1
Q
Doc for type 1 DM
A
INSULIN
other approved addon drug,
ACARBOSE and PRAMLINTIDE
2
Q
DOC in Gestational DM
A
INSULIN
other addon drug
METFORMIN AND GLYBURIDE
3
Q
Amylin analogue causes Gastroparesis
A
PRAMLINTIDE
4
Q
GLP 1 analogue - Incretins
Causing Pancreatitis and thyroid cancer
A
EXENATIDE
LIRAGLUTIDE
LIXISENATIDE
ALBIGLUTIDE
DULAGLUTIDE
SEMAGLUTIDE (oral)
5
Q
GLP 1 analogue - Incretins
Approved as Anti obesity drugs
A
LIRAGLUTIDE IV
SEMAGLUTIDE ORAL
6
Q
GLP 1 analogue - Incretins
Hepatic and renal safe
A
DULAGLUTIDE
SEMAGLUTIDE
7
Q
Dual GLP1 and GIP analogue
A
TIREZEPQTIDE INJ
8
Q
GLP 2 Analogue
Used in Short bowel syndrome
A
TEDUGLUTIDE
9
Q
DOC for T1DM
A
DOC- Insulin
ACARBOSE
PRAMLINTIDE
10
Q
DOC- T2DM, impaired glucose intolerance, PCOD, Clozapine T2DM
A
METFORMIN
INSULIN if not controlled
11
Q
DOC OF GESTATIONAL DM
A
DOC- INSULIN
METFORMIN AND GLYBURIDE
12
Q
Ultra short insulin (Rapid)
A
LISPRO
ASPART
GLULISINE
BOLUS INSULIN - 3hr
To control PPH
13
Q
Short - REGULAR insulin
A
Act as both BOLUS AND BASAL
6hr
14
Q
Intermediate insulin
A
LENTE INSULIN
Amorphous + Crystalline 30:70
NPH (Neutral Protamine Hagedorn)
Both basal insulin - 12-18 hr
15
Q
Long acting insulin
A
DETEMIR 18hr
GLARGINE 24hr
Both basal
Peakless, least risk of hypoglycaemia
16
Q
Ultra long acting insulin
A
DEGLUDEC 42hr
Longest acting
Peakless, least risk of hypoglycaemia
17
Q
Which insulin never mix together?
A
GLARGINE AND DEGLUDEC
GLARGINE IS ACIDIC INSULIN
18
Q
Nasal insulin
A
AFREZZA
Dry powder inhaler
Shortest acting
C/I - smoker, COPD, Asthma
Risk of lung cancer
19
Q
Insulin injection site
A
Abdomen
Lateral thigh
Upper arm
Buttock
20
Q
hypoglycaemic agent acts on Pancreas
Sundar MAID
A
SULPHONYLUREAS
MEGLINITIDE
AMYLIN ANALOGUE
INCRETINS - GLP 1 Analogue
DPP 4 inhibitor
21
Q
Hypoglycaemic agent acts on Peripheral organ
BATS
A
1- BIGUNIDES - on liver
2- ALPHA GLUCOSIDASE INHIBITOR
on intestine.
3- THIAZOLIDINEDIONES - on fat
4- SGLT 2 inhibitor - in kidney
22
Q
Suphonylurea cause SIADH, and disulfuram like reaction
A
CHLORPROPAMIDE 1st Gen
2nd gen - ‘Gli’
23
Q
MEGLINATIDE cause flu like syndrome
A
RAPEGLINIDE AND NATEGLINIDE
24
Q
Drugs causing hypoglycemia
A
INSULIN
SULFONYLUREAS
MEGLINITIDE
They are insulin secretagogue
25
AMYLIN ANALOGUE decrease glucagon and appetite by acting on Hindbrain?
PRAMLINTIDE - secreted from b cell
Giver through SC
Cause wt. loss
26
Which hypoglycaemic agent causes Gastroparesis
PRAMLINTIDE
27
Which hypoglycaemic agent cause pancreatitis and thyroid cancer ?
GLP 1 analogues - Incretins
EXENATIDE
LIRAGLUTIDE
LIXISENATIDE
ALBIGLUTIDE
DULAGLUTIDE renal/hepatic safe
SEMAGLUTIDE oral/renal/liver safe
28
GLP 1 analogue as oral drug
SEMAGLUTIDE
29
Which hyperglycaemic agent approved as anti obesity drug
LIRAGLUTIDE AND SEMAGLUTIDE
Both are GLP 1 analogue
TIRZEPEATIDE inj -
dual GLP1 and GIP Analogue
30
GLP 1 analogue as hypoglycaemic is Renal and Hepatic safe
DOLUTAGLUTUDE AND SEMAGLUTIDE
31
GLP 2 analogue used in SHORT BOWEL SYNDROME
TEDUGLUTIDE
32
Hypoglycaemic agent increases inflammation causing
Arthritis and Nasopharangitis
Also increases the risk of pancreatic cancer
DPP 4 inhibitor
SITAGLIPTIN
VILDAGLIPTIN
LINAGLIPTIN
33
DPP 4 inhibitor increases the risk of heart failure
SAXAGLIPTINS
Metabolised by CYP34A
34
DPP 4 inhibitor is most HEPATOTOXIC
VILDAGLIPTIN
35
DPP 4 inhibitor are Renal safe
LINAGLIPTIN and TENELIGLIPTIN
36
What are the ADRs of METFORMIN
Moa - inhibit hepatic gluconeogenesis
Git upset - unexplained diarrhoea
Reduce B12 absorption Megaloblastic anaemia
Lactic acidosis
Also C/I in renal failure if GFR <30ml/min.
37
Hypoglycaemic drug safe in renal failure
Lina ko PTSD
LINAGLIPTIN
PIOGLITAZONE
TENEGLIPTIN
SEMAGLUTIDE
DULAGLUTIDE
38
MOA of Alpha glucosidase inhibitor
ACARBOSE
VOGLIBOSE
MIGLITOL
Inhibit breaking down of complex carbohydrates into glucose
Acts on intestine
S/E - malabsorption and Gi infec.
39
THIAZOLIDINEDIONE acts on which tissue
Mnemonic- litazone
Adipose tissue
Cause wt. gain by stimulating PPAR gamma agonist - Lipogenesis
Antidiuretic effect - c/i in CHF
40
THIAZOLIDINEDIONE increase urinary bladder cancer
PIOGLITAZONE
41
Dual PPAR agonist + alpha agonist
Treats diabetic dyslipedemia
SEROGLITAZAR
42
SGLT 2 inhibitor acts on
-gliflozin
Kidney - PCT of nephron
Urinary excretion of Na/Glucose
Diuretic effect - approved in CHF
Oral drug
Wt. loss
43
SGLT 2 inhibitor approved for CHF
DAPAGLIFLOZIN
EMPAGLIFLOZIN
Have diuretic effect
44
SGLT 2 inhibitor C/I in CHF
PIOGLITAZONE AND ROSIGLITAZONE
Have antidiuretic effect
45
ADRs of SGLT 2 inhibitor
UTI/ cystitis/ candida
Fournier gangrene
Osteoporosis due to Ca excretion
Lower limb amputation
DKA
46
Which DM Drug is Bile acid - Binding Resin
COLESEVELAM
Reduce glucose absorption from
GIT
47
Antibiotic helps in diabetic Gastroparesis
ERYTHROMYCIN
Stimulate motilin receptors on stomach
48
Drug helps in diabetic diarrhea
CLONIDINE
Stimulate alpha 2a receptor in intestine
49
Anti VEGF helps in diabetic retinopathy
‘BRAP’
BEVACIZUMAB
RANIBIZUMAB
AFLIBERCEPT
PEGAPTANIB
Neovascularization inhibitor
Intravitreal inj
50
Drug help in diabetic neuropathy
PREGABALIN
51
Anti diabetic drug causing fractures
CANAGLIFLOZIN
DAPAGLIFLOZIN
PIOGLITAZONE
52
T4 (levothyroxine)
T3 (liothyronine)
T4 is given in
Ch. Hypothyroidism - Orally
Myxoedema coma - IV
T3 is active form of T4
via (peripheral 5’ deiodinase)
Fastest acting
53
Which anti thyroid drug inhibit the synthesis of T3/T4 including Oxidation,
Organification and
Coupling of iodine
THIONAMIDE AND ETHIONAMIDE
54
Which anti thyroid drug is a derivative of methimazole and is used as anti TB drug
ETHIONAMIDE
S/E - Hypothyroidism
55
Oral Iodides ?
Na iodide FASTEST ACTING
Saturated solution of KI (SSKI)
Lugol’s iodine - (5% iodine+10% KI)
- Fastest anti thyroid drug
- before surgery to reduce size
- S/E
MUMPS like,
Sialorrhea, Sialadenitis
56
Which GnRh agonist is used in managing uterine fibroids?
LEUPROLIDE
NAFARELIN
GOSAERLIN
They all flared up rxn as ADRs when given in continuous form
57
Which Radioactive iodine destroys thyroid gland?
IODINE - 131
Destroys thyroid by Beta rays
Half life 8 days
Considering in those,
Inoperable hypothyroidism
In old age/heart patient
C/I in pregnancy, age <35 year
S/E Permanent Hypothyroidism
58
Drugs inhibiting peripheral conversion of T4 to T3
PROPRANOLOL
PTU
IODIDES
DEXAMETHASONE
AMIODARONE (37% iodine)
1- Given in thyroid storm (PPID)
2- Thyroid storm + asthmatic
- Give VERAPAMIL/ DILTIAZEM
59
Which anti arrhythmic drug causes hypothyroidism containing 37% of iodine?
AMIODARONE
60
Which anti IGF -1 is used to treat thyroid eye disease - Proptosis
TEPROTUMUMAB
61
Which tyrosine kinase inhibitor used in metastatic medullary thyroid carcinoma?
Remember- vande matram
VANDETANIB
Major adverse effect is
QT prolongation.
62
Drugs inhibit Osteoclastic activity and inhibit resorption
1- Bisphosphonates ⭐ DOC
•Alendronate
•Risedronate
•IBANDRONATE
•Zoledronic acid - longest, potent, and once a year.
Mechanism:
→ Taken up by osteoclasts
→ Inhibit FPPS → osteoclast apoptosis.
BISPHOPHONATES is DOC for Paget disease, Hypercalcemia and Osteoporosis in Cushing syndrome and post menopausal osteoporosis.
2- Denosumab
• Anti-RANKL monoclonal antibody
• Prevents osteoclast formation, function, survival
3- Calcitonin
•Directly inhibits osteoclasts
•Rapid onset but weak and short-acting
Used in:
•Acute hypercalcemia
•Vertebral fracture pain
4 - Estrogen / Raloxifene
•↓ RANKL expression
•↑ OPG → ↓ osteoclast activation
Used in:
•Postmenopausal osteoporosis
5- Gallium Nitrate
(Mechanism only)
•Inhibits osteoclast activity
•Used for hypercalcemia of malignancy
•❌ Not used for osteoporosis
63
Drug stimulate Osteoblasts activity and promote formation
TERIPARATIDE (PTH)
64
Which drug inhibit both osteoclast and stimulate osteoblast
STRONTIUM RENELATE
65
Which monoclonal antibody inhibits sclerostin to stimulates Osteoblast
ROMOSOZUMAB
66
Which monoclonal antibody inhibit FGF23 to help increase phosphate level and bone mineralisation?
BUROSUMAB
67
ADRs of using BISPHOPHONATES
Reflux esophagitis
Osteonecrosis of mandible
Maximum use - 10years
>10 year - increase the risk of Subtrochanteric femur fracture
68
Which drug used in treating Osteoporosis for a prolonged use increase the risk of Osteosarcome
TERIPARATIDE (PTH)
max. For 2 years
> 2 year - Inc. risk of Osteosarcoma
Given in BISPHOPHONATES resistant cases.
S/C intermittent injections
C/I in hypercalcemia, Paget D
Renal safe drug - DENOSUMAB
69
Fastest acting lowering agent for hypercalcemia
CALCITONIN
70
Suppress PTH secretion used in hyperparathyrodism
CINACALECET
71
Drugs for HYPERPHOSPHOTEMIA
SEVELAMER - DOC
LANTHANUM CARBONATE
CA. CARBONATE
AL. HYDROXIDE
IRON SALTS
NIACIN
72
Diuretic c/i in Hypercalcemia
Thiazide diuretic - as it retain calcium level
73
SERM - treat and prevent breast cancer?
TAMOXIFEN
Helps in Osteoporosis
But Increases the risk of -
Cataract
Heptatotoxic
Hot flushes
Thromboembolism
74
Which anti RANK antibody is used to treat GIANT CELL TUMOR
DENOSUMAB
75
Which SERM treats post menopausal Osteoporosis
RALOXIFENE
S/E - hot flushes and Thromboembolism
76
Which SERM helps to induce Ovulation and helps in treating PCOD
CLOMIPHENE CITRATE
LETROZOLE AND CLOMIPEHE
(ovulation inducer in PCOD)
77
Which made in india (CDRI LKO.) SERM Drug is used as contraceptive
ORMELOXIFENE (centchroman)
78
Which SERM is given in post menopausal Hot flushes
BAZEDOXIFENE - DOC - HRT
PAROXITINE (SSRI) Also used.
79
Which SERM is used to treat Senile/Atrophic Vagintis
OSPEMIFENE
80
DOC For TAMOXIFEN Resistant breast cancer
FULVESTRANT, ELACESTRANT
SERD - (selective estrogen receptor down regulator)
81
Aromatase inhibitor a SERM is the DOC for post menopausal breast cancer
LETROZOLE
82
Glucocorticoid with maximum mineralocorticoid activity
HYDROCORTISONE 20mg
Shortest acting half life <12hr
83
Least potent Glucocorticoid
CORTISONE
Shortest acting half life <12hr
84
Most portent Glucocorticoid
DEXAMETHASONE
BETAMETHASONE
Half life - > 36hr
85
Which topical Glucocorticoid is most potent
BECLOMETHASONE DIPROPIONATE
CLOBETASOLE PROPIONATE0 0.5%
86
Mineralocorticoid with MAX. GC activity
FLUDROCORTISONE
Only oral and IV preparation
87
PGE1 blocks GC and progesterone receptor
Given in Cushing disease
Abortion/MTP in 1st trimester
MIFEPRISTONE
88
Drug used in Adrenal insufficiency
HYDROCORTISONE
89
Drug used in fetal lung maturation
DEXAMETHASONE 6mg
BETAMETHASONE 12mg
90
Drug used as emergency contraceptive
URLIPRISTAL 30mg once
Taken within 5 days of intercourse
91
CUSHINOID feature
Moon like faces
Buffalo hump
Central obesity
Thin skin with straie
Easy bruising
Poor wound healing
Increase blood RBS
Eye disease by corticosteroids
Oral - Cataract (Post. Subscapular)
Eye drop - Glaucoma
DUE TO PROLONGED USE OF HIGH DOSE OF CORTICOSTEROID
92
Medical adrenalectomy
Mnemonic - MOM
Inhibit production of Corticosteroids in the adrenal gland
MITOTANE
OSILODROSTAT
METYRAPONE
inhibit 11beta-hydroxylase inhibitor
93
Which antifungal drug inhibit corticosteroids synthesis causing adrenal insufficiency
KETOCONAZOLE
94
Which General Anaesthetic inhibite corticosteroids synthesis
ETOMIDATE
95
Testosterone get converted into Dihydrotestosterone (active form) by which enzyme
5 alpha reductase enzyme
Dihydrotesterone acts on androgen receptor
96
Usage of anti androgen
Prostate cancer in male
Hirsutism in female
Helps in Alopecia
97
Which anti androgen drug inhibit 5 alpha reductase enzyme
FINESTERIDE
DUTASTERIDE
Used in BPH to reduce the prostate size
98
ADRs of using Anti androgen drug
Gynaecomastia
Impotence
Androgen receptor antagonist are
FLUTAMIDE
SPIRONOLACTOME
DROSPERINONE
BICALUTAMIDE
ENZALUTAMIDE
NILUTAMIDE
CYPROTERONE
99
Which drug helps in Alopecia
FINESTERIDE+DUTASTERIDE
MINOXIDIL (2-5% cream)
100
Which is considerably as a first line drug for pt. With Alopecia areata
TRIAMCINILONE/HYDROCOTISONE
Intralesional administrative
In
Alopecia areata
Discoid lupus
Keloids
Necrobiosis lipodica diabeticorum
101
Prednisolone achieves its anti inflammatory action by acting on which enzymes
Phospholipase A2
102
Synthetic form of GHrh used for diagnosis dwarfism (GH deficiency)
SERMORELIN
103
Synthetic form of GHrh used for treatment of lipodystrophy in HIV positive patient
TESAMORELIN
104
Side effects of GH
Mnemonics CHILS
1 - Carpal tunnel syndrome
Median nerve entrapment
2 - Hyperglycaemia
3 - Inc. ICP - C/I in head injury
4 - lymphomas
5 - Slipped capital femoral epiphysis
105
S/E of Bromcriptine
Mnemonics- PPPEI
Puke - N/V
Postural hypotension
Psychosis
Ergotism
Inflammation - lead to fibrosis
Not HTN
106
Which GnRh agonist can be given via all route
LEUPROLIDE
107
Which GnRh agonist can be given via IM / IM depot
TRIPTORELIN
108
Oxytocin receptor antagonist, cardiosafe tocolytic given in premature delivery to delay labor
ATOSIBAN
109
Inhibitory hormone inhibit GH mainly
SOMATOSTATIN
110
Inhibitory hormone inhibit Prolactin mainly
DOPAMINE
111
DOC for Dwarfism
SOMATOTROPINS (recombinant GH)
Cause hyperglycaemia
In resistant cases- MECASERMIN
(recombinant IGF 1) Inj
Cause hypoglycaemia
112
DOC for Acromegaly
Somatostatin
OCTREATIDE AND LANREOTIDE
Resistant cases - PEGVISOMANT
GH receptor antagonist
But 1st treatment would always be pituitary removal
113
DOC for Prolactinoma
CABERGOLINE - (Dopamine D2 ag.)
In pregnancy - BROMOCRIPTINE
In resistant cases - pituitary removal
Lu- Dotate - Radioactive- lutetium
OCTREATIDE - PNET tumor
114
Drug used in short bowel syndrome
Mnemonics- GOT
GH
OCTREATIDE
TEDUGLUTIDE - recombinant GLP2
115
GnRh analog not used before surgery
As they cause flared up Rxn
GnRh agonist
LEUPROLIDE via all route
BUSERELIN - SC
HISTRELIN - SC
TRIPTORELIN - IM
NAFARELIN - nasal spray
116
GnRh analog can be used before surgery
As they can’t cause flared up Rxn
-relix
CETRORELIX
DAGARELIX
ABARELIX
GANIRELIX
Used in Prostate cancer
Endometriosis
117
Duration of Hexameric zinc insulin
6hr Regular Insulin
118
Amino acid sequence in the structure of human insulin
Human insulin: 51–amino-acid peptide with
A chain (21 AA) + B chain (30 AA) linked by 3 disulfide bonds.
119
Which drug act as a decoy VEGF receptor used in treatment of diabetic retinopathy
AFLIBERCEPT
remember BRAP
120
Which is dual SGLT1 an SGLT2 inhibitor?
SOTAGLIFOZIN
121
Which drug helps to prevent insulinoma induced hypoglycaemia
DIAZOXIDE
also used as VD in tx of HTN
122
Which drug helps to reverse insulin resistance
PIOGLITAZONE
123
Which monoclonal antibody is preferred in the treatment of X linked Hypophosphatemic Osteoporosis?
BUROSUMAB
Pharmacology
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