Nervous System

Question 1

Pancuronium special property amongst curarae drugs

Answer 1

It has antivagal properties so no need to give glycopyrrolate as it already has stopped tracheobronchial secretion

Question 2

Non depolarising steroidal drugs vs non depolarising non steroidal drugs ; (smooth muscle relaxant -SMR)- curarae drugs

Answer 2

Pancuronium,Rocuronium,Rapacurium,Vecuronium …………………Doxacurium,Mivacurium,Atracurium,Galamine,d-TC

Question 3

Galamine why not used

Answer 3

Nephrotoxicity and Teratogenicity

Question 4

Safest drug SMR in hepatic and renal failure

Answer 4

Atracurium. ………which undergo HOFFMAN DEGRADATION i.e self destruction by non enzymatic degradation

Question 5

d -Tubocurarine(d-TC) contraindicated in ??????

Answer 5

it release histamine causing bronchospasm so c/i in bronchial asthma…….it also cause vasodilatation which lead to hypotension

Question 6

Full form of NDRI and one example?

Answer 6

Nor-epinephrine Dopamine Reuptake inhibitors………….BUPRIOPION (Atypical Antidepressant) used as antismoking drug, in ADHD(Attention Deficit Hyperactivity Disorder) common in adults ,anti obesity

Question 7

Antiepileptic drugs used as anti obesity ????

Answer 7

Zonisamide and Topiramate (Felbamate not used clinically as it cause hepatotoxicity and agranulocytosis) ……….fun fact is wt gain drug is VALPROATE

Question 8

Newer drug for obesity ?????

Answer 8

LORCASERINE (5- HT i.e. Serotonin agonist) and it is now FDA approved

Question 9

Antibiotic with SMR (smooth muscle relaxant property) c/i in MYSTHENIA GRAVIS

Answer 9

Aminoglycosides( Neomycin - highest SMR-c/i in MG),Quinolones,Macrolides

Question 10

Line of drug in OPC poisoning

Answer 10

1st line is ATROPINE which control muscarinic manifestation and 2nd line is OXIMES which reactivates Cholinesterase enzyme

Question 11

ORGANOPHOSPHORUS COMPOUND POISONING (OPC) examples and binding sites….???????

Answer 11

Malathion ,Parathion……..binding sites are esteritic site of enzyme cholinesterase (not on anionic site) which inactivates it so Ach gets accumulated ……..OXIMES binds to anionic site and reactivates the enzyme which comes under Tx

Question 12

TEST for MG 1) inj Edrophonium 2) inj d-TC 3) definitive test 4)confirmatory test

Answer 12

1)Tensilon test also k.a Ameliorative test as it increases ms power 2) Provocative test 3) Radioimmuno Assay 4) single fibre electromyography

Question 13

How steroid act as antidepressant?

Answer 13

Inhibits synthesis of IL -1 and IL- 6 and catabolism of igG

Question 14

Use of every immunosupressant??????

Answer 14

Autoimmune ds and organ transplantation

Question 15

Immunosupression caused by 1)cyclosporine ,tacrolimus and 2)sirolimus ,everolimus

Answer 15

1)They are calcineurine inhibitor or blocker which inhibits synthesis ,storage and release of IL-2 , its ADR is NEPHROtoxic maximum in TACROlimus which is MACROlide………………2)M-TOR Blockers block at M-TOR receptor

Question 16

Uses of SIROLIMUS????????

Answer 16

Commonly for ❤️ transplantation ,putting stent like in MI pts PTCA ( Per Cutaneous Transluminal Coronary Angioplasty) -Drug eluting stent,post menopausal breast cancer,renal angiolipoma with tubular sclerosis

Question 17

Toxicity of M-TOR receptor blockers

Answer 17

i.e sirolimus and everolimus……..they are myelosuppressants so it causes thrombocytopenia,Hyperlipidemia, Infection

Question 18

Preferred drug for causing dryness of tracheobronchial secretion

Answer 18

Glycopyrrolate which don’t cross BBB and atropine cannot be used as it crosses BBB

Question 19

Anticholinesterase or acetylcholinesterase types?????? These are the drugs which inhibit acetylcholinesterases thus increasing availability of Ach and prolong action

Answer 19

(1) reversible- physostigmine ,Neostigmine,Pyridostigmine,Edrophonium,tacrine and rivastigmine. (PEN is water siluble and rest including physostigmine are lipid soluble ) (2)organophosphates which include malathion ,parathion, ecothiophate,nerve gases like tabun ,sarin,diflos and carbamates which include carbaryl and propoxur

Question 20

Preferred Tx for MG is????and its other uses…????

Answer 20

Neostigmine as it does not cross BBB so no A/E on CNS and has direct Nm receptor agonistic action; other uses are Tx of cobra bite,post opt paralytic ileus,atony of bladder,reversal if competitive sk ms relaxant

Question 21

Symptoms of anticholinesterase poisoning

Answer 21

Pin point pupil,salivation, lacrimation,sweating,bronchoconstriction,diarrhoea,urination ,bradycardia,hypotension,coma

Question 22

Antidote of choice for both OCP poisoning and carbamate poisoning

Answer 22

ATROPINE

Question 23

Mydriatics -shortest acting and longest acting

Answer 23

Tropicamide shortest………Atropine longest

Question 24

Anticholinergic reverse the bronchoconstriction caused by stimulation of M3 receptors……so they are used in Tx of COPD and bronchial asthma……what are the drugs???????

Answer 24

Ipratropium …..non selective action on all ms receptors whereas tiotropium is somewhat selective blocker on M1 and M 3 receptors

Question 25

Carbonic anhydrase inhibitors

Answer 25

Acetazolamide (oral) ,brinzolamide,dorzolamide both topical…….decrease secretion of aqueus humour so used in Tx of Glaucoma