opa": "Methimazole", "opb": "Propylthiouraril", "opc": "Carbimazole", "opd": "Perchlorate", "subject_name": "Pharmacology", "topic_name": null, "id": "8a4b25d1-a225-465a-9845-b866b911232b", "choice_type": "single"} {"question": "The most potent drug to reduce the plasma low density lipoprotein cholesterol level is", "exp": "Refer kDT 6/e p 614 The Most Common Cholesterol Meds: Statins These are usually the first type ofdrug that doctors prescribe to lower LDL. They also lower triglycerides, which are another type of blood fat, and mildly raise your \"good\" (HDL)cholesterol. Statins include: Atorvastatin (Lipitor", "cop": 4, "opa": "Plant sterols", "opb": "Fibrates", "opc": "Anion exchange resins", "opd": "Statins", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "c5c3d7e6-0867-4985-bcfd-d9e264964f51", "choice_type": "single"} {"question": "Dobutamine differs from dopamine in that", "exp": "Dopamine (DA):- It is a dopaminergic (D1 and D2) as well as adrenergic a and b1 (but not b2) agonist. Dobutamine:- A derivative of DA, but not a D1 or D2 receptor agonist. Though it acts on both a and b adrenergic receptors. Ref:- kd tripathi; pg num:-134", "cop": 4, "opa": "It has good blood-brain barrier penetrability", "opb": "It causes pronounced tachycardia", "opc": "It does not activate adrenergic b receptors", "opd": "It does not activate peripheral dopaminergic receptors", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "b59118d8-34fc-4814-935c-523da1791c48", "choice_type": "single"} {"question": "First to recover after muscle relaxants", "exp": "The sequence of recovery is in the same way as it goes i.e., first to recover are central muscles like larynx and diaphragm and then limb muscles. Ref: KATZUNG 12 th ed.", "cop": 3, "opa": "Laryngeal muscles", "opb": "Abdominal muscles", "opc": "Diaphragm", "opd": "Thenar muscles", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "cf02f413-724c-43ae-9532-1d95d388bc13", "choice_type": "single"} {"question": "Most impoant mechanism of development of resistance to drugs in tuberculosis is", "exp": "Most impoant mechanism of development of resistance to anti-tubercular drugs is mutation. DRUG RESISTANCE MUTATION IN GENE Rifampicin rpoB Isoniazid katG and inhA Ethambutol embB Pyrazinamide pncA", "cop": 4, "opa": "Transduction", "opb": "Conjugation", "opc": "Transformation", "opd": "Mutation", "subject_name": "Pharmacology", "topic_name": "Antimicrobial Drugs", "id": "392ec82a-44cd-4124-9faa-53f47bdcafa3", "choice_type": "single"} {"question": "Most specific drug used for NSAID induced peptic ulcer", "exp": "Gastric mucosal damage:- Gastric pain, mucosal erosion/ulceration and blood loss are produced by all NSAIDs to varying extents. Mech of peptic ulcer formation:- Inhibition of COX-1 mediated synthesis of gastroprotective PGs (PGE2, PGI2) is clearly involved. Deficiency of PGs reduces mucus and HCO3- secrection, tends to enhance acid secretion and may promote mucosal ischaemia. Thus, NSAIDs enhance aggressive factors and contain defensive factors in gastric mucosa--are ulcerogenic. Paracetamol, a very weak inhibitor of COX is practically free of gastric toxicity and selective COX-2 inhibitors are relatively safer. Treatment:- PGE2 analogue (misoprostol) administered concurrently with NSAIDs counteract their gastric toxicity. DOC for NSAID induced peptic ulcer is PPI. Ref:- kd tripathi;pg num:-194", "cop": 1, "opa": "Misoprostol", "opb": "Proton pump inhibitors", "opc": "H2 blockers", "opd": "Mucaine gel", "subject_name": "Pharmacology", "topic_name": "Autacoids", "id": "5b15da45-8dd0-4d27-81f0-8ed2e6d7fb76", "choice_type": "single"} {"question": "A patient suffering from syphilis is given penicillin. He may develop", "exp": null, "cop": 4, "opa": "Cholestatic Jaundice", "opb": "Grey syndrome", "opc": "Fanconi Syndrome", "opd": "Jarish — Herxheimer reaction", "subject_name": "Pharmacology", "topic_name": null, "id": "9825b1bd-c2f5-44ea-b7b9-fcaec5d72a1c", "choice_type": "single"} {"question": "Brinzolamide is a", "exp": "Ans is 'd' i.e. Highly specific reversible and noncompetitive carbonic anhydrase inhibitor o Carbonic anhydrase inhibitors act by a non-competitive, reversible inhibition of the enzyme carbonic anhydrase. o Brinzolamide is a highly .specific inhibitor of carbonic anhydrase II (CA II), which is the main carbonic anhydrase isoenzyme involved in the secretion of aqueous humour. o Inhibition caused by brinzolamide is reversible and non-competitive.", "cop": 4, "opa": "Highly specific irreversible and noncompetitive carbonic anhydrase inhibitor", "opb": "Highly specific irreversible and competitive carbonic anhydrase inhibitor.", "opc": "Highly specific reversible and competitive carbonic anhydrose inhibitor", "opd": "Highly specific reversible and non-competitive carbonic anhydrase inhibitor.", "subject_name": "Pharmacology", "topic_name": null, "id": "4e613b22-82b7-4997-a481-4eb9f1dc0b16", "choice_type": "single"} {"question": "Plasma half life of Carbimazole is", "exp": "Refer KDT 6/e p 250 Half life of Carbimazole is around 8 hours Where'as propylthiouracil has t1/2 of 2hrs", "cop": 2, "opa": "4 hrs", "opb": "8 hrs", "opc": "16 hrs", "opd": "24 hrs", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "79e55e9a-89e2-43ed-a5f5-e2a4b048bf5e", "choice_type": "single"} {"question": "Misoprostol is a", "exp": "Natural prostaglandin in body is PG E2 whereas Misoprostol and alprostadil are synthetic prostaglandins which are PG E1 analogues. Refer kDT 6/e p181", "cop": 1, "opa": "Prostaglandin E1 analogue", "opb": "Prostaglandin E2 analogue", "opc": "Prostaglandin antagonist", "opd": "Antiprogestin", "subject_name": "Pharmacology", "topic_name": "Autacoids", "id": "30d64046-3391-4717-9049-146187e06b49", "choice_type": "single"} {"question": "Common dose dependant side effects of Ethambutol is", "exp": "(Loss of visual acuity) (701-KDT) (742-43-KDT 6th)ETHAMBUTOL - It is distributed widely but penetrates meninges incompletely and is temporarily stored in RBC's* * Loss of visual acuity/ colour vision, field defects due to optic neuritis is the most important dose and duration of therapy dependent toxicity.* It should not be used below 6 years of age.* * Hyperuricemia is due to interference with urate excretion.", "cop": 2, "opa": "Red-urine", "opb": "Loss of visual acuity", "opc": "Nephropathy", "opd": "Peripheral neuropathy", "subject_name": "Pharmacology", "topic_name": "Anti Microbial", "id": "51a9b22a-fbb9-41fc-b022-af53e30a1e87", "choice_type": "single"} {"question": "Drug of choice for central diabetes insipidus", "exp": "Ans. is'b'i.e., DesmopressinDesmopressin (intranasal) is the DbC for central DI.", "cop": 2, "opa": "Vasopressin", "opb": "Desmopressin", "opc": "Lypressin", "opd": "Presselin", "subject_name": "Pharmacology", "topic_name": null, "id": "51caac51-a6aa-4398-93e1-7945d3f4082c", "choice_type": "single"} {"question": "Black widow spider toxin is known to cause", "exp": "Excess release of Acetylcholine Black widow spider toxin Induces massive release and depletion of acetylcholine Decrease release of Acetylcholine Botulinum toxin Inhibits synthesis of Acetylcholine Hemicholinium (HC3) blocks choline uptake (the rate limiting step in Achsynthesis) and depletes Ach Active transpo of ACh into synaptic vesicle Inhibited by vesamicol", "cop": 1, "opa": "Excess release of Acetylcholine", "opb": "Decrease release of Acetylcholine", "opc": "Inhibits synthesis of Acetylcholine", "opd": "Blocking Active transpo of ACh into synaptic vesicle", "subject_name": "Pharmacology", "topic_name": "Parasympathetic System & Glaucoma", "id": "e11332df-c198-42f9-aa4e-f66b50ba91ce", "choice_type": "single"} {"question": "Agent causing hemorrhagic cystitis", "exp": "Ans: a (Cyclophosphamide)Ref: KD Tripathi, 6th ed. Pg. 822Haemorrhagic cystitis is caused by a metabolite of cyclophosphamide - acrolein If severe, the cystitis may be effectively treated by mesna.Drugs causing Haemorrhagic cystitisIfosfamide Cyclophosphamide Aniline or toluidine derivatives Penicillins - rare Danazol - rare Ifosfamide is the most common cause of haemorrhagic cystitis.", "cop": 1, "opa": "Cyclophosphamide", "opb": "Vincristine", "opc": "Cisplatin", "opd": "5 Fluorouracil", "subject_name": "Pharmacology", "topic_name": "Anti-Cancer", "id": "ac0db10d-6cd8-4ef2-9de8-22577d1b8c18", "choice_type": "single"} {"question": "Loading dose of a drug depends upon", "exp": "(a)Volume of distributionRef: Lippincott, 6th ed., pg. 21 and Katzung, 13th ed., pg. 50-51Sometimes rapid achievement of desired plasma concentrations of drugs is needed to produce the prompt response (e.g. in serious infections or arrhythmias). When the time to reach steady state is long, as it is for drugs with long half-lives and having high volume of distribution (Vd) due to their tissue affinities, it may be desirable to administer a large dose (loading dose) to achieve the desired plasma levels rapidly. The volume ot distribution is the proportionality factor that relates the total amount of drug in the body to the concentration in the plasma (Cp).LOADING DOSE= Vd X Desired steady state plasma concentrationLoading dose can be given as single dose or multiple doses over a short time. E.g. in case of treatment of AF by digoxin (longer acting drug with high Vd), loading dose is must to saturate the tissues and to achieve desired plasma concentration rapidly (otherwise it would take about a week for digoxin to achieve the steady state plasma concentration). Loading dose of Chloroquine is also required to treat the malaria.On the other hand, maintenance dose is dependent of the clearance (Cl) as we have to maintain the steady state concentration in view of the volume of the plasma cleared of drug per unit time. Hence, equation for maintenance dose isMAINTENANCE DOSE= Cl X Desired steady state plasma concentration", "cop": 1, "opa": "Volume of distribution", "opb": "Clearance", "opc": "Half life", "opd": "bioavailability", "subject_name": "Pharmacology", "topic_name": "General Pharmacology", "id": "d746203f-d228-428c-8e11-06df6ca4c7a6", "choice_type": "single"} {"question": "Toxic dose of lidocaine causes", "exp": "Lignocaine reaching bloodstream causes severe CNS stimulation followed by coma.Ref:KDT 6/e p356.", "cop": 4, "opa": "Increase salivation", "opb": "Mydriasis and diarrhea", "opc": "Respiratory paralysis", "opd": "Seizures", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "266db90b-9a85-49b5-86b4-d659c4759d0f", "choice_type": "single"} {"question": "Drug of choice for treatment of Pneumocystitis jiroveci pneumonia is", "exp": "DOC for both prophylaxis and treatment of Pneumocystis jiroveci pneumonia is Cotrimoxazole Other drugs that can be used are Dapsone Clindamycin Pentamidine Atovaquone", "cop": 1, "opa": "Cotrimoxazole", "opb": "Amoxicillin", "opc": "Dexamethasone", "opd": "Ceftriaxone", "subject_name": "Pharmacology", "topic_name": "Antimetabolites and Quinolones", "id": "db3f3f9a-a2eb-4c5e-8278-e588c8d89945", "choice_type": "single"} {"question": "Acylovir triphosphate inhibits the synthesis of DNA by competing with", "exp": null, "cop": 3, "opa": "4-Oxyadenosine monophosphate", "opb": "2-Oxyadenosine diphosphate", "opc": "2-deoxyguanosine triphosphate", "opd": "4-deoxyguanosine triphosphate", "subject_name": "Pharmacology", "topic_name": null, "id": "70679ea9-2bbd-4b23-b190-d1d2279867b9", "choice_type": "single"} {"question": "Induction agent of choice in day care surgery is", "exp": "(Propofol) 585 - Lee's 13th) (375-KDT6th)* Geneal anaesthesia for day surgery should use agents that are rapidly eliminated and titratable* Most of those in common use are appropriate intravenous propofol or inhalation sevoflurane are both highly suitable for induction of anaesthesia in adults and childrenAdvantages of propofol over Thiopentone1. Rapid and smooth recovery2. Completely eliminated from body in 4 hours so patient is ambulatory early3. Antiemetic4. Antipruritic5. BronchodilatorDisadvantages of Day Surgery* Where day surgery is not well established, it may promote an over cautions attitude* May encourage poor management of operating list order* Surplus overnight capacity can attract emergency out liers and block beds* Antisocial hours may deter - day care nursing staff", "cop": 2, "opa": "Ketamine", "opb": "Propofol", "opc": "Methohexitone", "opd": "Thiopentone sodium", "subject_name": "Pharmacology", "topic_name": "Anaesthesia", "id": "de6ab9af-a223-49b8-8ed6-3e25f065f0b3", "choice_type": "single"} {"question": "Most effective agent to prevent motion sickness is", "exp": "Moon sickness is more easily prevented than cured.\n Transdermal hyoscine (scopolamine) is the best agent for the prevention of motion sickness.\n Antihistamines can also be used for prevention.", "cop": 3, "opa": "Ephedrine", "opb": "Nedocromil", "opc": "Hyoscine", "opd": "Cyproheptadine", "subject_name": "Pharmacology", "topic_name": null, "id": "4213ff3d-4479-41fc-ad5b-0ae8fab43ab6", "choice_type": "single"} {"question": "Drug used for trabeculectomy", "exp": "The main reason of failure of trabeculectomy surgery is scarring and closure of drainage site\n Antimetabolites prevent scarring and can be used to increase the success rate of trabeculectomy\n The most commony used antimetabolites are mitomycin-C and 5-fluorouracil.", "cop": 1, "opa": "Mitomycin-C", "opb": "Azathioprine", "opc": "Cituximab", "opd": "Ketorolac", "subject_name": "Pharmacology", "topic_name": null, "id": "d0d9acdc-758a-4ee9-8c49-4268b44b6ac2", "choice_type": "single"} {"question": "Pitolisant is approved for treatment of", "exp": "Pitolisant is a new drug approved for treatment of excessive day time sleepiness in patients with narcolepsy. It acts as inverse agonist of H3 receptors of histamine. New drugs recently approved for conditions mentioned in options are:* Tenosynol giant cell tumor: Pexidainib* Polyneuropathy in transthyretin amyloidosis: Tafamidis meglumine* Primary and secondary myelofibrosis: Fedratinib", "cop": 2, "opa": "Tenosynol giant cell tumor", "opb": "Excessive day time sleepiness in patients with narcolepsy", "opc": "Polyneuropathy due to transthyretin amyloidosis", "opd": "Primary myelofibrosis", "subject_name": "Pharmacology", "topic_name": "Sedative-Hypnotics and Parkinsonism", "id": "aea364f1-d174-4aa8-a133-f7591581901b", "choice_type": "single"} {"question": "In spinal anesthesia is the drug is deposited between", "exp": "Refer Katzung 10/e p 419. In spinal anesthesia ,drug is deposited in the sub Arachnoid space.,,whereas in epidural anesthesia, it is given outside the duramater", "cop": 2, "opa": "Dura and Arachnoid", "opb": "Pia and Arachnoid", "opc": "Dora and veebrae", "opd": "Into the cord substance", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "cdeb049b-d861-4174-b663-271abbf15332", "choice_type": "single"} {"question": "The drug that is not useful in congestive hea failure is", "exp": "Adrenaline causes vasoconstriction of coronary vessels and hence not used in hea failure. Digoxin cause an increase in accumulation of intracellular Calcium accumulation and is useful in hea failure. Thiazide decreases preload. enalapril or ACE inhibitors are useful to prevent remodeling of hea in hea failure (REF. Essentials of medical pharmacology KD TRIPATHI 6 Edition)", "cop": 1, "opa": "Adrenaline", "opb": "Digoxin", "opc": "Hydrochiorothiazide", "opd": "Enalapril", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "58dfa97d-7112-4757-be42-92806289d3d6", "choice_type": "single"} {"question": "Most common cause of acute cervicitis is", "exp": "Causes of acute cervicitis are : 1. Gonorrhoea 2. Septic aboion 3. Puerperal Sepsis. Ref Ktzung 12th ed.", "cop": 4, "opa": "E. Coli", "opb": "Chlamydia", "opc": "Pseudomonas", "opd": "Gonococcus", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "02a2adba-cb03-4e01-aef6-4810c8d3a96e", "choice_type": "single"} {"question": "Drugs like barbiturates precipitate symptoms of porphyria because", "exp": null, "cop": 1, "opa": "They depress ALA synthase", "opb": "They inhibit ALA synthase", "opc": "They induce heme oxygenase", "opd": "They inhibit heme oxygenase", "subject_name": "Pharmacology", "topic_name": null, "id": "49fc18c9-ce89-40cb-88c9-5a0f04d406d4", "choice_type": "single"} {"question": "Botulinum toxin acts by", "exp": "Ref: HL Sharma 3rd ed pg no:133 botulinum toxin and beta-bungaro toxin inhibits the release of Ach into the synapse", "cop": 3, "opa": "Secretion of Ach", "opb": "Synthesis of ACh", "opc": "Inhibits Ach release", "opd": "Muscle nerve block", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "77e93ead-40cb-41f2-b642-bb8a4ce20c7d", "choice_type": "single"} {"question": "Treatment of choice for extended spectrum betalactamase producing enterococci", "exp": "Ans. b. Piperacillin-Tazobactam", "cop": 2, "opa": "Amoxicillin-clavalunic acid", "opb": "Piperacillin-Tazobactam", "opc": "Ampicillin only", "opd": "Ampicillin + Sulbactam", "subject_name": "Pharmacology", "topic_name": null, "id": "91d7e986-4531-4f51-8fdf-37d8e046d56b", "choice_type": "single"} {"question": "Schizophrenia is treated by", "exp": "Ans. is 'b' i.e., Anti psychotics", "cop": 2, "opa": "Anti depressants", "opb": "Anti psychotics", "opc": "Anti epileptics", "opd": "Mood stabilizers", "subject_name": "Pharmacology", "topic_name": null, "id": "fec423fb-be98-40a8-a9f3-477f6e7555f4", "choice_type": "single"} {"question": "Common side effects of Dapsone is", "exp": "Hemolysis develops in almost every individual treated with 200-300 my Dapsone pe day. Doses of Les than 100 my in healthy persons and less than 50mg per day in persons with G6PD deficiency do not causes Hemolysis b Refer Goodman Gilman 12/e p 1564", "cop": 1, "opa": "Hemolytic anaemia", "opb": "Thrombocytopenia", "opc": "Cyanosis", "opd": "Bone marrow depressive", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "518bca36-932d-41bd-9d54-0f04844739d1", "choice_type": "single"} {"question": "Mechanism of action of disgitalis is", "exp": "Digoxin's primary mechanism of action involves inhibition of the sodium potassium adenosine triphosphatase (Na+/K+ ATPase), mainly in the myocardium. This inhibition causes an increase in intracellular sodium levels, resulting in decreased activity of the sodium-calcium exchanger, which normally impos three extracellular sodium ions into the cell and transpos one intracellular calcium ion out of the cell. The reversal of this exchanger causes an increase in the intracellular calcium concentration that is available to the contractile proteins. Increased intracellular calcium lengthens phase 4 and phase 0 of the cardiac action potential, which leads to a decrease in hea rate. Increased amounts of Ca2+ also leads to increased storage of calcium in the sarcoplasmic reticulum, causing a corresponding increase in the release of calcium during each action potential. This leads to increased contractility (the force of contraction) of the hea without increasing hea energy expenditure Refer kDT 7/e p 212", "cop": 1, "opa": "Inhibits Na +K+ ATPase pump", "opb": "Inhibits Na+ H+ ATPase pump", "opc": "Active metabolite are produced in liver", "opd": "Inhibit calcium concentrations in blood", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "7cb99279-2389-4a70-bf18-53cacd982dd0", "choice_type": "single"} {"question": "Zero order kinetics is seen with", "exp": null, "cop": 1, "opa": "Phenytoin", "opb": "Phenabarbtion", "opc": "Phenabarbtion", "opd": "Digoxin", "subject_name": "Pharmacology", "topic_name": null, "id": "7b0931c9-ebb2-4034-be0e-005ac73a12e5", "choice_type": "single"} {"question": "A paial agonist can antagonize the effects of a full agonist because it has", "exp": "High affinity but low intrinsic activity. The activity is mainly governed by affinity , intrinsic activity of a drug. iagonist has high affinity and intrinsic activity,antagonist has affinity but no intrinsic activity zero. Paial agonist has high affinity and low intrinsic activity. KDT 6/e pg 37", "cop": 1, "opa": "High affinity but low intrinsic activity", "opb": "Low affinity but high intrinsic activity", "opc": "No affinity and low intrinsic activity", "opd": "High affinity but no intrinsic activity", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "4f8512fb-f7cd-4f11-b3e3-08e8e12d67c5", "choice_type": "single"} {"question": "Oral vancomycin is indicated in the following condition", "exp": "GLYCOPEPTIDE ANTIBIOTICS Vancomycin Mech of action:- Vancomycin acts by inhibiting bacterial cell wall synthesis. It binds to the terminal dipeptide 'D-ala-D-ala' sequence of peptidoglycan units-- prevents its release from the bactoprenol lipid carrier so that assembly of the units at the cell membrane and their cross linking to form the cell wall cannot take place. pharmacokinetics:- Vancomycin is not absorbed orally. After i.v. administration, it is widely distributed, penetrates serous cavities, inflamed meninges and is excreted mainly unchanged by glomerular filtration with a t 1/2 of 6 hours. Dose reduction is needed in renal insufficiency. Toxicity:- Systemic toxicity of vancomycin is high. It can cause plasma concentration dependent nerve deafness which may be permanent. Kidney damage is also dose-related. Other oto- and nephrotoxic drugs like aminoglycosides must be very carefully administered when vancomycin is being used. Skin allergy and fall in BP during i.v. injection can occur. Vancomycin has the potential to release histamine by direct action on mast cells. Rapid i.v. injection has caused chills, fever, uicaria and intense flushing-- called 'Red man syndrome'. Uses:- Given orally (125-500 mg 6 hourly), it is the second choice drug to metronidazole for antibiotic associated pseudomembranous enterocolitis caused by C. difficile. Staphylococcal enterocolitis is another indication of oral vancomycin. Ref:- kd tripathi; pg num:-757", "cop": 4, "opa": "Bacillary dysentery", "opb": "Campylobacter diarrhoea", "opc": "Appendicitis", "opd": "Antibiotic associated pseudomembranous enterocolitis", "subject_name": "Pharmacology", "topic_name": "Antibiotics", "id": "479db772-a622-4918-9d00-f70d923eaf5a", "choice_type": "single"} {"question": "Prodrug of cetrizine is", "exp": "Ans. is 'c' i.e., Hydroxyzine Cetrizine is a metabolite of Hydroxyzine with marked affinity for peripheral HI receptors; penetrates brain poorly. It inhibits release of histamine and of cytotoxic mediators from platelets as well as eosinophil chemotaxis during secondary phase of allergic response. It is indicated in upper respiratory allergies, pollinosis, uicaria and atopic dermatitis; also used as adjuvant in seasonal asthama.", "cop": 3, "opa": "Foxefenadone", "opb": "Terfenadine", "opc": "Hydroxyzine", "opd": "Azelastine", "subject_name": "Pharmacology", "topic_name": null, "id": "e75d515d-ded7-43cf-bc59-0eb7d7ddc7f2", "choice_type": "single"} {"question": "Bull's eye retinopathy is seen with", "exp": null, "cop": 1, "opa": "Chloroquine", "opb": "Methanol", "opc": "Ethambutol", "opd": "Steroids", "subject_name": "Pharmacology", "topic_name": null, "id": "fd93cab2-31ee-4115-963b-f94f52378951", "choice_type": "single"} {"question": "Drug used for atrial fibrillation and atrial flutter is", "exp": "For AF, digoxin can be used- it decreases ventricular rate in AF Verapamil decreases conduction velocity and increases the refractory period of the AV node and so used in PSVT. REF.Essentials of Pharmacology KD Tripathi 8th ed.", "cop": 2, "opa": "Verapamil", "opb": "Digitalis", "opc": "Quinidine", "opd": "Diphenylhydantoin", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "8aa7af4a-430e-4aad-bb6f-30504bb91556", "choice_type": "single"} {"question": "Finasteride acts by blocking", "exp": "Finasteride is a competitive inhibitor of the enzyme 5alpha-reductase which conves testosterone into more active DHT responsible for androgen action in many tissues. finasteride, dutasteride- used for prostate cancer and BPH (Ref.Essentials of medical pharmacology TD Tripathi 7th edition page no.302)", "cop": 2, "opa": "Alpha receptor", "opb": "5 alpha reductase enzyme", "opc": "5 alpha reductase enzyme", "opd": "Beta receptors", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "95000cbc-958b-41e8-a3fa-15edf0dd1076", "choice_type": "single"} {"question": "Maximum incidence of impotance is seen in the patients with following anti hypeensive drug", "exp": "Common side effects of beta blockers include: Dizziness. Weakness. Drowsiness or fatigue. Cold hands and feet. Dry mouth, skin, or eyes. Headache. Upset stomach. Diarrhea or constipation. Refer kDT 6/e p139", "cop": 2, "opa": "CCBs", "opb": "Beta blockers", "opc": "ARBs", "opd": "ACE inhibitor", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "5cf372e5-f0d2-4c65-afda-f666323e8359", "choice_type": "single"} {"question": "Single lesion leprosy treatment", "exp": "ROM Regimen is used in single lesion leprosy.Now a days singlw lesion leprosy is also treated as paucibacillary leprosy and standared MDT of leprosy is given for 6 months- 1 yr. Ref: Harrison 17thed/1127", "cop": 4, "opa": "Dapsone and rifampicin", "opb": "Dapsone and clofazamine and ofloxacin", "opc": "Rifampicin ,ofloxacin and dapsone", "opd": "Rifampicin , olfoxacin and minocycline", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "492eefa5-964c-43d0-877a-4afc64c811bb", "choice_type": "single"} {"question": "Mechanism of action of Acyclov ir is", "exp": "(D) Inhibitor of HSV polymerase # Mechanism of action:> Acyclovir differs from previous nucleoside analogues in containing only a partial nucleoside structure: the sugar ring is replaced with an open-chain structure. It is selectively converted into acyclo-guanosine monophosphate (acyclo-GMP) by viral thymidine kinase, which is far more effective (3000 times) in phosphorylation than cellular thymidine kinase.ANTIVIRAL AGENTS ACTIVE AGAINST HERPESVIRUSESAgentDescription* AcyclovirInhibits HSV polymerase* FamciclovirProdrug of penciclovir (a guanosine analogue)* ValacyclovirProdrug of acyclovir; better absorption* GanciclovirMore potent polymerase inhibitor; more toxic than acyclovir* ValganciclovirProdrug of ganciclovir; better absorption* CidofovirNucleotide analogue of cytosine* FoscarnetPhosphonoformic acid; inhibits viral DNA polymerase", "cop": 4, "opa": "Inhibitor of viral DNA polymerase", "opb": "Inhibitor of viral thymidine kinase", "opc": "Inhibitor of viral reverse transcriptase", "opd": "Inhibitor of HSV polymerase", "subject_name": "Pharmacology", "topic_name": "C.N.S", "id": "8e840bab-f4a2-47a6-a9c1-a2d4087343ee", "choice_type": "single"} {"question": "Apalutamide was approved by FDA recently for", "exp": ".", "cop": 1, "opa": "Prostate cancer", "opb": "Breast cancer", "opc": "Hypeension", "opd": "HIV", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "543c6579-4974-450e-9c18-c61e22147ca0", "choice_type": "single"} {"question": "Mehemmoglobinemia is caused by", "exp": "Refer Katzung 11/e p449. The admistration of large doses of prilocarpine during regional anesthesia may lead to accumulation of the metabolite o-toludine an oxidizing agent capable of conveing hemoglobin to methemoglobin", "cop": 1, "opa": "Prilocarpine", "opb": "Ropivaciane", "opc": "Bupivacaine", "opd": "Procaine", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "7c4fe19f-5d78-4535-9006-7649d8c5a65a", "choice_type": "single"} {"question": "The term balanced anesthesia has been given by", "exp": "Refer Goodman Gilman 12/e p 528 Term balanced anaesthesia was introduced by Lundy in 1926", "cop": 3, "opa": "Simpson", "opb": "Fischer", "opc": "Lundy", "opd": "Moan", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "5ccaf367-a594-4445-8cfb-431757e9f3ac", "choice_type": "single"} {"question": "Leukotriene receptor antagonist used for bronchial asthma", "exp": "Refer KDT 6 /e p 222 Montelukast, zafirlukast and idalukast are Cys-LT, receptor antagonist Zileuton inhibits the production if Leukotriene by inhibiting the enzyme 5-lipoxygenase", "cop": 1, "opa": "Zafirkulast", "opb": "Zileuton", "opc": "Cromolyn Sodium", "opd": "Aminophylline", "subject_name": "Pharmacology", "topic_name": "Respiratory system", "id": "95b335dc-b6ae-4583-baf3-27380f8f683e", "choice_type": "single"} {"question": "Most common side effect seen with bisphosphonates", "exp": "-Bisphosphonates like alendronate and risedronate are used for prophylaxis and treatment of osteoporosis. -Esophagitis is their distinctive side effect. -Precaution is to be taken while taking the drug is to take it with full glass of water and in a sitting/ standing position.", "cop": 3, "opa": "Cholelithiasis", "opb": "Constipation", "opc": "Erosive esophagitis", "opd": "Osteonecrosis", "subject_name": "Pharmacology", "topic_name": "Osteoporosis, Sex Hormones and OCPs", "id": "800f683c-37b2-41d4-8eb5-f61d64c81c55", "choice_type": "single"} {"question": "Bisphosphonates are prescribed to a patient with the following advice", "exp": "Ans. (A) Take empty stomach with plenty of water(Ref: KDT 8th/370)Bisphosphonates are to be taken empty stomach in the morning with full glass of water and patient is instructed not to lie down or take food for at least 30 min. These measures are required to prevent contact of the drug with esophageal mucosa which result in esophagitis.", "cop": 1, "opa": "Take empty stomach with plenty of water", "opb": "Take after meals", "opc": "Discontinue if gastritis develops", "opd": "Discontinue if severe bone pain occurs", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "6fa9d4f1-baea-42b4-a304-6d1ad4483aa9", "choice_type": "single"} {"question": "A 60 year old hypeensive patient is on angiotensin II receptor antagonists (losaan) is post for hernia repair surgery. The hypeensive drug should be", "exp": "Before surgery antihypeensive drug should be used till the day of surgery Refer CMDT 2014_47", "cop": 1, "opa": "Continue till the day of operation", "opb": "Discontinued 24 hours preoperatively", "opc": "Discontinued one week preoperatively", "opd": "Administered in increased dosage on the day of operation", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "cc8be6b1-ba2a-4c3e-823b-a7b2964c69ab", "choice_type": "single"} {"question": "Muscarinic cholinergic agonists", "exp": "In addition to activating inhibitory G-proteins (Gi), muscarinic cholinergic agonists stimulate the activity of phospholipase C, increase production of IP 3, and increase release of intracellular calcium. Ref:- KD Tripathi", "cop": 2, "opa": "Decrease production of IP 3", "opb": "Activate inhibitory G-proteins (Gi)", "opc": "Decrease release of intracellular calcium", "opd": "Inhibit the activity of phospholipase C", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "b1ddd4b3-0434-4470-bbee-35c47cffeacc", "choice_type": "single"} {"question": "Vitamin K dependent clotting factors are", "exp": "Vitamin K-dependent clotting factors II, VII, IX, X, proteins C, and S,", "cop": 1, "opa": "Factor IX and X", "opb": "Factor IV", "opc": "Factor XII", "opd": "Factor I", "subject_name": "Pharmacology", "topic_name": "Hematology", "id": "3c5950de-f321-4172-ab0f-96769399c69c", "choice_type": "single"} {"question": "Anticholinesterase inhibitor that binds to the anionic site is", "exp": "Neostigmine and pyridostigmine antagonize nondepolarizing neuromuscular blockade by increasing the availability of acetylcholine at the motor endplate, mainly by inhibition of acetylcholinesterase. They bind to esteric site. Edrophonium binds to anionic site. It has a more rapid onset of action but may be less effective than neostigmine in reversing the effects of nondepolarizing blockers in the presence of a profound degree of neuromuscular blockade Reference: Katzung Pharmacology; 13th edition; Chapter 8; Cholinoceptor-Blocking Drugs", "cop": 2, "opa": "Physostigmine", "opb": "Edrophonium", "opc": "Neostigmine", "opd": "Echothiophate", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "36120002-553d-4918-a8f4-b85bad2b2da1", "choice_type": "single"} {"question": "Dicyclomine is a", "exp": "Dicyclomine is an antispasmodic anticholinergic drug used in various spasms also in dysmenorrheal .meftal spas contains dicyclomine along with mefenamic acid Ref: KDT 6th ed pg 104", "cop": 3, "opa": "Cholinergic drug", "opb": "Adrenergic drug", "opc": "Anticholnergic drug", "opd": "Anti adrenergic drug", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "aca44e62-1315-4d8f-bb8f-891470078061", "choice_type": "single"} {"question": "Drug of choice for gonococcal as well as non gonococcal urethritis is", "exp": "Gonococcal Infections For gonococcal urethritis: DOC is ceftriaxone For non gonococcal urethritis: DOC is AZITHROMYCIN It is used in combination with ceftriaxone in both gonococcal & non gonococcal urethritis AZITHROMYCIN (Single dose is enough)", "cop": 4, "opa": "Clindamycin", "opb": "Cefepime", "opc": "Metronidazole", "opd": "Azithromycin", "subject_name": "Pharmacology", "topic_name": "Protein Synthesis Inhibitors", "id": "dcfe5b2b-5c0c-49d9-b2f0-32e73a00f66b", "choice_type": "single"} {"question": "Bull's eye maculopathy is an adverse effect caused by", "exp": "Bull's eye maculopathy It is a rare dystrophy, also known asbenign concentric annular macular dystrophy (BCAMD). It causes a daboard, or ring-shaped, pattern of damage around the macula. It can be caused bychloroquineorhydroxychloroquine Side effects of antimalarial drugs Chloroquine (4-aminoquinoline) - Bull's eye maculopathy,confusion,psychosis,agranulocytosis. Primaquine (8-aminoquinoline ) - hemolytic anaemia in G6PD deficiency,leukopenia,agranulocytosis,leukocytosis,cardiac arrhythmias. Quinine - Cinchonism (constellation of symptoms:tinnitus,headache,nausea,dizziness,flushing,visual disturbances. Tafenoquine (8-aminoquinoline) - Hemolysis in G-6PD Def Pt", "cop": 1, "opa": "Chloroquine", "opb": "Lumefantrine", "opc": "Quinine", "opd": "Primaquine", "subject_name": "Pharmacology", "topic_name": "Anti-Malaria Drugs", "id": "e523a1a0-d0d4-46cc-b00e-dce65d87671e", "choice_type": "single"} {"question": "Ipratropium bromide used in Bronchial asthma, is", "exp": "(Anticholinergic) (217-KDT 6th)CLASSIFICATIONS OF DRUGS USED IN Br, ASTHMAI- Bronchodilators A. b2 sympathomimetics -Salbutamol, Terbutaline, Bambuterol, Salmeterol, formoterol, EphedrineB. Methvlxanthines -Theophylline, Aminophylline, Choline, theophylline, DoxophyllineC. Anticholinergics -Ipratropium bromide**, Tiotropium bromideII. Leukotriene antagonists -Montelukast, ZafirlukastIII. Mast cell stabilizers -Sodium cromoglycate, KetotifenIV. Corticosteroids - A-SystemicHydrocortisone, Prednisolone and othersB. Inhalational -Beclomethasone, dipropionate, Budonide, Fluticasone propionate, Flunisolide, CiclesonideV. Anti-IgE antibody -Omalizumb", "cop": 3, "opa": "b - Sympothomimetics", "opb": "Methylxanthines", "opc": "Anticholinergics", "opd": "Mast cell stabilizers", "subject_name": "Pharmacology", "topic_name": "Asthma", "id": "7d09ee32-1600-4562-a810-095f78ba72fb", "choice_type": "single"} {"question": "Acetazolamide acts at", "exp": "Acetazolamide is a reversible inhibitor of the carbonic anhydrase enzyme that results in the reduction of hydrogen ion secretion at the renal tubule and increased renal excretion of sodium, potassium, bicarbonate, and water by inhibiting the enzyme CA", "cop": 1, "opa": "PCT", "opb": "DCT", "opc": "Ascending loop of Henle", "opd": "Descending loop of Henle", "subject_name": "Pharmacology", "topic_name": "Kidney", "id": "4a27b7c2-71bc-4fcd-a1f7-d8a7d893b4bf", "choice_type": "single"} {"question": "Methotrexate resistance is due to", "exp": "Mechanism for Methotrexate resistance Impaired transpo of Methotrexate into cells Production big altered forms of DHFR that have decreased affinity for the inhibitor Increased concentrations of intracellular DHFR through gene amplification Decreased ability to synthesize Methotrexate polyglutamtes Increased expression of a drug reflux transpoer, of MRP class Refer Goodman Gilman 11/e p1336", "cop": 2, "opa": "Depletion of folate", "opb": "Overproduction of DHFRase", "opc": "Overproduction of thymidylate kinase", "opd": "Decreased DHFR ase", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "4da6ffe1-b2a0-41d4-b491-1bfcb3de27c8", "choice_type": "single"} {"question": "Neostigmine is not able to cross blood brain barrier because of its", "exp": "Quaternary ammonium compounds are water soluble and thus cannot cross blood brain barrier neostigmine is a quaternary derivatives where as physostigmine is a teritiary amine Ref-KDT 6/e p101", "cop": 4, "opa": "Primary structure", "opb": "Secondary structure", "opc": "Teritiary structure", "opd": "Quaternary structure", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "692f7ce0-4a26-4752-bfa6-aac117a61f9c", "choice_type": "single"} {"question": "Pharmacokinetics is", "exp": "(Includes absorption, distribution, binding/storage/biotransformation and excretion of the drug) (1-4-KDT 6th)Pharmacokinetics - to discover how the drug is distributed in and disposed of by, the bodyPharmacodynamics - to explore actions relevant to the proposed therapeutic use, and other effects at a range of doses.", "cop": 1, "opa": "Includes absorption, distribution, binding / storage/ biotransformation and excretion of the drug", "opb": "Includes physiological and biochemical effects of drugs", "opc": "Application of pharmacological information together with knowledge of the disease", "opd": "Scientific study of drugs in human", "subject_name": "Pharmacology", "topic_name": "General Pharmacology", "id": "68c43a43-5a1c-4fe9-ab87-ec0bb595bae4", "choice_type": "single"} {"question": "Donepezil has the following mechanism of action", "exp": "Donepezil: cerebro selective and reversible anti-AchE produces improvement in several cognitive as well as non cognitive (activities of daily living) scores in Alzheimer's Dementia. The benefit is ascribed to elevation of Ach level in the coex, especially in the surviving neurons that project from basal forebrain to cerebral coex and hippocampus. Therapeutic doses produce only weak peripheral AchE inhibition: cholinergic side effects are mild. Because of long t 1/2 (~70 hr), donepezil is administered once daily at bedtime It is generally well tolerated and is not hepatotoxic.", "cop": 2, "opa": "Dopaminergic blockade", "opb": "Cholinesterase inhibition", "opc": "Serotonin blockade", "opd": "Histaminergic action", "subject_name": "Pharmacology", "topic_name": "Parasympathetic System & Glaucoma", "id": "d7c29e86-157c-4675-8707-ec2e76c551aa", "choice_type": "single"} {"question": "Impoant adverse effect of nesiritide is", "exp": "The recommended dose of Natrecor is an IV bolus of 2 mcg/kg followed by a continuous infusion of 0.01 mcg/kg/min....Common side effects may include: headache, mild dizziness; nausea, vomiting; back pain; numbness or tingly feeling; tremors; or. vision changes Refer Goodman and Gilman 11e p696", "cop": 2, "opa": "Dysgusua", "opb": "Hypotension", "opc": "Cough", "opd": "Angioedema", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "e3a234c0-87f4-4a86-88ea-28d5f3be5291", "choice_type": "single"} {"question": "Fulvestrant is used in the treatment of", "exp": "Fulvestrant is a selective estrogen receptor downregulator (SERD) used in cases of hormone receptor positive metastatic breast carcinoma in post menopausal women.", "cop": 1, "opa": "HR positive metastatic breast cancer in post menopausal women", "opb": "Male breast cancer", "opc": "Paget's disease", "opd": "Acute myeloid leukemia associated with Down's syndrome", "subject_name": "Pharmacology", "topic_name": null, "id": "90f6f88d-9cea-497a-813e-82437057f311", "choice_type": "single"} {"question": "Wof is the fastest acting inhaled bronchodilator", "exp": "Salbutamol (Albuterol):- A highly selective b2 agonist when inhaled from pressurized metered dose inhaler (pMDI) produces bronchodilatation within 5 min and the action lasts for 2-4 hours(sho acting,fast acting),therefore used to abo and terminate attacks of asthma, but is not suitable for round-the-clock prophylaxis. side effects:- Muscle tremors are the dose related side effect. Palpitation, restlessness, nervousness, throat irritation and ankle edema can also occur. Hypokalaemia is a possible complication. Formoterol, Salmeterol are long acting B2 agonists, formoterol is fast acting compared to Salmeterol. Ref:- kd tripathi; pg num:- 223", "cop": 2, "opa": "Ipratropium bromide", "opb": "Salbutamol", "opc": "Salmeterol", "opd": "Formoterol", "subject_name": "Pharmacology", "topic_name": "Respiratory system", "id": "d65eb210-7494-49f2-93cc-392fdf406a9a", "choice_type": "single"} {"question": "First choice DMARD in rheumatoid ahritis is", "exp": "Rheumatoid Ahritis - Pain and inflammation of joints - For acute treatment we use: - NSAIDS - Steroids But it is only symptomatic treatment. It cannot slow down the joint destruction DMARDs- (Disease modifying anti-rheumatoid drugs) - As they are very slow acting so they are also called SAARDs (slow acting anti rheumatic drugs). Classification Conventional DMARDs Biologicals Chloroquine Penicillamine Azathioprine Gold salts Leflunomide Immunosuppressants Methotrexate (DOC) sulfasalazine Anakinra Sarilumab Adalimumab Cerolizumab Etanercept Infliximab Golimumab Abatacept Methotrexate - Drug of choice - Acts by increasing adenosine which possesses anti-inflammatory activity. DMARD of choice in pregnancy - CHLOROQUINE Sulfasalazine: It is a prodrug& can be used in ankylosing spondylitis.", "cop": 3, "opa": "Gold salts", "opb": "Penicillamine", "opc": "Methotrexate", "opd": "Sulfasalazine", "subject_name": "Pharmacology", "topic_name": "NSAIDs, Gout and Rheumatoid Ahritis", "id": "7cd16058-d2d0-4ddf-be81-b6ee74eedfc3", "choice_type": "single"} {"question": "Muscle relaxant of choice in renal and hepatic failure", "exp": "Refer Katzung 9/e p432 Atracurium and cis-Atracurium are muscle relaxants of choice for renal and hepatic failure patients", "cop": 1, "opa": "Cis Atracurium", "opb": "Vecuronium", "opc": "Rocuronium", "opd": "Rapacuronium", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "e6f70231-ec74-4ddb-a420-6faeca67410f", "choice_type": "single"} {"question": "Peginesatide is", "exp": null, "cop": 2, "opa": "IL - 11 analogue", "opb": "Erythropoietin receptor agonist", "opc": "G - CSF analogue", "opd": "GM - CSF analogue", "subject_name": "Pharmacology", "topic_name": null, "id": "3df75db5-b9de-46d0-a974-64c0110e1774", "choice_type": "single"} {"question": "Enhancement of the effects of bradykinin is most likely to occur with drugs like", "exp": "ACE inhibitors prevent the conversion of angiotensin I to angiotensin II and lower blood pressure by decreasing both the formation of aldosterone formation and the vasoconstrictive action of AII at AT-1 receptors. ACEIs also inhibit the metabolism of bradykinin, and this leads to additional hypotensive effects, because bradykinin is an endogenous vasodilator. Unfortunately, increases in bradykinin are associated with side effects, including cough and angioedema. Losartan, which blocks AT-1 receptors, does not increase bradykinin levels.", "cop": 3, "opa": "clonidine", "opb": "diazoxide", "opc": "lisinopril", "opd": "losartan", "subject_name": "Pharmacology", "topic_name": "C.V.S", "id": "2f88323b-7b9a-4d33-b330-9432fca0796f", "choice_type": "single"} {"question": "Nimodipine is used in(REPEAT)", "exp": "Nimodipine- A sho-acting calcium channel blocker Crosses blood brain barrier because of its high lipid solubility Selectively relaxes cerebral vasculature Can prevent and reduce the neurological deficit caused by cerebral vasospasm following subarachnoid hemorrhage", "cop": 1, "opa": "Subarachnoid haemorrhage", "opb": "Intra cerebral haemorrhage", "opc": "Extra dural haemorrhage", "opd": "Subdural haemorrhage", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "1a13ceed-422c-457b-9d9e-8de1276b9e82", "choice_type": "single"} {"question": "Drug capable of causing ocular hypotension with apnoea in infants is", "exp": "Brimonidine * Brimonidine, an alpha 2 selective adrenergic agonist used in treatment of Glaucoma has propensity to cause respiratory depression when used in children. * Brimonidine is notorious in causing CNS depression and apnoea in neonates. Hence, its use in children <2 years of age is contraindicated. * Brimonidine and Apraclonidine are Clonidine derivates - alpha 2 selective adrenergic agonist - reduce intraocular pressure by decreasing aqueous production. * Unlike Apraclonidine, Brimonidine being lipophilic can traverse the blood brain barrier and induce CNS depression. * Brimonidine is administered as topical eye preparation to reduce IOP in ocular hypeension and open angle glaucoma. * Topical Brimonidine gel (0.33%) is also used as a once daily treatment for persistent erythema of rosacea. Ref:- Goodman & Gilman Pharmacological Basis of Therapeutics 13th Ed; Pg num:- 1260", "cop": 2, "opa": "Latanoprost", "opb": "Brimonidine", "opc": "Apraclonidine", "opd": "Acetazolamide", "subject_name": "Pharmacology", "topic_name": "Autacoids", "id": "0312ef43-398b-4409-a3ad-a3febc1237cd", "choice_type": "single"} {"question": "The drug used in petit mal seizures and has a narrow spectrum of antiepileptic activity is", "exp": "Ethosuximide and valproate are the drugs of choice for absence seizures and are more effective than lamotrigineReference: Katzung Pharmacology; 12th edition; Page no: 418", "cop": 2, "opa": "Lamotrigine", "opb": "Ethosuximide", "opc": "Phenytoin", "opd": "Primidone", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "9587b40f-5950-423e-aaa2-7a05f813f832", "choice_type": "single"} {"question": "Bictegravir was approved by FDA recently for", "exp": "Bictegravir (an Integrase Inhibitor) is a component of the fixed-dose combination product bictegravir/emtricitabine/tenofovir alafenamide (brand name: Biktarvy), which received marketing approval for the treatment of HIV infection by U.S. Food and Drug Administration in February 2018.", "cop": 4, "opa": "Cystic fibrosis", "opb": "TB", "opc": "Hypeension", "opd": "HIV", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "98626654-2e98-438a-8a62-6a8c78867cb2", "choice_type": "single"} {"question": "Aeriolar dilators used in the treatment of CHF", "exp": "Nifedipine is a calcium channel blocker. Enalapril is an ACE inhibitor. Prazosin is alpha 1 blocker. Hydralazine is an aerial dilator and potassium channel opener (REF.Essentials of medical pharmacology KD TRIPATHI 8 Edition)", "cop": 1, "opa": "Hydralazine", "opb": "Nifedipine", "opc": "Prazosin", "opd": "Enalaprin", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "06f5d802-77ed-4901-a216-750a81cf1c8b", "choice_type": "single"} {"question": "High concentration of bupivacaine during labour is contraindicated due to its", "exp": null, "cop": 3, "opa": "CNS depressant action", "opb": "CNS stimulant action", "opc": "Cardiotoxicity", "opd": "Hypersensitivity reaction", "subject_name": "Pharmacology", "topic_name": null, "id": "67c57ebd-1b9b-4507-b9b5-da3e20e31224", "choice_type": "single"} {"question": "Tricyclic antidepressants can alter the oral absorption of many drugs by", "exp": "Alter gut motility Ref: KDT 6/6 pg 14,411", "cop": 2, "opa": "Complexing with other drugs in the intestinal lumen", "opb": "Altering gut motility", "opc": "Altering gut flora", "opd": "Damaging gut mucosa", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "087fcacc-3afe-429a-b0e3-4837da40a6d2", "choice_type": "single"} {"question": "The absolute CONTRAINDICATION to lithium is March 2004", "exp": "Ans. A i.e. Renal failure", "cop": 1, "opa": "Renal failure", "opb": "Glaucoma", "opc": "Epilepsy", "opd": "Angina", "subject_name": "Pharmacology", "topic_name": null, "id": "40aa7a30-092e-48e0-94ae-bf4b1ea6d09b", "choice_type": "single"} {"question": "Pentostatin inhibits", "exp": "Pentostatin is a purine analogue that inhibits Adenosine deaminase. It is used in cases of Hairy cell leukemia (Doc: Uadiribine).", "cop": 2, "opa": "Dihydrofolate reductose", "opb": "Adenosine deaminase", "opc": "Thymidylate synthase", "opd": "Uridylate synthose", "subject_name": "Pharmacology", "topic_name": null, "id": "6044e2db-f865-40bf-b3ce-6d6fdad8bebd", "choice_type": "single"} {"question": "An antiemetic drug that also decreases acid secretion due to its action on H1 receptors is", "exp": "promethazine is a first generation H1 antihidtaminic drug.it is inficated fir treatment of allergic reactions.because of its anticholinergic action and abikity to cross blood brain barrier it can be used as an antiemetic and an anti parkinsonian drug . acid secretion is reduced mainly by H2 blocking drugs like ranitidine but even H1 anti histamainics can also reduce secretion at high doses .", "cop": 1, "opa": "promethazine", "opb": "domperidone", "opc": "metaclopromide", "opd": "ondansetron", "subject_name": "Pharmacology", "topic_name": "Gastrointestinal tract", "id": "0ebe3045-f4de-4421-9006-62de997c3de3", "choice_type": "single"} {"question": "Drug of choice for Type 1 Brittle asthma is", "exp": "Brittle asthma is very severe asthma resistant to inhalational Beta 2 agonists. \nDOC for Type1 Brittle Asthma: Subcutaneous Terbutaline.\nDOC for Type2 Brittle Asthma: Subcutaneous Adrenaline.", "cop": 2, "opa": "Subcutaneous salbutamol", "opb": "Subcutaneous terbutaline", "opc": "Subcutaneous adrenaline", "opd": "Subcutaneous mometasone", "subject_name": "Pharmacology", "topic_name": null, "id": "13a0a6a1-2fd6-4e99-8f7f-4cb5ff13319a", "choice_type": "single"} {"question": "If a thiazide diuretic is administered for hypeension, the response that is seen within 24 hrs on excretion is", "exp": "Thiazides- medium efficacy diuretics with primary site of action in the early DT (Site III). Here they inhibit Na+-Ct sympo at the luminal membrane. Under their action, an increased amount of Na is presented to the distal nephron, more of it is exchanges with K+, urinary K+ excretion increased in parallel to the natriuretic response. They decrease renal Ca excretion and increase Mg excretion by a direct distal tubular action. They also decrease urate excretion by the same mechanism as furosemide. They are used in idiopathic hypercalciuria REF Essentials of Medical Pharmacology, K.D Tripathi,6 th edition, page 564", "cop": 3, "opa": "sodium excretion increases, potassium decreases", "opb": "Sodium increases, Potassium decreases, Calcium increases", "opc": "Sodium increases, Potassium increases, Calcium excretion decreases", "opd": "Sodium, Potassium, Calcium excretion increases", "subject_name": "Pharmacology", "topic_name": "Kidney", "id": "4d9d9c42-5601-492d-9640-014d365c4305", "choice_type": "single"} {"question": "Following monoclonal antibody is directed against alpha 4 integrin (REPEAT)", "exp": "Natalizumab is anti-integrin monoclonal antibody used in ulcerative colitis, Crohn&;s disease and multiple sclerosis.Ref: Katzung 13th ed.pg 962.", "cop": 2, "opa": "Efalizumab", "opb": "Natalizumab", "opc": "Ibalizumab", "opd": "Toclizumab", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "c3c292f9-9320-4197-9403-cc72287f035d", "choice_type": "single"} {"question": "Inhalational agent of choice for induction in children is", "exp": "Desflurane has the lowest blood partition co-efficient and hence it is the fastest inducing agent. But it can lead to coughing & bronchospasm on inhalation.\nTherefore Sevoflurane is the inhalational agent of choice for induction in children.", "cop": 2, "opa": "Desflurane", "opb": "Sevoflurane", "opc": "Isoflurane", "opd": "Halothane", "subject_name": "Pharmacology", "topic_name": null, "id": "cadca7f9-909f-48e6-a3d2-7876680c53a3", "choice_type": "single"} {"question": "Mechanism of action of Clonidine in opioid withdrawal syndrome is", "exp": "Ans. is 'c' i.e., Action on a2 presynaptic nerve ending Many of the symptoms of opioid withdrawl such as nausea, vomiting, cramps, sweating, tachycardia, and hypertension are a result of loss of opioid suppression of locus ceruleus system during abstinence syndrome. Clonidine is an a2 agonist that reduces adrenergic transmission from locus ceruleus.Clonidine acts on these a2 receptors and supress adrenergic activity in locus ceruleus. (Thus mimicking the action of opioids).In this way it alleviates mainly the autonomic symptoms of opioid withdrawl.Non autonomic symptoms of opioid withdrawl are not affected.", "cop": 3, "opa": "b blocking effect", "opb": "Inhibition of opioid receptor", "opc": "Action on a2 presynaptic nerve ending", "opd": "Postsynaptic action", "subject_name": "Pharmacology", "topic_name": "Opioids", "id": "59c0f225-9b88-45ce-828c-cfae6185ff71", "choice_type": "single"} {"question": "Dopamine is preferred in treatment of shock because of", "exp": "ref; KD Tripathi 6th edition pharmacology (page no;134) Dopamine (DA) is a dopaminergic (D1 and D2) as well as adrenergic alps 1 &b 1 (but not b2 ) agonist. The D1 receptors in renal and mesenteric blood vessels are the most sensitive: i.v. infusion of a low dose of DA dilates these vessels (by raising intracellular cAMP). This increases GFR and Na+ excretion.", "cop": 1, "opa": "Renal vasodilatory effect", "opb": "increased cardiac output", "opc": "Peripheral vasoconstruction", "opd": "Prolonged action", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "8d4ba708-7445-4634-8ec0-45e487a47ab1", "choice_type": "single"} {"question": "Mechanism of action of levosimendon include", "exp": "Mechanism of action Levosimendan exes its positive inotropic effect by increasing calcium sensitivity of myocytes by binding to cardiac troponin C in a calcium-dependent manner. ... The combined inotropic and vasodilatoryactions result in an increased force of contraction, decreased preload and decreased afterload. Refer katzung 11e p221", "cop": 2, "opa": "Na channel opener", "opb": "Potassium channel opener", "opc": "Beta blockers", "opd": "Beta 1 agonist", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "e585a010-5838-4816-b1e2-e47b96f3aaa2", "choice_type": "single"} {"question": "Pregnant patient can be safely given", "exp": null, "cop": 2, "opa": "Tetracycline", "opb": "Paracetamol", "opc": "Metronidazole", "opd": "Barbiturates", "subject_name": "Pharmacology", "topic_name": null, "id": "a52916aa-7a35-46ea-a598-31c1c0daa37e", "choice_type": "single"} {"question": "The action of botulinum toxin is through wof mechanisms", "exp": "Botulinum toxin Botulinum toxin A and B are highly potent exotoxins produced by Clostridium botulinum that are responsible for 'botulism' (a type of food poisoning). mech of action:- These neurotoxic proteins cause long-lasting loss of cholinergic transmission by interacting with axonal proteins involved in exocytotic release of ACh. uses:- In the treatment of a number of spastic and other neurological conditions due to overactivity of cholinergic nerves, like blepharospasm, spastic cerebral palsy, strabismus, spasmodic toicollis, nystagmus, hemifacial spasm, post stroke spasticity, spasmodic dysphonia, axillary hyperhydrosis, etc. It is increasing being employed as beauty treatment by removal of age-related facial wrinkles. Ref:- kd tripathi; pg num:-99,100", "cop": 4, "opa": "Direct action on acetylcholine esterase", "opb": "Prevention of choline uptake", "opc": "Direct action on muscarinic receptors", "opd": "Prevention of acetylcholine release", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "115a364b-70c5-4b80-9d04-1646bf75411b", "choice_type": "single"} {"question": "The treatment of single lesion paucibacillary leprosy is", "exp": "ROM Regimen is used in single lesion leprosy.For patients with single-lesion paucibacillary leprosy, the WHO recommends a single dose of rifampin (600 mg), ofloxacin (400 mg), and minocycline (100 mg). Multibacillary adults should be treated with 100 mg of dapsone plus 50 mg of clofazimine daily (unsupervised) and with 600 mg of rifampin plus 300 mg of clofazimine monthly(supervised).Ref: Harrison 19th ed/1127", "cop": 4, "opa": "Dapsone and rifampicin", "opb": "Dapsone and clofazamine and ofloxacin", "opc": "Rifampicin, ofloxacin and dapsone", "opd": "Rifampicin, ofloxacin and minocycline", "subject_name": "Pharmacology", "topic_name": "Antibiotics", "id": "41bf7e3e-cd6a-40d5-9068-942c359487d1", "choice_type": "single"} {"question": "Diphenhydramine used as antitussive is a", "exp": "Diphenhydramine is an anti histamine used for mild cough.", "cop": 3, "opa": "Central opioid agonist", "opb": "NMDA blocker", "opc": "Antihistamine", "opd": "Mucolytic", "subject_name": "Pharmacology", "topic_name": null, "id": "5f800056-dfda-44d7-a0ed-9f1b1e634c2a", "choice_type": "single"} {"question": "Praziquantel is used for the treatment of", "exp": "Platyhelminthes (flukes & tapeworms) DOC for all the platyhelminths is praziquantel DOC for Fasciola hepatica (liver fluke) is triclabendazole DOC for dog tapeworm is albendazole DOC for trichomoniasis is metronidazole Surgery is done for rhinosporidiosis Nematodes DOC for nematodes is albendazole DOC for filaria is diethyl carbamazine DOC for strongyloidiasis & onchocerca volvulus is Ivermectin", "cop": 3, "opa": "Strongyloidiasis", "opb": "Trichomoniasis", "opc": "Schistosomiasis", "opd": "Rhinosporidiosis", "subject_name": "Pharmacology", "topic_name": "FMGE 2019", "id": "9f4fdb68-9c73-4aab-9ca1-0795a41db7f3", "choice_type": "single"} {"question": "Nausea and vomiting that are associated with administration of opioid analgesic is the result of stimulation of the", "exp": null, "cop": 3, "opa": "Limbic system", "opb": "Emetic system", "opc": "Chemoreceptor trigger zone (CTZ)", "opd": "Opioid receptors in G.I.T.", "subject_name": "Pharmacology", "topic_name": null, "id": "75964e77-6141-4219-8d56-95d00e4a1211", "choice_type": "single"} {"question": "Opiod induced respiratory depression can be reversed with", "exp": "Ans: A (Naloxone) Ref: Goodman &Gillman's The Pharmacological Basis of Therapeutics, 2011, 12'h Edition, McGrow Hill, Burton LL P519- 520Explanation:Naloxone is the treatment of choice in the reversal of respiratory depression due to opioids.Naloxone has to be diluted and slowly administered intravenously to avoid withdrawal in opioid dependent patientsMonitoring of arousal and respiratory function are essential during this treatmentRestoration of respiration without naloxone therapy may still results in death of the patient due to complication that develop during comaNoncardiogenic pulmonary edema that develops during opioid poisoning can be reversed by positive pressure ventilation", "cop": 1, "opa": "Naloxone", "opb": "Theophylline", "opc": "Artificial ventillation", "opd": "Doxapram", "subject_name": "Pharmacology", "topic_name": "Adverse Drug Effect", "id": "36fea632-3cb4-49aa-aea8-fdca39e5dbc7", "choice_type": "single"} {"question": "Prolonged testosterone treatment to a man results in", "exp": "Prolonged use of testosterone may produce testicular atrophy thus causing azoospermia. (Ref.Essentials of medical pharmacology TD Tripathi 7th edition page no.299)", "cop": 3, "opa": "increased spermatogenesis", "opb": "Increased sperm motility", "opc": "Azoospermia", "opd": "Increased gonadotropins", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "229f849a-3f97-4efc-9191-556e87c767da", "choice_type": "single"} {"question": "Treatment for methotrexate poisoning", "exp": "Methotrexate poisoning: The toxicity of Mtx cannot be overcome by folic acid, because it will not be conveed to the active coenzyme form(due to inhibition of DHFA reductase by Mtx) Treatment:- Folinic acid (N5 formyl THFA, cirovorum factor) rapidly reverses the effects. Thymidine also counteracts Mtx toxicity. Ref:- kd tripathi; pg num:- 862", "cop": 3, "opa": "Dietary folic acid", "opb": "Niacin", "opc": "Folinic acid", "opd": "Biotin", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "8d588abc-ab15-4e22-8c23-2a39130101fa", "choice_type": "single"} {"question": "The drug that acts by inhibiting bacterial RNA polymerase is", "exp": "Answer: b) RifampicinANTI TUBERCULAR DRUGSFirst line DrugsEssential: Isoniazid (H), Rifampin (R), Pyrazinamide (Z), Ethambutol (E),Supplementary: Streptomycin (S), Rifabutin, RifapentineSecond Line DrugsOld Drugs: Thiacetazone, Paraaminosalicylic acid, Ethionamide , Cycloserine, Kanamycin,Amikacin, Capreomycin, Ciprofloxacin, Ofloxacin, Levofloxacin, Moxifloxacin, LinezolidAll first line Anti tubercular drugs are bactericidal except Ethambutol which is static.* Isoniazid: bacteriostatic against resting & bactericidal against rapidly multiplying organisms,o Effective against intracellular & extracellular organisms.o Resistance occurs d/t mutation in Kat G (gene for catalase peroxidase) or INH-A* Rifampicin: excreted in feces- safe in renal failure. Bactericidal against dormant organisms.o Effective against intracellular & extracellular organisms.* Ethambutol: inhibits the synthesis of arabinogalactan (cell wall component), d/t inhibition of arabinosyl transferase.* Pyrazinamide: active against intracellular bacteria only & in acidic media.* Streptomycin: active against extracellular bacteria only, given IM, contraindicated in pregnancyDrugMechanisms of Action and ResistanceAdverse effectsIsoniazidInhibit mycolic acid synthesisHigh level resistance - mutation in gene coding for Catalase peroxidaseHepatitis, Peripheral neuritis (always given in combination with pyridoxine), Hemolysis in G6PD deficiency, SLE in, slow acetylators, cheese reactionRifampicinInhibits DNA dependent RNA polymeraseResistance due to mutation in repo B geneProteinuria, Hepatitis, Flu-like syndrome,Red orange urine, Thrombocytopenia.Potent microsomal enzyme inducer;Contraindicated in patients on ARTEthambutolInhibits synthesis of arabinogalactan (cell wall component)Dose dependent retro bulbar neuritis, |.visual acuity and Red-green blindnessPyrazinamideAction similar to that of INHResistance due to mutation in the gene which encodes for enzyme generation in the active metabolite.Polyarthralgia, myalgia, Hepatitis & RashHyperuricemia, phototoxicity,| porphyrin synthesis, non gouty arthritis (40%)StreptomycinProtein synthesis inhibitorDeafness, Vestibular dysfunction &Nephrotoxicity.ISONIAZID* Isoniazid: prodrug that is activated by KatG, the mycobacterial catalase-peroxidase.* The target of the isoniazid derivative is enoyl-ACP reductase of fatty acid synthase II.* Fast acetylators: (30-40% of Indians) tl/2 of INH: 1 hr.* Slow acetylators: (60-70% of Indians tl/2 of INH: 3 hrs.* Isoniazid forms a covalent complex with an acyl carrier protein (AcpM) and KasA, a beta-ketoacyl carrier protein synthetase, which blocks mycolic acid synthesis.* Fast multiplying organisms are rapidly killed, but quiescent ones are only inhibited.* It acts on extracellular as well as on intracellular TB (bacilli present within macrophages); is equally active in acidic and alkalinemedium.* Isoniazid penetrates well into caseous material and persists in therapeutic concentrations.* Main excretory products in humans result from acetylation (acetylisoniazid) and hydrolysis (isonicotinic acid).* Hepatitis is d/t the metabolite acetylhydrazine.* Isoniazid induced peripheral neuritis - more common in slow acetylators.* Mental abnormalities may appear, including euphoria, transient memory impairment, loss of self- control, and psychosis.* Approximately 1 in 106tubercle bacilli will be genetically resistant to isoniazid.* INH neurotoxicity is treated by pyridoxine-100 mg/day.* The other congener of hydrazine- iproniazid is found to be a mood elevator.RIFAMPICIN* Acts best on slowly or intermittently (spurters) dividing ones, as well as on many atypical mycobacteria.* Both extra- and intracellular organisms are affected.* It has good sterilizing and resistance preventing actions.Rifampicin toxicity* Major adverse effecto Hepatitis, a, is dose-related and is reversible on discontinuation,o 'Respiratory syndrome': breathlessness associated with shock and collapse,o Purpura, haemolysis, shock and renal failure.* Minor reactions: not requiring drug withdrawal and more common with intermittent regimenso 'Cutaneous syndrome': flushing, pruritus + rash (especially on face and scalp), redness and watering of eyes.o 'Flu syndrome': with chills, fever, headache, malaise and bone pain,o 'Abdominal syndrome': nausea, vomiting, abdominal cramps with or without diarrhoea,o Orange discolouration of soft contact lenses.Other uses of rifampin* Leprosy* Prophylaxis of Meningococcal and H. influenzae meningitis and carrier state.* Second/third choice drug for MRSA, diphtheroids and Legionella infections.* Combination of doxycycline and rifampin is the first line therapy of brucellosis.DERIVATIVES OF RIFAMPICINRIFABUTIN: (Ansamycin)* Similar in action to rifampicin and shows cross resistance to rifampicin.* Mild inducer of cytochrome P-450 unlike rifampicin & rifapentin. Causes pseudojaundice.* Indicated in the treatment of tuberculosis in HIV patients on anti retroviral therapy due to less toxicity.* Rarely, it can cause anterior uveitis, hepatitis, Clostridium difficile-associated diarrhea, diffuse polymyalgia syndrome, yellow skin discoloration (Pseudo-jaundice) and pancytopenia. Unlike rifampicinRifabutin (as compared to rifampicin) is* Less effective against TB* More effective against MAC* Longer acting, ti/2 (45 hours)* Less potential to induce microsomal enzymes* Donot require dose adjustment in liver diseaseRIFAPENTIN:* Similar in action to rifampicin and shows cross resistance to rifampicin.* Potent Inducer of cytochrome P-450. Can cause light chain proteinuria.* Metabolized to 25-desacetyl rifapentin.* Should not be used in HIV individuals as it leads to drug resistance & more prone for toxicity.RIFAXIMIN: indicated for traveler's diarrhea (E.coli) & hepatic encephalopathy.OTHER DRUGS* Thiacetazone: tuberculostatic drug. Major adverse effects include hepatitis, bone marrow suppression and Steven Johnson syndrome (not used in HIV positive patients).* Para amino salicylic acid (PAS): bacteriostatic. It can cause kidney, liver and thyroid dysfunction.* Cycloserine is a cell wall synthesis inhibiting drug and can cause neuropsychiatric adverse effects.* Kanamycin, capreomycin and amikacin are injectable aminoglycosides, used in MDR tuberculosis.* Ethionamide: tuberculostatic can cause hepatitis, optic neuritis and impotence. Also used in leprosy.o Ethionamide also inhibit mycolic acid biosynthesis with consequent impairment of cell-wall synthesis.o Resistance can develop rapidly in vivo when ethionamide is used as a single-agent treatment, including low-level cross-resistance to isoniazid.* Fluoroquinolones: ciprofloxacin, ofloxacin, moxifloxacin& sparfloxacin. Effective against MAC in AIDS patients.* Newer macrolides like azithromycin and clarithromycin are effective against non-tubercular atypical mycobacteria.* Bedaquiline is an inhibitor of mycobacterial ATP synthase. It is indicated as a part of MDT in adults with pulmonary MDR-TB. It can cause QT prolongation.MULTI DRUG RESISTANT TUBERCULOSIS (MDR-TB)* Resistance to both Isoniazid & Rifampicin and may be any number of other anti-TB drugs.* Treatment is mainly based on culture sensitivity.* Usually fluoroquinolones are added.* For H resistance: RZE is given for 12 months.* For H+R resistance: ZE + S/ Kanamycin/Amikacin/ Capreomycin + cipro/Ofloxacin + Ethionamide.EXTENSIVELY DRUG RESISTANT TUBERCULOSIS (XDR-TB)* Resistance to four most effective drugs: H, R, a fluoroquinolone, one of Kanamycin/Amikacin/ Capreomycin and may be any number of other anti-TB drugs* Virtually untreatable: high mortality, particularly among HIV positive patients.", "cop": 2, "opa": "Cephalosporins", "opb": "Rifampicin", "opc": "Macrolides", "opd": "Aminoglycosides", "subject_name": "Pharmacology", "topic_name": "Anti Microbial", "id": "e1b72df5-c111-4607-9ca6-74d439d64be3", "choice_type": "single"} {"question": "A patient after valve replacement will require follow up treatment with", "exp": "Warfarin-Warfarin being oral anticoagulant is used as prophylaxis after valve replacement because of propensity of these pts. developing thromboembolism is higher. Rx- warfarin + Inj heparin -life time use Heparin is discontinued after five days where as warfarin is taken lifelong. As warfarin takes at least 5 days to show its effect. Note-with warfarin therapy INR monitoring should be done.", "cop": 1, "opa": "Warfarin", "opb": "ACE inhibitors", "opc": "Beta blockers", "opd": "Thiazide", "subject_name": "Pharmacology", "topic_name": "FMGE 2019", "id": "29986844-1c38-47d7-8084-0092f8072914", "choice_type": "single"} {"question": "Bisphoshonates are prescribed to a patient with the following advice", "exp": "Refer KDT 7th/345 Bisphoshonates are to be taken empty stomach in the morning with full glass water and patient is instructed not to lie down or take food for at least 30 min. These measures are required to prevent contact of the drug with esophageal mucosa which result in esophagitis", "cop": 1, "opa": "Take empty stomach with plenty of water", "opb": "Take after meals", "opc": "Duscintunes if gastritis develops", "opd": "Discontinues if severe bone pain occurs", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "23a98b50-b1b6-4839-a585-a494569ab29e", "choice_type": "single"} {"question": "Theophylline is a", "exp": "Theophylline- Phosphodiesterase inhibitor (inhibit the degradation of CAMP) Sodium cromoglycate is a mast cell stabilizer used for prophylaxis of asthma Montelukast and zafirlukast are leukotriene antagonist Zileuton is a LOX inhibitor", "cop": 3, "opa": "Mast cell stabilizer", "opb": "Leukotriene antagonist", "opc": "Phosphodiesterase inhibitor", "opd": "Leukotriene synthesis inhibitor", "subject_name": "Pharmacology", "topic_name": "Respiratory System", "id": "0089e1bb-127c-440f-8402-43f057782003", "choice_type": "single"} {"question": "Mercaptopurine is", "exp": "Ref: Katzung, 14th ed. pg. 960; KDT, 6th ed. pg. 820* Mercaptopurine is synthetic purine used in cancer chemotherapy.* Use: Childhood acute leukemia.", "cop": 1, "opa": "Purine analogue", "opb": "Nucleoside analogue", "opc": "Pyrimidine analogue", "opd": "Anti tumor antibiotics", "subject_name": "Pharmacology", "topic_name": "Anti-Cancer", "id": "197a89cf-e96f-46d4-8c94-cb20c8754973", "choice_type": "single"} {"question": "One of the following diuretic does not require its presence in the tubular lumen for its pharmacological effects", "exp": "Most of the diuretics act from the luminal side of membrane in the nephron. Thazides,loop diuretics,carbonic anhydrase inhibitors and epithelial Na+ channel blockers are secreted in the proximal tubules through organic anion/cation transpo process. Osmotic diuretics reach the lumen of proximal tubules glomerular filtration. Aldosterone antagonists like spironolactone do not act through luminal side rather they act from basolateral side of the membrane.Therefore,these agents do not require access to the tubular lumen.", "cop": 4, "opa": "Thiazide diuretics", "opb": "Loop diuretics", "opc": "Carbonic anhydrase inhibitors", "opd": "Aldosterone antagonists", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "ea3002b4-8786-4c8f-8a68-544c6ef0a891", "choice_type": "single"} {"question": "Inhalational anesthetic with highest respiratory irritation is", "exp": "* Desflurane, a fluorinated inhalational anesthetic agent - is highly irritant on the tracheobronchial tree - making it unsuitable for use as the primary anesthetic for induction of anesthesia. * Among the fluorinated inhalational anaesthetics, Desflurane and Isoflurane are respiratory irritants; Sevoflurane is devoid of tracheobronchial irritation.Ref:- Goodman & Gilman Pharmacological Basis of Therapeutics 13th Ed; Pg num:- 395", "cop": 4, "opa": "Sevoflurane", "opb": "Halothane", "opc": "Nitrous Oxide", "opd": "Desflurane", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "079dea40-b9e1-4ee9-a23b-3054af8a7db7", "choice_type": "single"} {"question": "LMV heparin is preferred over unfranctioned heparin because", "exp": "Refer KDT 7/e p 619 Major advantage of LMV heparins over unfranctioned heparin is that it does not require monitoring bad it has consistent subcutaneous bioavalilabilty Both of these work by activating antithrombin Risk of bleeding is present with both LMV as well as unfranctioned heparin None of these us effective orally", "cop": 4, "opa": "LMV heparin directly inhibits thrombin whereas unfranctioned heparin acts activation of antithrombin", "opb": "LMV heparins have been lesser risk of causing bleeding", "opc": "LMV heparin have lesser risk of causing bleeding", "opd": "LMV heparin has consistent bioavalilabilty", "subject_name": "Pharmacology", "topic_name": "Respiratory system", "id": "38464fd4-f7bd-4f3f-af2b-d40b758b8227", "choice_type": "single"} {"question": "Carbonic anhydrase inhibitors should not be given in", "exp": "Carbonic anhydrase inhibitors(CAIs)are more likely to produce acidosis in patients of COPD,CRF and DM.They are contraindicated in COPD as they may precipitate respiratory acidosis. They are sulfonamides in structure,so should not be given in hypeensitive persons.", "cop": 1, "opa": "Sulfonamide hypersensitivity", "opb": "Glaucoma", "opc": "High altitude sickness", "opd": "Metabolic acidosis", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "f3f3db02-5a89-4d17-a1a7-d8c1f6921fdf", "choice_type": "single"} {"question": "Prolonged treatment with INH leads to deficiency of", "exp": "Refer Katzung 11/e p825 Isoniazid can cause peripheral neuropathy It is due to deficiency of Pyridoxine", "cop": 1, "opa": "Pyridoxine", "opb": "Thiamine", "opc": "Pantothneic acid", "opd": "Niacin", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "72c57163-10cf-46ee-ad6e-87ee541bfffe", "choice_type": "single"} {"question": "Warfarin induced skin necrosis is more common in patients with", "exp": "It is due to decreased levels of protein C. It is more likely to occur in patients with genetic deficiency of protein C. Most common side effect of warfarin:Bleeding Dermal vascular necrosis is early appearing adverse effect. Due to decreased osteocalcin synthesis Warfarin causes nasal hypoplasia and therefore contraindicated in pregnancy", "cop": 1, "opa": "Protein C deficiency", "opb": "Sickle cell anemia", "opc": "Factor V leiden deficiency", "opd": "Antithrombin 3 deficiency", "subject_name": "Pharmacology", "topic_name": "Hematology", "id": "5b69f8b0-73f5-4478-8713-5a639ae4bae0", "choice_type": "single"} {"question": "Metabolite of progesterone in urine", "exp": "Metabolites of progesterone may be classified into 3 groups based on degree of reduction. Pregnanediones: the C4-5 double bond is reduced producing 2 pregnanediones and allopregnanediones Pregnanolones: the keto group at C3 is reduced producing a hydroxyl groups in alpha and beta orientation. Urinary pregnanolones exit in alpha orientation Pregnanediols: keto group at c20 is reduced and compounds with c20 hydroxyl groups in alpha orientation are quantitatively more impoant. Hence urinary measurement of pregnanediols can be used as an index of endogenous production of progesterone and also its concentration correlates well with many clinical conditions Ref: Katzung 12 th ed.", "cop": 3, "opa": "Pregnenolone", "opb": "17 hydroxypregnenolone", "opc": "Pregnanediol", "opd": "Pregnanetriol", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "727d1f5c-0b49-4388-a649-dda4939140b3", "choice_type": "single"} {"question": "Long term adverse effect of tamoxifen is", "exp": "TAMOXIFEN - It is SERM - Actions Bone - | formation of bone; decrease risk of osteoporosis Blood - | HDL Breast -Decrease risk of breast cancer Liver - | clotting factor leading to thromboembolism Endometrium - | risk of endometrial cancer", "cop": 3, "opa": "Weight gain", "opb": "Osteoporosis", "opc": "Venous thrombosis", "opd": "Breast cancer", "subject_name": "Pharmacology", "topic_name": "Osteoporosis, Sex Hormones and OCPs", "id": "c204c738-ba2f-479f-8b6e-96794db8b459", "choice_type": "single"} {"question": "Drug of choice for invasive aspergillosis is", "exp": "Voriconazoleis the drug of choice for invasive aspergillosis, Posaconazole is the only azole active against mucormycosis. Liposomal AMB is the drug of choice or co drug of choice for most systemic fungal infections. It can be used intrathecally in fungal meningitis and locally for corneal ulcers and keratitis. Caspofungin is approved for invasive aspergillosis not responding to AMB or voriconazole. It is quite nontoxic and causes only infusion related reaction.", "cop": 2, "opa": "Posaconazole", "opb": "Voriconazole", "opc": "Liposomal AMB", "opd": "Caspofungin", "subject_name": "Pharmacology", "topic_name": "NEET Jan 2020", "id": "1fdbab18-c16b-4e96-9bf4-bfeaf309716c", "choice_type": "single"} {"question": "Most common drug transpo mechanism is", "exp": "Passive diffusion- entry of drugs from high to low conc. with no requirement of ATP or energy Pg.no 30 KD TRIPATHI Seventh edition", "cop": 2, "opa": "Active transpo", "opb": "passive diffusion", "opc": "facilitated diffusion", "opd": "P glycoprotein", "subject_name": "Pharmacology", "topic_name": "General pharmacology", "id": "9d5c03e5-70ac-4048-8226-44f48178a6f1", "choice_type": "single"} {"question": "The following sympathomimetic amine has agonistic action on a1 + a2 + b1 + b3 adrenoceptors, but not on b2 receptors", "exp": "Ref:- kd tripathi; pg num:-130", "cop": 3, "opa": "Phenylephrine", "opb": "Isoprenaline", "opc": "Noradrenaline", "opd": "Adrenaline", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "fe23abba-e833-472f-b296-a3d92ea90cca", "choice_type": "single"} {"question": "Wof antimetabolite anti neoplastic agent is used in treatment of mesothelioma", "exp": "Pemetrexed Mech of action:- The newer congener of Mtx primarily targets the enzyme thymidylate synthase. Though, it is also a DHFRase inhibitor, the pool of THFA is not markedly reduced. Adverse effects:- mucositis, diarrhoea, myelosuppression, itching, erythematous rash mostly involving the hands and feet, 'hand- foot syndrome' is quite common. Dexamethasone can relieve it. Uses:- In combination with cisplatin,pemetrexed is approved for treatment of mesoepithelioma and non-small cell lung carcinoma. Ref:- kd tripathi; pg num:-863", "cop": 4, "opa": "6 thioguanine", "opb": "5 FU", "opc": "Busulfan", "opd": "Pemetrexed", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "50dbf727-3b07-4fc9-9743-d263d4050e7f", "choice_type": "single"} {"question": "The following drug is available in the form of transdermal patch", "exp": "Scopolamine is used as transdermal patch for motion sickness .sticked in post-auricular region 30min before travel Ref: KDT 6th ed pg 114", "cop": 2, "opa": "Dexmedetomidine", "opb": "Scopolamine", "opc": "Atropine", "opd": "Homatropine", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "9f3e1d42-db17-49b2-b3e3-ce364da5ce6d", "choice_type": "single"} {"question": "Cough syrup acts by inhibiting", "exp": "Ans. (a) Cough center* Forceful expulsion of air from lungs due to pulmonary irritation is called coughing. It can be productive or non- productive.* Anti-tussive is a class of drug which relieves coughing by suppressing cough center. These drugs are mainly used for dry cough. Example of anti-tussives are:# Opioids: Codeine, Phalcodeine, Ethylmorphine# Non-Opioids: NOSCAPINE, Dextromethorphan* Expectorants are class of drugs that increase bronchial secretion or reduce its viscosity (mucolytics). They are mainly used in productive cough. Example of expectorants are:# Mucolytics: Bromhexeine, Ambroxol# Bronchial secretion enhancers: Guaiphenisine, sodium or potassium citrate", "cop": 1, "opa": "Cough center", "opb": "Respiratory center", "opc": "Breathing center", "opd": "Pulmonary secretion center", "subject_name": "Pharmacology", "topic_name": "Asthma", "id": "d83d028f-6839-4211-966e-e871175699fb", "choice_type": "single"} {"question": "The aim of post marketing pharmacokinetics is", "exp": "(Safety and comparisons with other medicines) (43-Bennett & Brown) (61-62-GG)Pharmacokinetics - what the body does to the drag. This refers to movements of the drug in and alteration of the drug by the body; includes absorption, distribution, binding/localization/storage, biotransformation and excretion of the drug (1-KDT)* Post licensing (marketing) studies of safety and comparisons with other medicines (43-BB)Pharmacodynamics - What the drug does to the body. This includes physiological and biochemical effects of drugs and their mechanism of action at macromolecular/subcellular/ organ system levels.Post marketing detection of adverse reaction - several strategies exist to detect adverse reactions after marketing of a drug, but debate continues about the most efficient and effective method. Formal approaches for estimation of the magnitude of an adverse drug effect are the follow-up or \"cohort\" study of patients who are receiving a particular drug, the \"case control\" study where the potential for a drug to cause a particular disease is assessed, and meta-analysis of pre and post marketing (61-62-Goodman & Gillman's 10th)", "cop": 4, "opa": "Efficacy of the drug", "opb": "Dosage of the drug", "opc": "Deals with alteration of the drug includes absorption, distribution, binding / storage", "opd": "Safety and comparisions with other medicines", "subject_name": "Pharmacology", "topic_name": "General Pharmacology", "id": "c61e1ba9-8e7f-44d4-bda5-0e04fe2d46f4", "choice_type": "single"} {"question": "Not a feature of Stein Leventhal syndrome is", "exp": "Stein-Leventhal syndrome is another term for polycystic ovarian disease (PCOD). In this condition, androgens are raised due to hypehecosis leading to hirsutism. Oestrogen level is normal but LH level and LH / FSH ratio is raised. It is an impoant cause of secondary amenorrhoea and infeility in young women. Clomiphene is the drug of choice for infeility in PCOD and cyproterone acetate is the drug of choice for hirsutism. ref Katzung 12th ed.", "cop": 3, "opa": "Increased androgens", "opb": "Increased or normal oestrogens", "opc": "Galactorrhoea", "opd": "Increased LH", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "d9afed84-42f7-4250-9a5d-ac042c059912", "choice_type": "single"} {"question": "Chloroquine is used in the treatment of", "exp": null, "cop": 1, "opa": "DLE", "opb": "Pemphigus", "opc": "Psoriasis", "opd": "Nummular eczema", "subject_name": "Pharmacology", "topic_name": null, "id": "ff7dd22e-0ecd-4df0-9aa3-a195c0206d0a", "choice_type": "single"} {"question": "Idazoxan is a (REPEAT)", "exp": "Yohimbine, idazoxan -selective alpha 2 blockers.", "cop": 3, "opa": "Alpha 1 agonist", "opb": "Alpha 1 blocker", "opc": "Alpha 2 blocker", "opd": "Alpha 2 agonist", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "7f1e4a46-7c46-4595-83ee-301d13c642d1", "choice_type": "single"} {"question": "Drug of choice to treat severe fungal infection in \nAIDS is", "exp": null, "cop": 2, "opa": "Acyclovir", "opb": "Ketoconazole", "opc": "Aerosolized pentamidine", "opd": "Didanosine", "subject_name": "Pharmacology", "topic_name": null, "id": "f5f10acd-0d97-4332-af88-f521d449a8c5", "choice_type": "single"} {"question": "Approved drug for prostate cancer is", "exp": "Apalutamide was approved by FDA in 2018 for the treatment of HIV. It is androgen antagonist. Nilutamide, flutamide, bicalutamide are old drugs used in prostate cancerRef: Pancytopenia, Urticarial rash and ARF in bilateral RASEducational point:# Fosinopril excreted more in bile than others.# Losartan is an angiotensin II receptor antagonist. It is not an ACE inhibitor and does not cause cough.", "cop": 1, "opa": "Captopril", "opb": "Enalapril", "opc": "Ramipril", "opd": "Lisinopril", "subject_name": "Pharmacology", "topic_name": "ACE Inhibitors", "id": "fd45007c-9422-4d9a-b805-8167b274a0fb", "choice_type": "single"} {"question": "Route of administration of amyl nitrite in cyanide poisoning is", "exp": "Amyl nitrite is usually given in cyanide poisoning by inhalational route.", "cop": 2, "opa": "Sublingual", "opb": "Inhalational", "opc": "Intravenous", "opd": "Intramuscular", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "a2bb5a7c-2a44-43f8-abad-97ef350d6e74", "choice_type": "single"} {"question": "The following ADR is seen with withdrawal of", "exp": "The picture shows piloerection which occurs due to sympathetic stimulation which is typically seen with opioid withdrawalRef: Goodman Gillman 12th ed pg 660", "cop": 3, "opa": "Strychnine", "opb": "Clonidine", "opc": "Morphine", "opd": "Baclofen", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "1948367c-d235-4e3d-b564-c1fada228e3f", "choice_type": "single"} {"question": "Ivacaftor was approved by FDA in 2018 for", "exp": "Ivacaftor is used for treating cystic fibrosis", "cop": 1, "opa": "Cystic fibrosis", "opb": "Migraine", "opc": "Hypeension", "opd": "Glycogen storage disorders", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "3d795a0e-7c30-4278-bb77-8f53fdf275d4", "choice_type": "single"} {"question": "Beta 2 agonist causes", "exp": null, "cop": 4, "opa": "Mydriasis", "opb": "Contraction of urinary spinctors", "opc": "Vasoconstriction", "opd": "Bronchial muscle relaxation", "subject_name": "Pharmacology", "topic_name": null, "id": "ae03841b-a556-49fc-a0c4-01b243f77ace", "choice_type": "single"} {"question": "Red discolouration of urine is seen with", "exp": "Doxorubicin & Daunorubicin can cause red discolouration of urine.", "cop": 3, "opa": "Methotrexate", "opb": "Cytarabine", "opc": "Doxorubicin", "opd": "Cisplatin", "subject_name": "Pharmacology", "topic_name": null, "id": "a1f7582c-a4c0-4f14-8d5f-47af930d1a19", "choice_type": "single"} {"question": "Drug of choice for poisoning with Amanita muscaria", "exp": "Amanita muscaria signs and symptoms are mainly related to anxiety and insomnia which can be treated best with benzodiazepines like diazepam Atropine is contraindicated but for amanita inocybe poisoning atropine is drug of choice Ref: KDT 6th ed pg 98", "cop": 3, "opa": "Atropine", "opb": "Physostigmine", "opc": "Diazepam", "opd": "Pencillin", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "f9e02e89-e8ca-4c35-bc36-d6653ac50db2", "choice_type": "single"} {"question": "Salbutamol is used in", "exp": null, "cop": 2, "opa": "Cardiac asthma", "opb": "Bronchial asthma", "opc": "Pulmonary oedema", "opd": "Cor Pulmonary", "subject_name": "Pharmacology", "topic_name": null, "id": "1c48c526-b6bb-46b3-aaed-6efcbe6be5b7", "choice_type": "single"} {"question": "Drug of choice for non gonococcal urethritis is", "exp": "i.e. (Doxycycline) : (715-KDT 6th) (1399-1249-CMDT-11) Drug of choice for Nongonococcal Urethritis trachomatis. Mvcoplasma genitaliumUreaplasmaUrealyticum)* Azithromycin (preferred and safe in pregnancy) lg single doseorDoxycycline (C/I in pregnancy) 100 mg BD for 7 daysorLevoflaxacin (C/I in pregnancy) 500 mg OD for 7 days* Diagnosis made by nucleic acid amplification of urine or swab specimen Drug of choice for Gonococcal Urethritis* Ceftriaxone (III generation cephalosporins) single dose 1/MorCefixime 400mg orally onceorCefpodoxime 200-400mg orally once", "cop": 1, "opa": "Doxycycline", "opb": "Tetracycline", "opc": "Ciprofloxacin", "opd": "Ceftriaxone", "subject_name": "Pharmacology", "topic_name": "Anti Microbial", "id": "1ca7b390-aad5-4b5b-b45b-cbc3a4afb7ec", "choice_type": "single"} {"question": "Muscarinic receptors on blood vessel endothelium cause", "exp": "Ans. is'b' i.e., Vasodilatation through NONo direct cholinergic supply is present in blood vessels.But cholinergic receptor (M, types) are present on blood vessels endothelium.Stimulation of these receptors causes release of EDRF (NO) from endothelium resulting in vasodilatation.", "cop": 2, "opa": "Vasodilatation through acetylcholine", "opb": "Vasodilatation through NO", "opc": "Vasoconstriction through acetylcholine", "opd": "Vasoconstriction through endotheline", "subject_name": "Pharmacology", "topic_name": null, "id": "48a79c3e-13c2-4c64-841b-fe25c7548705", "choice_type": "single"} {"question": "Preferred drug for the treatment of ventricular tachycardia is", "exp": "Doc for ventricular tachycardia - Lignocaine", "cop": 4, "opa": "Digoxin", "opb": "Propranolol", "opc": "Diltiazem", "opd": "Lignocaine", "subject_name": "Pharmacology", "topic_name": "FMGE 2019", "id": "33f64282-e473-44ed-80f2-ca5e482483be", "choice_type": "single"} {"question": "Indication for intramuscular iron therapy is", "exp": "Refer KDT 6/e p 868 Drug of choice for acute iron poisoning is desferroxamine, however it has to be admistered parentarally It is not effective by oral route In beta thalassemia major iron excess can result due to repeated blood transfusions and massive Hemolysis Cheating agent has to be admistered for long time OK this case", "cop": 2, "opa": "Oral desforaxamine", "opb": "Oral deferiprone", "opc": "Intramuscular EDTA", "opd": "Oral succimer", "subject_name": "Pharmacology", "topic_name": "Respiratory system", "id": "b7d06c4c-1491-40b9-bb0e-9343e1dd98e8", "choice_type": "single"} {"question": "Hypeension and pulmonary edema associated with scorpion sting is managed by", "exp": "* Prazosin, a alpha1 selective adrenergic antagonist is a orable choice for management of scorpion sting associated hypeension and pulmonary edema. Ref:- Harrisons Principles of Internal Medicine 20th Ed; Pg Num:- 3329", "cop": 4, "opa": "Carvedilol", "opb": "Spironolactone", "opc": "Phentolamine", "opd": "Prazosin", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "7983f282-14b1-4ddb-9202-c3f1a1fc5d21", "choice_type": "single"} {"question": "The loading dose of Aminophylline is", "exp": "Refer KDT 6/e p 221 Aminophylline IA admistered I'm a dose of 5-7mg/kg slow intravenous infusion. In children, dose required is 7.5mg/kg", "cop": 4, "opa": "50-75mg/kg", "opb": "O. 5-1mg/kg", "opc": "2-3.5mg /kg", "opd": "5-6mg/kg", "subject_name": "Pharmacology", "topic_name": "Respiratory system", "id": "20e356b3-57f4-4608-8896-2a0e8c506926", "choice_type": "single"} {"question": "High dose Methotrexate is used for treatment of", "exp": "Refer Harrison 17th/612 Drugs needs for Osteosarcoma Doxorubicin Ifosfamide Cisplatin High dose Methotrexate with Leucovorin", "cop": 1, "opa": "Osteosarcoma", "opb": "Rhabdomyosarcoma", "opc": "Retinoblastoma", "opd": "Ewings sarcoma", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "fcd2f778-46fd-497a-bd0e-b89d2d6055fe", "choice_type": "single"} {"question": "Antihistamines used in motion sickness is", "exp": "Diphenhydramine and promethazine have maximum anti cholinergic activity and maximum ability to cross the blood brain barrier and are thus most effective in motion sickness . Refer katzung 11/e p278", "cop": 3, "opa": "Cetrizine", "opb": "Meclizine", "opc": "Diphenhydramine", "opd": "Fexofenadine", "subject_name": "Pharmacology", "topic_name": "Autacoids", "id": "5329c580-90e1-49ce-b665-03276984efea", "choice_type": "single"} {"question": "The drug treatment in a female with complaints of occasional amenorrhea and milk ejection 5yrs after her last baby is born", "exp": "Cabergoline,pergolide,bromocriptine(Dopamine agonists) are used for hyperprolactinomaRef: KDT 6th ed P 236", "cop": 1, "opa": "Cabergoline", "opb": "Atosiban", "opc": "Methysergide", "opd": "Ergotamine", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "e20802e4-38bb-440e-9ae6-3f65f2d3cf48", "choice_type": "single"} {"question": "Cisplatin induced vomiting on 3rd day of treatment DOC", "exp": "vomiting induced by chemotherapy has two stages early onset and delayed onset early onset is within 24 hrs of the therapy which can be controlled by drugs like ondansetron but Delayed onset of vomiting is not controlled by ondansetron in cisplatin treatment. hence more poerful drug acting on NK 1 receptors is used like aprepitant and fos apripetant. Ref:katzung 10/6 p 1027.", "cop": 1, "opa": "Aprepitant", "opb": "Ondansetron", "opc": "Metaclopramide", "opd": "Prochlorperazine", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "8086ae7f-2a79-4d13-9704-c608d5df9eeb", "choice_type": "single"} {"question": "Pramipexole is", "exp": "(A) Dopamine agonist # Dopamine agonist: Mirapex is a dopamine agonist used for Parkinson's disease.> Pramipexole Side Effects: Drowsiness and the possibility of suddenly falling asleep during daily activities, which could result in an accident while driving.> Most common MIRAPEX side effects are nausea, sleeplessness, constipation, involuntary movement, dizziness upon standing, and hallucinations.", "cop": 1, "opa": "Dopamine agonist", "opb": "Antimalarial", "opc": "MAO-inhibitor", "opd": "Dopamine antagonist", "subject_name": "Pharmacology", "topic_name": "Miscellaneous (Pharmacology)", "id": "5410a9a0-c9e2-46f2-9958-13482724e196", "choice_type": "single"} {"question": "Type 1 lepra reaction is treated with", "exp": "Treatment of choice for type 1 as well as type 2 lepra reaction is coicosteroids. For severe reaction, prednisolone 40-60mg/day is staed immediately and continued till the reaction subsides. The dose is then tapered over 2-3 months. For resistant cases of ENL drug of choice is thalidomide", "cop": 1, "opa": "Coicosteroid", "opb": "Minocycline", "opc": "Dapsone", "opd": "Rifampicin", "subject_name": "Pharmacology", "topic_name": "Mycobacterial Diseases (TB, Leprosy and MAC)", "id": "95caeb52-609f-444d-a6a0-192c15141e64", "choice_type": "single"} {"question": "Paradoxical action among diuretics is seen with", "exp": "DIURETICS ARE CONTRAINDICATED IN DIABETES IN WHICH THERE IS AN INCREASED EXCRETION OF URINE But, Thiazides are used in diabetes insipidus- paradoxical action -they create mild hypovolemia which encourages salt and water uptake in the proximal tubule and thus improve nephrogenic diabetes insipidus- action may be mediated through CAMP- poorly understood REF KD Tripathi 8th ed", "cop": 1, "opa": "Thiazide", "opb": "Triamterene", "opc": "Spirinolactone", "opd": "Furosemide", "subject_name": "Pharmacology", "topic_name": "Kidney", "id": "45247a5e-a146-4024-aa56-fec451ee6e4c", "choice_type": "single"} {"question": "Cinnarizine used for motion sickness is a", "exp": "Cinnarizine is an antihistamine with anticholinergic property given for motion sickness & also used in the treatment of vertigo.", "cop": 2, "opa": "5HT4 - antagonist", "opb": "H2 - antagonist", "opc": "Antihistamine", "opd": "NK1 antagonist", "subject_name": "Pharmacology", "topic_name": null, "id": "141f55ee-884b-4b93-a152-6bb445058c86", "choice_type": "single"} {"question": "Sargramostim is a", "exp": "Sargramostim: GM - CSF analogue.\nFilagastrim: G - CSF analogue.", "cop": 1, "opa": "GM - CSF", "opb": "G - CSF", "opc": "IL - 11 analogue", "opd": "Erythropoietin analogue", "subject_name": "Pharmacology", "topic_name": null, "id": "b9511713-510d-484b-bf40-3c0afecd12e0", "choice_type": "single"} {"question": "Infantile spasms with tuberous sclerosis DOC (REPEAT)", "exp": ".", "cop": 1, "opa": "Vigabatrin", "opb": "Valproate", "opc": "Barbiturate", "opd": "Ethosuximide", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "e96f0639-8d13-4b84-8986-4b350dc22fca", "choice_type": "single"} {"question": "The risk of thromboembolism increases in pregnancy because", "exp": null, "cop": 2, "opa": "Viscosity of blood increases", "opb": "Increased hepatic production of clotting factor", "opc": "Increased antithrombin III levels", "opd": "Increased progesterone levels", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "22884e7f-9951-4516-98f1-2cf19426225f", "choice_type": "single"} {"question": "Derivative of morphine used for diarrhoea", "exp": "Drugs used in the treatment of diarrhea include opiates (morphine, codeine), synthetic anti-diarrheals (diphenoxylate, loperamide), anticholinergics (atropine, propantheline), adsorbents (kaolin, pectin, cholestyramine resin) and Lactobacillus acidophilus. Chronic diarrhea and acute diarrhea caused by microorgansims, drugs and viruses are described. The management of diarrhea can be divided into three categories: (1) suppoive therapy (fluid and electrolyte replacement); (2) symptomatic therapy which improves the consistency of the stool and reduces the frequency of bowel movements; and (3) specific therapy aimed at treating the cause (e.g., antibiotics for bacteria-induced diarrhea) or blocking the cellular mechanisms of fluid and electrolyte loss. Most acute diarrheal conditions can be managed successfully by avoiding oral solids and ingesting carbohydrate-electrolyte solutions. Synthetic antidiarrheals may increase the toxicity associated with bacterial diahhrea. Ref: katzung 13th ed..", "cop": 2, "opa": "Oxymorphine", "opb": "Diphenoxylate", "opc": "Pethidine", "opd": "Codeine", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "6ba00aa2-e8e2-4538-be11-471cfe3806dc", "choice_type": "single"} {"question": "In competetive antagonism", "exp": "Vmax corresponds to efficacy which remains same in competitive antagonism.\nKm corresponds to potency and in competitive antagonism Km increases, potency decreases.", "cop": 1, "opa": "Vmax remains same", "opb": "Potency remains same", "opc": "Km decreases", "opd": "Efficacy decreases", "subject_name": "Pharmacology", "topic_name": null, "id": "7c6e3727-7f13-487c-8563-b049d168b407", "choice_type": "single"} {"question": "Mydriatic with no cycloplegic effect is seen with", "exp": "Mydriasis with no loss of accommodation(cycloplegia) is seen with phenylephrine which is alpha agonist Ref: Katzung 11th ed pg 117", "cop": 2, "opa": "Atropine", "opb": "Phenylephrine", "opc": "Tropicamide", "opd": "Homatropine", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "d54d421c-8494-4104-8d29-854bf250e964", "choice_type": "single"} {"question": "Best for treatment of irritable bowel syndrome with spastic colon is", "exp": "Ans. d (Dietary fibers). (Ref. KD Tripathi 5th ed. - 614)Spastic constipation/Irritable bowel1st choice laxative:# Dietary fibers# Bulk forming laxative such as Ispaghula, methylcellulose.While Stimulant purgatives like:# Castor oil,# Senna,# Bisacodyl, Phenolphthalein........ are contraindicated.", "cop": 4, "opa": "Liquid paraffin", "opb": "Senna", "opc": "Bisacodyl", "opd": "Dietary fibers", "subject_name": "Pharmacology", "topic_name": "G.I.T", "id": "1d436b15-2f09-42bc-b085-29571f1a7332", "choice_type": "single"} {"question": "Select the most suitable antiarrhythmic drug for counteracting ventricular extrasystoles due to digoxin toxicity", "exp": "Digitalis Toxicity:- Toxicity of digitalis is high, margin of safety is low (therapeutic index 1.5-3). Higher cardiac moality has been repoed among patients with steady-state plasma digoxin levels > 1.1 ng/ml but still within the therapeutic range during maintenance therapy. Manifestations and treatment of toxicity For ventricular arrhythmias:- Lidocaine i.v. repeated as required is the drug of choice. It suppresses the excessive automaticity, but does not accentuate A-V block. Quinidine, procainamide and propafenone are contraindicated. Ref:- kd tripathi; pg num:-516", "cop": 3, "opa": "Verapamil", "opb": "Quinidine", "opc": "Lignocaine", "opd": "Amiodarone", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "1c3c9d5b-4034-4169-86c3-eeb748855139", "choice_type": "single"} {"question": "The parenteral administration of streptokinase", "exp": "Streptokinase (SK) is thrombolytic (or fibrinolytic) because it activates plasminogen, resulting in the increased formation of plasmin. Its efficacy is equivalent to that of tissue plasminogen activator (t-PA), but SK is not clot-specific. All thrombolytics can cause bleeding, which may be counteracted to some extent by administration of antifibrinolysins, such as aminocaproic acid.", "cop": 4, "opa": "increases the formation of plasminogen", "opb": "is less effective following a myocardial infarct than t-pA", "opc": "causes a high incidence of thrombocytopenia", "opd": "may cause bleeding reversible by aminocaproic acid", "subject_name": "Pharmacology", "topic_name": "Anti-Cancer", "id": "c66be654-2a6d-4efa-b3a1-8302aafe5651", "choice_type": "single"} {"question": "A 2 years old child without fever develops bone pain, vomiting and features of increased intracranial pressure following excessive meditation. The drug most likely to be responsible for this is;", "exp": "Since vit. A is stored in liver, deficiency symptoms appear only after long- term deprivation, but vit A deficiency is quite prevalent, especially among infants and children in developing countries. Manifestations are: * Xerosis (dryness) of eye, 'Bitot' s spots', kerato- malacia (softening of cornea), corneal opacities, night blindness (nyctalopia) progressing to total blindness. * Dry and rough skin with papules (phryno- derma), hyperkeratinization, atrophy of sweat glands. * Keratinization of bronchopulmonary epithe- lium, increased susceptibility to infection. * Unhealthy gastrointestinal mucosa, diarrhoea. * Increased tendency to urinary stone formation due to shedding of ureteric epithelial lining which acts as a nidus. * Sterility due to faulty spermatogenesis,etc ESSENTIALS of medical PHARMACOLOGY SIXTH EDITION-KD TRIPATHI Page:870", "cop": 1, "opa": "Vitamin A", "opb": "Phenothiazine", "opc": "Phenytoin", "opd": "Vitamin D", "subject_name": "Pharmacology", "topic_name": "Other topics and Adverse effects", "id": "a662d33a-5b53-43c7-b69d-c6c097a840ea", "choice_type": "single"} {"question": "Vitamin K is a cofactor in", "exp": "Refer Katzung 10/e p 549 Vitamin K is involved in activition if various clotting factors as well as anticlotting clotting proteins It carries out the final step in activation of these ors I. E, gamma carboxylation of glutamate residues in these factors", "cop": 1, "opa": "Carboxylation", "opb": "Hydroxylation", "opc": "Deaminatiom", "opd": "Hydrolysis", "subject_name": "Pharmacology", "topic_name": "Respiratory system", "id": "47718736-f2ae-4566-818b-7f1e88e2fb41", "choice_type": "single"} {"question": "Bisphoshonates act by", "exp": "Refer Katzung 10/e p713 bisphoshonates are used for the treatment of post menopausal osteoporosis, steroid induced osteoporosis, Pagets disease and hypercalcemia of malignancy", "cop": 2, "opa": "Increasing the Osteoid formation", "opb": "Increasing the mineralization of Osteoid", "opc": "Decreasing the osteoclast mediated resorption of bone", "opd": "Decreasing the parathyroid hormone receptors", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "f9ee298d-6b1c-4090-be4d-8a60ea0a58ed", "choice_type": "single"} {"question": "Loading dose of 25mg was needed to achieve 0.5mg / L of Plasma concentration. Volume of distribution is 40L. Calculate the Bioavailabity", "exp": null, "cop": 3, "opa": "40%", "opb": "50%", "opc": "80%", "opd": "70%", "subject_name": "Pharmacology", "topic_name": null, "id": "3d0bf558-b34d-46a3-8de8-40d257686423", "choice_type": "single"} {"question": "Neostigmine used in treatment of Myasthenia gravis acts by", "exp": "Refer kDT 6/e p 101 In most people with myasthenia gravis, the immune system blocks or damages these acetylcholine receptors. The acetylcholine cannot then attach to the receptor and so the muscle is less able to tighten.Neostigmine works by slowing the breakdown of acetylcholine when it is released from nerve endings.", "cop": 3, "opa": "Increasing the number of receptor for acetylcholine", "opb": "Increasing synthesis of acetylcholine", "opc": "Decreasing breakdown of acetylcholine", "opd": "Increasing acetylcholine degradation", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "8c63407c-a9ca-4166-a9f6-f95132b8992f", "choice_type": "single"} {"question": "Therapeutic index is a measure of", "exp": "(c) Safety,Ref: Lippincott, 6th ed., pg. 35The therapeutic index (TI) of a drug is the ratio of the dose that produces toxicity to the dose that produces a clinically desired or effective response in a population of individuals:TI=TD50/ED50Where TD50 = the drug dose that produces a toxic effect in 50% the population and ED50 = the drug dose that produces a therapeutic or desired response in 50% the population. TI is a measure of a drug's safety, because a larger value indicates a wide margin between doses that are effective and doses that are toxic.", "cop": 3, "opa": "Potency", "opb": "Efficacy", "opc": "Safety", "opd": "Potency + efficacy", "subject_name": "Pharmacology", "topic_name": "General Pharmacology", "id": "c6a89293-f155-4838-a11c-92ed10b1f6d1", "choice_type": "single"} {"question": "The Gustatory nucleus is a pa of(NOT REALTED TO PHARMACOLOGY)", "exp": "The rostral pa of the solitary nucleus is sometimes referred to as the gustatory nucleus. The solitary nucleus conveys information about taste and visceral sensations", "cop": 1, "opa": "Solitary nucleus", "opb": "Hypoglossal nucleus", "opc": "Nucleus ambiguous", "opd": "Dorsal motor nucleus", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "dc0cb196-956c-4ef9-ac37-a22dfeb1d726", "choice_type": "single"} {"question": "Fluoroquinolone contraindicated in liver disease is", "exp": "Dose ofpefloxacin needs to be reduced in liver disease, but not in renal insufficiency. FQs c/I in renal failure except P - Pefloxacin M -Moxifloxacin T - Trovafloxacin", "cop": 2, "opa": "Levofloxain", "opb": "Pefloxacin", "opc": "Ofloxacin", "opd": "Lemefloxacin", "subject_name": "Pharmacology", "topic_name": "NEET Jan 2020", "id": "c669fa5c-d557-4e15-88c3-1c3e091b2be0", "choice_type": "single"} {"question": "The ratio of the median lethal dose of the median effective dose is the", "exp": null, "cop": 4, "opa": "Morbidity index", "opb": "Moratality index", "opc": "Anesthetic ratio", "opd": "Therapeutic index", "subject_name": "Pharmacology", "topic_name": null, "id": "4547a3c5-df16-421f-b335-aa8591d07cc7", "choice_type": "single"} {"question": "A child presents with bladder exstrophy and chronic renal failure. The muscle relaxant of choice to be used during surgery of exstrophy in this child is", "exp": "Atracurium:- A bisquaternary competitive blocker and shoer acting: reversal is mostly not required. The unique feature of atracurium is inactivation in plasma by spontaneous non- enzymatic degradation (Hofmann elimination) in addition to that by cholinesterases. Consequently its duration of action is not altered in patients with hepatic/renal insufficiency or hypodynamic circulation. It is the preferred muscle relaxant for liver/kidney disease patients as well as for neonates and the elderly. Hypotension may occur due to dose dependent histamine release. Ref:- kd tripathi; pg num:-353,354", "cop": 4, "opa": "Pancuronium", "opb": "Rocuronium", "opc": "Mivacurium", "opd": "Atracurium", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "9dd8a668-2d89-4f2a-8467-ae1d03d0733d", "choice_type": "single"} {"question": "GABA transmission is facilitated by", "exp": "GABAergic transmission refers to activation ofGABA receptors and release of GABA by endogenous or pharmacological modulators. g-Aminobutyric acid (GABA) is the most prevalent inhibitory neurotransmitter in the mammalian central nervous system. Ref: KD Tripathi 8th ed.", "cop": 1, "opa": "Vigabatrin", "opb": "Carbazepine", "opc": "Phenytoin", "opd": "Buspirone", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "c3d66e21-77a4-4497-8b9c-1f988829dcd7", "choice_type": "single"} {"question": "The composition of Lugol&;s iodine", "exp": "Lugol's iodine is 10% KI with 5% Iodine. Used as an adjuvent in Graves patients planned for surgery. Iodides decrease the vascularity of the gland anf inhibit the release of thyroid hormones hence called thyroid constipating agents. Ref: KDT 7th ed Pg 255", "cop": 1, "opa": "10% KI with 5% Iodine", "opb": "5% KI and 15% Iodine", "opc": "5% Iodine with 20% KI", "opd": "10% Iodine and 20% KI", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "f9ab78d5-991f-4511-8a47-d9d017ca0e84", "choice_type": "single"} {"question": "Lutetium dotatate was approved by FDA in 2018 for", "exp": "Lutetium (Lu 177) dotatate a radiolabeled somatostatin analogue, for the treatment of somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumours (GEP-NETs), including foregut, midgut, and hindgut neuroendocrine tumours in adults.", "cop": 2, "opa": "TB", "opb": "Neuroendocrine tumours", "opc": "Crohn's disease", "opd": "Peptic ulcer", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "90edd1c7-4188-4843-b656-0fde8646781e", "choice_type": "single"} {"question": "Sho acting anticholinesterase drug is", "exp": "Refer kDT 6/e p 101 Edrophonium is the only sho-acting anticholinesterase available; it is a synthetic quaternary ammonium compound. The drug competes with acetylcholine and binds by a non-covalent bond to acetylcholinesterase at the anionic site. The recommended dose for antagonism of neuromuscular block is 0.5-1 mg kg-1.", "cop": 1, "opa": "Edrophonium", "opb": "Neostigmine", "opc": "Dyflos", "opd": "Ectothiophate", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "ea03694c-4fdf-4976-b5ee-b6bc17e5d4b4", "choice_type": "single"} {"question": "Monday disease is seen with", "exp": "Nitrates because of tolerance produce Monday headache in workers working in nitrate industry which gradually subsides by Friday. Ref: Katzung 12th ed.", "cop": 2, "opa": "Beta blockers", "opb": "Nitrates", "opc": "Calcium channel blockers", "opd": "Potassium channel openers", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "9ce33492-0d63-4de0-a257-2d0560792be6", "choice_type": "single"} {"question": "Erenumab was approved by FDA in 2018 for", "exp": "Erenumab belongs to a new class of drugs known as selective calcitonin gene-related peptide (CGRP) antagonists, which are used for the treatment of acute migraine attacks.", "cop": 2, "opa": "Phenylketonuria", "opb": "Migraine", "opc": "Hypeension", "opd": "Glycogen storage disorders", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "a59f3a04-43fd-49b1-aa8b-5b95c654a4f4", "choice_type": "single"} {"question": "Drug of choice for Hypercalcemia of malignancy is", "exp": "Drug of choice for hypercalemia of malignancy is Bisphophonates and for immediate treatment IV fluids are used.Salcatonin / calcitonin is fastest calcium lowering drug.", "cop": 3, "opa": "Salcatonin", "opb": "IV fluids", "opc": "Bisphosphonates", "opd": "SERM", "subject_name": "Pharmacology", "topic_name": null, "id": "2771a081-1246-4070-872a-26aa295b81e0", "choice_type": "single"} {"question": "Short acting mydriatic used in fundoscopy is", "exp": "(Tropicamide) (98 - KDT) (111-KDT6th)Tropicamide - It has the quickest (20 - 40 min) and briefest (2-6 hours) action, but it is a relatively unreliable cyclopegic* However it is satisfactory for refraction testing in adults and as short acting mydriatic for fundoscopy", "cop": 4, "opa": "Atropine", "opb": "Homatropine", "opc": "Cyclopentolate", "opd": "Tropicamide", "subject_name": "Pharmacology", "topic_name": "A.N.S.", "id": "a3b2da3c-d280-473c-9406-57c731c6ed22", "choice_type": "single"} {"question": "DENOSUMAB a monoclonal antibody against RANKL receptor is used in the treatment of", "exp": "Ans. is 'b' i.e. Osteoporosis Osteoclast is a cell responsible for bone resorption.Osteoclasts express RANK receptors on its surface (RANK receptor activator for nuclear factor)When RANK receptor combine with their ligands (RANKL), osteoclastogenesis is a initiated and bone resorption occurs.Denosumab is a fully humanized monoclonal antibody against RANK ligand.It prevents the activation of the osteoclasts by these ligand.Note:Osteoporosis is a disease characterized by decrease in the bone massIn osteoporosis there is increase in the osteoclast activity and there is increased expression of RANK and RANKL.", "cop": 2, "opa": "Rheumatoid arthritis", "opb": "Osteoporosis", "opc": "Osteoarthritis", "opd": "SLE", "subject_name": "Pharmacology", "topic_name": "Immunomodulator", "id": "3bead08e-1416-4451-a66f-a5cc67c843b5", "choice_type": "single"} {"question": "Drug that can be used for producing alkalinization of urine is", "exp": "CARBONIC ANHYDRASE INHIBITORS Carbonic anhydrase is an enzyme which catalyses thereversible reaction H2O+CO2 -> H2CO3. Carbonic acid spontaneously ionizes H2CO3 -> H+ + HCO3-. Carbonic anhydrase thus functions in CO2 and HCO3 - transpo and in H+ ion secretion. The enzyme is present in renal tubular cell (especially PT) gastric mucosa, exocrine pancreas, ciliary body of eye, brain and RBC. Acetazolamide:- Mech of action:- It is a sulfonamide derivative which noncompetitively but reversibly inhibits CAse (type II) in PT cells resulting in slowing of hydration of CO2 ->decreased availability of H+ to exchange with luminal Na+ through the Na+-H+ antipoer. Inhibition of brush border CAse (type IV) retards dehydration of H2CO3 in the tubular fluid so that less CO2 diffuses back into the cells. The net effect is inhibition of HCO3 - (and accompanying Na+) reabsorption in PT. However, the resulting alkaline diuresis is only mild (maximal fractional Na+ loss 5%), because pa of the Na+ (but not HCO3 - ) rejected in the PT is reabsorbed at the high capacity AscLH. The urine produced under acetazola mide action is alkaline and rich in HCO3 - which is matched by both Na+ and K+. Continued action of acetazolamide depletes body HCO3 - and causes acidosis. Ref:- kd tripathi; pg num:-586,587", "cop": 3, "opa": "Hydrochlohiazide", "opb": "Furosemide", "opc": "Acetazolamide", "opd": "Spironolactone", "subject_name": "Pharmacology", "topic_name": "Kidney", "id": "305d571d-7107-44b8-9a78-5afe5eca1d51", "choice_type": "single"} {"question": "The following is the indication of eptifibatide", "exp": "Eptifibatide, terofiban are the newer antiplatelet drugs(Glycoprotein IIB/IIIA inhibitors) used in unstable anginaRef: Goodman Gillman 12thed. Pg: 871", "cop": 1, "opa": "Angina", "opb": "HIV", "opc": "CCF", "opd": "Hypeension", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "11b8bde2-6539-4460-825f-a99356dd2ff4", "choice_type": "single"} {"question": "5HT1 paial agonists are used as", "exp": "Buspirone, gepirone, spiperone - atypical anti-anxiety agents they do not affect GABA levels- so atypical they are serotonin paial agonists Ref: KD Tripathi 8th ed", "cop": 1, "opa": "Anti anxiety drugs", "opb": "Antipsychotic drugs", "opc": "Anti reflux medications", "opd": "Anti emetic", "subject_name": "Pharmacology", "topic_name": "Autacoids", "id": "17ae4de6-c1da-4272-bda2-b2bf5081aeb0", "choice_type": "single"} {"question": "ADR of acarbose", "exp": "The most common ADR of alpha glucosidase inhibitors are flatulence due to indigestion of polysaccharides Ref: Katzung 12th ed, diabetis Mellitus..", "cop": 1, "opa": "Flatulence", "opb": "Hypoglycemia", "opc": "Periodic Hyperglycemia", "opd": "Weight gain", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "97eba6d8-3732-4824-b360-191ce78acb23", "choice_type": "single"} {"question": "Hot nodule in liver scan is due to(NOT RELAVENT TO PHARMACOLOGY)", "exp": "50% of the focal nodular hyperplasia shows presence of Kupfer cells (phagocytes). So uptake of sulphur colloid is noted in these lesions. No uptake is seen in HCC, hepatic adenoma and metastases", "cop": 2, "opa": "Hepatic adenoma", "opb": "Focal nodular hyperplasia", "opc": "Metastasis", "opd": "HCC", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "ef20a824-c652-490b-9ced-faf4a716d430", "choice_type": "single"} {"question": "Pegvaliase was approved by FDA in 2018 for", "exp": "Pegvaliase is a drug approved for the treatment of phenylketonuria. Chemically, it is a pegylated derivative of the enzyme phenylalanine ammonia-lyase that metabolizes phenylalanine to reduce its blood levels.", "cop": 1, "opa": "Phenylketonuria", "opb": "Pancreatic tumours", "opc": "Crohn's disease", "opd": "Glycogen storage disorders", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "a4dab156-b547-47c3-aa70-e89821931589", "choice_type": "single"} {"question": "Activation of postsynaptic M2 receptors on the hea is associated with", "exp": "M2 and M4 receptors act by the opening of K+ channels. M1 and M4 act by the IP3-DAG pathway.", "cop": 2, "opa": "Activation of adenylyl cyclase", "opb": "Opening of Na+/K+ cation channels", "opc": "Decrease in cAMP formation", "opd": "Increase in IP3 and DAG", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "ea1dea4b-d706-42cc-a6cf-4020b6560419", "choice_type": "single"} {"question": "Condyloma accuminata in pregnancy is treated by", "exp": "Treatment of condyloma -acuminata - (verruca-genital is) Podophyllum is effective only on the genital was Podophyllum is potentially toxic and must be avoided in during pregnancy Chemical cauterization is usually done with liquified phenol or concentrated trichloroacetic acid Ref: KD Tripathi 8th ed/", "cop": 3, "opa": "Podophyllin", "opb": "Podophyllin toxin", "opc": "Trichloroacetic acid", "opd": "5-FU cream", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "f921a40f-5ca8-424f-85db-7dbf2408f3bc", "choice_type": "single"} {"question": "Action of adranaline is reversed by prazosine but not by propranol", "exp": "i.e. (Urinary symptoms of BHP): (133-KDT 6th)* Prazocine is a1 blocker and propranol is non selective beta blocker* Urinary symptoms in BHP are solely due to alpha receptorsThe a blockers have no effect on adrenergically induced cardiac stimulation, bronchial dilatation, vasodilation and most of the metabolic changes because these are mediated predominantly through b-receptors (133-KDT 6th)", "cop": 3, "opa": "Tachycardia", "opb": "Bronchial dilatation", "opc": "Urinary symptoms of BHP", "opd": "Migraine", "subject_name": "Pharmacology", "topic_name": "A.N.S.", "id": "f90048ab-aaaa-4bfa-be57-b3f10b974f56", "choice_type": "single"} {"question": "Drug used in type DM 1 apa from insulin", "exp": "Pramlintide is recently approved to be used for type 1 diabetes apa from insulin. It is given by SC route. It is an amylin analogue. Ref: KD Tripathi 8th ed.", "cop": 3, "opa": "Glibenclamide", "opb": "Metformin", "opc": "Pramlintide", "opd": "Empagliflozin", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "4940435a-0ef5-4129-84aa-cd45c8c84a05", "choice_type": "single"} {"question": "Melphalan is used in", "exp": "Ans. is 'a' i.e., Multiple myeloma Melphalan is an anticancer (alkylating) agent which is most effective in multiple myeloma.Most common toxicity of Melphalan is Bone marrow toxicity.", "cop": 1, "opa": "Multiple myeloma", "opb": "Wilm's tumour", "opc": "Neuroblastoma", "opd": "Retinoblastoma", "subject_name": "Pharmacology", "topic_name": "Anti-Neoplastic Agents", "id": "3953b5ca-19e2-43a6-bb31-158755d1f218", "choice_type": "single"} {"question": "lxabepilone is", "exp": "Ans. is 'b' i.e., Antineoplastic Ixabepilone o Ixabepilone also known as azaepothilone B. o It has been approved by FDA for the treatment of aggressive metastatic or locally advanced breast cancer which is not responding to standard chemotherapy o It is given in combination with capecitabine. o It has also been investigated for use in treatment of non-Hodgkin's lymphoma. o It acts by binding to tubulin and promoting microtubule stabilization (like taxanes) thereby acting on M phase of cell cycle.", "cop": 2, "opa": "lxabepilone is", "opb": "Antineoplastic", "opc": "Antidiarrheal", "opd": "Antihelminth", "subject_name": "Pharmacology", "topic_name": null, "id": "dde01633-b49c-43ec-ba77-d26384cbd090", "choice_type": "single"} {"question": "Treatment of chronic phase of CML is", "exp": "(A) Imatinib # Standard treatment for chronic phase CML is a tyrosine kinase inhibitor (TKI) such as imatinib, Nilotinib, or Dasatinib.> For imatinib, the usual starting dose is 400 mg per day.> If the first drug stops working (or it never really worked well at all) the dose may be increased or the patient may be switched to one of the other TKIs (including Bosutinib/Bosulif).> Ponatanib is an option after all of the other TKIs have been tried or if the leukemia cells later develop the T315I mutation.> Switching to another TKI is also an option if the patient can't take the first drug because of side effects.> Some people in chronic phase may be treated with an allogeneic stem cell transplant (SCT).", "cop": 1, "opa": "Imatinib", "opb": "Hydroxyurea", "opc": "Interferon", "opd": "Cytarabine", "subject_name": "Pharmacology", "topic_name": "Miscellaneous (Pharmacology)", "id": "a03269ad-14b3-4d66-925e-9a4f0f7eaf08", "choice_type": "single"} {"question": "Diuretic that is useful in mild to moderate hypeension is", "exp": "Thiazides are not only drug of choice for mild to moderate hypeension but I first line choice for this type of patients as antihypeensive drugs Refer Harrison 19e/p1623", "cop": 2, "opa": "Loop diuretics", "opb": "Thiazides", "opc": "Osmotic diuretics", "opd": "Potassium sparing diuretics", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "1c777ccb-4ea8-40fd-8bc0-ff217b1b3941", "choice_type": "single"} {"question": "Telmisaan lowers blood pressure by", "exp": "Refer kDT 7/e p 561 Telmisaan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor in many tissues, such as vascular smooth muscle and the adrenal gland. Its action is therefore independent of the pathways for angiotensin II synthesis.", "cop": 3, "opa": "Inhibiting formation of angiotensin 1 to angiotensin", "opb": "Inhibiting conversion ofrenin to angiotensin 1", "opc": "Blocking AT1 receptors", "opd": "Interfering with degradation of bradykinin", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "0cd01938-89d7-4b42-b636-89af96e94768", "choice_type": "single"} {"question": "Effect of Vmax and Km in competitive inhibition is as follows", "exp": "In competitive inhibition, Drug binds to enzyme only .So, Velocity remains unchanged and Conc- km increases. In non- competitive inhibition, drug binds to enzyme substrate complex deceasing velocity unaffecting km. Ref: K.D.Tripati.7th ed. Pg 39", "cop": 3, "opa": "Km unchanged", "opb": "Vmax increased, Km unchanged", "opc": "Km increased, V max unchanged", "opd": "Km and Vmax increased", "subject_name": "Pharmacology", "topic_name": "General pharmacology", "id": "77d6f286-737d-4da4-b6e8-533dcea8cded", "choice_type": "single"} {"question": "The following antiasthma drug is not a bronchodilator", "exp": "Bronchodilators :- a) b2 Sympathomimetics: Salbutamol, Terbutaline, Bambuterol, Salmeterol, Formoterol, Ephedrine. B) Methylxanthines: Theophylline (anhydrous), Aminophylline, Choline theophyllinate, Hydroxyethyl theophylline, Theophylline ethanolate of piperazine, Doxophylline. C) Anticholinergics: Ipratropium bromide, Tiotropium bromide. Sodium cromoglycate:- mech of action :- It inhibits degranulation of mast cells by trigger stimuli(MAST CELL STABILISER). Bronchospasm induced by allergens,irritants,coldair and exercise may be attenuated. It is also not a bronchodilator and does not antagonize constrictor action of histamine, ACh, LTs, etc. Therefore, it is ineffective if given during an asthmatic attack. Pharmacokinetics:- Sod. cromoglycate is not absorbed orally. It is administered as an aerosol through metered dose inhaler it is rapidly excreted unchanged in urine and bile. uses:- 1. Bronchial asthma: Sod. cromoglycate is a long-term prophylactic in mild-to-moderate asthma. Decrease in the frequency and severity of attacks is more likely in extrinsic (atopic) and exercise-induced asthma, especially in younger patients. 2. Allergic rhinitis 3. Allergic conjunctivitis Ref:- kd tripathi; pg num:- 222,229", "cop": 3, "opa": "Ipratropium bromide", "opb": "Theophylline", "opc": "Sodium cromoglycate", "opd": "Formoterol", "subject_name": "Pharmacology", "topic_name": "Respiratory system", "id": "c9be6c4f-136a-440b-95c0-38d129e30a9c", "choice_type": "single"} {"question": "The following teratogenic effect is produced by", "exp": "The picture shows scalp defect-aplasia cutis which is a teratogenic effect of carbimazoleRef: KD Tripathi 7th ed pg 253", "cop": 2, "opa": "Propylthiouracil", "opb": "Carbimazole", "opc": "Valproate", "opd": "Phenytoin", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "72b1bcdd-0376-43ca-97f3-f814596322f1", "choice_type": "single"} {"question": "Alkalinization of urine is done in", "exp": "Alkalinization of urine is done to treat acidic drug poisoning \nEx:- Aspirin, Barbiturates, Methotrexate, Penicillin.\nAcidification of urine is done to treat basic drug poisoning \nEx: - Amphetamine, Morphine, Atropine, Quinine.", "cop": 1, "opa": "Aspirin", "opb": "Atropine", "opc": "Amphetamine", "opd": "Morphine", "subject_name": "Pharmacology", "topic_name": null, "id": "47ed4f42-2fc9-41a0-b8b2-c5e2ffdc6cb7", "choice_type": "single"} {"question": "Not used in treatment protocol of hodgkin's lymphoma", "exp": "Ref: Katzungy 14th ed. pg. 970; Harrison, 17th ed. pg. 699Preferred regimen for Hodgkins and Non-hodgkins lymphomaHodgkins lymphoma (ABVD)Non-hodgkin's lymphomaA: Adriamycin (Doxorubicin)B: BleomycinV: VinblastinD: DacarbazineR: RituximabC: CyclophosphamideH: Hydroxdaunorubicin (doxorubicin)O: Oncovin (vincristine)P: Prednisolone", "cop": 1, "opa": "VinCristine", "opb": "Vinblastine", "opc": "Bleomycin", "opd": "Adriamycin", "subject_name": "Pharmacology", "topic_name": "Anti-Cancer", "id": "5cce7626-4d1f-4633-915c-3956db83a24a", "choice_type": "single"} {"question": "Lactic acidosis is common in", "exp": "(Phenformin) (247-KDT) (689-BB) (267-KDT 6th)* Lactic acidosis more common in Phenformin and rare in Metformin* * Hypoglycemia is the most common adverse effect with sulphonyl ureas.Repaglinide indicated only in type 2 DM as an alternative to sulfonyl ureas.* It should be avoided in liver diseaseRosiglitazone - Thiozolidinediones* It is indicated once daily in patients not controlled by metformin alone.* It is contraindicated by cardiac or hepatic failure.* Weight gain and oedema are the main adverse effects others - headache, myalgia and mild anaemia", "cop": 2, "opa": "Metformin", "opb": "Phenformin", "opc": "Repaglinide", "opd": "Rosiglitazone", "subject_name": "Pharmacology", "topic_name": "Endocrinology", "id": "5706486d-3386-477f-8b63-38ed3768f97c", "choice_type": "single"} {"question": "The characteristic toxicity of ethambutol is", "exp": "Ethambutol It is selectively tuberculostatic. mechanism of action:- It has been found to inhibit arabinosyl transferases (encoded by embABgenes) involved in arabinogalactan synthesis thereby interfering with mycolic acid incorporation in mycobacterial cell wall. Ethambutol Resistance:- Develops slowly and is most commonly associated with mutation in embB gene, reducing the affinity of the target enzyme for Ethambutol. No cross resistance with any other antitubercular drug has been noted. pharmacokinetics:- About 3/4 of an oral dose of Ethambutol is absorbed.It is distributed widely, but penetrates meninges incompletely and is temporarily stored in RBCs. Less than 1/2 of E is metabolized. It is excreted in urine by glomerular filtration and tubular secretion; plasma t 1/2 is ~4 hrs. Caution isrequired in its use in patients with renal disease. side effects:- Loss of visual acuity/colour vision, field defects due to optic neuritis is the most impoant dose and duration of therapy dependent toxicity. Contraindication:- Young children & patients with optic neuritis. Ref:- kd tripathi; pg num:-769", "cop": 2, "opa": "Hepatitis", "opb": "Visual field defects", "opc": "Vestibular disturbance", "opd": "Renal damage", "subject_name": "Pharmacology", "topic_name": "Antibiotics", "id": "5a10d4c1-79ab-4fb6-8882-ee2a685c386c", "choice_type": "single"} {"question": "A patient is having bronchodilation, increased temperature, constipation and tachycardia. The tentative diagnosis is", "exp": null, "cop": 4, "opa": "Oraganophosphate poisoning", "opb": "Paracetamol poisoning", "opc": "Mushroom poisoning", "opd": "Atropine poisoning", "subject_name": "Pharmacology", "topic_name": null, "id": "ae2c231d-d282-4015-b466-92842b25d218", "choice_type": "single"} {"question": "Drug of choice in pregnancy induced hypertension is", "exp": null, "cop": 4, "opa": "Amlodipine", "opb": "Losartan", "opc": "Diuretic", "opd": "Methyldopa", "subject_name": "Pharmacology", "topic_name": null, "id": "f2b9d5a2-7920-445c-a74c-88ddb9f93498", "choice_type": "single"} {"question": "Tetracyclines act by", "exp": null, "cop": 1, "opa": "Inhibiting the binding of aminoacyl tRNA to the ribosomal complex", "opb": "Inhibiting peptidyl transferase", "opc": "Inactivating elongation factors", "opd": "Causing misreading of mRNA", "subject_name": "Pharmacology", "topic_name": null, "id": "6f9758f3-af10-49a6-9726-ef21ac632125", "choice_type": "single"} {"question": "Ivermectin is a", "exp": "Ivermectin is the drug of choice for Strongyloides and Onchocerca volvulus. It is a filaricide (effective against W. bancrofti and malayi).Ivermectin, a semisynthetic macrocyclic lactone, a mixture of avermectin B1a and B1b. It is derived from the soil actinomycete Streptomyces avermitilisIvermectin is used only orally in humans. The drug is rapidly absorbed, reaching maximum plasma concentrations 4 hours after a 12mg dose. Ivermectin appears to paralyze nematodes and ahropods by intensifying g-aminobutyric acid (GABA)-mediated transmission of signals in peripheral nervesReference: Katzung Pharmacology; 13th edition; Chapter 53; Clinical Pharmacology of the Antihelminthic Drugs", "cop": 3, "opa": "Cysticide", "opb": "Taenicide", "opc": "Filaricide", "opd": "Anti-amoebic", "subject_name": "Pharmacology", "topic_name": "Other topics and Adverse effects", "id": "233421c4-9823-4916-8bb9-e99b48718a4f", "choice_type": "single"} {"question": "Mechanism of action of Paclitaxel", "exp": "(It enhance polymerization of tubulin) (774-KDT) (825-KDT 6th)Mechanism of actionA. Vinca-Alkaloids (Vincristine, Vinblastine) - These are mitotic inhibitors bind to microtubular protein- tubulin\" prevent its polymerization and assembly of microtubules, causes disruption of mitotic spindle and interfere with cytoskeletal functions.B. Texanes (Paclitaxel, Docetaxel) - complex diterpintaxane. It enhances polymerization of tubulin cytotoxic action of Paclitaxel emphasizes the importance of tubulin-microtubule dynamic equilibrium.C. Epipodophvllotoxins (Etoposid) - plant glycoside, it is not mitotic inhibitor but arrest cells in the G2 phase and causes DNA breaks by affecting DNA topoisomerase II functionsD. Camptothecin analogues (Topotecan and Irinotecan). They act in a manner similar to etoposide, but interact with a different enzyme DNA topoisomerase I", "cop": 2, "opa": "It prevents polymerization of tubulin", "opb": "It enhance polymerization of tubulin", "opc": "Causes DNA breaks by affecting DNA topoisomerase II function", "opd": "Cause DNA breaks by affecting DNA topoisomerase I", "subject_name": "Pharmacology", "topic_name": "Anti-Cancer", "id": "8e720863-7df2-48e6-af93-a9c17451badd", "choice_type": "single"} {"question": "Triamterene causes", "exp": "Inhibitors of renal epithelial Na+ channel Include Triamterene and amiloride. Triamterene:- It is incompletely absorbed orally, paly bound to plasma proteins, largely metabolized in liver to an active metabolite and excreted in urine. Plasma t 1/2 is 4 hours, effect of a single dose lasts 6-8 hours. Side effects:- consist of nausea, dizziness, muscle cramps and rise in blood urea. Impaired glucose tolerance and photosensitivity are repoed, but urate level is not increased. Ref:- kd tripathi; pg num:-590", "cop": 2, "opa": "Better glucose tolerance", "opb": "Muscle cramps", "opc": "Decrease in urea level", "opd": "Hypokalemia", "subject_name": "Pharmacology", "topic_name": "Kidney", "id": "84911b71-e906-4984-8346-6418c0aed663", "choice_type": "single"} {"question": "Antihypeensive drug that causes coombs test positive is", "exp": "Refer kDT 6/e p547 Methyldopa is known to cause the production of autoantibodies against red blood cells (RBCs), leading to apositive direct antiglobulin test (DAT) and hemolytic anemia. ... Her mother had the history of taking methyldopain her pregnancy.", "cop": 1, "opa": "Methydopa", "opb": "Clonidine", "opc": "Hydralizine", "opd": "Sodium nitroprusside", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "7a7b8626-e14d-4b6c-a2e7-7fa3e3a615a6", "choice_type": "single"} {"question": "Absolute contraindication to thrombolytic therapy is", "exp": "Ans. b (History of hemorrhagic stroke in past one year). (Ref. Harrison's Medicine - 18th/Table 370-1).Thrombolytic therapyIndicationContraindicationClinical diagnosis of strokeOnset of symptoms to time of drug administration 3 hCT scan showing no hemorrhage or edema of >1/3 of the MCA territoryAge 18 yearsConsent by patient or surrogateSustained BP >185/110 mm Hg despite treatmentPlatelets <100,000; HCT <25%; glucose <50 or >400 mg/dLUse of heparin within 48 h and prolonged PTT, or elevated INRRapidly improving symptomsPrior stroke or head injury within 3 months; prior intracranial hemorrhageMajor surgery in preceding 14 daysMinor stroke symptomsGastrointestinal bleeding in preceding 21 daysRecent myocardial infarctionComa or stupor", "cop": 2, "opa": "Pregnancy", "opb": "History of hemorrhagic stroke in past one year", "opc": "Patients on nitrates", "opd": "Hypertension", "subject_name": "Pharmacology", "topic_name": "Hematology", "id": "e53d622f-a4be-482a-ad49-8fd81e6d2dbd", "choice_type": "single"} {"question": "Treatment for scabies is", "exp": "(B) Benzene hexachloride", "cop": 2, "opa": "Erythromycin", "opb": "Benzene hexachloride", "opc": "Piperazine", "opd": "Thiabendazole", "subject_name": "Pharmacology", "topic_name": "Miscellaneous (Pharmacology)", "id": "addea36e-b848-486b-815a-3e9db4fa86f0", "choice_type": "single"} {"question": "A patient with normal renal function has received a daily maintenance dose of digoxin for 2 weeks, if the dosage is changed, the new steady state plasma digoxin concentration would be achieved in approximately", "exp": "The time required to establish a new steady-state plasma drug concentration when maintenance doses are changed is approximately four half-lives, the same amount of time required to establish the initial steadystate level. Because the half-life of digoxin is approximately 1.6 days, the time required to reach a new steady state is approximately 7 days. Digitoxin has a much longer half-life of approximately 7 days and the time required to reach steady state with digitoxin is approximately 4 weeks. The time required to reach steady state is independent of dose or dosage interval", "cop": 2, "opa": "2days", "opb": "1 week", "opc": "2 weeks", "opd": "4 weeks", "subject_name": "Pharmacology", "topic_name": null, "id": "df88073a-83fb-4f70-b725-78b4a7cd80ac", "choice_type": "single"} {"question": "Drug of choice for treatment of chronic myeloid leukemia is", "exp": "Imatinib - first line drug for chronic phase CML,in blast crisis and second line therapy for chronic phase CML that has progressed on prior IFN-a therapy Imatinib is also first line drug for metastatic c-kit positive GIST. Nilotinib, Bosutinib, Dasatinib - used in treatment of resistant CML Dasatinib is also used for treatment of Philadelphia chromosome positive ALL. Sunitinib-approved for the treatment of Advanced RCC and for the treatment of GIST after disease progression on or with intolerance to Imatinib. Methotrexate- DOC of choriocarcinoma Cisplatin - DOC- esophageal or gastric cancer Tamoxifen - DOC for ER positive breast cancer", "cop": 1, "opa": "Imatinib", "opb": "Cisplatin", "opc": "Methotrexate", "opd": "Tamoxifen", "subject_name": "Pharmacology", "topic_name": "Targeted Anticancer Drugs and Immunosuppressants", "id": "f1403de7-63f8-4601-8aea-f51648589aa8", "choice_type": "single"} {"question": "Immediate treatment of hypercalcemia of malignancy is", "exp": "Drug of choice for hypercalcemia of malignancy is Bisphosphanates but immediate treatment involves administration of IV fluids.", "cop": 1, "opa": "IV Fluids", "opb": "Bisphosphonates", "opc": "Calcitonin", "opd": "Glucocorticoids", "subject_name": "Pharmacology", "topic_name": null, "id": "81f804f7-1159-4672-8679-3b2b77d50598", "choice_type": "single"} {"question": "Anti CD25 antibody among the following is", "exp": "IL-2 receptor antagonist The CD-25 molecule is expressed on the surface of immunologically activated, but not resting T-cells. It acts as a high affinity receptor for IL-2 through which cell proliferation and differentiation are promoted. Some anti CD-25 antibodies have been developed as IL-2 receptor antagonist to specifically arrest the activated T-cells. 1)Daclizumab It is a highly humanized chimeric monoclonal anti CD-25 antibody which binds to and acts as IL-2 receptor antagonist. Combined with glucocoicoids, calcineurin antagonists and/or azathioprine/MMF, it is used to prevent renal and other transplant rejection reaction. The plasma t 1/2 of daclizumab is long (3 weeks), and it has also been used in combination regimens for maintenance of graft. 2)Basiliximab This is another anti CD-25 antibody with higher affinity for the IL-2 receptor, but shoer plasma t 1/2 (1 week). Ref:- kd tripathi; pg num:-884", "cop": 2, "opa": "Muromonab", "opb": "Daclizumab", "opc": "Adalimumab", "opd": "Transtuzumab", "subject_name": "Pharmacology", "topic_name": "Immunomodulators", "id": "e25842d5-9fa8-43ee-a888-e785766dde8d", "choice_type": "single"} {"question": "Pharmacodynamics include", "exp": "Pharmacodynamics- the study of drug actions in the body and mechanism of action drug actions- therapeutic effects and adverse effects pharmacokinetics- ADME- absorption, distribution, metabolism and excretion ref KD Tripathi 8th ed", "cop": 4, "opa": "Drug elimination", "opb": "Drug excretion", "opc": "Drug absorption", "opd": "Mechanism of action", "subject_name": "Pharmacology", "topic_name": "General pharmacology", "id": "35e6f1ef-c82a-4b5f-b937-aa06dc0c543c", "choice_type": "single"} {"question": "Shoest acting non depolarising muscle relaxant", "exp": "Refer Miller's anesthesia 5/e p 892 Among the given options Rapacuronium IA the shoest acting drug Rapacuronium has been withdrawn from the market because it produces intense bronchospasm in a significant number of patients Mivacurium is shoest acting NDMR", "cop": 2, "opa": "Succinylcholine", "opb": "Rapacuronium", "opc": "Atracurium", "opd": "Pancuronium", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "0be58ffb-50af-41c1-b0a3-a7912c9cbc7c", "choice_type": "single"} {"question": "Simple paial seizures DOC", "exp": "CBZ is used for simple paial seizures", "cop": 4, "opa": "Phenytoin", "opb": "Valproate", "opc": "Barbiturate", "opd": "Carbamazepine", "subject_name": "Pharmacology", "topic_name": "Central Nervous system", "id": "6ee7aa9f-4bb4-4ca7-ab1f-fa1ac5d9bb71", "choice_type": "single"} {"question": "The biochemical mechanism of action of digitalis is associated with", "exp": "Digitalis medicines strengthen the force of the heabeat by increasing the amount of calcium in the hea's cells. (Calcium stimulates the heabeat.) ... Digitalismedicines control irregular hea rhythms (called arrhythmias) by slowing the signals that sta in the sinoatrial (SA) node. Refer katzung 11e p 214", "cop": 3, "opa": "An increase in conduction from Atrium to ventricle", "opb": "An increase in ATP synthesis", "opc": "An increase in systolic intracellular calcium levels", "opd": "A block of calcium channel", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "090238f1-55fc-4e9e-8213-c59852ed1ec7", "choice_type": "single"} {"question": "If a thiazide diuretic is administered for hypeension, the response seen within 24 hrs on excretion of different electrolytes is", "exp": "Excretory and Renal Hemodynamic Effects of Diuretics: Na+ K+ H+ Ca2+ Mg2+ Cl- HCO3- Carbonic anhydrase inhibitors | || I NC V | || Osmotic diuretics || | I | || | | Loop Diuretics || || | || || || | Thiazides | || | | | | | Epithelial sodium channels blockers | | | | | | | Aldosterone antagonists | | | I | | | |: INCREASE, |: DECREASE, NC: No change, V: Variable change. I: Insufficient data Do not get confused by the term 'within 24 hours' in the question. These are the acute effects of diuretics and these may be modified later by the compensatory responses of the body.", "cop": 3, "opa": "Sodium| Potassium| Calcium|", "opb": "Sodium| Potassium| Calcium|", "opc": "Sodium| Potassium|Calcium|", "opd": "Sodium| Potassium| Calcium|", "subject_name": "Pharmacology", "topic_name": "Hematology and CVS", "id": "07a583cf-ef78-48b8-bf47-19606638e2cd", "choice_type": "single"} {"question": "Local anaesthetic causing malignant hypehermia is", "exp": "Lignocaine by releasing calcium from sarcoplasmic retinaculum can cause malignant hypehermia in susceptible individuals.", "cop": 1, "opa": "Lignocaine", "opb": "Prilocaine", "opc": "Bupivacaine", "opd": "Dibucaine", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "946e4f01-5fd9-41ad-a551-d1aafd7e8b0a", "choice_type": "single"} {"question": "Ticagrelor is used", "exp": "Ticagrelor is a platelet agreggaion inhibitor, used for the prevention of thrombotic events in people with an acute coronary syndrome or myocardial infarction with ST elevation. other drus in this group include cangrelor pasugrel . The drug is combined with acetylsalicylic acid Ref: KD T ripathi 8th ed.", "cop": 2, "opa": "In COPD patients", "opb": "For prevention of thrombotic events", "opc": "As Antihypeensive", "opd": "For Weightloss in childhood obesity", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "c658e252-3c47-4c67-83c5-53ac0639f5b3", "choice_type": "single"} {"question": "Mexiletine is an oral active congner of", "exp": "Ans. is'b'i.e., LidocaineRef: Clinical pharmacology 3'd/e p. 501; KDT Vhle p. 531Mexiletine is an orally active congener of lidocaine.It is a local anaesthetic and an orally active antiarrhythmic; chemically and pharmacologically similar to lidocaine.", "cop": 2, "opa": "Dopamine", "opb": "Lidocaine", "opc": "Dobutamine", "opd": "levodopa", "subject_name": "Pharmacology", "topic_name": null, "id": "445d678a-3ad3-464e-8274-24370cfd4d26", "choice_type": "single"} {"question": "Drug used in hepatitis B infection is", "exp": "Ans. is 'a' i.e., Entecavir Treatment of acute hepatitis Hepatitis B - No treatment is required. Hepatitis C - Pegylated Interferon (PEG - IFN). Treatment of chronic hepatitis Hepatitis B - Lamivudin, entecavir (preferred) or interferon. Hepatitis C - Pegylated Interferon (PEG - IFN), entecavir plus ribavirin.", "cop": 1, "opa": "Entecavir", "opb": "Astacavir", "opc": "Zanamivir", "opd": "Abacavir", "subject_name": "Pharmacology", "topic_name": null, "id": "39da6194-e889-475e-8f60-7fd534db254a", "choice_type": "single"} {"question": "Nitrous oxide contraindicated on patients with pnumothorax, pneumopericrdium or intestinal obstruction, because it", "exp": "Refer Goodman Gilman 12/e p 547 N2O use is contraindicated in pneumothorax and volvulus because it may lead to development of High pressure in the closed cavities in the body", "cop": 4, "opa": "Depressess an already compromised myocarium", "opb": "Permits the use of limited FIO2 only", "opc": "Is less soluble than nitrogen", "opd": "Causes the expansion of air filled body cavities", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "497b5293-6633-49c3-8ca7-576ca749978f", "choice_type": "single"} {"question": "BAL is contraindicated in", "exp": "BAL or Dimercaprol is a chelating agent used to treat poisoning by Arsenic, Lead, Mercury and Gold. \nIt is contraindicated in Iron & Cadmium poisoning.", "cop": 4, "opa": "Arsenic", "opb": "Lead", "opc": "Mercury", "opd": "Iron", "subject_name": "Pharmacology", "topic_name": null, "id": "8abab594-12b3-4b7c-a337-f59391f4c9ae", "choice_type": "single"} {"question": "Lovastatin causes", "exp": "Ans. is 'a' and 'c' i.e., Increased LDL receptor and Decreased LDL cholesterol Statins -Mechanism of action -Decrease the synthesis of cholesterol by inhibition of rate limiting enzyme HMG CoA. reductase.Effect on lipids Decrease in lipids Decrease Triglycerides Increase HDLStatins decrease synthesis of cholesterol by liver (inhibition of HMG CoA reductase). This leads to compensatory increase in LDL receptor expression on liver cells.Increased LDL receptor causes increase uptake and catabolism of IDL and LDL. This reduces LDL and IDL concentration.Other important points about statinsStatins are administered at bed time to obtain maximum effectiveness.Simvastatin is more potent than lovastatinSimvastatin has extensive first pass metabolismPravastatin causes decrease in fibrinogen level.Statins cause myopathy and lens opacity", "cop": 1, "opa": "Increased LDL receptor", "opb": "Decreased HDL cholesterol", "opc": "Decreased LDL cholesterol", "opd": "Increased SGOT/SGPT ratio", "subject_name": "Pharmacology", "topic_name": "Hypolipidemic", "id": "aaedaaf0-f40f-4e3c-a6f5-040b55fa5c78", "choice_type": "single"} {"question": "A methotrexate intolerant psoriasis patient has been prescribed an alternate disease modifying drug (DMARD) that resulted in liver dysfunction combined with skin rashes and bone marrow suppression of RBC's & platelets. The most probable drug is", "exp": "Answer: b) Leflunomide* Abatacept is associated with infections due to inhibition of normal T-cell activity.* Sulfasalazine causes agranulocytosis and hepatitis along with rashes.* Leflunomide causes skin rashes and bone marrow suppression of RBC's & platelets.* Anakinra therapy may lead to neutropenia but not bone marrow suppression.", "cop": 2, "opa": "Anakinra", "opb": "Leflunomide", "opc": "Abatacept", "opd": "Sulfasalazine", "subject_name": "Pharmacology", "topic_name": "Immunomodulator", "id": "847f5f56-7cef-4265-bcb7-a760ebe85939", "choice_type": "single"} {"question": "Lubipristone is a", "exp": "Lubipristone is a chloride channel activator used in treatment of IBS (Irritable bowel syndrome) with constipation.", "cop": 3, "opa": "Enkephalinase inhibitor", "opb": "Guanylyl cyclase agonist", "opc": "Chloride channel activator", "opd": "5HT4 agonist", "subject_name": "Pharmacology", "topic_name": null, "id": "d15a9e81-c478-4d61-b6eb-74beebbf5206", "choice_type": "single"} {"question": "Anticoagulant of choice in pregnancy", "exp": "Ref: KD Tripathi, 6th ed. pg. 597* Heparin is a powerful and instantaneously acting anticoagulant, effective both in vivo and in vitro.* It acts indirectly by activating plasma antithrombin III* The heparin -AT III complex then binds to clotting factors of the intrinsic and common pathways (Xa, IIa, IXa, XIa, XIIa and XIIIa) and inactivates them.* Heparin is the anticoagulant of choice in pregnancy* Warfarin on the other hand is effective only in vivo (body). It acts by inhibiting vitamin K.Heparin is monitored by aPTTLow molecular heparin inhibits factor Xa only. It does not require monitoring because of consistent bioavailability.Antidote for heparin overdose: Protamine Sulfate.Warfarin monitoring is done by: INRAntidote of warfarin overdose: Vitamin K.TOC for warfarin induced bleeding: FFP", "cop": 4, "opa": "Warfarin", "opb": "Vitamin K", "opc": "Tranexamic acid", "opd": "Heparin", "subject_name": "Pharmacology", "topic_name": "Hematology", "id": "a51ba09d-d113-450c-8d5b-557daa62692b", "choice_type": "single"} {"question": "High plasma protein binding of a drug results in", "exp": "* Most drugs bind to plasma proteins in a reversible fashion without translating into a pharmacological response. (Plasma proteins are hence called Silent Receptors) * Acidic drugs bind to Albumin, Basic drugs to alpha1 acid- glycoprotein. * Binding of the drug to plasma protein affects the pharmacokinetic handling of drug by the body. Ref:- HL & KK Sharma's Principles of Pharmacology 3rd Ed; Pg Num:- 48", "cop": 3, "opa": "Less drug interaction", "opb": "High volume of distribution", "opc": "Decreased glomerular filtration", "opd": "Lowers duration of action", "subject_name": "Pharmacology", "topic_name": "General pharmacology", "id": "53b0dffe-dd31-42f3-b3fc-1fdb697f296f", "choice_type": "single"} {"question": "Increasing the concentration of norepinephrine in adrenergic synapses leads to", "exp": "Classification:- Adrenergic receptors are classified into two types a and b. The a receptors were demonstrated to be present prejunctionally as well. To differentiate these release inhibitory prejunctional a receptors, a subdivision into a1 and a2 was suggested. b receptors were fuher subdivided into b1, b2, beta 3subtypes. Alpha2 receptor is located prejunctionally and inhibits the release of neurotransmitter. Ref:- kd tripathi; pg num:-126,127", "cop": 4, "opa": "Activation of tyrosine hydroxylase", "opb": "Activation of dopa decarboxylase", "opc": "Increased release of norepinephrine", "opd": "Activation of presynaptic Gi (C) coupled receptors", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "d9aeb843-3b3b-4b6a-8ea0-4eee8e01ee90", "choice_type": "single"} {"question": "A patient present to emergency with pinpoint Pupil,salivation, lacrimation, tremors and red tears. Plasma chlolinesterase level was 30% of normal. Most probable diagnosis is", "exp": "These are characteristic features of anti-cholinestearse(organophosphate and carbamate) poisoning. Features of Organophosphate poisoning: Muscarinic symptoms: Pin point pupil, salivation,lacrimation, urination, defecation, gastrointestinal distress, vomiting, bronchospasm, bradycardia Nicotinic symptoms: Fasciculations and fibrillations of muscle, tachycardia, tachypnea CNS symptoms: Temors, giddiness, ataxia, coma Red tears: Due to accumulation of porphyrin in the lacrimal glands Ref-Katzung 12/e p110", "cop": 1, "opa": "Organophosphate poisoning", "opb": "Datura poisoning", "opc": "Opioid poisoning", "opd": "Pontine hemorrhage", "subject_name": "Pharmacology", "topic_name": "Autonomic nervous system", "id": "d6ad8a8e-4a7d-4804-8e87-394adbf3d31b", "choice_type": "single"} {"question": "The antiretroviral drug most commonly associated with nephrolithiasis is", "exp": "Side effects of Indinavir- Nephrolithiasis, indirect hyperbilirubinemia, hyperglycemia, fat redistribution, lipid abnormalities. Ref: Sharma and Sharma , Chapter 62 pg : 809", "cop": 1, "opa": "Indinavir", "opb": "Zidovudine", "opc": "Tenofovir", "opd": "Eirenz", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "00cc12d8-9ff5-4bd1-ae1d-477a52e91899", "choice_type": "single"} {"question": "Efavirenz is used for treatment of HIV infections. It acts", "exp": null, "cop": 2, "opa": "As protease inhibitor", "opb": "As reverse transcriptase inhibitor", "opc": "As integrase inhibitor", "opd": "By inhibiting the HIV entry into the cell", "subject_name": "Pharmacology", "topic_name": null, "id": "30e6f301-7543-4d61-8817-c0a67c62775e", "choice_type": "single"} {"question": "Drug resistance transmitting factor present in bacteria", "exp": "Ref KDT 6/e p671 Plasmids contain extra chromosomal DNA that help in transforming the gene responsible for multiple drug resistance among bacteria These are therefore involved in horizontal transfer not resistance", "cop": 1, "opa": "Plasmid", "opb": "Chromosome", "opc": "Introns", "opd": "Centromere", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "0d64c258-c888-4d6c-9a05-6af8d83b5a9f", "choice_type": "single"} {"question": "Belimumab is used in", "exp": "Belimumab is a monoclonal antibody against B - cell activating factor ( BAFF ) and is thus useful in decreasing autoimmune response in Systemic lupus erythematous .", "cop": 4, "opa": "Osteoporosis", "opb": "Malignant melanoma", "opc": "Merkel cell carcinoma", "opd": "Systemic lupus erythematous", "subject_name": "Pharmacology", "topic_name": null, "id": "7783479e-9d7b-4b0c-a4b8-2fd447862201", "choice_type": "single"} {"question": "Drug of Choice for Digoxin induced Ventricular Tachycardia", "exp": "* Lignocaine is the drug of choice for Digoxin induced Ventricular Tachycardia. * Digoxin, a cardiac glycoside - used in treatment of hea failure and in control of ventricular rate in atrial fibrillation/flutter. * It has low margin of safety and high toxicity index. (Therapeutic Index: 1.5-3). * About 25% of patients on Digoxin therapy develop toxicity features. * Digoxin toxicity can induce almost any cardiac dysrrhythmia except rapidly conducted atrial arrhythmias like atrial flutter and atrial fibrillation. Mobitz type II AV block is also a rare phenomenon in digoxin toxicity. Second-degree AV block (Type 2) is usually caused by structural damage to the distal conduction system located in the ventricular poion of the myocardium- linked to an infarction/idiopathic Fibrosis/cardiac surgery/ infections/ inflammations/ auto-immune disease. * Digoxin- specific Fab antibody is a specific antidote for Digoxin Overdosage. (~40mg of Fab = 1mg Digoxin ). Ref:- KD Tripathi Essentials of Medical Pharmacology 8th Ed; Pg num:- 560", "cop": 4, "opa": "Verapamil", "opb": "Diltiazem", "opc": "Propranolol", "opd": "Lignocaine", "subject_name": "Pharmacology", "topic_name": "Cardiovascular system", "id": "df91c6b1-f22f-448b-9506-726f35341f42", "choice_type": "single"} {"question": "SERM drug used in treatment of osteoporosis aEUR'", "exp": "Raloxifene Traditionally hormone replacement therapy with estrogen was being used to prevent/treat osteoporosis in postmenopausal worsen. H has been shown to reduce the risk of osteoporosis in women. But long term use of estrogen leads to range of adverse effect including cardiovascular disease, stroke, pulmonary emboli and invasive breast cancer. These serious adverse effect made to look for other options. Selective estrogen receptor modulators These are class of compounds that act on estrogen receptors. Their characteristic feature is that they do not have pure agonist or antagonistic action on estrogen receptors. - Their selective action distinguishes these substances .from pure receptor agonist or antagonist. - SERMS are \"selective\" that means SERMS block estrogen in some tissues and activate estrogen action in others. - All the SERMS bind to the estrogen receptor but each agent produces a unique receptor drug conformation. - As a result specific coactivator or co-oppressor proteins are bound to the receptor resulting in differential effects. Two SERMS are currently being used Raloxifens For the t/t and prevention of osteoporosis Tamoxifen --> For the t/t and prevention of Breast Ca The .first SERM to reach the market was Tamoxifen which blocks the stimulative effect of estrogen on breast tissue and is used in breast cancer. Raloxifene is the second SERM to be approved by the FDA. Raloxifens has been approved for the tit and prevention of osteoporosis in postmenopausal women. Raloxifens acts like estrogen on bone and helps to build and maintain bone density. - Raloxifen has been shown in clinical trials to increase bone density in the spine and hip and to reduce the risk of spinal fractures in women with osteoporosis. While it acts like estrogen on bone, it blocks the action of estrogen on breast and uterus. - This profile makes it very useful for the t/t of osteoporosis because Raloxifene provides the bone benefits of estrogen without increasing the risk for estrogen related breast and uterine cancers. Raloxifene in Breast cancer Due to its antiestrogenic effect on breast, Raloxifene has been shown to reduce the risk of invasive breast cancer in women who are taking it for osteoporosis. Raloxifene reduces the risk of breast cancer by 50-70% in both low risk and high risk postmenopausal women. The national cancer institute U.S.A. funded the STUDY OF TAMOXIFEN AND RALOXIFEN (STAR) a clinical trial comparing raloxtfens with tamoxifen in preventing breast cancer, in postmenopausal women who are at increased risk of developing the disease. The study found that tamoxifen and Raloxifen are equally effective in reducing invasive breast cancer risk in postmenopausal women who are at increased risk of the disease. The study also .found out that women who took raloxifen had fewer uterine cancer and.fewer blood clots than women who took tamoxifen. However, Raloxifen did not decrease the risk of noninvasive breast Ca. On September 14 2007, the US. food and drug administration announced approval of raloxifens for reducing the risk of invasive breast cancer in postmenopausal women with osteoporosis and in postmenopausal women at high risk for invasive cancer.", "cop": 1, "opa": "Raloxifene", "opb": "Estrogen", "opc": "Strontium", "opd": "Alendroate", "subject_name": "Pharmacology", "topic_name": null, "id": "5dc249fb-caf6-42bf-b6c9-b77fe224d93b", "choice_type": "single"} {"question": "The anticoagulant of choice in pregnancy is", "exp": "(Heparin) (562-KDT) (598-KDT6th)HEPARIN - is the anticoagulant of choice during pregnancy because it does not cross BBB or placentaAdverse effects1. Bleeding due to overdoses is the most serious complications2. Thrombocytopenia is another common problem3. Transient and reversible alopecia is infrequent4. Osteoporosis5. Hypersensitivity reactionsCONTRAINDICATIONS1. Bleeding disorders, thrombocytopenia2. Severe hypertension (risk of cerebral haemorrhage) threatened abortion, piles, GI ulcers (aggrevated bleeding)3. SABE, large malignancies, Tuberculosis (hemoptesis)4. Ocular and neuro-surgery, lumber puncture5. Chronic alcoholics, cirrhosis, renal failure6. Aspirin and other antiplatelet drugs, should be used very cautiously during heparin therapy", "cop": 1, "opa": "Heparin", "opb": "Warfarin", "opc": "Dicumarol", "opd": "Phenindione", "subject_name": "Pharmacology", "topic_name": "Hematology", "id": "e28fc0a0-044f-4b64-85e1-49482b7f34d9", "choice_type": "single"} {"question": "Etanercept is a biological disease modifying agent used in the management of rheumatoid ahritis. its mechanism of action is", "exp": "TNF alpha blocking drugs are used in Rheumatoid ahritis and crohn's disease. these include adalimumab ceolizumab etanercept infliximab golimumab Refer kDT 6/e 883", "cop": 1, "opa": "TNF alpha blocked", "opb": "COX2 inhibition", "opc": "IL 6 inhibition", "opd": "Stabilization of mast cells", "subject_name": "Pharmacology", "topic_name": "Autacoids", "id": "e30b324b-5ecc-4677-b5f0-5d1d98cc367d", "choice_type": "single"} {"question": "Colour of oxygen cylinder is", "exp": "Refer anesthetic equipments and procedures, Practical Approach /p 37,38. The color of a medical oxygen xylinder6 is a black body with a white shoulder", "cop": 1, "opa": "Black body with white shoulder", "opb": "Black body with grey shoulder", "opc": "Grey body with white shoulder", "opd": "Grey body with black shoulder", "subject_name": "Pharmacology", "topic_name": "Anesthesia", "id": "3f8cd580-b3cb-4db8-bd4b-4cd7213b1bfc", "choice_type": "single"} {"question": "Drug of choice in nocturnal enuresis is", "exp": "(Imipramine) (449-KDT 6th)Enuresis - In children above 5years, imipramine at bed time is effective, but bed wetting may again start when the drug is stopped* Elderely subjects with bed wetting have also benefittcd* Imipramine is most likely and nortriptyline is least likely to cause orthostatic hypotension (145-LP3rd)", "cop": 1, "opa": "Imipramine", "opb": "Diazepam", "opc": "Amoxapine", "opd": "Reboxetine", "subject_name": "Pharmacology", "topic_name": "C.N.S", "id": "07c3a76f-28b7-42a8-9556-bbf3a36b8d04", "choice_type": "single"} {"question": "Lorazepam is preferred over Diazepam in treatment of status epilepticus as", "exp": null, "cop": 2, "opa": "It has longer half life than diazepam", "opb": "It has more sustained action because of lower lipid solubility & slower distribution", "opc": "Faster clearance", "opd": "More bioavailability", "subject_name": "Pharmacology", "topic_name": null, "id": "b3808aa4-f782-4727-9d24-612036963a46", "choice_type": "single"} {"question": "Nitroglycerine exes beneficial effect in classical angina pectoris primarily by", "exp": "nitrates are vasodilators mainly acting on the veins only. hence they are venous dilators therefore decrease the preload on the hea where as aerial dilators like hydralazine decrease the after load. Ref: KD Tripathi 8th ed.", "cop": 3, "opa": "Increase in total coronary blood flow", "opb": "Redistribution of coronary blood flow", "opc": "Reduction of cardiac preload", "opd": "Reduction of cardiac afterload", "subject_name": "Pharmacology", "topic_name": "All India exam", "id": "3687a1dd-1960-498a-b6e2-3f3827684759", "choice_type": "single"} {"question": "Drug causing hirsuitism and gynaecomastia", "exp": "Ans. is 'a' i.e., Spironlactone", "cop": 1, "opa": "Spironolactone", "opb": "Rifampicin", "opc": "Penicillin", "opd": "Bumetanide", "subject_name": "Pharmacology", "topic_name": null, "id": "a49c9584-7c17-48f0-9959-46e9971bee08", "choice_type": "single"} {"question": "Selegiline is", "exp": "(B) MAO-B inhibitor # Selegiline is a MAO-B inhibitor.> MAO exist in forms MAO-A & MAO-B.> MAO-A predominates in peripheral adrenergic structures & intestinal mucosa.> MAO-B predominates in brain & Blood platelets. Selegline, along c- levodopa, prolongs its action, & wearing-off effect.> Based on the theory that oxidation of DA or toxin MPTP in the striatum by MAO to free radicals is cause for parkinsonism early therapy c- selegiline night delay progression of disorders.> Non selective MAO inhibitors include: Phenelzinec/lsocarboxazide/Tranylcypromine.> Selective MAO-A are: Clorgiline/ Moclobemidee> Selective MAO-B are: Selegiline (Deprenyl), Rasagline, Periphery, BLood brain barrier", "cop": 2, "opa": "Dopa decarboxylase inhibitor", "opb": "MAO-B inhibitor", "opc": "COMT inhibitor", "opd": "MAO-A inhibitor", "subject_name": "Pharmacology", "topic_name": "Miscellaneous (Pharmacology)", "id": "910bbdab-feea-4b56-bc3a-0c15cdfc7d45", "choice_type": "single"} {"question": "Drug of choice for cerebral malaria due to Pl.falciparum is", "exp": "Resistance has been developed for chloroquine for P. falciparum due to mutations in chloroquine transpoer gene, Quinine is the mainstay of treatment for cerebral and other forms of complicated malaria, through some resistance is repoed, in such cases aemisnin compounds are used. Quinine 20mg/kd loading dosein 5%dextrose infusion over 4 hrsRef: HL Sharma 3rd ed Pg:830", "cop": 2, "opa": "Choloroquine", "opb": "Quinine", "opc": "Mefloquine", "opd": "Sulfadoxine+pyrimethamine", "subject_name": "Pharmacology", "topic_name": "Chemotherapy", "id": "29d00707-e2ad-45b8-b806-6031e25f572a", "choice_type": "single"} {"question": "Drug frequently associated with the development of noninfectious chronic meningitis is", "exp": "Answer: a) IbuprofenDrugs associated with noninfectious chronic meningitis: NSAIDs (mc-ibuprofen), sulfonamides, isoniazid, tolmetin, ciprofloxacin, penicillin, carbamazaepine, lamotrigine, IV immunoglobulin, OKT3 antibodies, phenazopyridine", "cop": 1, "opa": "Ibuprofen", "opb": "Cefipime", "opc": "Acyclovir", "opd": "Phenobarbital", "subject_name": "Pharmacology", "topic_name": "Anti Microbial", "id": "836d404b-18c5-4a99-b6d4-8ee8e9dc6b8a", "choice_type": "single"}