Cns Formatted

PHARMACOLOGY 33
Central Nervous system
GENERAL ANESTHETICS (GA’s) CLASSIFICATION

 General Anaesthetics (GAs) are drugs which produce A. Inhalational
reversible loss of all sensation and consciousness I. Gas
1. Nitrous oxide (N2O)
FEATURES
1. Loss of all sensations II. Liquids
2. Unconsciousness 1. Ether
3. Muscle relaxation 2. Halothane
4. Abolition of reflexes 3. Enflurane
5. Amnesia 4. Isoflurane
5. Desflurane
STAGES OF ANAESTHESIA 6. Sevoflurane
 First demonstrated by Guedel – classically seen
with Ether B. Intra venous
1. Stage of Analgesia – Initiates from beginning of I. Inducing Agents
inhalation of anaesthetic to loss of consciousness 1. Thiopentone Na (Pentothal)
 Minor surgical procedures like dental 2. Methohexitone
extraction, incision of abscess, obstetrical 3. Propofol
manoeuvres can be performed 4. Etomidate
2. Stage of Delirium – It extends from loss of
consciousness to beginning of surgical anaesthesia II. Benzodiazepines
 Patient is restless, excitable, breath 1. Diazepam
holding, aggressiveness, shouting, 2. Lorazepam
muscular activity 3. Midazolam
 There may be hypertension, tachycardia,
increased muscle tone III. Dissociative Anaesthesia
 No surgical procedures should be tried in this 1. Ketamine
stage
3. Stage of Surgical Anaesthesia – Extends from onset IV. Neurolept Anaesthesia
of regular respiration to cessation of spontaneous 1. Fentanyl + Droperidol + N2O + O2
breathing
 It is divided into 4 phases MECHANISM OF ACTION
o Plane 1 – Roving of eyeballs, thus  Exact mechanism is not known
plane ends when eyeball is fixed  Multiple mechanisms – GABA potentiation, anti-
o Plane 2 – Loss of corneal and glutamate /NMDA etc
laryngeal reflexes
o Plane 3 – Pupil starts dilating & light NITROUS OXIDE
reflex is lost  Laughing gas
o Plane 4 – Inter costal paralysis,  First discovered by J. B Priestly in 1776
shallow abdominal respiration, and  First demonstrated by Horace Wells (Dentist) in
dilated pupil 1844
4. Stage of Respiratory / Medullary paralysis
 Failure of respiration, circulation, muscle Features
totally, flabby, widely dilated pupils  Supplied in steel cylinders, non-inflammable,
 All the surgeries should be performed in Stage 3 low potency (MAC – 105)
 Anaesthetists should see that Stage 4 has not  Good analgesic but poor muscle relaxant
reached which could be fatal  Produces second gas effect – Diffusion hypoxia
(always combined with O2)
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PHARMACOLOGY 34
 As a single agent preferred for dental &  It is degraded by soda lime nephrotoxic metabolite
obstetric analgesia compound A
 Long term exposure for nurses in OT can cause
bone marrow depression THIOPENTONE NA
 Can aggravate pneumothorax, cavities in lungs  Ultra-short acting thiobarbiturate
 Non-toxic to organs  Action in 15 – 20 seconds, terminated after 10 – 20
 Induction & recovery is quite and smooth min
 Poor analgesia & poor muscle relaxation
ETHER  Can cause laryngospasm, shivering, delirium
 Irritant, inflammable, produces lot of sensations  Also used for rapid control of convulsions, to
(Atropine essential) facilitate verbal communication with psychiatric
 High blood solubility (Hence induction is patients, this is called as Pentothal interview
prolonged, recovery is slow)
 Good analgesia & good muscle relaxation PROPOFOL
 Cheapest  Oily liquid
 Safe in inexperienced hands  Action starts in 15 – 45 sec, lasts for 15 minutes
 Non toxic to organs  Suitable for outpatient surgery
 Cross tolerance – ethyl alcohol  Produces excitation & involuntary movements
HALOTHANE BENZODIAZEPINES (BZD)

 Sweet odour, non-irritant, non-inflammable,  Sedation, amnesia, unconsciousness in 10 minutes
fluorinated anaesthetic  Patient responds after 1 hour, amnesia for 3 hours,
 Induction & recovery is quick & smooth (no sedation for 6 hours or more
secretions)  Preferred for endoscopy, angiography, cardiac
 No analgesic, no muscle relaxation catheterisation, ECT
 Depresses heart, Lungs (respiratory depression)  Midazolam – BZD used only as anaesthetic
 Decreased GFR, hepatotoxic
 Malignant hyperthermia (genetically determined) KETAMINE
 to be treated by Dantrolene  Blocks NMDA receptors
 Sensitises heart for arrhythmias due to Adrenaline
Features
ENFLURANE  Analgesic + Immobility + Amnesia & light
 Similar to Halothane sleep, feeling of dissociation
 No sensitisation of heart for arrhythmias  No respiratory depression, patient remains
 Contraindicated in epilepsy conscious
 Increases CO, HR, BP  contraindicated in
ISOFLURANE IHD / MI
 No sensitisation of heart for arrhythmias
 Safe in patients with myocardial ischemia since it Used for
maintains coronary circulation  Head & neck surgeries, children, asthmatics,
severe bleeding cases, burns, replacement for
DESFLURANE Benzodiazepines
 Pungent odour
 Fastest inducing agent NEUROLEPT ANALGESIA
 Induces coughing, laryngospasm, breathlessness  Fentanyl + Droperidol
SEVOFLURANE Features
 No imitation like Desflurane  Generalized quiescence, psychic indifference,
analgesia

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PHARMACOLOGY 35
 Patient remains conscious SEDATIVES – HYPNOTICS

 Replacement for Benzodiazepines  Sedative – drug that decreases excitement & make
patient calm without inducing sleep
Adverse Effects  Hypnotic – drug that induces & maintains sleep
 Respiratory depression, muscle dystonia
CLASSIFICATION
PRE – ANAESTHETIC MEDICATION A. Benzodiazepines (BZD’s)
Objectives I. Long acting (24-48 hrs)
1. Relieve anxiety, apprehension 1. Diazepam
2. Decrease secretions 2. Chlordiazepoxide – 1st drug discovered
3. Produce amnesia 3. Clonazepam
4. Decrease chances of vomiting 4. Flurazepam
5. Decrease gastric acidity 5. Clobazam
6. Make anaesthesia smooth & pleasant
7. Reduce complications of GA II. Short acting (12-24 hrs)
1. Temazepam
Drugs Used 2. Lorazepam
1. Opioid analgesics 3. Oxazepam
2. Anticholinergic drugs (Atropine / Glycopyrrolate) 4. Nitrazepam
3. Sedative hypnotics 5. Alprazolam
4. H2 Blockers
5. Antiemetics III. Ultra short (< 6 Hrs)
6. Antihistamines 1. Triazolam
2. Midazolam
MISCELLANEOUS
 First IV anaesthetic introduced  Thiopentone Na B. Barbiturates
 William T. G Morton  first demonstrated Ether I. Long acting (t1/2: 100 hrs)
anaesthesia 1. Phenobarbitone
 Conscious sedation – type of GA where patient 2. Mephobarbitone
remains conscious but will not have any pain 3. Hexobarbitone
/sensation & will remain quite. Used for minor
procedures in patients having cardiovascular or II. Short acting (t1/2: 30-50 hrs)
respiratory problems. Drugs used are Nitrous 1. Pentobarbitone
oxide, Diazepam, Propofol, Fentanyl 2. Secobarbitone
 Potency of Inhalational anaesthetic agents is 3. Butobarbitone
measured in terms of Minimum Alveolar 4. Amobarbital
Concentration (MAC). It is defined as the lowest 5. Mephobarbitone
concentration of inhalational anaesthetic at one
atmosphere pressure that produces immediately in III. Ultra-short acting (t1/2: 5-10 hrs)
response to a surgical stimulus in 50% of 1. Thiopentone
individuals. For any drug higher the MAC, lower is 2. Methohexitone
the potency as inhalational anaesthetic. Nitrous
oxide has highest MAC that is 105 C. Newer drugs (Z - agents)
1. Zolpidem
2. Zopiclone
3. Eszopiclone
4. Zaleplon
5. Indiplone

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PHARMACOLOGY 36
BENZODIAZEPINES 4. Clobazam, Lorazepam – For epilepsy

 Lipid soluble 5. Triazolam – avoided in children (known to cause
 Excellent absorption psychiatric disorder)
 Vd high 6. Diazepam – given orally / IV (avoided by IM route
due to erratic absorption)
Mechanism of Action 7. Shortest acting sedative / hypnotic  Zaleplon
 Facilitates GABA action (preferred for sleep onset insomnia)
 Act on GABA – BZD receptors chloride channel
complex  chloride influx  hyperpolarisation BARBITURATES
 Mechanism of Action: GABA facilitator + GABA
Actions mimetic
1. Sedative/hypnotic  More powerful than BZD as CNS depressant
2. Reduces anxiety  Highly protein bound
3. Muscle relaxation  More hangover, dizziness, lethargy
4. Anticonvulsant  Impairment of learning, judgment, memory
5. Amnesia and anaesthesia (IV)  Avoided in children
 Tolerance, dependence abuse liability
Advantages of BZD’s over Barbiturates  No specific antidote avoidable low margin of safety
1. High margin of safety (high TI)  Poisoning treated symptomatically  Forced
2. Less hangover alkaline diuresis + Respiration & CVS support
3. Less effect on CVS, RS, body system  Drug Automatism  commonly seen with
4. Less tolerance, dependence (abuse liability) barbiturate addicts (due to amnesia)
5. Less drug interaction  Fatal dose of Phenobarbitone: 5 – 10 gm
6. Specific antidote available- Flumazenil  Idiosyncratic reactions like excitement common
 Long term use can cause megaloblastic anaemia
Adverse Effects Osteomalacia, frozen shoulder, Dupuytren’s
 Drowsiness, lethargy, headache, blurring of vision, contracture
motor in coordination
 Rapid IV infusion  RS and CVS depression Uses
 Given during pregnancy  can cause hypotonia  Phenobarbitone  GTCS / CPS / SPS & status
and respiratory depression in neonate (this is called epilepticus; Congenital non-haemolytic jaundice
Floppy baby syndrome) (enzyme inducer) & kernicterus
Uses of BZD’s Contraindications

1. Insomnia  Acute intermittent porphyria, emphysema, apnoea
2. Anxiety
3. Status epilepticus / emergency control of MELATONIN
convulsions in drug poisoning  Hormone from pineal gland
4. Chronic muscle spasms  Now tried in cases of jet lag for synchronising
5. Pre anaesthetic medication sleep-wakefulness cycle (flight travellers)
6. IV – GA  Other drug for same purpose tried is Ramelteon
7. Before ECT, endoscopy, cardiac catheterization
8. Alcohol withdrawal symptoms
Notes
1. Diazepam – all purpose BZD (can used in all
indications)
2. Alprazolam – preferred for anxiety
3. Midazolam – used only as IV GA

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PHARMACOLOGY 37
ANTIEPILEPTICS Osteomalacia, Teratogenicity (Cleft palate, Hare lip,

 Epilepsy is a chronic disorder characterised by recurrent Microcephaly, Hypoplastic phalanges), Foetal
seizures often accompanied by episodes of Hydantoin syndrome
unconsciousness and/or amnesia  Ataxia, Diplopia, Nystagmus, Vertigo
 Seizure indicates a transient alteration in behaviour
because of disordered firing of groups of brain neurons Adverse Effects of Carbamazepine
 Ataxia, Vertigo, Diplopia, Nystagmus
CLASSIFICATION  Water retention (ADH like action), teratogenicity,
1. Barbiturates: Phenobarbitone allergic reaction, thrombocytopenia
2. Deoxybarbiturates: Primidone  Oxcarbazepine – less drug interactions, less allergic
3. Hydantoin derivatives: Phenytoin, Fosphenytoin reaction
4. Iminostilbenes: Carbamazepine, Oxcarbazepine
5. Succinamides: Ethosuximide Adverse Effects of Valproate
6. Aliphatic carboxylic acid: Valproic acid (Sodium  Alopecia, curling of hair, acute fulminant hepatitis,
valproate), Divalproex sodium pancreatitis, teratogenicity, neural tube defects,
7. Benzodiazepines: Diazepam, Clobazam, Clonazepam spina bifida, rise in blood ammonia
8. GABA Transaminase inhibitor: Vigabatrin
9. GABA transporter / GABA uptake inhibitor: Tiagabine Ethosuximide
10. Miscellaneous: Levetiracetam, Topiramate,  First line antiepileptic which is not teratogenic
Zonisamide, Felbamate, Lamotrigine, Gabapentin  No severe side effects
Common Mechanisms of Action with examples Special Information

1. Prolonging inactivation of Na+ channels   Phenytoin  Trigeminal neuralgia, Digitalis
Phenytoin, Carbamazepine, Sodium Valproate, induced arrhythmias
Lamotrigine, Topiramate, Zonisamide  Carbamazepine  drug of choice for Trigeminal
2. Potentiating GABA action  BZD’s, Barbiturates, neuralgia, Diabetes Insipidus, Manic depressive
Sodium Valproate, vigabatrin, gabapentin, psychosis, chronic neuropathic pain
tiagabine  Valproate  Manic depressive psychosis
Gabapentin  Excesses GABA levels in brain  Gabapentin  Migraine, Neuropathic Pain, Mood
3. Inhibiting ‘T’ type Ca +2 currents in Thalamus  Stabilizers
Ethosuximide, Trimethadione, Sodium Valproate  Carbamazepine  induces its own metabolism (auto
 Sodium Valproate is only drug having multiple induction)
mechanisms  Phenytoin  saturation kinetics (t ½ increases with
dose & time)
First Choice Drugs for Epilepsies  Felbamate  not used everywhere (banned in some
1. GTCS/ CPS/SPS  carbamazepine, phenytoin countries due to aplastic anaemia, hepatitis)
2. Absence seizures  Sodium Valproate,  Vigabatrin  can cause psychosis, depression,
Ethosuximide (in children) visual disturbances (visual fled testing mandatory)
3. Myoclonic  Sodium Valproate  Diazepam  used only as anticonvulsant
4. Atonic  Sodium Valproate (emergency control) but not as antiepileptic due to
5. Status epilepticus  Diazepam, Lorazepam sedation & raped development of tolerance
6. Febrile seizures  Diazepam (rectal /IV)  Therapeutic Drug Monitoring (TDM) is required for
7. Infantile spasms  No antiepileptic drug is Barbiturates, Phenytoin, Carbamazepine, and
effective. Sodium Valproate is tried along with Valproate since they have low margin of safety (low
steroids TI)
 During pregnancy  Antiepileptics should not be
Adverse Effects of Phenytoin stopped, along with it, always Folic acid + Vitamin
 Gingival hyperplasia, Hirsutism, Hypersensitivity, K given to prevent neural tube defects
Hyperglycaemia, Megaloblastic anaemia,

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PHARMACOLOGY 38
 Always epilepsy treated with single drug less. Hence Therapeutic Drug Monitoring (TDM) is
(monotherapy) essential. TDM is not useful with Valproic acid &
 Drug should not be abruptly withdrawn not required with Ethosuccimide and
 Patients must maintain seizure diary Phenobarbitone
 Barbiturates, Carbamazepine, Phenytoin, Valproate
 enzyme inducers
 Fosphenytoin preferred for IV use over Phenytoin
since it does not cause thrombophlebitis, can be
given rapidly OPIOID ANALGESICS
 Suitable for visceral, ischemic, traumatic, cancer pain
Topiramate  Chief source: Poppy seeds (Papaver somniferum)
 Newer antiepileptic with multiple mechanisms  Opioid receptors: µ (mu), k (kappa), δ(delta)
 It acts by prolonging inactivation of Na+ channels,
GABA potentiation, and antagonism of glutamate CLASSIFICATION
reception I. Pure agonists
 It has weak carbonic anhydrase inhibitor activity A. Natural
 Adverse effects include sedation, ataxia, word 1. Morphine
finding difficulties, renal stones, impairment of 2. Codeine
attention, weight loss B. Semi synthetic
1. Pholcodine
Tiagabine 2. Heroin
 It depresses GABA transporter GAT – 1, thus C. Synthetic
potentiates GABA mediated neuronal inhibition. 1. Pethidine
 It can cause sedation, nervousness, amnesia, asthma 2. Fentanyl
3. Methadone
Zonisamide 4. Dextropropoxyphene
 Acts by prolonging inactivation of Na+ channels, 5. Tramadol
also has weak carbonic anhydrase inhibitor activity
 Used in refractory partial seizures II. Partial agonists / antagonists
1. Pentazocine
Levetiracetam 2. Buprenorphine
 Exact mechanism is not known, found effective in 3. Nalorphine
refractory partial seizures
III. Pure antagonists
Pregabalin 1. Naloxone
 It causes modulation of calcium currents & release 2. Naltrexone
of neuro transmitters 3. Nalmefene
 Used in partial seizures, painful diabetic
neuropathy, post herpetic neuralgia MECHANISM OF ACTION
 Reduces release of substance P from substantia
Felbamate gelatinosa
 Antiepileptic drug, not much favoured due to  Increases permeability to K+ - cellular
hepatitis as a side effect hyperpolarisation
 Acts on opioid receptors
Notes
 Antiepileptic drugs also tried in migraine are ACTIONS
Gabapentin, Topiramate 1. Analgesia: Suppress pain perception, reaction &
 Most of the first line antiepileptic drugs have low autonomic effects associated with pain. Site:
therapeutic index i.e. their margin of safety is very substantia gelatinosa of dorsal horn of spinal cord

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PHARMACOLOGY 39
(spinal), medulla, midbrain, limbic system (supra

spinal) DEXTROPROPOXYPHENE
2. Sedation  Opioid analgesic very commonly combined with
3. Euphoria Paracetamol
4. Depresses: Respiratory centre, cough centre,
vasomotor centre, temperature regulating centre TRAMADOL
5. Stimulates: CTZ, Edinger Westphal nucleus, vagal  Opioid this also acts through non-opioid
centre, cortical area, hippocampus cells mechanism
6. Endocrine: Decreases FSH, LH, ACTH; Increases GH  Inhibits reuptake of NA and 5HT
& prolactin, ADH
7. CVS: Vasodilation, (Histamine release) MORPHINE
8. GIT: Constipation, spasm of sphincter of ODDI  Sir William Osler called it- God’s own medicine
(precipitates Biliary colic)  Serturner isolated it in 1803 from juice of poppy
9. Respiratory System: Bronchoconstriction plant, naming it after Morpheus, the Greek god of
dreams
CONTRAINDICATIONS  Used for cancer pain, acute LVF with pulmonary
 Head Injury, Respiratory insufficiency / Bronchial edema
asthma, Infants & elderly patients, undiagnosed  Morphine is contraindicated in Head Injury
abdominal pain patients. The reasons are
1. Chance of respiratory depression caused by
CODEINE, PHOLCODINE Morphine is high in head injury patient
 Not used as analgesic but cough suppressants 2. It may cause rise in intracranial pressure by
 Most common side effect of Codeine  retaining CO2 which can aggravate brain
constipation (Pholcodine  No constipation) damage
3. Since Morphine produces signs and symptoms
PETHIDINE like miosis, vomiting and altered mentation, it
 1/10 analgesic potency
th may interfere with assessment of progress in
 No cough suppression head injury cases
 No spasmodic action  In undiagnosed abdominal pain, Morphine has to
 No histamine release be avoided since it can aggravate certain types of
 It has anticholinergic property pain like biliary colic, pancreatitis, diverticulitis; it
 Metabolite called Norpethidine  produces hyper may even cause rupture of appendix
reflexes, tremors, myoclonus  Withdrawal syndrome of Morphine is characterized
by yawning, lacrimation, sweating, anxiety,
FENTANYL gooseflesh, mydriasis, tremors, insomnia,
 100 times more potent abdominal colic, diarrhoea, rise in BP, palpitations.
 Short duration (up to 40 min)  Treatment consists of opioid substitution therapy
 Also available as Transdermal patch with Methadone and then gradually withdrawing
 Preferred as general anaesthetic (Neurolept it. Advantage of Methadone is that it is slow & long
analgesia) acting due to tight tissue binding capacity. Presence
 Remifentanil, Sufentanil – 1000 times potent than of Methadone in place of Morphine will not allow
Morphine the addict to go in withdrawal syndrome. At the
same time, subject will not develop kick as with
METHADONE Morphine. So he himself may give up the habit
 High binding to tissue protein & slow release since there is no experience of pleasure.
 Preferred for substitution therapy for opioid
dependence Acute Morphine Poisoning
 1 mg Methadone for 4 mg Morphine, 2 mg Heroin,  Respiratory depression + pinpoint pupils
10 mg Pethidine (diagnostic features)

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 Drug of Choice: Naloxone IV; Lethal dose: 250 mg ANXIOLYTIC DRUGS

 Tolerance develops to all actions of Morphine  These are an ill-defined group of drugs, mostly mild
except constipation & miosis CNS depressants, which are aimed to control the
symptoms of anxiety, produce a restful state of mind
PETHIDINE without interfering with normal mental or physical
 Pre-anaesthetic medication, balanced anaesthesia, functions
pain of fracture, burns, trauma, cancer pain etc  The anxiolytic-sedative drugs differ markedly from
 Also used for segmental analgesia (Labour pain) by antipsychotics, and more closely resemble sedative-
giving epidural / intra thecal hypnotics
 They,
DIPHENOXYLATE (LOPERAMIDE) 1. Have no therapeutic effect to control thought
 Used for diarrhoea (not used as analgesic) disorder of schizophrenia
2. Do not produce extrapyramidal side effects
PENTAZOCINE 3. Have anticonvulsant property
 1/2 - 1/3 potency as Morphine 4. Produce physical dependence and carry abuse
 Less spasmodic than Morphine liability
 Produces tachycardia, rise in BP due to sympathetic 5. Do not selectively block conditioned avoidance
stimulation. Hence to be avoided in MI /IHD response in animals
BUPRENORPHINE CLASSIIFCATION
 25 times more potent I. Benzodiazepines
 Not used in labour pain, because respiratory 1. Diazepam
depression may occur in neonates and that cannot 2. Chlordiazepoxide
be reversed by Naloxone 3. Oxazepam
4. Lorazepam
OPIOID ANTAGONISTS 5. Alprazolam
Naloxone
 Used only IV for Morphine poisoning II. β – blockers
 Other uses 1. Propranolol
1. Diagnosis of opioid dependence
2. Reverses respiratory depression in neonates III. Antihistamines
following use in mother during labour 1. Hydroxyzine
3. Reverses alcohol intoxication
4. Endotoxic/ Hypovolemic shock IV. Azapirones
1. Buspirone
Naltrexone & Nalmefene 2. Gepirone
 Orally effective/long acting 3. Ipsapirone
 Benzodiazepines preferred for anxiety are Alprazolam,

Chlordiazepoxide
BUSPIRONE
 Acts as by stimulating pre-synaptic 5HT1A auto
receptors
 Used for mild to moderate cases of chronic anxiety
(not acute)
 Reduces activity of dorsal raphe serotonergic
neurons

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PHARMACOLOGY 41
MOOD STABILISERS (DRUGS USED FOR MANIA) NSAIDS

Lithium (Non-opioid analgesics) (Non-narcotic)
 Drug of choice  Nonsteroidal anti-inflammatory drugs are aspirin-type
or non-opioid analgesics. In addition, they have anti-
Mechanism of Action inflammatory, antipyretic and uricosuric properties
 Exact mechanism of action is not known without addiction liability
 Most accepted hypothesis is that it inhibits  Preferred for somatic, inflammatory pain, pain arising
hydrolysis of inositol-1-phosphate by inositol from integument structures (tendons, ligaments,
monophosphatase. As a result, regeneration of muscles)
membrane phosphatidyl inositides is depleted by
decreasing supply of free inositol. They have CLASSIFICATION
predominant effect on hyperactive neurons which I. Salicylates
require free inositol 1. Aspirin (acetyl salicylic acid)
 It also causes depletion of Noradrenaline and
Dopamine in brain. It partly replaces body Na+ II. Propionic acid derivatives
which may affect ionic fluxes across brain cells. 1. Ibuprofen
2. Keto/Flurbiprofen
Adverse Effects 3. Naproxen
 Low margin of safety (low TI)
 Excessive Thirst & polyuria, Tremors, Seizures, III. Aryl-acetic acid derivatives
Giddiness, Ataxia, Nystagmus 1. Diclofenac
 Also, can cause diabetes insipidus by blocking 2. Aceclofenac
action of ADH
 Insulin like action, increase leukocyte count (tried IV. Anthranilic acid derivatives
in Neutropenia) 1. Mefenamic acid
 Decreases Thyroxin synthesis (may cause goitre)
V. Oxicam derivatives
Lithium Toxicity 1. Piroxicam
 There is no specific antidote 2. Tenoxicam
 Best way to treat is by giving excess of Na+ in form
of normal saline or NaHCO3. Excess infusion of Na+ VI. Pyrrolopyrole derivatives
will inhibit Na+ reabsorption in kidney, which also Ketorolac
indirectly inhibits Li+ absorption since Sodium &
Lithium are reabsorbed together in proximal tubule VII. Indole derivatives
1. Indomethacin
Other drugs used
 Carbamazepine, Sodium Valproate, Lamotrigine, VIII. Pyrazolone derivatives
Topiramate, Aripiprazole, Quetiapine 1. Phenylbutazone
2. Oxyphenbutazone
IX. Preferential Cox–2 Inhibitors

1. Nabumetone
2. Meloxicam

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PHARMACOLOGY 42
X. Selective Cox–2 Inhibitors  Anti-inflammatory:4 – 5 gm / day

1. Celecoxib  Antiplatelet: 50 – 150 mg /day (Low dose Aspirin)
2. Etoricoxib  Follows saturation kinetics
3. Parecoxib (Coxibs)
Newer Uses of Aspirin
XI. Drugs with Poor Anti-Inflammatory Property 1. Prevention of colon cancer
1. Para amino phenol derivatives: Paracetamol 2. Familial colonic polyposes
(Acetaminophen) 3. Patent ductus arteriosus
2. Benzoxazocine derivatives: Nefopam 4. Pregnancy induced hypertension
3. Pyrazolone derivatives: Metamizol
Aspirin as anti-thrombotic or antiplatelet agent
MECHANISM OF ACTION  In low doses i.e. 75 – 150 mg/day, Aspirin
 Inhibit PG synthesis by inhibiting cyclooxygenase preferentially inhibits an enzyme in platelets
required for thromboxane A2 generation. The
ASPIRIN enzyme is called thromboxane A2 synthetase. The
 Oldest NSAID action lasts for the life time of platelets (around 7
 Obtained from bark of Willow plant days). Hence fresh platelets must be synthesized for
 Synthesized by Hoffman in 1899 aggregation.
 Aspirin should be stopped at least 7 days prior to  In high doses, along with this action, Aspirin also
any planned surgery irreversibly acetylates cyclooxygenase enzyme
 Reye’s syndrome (hepatic encephalopathy) occurs when resulting in decrease in prostaglandin synthesis
Salicylates are given in children for viral fever  For platelet function, prostacyclin (PGI2) is involved
(influenza) as an inhibitor of platelet aggregation. PGI2 is
synthesized by vascular endothelium which is a
Actions continuous process not fully stopped by Aspirin
 Analgesic, antipyretic, anti-inflammatory, anti
thrombotic (anti platelet) Acute Paracetamol Poisoning
 When large doses (more than 10 gm in adult) are
Adverse Effects taken, it can cause toxicity. Predominant organ
 Gastric mucosal damage/gastritis, bleeding, Na+ & damaged is liver resulting in centrilobular hepatic
H2O retention necrosis. Untreated cases can also result in
 Delay / prolongation of labour, asthma/allergic hypoglycaemia, renal tubular necrosis which in
reactions fatal
 Aspirin not preferred in chronic gouty arthritis  Poisoning can occur in children where glucuronide
since large dose only (more than 5 gm) helps in uric conjugation is deficient or in patients already
acid excretion which is not safe suffering from liver disease or in chronic alcoholics.
 Less than 2 gm causes urate retention which will High doses of Paracetamol results in accumulation
aggravate gout of a toxic metabolite called N – acetyl – p –
benzoquinone imine (NABQI)
Salicylates Poisoning  In low doses, this metabolite is produced in small
 Seen at serum levels > 50 mg/dl amounts which can be easily detoxified by
 Fatal dose in adults: 15 to 30 g conjugation with glutathione. This is not possible in
 Vomiting, dehydration, acidosis, hyperpyrexia, high doses since there is depletion of glutathione
hypoglycaemia, petechial haemorrhages stores
 No specific antidote, symptomatic, NAHCO3 IV &  NABQI covalently binds to protein in hepatic cells
gastric lavage and several tubular cells resulting in necrosis
 Along with all general measures, specific antidote
Dosage used is N-acetyl Cysteine by intravenous route. It
 Analgesic / Antipyretic dose: 0.3 – 0.6 gm 8 hourly
th

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PHARMACOLOGY 43
replenishes glutathione stores of liver & helps in ANTIPSYCHOTIC DRUGS

preventing organ toxicity (Neuroleptics / Ataractic / Major tranquillisers)
 Paracetamol is a safe drug as analgesic / antipyretic,  The psychopharmacological agents or psychotropic
but not preferred as anti inflammatory. The reason drugs are those having primary effects on psyche
for poor anti-inflammatory action is inability to (mental processes) and are used for treatment of
inhibit cyclooxygenase enzyme in presence of psychiatric disorders
peroxides which are abundant at the site of
inflammation CLASSIFICATION
I. Classical/Typical
Dangers of Coxibs A. Phenothiazines
 Na, H2O retention, edema, CHF and Hypertension i. Aliphatic side chain
1. Chlorpromazine
IMPORTANT POINTS 2. Triflupromazine
 NSAID preferred in dysmenorrhoea  Mefenamic
acid ii. Piperidine side chain
 NSAID given as prodrug  Nabumetone 1. Thioridazine
 NSAIDS having irreversible action on Cox  2. Mesoridazine
Aspirin
 NSAIDS having long t1/2 (long acting)  Oxicam iii. Piperazine side chain
derivatives 1. Trifluoperazine
 NSAIDS with analgesic potency equalling to 2. Fluphenazine
Morphine  Ketorolac
 NSAID causing frontal headache  Indomethacin B. Butyrophenones
 NSAID causing anticholinergic sympathomimetic 1. Haloperidol
side effects  Nefopam 2. Trifluperidol
 NSAID causing bone marrow depression  3. Penfluridol
Phenylbutazone 4. Droperidol
 NSAID preferred in Hodgkin’s lymphoma, Bartter’s
syndrome  Indomethacin C. Thioxanthones
 Antidote for Paracetamol poisoning  N – acetyl 1. Flupenthixol
Cysteine
 Toxic metabolite of Paracetamol  N- acetyl – p – II. Atypical
benzoquinone imine 1. Clozapine
 Safest analgesic /antipyretic  Paracetamol 2. Olanzapine
 Safest NSAID in gastritis  Coxibs (selective Cox II 3. Risperidone
inhibitor) 4. Quetiapine
5. Aripiprazole
6. Ziprasidone
III. Miscellaneous
1. Pimozide
2. Loxapine
MECHANISM OF ACTION
Older (typical)
 Blocks D2 receptors in prefrontal, temporal region,
mesocortical areas
 In normal individuals, action produced is called
Neuroleptic syndrome – like indifference to

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PHARMACOLOGY 44
surroundings, paucity of thought, psychomotor hallucinosis, Huntington’s disease, Gilles de la

slowing, and emotional quietening Tourette’s syndrome
 Tolerance develops to only sedative & hypotensive
action, not antipsychotic actions
Newer (atypical) ANTIDEPRESSANTS

 5-HT2, α, D4 receptor blockers  These are drugs which can elevate mood in depressive
illness
NOTES
 EPS (Extra Pyramidal Symptoms) least seen in 1. Reversible inhibitors of MAO-A (RIMAs): Clorgyline,
Thioridazine & atypical antipsychotics Moclobemide
 All typical antipsychotics have antiemetic property 2. Tricyclic antidepressants (TCAs)
except Thioridazine i. NA + 5HT reuptake inhibitors: Imipramine,
 They decrease seizure threshold precipitate Amitriptyline, Trimipramine, Doxepin, Dothiepin,
epilepsy Clomipramine
 Anticholinergic & α – blocking property ii. Predominantly NA reuptake Inhibitors: Desipramine,
 Antagonise Dopamine  can produce Nortryptyline, Amoxapine, Reboxetine
gynaecomastia, galactorrhoea, amenorrhoea, 3. Selective serotonin reuptake inhibitors: Fluoxetine,
infertility Fluvoxamine, Paroxetine, Sertraline, Citalopram,
 Acute Schizophrenia preferred drug Haloperidol Escitalopram
 Depot infection Fluphenazine preferred 4. Atypical antidepressants: Trazodone, Mianserin,
 Clozapine  causes Agranulocytosis, myocarditis Mirtazapine, Venlafaxine, Bupropion, Duloxetine,
 Thioridazine  sexual dysfunction, eye damage Tianeptine
 Biggest advantage of atypical anti psychotics is that  Cheese reaction: common with MAO – A inhibitors
they do not produce extra pyramidal side effects  Imipramine, Amitriptyline, Nortryptyline  therapeutic
like acute muscle dystonia, Parkinsonism etc. Some window phenomenon
of them are also effective in treating negative  Bupropion – also tried in cessation of cigarette smoking
symptoms of Schizophrenia as transdermal patch
 SSRI, now preferred over TCA’s since
ADVERSE EFFECTS OF ANTIPSYCHOTICS  They lack CVS, sedative, anticholinergic side effects
1. Extra pyramidal disturbances (EPS)  No α blocking action
 Parkinsonism, Acute muscle dystonia,  No interference with psychomotor function
Akathisia, Malignant Neuroleptic syndrome  SSRI – also preferred in cases like panic disorder, post-
 Tardive dyskinesia, Perioral tremors (Rabbit traumatic stress disorders, kleptomania, compulsive
syndrome) buying, phobias, eating disorders
 All EPS can be treated a except Tardive  Trazodone  not preferred now since it can cause
dyskinesia prolonged, painful penile erection (priapism)
2. Anticholinergic: dry mouth, blurring of vision,  Doxepin  used for pruritis
constipation  Amitriptyline  prophylaxis of migraine
3. Postural hypotension palpitation
4. Drowsiness, lethargy, mental confusion, increased
appetite, weight gain
5. Blue pigmentation of skin, corneal & lenticular
opacities
6. Cholestatic jaundice, myocarditis
USES
 Schizophrenia (all psychoses), Antiemetic, Severe
Anxiety, Intractable Hiccough, Tetanus, Alcoholic

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PHARMACOLOGY 45
PREVIOUS YEARS MCQS

8. Lidocaine produces its antiarhythmic effects by
1. Relative contraindications for the administration of A. Increasing A – V conduction
ketamine hydrochloride include all of the following B. Decreasing cardiac excitability
EXCEPT C. Increasing cardiac conduction velocity
A. Age < 5 years D. Increasing spontaneous pacemaker activity
B. History of epilepsy
C. Raised intracranial tension 9. The organ most resistant to GA is
D. Recent anterior myocardial infarction A. Spinal cord
B. Medulla oblongata
2. Dissociative sedation and analgesia described by C. Medullary cortex
Robert and Rosebaum in 1971 is D. Cerebrum
A. 5 to 20% N2O
B. 20 to 30% N2O 10. Cardiac arrhythmias are most commonly seen during
C. 30 to 50% N2O administration of
D. 50 to 70% N2O A. Thiopental
B. Halothane
3. Nitrous oxide is carried in the blood stream by C. Ethyl Ether
A. Hemoglobin D. Nitrous oxide
B. White blood cells
C. Red Blood cells 11. Which produces dissociative anaesthesia
D. Serum A. Propanidid
B. Theiopentone sodium
4. Chloroxylenol has C. Fentany – droperodol
A. Local anesthetic property D. Ketamine
B. Local anesthetic and antiseptic action
C. Antiseptic action 12. Problems associated with nitrous oxide anaesthesia is
D. Antibiotic action A. Behavioral problem
B. Sensitizes the heart to adrenaline
5. Rapid onset of inhalational GA depends on C. Prolonged difficult induction
A. Blood solubility D. Tachycardia and or arrhythmias
B. Cerebral blood flow
C. Partial pressure of GA 13. Methemoglobinemia is a complication following the
D. All of the above administration
A. Lignocaine
6. A patient, without prior medication, breathes a gas B. Benzacaine
mixture consisting of 50 percent nitrous oxide and 50 C. Prilocaine
percent oxygen by volume, which of the following D. Procaine
effect would be expected
A. Analgesia 14. Ketamine is a
B. Excitation A. Short general anesthetic agent
C. Surgical anesthesia B. Local anesthetic agent
D. Respiratory arrest C. Antidepressive agent
D. Hypnotic agent
7. Which factor of the following contributes to short
duration of anesthetic action of single dose thiopental 15. A dentist who first used ether a s a general anaethetic
A. Rapid biotransformation was
B. Rapid accumulation in body fat A. Martin
C. High lipid solubility B. Morton
D. Ability to enter and leave brain tissue every rapidly C. Morrison
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PHARMACOLOGY 46
D. Murray A. Methoxyflurane
B. Sevoflurane
16. Which of the following anesthetic drugs produces C. Desflurane
powerful stimulation of the cerebral cortex D. Isoflurane
A. Cocaine
B. Procaine 24. Which one of the following agents sensitizes the
C. Lidocaine myocardium to catechlomines?
D. Tetracaine A. Isoflurane
B. Ether
17. The most important property in determining the C. Halothane
induction of a general anaesthetic agent is D. Proplofol
A. Alveolar exchange
B. Pulmonary ventilation 25. In which of the following stages general anesthesia
C. Solubility of anaesthetic in blood surgery is done
D. Solubility of anaesthetic in tissue A. Stage I
B. Stage II
18. The dentist who first used Nitrous oxide for the C. Stage III plane 2
abolition of pain due to dental extraction was D. Stage III plane 3
A. Harper David
B. Harvey William 26. All of the following causes increase in heart rate
C. Horace wells except
D. Hunter John A. Halothane
B. Isoflurane
19. The drug combination which produces C. Sevoflurane
Neuroleptanalgesia is D. Desflurane
A. Droperidol+ Fentanyl
B. Droperidol + Ketamine 27. Morphine is contraindicated in following conditions
C. Droperidol + ether EXCEPT
D. Droperidol + Thiopental sodium + Nitrous oxide A. Biliary colic
B. Head injury
20. In the second stage of anesthesia the pupil is C. Acute left ventricular failure
A. Constricted D. Undiagnosed abdominal pain
B. Partially dilated
C. Normal in size 28. Which of the following opioids induces dysphoria
D. Totally dilated rather than euphoria
A. Buprenorphine
21. Hallucinations are seen after _________ anesthesia B. Pentazocine
A. Ketamine C. Pethidine
B. Thiopentone D. Methadone
C. Tentanyl
D. Nitrous oxide 29. Which one of the following is NOT an endogenous
opioid peptide?
22. Site of action of muscle relaxant is A. Beta endorphin
A. Myoneural junction B. Enkephalins
B. Central C. Dynorphins
C. Ascending reticular D. Interleukins
D. Red nucleus activating system
30. Analgesia produced by morphine is accompanied by
23. Which of the following inhalational agents is the following effects EXCEPT
indication agent of choice in children A. Euphoria

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PHARMACOLOGY 47
B. Motor incordination C. Triazolam

C. Reduced perception of pain D. Diazepam
D. Altered emotional reaction to pain
38. Which of the following Benzodiazepines is used
31. Which pharmacological effect of pethidine is not primarily as anticonvulsant
similar to that a Morphine A. Nitrazepam
A. Analgesic B. Clonazepam
B. Euphoric C. Alprazolam
C. Respiratory depressant D. Midazolam
D. Antimuscarinic action
39. Which one of the following drug is a Benzodiazepine
32. Which of the following Non steroidal Anti antagonist
Inflammatory Drugs causes irreversible inhibition of A. Flumazenil
both cyclooxygenase 1 and 2 B. Buspirone
A. Ibuprofen C. Ondansetron
B. Piroxicam D. Chlorazepate
C. Paracetamol
D. Aspirin 40. Which one of the following antidepressant drugs acts
as a selective serotonin reuptake inhibitor (SSRI)
33. Analgesic and antipyretic dose of aspirin given 3 – 4 A. Fluoxetine
times of day in adults is B. Imipramine
A. 325 – 650 mgm C. Amitriptylline
B. 1 – 2 gm D. Mianserin
C. 75 – 150 mgm
D. 5 gm 41. Select a drug which as a selective monoaminooxidase –
B inhibiting action
34. Which of the following analgesic drugs does not have A. Phenelzine
gastric ulcerogenic adverse effect B. Tranylcypromine
A. Diclofenac C. Selegiline
B. Paracetamol D. Clorgyline
C. Piroxicam
D. Ibuprofen 42. Neuroleptic agents can cause extrapyramidal adverse
reactions as they disrupt transmission of
35. Aspirin is not used in labour as it can cause A. Dopamine
A. Neonatal respiratory depression B. Norepinephrine
B. Prolonged labour C. Acetylcholine
C. Increased in maternal blood pressure D. Serotonin
D. Neonatal jaundice
43. Phenytoni is effective in all the following types of
36. Which of the following drugs used in treatment of epilepsy EXCEPT
Gout acts by inhibiting uric acid synthesis A. Grandamal epilepsy
A. Allopurinol B. Temporal lobe epilepsy
B. Probenecid C. Petitmal epilepsy
C. Sulfinpyrazone D. Status spileptius
D. Colchicine
44. Which of the following antiepileptic drugs is useful as
37. Which of the following Benzodiazepines has longest an antiarrhythmic drug
elimination half-life A. Primidone
A. Flurazepam B. Phenytoin sodium
B. Midazolam C. Clonazepam

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PHARMACOLOGY 48
D. Methsuximide
52. Mode of action of benzodiazepines is through the
45. Which of the following antiepileptic drugs is a following neurotransmitter
primary therapy for treatment of trigeminal neuralgia? A. Acetylcholine
A. Carbamazepine B. Dopamine
B. Primidone C. Nor epinephrine
C. Sodium valproate D. GABA
D. Ethosuximide
53. Inverse agonist for benzodiazepine receptor is
46. Which of the following drugs is useful in treatment of A. Barbiturate
both Grandmal and Petitmal epilepsy B. Beta – Carboline
A. Ethosuximide C. Picrotoxin
B. Primidone D. Muscimol
C. Sodium valproate
D. Phenobarbitone 54. Which of the following hypnotics produces minimum
hangover effect
47. Which of the following drugs is not useful for A. Barbiturates
treatment of Parkinsonism B. Diazepam
A. Amantadine C. Zopiclone
B. Alpha methyl dopa D. Flurazepam
C. Benztropine
D. Bromocriptine 55. Which of the following antiepileptic drugs is useful
for treatment of cardiac arrhythmias
48. Which of the following vitamins reduces efficacy of A. Carbamazepine
Levodopa B. Phenytoin sodium
A. Riboflavin C. Trimethadone
B. Claciferol D. Sodium valproate
C. Thiamine
D. Pyridoxine 56. Antiepileptic drug useful only for Petit – mal epilepsy
is
49. Which of the following drugs is NOT a dopaminergic A. Ethosuximide
agonist B. Lamotrigine
A. Bromocriptine C. Gabapentin
B. Lisuride D. Clobazam
C. Pergolide
D. Carbidopa 57. Which of the following drugs is used for treatment of
mania
50. Sulfinpyrazone is used in treatment of Gout because A. Trimipramine
of B. Lithium carbonate
A. Anti inflammatory activity C. Trazodone
B. Inhibition of uric acid synthesis D. Mianserin
C. Uricosuric action
D. Analgesic activity 58. All the following antidepressants have anticholinergic
action EXCEPT
51. Which of the following is the drug of choice for A. Timipramine
treatment of acute attack of Gout B. Amitriptyline
A. Allopurinol C. Doxepin
B. Probenecid D. Fluoxetine
C. Colchicines
D. Aspirin

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PHARMACOLOGY 49
59. Tolerance to following effects of opioids occurs B. Have synergestic action with other CNS
EXCEPT depressants
A. Respiratory depression C. Cross tolerance to other CNS depressants does not
B. Sedation occur
C. Euphoria D. Prolongs reaction time
D. Constipation
67. Disulfiram has the following properties EXCEPT
60. Orally effective opioid antagonist is A. It inhibits the enzyme aldehyde dehydrogenase
A. Naloxone B. Used for treatment of chronic alcoholism
B. Nalorphine depressants
C. Naltrexone C. Cross tolerance to other CNS depressants does not
D. Butorphanol occur
D. Prolongs reaction time
61. Drug dependence is produced by the following drugs
EXCEPT 68. Ethanol is useful in treatment of methanol poisoning
A. Pethidine because it prevents formation of
B. Phenobarbital A. Formaldehyde
C. Nitrazepam B. Aldehyde dehydrogenase
D. Haloperidol C. Acetic acid
D. Aldehyde
62. Which of the following NSAID SHOULD NOT be
used in patients with G-6- PD deficiency 69. Which of the following Antiparkinsonian drugs is a
A. Aspirin central anticholinergic
B. Flurbiprofen A. Bromocriptine
C. Diclofenac B. Carbidopa
D. Paracetamol C. Amantadine
D. Benzhexol
63. Which of the following NSAIDS is a selective COX – 2
inhibitor 70. Which of the following drugs is effective in drug
A. Piroxicam induced parkinsonism
B. Ibuprofen A. Levodopa
C. Phenylbutazone B. Bromocriptine
D. Celecoxib C. Benserazide
D. Procyclidine
64. Termination of action of which barbiturate is brought
about by redistribution 71. Which of the following is NOT a local action of ethyl
A. Phenobarbitone alcohol
B. Thiopentone A. It has antiseptic action
C. Secobarbitone B. It precipitates surface proteins
D. Pentobarbitone C. Has mild rubefacient action
D. Local application produces intense pain
65. Which barbiturate is used as an anaesthetic
A. Phenobarbitone 72. Which of the following is a short acting
B. Thiopentone benzodiazepine
C. Butobarbitone A. Flurazepam
D. Mephobarbitone B. Triazolam
C. Nitrazepam
66. Which of the following is NOT APPLICABLE to D. Diazepam
benzodiazepines
A. Dependence liability is low

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PHARMACOLOGY 50
73. Which of the following effects is NOT produced by C. Valproic acid

ethyl alcohol D. Trimethadione
A. Diuresis
B. Cutaneous vasodilation 81. Drug of first choice for status epilepticus is
C. Euphoria A. Phenytoin IV
D. Potent analgesia B. Phenobarbitone IM
C. Paraldehyde IM
74. Disulfiram produces the following effects EXCEPT D. Diazepam IV
A. Inhibits aldehyde dehydrogenase activity
B. Inhibits dopamine beta – hydroxylase 82. Neuroleptic drugs may interact with receptor of
C. Inhibits cytochrome P450 enzymes following types EXCEPT
D. Reduces t ½ of several drugs A. D2 receptors
B. D1 receptors
75. Which of the following statements regarding methanol C. 5HT2 receptor
poisoning is NOT CORRECT D. Muscarinic receptor
A. Acidosis to be corrected by sodium bicarbonate
B. Ethanol administration increases methanol toxicity 83. Which of the following antipsychotic agents produces
C. Haemodialysis hastens recovery least extrapyramidal side effects
D. Gastric lavage is useful A. Risperidone
B. Chlorpromazine
76. Which of the following statements is NOT C. Haloperidol
APPLICABLE to barbiturates D. Eluphenazine
A. They reduce REM stage of sleep
B. Short term memory is decreased 84. Which of the following effect is NOT produced by
C. They have analgesic action neuroleptic drugs
D. Some derivatives have anticonvulsant action A. Antipsychotic
B. Antiemetic
77. Which of the following is useful for treatment of C. Decreased secretion of prolactin
benzodiazepine overdose D. Reduced motor activity
A. Mucscimol
B. Flumazenil 85. Tricyclic antidepressants produce the following effects
C. Picrotoxin EXCEPT
D. Bicuculline A. Produce mood elevation in a normal subject
B. Block reuptake of nor-epinephrine
78. Which of the following benzodiazepines has a long C. Block reuptake of serotonin
half life D. Dryness of mouth
A. Nitrazepam
B. Triazolam 86. Which of the following is the drug of choice for acute
C. Temazepam mania
D. Midazolam A. Clozapine
B. Lithium
79. Benzodiazepines have the following uses EXCEPT C. Buspirone
A. Antianxiety D. Trazodone
B. Skeletal Muscle relaxant
C. Analgesic 87. Which of the following is NOT suitable for treatment
D. Antiepileptic agent of Grandmal epilepsy
A. Carbamazepine
80. Which is the drug of choice for trigeminal neuralgia B. Ethosuximide
A. Ethosuximide C. Valproate
B. Carbamazepine D. Phenobarbital

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PHARMACOLOGY 51
A. Analgesic activity
88. Which of the following drugs is NOT suitable for B. Uricosuric activity
petitmal epilepsy C. Decreases uric acid synthesis
A. Clonazepam D. Inhibits granulocyte phagocytic activity
B. Ethosuximide
C. Valproate 96. Mechanism of action of ethanol in treatment of
D. Phenytoin methanol poisoning is ethanol
A. Chemically neutralizes methanol
89. Following are adverse effects of phenytoin EXCEPT B. Hastens the excretion of methanol
A. Hirsutism C. Inhibits metabolism of methanol to formaldehyde
B. Gingival hyperplasia D. Blocks the receptor for methanol
C. Sedation
D. Cardiac arrhythmias 97. Mechanism of action of disulfiram in treatment of
alcohol addiction is as disulfiram
90. Which of the following drugs is preferred for acute A. Inhibits formation of acetaldehyde
opioid overdose B. Inhibits metabolism of acetaldehyde to acetic acid
A. Naltrexone C. Increases rate of metabolism of ethanol
B. NalorphinePentazocine D. Increases rate of excretion of ethanol
C. Naloxone
98. Gum Hyperplasia can occur as adverse effect of which
91. Which of the following opioids has the highest abuse of the following drugs
potential A. Carbamazepine
A. Morphine B. Phenytoin
B. Heroin C. Sodium valproate
C. Buprenorphine D. Primidone
D. Codeine
99. Which one of the following antiepileptic drugs is
92. Which of the following statements does not apply to effective in most of the types of epilepsy including
physical dependence absence seizures
A. Occurs after repeated drug use A. Phenytoin
B. Abrupt stopping of drug use produces withdrawal B. Sodium valproate
syndrome C. Ethosuximide
C. Drug tolerance occurs D. Phenobarbitone
D. Tolerance occurs to all the effects of the drug
100. Which of the following antiepileptic drugs is also used
93. Which of the following drugs does not produce drug for treatment of Digoxin induced arrhythmias
dependence A. Phenobarbitone
A. LSD B. Phenytoin
B. Cannabinoids C. Carbamazepine
C. Haloperidol D. Clonazepam
D. Cocaine
101. Benzodiazepine with the longest plasma half-life is
94. NSAIDS produce the following effects EXCEPT A. Temazepam
A. GI ulceration B. Oxazepam
B. Inhibition of platelet aggregation C. Nitrazepam
C. Stimulation of uterine motility D. Triazolam
D. Anti-inflammatory activity
102. Which of the following benzodiazepines is chosen as
95. Which is the mechanism of action of colchicine for its an antianxiety
use in acute attack of Gout A. Flurazepam

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PHARMACOLOGY 52
B. Alprazolam D. Dopamine receptors

C. Temazepam
D. Triazolam 110. Which of the following Morphine like drugs can cause
mydriatic action rather than miosis
103. Which of the following anxiolytic drugs is acting A. Methadone
through 5HT1 A receptor B. Pethidine
A. Buspirone C. Codeine
B. Chlordiazepoxide D. Heroin
C. Clorazepate
D. Alprazolam 111. Which of the following morphine like drugs causes
dysphoria rather than euphoria
104. Which one of the following MAO inhibitors is A. Buprenorphine
selective for MAO – B B. Pentazocine
A. Clorgyline C. Codeine
B. Selegiline D. Methadone
C. Phenelzine
D. Nialamide 112. Aspirin can cause hyperuricaemia at doses
A. Less than 2 gm / day
105. Which one of the following antidepressant drugs is B. At larger doses 8 gm /day
selective blocker of 5 HT reuptake C. At smaller doses 50 – 75 mg /day
A. Imipramine D. Effect is not related to dose
B. Fluoxetine
C. Desipramine 113. Which one of the following analgesic drugs does not
D. Amitryptiline cause Gastrointestinal toxicity associated with
NSAIDS
106. Which one of the following receptors provides A. Ibuprofen
protection against extrapyramidal adverse effects of B. Indomathacin
antipsychotic drugs C. Paracetamol
A. D1 receptors D. Piroxicam
B. D2 receptors
C. M1 receptors 114. Which one of the following effects of Aspirin is not
D. 5HT receptors associated with its cyclooxygenase inhibiting action
A. Antipyretic
107. Phenothiazines have antiemetic activity in doses B. Analgesic
A. Lower than antipsychotic dose C. Platelet aggregation
B. Same as antipsychotic dose D. Displacing thyroid hormone form its protein
C. More than antipsychotic dose binding site
D. In toxic doses
115. Morphine has the following actions on the gut
108. Which one is a full competitive antagonist for opioids EXCEPT
A. Naltrexone A. Gastric emptying is delayed
B. Nalorphine B. Increase in intrabiliary pressure
C. Pentazocine C. Increase in intestinal secretions
D. Methadone D. Increase in smooth muscle tone
109. Analgesic doses of Morphine induce nausea and 116. Miosis or pinpoint pupila is a sign of addiction due to
vomiting by acting at which of the following drug of abuse
A. Vomiting centre A. Morphine
B. Chemoreceptor trigger zone B. Pethidine
C. Gastro intestinal irritant action C. Phenobarbitone

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PHARMACOLOGY 53
D. Amphetamine C. After discontinuing, low dose of methadone, addict

experiences a mild endurable withdrawal
117. Release of which of the mediators is associated with symptoms
morphine D. It is free from Toxicity
A. Histamine
B. Bradykinin 124. Disulfiram is useful in treatment of alcohol addiction,
C. 5 hydroxyltryptamine as its administration
D. Substance P A. Leads to gradual alcohol withdrawal syndrome
B. Leads to increase in acetaldehyde blood level
118. For treatment of Rheumatoid arthritis which one is not causing severe unpleasant reactions
a disease modifying agent: C. Increased rate of metabolism of alcohol, hence
A. Sodium aurothiomalate reducing its blood levels
B. Ibuprofen D. Counteracts the central effect of alcohol
C. Penicillamine
D. Chloroquine 125. In which of the following types of epilepsy, phenytoin
is not useful
119. With which of the anti depressant drug, hypertensive A. General tonic clonic seiqures
reaction may occur if food rich in tyramine is ingested B. Cortical focal seizures
A. Clorgyline C. Petitmal (absence) seizures
B. Selegiline D. Temporal lobe epilepsy
C. Fluoxetine
D. Doxepin 126. Which of the following is the mechanism of action
of L – dopa
120. Which one of the following is NOT a A. Dopamine D1 receptor agonist
nonbenzodizepine anxiolytic, drug B. Dopamine precursor
A. Buspirone C. Induces release of dopamine
B. Ondan setron D. Inhibits metabolism of dopamine
C. Propranolol
D. Chlordizepoxide 127. Flumazenil antagonizes the action of benzodi-
azepines by
121. Which of the following anti – epileptics is the drug of A. Increasing excretion of benzodiazepine
choice for trigeminal neuralgia B. Physiological antagonism
A. Carbamazepine C. Competitive receptor antagonism
B. Phenytoin D. Reduces oral absorption of benzodiazepine
C. Sodium vlaproate
D. Phenobarbitone 128. In antipsychotic drug induced parkinsonism which of
the following drugs is effective
122. Which of the following Benzodiazepine drugs is used A. Levodopa
primarily as an anticonvulsant B. Carbidopa
A. Oxazepam C. Benzhexol
B. Clonazepam D. Selegiline
C. Alprazolam
D. Chlordiazepoxide 129. Concomitant administration of which of the following
vitamins/micronutrients can decrease availability of L
123. Which property of Methadone makes it useful for – dopa in brain
treatment of opioid addicts A. Pyridoxine
A. It is well absorbed from GIT B. Vitamin A
B. It is an effective analgesic C. Vitamin B12
D. Folic acid

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130. Which of the following drugs is NOT USEFUL in B. Increases uric acid excretion
rheumatoid arthritis C. Inhibits inflammation
A. Prednisolone D. Inhibits neutrophil migration
B. Chloroquine
C. Aspirin 138. Which of the following opioid is used as antitussive
D. Colchicine agent
A. Morphine
131. Which of the following statements regarding B. Codeine
paracetamol is INCORRECT C. Diphenoxylate
A. Analgesic activity equal to aspirin D. Buprenorphine
B. Potent anti-inflammatory activity
C. Inhibits PG synthesis in CNS 139. Naloxone is useful for overdose of
D. Good GI tolerance A. Only Morphine
B. Only pethidine
132. Which of the following statements is NOT TRUE in C. All opioids
Paracetamol overdose D. Only bupernorphine
A. Acute liver damage
B. Acute renal tubular necrosis 140. Which of the following statement is NOT CORRECT
C. N-acetyl cysteine regarding dextropropoxyphene
D. Toxic dose 2 – 4 Gms, in adults A. It has antitussive action
B. Less analgesic than methadone
133. Which of the following is NOT a uricosuric agent C. Dependence liability less than Morphine
A. Probenecid D. Commonly combined with Paracetamol
B. Sulfinpyrazone
C. Colchicine 141. Phenytoin produces following effects EXCEPT
D. Large dose of aspirin A. Potent inducer of hepatic metabolizing enzymes
B. Overdose produces cerebellar signs
134. Which is the mechanism of antipsychotic action of C. Membrane – stabilizing effect
Haloperidol D. Its metabolism is only by first order kinetics
A. D2 receptor block
B. D1 receptor block 142. Which is the drug of choice for absence seizures
C. Alpha receptor block A. Ethosuximide
D. M1receptor block B. Carbamazepine
C. Primidone
135. Iatrogenic parkinsonism can be treated by D. Phenytoin
A. L – dopa
B. Bromocriptine 143. Ethyl alcohol produces following effects EXCEPT
C. Benztropine A. Antidiuresis
D. Carbidopa B. Gastric acid stimulation
C. Cutaneous vasodilatation
136. Which of the following is NOT an indication for D. Foetal malformation
antipsychotic
144. Which of the following drugs is NOT benzodiazepine
A. Schizophrenia
derivative
B. Mania
A. Triazolam
C. Severe Mental Depression
B. Buspirone
D. As anti – emetic
C. Alprazolam
137. Which is the mechanism of allopurinol for its use in D. Nitrazepam
treatment of Gout
A. Decreases uric acid synthesis

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145. Which of the following benzodiazepines is most 152. Which of the following antipsychotic drugs have least
suitable as a hypnotic agent potential to induce extrapyramidal syndrome
A. Diazepam A. Clozapine
B. Nitrazepam B. Fluphenazine
C. Flurazepam C. Haloperidol
D. Triazolam D. Chlorpromazine
146. Which of the following is a selective serotonin 153. Morphine induces vomiting by acting at
reuptake inhibitor antidepressant A. Vomiting centre
A. Mianserin B. CTZ
B. Fluoxetine C. Peripheral direct action on GIT smooth muscle
C. Dothiepin D. Prokinetic action
D. Clomipramine
154. Which of the following statement is NOT TRUE for
147. Aspirin in low doses inhibits platelet aggregation by pethidine when compared to morphine
A. Inhibiting thromboxane synthesis A. It causes less spasm of biliary smooth muscle
B. Inhibiting other chemotactic substance B. It causes less neonatal depression when given
C. Inhibiting synthesis of kinins during labour
D. By release of antiplatelet aggregatory substances C. It has rapid onset of action
D. It is not addictive and does not have abuse potential
148. Which of the following analgesic agent is not effective
as anti-inflammatory agent 155. Pentazocine has following properties EXCEPT
A. Diflunisal A. It can cause dysphoria
B. Paracetamol B. It has sympathomimetic action
C. Sulindac C. It induces less respiratory depression compared to
D. Diclofenac morphine
D. It is a pure agonist of opioid receptors
149. Incidence of Gastic acidity is more than Aspirin with
following NSAID 156. Which of the following opioid agonists is used as
A. Ibuprofen antidiarrhoeal agent
B. Indomethacin A. Methadone
C. Naproxen B. Codeine
D. Ketoprofen C. Diphenoxylate
D. Dextropropoxyphene
150. Which of the following is the mechanism of action of
anti-axiety drug Buspirone 157. Which of the following statements is NOT TRUE for
A. 5HT1 A receptor antianxiety drug Buspirone
B. Antagonist at 5HT3 receptor A. It lacks anticonvulsant action
C. GABA receptor modulating action B. Does not lead to development of tolerance
D. Inverse agonist at GABA receptor C. It undergoes extensive first pass metabolism
D. Antianxiety effect appears within a day after
151. Hypertensive reaction with ingestion of Tyramine rich administration of the drug
substances can occur with which of the following
drugs 158. Which of the following drugs can cause
A. MAO inhibitors retroperitoneal fibrosis as a dangerous adverse effect
B. 5HT reuptake inhibitor after long term administration
C. Tricyclic antidepressants A. Cypropheptadine
D. Bicyclic antidepressants B. Methysergide
C. Ketanserin
D. Sumatriptan

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PHARMACOLOGY 56
159. Which of the following antiepileptic drug is relatively 166. Which one of the following is the commonest adverse
safer to be administered during pregnancy effect of aspirin at therapeutic analgesic doses
A. Phenytoin A. Metabolic acidosis
B. Carbamazepine B. Epigastric distress
C. Phenobarbitone C. Salicylism
D. Valproic acid D. Increase in rate and depth of respiration due to
stimulation of respiratory center
160. Which of the following antiepileptic is a GABA
analogue 167. Which one is the mechanism of uricosuric action of
A. Vigabatrin Allopurinol
B. Carbamazepine A. Inhibits renal tubular transport of uric acid
C. Primidone B. Decreases uric acid synthesis
D. Valproic acid C. Inhibits neutrophil meigration to urate deposition
site
161. Which of the following drugs increases metabolism of D. Inhibits inflammation by inhibition of synthesis of
phenytoin and hence decreases its effect prostaglandins
A. Carbamazepine
B. Aspirin 168. Mechanism of action of Benzodiazepines
C. Sodium valproate A. Modulate the activity of GABA, a major
D. Diazepam neuroinhibitor transmitter
B. 5HT3 receptor antagonism
162. As hypnotic which advantage benzodiazepines do not C. 5HT1 receptor agonist action
have D. Central adrenergic receptor agonist
A. Carbamazepine
B. Aspirin 169. Which one is the mechanism of antipsychotic action of
C. Sodium valproate phenothiazine group of drugs
D. Diazepam A. D2 receptor block
B. D1 receptor block
163. Which one of the following antianxiety drug is used as C. Alpha adrenergic receptor agonist
an antiemetic drug also D. M1 receptor block
A. Buspirone
B. Propranolol 170. Which of the following opioid agonist is nearly 80
C. Ondansetron times more potent analgesic than morphine
D. Clonazepam A. Fentanyl
B. Pethidine
164. Which one of the following antianxiety drugs acts by C. Methadone
reducing peripheral autonomic manifestations of D. Dextropropoxyphene
anxiety
A. Busirone 171. The dose of Aspirin for Cardioprotective effect is
B. Propranolol A. 300 – 600 mg/day
C. Oxazepam B. 50 – 75 mg/day
D. Alprazolam C. 250 mg / day
D. 300 mg 6 hrly
165. Which of the following drugs used for treatment of
parkinsonism is an antiviral drug too 172. Main enzymatic pathway for hepatic metabolism of
A. Amantadine paracetamol is
B. Levodopa A. Oxidation
C. Benzhexol B. Glucuronide conjugation
D. Bromocryptine C. Glycine conjugation

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PHARMACOLOGY 57
D. Dealkylation 180. Morphine as analgesic is used in following conditions

EXCEPT
173. Which one of the following adverse effect is associated A. Burns
with acute high dose of paracetamol B. Post operative
A. Gastrointestinal bleeding C. Fractures
B. Hypersensitivity reaction D. Biliary colic
C. Haemopoietic system toxicity
D. Hepatic cell damage 181. On – off phenomenon can occur while with treatment
with which of the drugs in parkinsonism
174. Which one of the following benzodiazepines is used A. Levodopa
in treatment of epilepsy B. Bromocryptine
A. Probenecid C. Amantadine
B. Sulfinpyrazone D. Selegiline
C. Colchicine
D. Aspirin 182. Which one of the following local anaesthetic drugs is
hydrolysed by plasma cholinesterase resulting in very
175. Which one of the following benzodiazepines is used short half – life
in treatment of epilepsy A. Lignocaine
A. Clonazepam B. Procaine
B. Alprazolam C. Benzocaine
C. Triazolam D. Bupivacaine
D. Flurazepam
183. Which of the following drugs is most suitable for
176. N – acetyl cysterine is a life saving drug in treatment
substitution therapy for heroin abuse
of acute overdose effects of
A. Buprenorphine
A. Aspirin
B. Methadone
B. Paracetamol
C. Fentanyl
C. Indomethacin
D. Codeine
D. Piroxicam
184. Carbarmazepine is useful for following disorders

177. Opioid drug having sympathomimetic action is
EXCEPT
A. Pentazocine
A. Grandma epilepsy
B. Methadone
B. Petimal epiliepsy
C. Pethidine
C. Termporal lobe epilepsy
D. Codeine
D. Trigeminal neuralgia
178. Which of the following morphine like drugs is used

185. Which of the following actions is produced by
only for its antitussive action
buspirone
A. Codeine
A. Hypnotic
B. Pethidine
B. Anticonvulsant
C. Pentazocine
C. Muscle relaxant
D. Methadone
D. Antianxiety
179. Morphine has affinity for which of the opioid

186. Agranulocytosis is an adverse effect of
receptors
A. Risperidone
A. Mu receptors
B. Clozapine
B. Kappa
C. Perphenazine
C. Sigma
D. Promazine
D. Delta

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PHARMACOLOGY 58
187. Which of the following drugs is NOT useful for B. Withdrawal symptoms produce hallucinations
therapy of status epilepticus C. Hypertension
A. Diazepam D. No adverse effects on stomach
B. Phenol barbital
C. Phenytoin 195. The daily dose of aspirin required for treatment of
D. Gabapentin rheumatic fever in adults is
A. 150 mg / day
188. Mode of action of sodium valproate as antiepileptic B. 4 – 6 gms / day
agent is C. 1 – 2 gms / day
A. Decreases GABA degradation D. 50 mg / day
B. Acts as GABA agonist
C. Blockade of glutamate receptor 196. Which of the following NSAIDS does not inhibit renal
D. Carbonic anhydrase inhibition prostaglandins
A. Sulindac
189. Which of the following is a disease modifying drug B. Phenylbutazone
for treatment of rheumatoid arthritis C. Phenacetin
A. Ibuprofen D. Aspirin
B. Betamethasone
C. Leflunomide 197. Which of the following NSAIDS is a selective COX –
D. Celecoxib 2 inhibitor
A. Ibuprofen
190. Which of the following drugs causes irreversible B. Aspirin
inhibiton of the enzyme cyclooxygenase C. Celecoxib
A. Dicolofenac D. Indomethacin
B. Aspirin
C. Sulindac 198. Which of the following drugs is used in trigeminal
D. Paracetamol neuralgia
A. Ethosuximide
191. Intolerance to alcohol is produced by B. Carbamazepine
A. Metformin C. Trimethadone
B. Acarbose D. Sodium valproate
C. Chlorpropamide
D. Guargum 199. Disulfiram is used for
A. Acute over dose of ethyl alcohol
192. Naloxone has following actions EXCEPT B. Acute overdose of methyl alcohol
A. Competitive antagonist of opioids receptors C. Treatment of chronic ethyl alcohol abuse
B. Antagonizes all actions of opioids D. Inhibition of methyl alcohol metabolism
C. Produces analgesia
D. Produces withdrawal symptoms in opioid 200. Chlorpromazine has all the following actions EXCEPT
depednet persons A. Tolerance develops antipsychotic activity
B. Can produce galactorrhoea
193. Drugs dependence may involve all the following C. Has adrenergic blocking activity
EXCEPT D. Depresses chemoreceptor trigger zone
A. Drug tolerance
B. Intense craving for the drug 201. Which of the following is a major adverse effect of
C. Withdrawal symptoms clozapine
D. Only CNS depressant are involved A. Extrapyramidal reactions
B. Hyperprolactinaemia
194. Alcohol dependence may lead to following EXCEPT C. Agranulcoytosis
A. Cross – tolerance to other sedatives D. Severe bradycardia

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PHARMACOLOGY 59
209. Which of the following NSAIDS should be avoided in

202. Which of the following is an antidote for a patient of gout
benzodiazepine overdose A. Indomethacin
A. GABA B. Aspirin
B. Flumazenil C. Diclofenac
C. Hydroxyzine D. Naproxe
D. Meprobamate
210. The newer neuroleptics induce minimum
203. Disulfiram is used as aversion therapy in chronic extrapyramidal recations as adverse effects because
alcoholism because is they cause
A. Inhibits aldehyde dehydrogenase A. Blockade of D1 and D2 receptors
B. Is effective as a single dose B. Selective blockade of D2 receptors
C. Always useful in all alcoholics C. Selective blockade of D1 receptors
D. Does not produce unpleasant symptoms after D. 5HT receptor block
alcohol ingestion
211. Which of the following opiate drugs is used in
204. Diazepam has following actions EXCEPT treatment of morphine addiction
A. Antipsychotic A. Codeine
B. Antianxiety B. Methadone
C. Muscle relaxant C. Naloxone
D. Antiepileptic D. Buprenorphine
205. Ethyl alcohol produces following actions EXCEPT 212. All of the following are side effects of tricyclic
A. CNS stimulation antidepressants except
B. Produces vasodilatation A. Postural hypotension
C. Increases gastric acid secretion B. Sedation
D. Produces liver damage C. Urinary retention
D. Muscle pains
206. Megaloblastic anaemia due to folate deficiency can
occur as adverse effect with long term use of which of 213. Which of the following drugs is the drug of choice for
the following antiepileptic drugs treatment of status epilepticus
A. Phenytoin A. Valproic acid
B. Carbamazepine B. Diazepam
C. Clonazepam C. Phenytoin sodium
D. Sodium valproate D. Primidone
207. Acute hepatotoxicity with overdosage is known to 214. Barbiturates produce all the following actions EXCEPT
occur with which of the following analgesic drugs A. Tolerance
A. Paracetamol B. Drug dependence
B. Ibuprofen C. Inhibit hepatic microsomal enzymes
C. Sulindac D. Decrease duration of REM sleep
D. Piroxicam
215. Which of the following drugs is useful for
208. Which of the following drugs used for treatment of Benzodiazepine overdose
rheumatoid arthritis is not a disease modigying drug A. Chlordiazepoxide
A. Penicillamine B. Buspiorne
B. Indomethacin C. Flumazenil
C. Chloroquine D. Alprazolam
D. Gold compounds

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216. CNS depressant drug which reduces excitement D. No action at GABA sites
without much effect on sleep is (also called anti-
anxiety drug) 223. Which of the following describes the action of
A. Anticholinergic benzodiazepines
B. Antipsychotic A. Sedative and anxiolytic
C. Sedative B. Anticonvulsant and centrally acting muscle relaxant
D. Hypnotic C. Preanaesthetic medication
D. All of the above
217. CNS depressant drug which produces sleep but patient
may be awakened by inducing pain. This type of drug is 224. Benzodiazepams are used for all of the following
called except
A. Antileptic A. Sedative and tranquillizers
B. Antisympathetic B. Muscle relaxants and anaesthetics
C. Sedative C. Antiepileptics
D. Hypnotic D. Antihistamines and antipsychotics
218. All of the following are true regarding sedative 225. Benzodiazepams are preferred to barbiturates as anti-
hypnotics EXCEPT anxiety drugs because
A. They are mainly used in treatment of insomnia A. Benzodialzepams has less CNS depressent action
B. Their action on CNS is dose – dependent B. It has less addiction protential
C. They produce analgesia C. It has rapid onset of action
D. They produce drug dependence D. None of the above
219. Drugs which induces natural sleep when administered 226. Which of the following benzodiazepines do not
in therapeutic doses is called as produce any active metabolite in the body
A. Hypnotic A. Diazepam and chlorodiazepoxide
B. Sedative B. Flurazepam and alprazolam
C. Soporifics C. Oxazepam and lorazepam
D. Analgesics D. All of the above
220. Which of the following is an effective anti-anxiety 227. Which of the following benzodiazepines have marked
drug antiepileptic activity
A. Dantrolene A. Diazepam and flurazepam
B. Chlordiazepoxide B. Flurazeapm and oxazepam
C. Baclofen C. Diazepam and clonazepam
D. Promazine D. Oxazepam and clonazepam
221. Benzodiazepams exert their anti-anxiety effect by 228. All are true of Benzodiazepines except
modifying which of the following neurohormones A. Diazepam is used in treatment of status epileptius
A. GABA B. Benzodiazepam is in the long term treatment of
B. Serotonin psychic disorders
C. Dopamine C. Clonazepam is used in the treatment of petitmal
D. Glycetyl acetic acid epilepsy
D. None of the above
222. The action of benzodiazepines at neurons of GABA
sites can be described as 229. Which of the following relaxes skeletal muscle by
A. GABA mimetic as well as GABA facilitatory acting on CNS
B. GABA facilitatory only no GABA mimetic action A. Diazepam
C. GABA mimetic only no GABA facilitatory action B. Meprobromate
C. Chlorodiazepoxide
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D. All of the above A. They depresses all areas of CNS and the effect is
dose dependent
230. Which of the following is least likely to produce B. Sleep is mainly maintained by depressing reticular
respiratory depression when given IV activating system
A. Diazepam C. They mainly potentiate GABA facilitatory action as
B. Fentanyl well as GABA – mimetic action
C. Phenobarbitone D. All of the above (They suppress the REM, sleep)
D. Morphine
238. Which of the following is not of barbiturates
231. One of benzodiazepines [BDZ] comparatively safe in A. Respiratory depression is the main cause of death in
pregnancy is [category – B] barbiturates poisoning
A. Alprozolam B. Hypnotic doses of barbiturates produce myocardial
B. Zolpidem depression and cardiac arrest
C. Lorazepam C. Barbiturates reduces urinary flow and increases
D. None of the above ADH releases
D. Barbiturates effect on CNS ranges from sedation,
232. Verrill’s sign is seen in
hypnosis and come
A. Diazepam administration
B. Digitalis toxicity 239. IV ultrashort acting barbiturate
C. Paget’s disease A. Mepmobnomate
D. Unconsclous states B. Pentobarbitone
C. Thilopentone
233. Diazepams are preferred to barbiturates for
D. Phenobarbitone
emergency treatment of CNS stimulation because
A. Diazepam has rapid onset of action 240. The action of highly lipid soluble thiopental and other
B. Barbiturates do not have anticonvulsant effect ultrashort acting barbiturates is terminated mainly by
C. Diazepam has less profound CNS depression A. Redistribution
D. All of the above B. Dealkylation in the liver
C. Renal excretion
234. Which of the following is specific antagonist to D. Conjugation in the liver
benzodiazepine
A. Amphetamine 241. Which of the following is true of thiobarbiturates
B. Flumazenil A. A rapid redistribution from brain to body
C. Mebrobromate B. Fast onset and short duration of action tissues due
D. MAO inhibitors to high lipid solubility
C. They are used in induction of anaesthesia
235. Which of the following has additive action on CNS D. All of the above
depression when given taken together
A. Narcotics and antipsychotics 242. Acute barbiturate poisoning results in
B. Alcohol and anti – anxiety drugs A. Renal failure
C. Antianxiety and barbiturate B. Liver failure
D. All of the above C. Respiratory failure
D. Convulsions
236. Which of the following drugs are not anti-depressents
A. Diazepam and meprobomate 243. Whichof the following is least appropriate for the
B. MAO inhibitors treatment of acute overdosage of pentobarbital
C. Amphetamines A. Injection of analeptics like metrazol, bemegride to
D. Tricyclic compounds like phenothiazines stimulate CNS
B. Force alkaline dieresis with mannitol and sodium
237. Which of the following is true regarding barbiturates bicarbonate

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PHARMACOLOGY 62
C. Gastric lavage and heamoperfusion B. Chlorpromazine

D. Use of vasopressor to such as dopamine for renal C. Trifluoperazine
vasodilation D. Diazepams
244. In acute barbiturate poisoning first and foremost thing 251. Which of the following drugs causes extrapyramidal
advised is symptom
A. To inject analeptics A. Antibiotics
B. To maintain adequate respiration B. Salicylates
C. Akalinization of urine C. Barbiturates
D. Gastric lavage D. Phenothiazines
245. Barbiturates in paediatrics is 252. Phenothiazines like chloropromazine exhibit their

A. Contraindicated antipsychotic action mainly by blocking the following
B. Low safety receptors in CNS
C. Can be used safely A. Dopaminergic
D. Of much use B. Histamine
C. Serotonin
246. Barbiturates may potentiate the side effect of D. Adrenergic
orthostatic hypotension to a significant effect with all
of the following except 253. Which of the following is an irreversible side effect
A. Tricyclic compounds resulting from long term administration of
B. MAO inhibitors phenothiazine antipsychotics
C. Reserpine and Gunathedine A. Infertility
D. Chlorthiazide B. Parkinonism
C. Xerostomia
247. Which of the following is not true of barbiturates D. Tardive dyskinesia
A. They have significant analgesic property and
elevates pain threshold 254. Phenothiazines are used to
B. They have anticonvalsent action A. Produce muscle relaxation
C. They do not have selective anti-anxiety action and B. Alter psychotic behavior
impairs short term memory and learning C. Suppress coughing
D. They are mainly metabolized in liver D. Produce analgesia
248. Chlorpromazine is a 255. Which of the following are side effects of

A. Barbiturate chloropromozine
B. Tricylic anti depressent A. Adrengenic and cholinergic blockade results in
C. MAO inhibitor xerostomia and dry month
D. Phenothiazine B. Alpha –adrenergic blockade results in postural
hypotension
249. The antipsychotic (major tranquilizers) belonging to C. Cholestatic jaundice and photo sensitivity which
phenothiazine group has all of the following actions are not dose dependent
except: D. All of the above
A. Anti-anxiety and anticonvulsant effect
B. Anti-emetic and local anaesthetic effect 256. Besides antipsychotic action, phenothiazines are
C. Anti – histaminic and anti cholinergic effect potent
D. A – adrenergic and dopaminergic blocking action A. Analgesis
B. Anti-emetics
250. The antipsychotic drug producing the greatest sedative C. Antihypertensives
effect is D. Anticonvulsants
A. Haloperidol
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257. The drugs used in the treatment of mental depression D. All of the above
are
A. Phenothiazines an benzodiazepines 264. Which of the following is serious complication of CNS
B. Tricyclic compounds and MAO inhibitors depressents that leads to death
C. Benzodiazepines and barbiturates A. Cardiovascular collapse
D. Phenothiazenes and barbiturates B. Respiratory depression
C. Blockade of autonomic ganglion
258. Amitryptyline is a D. Cardiac depression
A. Antibiotic
B. Sedative 265. The drug of choice in acute maniac depressive
C. Tricyclic antidepressant psychosis is
D. Diuretic A. Lithium carbonate
B. Phenothiazenes
259. Which of the following drugs are currently the C. Tricyclic antidepressants
mainstay of treatment of depressive psychosis D. Benzodiazepines
A. Second generation tricyclic antidepressents
B. MAO inhibitors 266. Which of the following is the most abused CNS
C. Barbiturates stimulant
D. Phenothiazenes A. Diazepam
B. Cocaine
260. The effect of tricyclic compounds on ANS is mainly C. Amphetamine
A. Anticholinergic (muscuranic blockade ) like D. Barbiturates
atropine
B. β- adrenergic blocking like propanolol 267. Which of the following is true of amphetamine
C. Anticholinergic (nicotinic blockade) A. It is a centrally acting sympathethomimetic drug
D. None of the above B. Its central actions are largely mediated by release of
mediators like noradranaline and dopamine
261. The depressive action of tricyclic compounds is related C. It is the drug of abuse capable of producing
to which of the following physical as well as psychological dependence
A. Inhibition of the uptake of Biogenic amines like Nor D. All of the above
adrenaline, 5. HT and dopamine into their
respective neurons 268. Which of the following actions is true of amphetamine
B. Inhibition of the synthesis of neuronal transmitter A. Increased fatigue
like GABA and dopamine B. Reduced apetite
C. Blockade of dopanergic nerve endings C. Reduced pain threshold
D. Facilitatory of action on GABA transmission D. None of the above
262. Which of the following are common side effects of 269. In which of the following disorders amphetamine is
tricyclic antidepresents not used
A. Xerostomia and constipation A. Narcolepsy
B. Postural hypotension B. Obesity
C. Sedation and mental confusion C. Mild depression
D. All of the above D. Anorexia nervosa
263. Which of the following is true of MAO inhibitors 270. Which of the following psychostimulant is preferred
A. They inhibit MAO in irreversible reaction to amphetamine in treatment of hyperkinetic children
B. Ingestion of tyramine rich food like cheese may A. Methylphenidate
lead to hypertensive crisis taking MAO inhibitors B. Nikethemide
C. Their side effects are similar to tricyclic compounds C. Ethyl butamide

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D. Doxaprum
278. Damage to certain areas of brain are associated with
271. Which of the following methyl xanthenes is used in certain disorders which of the following are correctly
CNS stimulation matched
A. Caffeine A. Sleep arousal – Reticular system
B. Theophylline B. Increased pain – perception – Thalamus
C. Theobromine C. Parkinsonism – Basal ganglia
D. All of the above D. All of the above
272. The higher centre most commonly affected by caffeine 279. Carbamazepine is a type of
is A. Antidepressant
A. Medulla B. Anti – inflammatory
B. Cortex C. Antibiotic
C. Hypothalamus D. Antiemetic
D. It doesnot affect higher centres
280. Which of the following has neurone membrane
273. Which of the single most effecting drug in stability effect
parkinsonism treatment which converts rapidly into A. Phenytoin
active dopamine B. Morphine
A. Bromocriptine C. Barbiturate
B. Levodopa D. Benzodiazepine
C. Carbidopa
D. Amantadine 281. Pseudolymphoma and gingival enlargements are the
side effects of
274. All of the following penetrate the CSF except A. Phenytoin or diphenylhydantion
A. Dextrose B. Barbiturates
B. Dilantine C. Carbamazepine
C. Diazepam D. Sodium valproate
D. Dopamine
282. Which of the following are side effects of phenytoin
275. Which of the following is administrated along with A. Megaloblastic anaemia
levodopa for a beneficial effect in the treatment of B. Osteomalacia
parkinsonism C. Hyperglycaemia
A. Bromocriptine D. All of the above
B. Carbidopa
C. Promethazine 283. Which of the following are long acting Barbiturates
D. Amantadine A. Phenobarbitone and mephobarbitone
B. Secobarbitone and pentobarbitone
276. All of the following are side effect of levodopa except C. Thiopentone and hexobarbitone
A. Nausea and vomiting D. Pentobarbitons and thiopentone
B. Postural hypotension and arrhythmias
C. Sedation 284. The drug of choice in terminating tonic clonic seizures
D. Fluctuation in motor performance is
A. Diazepam
277. Which of the following in a absolute contraindication B. Phenobarbitone
of hypnotic drugs C. Diphenylhydantoin
A. Porphyrism D. Sodium valproate
B. Angina pectoris
C. Liver diseases 285. The barbiturate which is used in treatment of
D. Renal impairement grandmal epilepsy is

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PHARMACOLOGY 65
A. Secobarbital C. Diazepam
B. Pentobarbital D. Cabemezipine
C. Thiopental sodium
D. Phenobarbital
293. Which of the following anti-epileptic agents cause the
286. The drug of choice in grand mal epilepsy reversible side effect of gingival hyperplasia
A. Phenobarbitone A. Ethosuximide
B. Ethosuximide B. Phenobarbitone
C. Phenytoin C. Sodium valproate

D. Diazepam D. None of the above
287. Drug of choice in trigeminal neuralgia is 294. Drug of choice in status epilepticus is
A. Phenobarbitone A. Diazeapm
B. Phenytoin B. Phenytoin
C. Carbamazepine C. Ethosuximide
D. Diazepam D. Sodium valproate
288. The reason why phenytoin is preferred in the 295. The sudden withdrawal of which of the following
treatment of grand mal epilepsy over phenobarbitone anti-epileptics result in precipitation of status
in that phenytoin epilepticus
A. Dose not cause depression A. Phenytoin
B. Is not drug of addiction B. Valproate
C. Is effective in all age groups C. Phenobarbitone
D. Produces less sedation for a given degree of cortical D. Diazepam
depression
296. Which of the following is true of carbamazepine
289. If a grand mal develops in a petit mal patient, you A. It is a general purpose analgesic
would like to prefer B. It is effective during the attack of trigeminal
A. Sodium valproate neuralgia
B. Phenytoin C. It is used in temporal lobe epilepsy and in grand
C. Diazepam mal epilepsy similar to phenytoin
D. Phenobarbitone D. Used in the treatment of post herpetic neuralgia
290. Drug of choice in petit mal epilepsy

A. Phenytoin 297. Which of the following drugs is least efficacious in the
B. Diazepam treatment of temporal lobe epilepsy
C. Phenobarbitone A. Phenobarbitone
D. Sodium valproate and ethosuximide B. Phenytoin sodium

C. Primidone
291. Which of the following is the current drug of choice D. Carbamazepine
for status epilepticus
A. Phenytoin 298. An attack of migraine can be easily terminated by
B. Diazepam A. Acetylcholine
C. Carbamazepine B. Ergotamine
D. Chlorpromazine C. Morphine
D. Ibuprofen
292. Best and most effective drug to control convulasions in

299. Phenytoin is associated with
toxicity cases is
A. Folic acid deficiency
A. Phenobarbitone
B. Alzhiemer’s disease
B. Phenytoin

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PHARMACOLOGY 66
C. Cushing’s syndrome 306. Actions of ethyl alcohol is characterized by all of the

D. Vitamin C deficiency following except
A. It increases gastic secretion and results in chronic
300. Which of the following durgs causes extrapyramidal gastritis
symptoms B. It produces cutaneous and gastric vasoconstriction
A. Diphenylhydantion of following ingestion
B. Primidone C. It mobilizes peripheral fat and increases fatty
C. Phenobarbitone synthesis in liver
D. Sodium valporate D. It results in Wernicke’s encephalopathy and
Korsakoff’s psychosis
301. Ethanol is a
A. Mild rubefacient and counter irritant 307. One of the obvious consequences of alcohol (ethanol),
B. Astringent ingestion in many individuals is facial flushing and
C. Antiseptic increased heart rate triggered off by alcohol getting
D. All of the above metabolized to
A. Formaldehyde
302. Which of the following are pharmacologically or toxic B. Acetaldehyde
effects of ethyl alcohol C. Propanaldehyde
A. Alcohol euphoria is a result of removal of inhibitory D. Butanaldehyde
effect of the cortex
B. It inhibits ADH secretion and increases dieresis 308. Korsakoff’s syndrome is associated with long term use
C. In moderate dose it increases BP while in large of
doses it decreases BP A. Alcohol
D. All of the above B. Amphetamines
C. Barbiturates
303. All of the following are true of pharmacokinetics of D. Diazepam
alcohol except
A. It is mainly absorbed from stomach and is very fast 309. The ethyl alcohol (ethanol) is more effective when
B. It crosses blood – brain barrier and placenta freely mixed with water and used as
C. It follows zero order kinetic i.e. constant amount (10 A. 10 to 20 percent
– 15 ml/hr) B. 20 to 30 percent
D. 90% of it is metabolized by liver and is excreated C. 40 to 50 percent
through kidney and lungs D. 60 to 70 percent
304. Which of following is not a factor in determining the 310. Corneal and laryngeal reflexes are lost in which stage
blood levels of alcohol of general anaesthesia?
A. Gastric emptying time A. Stage – III plane – 1
B. Rate of metabolism and body weight B. Stage- III plane – 4
C. Rate of intake and alcohol content of beverage C. Stage – III plane – 3
D. Rate of urinary excretion and state of mind D. Stage – III plane – 2
305. Which of the following drugs are not synergistic with 311. Diffusion hypoxia, which is one of the main side
alcohol in depressing the CNS effects of N2O inhalation, is avoided by
A. Amphetamine caffeine and methyl phenidate A. Avoiding N2O inhlation
B. Barbiturates and diazepams B. Lowering the concentration of N2O gas
C. Meperidine and morphine C. Continuing 100% O2 inhalation
D. All of the above D. Discontinuing 100% O2 inhalation
312. Which of the following is an inducing agent used in

general anaesthesia?
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PHARMACOLOGY 67
A. Enflurane A. GABA – mimetic action

B. Nitro-oxide B. GABA – facilitatory action
C. Methohexitone sodium C. Both of the above
D. Ketamine D. None of the above
313. N2O is a 321. Benzodiazepines have

A. Good anaesthetic agent A. High therapeutic index
B. Good analgestic and poor muscle relaxant B. Low therapeutic index
C. Poor analgesic and poor muscle relaxant C. Either high or low therapeutic index
D. Good analgestic and good muscle relaxant D. Unpredictable therapeutic index
314. Which of the following anaesthic agents sensitizes the 322. Competitive antagonist at Benzodiazepine site is
heart to adrenaline? A. Bicuculline
A. Diethyl ether B. Flumazenil
B. Fluothane (halothane) C. β carboline (DMCM)
C. Enflurane D. Picrotoxin
D. Isoflurane
323. Mechanism of action of ‘phenytoin’ is by
315. Neurolept analgesia is A. Prolongation of sodium ion channel inactivation
A. Fentanyl and droperidol combination B. Facilitation of GABA mediated chloride ion channel
B. Pethidine and droperidol combination opening
C. 65% N2O and 35% O2 combination C. Inhibition of ‘T’ type calcium ion current
D. 50% N2O and 50% O2 combination D. All of the above
316. Promthazine is an 324. Mechanism of action of ‘sodium valproate’ is

A. Antihistaminic A. Prolongation of sodium ion channel inactivation
B. Pre-anaesthetic medication B. Facilitation of GABA mediated chloride ion channel
C. Antiemetic drug opening
D. All of the above C. Inhibition of ‘T’ type calcium ion current
D. All of the above
317. Antiseptic action of ethyl alcohol is maximum at
which of the following concentration? 325. Drug of choice for petit mal seizures is
A. 20 to 70% A. Carbamazepine
B. 70 to 90% B. Phenytoin
C. 90 to 100% C. Valproate
D. 100% D. Diazepam
318. Toxic effects of methanol are mainly due to 326. Drug of choice for febrile seizures is
A. Acetaldehyde A. Diazepam
B. Formic acid B. Carbamazepine
C. Acetic acid C. Phenytoin
D. None of the above D. Valproate
319. Short – acting barbiturate is 327. ‘Pergolide’ comes under which of the following
A. Phenobarbitone groups?
B. Thiopentone A. Dopamine facilitators
C. Pentobarbitone B. Peripheral decarboxylase inhibitor
D. Methohexitone C. Direct dopaminergic agonists
D. Dopamine precursor
320. Benzodiazepines have
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PHARMACOLOGY 68
D. All of the above

328. ‘Phenothiazines’ are
A. Antianxiety drugs 336. Morphine is contraindicated in head injury. Reason(s)
B. Antidepressant drugs is/are
C. Antipsychotic drugs A. Morphine will add to CO2 retention that is caused
D. Antimanic durgs by head injury itself
B. Morphine will cause respiratory depression
329. “Buspirone” is an C. Vomiting, miosis and altered mentation interfere
A. Antianxiety drug with assessment of progress in head injury
B. Antidepressant drug D. All of the above
C. Antipsychotic drug
D. Antimanic drug 337. “Heroin” is (in comparison to morphine)
A. 1/6 to 1/10 times less potent than morphine
330. Which of the following is not an action of B. 3 times more potent than morphine
phenothiazines? C. 1/8 to 1/10 in analgesic potency
A. Sedative effect D. 80 to 100 times more potent than morphine
B. Antiemetic action
C. Antiepileptic action 338. The only opioid, which inhibits reuptake of NA and 5
D. Antipsychotic action – HT is
A. Dextropropoxyphene
331. Endocrinal effect(s) of antipsychotic drugs is/are B. Tramadol
A. Galactorrhoea C. Ethoheptazine
B. Gynaecomastia D. Methadone
C. Both of the above
D. Increased gonadotropin secretion 339. Morphine has
A. Strong agonistic action on mu (µ) receptors
332. Patients on MAO inhibitors are advised to avoid B. Weak agonistic action on mu (µ) receptors
A. Levodopa C. Strong agonistic action on Kappa (K) receptors
B. Alcohol D. Weak antagonistic action on mu (µ) receptors
C. Cheese
D. All of the above 340. Pure antagonist is
A. Nalorphine
333. All of the following drugs are psychotomimetics B. Pentazocine
except C. Naloxone
A. LSD D. Nalbuphine
B. Phencyclidine
C. Meprobamate 341. Which of the following drug is irreversible cyclo-
D. Mescaline oxgenase (cox) inhibitor
A. Aspirin
334. Which of the following effects is not produced by B. Phenylbutazone
morphine? C. Indomethacin
A. Fall in blood pressure D. Ibuprofen
B. Mydriasis
C. Emesis 342. Which of the following is wrong about NSAIDs
D. Bradycardia A. They inhibit synthesis of thromboxane A2 (TxA2)
B. They inhibit synthesis of prostaglandin I2 (PGI2)
335. “Drug of choice” to treat morphine dependence is/are C. They cause dysmenorrhoea
A. Methadone D. They cause constipation
B. Naloxone
C. Nalorphine 343. Aspirin is not contraindicated in
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PHARMACOLOGY 69
A. Children suffering from chickenpox or influenza 350. Nikethamide comes under

B. G – 6 phosphate dehydrogenase deficient A. Analeptics
individual B. Convulsants
C. Patient with chronic liver disease C. Psychostimulants
D. Patient with COPD (chronic obstructive pulmonary D. None of the above
disease)
351. Extrapyramidal symptoms which are produced by
344. Edema is the major limitation of use for antipsychotic drugs are due to the following
“phenylbutazone”. This is because of mechanism of action
A. Retention of water and sodium ion by direct action A. Dopaminergic blockade in the basal ganglia
on renal tubule B. Dopaminergic blockade in CTZ
B. Loss of protein by direct action on renal tubule C. NA and 5 –HT blockade
C. Hepatocellular damage D. Only 5 – HT blockade
D. Cardiac damage
352. Treatment/s of choice for malignant neuroleptic
345. Ibuprofen is syndrome is/are
A. Not to be prescribed to pregnant woman A. Dantrolene
B. Contraindicated in patient with peptic ulcer B. Bromocriptine
C. The safest NSAID by spontaneous adverse drug C. Antiparkinsonian anticholinergic drug
reaction D. Both A and B
D. Cardiac damage
353. Which of the following typical antipsychotic drugs has
346. Analgesic of choice for asthmatic patient is lowest incidence of extrapyramidal symptoms?
A. Aspirin A. Haloperidol
B. Nimesulide B. Thioridazine
C. Diclofenac C. Droperidol
D. Ibuprofen D. Clozapine
347. Poor anti-inflammatory action of paracetamol is

354. Which of following side effects is the major one for
because
antipsychotic drug clozapine?
A. Penetration at the site of inflammation is poor
A. Extrapyramidal symtoms
B. It is unable to inhibit cyclooxygenase in the
B. Agranulocytosis
presence of peroxides which is generated at site of
C. Blue pigmentation of exposed skin
inflammation
D. Cholestatic jaundice
C. Its mechanism of action is different (does not cause
cyclo – oxygenase inhibition)
355. Which of the following is wrong about hydroxyzine?
A. It is a H1 antihistaminic
B. It is a drug with selective anxiolytic effect
348. Toxicity of paracetamol is due to the
C. It is a drug with antiepileptic property
A. N – acetyl – benzoquinone – imine metabolite
D. It is a drug with antiemetic property
B. Depletion of glutathione store in liver
C. Both of the above
356. Drug of choice for rheumatoid arthritis is
A. Gold
B. NSAIDs
349. Drug of choice for hyperuricaemia (chronic gout) is
C. Probenecid
A. Allopurinol
D. Allopurinol
B. NSAIDs
C. Colchicines
357. Prothrombin time is prolonged when
D. Corticosteroids
A. Intrinsic pathway is interfered

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PHARMACOLOGY 70
B. Extrinsic pathway is interfered B. 1 mg

C. Common pathway is interfered C. 10 mg
D. Both B and C D. 1000 mg
358. Which of the following is/are styptics? 366. Warfarin act as anticoagulant
A. Thrombin A. Only in vivo
B. Fibrin B. Only in vitro
C. Russell’s viper venom C. Both of the above
D. All of the above D. None of the above
359. All of the following are coumarin derivatives except 367. Heparin acts as anticoagulant
A. Dicumarol A. Only in vivo
B. Warfarin sodium B. Only in vitro
C. Ethylbiscoumacetate C. Both of the above
D. Phenindione D. None of the above
360. Heparin acts on 368. Warfarin is competitive antagonist to

A. Intrinsic pathway of clotting system A. Vitamin C
B. Extrinsic pathway of clotting system B. Vitamin B12
C. Common pathway of clotting system C. Vitamin K
D. Both A and C D. Vitamin B
361. Which of the following is not an action of heparin? 369. Vitamin K interferes with the synthesis of all of the
A. Anticoagulant following except
B. Antiplatelet A. Factor X
C. Lipemia clearing B. Factor IV
D. Hypotension C. Factor VII
D. Factor II
362. Anticoagulation of choice during pregnancy is
A. Heparin 370. Which of the following blood clotting factors level
B. Warfarin decreases first during warfarin therapy?
C. Phenindione A. Factor IX
D. None of the above B. Factor X
C. Factor VII
363. Which of the following should not be mixed with D. Factor II
heparin in same syringe?
A. Penicillin 371. Dose of oral anticoagulant must be individualized by
B. Tetracycline A. Prothrombin time
C. Both of the above B. Bleeding time
D. None of the above C. Partial prothrombin time
D. Clotting time
364. Heparin antagonist is
A. Coumarin 372. Which of the following enhance/s anticoagulant action
B. Warfarin of warfarin?
C. Protamine sulfate A. Aspirin
D. Phenindione B. Cefamandole
C. Phenylbutazone
365. How much protamine is needed to neutralize 100 units D. All of the above
of heparin?
A. 100 mg

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373. Which of the following drug/s reduce/s the 381. Anticoagulants are used for
anticoagulant action of oral anticoagulants? A. Rheumatic heart disease
A. Barbiturate B. Defibrination syndrome
B. Rifampin C. Both of the above
C. Griseo – fulvin D. None of the above
D. All of the above
382. Which of the following is not fibrinolytic?
374. Anticoagulant is used in A. Epsilon amino-caproic acid
A. Deep vein thrombosis B. Streptokinase
B. Pulmonary embolism C. Urokinase
C. Myocardial infarction D. Alterplase
D. All of the above
383. Which of the following lipoproteins is safest for heart?
375. Which of the following is correct about warfarin? A. LDL
A. Onset of action is delayed B. HDL
B. Used for initiation of therapy C. VLDL
C. Blocks action of thrombin D. Chylomicrons
D. All of the above
384. Which of the following NSAIDs is a propionic acid
376. All of the following are antifibrinolytic except derivative?
A. Epsilon amino – caproic acid A. Aspirin
B. Tranexaemic acid B. Phenylbutazone
C. Aprotinin C. Ibuprofen
D. Alteplase D. Pioxican
377. Onset of action of warfarin is

A. 4 – 6 hr 385. Which of the following has highest degree of COX – 2
B. 8 – 12 hr inhibitor activity?
C. 1 – 3 hr A. Lumiracoxib
D. 3 – 5 hr B. Valdecoxib
C. Rofecoxib
378. Fibrinolytics are used in D. Colecoxib
A. Acute myocardial infarction
B. Deep vein thrombosis 386. Which of the following NSAIDS has many divergent
C. Both of the above ways of anti-inflammatory action?
D. None of the above A. Ibuprofen
B. Piroxicam
379. Which of the following drugs interferes with platelet C. Indomethacin
function? D. Aspirin
A. Dipyridamole
B. Ticlopidine 387. A common side effect associated with all NSAID
C. Sulfinpyrazone drugs is
D. All of the above A. Drowsiness
B. Gastric irritation
380. Antagonist of warfarin is C. Xerostomia

A. Protamine sulfate D. Constipation
B. Vitamin K
388. Gastric irritation is minimum with one of the
C. Vitamin C
following non-steroidal anti-inflammatory drugs
D. Coumarin
A. Piroxican

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B. Tenoxicam
C. Meloxicam 395. The most common adverse effect of overdose of
D. Indomethacin paracetamol in children is
A. Methaemoglobinaemia
389. Less gastrointestinal bleeding is seen in the following B. Hepatic necrosis
NSAIDS C. Gastric irritation
A. Meloxican D. Renal papillary necrosis
B. Naproxen
C. COX 2 specific inhibitors 396. Which of the following drug combinations are present
D. Ibuprofen in APC?
A. Acetomenophen phenylbutazone and codeine
390. Which of the following anti-inflammatory drug is a B. Aspirin, phenacetin, and caffine
COX – 2 inhibitor C. Acetaminophen, phenylbutazone and codeine
A. Aspirin D. Aspirin, phenacetin and codeine
B. Ketoprofen
C. Rofecoxib 397. Which of the following pharmacological actions of
D. Sulidec aspirin are correctly matched?
A. Analgesia – inhibition or prostaglandin synthesis
and raising the threshold to pain perception
391. Which of the following drugs is used to counter act the B. Antipyretic – Inhibition of prostaglandin synthesis
gastric irritation produced by administration of by blocking the pyrogens in the CNS and reducing
NSAIDS? hypothaimic thermoset
A. Roxatidine C. Anti inflammatory inhibition of prostaglandin
B. Pirenzipine synthesis
C. Betaxotol D. All of the above
D. Misoprostol
398. Which of the following is not true about aspirin
392. Pregnant patient can be safely given (acetylsalicylic acid)
A. Tetracycline A. It is converted into active salicylic acid in the body
B. Paracetamol B. Aspirin in small doses irreversibly inhibits platelet
C. Metronidazole aggregation and prolongs he bleeding time twice
D. Barbiturates the normal value
C. Analgesic effect is mainly due to CNS depression
393. Which of the following can the given safety in peptic
and resembles the action of opoid analgesies
ulcers?
D. Alkalinisation of urine increases its excretion and is
A. Aspirin
indicated in acute salicylate poisoning
B. Diclofenac
C. Brufen 399. Aspirin acts on which part of brain?
D. Paracetamol (acetaminophen) A. Substantia gelatinosa
B. Limbic system
394. All of the following are true of paracetamol C. Medulla
(acetaminophen) except: D. Cortex
A. In chronic overdoses it causes methaemoglobinemia
cyanosis and haemolytic anaemia 400. Acute salicylate poisoning produces all of the
B. Acute paracetamol poisoning in children results in following except
renal tubular necrosis and hepatic necrosis A. Vomiting and electrolytic disturbances
C. The patients allergic to aspirin are also cross allergic B. Hallucinations and tinnitus
to paracetmol C. Hyperventilation
D. It has only analgesic and antipyretic action without D. Rapid decrease in body temperature
any anti-inflammatory action

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401. Which of the following is true of antipyretic action of

aspirin? 407. The increased bleeding time in patients with aspirin
A. Aspirin reduces body temperature in fever patients therapy can be attributed to
but does not cause hypothermia in normal A. Irreversible inhibition of thrombaxene synthesis
individuals and interference with platelet aggregation
B. It inhibits the prostaglandin synthesis in the CNS B. Increased synthesis of prostacyclins and increased
and resets the hypothalamic thermostat which is platelet aggregation
disturbed during fever C. Decreased collagen synthesis and rupture of
C. Aspirin does not decrease heat production but vascular muscularture
reduces body temperature by promoting heat loss D. All of the above
by sweating and cutaneous vasodilation
D. All of the above 408. A patient on 300 mg of aspirin will show all the
following except
402. Aspirin is contraindicated with A. Irreversible inhibition of cyclo-oxygenase pathway
A. Prednisolone B. Prolonged bleeding time
B. Warfarin C. Inhibition of thromboxane TXA2
C. Theophylline D. Inhibition of prostaglandin PGI2
D. Oral contraceptives
409. Aspirin is used in treatment of myocardial infarction
403. Which of the following is not related to A. It inhibits thromboxanes
pharmacokineties of orally administered aspirin? B. It stimulates prostacyclins
A. Microfining of the drug particles C. It is a vasodilator
B. pH of the stomach and small intestine D. It helps in reducing inflammatory aggregate
C. Local concentration of prostaglandins in the GIT
D. Gastric emptying time 410. Aspirin is contraindicated in
A. MI
404. Which of the following is not a side effect of aspirin? B. Angina
A. Peptic ulceration and GIT bleeding C. Peptic ulcer
B. Reye’s syndrome in children suffering with viral D. Hypertension
diseases
C. Tinnitus is produced in acute salicylism 411. Aspirin is avoided in children with influenza
D. Methaemoglobinaemia and increased platelet infection because of associated of
aggregation A. Reye’s syndrome
B. Nausea
C. Diarrhoea
405. Which of the following is not a contraindication of D. Acid – base imbalance
aspirin?
A. Diabetes and peptic ulcers 412. Prolonged use of aspirin causes
B. Patients with bleeding tendencies A. Hypoprothrombinaemia
C. Patients with rheumatoid arthritis and in acute B. Hyperprothrombinaemia
rheumatic fever C. Hypophosphatasia
D. In asthamatic patients D. Hypercalcemia
413. Bleeding time is most like to be prolonged by the

406. Increase of single dose of aspirin form 600 mg to 1
administration of
gram per dose in therapeutic levels results in
A. Vitamin K
A. Anti-inflammatory action
B. Barbiturates
B. Increased antipyretic action
C. Acetaminophen
C. Increased analgesic effect
D. Acetyl salicylic acid
D. Respiratory depression

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414. Prolonged use of aspirin leads to 421. Which of the following can be gives safely to a patient
A. Peptic ulcer of congestive heart failure?
B. Carcinoma A. Aspirin
C. Hypertension B. Paracetamol
D. Bleeding defects C. Dicofenac sodium
D. Ibuprofen
415. Salicylate administration is contraindicated in
pregnancy because 422. Which of the following is not a therapeutic action of
A. It delays onset of labour aspirin?
B. Causes pulmonary hypertension of newborn A. Anti-inflammatory
C. Readily croses placental barrier B. Analgesic
D. All of the above C. Pyretic action
D. Antiplatelet aggregation
416. An attack of bronchial asthama is most likely to be
triggered by 423. Which of the following NSAIDs is used most
A. Aspirin commonly in the treatment of acute gout
B. Ibuprofen A. Aspirin
C. Diclofenac potassium B. Indomethacin
D. Mefenamic acid C. Diclofenc
D. Ibuprofen
417. Which of the following is a non-steroidal anti-
inflammatory agent with a tendency to produce blood 424. Which of the following has been rated as safest
dyscrasias? NSAID by the spontaneous adverse drug reaction
A. Ibuprofen reporting system in UK?
B. Indomethacin A. Aspirin
C. Acetaminophen B. Ibuprofen
D. Aspirin C. Phenyl burazone
D. Indomethacin
418. Which of the following is true of paracetamol
(acetaminophen)? 425. Which of the following NSAIDs is most likely to
A. It is a deactivated metabolite of phenacetin which cause bone marrow depression and Agranulocytosis?
has similar properties A. Indomethacin
B. Analgesic effects are comparable to that of aspirin B. Phenylbutazone
and is a good antipyretic C. Diclofenac
C. It is has negligible anti-inflammatory action D. Aspirin
D. All of the above
426. Which of the following is most likely to cause sodium
419. Which of the following has poor anti-inflammatory and water retention in the body and precipitates CHF
action? A. Phenylbutazone
A. Paracetamol (acetaminophen) B. Ibuprofen
B. Ibuprofen C. Enphenamic acid
C. Ketorolac D. Piroxicam
D. Diclofenac
427. All of the following statements about pain are correct
420. Paracetamol is contraindicated in except
A. Nephritis A. Analgesia is associated with µ and k
B. Chronic hepatitis B. Dysphoria is associated with κ receptors
C. Bleeding disoders C. NSAIDs benefit by preventing prostaglandin
D. Pregnancy synthesis

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PHARMACOLOGY 75
D. Noloxine is a non-competitive antagonist and D. All of the above

irreversibly opposes the opioids
435. Which of the following is true of action of morphine
428. The major opoid receptor for morphine is on CVS
A. Mu receptors (m) A. It causes Bradycardia due to stimulation of vagal
B. Kappa receptors (k) centre
C. Delta receptors (1) B. It causes vasodilation by depressing vasomototone
D. None of the above as well as by histamine release
C. Results in postural hypotension due to loss of
429. Which of the following is true above enkaphalin vascular reflexes
A. There are most widely distributed endogenous D. All of the above
opoid peptides
B. They are situated mainly in medulla and peri – 436. Morphine causes vomiting by acting on
acquctal grey matter A. Medullary chmoreceptor trigger zone
C. Opoid have affinity to bind to the receptors of B. Gastric mucosal irritation
enkephalins C. Both of the above
D. All of the above D. None of the above
430. Which of the following is true of endorphins 437. About morphine true is
A. They are endogenous opiod peptides with A. Conjugated in liver
morphine like action B. Increases biliary tract pressure
B. b- endorphin is the most common peptide C. Increases urinary retention
C. They are mainly distributed in arcuate nucleus of D. All of the above
anterior pituatory
D. All of the above 438. Morphine in small doses cause respiratory depression
by
431. Which of the following are totally synthetic opiods A. Making the medullary respiratory centre less
A. Morphine and codeine sensitive respiratory centre to CO2 changes
B. Diacetylmorphine (heroin) and ethylmorphine B. Making the carotid chemoreceptor system
C. Pethidine (meperidine) and ethoheptazine insensitive to O2 pressure changes
D. All of the above C. Depressing the nerve conduction to respiratory
muscles
432. Which of the following is not a synthetic opoid D. None of the above
A. Pethidine (mederidine)
B. Fentanyl 439. Which of the following is not a contraindication in the
C. Methadone presence of glaucoma
D. Methylmorphine (codeine) A. Diazepam
B. Morphine
433. Which of the following are pharmacological action of C. Scopalamine
morphine D. Meperidine
A. Anaegasia, sedation and moody changes
B. Constipation and vomiting sensation 440. Morphine is contraindicated in all of the following
C. Miosis except
D. All of the above A. Pulmonary oedema
B. Emphysema
434. Which of the following potentiate the action of C. Bronchial asthma
morphine D. Head injury
A. Tricyclic antidepressents and MAO inhibitors
B. Phenthianzines and barbiturates 441. Which of the following is a contraindication for
C. Codine and alcohol morphine
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PHARMACOLOGY 76
A. Patients with acute myocardial infaraction D. Constipation is their main side effect
B. Patients with severe burns
C. Asthamatic patients with head injuries 449. Heroin, an addict drug contains
D. Patients with cancer pain A. ASA
B. Acetyl morphine
442. Which of the following is a feature of morphine C. Pentazocine
poisoning D. Propoxyphene
A. Stupor or coma, miosis and respiratory failure
B. Delirium or convulsions, miosis and cardiac arrest 450. Ethohptazine is chemically related to
C. Delirium, mydriasis and respiratory failure A. Morphine
D. Coma, mydriasis and cardiac arrest B. Methadone
C. Meperidine
443. Death in acute morphine poisoning is due to D. Codine
A. Respiratory failure
B. Cardiac arrest 451. Which of the following is used as substitution therapy
C. Fall in BP and shock in opiod addicts
D. Convulsions A. Methadone
B. Pethidine (meperidone)
444. Which of the following is not true of codeine C. Fentanyl
A. Methylation of morphine yields codeine D. Anileridine
B. It is more potent and efficient than morphine
C. It is a selective cough suppresent 452. All the following statements about opioids agonists is
D. Codeine causes constipation as a side effect correct except
A. Pentazocine and buprenorophine are partial opoid
445. Which of the following narcotics have efficient cough agonists/antagonists
reflex suppression B. Pentazocine shows withdrawal symptoms in opioid
A. Morphine dependent patients
B. Meperidine C. Partial agonists are free from classic opiod adverse
C. Codeine effects
D. Pethidine D. Ethomorphine is similar to pethidine chemically
446. Which of the following has marked similar acitons or

morphins and used as its substitute 453. Which of the following analgesics are avoided in
A. Pethidine patients with opoid dependence
B. Codine A. Nalorphine
C. Ehtoheptazine B. Pentazocaine
D. Fentanyl C. Levallorphine
D. All of the above
447. Compared to morphine, meperidine (pathidine) has
A. Greater anticholinergic action 454. Which of the following analgesics are avoided in
B. Less analgesic and anti-tussive action patients with opoid dependence
C. Constipation, mioss and urinary retention less A. Pentazocaine
prominent B. Indomethacin
D. All of the above C. Aspirin
D. Acetaminophen
448. All of the following are common to methadone,
meperidine and morphine except 455. Which of the following are pure opoid antagonists
A. All of them causes of mydriasis A. Naloxone Naltrexone
B. All of them are antagonized by naloxine B. Malorphone and levllorphan
C. All of them having analgesic property C. Pentazocaine and nalbupine

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PHARMACOLOGY 77
D. Bupenorphine and butorphanol 463. The most sensitive area of CNS that is effected by
general anaesthetics
456. The dentist who gave a demonstration of ether A. Reticular activating system
anaesthesia in 1846 was B. Medullary centre
A. Martin C. Cerebral cortex
B. Morton D. Limbic system
C. Morrison
D. Murray 464. Which of the following order correctly describes the
depression of centres following GA from first to last
457. Which of the following is called stage of surgical A. Cortical centre – Spinal cord – Medullary centre
anaesthesia after administration of general anaesthesia B. Medullary centre – Spinal cord – Cortical centre
A. Stage I C. Spinal cord – Medullary centre – cortical centre
B. Stage II D. Medulalry centre – Cortical centre spinal cord
C. Stage III
D. Stage IV 465. The organ most resistant to GA is
A. Spinal cord
458. Which of the following is not an inhalational B. Medulla oblongata
anaesthetic C. Medullary cortex
A. Nitrous oxide D. Cerebrum
B. Cycloproprane
C. Halothane 466. Potency of the inhalational anaesthetic is measured by
D. Thiopentone A. Degree of blood solubility
B. Minimum alveolar concentration (MAC)
459. Which of the following is halogeneated hydrocarbon C. Partial pressure of the gas (PP)
general anesthetic D. Chemical nature of the anaesthetic agent
A. Nitrous oxide
B. Cyclopropane 467. Rapid onset of inhalational GA depends
C. Halothane A. Blood solubility
D. Thiopentone B. Cerebral blood flow
C. Partial pressure of GA
460. Which of the following routes of administration can D. All of the above
be easily controllable
A. Inhalation 468. Rapid recovery (or) rapid induction of inhalational GA
B. Intravenous is more dependent on
C. Highly potent A. Degree of blood solubility
D. All of the above B. Alveolar exchange
C. Pulmonary ventilation
461. The stages of anaesthesia are not clearly marked in a D. Partial pressure of anaesthetic in the inspired gas
GA that is / has
A. Low alveolar exchange 469. Which of the following statement is not true of
B. High rate of induction inhalational general Anaesthetics
C. Highly potent A. They are highly lipid soluble and is the reason for
D. All of the above rapid induction
B. The depth of anaethesia depends on its potency and
462. The last sensation to be depressed by GA is partial pressure in brain
A. Taste C. At higher doses they cause respiratory paralysis by
B. Pain depressing medullary respiratory centre
C. Touch D. They undergo little metabolism and lives and are
D. Hearing eliminated unchanged

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PHARMACOLOGY 78
470. Which of the following does not affect rate of D. None of the above
induction of GA
A. Haemoglobin content of blood 476. Which of the following is a complication of halothane
B. Pulmonary ventilation A. Broncho constriction
C. Partical pressure of anaesthetic in the inspired air B. Direct stimulation of heart
D. Degree of blood solubility C. Liver damage and Hepatitis
D. All of the above
471. When equilibrium condition exist, most of the
inhalational anaesthetics accumulate in 477. Cardiac arrhythmias are most commonly seen during
A. Brian administration of
B. Blood A. Thiopental
C. Muscle B. Halothane
D. Adipose tissue C. Ethyl either
D. Nitrous oxide
472. Which of the following are potent inflammable GA
A. Diethyl ether and cyclopropane 478. Which of the following is not a feature of diethyl ether
B. Halotherne an dnitrousoxide A. Highly volatile inflammable and explosive liquid
C. Enflurance an isoflurane B. Prolonged induction and slow recovery
D. Nitrous oxide and methoxyflurane C. Increased salivation and marked respiratory
secretions
473. Read the following characteristic of a GA. It is a D. Poor analgesic and poor muscle relaxant property
volatile liquid with sweet odournon-irritant and non –
inflammable. It causes bronchodilation and in 479. Which of the following is true of diethyl ether
preferred in Asthamatics. The drug we are talking A. It sensitizes heart to adrenaline
about is B. It is a hepatotoxic, maintain blood pressure
A. Diethyl ether C. Post anaesthetic, vomiting are retching are marked
B. Nitrous oxide D. All of the above
C. Halothane
480. Which of the following general anaesthetics is
D. Cycloproprane
indicted in children
A. Enflurane
474. Which of the following correctly describes halothane
B. Halothane
A. It is a potent anaesthetic with plasant induction. It
C. Cyclcopropane
is a good muscle relaxant
D. Sevoflurane
B. It is a potent anaesthetic but not a good analgesic
and muscle relaxant
481. Which of the following is unsafe in porphyria
C. It activates the myocardium increases heart rate and
A. Ketamine
cardiac output
B. Thiopentone
D. It stimulates the respiration
C. Severflurane
D. Nitrous oxide
475. Atropine is administered before halothane GA
because to
482. Which of the following is the most common adverse
A. Reduce laryngeal or bronchial secretions caused by
effect of thiopental
halothane because of its stimulatory effect on
A. Laryngospasm
parasympathetic system
B. Nausea and vomiting
B. Reduce bronchial secretions caused by halothane
C. Hypertension
because of its stimulatory effect on sympathetic
D. All of the above
system
C. To reduce the post partal blood loss caused by 483. Which of the following correctly describes
halothane in late pregnancy thiopentone

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PHARMACOLOGY 79
A. It is an IV general anaesthetic A. Slow induction

B. It has rapid induction and rapid recovery B. Slow recovery
C. It is a poor analgesic and poor muscle relaxant C. Potent anaesthetic property
D. All of the above D. Good analgesic property
484. Which of the following anaesthetics can be used as 491. A patient, without prior medication, breathes a gas
analgesia for minor dental proceduces and obstetric mixture consisting of 50 percent nitrous oxide and 50
procedures percent oxygen by volume. Which of the following
A. Nitrogen oxide effects would be expected
B. Cyclopropane A. Analgesia
C. Thiopentone B. Excitation
D. Halothane C. Surgical anaesthesia
D. Respiratory arrest
485. Which of the following genral anaesthetics sensitized
myocardium to adrenaline and causes cardiac 492. 70% N2O concentration in 30% O2 is has
abnormalities A. Good muscle relaxation
A. Nitrous oxide B. Good onset and recovery, safe and less toxic
B. Diethyl ether anaesthetic activity
C. Cyclopropane C. Slow onset and recovery and has only analgesic
D. Thiopentone effect
486. Nitrous oxide is contraindicated in all of the following
except 493. Nitrous oxide is carried in the blood stream by
A. Iron deficiency anaemia A. Haemoglobin
B. Epileptic patient B. White blood cells
C. Normal pregnancy C. Red blood cells
D. Severe hypertension D. Serum
487. Which of the following anaesthetics produce 494. Which of the following produces diffusion hypoxia if
megalobastic anaemia suddenly discontinued after prolonged use
A. Nitrous oxide A. Nitrous oxide
B. Halothane B. Halothane
C. Diethyl ether C. Diethyl ether
D. Cyclopropane D. Cyclopropane
488. In concentrations commonly used for inhalation 495. Problems associated with nitrous oxide anaesthesia is
sedation, N2O, will not produce A. Behavioral problem
A. Hypnosis B. Sensitizes the heart to adrenaline
B. Amnesia C. Prolonged difficult induction
C. Anaesthesia D. Tachycardia and or arrhythmias
D. Analgesia
496. Which factor of the following contributes to short

489. Dissocative sedation and analgesia described by
duration of anaesthetic action of single dose
Robert and Rosebum in 1971 is
thiopental
A. 5 to 20% N2O
A. Rapid biotransformation
B. 20 to 30% N2O
B. Rapid accumulation in body fat
C. 30 to 50% N2O
C. High lipid solubility
D. 50 to 70% N2O
D. All of the above
490. 35% N2O with 65% O2 has

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PHARMACOLOGY 80
497. Ketamine is a 504. Which of the following is a potent preoperative

A. Short general anaesthetic agent antiemetic
B. Local anaesthetic agent A. Glycopyrolate
C. Antidepressive agent B. Metoclopramide
D. Hypnotic agent C. Hyoscine
D. Atropine
498. Relative contraindications for the administration of
ketamine hydrochloride include all of the following 505. The oxygen cylinder is colour coded as
EXCEPT A. Blue
A. Age 10 years B. Black and white rings
B. History of epilepsy C. Orange
C. Raised intracranial tension D. Grey
D. Recent anterior myocardial infarction
506. Preferred induction drug is day care surgery is
499. Which of the following is true A. Propofol
A. Neurolept analgesia is produced by fentanyl – B. Thiopentone
droperidol combination C. Diazepam
B. Neurolept anaesthesia is produced by 65% N2O and D. Ketamine
35% O2 with a neurolept anaesthesia
C. Both of the above Tripathi- Essentials of Medical
1. D
D. None of the above Pharmacology, 7/E, Pg. 384
2. D -
500. The drug combination which produces
Lippincott’s Pharmacology, 6/E,
neuroleptanalgesia is 3. C
Pg.180
A. Droperidol + Fentanyl
Tripathi- Essentials of Medical
B. Droperidol + Ketamine 4. C
Pharmacology, 7/E, Pg. 898
C. Droperiodl + Ether
D. Droperidol + Thiopental sodium + Nitrous oxide 5. D
Pharmacology, 7/E, pp. 375, 376
501. Which of the following is shortest acting IV analgesics 6. A
A. Fentanyl
B. Remifentanil 7. C
C. Alfentanil
D. Sufentanil 8. B
502. Which of the following are used in preanaesthetic
9. B Pharmacology, 7/E, Pg. 374
medication
A. Opoids
B. Sedative – hypnotics 10. B
C. Anticholinergics
D. All of the above 11. D
503. Anticholinergics in preanaesthetic medication are 12. A
mainly given for/to
A. Reduce post operative pain 13. C
B. To reduce secretions and possible laryngospam
C. To produce hypotension 14. A
D. To provide skeletal muscle relaxation
15. B

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PHARMACOLOGY 81
Tripathi- Essentials of Medical Pharmacology, 7/E, Pg. 455

16. A Pharmacology, 7/E, Pg. 365
41. C
17. C Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 375 42. A
Pharmacology, 7/E, Pg. 372 43. C
19. A - Tripathi- Essentials of Medical
44. B
20. B
Pharmacology, 7/E, Pg. 374 Tripathi- Essentials of Medical
45. A
21. A
46. C
Tripathi- Essentials of Medical Pharmacology, 7/E, pp. 417, 418
22. A
Pharmacology, 7/E, pp. 347, 348 Tripathi- Essentials of Medical
47. B
23. B
48. D
24. C
49. D
25. D
50. B
26. A
51. C
27. C
Pharmacology, 7/E, Pg. 473, 474 Tripathi- Essentials of Medical
52. D
28. B
53. B
29. D
54. C
30. B
55. B
31. D
56. A
32. D
57. B
33. A
58. D
34. B
59. D
35. B
60. C
36. A
61. D
Tripathi- Essentials of Medical Pharmacology, 7/E, Pg. 439, 441
37. A
62. A
38. B
63. D
39. A
64. B
40. A Tripathi- Essentials of Medical Pharmacology, 7/E, Pg. 400

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PHARMACOLOGY 82
Tripathi- Essentials of Medical Tripathi- Essentials of Medical

65. B 88. D
Pharmacology, 7/E, Pg. 400 Pharmacology, 7/E, Pg. 415
89. C
66. C Pharmacology, 7/E, pp. 401, 402, Pharmacology, 7/E, pp. 414, 415
403 Tripathi- Essentials of Medical
90. D
67. D
91. B
68. A
92. D
69. D
93. C
70. D
94. C
71. B
95. D
72. B
96. C
73. D
97. B
74. D
98. B
75. B
99. B
76. C
100. B
77. B
101. C
78. A
102. B
79. C Pharmacology, 7/E, pp. 401, 402, Tripathi- Essentials of Medical
103. A
403 Pharmacology, 7/E, Pg. 467
80. B 104. B
81. D 105. B
106. C
82. D Pharmacology, 7/E, pp. 437, 438, Pharmacology, 7/E, pp. 437, 438
107. A
83. A
Tripathi- Essentials of Medical 108. A Pharmacology, 7/E, Pg. 480
84. C
85. A 109. B
86. B 110. B
87. B 111. B

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PHARMACOLOGY 83

112. A 136. C
Pharmacology, 7/E, Pg. 196 Pharmacology, 7/E, pp. 446, 447
113. C 137. A
138. B
114. D Pharmacology, 7/E, pp. 195, 196, Pharmacology, 7/E, Pg. 218
139. C
115. C
140. A
116. A
141. D
117. A
142. A
118. B
Tripathi- Essentials of Medical 143. A Pharmacology, 7/E, pp. 389, 390,
119. A
Pharmacology, 7/E, Pg. 455 391
120. D 144. B
121. A 145. D
122. B 146. B
123. C 147. A
124. B 148. B
125. C 149. B
126. B 150. A
127. C 151. A
128. C 152. A
129. A 153. B
130. D 154. D
131. B 155. D
Pharmacology, 7/E, pp. 206, 207 Pharmacology, 7/E, pp. 480, 481
132. D 156. C
133. C 157. D
134. A 158. B
Lipincott’s Pharmacology, 6/E, Pg. Tripathi- Essentials of Medical
159. B
135. C 69 Pharmacology, 7/E, Pg. 90

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PHARMACOLOGY 84

160. A 185. D
161. A 186. B
162. C - Tripathi- Essentials of Medical
187. D
Pharmacology, 7/E, Pg.421
164. B Tripathi- Essentials of Medical
165. A Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 432 190. B
Pharmacology, 7/E, pp. 402, 403 193. D
Pharmacology, 7/E, Pg. 438 194. D
171. B Lipincott Pharmacology, 6/E, Pg.
451
173. D Tripathi- Essentials of Medical
199. C
175. A
200. A
176. B
201. C
177. A
202. B
178. A
203. A
179. A
Tripathi- Essentials of Medical 204. A Pharmacology, 7/E, pp. 357, 418,
180. D 465
181. A 205. A Pharmacology, 7/E, pp. 388, 389,
Tripathi- Essentials of Medical 390
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PHARMACOLOGY 85

209. B 233. C
210. D 234. B
211. B
Pharmacology, 7/E, Pg. 473 235. D Pharmacology, 7/E, pp. 391, 467,
212. D
236. B
213. B
237. D
214. C
238. B
215. C
239. C
216. C
240. A
217. D
241. D
218. C
242. C
219. C - Pharmacology, 7/E, Pg. 401
Tripathi- Essentials of Medical 243. A
Tripathi- Essentials of Medical 244. B
Tripathi- Essentials of Medical 246. D
223. D Pharmacology, 7/E, pp. 357, 383,
398, 465 247. A Pharmacology, 7/E, pp. 399, 400,
224. D Pharmacology, 7/E, pp. 357, 383,
398, 465 248. D
Pharmacology, 7/E, pp. 407, 408 252. A
231. D Pharmacology, 7/E, Pg. 90 255. D Pharmacology, 7/E, pp. 443, 444,
445
232. A -

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PHARMACOLOGY 86

256. B
258. C Pharmacology, 7/E, Pg. 414
Tripathi- Essentials of Medical 284. C
262. D Pharmacology, 7/E, Pg. 415
269. D 293. D Pharmacology, 7/E, pp. 414, 416,
417
Pharmacology, 7/E, pp. 428, 429 300. A
277. A - Tripathi- Essentials of Medical
301. D
278. D Pharmacology, 7/E, pp. 187, 399, Tripathi- Essentials of Medical
302. D
425 Pharmacology, 7/E, pp. 392, 393
279. A 303. A
280. A Tripathi- Essentials of Medical 304. D Tripathi- Essentials of Medical

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PHARMACOLOGY 87

329. A
Pharmacology, 7/E, Pg. 391 330. C Pharmacology, 7/E, pp. 436, 437,
306. B
316. Pharmacology, 7/E, Pg. 483
D Pharmacology, 7/E, pp. 164, 386,
663 341. A
Pharmacology, 7/E, Pg.401 346. B
325. C
Pharmacology, 7/E, Pg. 417 350. A -
326. A 351. A
352. D
328. C
Pharmacology, 7/E, Pg. 436 353. B Tripathi- Essentials of Medical

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PHARMACOLOGY 88

378. C
Pharmacology, 7/E, Pg. 441 379. D Pharmacology, 7/E, Pg. 629
355. C
357. D Pharmacology, 7/E, pp. 624, 625
370. C Pharmacology, 7/E, pp. 206, 207
Tripathi- Essentials of Medical 395. B Pharmacology, 7/E, Pg. 207
371. A
372. D - 396. B -
373. D 397.
Pharmacology, 7/E, Pg. 623 D
374. D 398.
Pharmacology, 7/E, Pg. 624 C
375. A 399. A -
376. D 400. D
377. A 401. D

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PHARMACOLOGY 89

402. B 427. D
403. C 428. A
404. D 429. D
405. C 430. D
406. A 431. C
407. D 432. D
408. C 433. D
409. A 434. D
410. C 435. D
411. A 436. A
412. A 437. D
413. A 438. A
414. A 439. B
415. D 440. A
416. A 441. C
417. B 442. A
418. D 443. A
419. A 444. B
420. B 445. C
421. B 446. A
Pharmacology, 7/E, pp. 206, 207 Pharmacology, 7/E, Pg. 475
422. C 447. D
423. B
Pharmacology, 7/E, Pg. 203 448. A Pharmacology, 7/E, pp. 472, 475,
424. B
449. B
425. B
Pharmacology, 7/E, Pg. 203 450. C -
426. A
Pharmacology, 7/E, Pg. 203 451. A Tripathi- Essentials of Medical

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PHARMACOLOGY 90

476. C
Pharmacology, 7/E, Pg. 379 484. A Pharmacology, 7/E, Pg. 378
460. A
485. C -
461. B
Pharmacology, 7/E, Pg. 373 486. C -
462. D
463. A 488. B
464. A 489. D -
465. B 490. D
466. B 491. A
467. D 492. B
Tripathi- Essentials of Medical 493. C -
468. A
499. C -
474. B
475. A
Pharmacology, 7/E, Pg. 386 501. B -

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502. D
503. B
504. B
505. B -
506. A

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PHARMACOLOGY 33

Central Nervous system

GENERAL ANESTHETICS (GA’s) CLASSIFICATION

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HALOTHANE BENZODIAZEPINES (BZD)

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 Patient remains conscious SEDATIVES – HYPNOTICS

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BENZODIAZEPINES 4. Clobazam, Lorazepam – For epilepsy

Uses of BZD’s Contraindications

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ANTIEPILEPTICS Osteomalacia, Teratogenicity (Cleft palate, Hare lip,

Common Mechanisms of Action with examples Special Information

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I Brihaspathi Academy I Subscriber’s Copy I

(spinal), medulla, midbrain, limbic system (supra

I Brihaspathi Academy I Subscriber’s Copy I

 Drug of Choice: Naloxone IV; Lethal dose: 250 mg ANXIOLYTIC DRUGS

 Benzodiazepines preferred for anxiety are Alprazolam,

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MOOD STABILISERS (DRUGS USED FOR MANIA) NSAIDS

IX. Preferential Cox–2 Inhibitors

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X. Selective Cox–2 Inhibitors  Anti-inflammatory:4 – 5 gm / day

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replenishes glutathione stores of liver & helps in ANTIPSYCHOTIC DRUGS

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surroundings, paucity of thought, psychomotor hallucinosis, Huntington’s disease, Gilles de la

Newer (atypical) ANTIDEPRESSANTS

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PREVIOUS YEARS MCQS

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B. Motor incordination C. Triazolam

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73. Which of the following effects is NOT produced by C. Valproic acid

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B. Alprazolam D. Dopamine receptors

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D. Amphetamine C. After discontinuing, low dose of methadone, addict

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D. Dealkylation 180. Morphine as analgesic is used in following conditions

184. Carbarmazepine is useful for following disorders

178. Which of the following morphine like drugs is used

179. Morphine has affinity for which of the opioid

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209. Which of the following NSAIDS should be avoided in

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C. Gastric lavage and heamoperfusion B. Chlorpromazine

245. Barbiturates in paediatrics is 252. Phenothiazines like chloropromazine exhibit their

248. Chlorpromazine is a 255. Which of the following are side effects of

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C. Phenytoin C. Sodium valproate

290. Drug of choice in petit mal epilepsy

B. Diazepam treatment of temporal lobe epilepsy