MDS PREP
Metronidazole is a treatment of choice for :
1) Salmonellosis
2) Ulcerative colitis
3) hookworm parasitic infection
4) Pseudomembranous colitis
Pharmacology Answer: 4
metronidazole 250 mg po qid for 7 to 10 days is the treatment of choice.
Oral vancomycin 125 mg qid is reserved for the most severe or resistant cases
The antimicrobials most widely regarded as optimal for the treatment of salmonellosis in adults is the group of fluoroquinolones.
The Nitrate which does not undergo first pass metabolism is:
1) Isosorbide mononitrate
2) Nitroglycerine
3) Pentaerythritol tetranitrate
4) Isosorbide dinitrate
Pharmacology Answer: 1
In humans, isosorbide mononitrate is not subject to first pass metabolism in the liver.
This reduces the intra- and interindividual variations in plasma evels and leads to predictable and reproducible clinical effects.
Which of the following is not a loop diuretic:
1) Fruesmide
2) Torsemide
3) Ethacrynic acid
4) Chlorthalidone
Pharmacology Answer: 4
Chlorthalidone (Thiazide like diuretic)
The administration of penicillin G along with probenacid results in
1. increased excretion of probenacid in the feces and perspiration
2. increased excretion of probenacid in urine
3. increased metabolism of penicillin G
4. decreased renal excretion of penicillin G
Pharmacology Answer: 4
The administration of penicillin G along with probenacid results in decreased renal excretion of penicillin G
Which of the following is the first drug to be prescribed in status asthmaticus?
1) Salbutamol
2) Humidified oxygen inhalation
3) Hydrocortisone hemisuccinate
4) Sodium bicarbonate infusion
Pharmacology Answer: 3
Status asthmaticus/Refractory asthma
Any patient of asthma is susceptible to develop acute severe asthma which may be life-threatening. Upper respiratory tract infection is the most common precipitant.
(i) Hydrocortisone hemisuccinate 100 mg (or equivalent dose of another glucocorticoid) i.v. stat, followed by 100-200 mg 4-8 hourly infusion; may take upto 6 hours to act.
(ii) Nebulized salbutamol (2.5-5 mg) + ipratropium bromide (0.5 mg) intermittent inhalations driven by O2 .
(iii) High flow humidified oxygen inhalation
(iv) Salbutamol/terbutaline 0.4 mg i.m./s.c. may be added since inhaled drug might not get to smaller bronchi owing to severe narrowing/plugging with secretions
(v) Intubation and mechanical ventilation if needed
(vi) intensive antibiotic therapy to be used for treating chest infection
(vii) Treat dehydration and acidosis with saline + sod. Bicarbonate/lactate infusion.
Which of the following drugs have a narrow therapeutic index?
1) Lithium
2) Diazepam
3) Penicillin
4) Desipramine
Pharmacology Answer: 1
Other drugs with narrow therapeutic index:
Digoxin Gentamicin Amphotericin B Levothyroxine Prazosin Theophylline Quinidine Warfarin Valproic acid
Which one of the following drugs increases gastrointestinal motility?
1) Glycopyrrolate.
2) Atropine.
3) Neostigmine.
4) Fentanyl.
Pharmacology Answer: 3
Synthetic opioids, sharing properties of opium and morphine, include meperidine, propoxyphene, diphenoxylate, fentanyl, buprenorphine, methadone, and pentazocine. Various opiate effects are analgesia, respiratory depression, constipation, and euphoria.
Fentanyl (80 to 100 times more powerful than morphine) is especially dangerous.
Atropine blocks the muscarinic receptors. Atropine decreases gastrointestinal tract motility and secretion and causes constipation.
Although various derivatives and congeners of atropine (such as propantheline, isopropamide, and glycopyrrolate) have been advocated in patients with peptic ulcer or with diarrheal syndromes
Neostigmine is Cholinesterase inhibitors that enhance the effects of parasympathetic stimulation and leads to reversal of intoxication by agents with a anticholinergic action
Which of the following antihypertensive drugs should not be used in a patient on Lithium in order to prevent Lithium Toxicity?
1) Clonidine
2) Beta blockers
3) Calcium Channel Blockers
4) Diuretics
Pharmacology Answer: 4
Diuretics increase sodium loss in urine and increase lithium retention. Hence they should not be used in patients on Lithium.