1.

Mention indications for the use of levo thyroxine

2. What are the adverse effects of levothyroxine? Mention the
precautions to be taken
3. To minimize/ overcome these AE
4. How the dose of levothyroxine monitored?
5. Mention the clinical importance of kinetic features of levothyroxine
6. What are the precautions to be taken to avoid cretinism
7. What is the cause of non toxic endemic goiter
8. How to treat myxedema coma
1.
2.
3.
4.
5.
6.
7.

Name thioamides
Explain the mechanism Thioamides and clinical use
Mention the adverse effects of thioamides
Mention the advice to be given to patients on thioamides
Mention the uses of Potassium iodide with basis for using
Mention the limitations of Potassium iodide
What drugs are used during thyrotoxic crisis? explain the reason for
using
8. What drugs are used for preoperative preparation of thyroidectomy
9. Explain how 131I acts? Mention the indications and limitations of 131I
therapy

1. Mention indications for the use of Insulin ( with route of

administration)
2. Name Bolus & Basal Insulin preparations available
3. Explain the advantages of rapid , ultrashort acting insulin analogs
4. Mention the advantage of Isophane Insulin
5. Explain the advantage / limitations of Long acting ( peakless)Insulin
analogs
6. Mention (2) bolus/ basal insulin regimen
7. Mention the AE of Insulin administration. What advice to be given to
patients?
8. Mention the drug interactions with insulin use
1. Compare between the following drugs Mechanism, AE, Wt,
relation with food
A] SUD (ide) & Meglitinides ( glinide)
B] GLP-1R agonists ( tide) & DPP4I (gliptin)
C] Metformin & glitazones
2. Explain how alpha glucosidase inhibitors (bose) act
3. List Drugs given by oral / SC injection
4. List drugs that hypoglycemia vs normoglycemia
5. Compare drugs in relation to body weight
6. Compare drug administration in relation with food intake
7. Name a drug that reduces only PP hyperglycemia
Special note on: Lactic acidosis by metformin
Adverse effects / precautions of Glitazones

Osteoporosis:
. What drugs are used to treat postmenopausal osteoporosis?
. Which of them mainly affect bone resorption
. Which of them mainly increase bone formation
. Why do you use VD + Ca
. rPTH- rationale for using in osteoporosis?
. Compare between Estrogen therapy and raloxifene in osteoporosis
. What advice to be given when BP prescribed?
Rickets/ osteomalacia:
. VD deficiency rickets/ osteomalacia how do you treat?
. Renal rickets/ osteomalacia how do you treat?
Calcium supplements:
. Indication
. IV calcium gluconate- indication / precation

Pharmacological actions of Antidepressants

Drug

Sedatio
n

Agit
a
tion

Seizur
e

X H1 X M

Amitriptylin
e

+++

++

++ ++ +
+
+
+

++
+

++
+

0/+ ++

++

Imipramine

++

0/+ ++

++ +
+

++

++
+

0/+ ++

++

Clomiprami
ne

++

+++

++ +
+
+

++

++
+

++

Duloxetine

0/+

0/+

0/+

0/+ 0/+ 0/+

Venlafaxine

0/+

++
+

++
+

Fluoxetine

0/+

0/+

0/+

++
+

++
+

0/+

Fluvoxamin
e

0/+

++
+

++
+

Citalopram

0/+

0/+ 0

++
+

++
+

Sertraline

0/+

++

++

X
1

BP Hear GIT
t

Sex

++
+

Wt

Therapeutic uses of anti depressant drugs:

Endogenous depression: Highlighted as best drugs with reference
to efficacy and tolerability are - SSRIs, Mirtazapine, Nefazodone,
Duloxetine. MAOAI can also be used in mild depression; TCA last
choice
Takes 2-3 weeks for clinical benefit. Gradually increased dose
If need to change the drug it should be cross tapered
While stopping, dose should be tapered
Panic disorders: SSRI Alprazolam
School phobia, Social phobia: SSRI Alprazolam
Post-traumatic stress disorder, impulse control disorders: SSRI
Bulimia nervosa: SSRI
Attention deficit hyperkinetic disorder: Imipramine, Duloxetine
Neuropathic pain: TCA, Duloxetine ( NE in spinal chord
descending
analgesic pathway)
Enuresis & bed wetting in children: TCA (M blockade action)
Prophylaxis of migraine: Amitriptyline
Fibromylagia Duloxetine

Treatment of Mania & manic depressive illness

Pathophysiology of Mania: Over activity of NE, DA neurons in

Mesolimbic / mesocortical system
Treatment of acute attacks of mania:
Lithium (takes 10-15 days for beneficial effects to develop) + Atypical
antipsychotics / BDZ for quick effect
Manic depressive illness
(Bipolar illness): Most mania
patients swing between depression &
mania, in between normal moods

Li+

Prophylactic treatment of bipolar

illness: Lithium Valproic acid /
Carbamazepine/ Lamotrigine /
atypical antipsychotic
6