Exam (elaborations)
Exam (elaborations) 22 pharmacology mcq
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22 pharmacologymcq
,Which of the following agents has a pure beta agonist effect in the circulation?
1. Isoprenaline
2. Dopamine
3. Adrenaline
4. Noradrenaline - CORRECT ANSWERS-1. Isoprenaline
Isoprenaline is a pure β-receptor agonist and a potent vasodilator.
Dopamine acts on D1 receptors (vasodilation) at higher doses it affects α- and β-
receptors.
Adrenaline acts on β1, β2 and α1 receptors depending on the dose.
Noradrenalin is a potent α- and β1-receptor agonist.
Which of the following statements regarding Carbamazepine is CORRECT?
1. It is an enzyme inhibitor
2. Overdose causes seizures
3. Sodium Valproate increases Carbamazepine clearance
4. It metabolizes to non-active metabolites. - CORRECT ANSWERS-2. Overdose
causes seizures
CBZ is both enzyme substrate and inducer.
Overdose MAY cause convulsions.
CBZ may in crease clearance of Phenytoin, VA, Clonazepam, Primidone.
The SE include: diplopia, ataxia, drowsiness, aplastic anaemia, agranulocytosis, skin
reactions, occasional hyponatraemia and DI.
VA DECREASES CBZ clearance.
CBZ is COMPLETELY metabolized. Some metabolites have ANTISEIZURE activity.
Regarding L-dopa, which of the following statements is CORRECT?
1. It is a precursor to dopamine
2. It has a half life of 5 hours
3. It causes a negative Coombs test.
4. 25% of the oral dose reaches the brain - CORRECT ANSWERS-1. It is a precursor to
Dopamine
Levodopa is a levo-rotating isomer of Dopa - the PRECURSOR of Dopamine.
The plasma half-life is 1-3hrs.
Levodopa can cause POSITIVE COOMB's test.
Only 1-3% reaches brain. The rest is metabolized extracranially.
Regarding Ergotamine, which of the following statements is INCORRECT?
1. It causes vasoconstriction
2. It can be given parenterally
3. It works well in the early treatment of acute migraine
4. It causes GI haemmorhage - CORRECT ANSWERS-Ergotamine can be
administered PO, PR, INH and IM. Ergot derivatives are highly specific for migraine
pain. They are not analgesic for any other condition.
, The vasoconstriction (partial agonist effects at α-receptors and some as a result of
effects at 5-HT receptors) produced by Ergotamine is long lasting and cumulative. The
direct receptor stimulation thus prevents vasodilatation and stretching of the pain
endings.
The most toxic effects of the ergot derivatives are GIT disturbances (diarrhoea, nausea
and vomiting). There have been reports of bowel infarction/ischaemia due to
vasoconstriction in the gut.
GIT haemorrhage DOES NOT occur.
Regarding drugs that are used to treat glaucoma, which is the CORRECT pairing of
drug-mechanism of action?
1. Timolol - ciliary muscle contraction
2. Pilocarpine - ciliary muscle contraction
3. Latanoprost - increased aqueous production.
4. Acetazolamide - increased aqueous production - CORRECT ANSWERS-2.
Pilocarpine - ciliary muscle contraction
Timolol - a β-blocker, it DECREASES aqueous HUMOR PRODUCTION
Pilocarpine CONTRACTS ciliary MUSCLE causing IMPROVED OUTFLOW of aqueous
HUMOR
Latanoprost increases OUTFLOW of aqueous HUMOR
Acetazolamide DECREASES aqueous humor PRODUCTION
Which of the following statements regarding neuromuscular junction blockers is
INCORRECT?
1. Atracurium is inactivated by Hofmann elimination
2. Vecuronium is predominantly renally excreted
3. Pancuronium and Vecuronium are both steroid neuromuscular blocking drugs
4. Pancuronium has a longer duration of action than Vecuronium - CORRECT
ANSWERS-2. Vecuronium is predominantly renally excreted
Atracurium is eliminated by HOFMANN degradation
Vecuronium is MOSTLY FAECALY excreted (40-75%) with renal excretion being only
30% (unchanged and metabolites).
Pancuronium and Vecuronium are BOTH STEROIDAL NMBD
Pancuronium duration of action is about 100min. Vecuronium duration of action is about
45-65min
Vecuronium, pancuronium, pipecuronium and rocuronium are STEROID NMBD.
Tubocurarine, atracurium and doxacurium are ISOQUINOLONE NMBD
Atracurium is metabolised by two pathways:
- Ester hydrolysis- this action is catalysed by non-specific esterases, not by AChE or
pseudocholinesterase.
- Hofmann elimination - a spontaneous non-enzymatic chemical breakdown occurs at
physiologic pH and temperature.
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