1
Q
Doc - for MTP/Abortion in 1st trimester (63days)
A
PGE1 - MISOPROSTOL
Also used in NSAIDS induced peptic ulcer
S/E - Diarrhoea chloride secretions
Teratogenic - MOBIUS SYNDROME - 6TH CN DAMAGE
2
Q
DOC - To open ductus arterious
A
ALPRASTODIL - PGE1
3
Q
Doc - cervical ripening
A
DINOPROSTONE -PGE2
4
Q
DOC - MTP IN 2ND TRIMESTER
A
DINOPROST - PGF2 ALPHA
5
Q
Which drug helps to control PPH resistant to oxytocin?
A
CARBOPROST - PGF2 ALPHA
C/I in Asthma
Dosage - 250ug inj
Max - 2000ug or 8injection/day
6
Q
DOC - Glaucoma both POAG, ACG
A
LATANOPROST
BIMATOPROST
TRAVOPROST
TAFLUPROST
They all PGF2 ALPHA DRUG
7
Q
Doc - pulmonary artery hypertension?
A
Prostacyclin - PGI2
TREPROSTONIL, ILOPROST, EPOPROSTENOL.
they serve as VD and anti platelet effect.
8
Q
Physiological antagonism of PGI2
A
Thromboxane A2
VC and platelet aggregation
9
Q
Medical abortion in 1 trimester dosage?
A
Day 1 - MIFEPRISTONE (RU486) 200mg
Blocks progesterone receptor - death of fetus
Day 3 - MISOPROSTOL
To expel the baby out
Upto 49 days - 400mg oral or s/l
Upto 63 days - 80pmg vaginally or s/l
10
Q
Doc - close ductus areteriosus
A
NSAID - IBUPROFEN (DOC) , INDOMETHACIN (mc used)
11
Q
Uterine stimulant
A
OXYTOCIN - DOC induction of labour and control PPH
CARBETOCIN - LONGEST ACTING OXYTOCIN
CARBOPROST, ERGOMETRINE, METHYLERGOMETRINE
These three drug used in resistant case of OXY to control PPH and is c/i in induction of labour - cause fetal hypoxia
12
Q
Uterine relaxant block Oxytocin receptor
A
ATOSIBAN - safe in heart disease pt.
13
Q
Beta 2 agonist as tocolytics ?
A
RITODRINE
ISOXSUPRINE
14
Q
CCB as uterine relaxant
A
NIFEDIPINE
15
Q
General Anaesthetic with maximum tocolytic effect.
A
HALOTHANE
16
Q
Drug avoid during labour pain?
A
NSAIDS
Reason - as it reduces the prostaglandin level thereby decreases the contraction.
17
Q
Drug inhibit Phospholipase A2 enzyme?
A
Corticosteroids
18
Q
Drugs inhibiting COX
A
NSAIDS - ASPIRIN only irreversible COX inhibitor
Dosage
Low dose - 40-325mg - Antiplatelet
Tx - MI OR STROKE
Medium dose - <2gm
Tx - Analgesic/Antipyretic.
High dose - 2-5gm - Tx - Anti-inflammatory
S/E all NSAIDS - Rashes - SJS, peptic ulcer.
19
Q
Aspirin usage in Gout
A
<2g/d - increase uric acid in blood
2-5g/d - variable effects
>5g/d - increases urate excreation or (uricosuric)
20
Q
Reye’s Syndrome
A
Viral fever
Aspirin
Liver damage (sudden)
21
Q
Aspirin is acceptable in which childhood disease?
A
KAWASAKI DISEASE
22
Q
Samtars triad
A
Ethmoidal polyps in nose
Asthma
Aspirin
23
Q
Non selective COX inhibitors is longest, undergo enterohepatic circulation?
A
PIROXICAM > TENOXICAM
24
Q
Non selective COX as INTRAVENOUS NSAID
A
KETOROLAC
25
Non selective COX inhibitor used in Dysemeorrhea
MEFENAMIC ACID
S/E - cause autoimmune haemolytic anemia
26
What drug cause Aseptic meningitis as a specific side effects?
IBUPROFEN
27
What NSAID drug cause pancreatitis and epilepsy as a specific side effects?
INDOMETHACIN
28
Preferential COX 2 inhibitor cause Steven Johnson syndrome as side effect ?
NIMESULIDE
29
Which preferential COX2 inhibitor is best as topical cream to relieve from arthritis, or muscle spasm
DICOLEFNAC
30
CELECOXIB, ETORICOXIB, PARECOXIB
are ?
Selective COX2 inhibitor
31
Which selective COX2 inhibitor cause MI or stroke and is banned ?
ROFECOXIB AND VALDECOXIB
32
Paracetamol acts on which receptors?
COX3 and TRPV1
remember - TRPV1 as TRP popular and PCM indeed is famous drug.
Safest in children
Safest NSAIDS in renal disease
Safest in peptic ulcer
33
Which antihistamine drug is least sedative in 1st generation
CHLORPHENIRAMINE
34
Which preferential COX2 inhibitor is used a topical to treat arthritis or muscle spasms?
DICLOFENAC
35
Selective COX2 inhibitor
CELECOXIB
ETORICOXIB
PARECOXIB
less risk of peptic ulcer
36
Selective COX2 inhibitor cause MI or STROKE and is banned?
ROFECOXIB
VALDECOXIB
37
Paracetamol acts on which receptors?
COX3 and TRPV1
Remember TRPV1 as TRP being famous as PCM is indeed famous drug.
Safest in children no risk of REYS
Safe in renal disease
Safest in peptic ulcer
38
What NSAID drug cause Autoimmune haemolytic anaemia side effects?
Mefenamic Acid
39
Toxic form of PCM
NAPQ1 cause Zonal necrosis - Centrilobular necrosis with periportal sparing.
In presence of CYP2E1 get metabolised and is removed by glutathione in phase 2 rxn.
Antidote - N-Acetylcysteine
40
Nomogram to use in PCM Toxicity
RUMACK MATHEW NORMOGRAM
41
Nomogram to use in VANCOMYCIN Toxicity
KULLER’S Normogram
And to for the dosage
MATZKE SCALE
42
Which 2nd Gen antihistamine drug is the only drug that cross BBB and cause sedation - use as Anti allergic drug?
CETRIZINE
LEVOCETRIZINE - requires half dose and less sedation.
43
Histamine acts on which receptors
All H1-H4
GPCR
44
H1 Partial Agonist use as Anti - Vertigo and in brand name Vertin
BETAHISTINE
45
Which 1st Gen antihistamine drug cause maximum sedation and is use as anticholinergic in parkinsonism?
PROMETHAZINE
46
Which 1st Gen antihistamine drug used as transdermal patch for motion sickness.
DIPHENHYDRAMINE
IN post auricular area
47
Which 1st Gen antihistamine drug requires vitamins and is a DOC to treat motion sickness?
DOXYLAMINE with VIT B6
48
Which 1st Gen antihistamine drug has additional anti serotonin effects use in MIGRANINE?
CRYTOHEPTADINE
49
Doc - Mountain Sickness
ACETAZOLAMIDE
50
2nd Gen antihistamine drug cause QT Pronlongation?
TERFINDINE
ASTEMIZOLE
cause torsade de pointes
Active form of TERFINADINE IS FEXOFENADINE - no risk of QT prolongation.
51
Most potent 2nd Gen antihistamine drug is ?
LORATIDINE
52
Which 2nd Gen antihistamine drug inhibit PAF (antiplatlet)
RUPATADINE
NEWER DRUG
APAFANT
MODIPAFANT
watch PAF word in drug
53
Which antihistamine drug has maximum topical activity?
AZELASTINE
Others -
LEVOCARBASTINE - mast cell stab.
OLAPATIDINE
KETOTIFEN
54
H3 inverse agonist to increase wakefulness to treat Narcolepsy
TIPROLISANT (PITOLISANT)
DOC - MODAFINIL
55
Which Serotonin acts on inotropic receptors?
5HT3
Rest all (5HT1 to 5HT7) on GPCR receptor
56
5HT- 1A partial agonist as Anti Anxiety (GAD).
BUSPIRONE
57
5HT- 1B/1D agonist use as acute migraines
TRIPTANS -
SUMETRIPTAN - overall DOC
Given via - oral, S/L, nasal
Nasal - ZOLMITRIPTAN
ERGOTAMINE
58
Tryptans as nasal spray in case of vomiting ?
ZOLMITRYPTAN
59
Most effective
Fastest acting
Longest acting
Tryptans
Most effective - ELETRIPTAN
Fastest - RIZATRIPTAN
Longest - FROVATRIPTAN
60
5HT- 1B/1D agonist + alpha blocker
ERGOMETRINE
Cause - Vasoconstriction in end arteries of the finger - Ischemic Necrosis or Ergotism or Dry gangrene.
Treatment - NITROPRUSSIDE - (VD)
61
Prophylaxis of Chronic Migraine
Beta blocker - PROPRANOLOL
AED - V /TOPIRAMATE/ GABAPENTIN
CCB - FLUNARIZINE , VERAPAMIL
TCA- AMITRIPTYLINE, NORTRIPT.
Anti-5HT - CYPROHEPTADINE
MAO inhibitor - PHENYLZINE
62
CGRP 2 inhibitor drug end with -Gpant mainly bhi given in Acute Migraine.
Note - Calcitonin gene related peptide -2 inhibitor
UBROGEPANT
RIMEGEPANT
ZAVAGEPANT
63
Monoclonal IG used as a prophylaxis of migraine
ERENUMAB
blocks the CGRP -2
64
5HT -2C agonist
Drug - LORCASERIN
(Suppress appetites)
Banned - In. risk of colorectal cancer
65
5HT A/B/C antagonist
Antipsychotic increases appetite.
CLOZAPINE
S/E - Obesity
OLANZAPINE - causes maximum obesity.
66
5HT -2 to 5HT -4 antagonist
To treat Serotonin syndrome and also used in migraine prophylaxis.
KETASERIN
RITANSERIN
CYPROHEPTADINE
67
5HT-3 Antagonist
(Remember Setron)
In GIT
• Setrons blocks the 5HT3 receptor and produces anti motility effect.
In Brain (CTZ area)
Antiemetics,
ONDANSETRON
GRANISETRON
TROPISETRON
RAMOSETRON
PALONOSETRON
68
Which 5HT3 receptor blocker/Antagonist is given in diarrhoea in IBS only in females?
ALOSETRON
C/I in Males - causes ischemic colitis
69
DOC of 5HT3 blocker
(Remember - setron)
•Chemotherapy induced Nausea and vomiting (CINV)
•Radiotherapy induced N/V
•GIT Infections causing vomiting
Note- Not effective in motion sickness
S/E of 5HT3 blocker
Constipation
Qt prolongation
70
Drugs only effective in Early phase of CINV to treat Nausea and vomiting
Setrons
Except PALANOSETRON also used in Delayed phase of CINV
71
Drugs effective in Delayed phase of CINV (more than 24hr)
Pitant - NK1 Antagonist
APREPITANT
FOSAPREPITANT
ROLAPITANT
NETUPITANT
72
Drugs when both Setron and Pitant is not effective in Delayed phase of CINV ?
Remember -nabi.
DEXAMETHASONE
and
CB1 Agonist (Cannabinoid agonist)
DRONABINOL
NABILOL
Note - CB1 agonist increase or stimulate appetite as the cancer patient has severe weight loss or ataxia.
73
5HT-4 Receptor as Agonist
Pro kinetic - increase GI motility
End with -Pride
CISAPRIDE - cause QT banned
MOSAPRIDE
RENZAPRIDE
PRUCALOPRIDE - mc in Constipation
ITOPRIDE
TEGASEROD - cause QT banned
74
D2 (Dopamine) Antagonist has antiemetic action and cannot cross BBB.
DOMPERIDONE
75
Which antibiotics increase motilin receptors on the stomach and is used in Gastroparesis?
ERTHYROMYCIN
76
Which Anticholinestrase (increase Ach) used as pro kinetic and used in POST OPERATIVE PARALYTIC ILEUS
NEOSTIGMINE
77
Pro kinetic + antiemetic
Cross BBB and cause Drug induced Parkinsonism/ Muscle dystonia.
METOCLOPRAMIDE
ACTION
5HT4 receptor agonist - In. Motility
D2 antagonist
Increase Ach
Tx - BENZHEXOL
78
What drug is considered as Microtubule inhibitor that inhibit the movement of spindle fibre, suppress the growth of rapidly dividing cells.
COCHICINE
Inhibit the migration of WBC
S/E - BM suppression, GI ulcers.
79
Xanthine Oxidase inhibitors
For chronic Gout
Inhibits Hypoxanthine (Purine) for its conversion.
Drugs,
1- ALLOPURINOL
2- OXYPURINOL
3- FEBUXOSTAT - non competitive inhibitor (most preferred)
Note- ALLOPURINOL and OXYPURNOL are fake purines and act as competitive inhibitors,
ALLOPURINOL - associated with hypersensitivity
80
Uric acid oxidase enzymes
For chronic Gout
PEGLOTICASE (mammal)
RASBURICASE (Birds)
They are proteins , thus given only via injection.
Used in Allopurinol resistant Gout
Eg- Tunor lysis syndrome
81
URICOSURIC AGENTS
For chronic Gout
(Inhibit OATP/URAT)
Drugs,
PROBENACID
SULFINAPYRAZONE - (NSAID like action - in both Acute and Chronic)
BENZBROMARONE - (safe in renal disease)
LESINURAD
82
What if we combine 6 Mercaptopurine and Azathioprine with Allopurinol?
ALLOPURINOL will inhibit Xanthine Oxidase and increase the toxicity of such two mentioned drug causing
BM TOXICITY.
So reduce the dose of 6MP/AZP If combined with ALLOPURINOL by 75% to reduce the toxicity
83
Drugs causing Gout
Memonic - PAINED
PYRAZINAMIDE
ASPIRIN - low dose <2mg/d
Immunosuppressant- CYCLOSPORIN, TACROLIMUS
NIACIN - vitamin C/I in Gout
ETHAMBUTOL
Diuretic - THIAZIDE/LOOP., as they inhibit the excretion of uric acid in urine.
84
Drugs benefit in Gout
Mnemonics - FALSe
FENOFIBRATE
ASPIRIN (>5mg/d)
LOSARTAN
STATIN
Note - both Finofibrate and Statins are hypolipidemic drug, lowers the uric level by increasing Uricosuric effect
85
What type of hypersensitivity rxn is Rheumatoid Arthritis?
And most common joints involved?
Type 3/4 HS
Mc joints - MCP, ICP
86
Approach to treat Acute Rheumatoid Arthritis.
NSAIDS (all except PCM)
CORTICOSTEROIDS (intra-arterial inj)
Then
(Definitive Treatment.,
DMARDS 2nd line)
87
Conventional DMARDS in RA
Memonics - Malika Sherawat Pa GL C
1- METHOTREXATE - inhibit DHFR
Adenosine efflux
Most effective in RA - (DOC)
C/i in Pregnancy
2- SULPHASALAZINE - prodrug
Active form - (Sulfapyridine - RA)
(5-ASA - Ulcerative colitis
-sala - MESALAZINE, OLSALAZINE)
3- PENICILLAMINE -GOLD. Copper C
Notes - (Nephrotoxic)
4- LUFUNOMIDE (100mg)
5 CHLOROQUINE Or HYDROXY CQ -
Immunosuppression (IL6,IL1,TNFa).
Safest in pregnancy
88
Which Uricosuric agent is safe in renal disease and is c/i in liver disease
BENZBROMARONE
89
Newer DMARDS for RA
Block Anti TNF-alpha
Mnemonics - ICAGE
IV INFLIXIMAB
S/C.,
CENTOLIZUMAB
ADALIMUMAB
GOLIMUMAB
ETANERCEPT
90
Which drug is used in RUPA, RA, Psoriatic arthritis, Ankylosing spondylitis?
And used in METHOTRAXATE - Resistant cases.
IV INFLIXIMAB
S/E reactivation of latent TB,
So the Montoux test is done before administration.
91
Newer DMARDS for RA
As Anti IL-6
TOCILIXUMAB
SARILUMAB
92
Newer DMARDS for RA
as Anti CD-20
Remember - Ritu ke age 20
RITUXIMAB
93
Newer DMARDS for RA
As Anti - IL-1
ANAKINRA
94
Newer DMARDS for RA
Recombinant CTLA4
ABATACEPT
95
Newer DMARDS for RA
JAK1, 3 inhibitor
JAK1, 2 inhibitor
JAK1 inhibitor
TOFACITINIB - Approve for RA,UC/CD
BARICITINIB
UPADACITNIB
96
Dual COX and LOX
LECOFELONE
Used in osteoarthritis
97
Housekeeping function - maintains normal body function
COX - 1
98
Inflammation is the maine function
COX 2
99
Cause pain perception, fever but no role in inflammation
COX3
100
Dose limiting side effects of using Colchicine in Acute attack of Gout
Nausea
Vomiting
Watery and bloody diarrhoea
Abdominal cramps
101
Which ARB Is used to treat HTN and proteinuria in conditions like diabetic nephropathy and CKD
LOSARTAN
Renal protective and has been shown to reduce proteinuria
Also reduce uric acid levels due to its uricosuric effect.
102
5HT1 Receptor agonists is the new drug in the regimen and is cardio protective
LASMIDITAN - doesn’t cause VC
Pharmacology
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