Q.

Comment on effect of blood pressure of Acetylcholine before and after Atropine

administration showing on tracing

Q. Interpret the effects of adrenaline before and after phenoxybenzamine and propranolol.

Q. Interpret the effects of adrenaline before and after phenoxybenzamine. Why the effects of
adrenaline is so short lasting? How can you prolong its effect?
Q. Comment on effect of Ephedrin on blood pressure showing tracing.

Question :

1)Comment on relative safety of Salbutamol and Isoprenaline as bronchodilator, giving

reasons.
Q. Comment on Potency and Efficacy of Drugs as shown in the tracing
 Q. What will happen if you give Ergometrine to a patient in 1st stage of
labour?
Ans: At term, uterus is so much sensitive to ergometine, so If I give it before opening of cervix,
it can cause rupture of uterus.
Q. Enlist the drugs for heart failure.
Ans: Digoxin Digitoxin dobutamine dopamine NA inamrinone milrinone frusemide ACE
inhibitors (captopril, enalapril, Lisinopril), ARB (losartan) spironolactone, b blockers, hydralazine,

Q. Give the drug interaction of following combination:

i) Frusemide with Digoxin.
Ans: digoxin toxicity. frusemide cause hypokalemia
ii) Cimetidine with Warfarin.
Ans: Hemorrhage. cimetidine inhibits the warfarin metabolizing enzyme
iii) Aspirin with Tolbutamide
ans: hypoglycemic shock.. aspirin displaces tolbutamide from PLASMA PROTEIN.
iv) Insulin with beta blocker
Ans: masking of signs symptoms of hypoglycemia.

Q. A 35 years old patients with [Link] positive peptic ulcer disease:

1)Which regimes can be given?
Ans: triple therapy .
A PPI 12 hr 7 d
Clarithromycin 500 mg 12 hr 7 d
Amoxicillin 1 g 12 hr 7 d
PPI once daily 4-6 wk
2)Mention 2 drugs which protect gastric mucosa from hydrochloric

acid.
Ans: sucralfate
misopsrostol
Q. a)
Describe the consequences and mechanism of interaction if you prescribe the following drugs
together

i)Oral contraceptive pill + Tetracycline

Ans:  Alteration of Gut Flora: Tetracycline antibiotics can disrupt the normal gut flora, which
may impair the enterohepatic circulation of estrogen, the hormone in OCPs. Estrogen is normally
reabsorbed in the intestines, and disruption of the gut flora may lead to decreased reabsorption and
lower levels of estrogen in the body.

 Increased Clearance: Tetracyclines may also increase the hepatic metabolism of estrogen,
potentially reducing its blood levels.
ii)Ciprofloxacin + Terfenadine
Ans: QT prolongation
iii)Propranolol + Insulin
Q. a) Name prostaglandin analogues used in following diseases
PUD- Misoprostole
Induction of labour- dianoprost
Glaucoma-latanoprost
Q. b) Write down name of five drugs used in Enteric fever.
Ans : Ceftriaxon
Azithromycin

Cotrim
Ciprofloxacin
Chloramphenicol
Q. Name one drug for that are contraindicated for each of the following:
i) Bronchial Asthma –non selective beta blocker, NSAID
ii) Heart block - beta blocker,
iii) Hyperkalemia -Spironolacton. ACE inhibitor
iv) Hypokalamia-loop diuretics ,thiazide
v) Glaucoma-atropin
Q. a) What is inverse agonist. Write down the name of inverse agonist of benzodiazepines.
Ans: If a drug activates a receptor to produce effectrs that are specifically opposite to those of
the agonist ex: b carbolines, bretazenil,zolpidem at high conc.

Q.b) Mention the drugs showing post antibiotic effect

Ans: AG, FQ, penicillin, cephalosporin, macrolide, carbapenem, tetracycline, rifampicin
Question:
Describe the consequences and mechanism of action of interaction if you prescribe

[Link] and Tetracycline together

Ans: complex formation, decreased absorption of tetracycline
[Link] and Sulfonamide together.
Ans: bleeding
[Link] and tetracycline are prescribed together
Ans: decreased bioavailability of both
Q. Name two indications of each of the following drugs

i) Propranolol – HTN, IHD, HF, hyperthyroidism, gluocoma,

ii) Carbamazepine- focal seizure, GTCS, trigeminal neuralgia, mania in bipolar disease
iii) Albendazole – round, hook, whip, pin worm, hydatid disease, neurocysticercosis,
cutaneous & visceral larva migrans
iv) Chloroquine- non falciparum & sensitive malaria, RA, SLE, amoebic liver disease
[Link] the use of adrenaline with local anesthetics.
Ans: prolongation of action of LA
2. Which cephalosporin causes bleeding and why?
Ans: Cefamandole, cefmetazole,cefotetan,cefoperazone, presence of Methylthiotetrazole
group
Q. Haemolytic anaemia following Primaquine therapy may occur in a small proportion of
population- Explain.
Ans: G6PD deficiency, primaquine oxidizes GSH , in G6PD deficiency – decreased NADPH-
decreased GSH. So oxidative free radicals are not properly destroyed – more damage to RBC
membrane.
Question:
1) Describe the consequences and mechanism of interaction if-
Iron and tetracycline are prescribed together
Ans: tetracycline is chelated by iron.
2) Describe the consequences and mechanism of interaction if-
Nonsteroidal anti-inflammatory drugs and Furosemide.
Ans:- Reduced Diuretic Effect of Furosemide: NSAID decreased PG synthesis and cause water
and salt retention
-Impaired Renal Blood Flow
-Risk of Kidney Damage:
Q. Name two inhibitors of each enzyme -
i) Phosphodiesterase – imamrione, milrinone, sildenafil, theophyline
ii) Cholinesterase- physostigmine, neostigmine, pyridostigmine,
iii) Carbonic anhydrase- acetazolamide, dorzolamide, methazoalmide,
iv) Cyclooxygenase- aspirin , Ibuprofen, ketorolac, celecoxib, rofecoxib,
Q. a) Enlist the drugs (3) responsible for drug induced parkinsonism.
Ans: Clopromazine, haloperidole, procloperazine, thioridazine

Q. b) Which fluroquinolones are used for lower respiratory tract infection?

Ans: gatifloxacin, gemifloxacin,sparfloxacin, levofloxacin
Q. 1) Mention the endocrine effect of chlorpromazine.
Ans: weight gain
Hyperprolactinemia
Women: amenorrhea, galactorrhea, false positive preg test, increased libido
Men: gynecomastia, decreased libido

Q. 2) Write down the names of antimicrobials acting on 50s ribosomal subunit.

Ans: Chloramphenicol, macrolides, clindamycin,linezolide
Q. Compare physiological and pharmacological drug antagonism with example.
Ans: pharmacological: act on same receptor. Ex: prazosine & norepinephrine
Physiological: act on different receptor. Ex: histamine and epinephrine
[Link] two diseases for each drug-
Metronidazole- amoebic dysentery, amoebic liver abscess, PUD, pseudomemranous colitis
Phenytoin- partial seizure, GTCS
Neostigmine – myesthenia gravis, paralytic ileus, atony of UB
Tamsulosin- BPH, Urinary Symptoms Associated with Bladder Outlet Obstruction
Question:
1)Describe the consequences and mechanism of interaction if
i) Gentamycin and furosemide are prescribed together.
Ans: ototoxicity
ii) Phenytoin and corticosteroid are prescribed together.
Ans: Phenytoin Reduces the Effectiveness of Corticosteroids (Induction of CYP450
Enzymes)
Question:
2) Administration of Sodium bi carbonate to change urinary PH favors excretion of
phenobarbitone because-
Ans: It is an acidic drug, so alkalization of urine causes excretion of it by decreased its tubular
reabsorption
 Q. a) What do you mean by excipients? Name some excipients with their specialized
pharmaceutical functions.
Ans: additional chemical substances that are used in drug production having no drug property
are called excipient.
starch,dextrose: form bulk of the drug
methyl cellulose: binder
vee gum: disintegrating agent
stearic acid: lubricant
brilliant blue, caramel: colouring agent

b) Give three examples of fixed dose combination of drugs with their therapeutic uses.
Ans: co-trimoxazole: trimethoprim 80 mg + sulfamethoxazole 400 mg- UTI, CAP, otitis media
Fansidar: sulfadixine 500 mg + pyrimethamine 25 mg – CQ resistant pf malaria, toxoplamosis
Malarone: atovaquone 250 mg+ proguanil 100 mg -CQ resistant pf malaria, toxoplamosis

Q. a) Write down three names of drugs which inhibit dihydrofolic acid reductase.
Ans: trimethoprim, pyrimethamine, methotrexate
b) Write down four names of antimicrobial drugs which are used to treat anaerobic organism.
Ans: metronidazole, clindamycin, tetracycline, chloramphenicol
Q) four drugs that can be used in renal failure:
Ans: doxycycline, azithromycin, moxifloxacin, rifampicin

b) Write down four names of drugs that causes disulfiram like reaction with alcohol.
Ans: sulfonylurea, metronidazole, cefotetan, cefoperazone,co-trimoxazole, gresiofulvin
Q. a) Which type of drug antagonism will happen if following drugs are administered together?

i) Adrenaline + Histamine- physiological

ii) Histamine + Chlorpheniramine- pharmacological

Q. b) What will happen if the following drugs are administered simultaneously?

i) Bile acid – binding resins with Furosemide : Furosemide is a loop diuretic that is usually
absorbed in the proximal small intestine. If it comes into contact with bile acid-binding resins, the
resin can bind to furosemide, decreasing its absorption and reducing its effectiveness in treating
conditions like heart failure, hypertension, and edema.
ii) Iron with Ciprofloxacin- oral absorption will be impaired
Q. Benzodiazepine is preferrable than Barbiturate as sedative hypnotic- why? (mention at least 3
causes)
Ans:1. high TI, LESS CADIO RESP DISTRESS
[Link] drug interacton
[Link] antagonist flumazenil
Q. Why Pyrazinamide is added in antitubercular combination therapy?
Ans: more active against dormant bacilli
Act as intracellular bac, slowly multiplying bacili
Q. Describe consequences and mechanism of interaction of following drugs -

Warfarin + NSAID- Increased Risk of Bleeding

Gastrointestinal side effects

Tetracycline + Penicilin : antibiotic antagonism due to use of both bactericidal and

bacteriostatic
Sulphamethoxazole + Trimethoprim: chemotherapeutic potentiation
ACEi+ Spironolactone : hyperkalemia
Q. What is entonox? Mention it’s uses.
Ans: Entonox is a medical gas mixture consisting of 50% nitrous oxide (N₂O) and 50% oxygen (O₂). It
is commonly referred to as "laughing gas" due to the euphoric or sedative effects it can induce at
low concentrations. It is used in a variety of clinical settings for its analgesic and anxiolytic (anxiety-
reducing) properties.

Q. What are the most effective macrolides?

Ans: erythromycin, azithromycin, clarithromycin
Name the enzymes inhibited by each drugs-
i) Steroid – phospholipase A2
ii) Celecoxib- cyclooxygenase 2

iii) Isoniazide- InhA (Enoyl-acyl carrier protein reductase) & KatG (Catalase-
peroxidase enzyme)

iii)Ciprofloxacin : topoisomerase 2 & 4

Q. Describe the consequences and mechanism of interaction if

i) Levodopa and carbidopa are prescribed together.

Ans: increased the action of levodopa in the brain by inhibition of peripheral conversion by inhibiting
DOPA decarboxylase by carbidopa
ii)Isoniazide and Vit B6 are prescribed together.
Ans: prevent isoniazid induced peripheral nephropathy
Question
i) What is the lifesaving use of Epinephrin?
Ans: anaphylactic shock
ii) Select the specific α1 blocker out of the following-
Tolazoline, Prazosin, Phenoxybenzamine, Phentolamine, Salbutamol.
Ans: prazosin,
iii) Write down the non-cardiovascular uses of propranolol.
Ans: hyperthyroidism, pheocromocytoma, cushing’s disease, glaucoma, esophageal varices
Q, A 35 years old patient with H. pylori positive peptic ulcer disease

i)Which regimens can be given?

ii)Mention 2 drugs which protect gastric mucosa from hydrochloric acid.
Q. Describe the consequences and mechanism of interaction if following drugs are used together-
i)Cefixime and Azithromycin : antibiotic antagonism
ii) Prazosin and Adrenaline: hypotension
iii) Aminoglycoside and Frusemide : increased ototoxicity
iv) Iron and Deferoxamine : chetation of iron, thus decreased absorption
Q. Why are aminoglycosides not given orally?
Ans: it is a polycationic structure ,highly polar
Q. What are the advantages of subcutaneous insulin injection?
Ans: Convenient and Flexible:

 Self-administration:

Mimics Physiological Insulin Release, Lower Risk of Hypoglycemia (Compared to

Intravenous Insulin), Reduced Cost and Accessibility, Better Absorption of Insulin,
Adjustable Doses, Reduced Need for Frequent Blood Draws:

Question:
1)In athletes who deny taking stimulant drug like Amphetamines, their urine is made acidic (by
administration of ammonium chloride solution) before detecting drug in urine- why?
Ans: Amphetamine is basic in nature
QUESTION:
Write down the indication of the following drugs-
1. Timolol : glaucoma
2. Carbamazepine: GTCS, focal seizure
3. Metronidazole
4. Chloroquine
5. Salbutamol:asthma, COPD, HYPERKALEMIA
Ques:
1. A 35 years old patient with H. pylori positive peptic ulcer disease:
a. Which regimen can be given?

2. Name two anthelminthic drugs that are most commonly used?

Ans: albendazole, mebendazole
Q. Give the drug interaction of following combination:
i) Frusemide with Digoxin: digoxin toxicity

ii) Cimetidine with Warfarin: hemorrhage

iii) Aspirin with Tolbutamide : aspirin's ability to displace tolbutamide from plasma proteins,
leading to increased free tolbutamide levels and an enhanced hypoglycemic effect.

iv) Insulin with beta blocker

QUESTION:
a) What is inverse agonist. Write down the name of inverse agonist of benzodiazepines.

b) Mention the drugs showing post antibiotic effect.