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PHARMACOLOGY 14

Autonomic Nervous System

AUTONOMIC NERVOUS SYSTEM CHOLINE ESTER


 Bethanechol, Carbachol – for post operative
CHOLINERGIC DRUGS urinary retention, paralytic ileus
(Parasympathomimetic) (Cholinomimetic)  Methacholine (provocholine) – paroxysmal
supraventricular tachycardia (sometimes
ACETYLCHOLINE
used), also used in experiments to induce
 Acetylcholine – Major neurotransmitter in
bronchoconstriction
cholinergic never endings
 Acetylcholine is synthesized in axoplasm
CHOLINOMIMETIC ALKALOIDS
of cholinergic nerve endings form acetyl
 Pilocarpine
CoA and Choline
 Used in glaucoma (causes miosis –
 Acetylcholine cannot be used
spasm of accommodation) (AIPG-99)
therapeutically since it is destroyed in our
 To counteract mydriatic effect
body in milliseconds by enzyme True
 Along with mydriatics to break
Cholinesterase in RBC
adhesion
 Vagusstoff – Now known as Ach
 Used in dry mouth (as sialogogue –
 Various sites where Acetylcholine is
drug increasing salivary secretion)
released as neurotransmitter are
 Xerostomia associated with Sjogren
1. Preganglionic autonomic fibres
syndrome
2. Post ganglionic parasympathetic fibres
 Cevimeline  used in dry mouth as a
3. Post ganglionic sympathetic to sweat
sialogogue
glands, hair follicles, vasodilator fibres
4. Non-innervated receptors on vascular
ANTICHOLINESTERASES (Anti ChEs)
endothelium
 Protect Ach from hydrolysis  potentiate
5. Neuromuscular junction
action of Ach
6. Adrenal medulla
 Reversible  used in therapy,
7. Autonomic ganglia
 Irreversible  Organo Phosphorous
8. CNS
Compounds (OP’s), carbamates are
 Choline uptake – (rate limiting step in Ach
insecticides, pesticides
synthesis) blocked by Hemicholinium
 Cholinergic transmission interfered by
Reversible
Black widow spider toxin, Botulinum toxin
1. Physostigmine (Eserine)*
 Natural,
RECEPTORS
 Penetrate eye, CNS (BBB)
 Muscarinic + Nicotinic
 Tertiary amine
1. M1 – autonomic ganglia, gastric
 Miotic action – glaucoma
glands, CNS
 Belladona (atropine) poisoning
2. M2 – heart
3. M3 – smooth muscle, Ciliary muscle,
2. Neostigmine
glands, Vascular endothelium
 Synthetic
4. M4, M5 – CNS
 Poor penetration in eye
5. NM – neuromuscular junction
 No CNS actions
6. NN – autonomic ganglia, adrenal
 Tertiary quaternary ammonium
medulla, CNS
compounds amine
 To demonstrate nicotinic action,
 Myasthenia gravis**
Muscarinic receptors to be blocked
 Cobra bite
 Reversal of muscle relaxants
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PHARMACOLOGY 15
Autonomic Nervous System

 Postoperative paralytic ileus weakness. Other drugs which are used in Myasthenia
 Post operative urinary retention gravis are Glucocorticoids and Immunosuppressants.
 The direct cholinoceptor action is
possessed only by Neostigmine. *** Rivastigmine, Donepezil, Galantamine are preferred
 Amongst all Anticholinesterases, in Alzheimer’s disease since they attain maximum
Neostigmine is preferred in concentration in brain due to lipophilicity. They are also
Myasthenia Gravis since it has two termed as Cerebro selective anticholinesterases.
functions. It increases the action of
acetyl choline by preventing its Irreversible
breakdown. And also can directly  Organophosphorous compounds**** –
stimulate nicotinic receptors at Diazinon, Malathion, and Parathion)
neuromuscular junction  Nerve gases – Tabun, Sarin, Soman
 Poisoning treated by Atropine + Oximes
3. Pyridostigmine (enzyme reactivation)
 Longer acting than neostigmine
 Myasthenia gravis **** In Organophosphorous poisoning, Atropine is given
 Uses are same as neostigmine to block Muscarinic actions i.e., salivation, lacrimation,
sweating, miosis, diarrhoea, hypertension. Oximes are
4. Edrophonium given to reactivate the enzyme cholinesterase. They bind
 Very short acting (30 min) to anionic site of enzyme and attack the phosphate group
 Used for diagnosis of myasthenia to form oxime phosphate; Oximes have to be given before
gravis aging of the enzyme. Once aging occurs, enzyme is
 Tensilon test totally resistant to hydrolysis. Oximes should not be
given for carbamate poisoning, since anionic site of
5. Tacrine enzyme is not free and hence Oximes cannot bind to the
 Acridine derivative enzyme. If Oximes remain free in circulation, it also
 Used for Alzheimer’s disease exerts mild anticholinesterase action.
 Disadvantage: Hepatotoxicity,
diarrhea SELECTIVE BLOCKERS & STIMULANTS
 Oxotremorine – selective M1 agonist, used
6. Rivastigmine in animal experiments as a drug to induce
 Used for Alzheimer’s disease*** Parkinsonism
 Dementia in parkinsons disease  Phenyltrimethylammonium (PTMA) –
selective NM agonist
7. (DFP) Dyflos, Echothiophate –long acting  Dimethylphenylpiperazinium (DMPP) –
(t1/2 100hrs) selective NN agonist
 Glaucoma (OP compounds)  d- Tubocurarine – selective NM blocker
 Hexamethonium, Trimethaphan – selective
* In Atropine poisoning, Physostigmine is preferred over NM NN blocker
Neostigmine, since former can cross blood brain barrier
and overcome both central and peripheral effects of CHOLINERGIC DRUG ACTIONS
Atropine while Neostigmine cannot cross blood brain  Myocardial depression, decreased BP and
barrier. Smooth muscle contraction
 Glands secretion increased, miosis, spasm
** Myasthenia Gravis is an autoimmune disorder where of accommodation
antibodies are produced which destroy the NM receptors
and patient will complain of easy fatigability and ANTICHOLINERGIC DRUGS ACTIONS
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PHARMACOLOGY 16
Autonomic Nervous System

 Tachycardia, CNS stimulation, mydriasis,


cycloplegia, smooth muscle relaxation, Dicyclomine, Hyoscine butyl bromide,
drying of secretions, rise in body Propantheline, Oxyphenonium, Pipenzolate,
temperature Isopropamide
 Used in abdominal, renal colics, hyper
Atropine motility, hyperacidity
Source
 Atropa belladonna, Datura Ipratropium bromide
stramonium  Bronchial asthma
Uses
 Pre anaesthetic medication, sinus Glycopyrrolate
Bradycardia/ Heart block, sick sinus  Pre anaesthetic medication
syndrome, OP poisoning
 Early mushroom poisoning (amanita Pirenzepine
muscaria), inflammatory condition of  Peptic ulcer
eye, to check for errors of refraction /
fundoscopy Oxybutinin, Flavoxate, Tolterodine (called vasico
selective anticholenergics)
Atropine Toxicity (Described as – blind as bat, dry  Neurogenic bladder blocker, urinary
as bone, red as beet, hot as hare, mad as hen) (MAN- hesitancy (urinary disorder causing
94) excessive urination), spina bifida, urge
 Dry mouth, Dilated pupil, Dry skin, incontinence, irritable bladder syndrome
Photophobia, Fever, Flushing, Ataxia,
Excitement, Constipation, Urinary Anticholinergics used for Parkinsonism – Benzhexol
retention (Trihexyphenidyl), Benztropine, Cycrimine,
 Antidote – IV Physostigmine Procyclidine, Ethoheptazine
All antimuscarinic agents are bronchodilators, but all are
Contra Indications not used in bronchial asthma. This is because along with
 Acute congestive Glaucoma bronchodilation, they also decrease the volume and
 Benign enlargement of prostate consistency of respiratory secretions and depress
mucociliary clearance which is dangerous in asthma.
Scopolamine / Hyoscine Ipratropium & Tiotropium bromides are antimuscarinics
Source but they do not cause above problem significantly. Hence
 Hyoscyamus niger they are preferred in bronchial asthma. Antimuscarinics
usually act on larger airways and not on terminal
Uses (AIPG-02) bronchioles hence more effective in COPD than bronchial
 Motion sickness asthma.
 To produce sedation & amnesia
during labour Antimuscarinic agents are passive mydriatics. They
cause mydriasis by blocking M3 receptors on sphincter
Mydriatics /Cycloplegics pupillae which is an indirect action, while
 Atropine actions last for 7 days (Longest sympathomimetics are active mydriatics. They cause
acting) mydriasis by acting on α1 receptor on radial muscle or
 Homatropine – up to 3 days dilator pupillae which is direct action. M3 receptors are
 Cyclopentolate – 1 day also present on ciliary muscle of iris. So antimuscarinic
 Tropicamide – 3 – 6 hrs (quickest acting, agents also cause cycloplegia (paralysis of
shortest acting) accommodation) while sympathomimetics do not cause
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PHARMACOLOGY 17
Autonomic Nervous System

cycloplegia since adrenergic receptors are absent on


ciliary muscles. Direct sympathomimetics
Centrally acting antimuscarinics like Benzhexol are  Act directly on above receptors
preferred for drug induced Parkinsonism where Levodopa  Ex: Most sympathomimetics
is ineffective. Most of the drugs induce Parkinsonism by
blocking dopaminergic receptors in brain. Hence if a Indirect sympathomimetics
dopaminergic agonist like Levodopa, Bromocriptine etc is  Act on adrenergic neurons to release NA
prescribed, they increase dopamine levels but receptors which acts on receptors
are blocked. Antimuscarinics help in such cases by  Ex: Tyramine, amphetamine
suppressing cholinergic over-activity in brain. Any case
of Parkinsonism usually is treated in two ways – 1) By Mixed sympathomimetics
increasing the level and action of Dopamine and 2) By  Both ways
decreasing cholinergic over activity.  Ex: Ephedrine, Amphetamine,
Mephentermine
Hyoscine (Scopolamine) is the only anticholinergic which
is available as Transdermal patch. When given just before ADRENALINE
journey, it can relieve motion sickness by blocking  Biphasic response on BP
cholinergic pathway between vestibular apparatus and  Exhibits Dales vasomotor Reversal
cerebellum with vomiting centre. Phenomenon
 NA – Uniphasic response on BP
Mydriatics  Adrenaline, NA, dopamine – increases BP
1. Antimuscarinic drugs – Atropine,  Isoprenaline – decreases BP
Homatropine, Cyclopentolate,
Tropicamide, Eucatropine Actions (AIPG-2003)
2. Sympathomimetics – Phenylephrine, 1. Cardiac stimulation ( ↑HR, ↑CO,
Adrenaline, Dipivefrine ↑conduction velocity) – O2 consumption by
heart increased
Miotics 2. Rise followed by fall in BP
1. Cholinergic drugs – Pilocarpine, Carbachol, 3. Bronchodilation, High doses  pulmonary
DFP, Physostigmine edema
2. α – Blockers – Prazosin, Phenoxybenzamine 4. Decreased IOP  by decreasing aqueous
3. Adrenergic neuron blockers formation  hence used in glaucoma
5. Tremors of skeletal muscle
6. Glyogenolysis – increased blood glucose,
ADRENERGIC DRUGS lipolysis, calorigenesis
(Sympathomimetics)
Administration
 Catecholamines – Adrenaline (Epinephrine),
 Not preferred by IV – it causes
Nor-adrenaline (Nor-epinephrine),
arrhythmias, hypertension
Isoprenaline, Dopamine
 Mostly given by IM/SC

Receptors
Side effects
 Adrenaline – α1, α2, β1, β2, β3 receptors
 Sweating, palpitation, restlessness, anxiety,
 Noradrenaline (NA) – α1, α2, β1, β3, (no β2
tremor
action)
 Isoprenaline – β1, β2, β3, (no α action)
Contraindications
 Dopamine – D1, D2, β1, α1
 Hypertension, angina, hyperthyroidism
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PHARMACOLOGY 18
Autonomic Nervous System

BP. After this response, if α-blocker is injected,


Receptors location we get only fall in BP which is termed as Dale’s
1. α1 – smooth muscle contraction, blood vasomotor reversal phenomenon. After
vessel constriction, glands—increased obtaining biphasic response, if β blocker is
secretion, gut – relaxation given and Adrenaline is repeated, we get re-
2. α2 – vasoconstriction, platelet aggregation, reversal phenomenon where marked rise in BP
inhibition of transmitter release, decreased is seen. Since Nor Adrenaline does not act on
central sympathetic out flow, decreased β2 receptors, we get only rise in BP and no fall.
insulin release
3. β1 – heart, JG cells of kidney (cardiac  Isoprenaline acts only on β receptors and we
stimulation, Renin release) get only fall and no rise.
4. β2 – bronchi, blood vessels, GIT, urinary  Amongst catecholamines, Nor Adrenaline is
tract, eye (dilation, aqueous secretion) the major neurotransmitter of ANS
5. β3 – adipose tissue  Adrenaline is a neurotransmitter of brain,
synthesized in adrenal medulla from Nor
Uses Adrenaline.
1. Anaphylactic shock – IM route (DOC),  The word NOR means Nitrogen Ohne Radical
resolves laryngeal edema, (Ohne – without)
bronchoconstriction relieved and increased  Nor Adrenaline nowadays very rarely used
BP is controlled. Concentration: 1:1000 except for few cases of hypotension where it is
2. Along with local anaesthetics – 1:20,000 to infused IV.
1:1,00,000 SC  Isoprenaline is used in partial or complete AV
3. To control local bleeding (0.1 % solution); block and second line bronchodilation when
styptic 1:1000 Salbutamol is not available. It is also available
4. Cardiac arrest/heart block/Stoke’s Adam by sublingual route.
syndrome - 1:1000 IV  In emergencies, Adrenaline and Atropine can
5. Glaucoma (Dipivefrine (Prodrug) also be given through endotracheal tube
preferred) – Adrenaline poorly penetrates,
cornea. Hence Prodrug of adrenaline Isoprenaline
Dipivefrine preferred in glaucoma as eye Occasionally used to maintain ventricular rate till
drops pace maker is implanted
6. Bronchial asthma (selective β2 stimulant C/I in HOCM, TOF
preferred) - 1:100 inhalational Ephedrine
7. Severe hypoglycaemia cases not Used in mild chronic bronchial asthma and for
responding to IV glucose and steroids hypotension during spinal anaesthesia

Action of Adrenaline on BP Ibopamine


 In rapid IV administration, Adrenaline first  Dopaminergic agonist
causes rise in BP due to α receptor mediated  Used orally
vasoconstriction. After some time as the drug is Dopexamine
degraded BP starts coming to baseline.  Inotropic agent, stimulates cardiac
Following this, β2 mediated vasodilation occurs dopaminergic and peripheral β2 receptor
resulting in fall in BP. β receptors are more  Tried in CHF, cardiac surgery by IV route
sensitive than α-receptors to the effect of
Adrenaline. Hence in low concentration, only β All catecholamines are synthesized in our body except
action is seen. Rise in BP followed by fall is Isoprenaline
termed as Biphasic response of Adrenaline on
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PHARMACOLOGY 19
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 Conversion of Tyrosine to DOPA by Tyrosine


Hydroxylase is the rate limiting step in Fenoldopam
catecholamine synthesis. Metyrosine (α- methyl  D1 receptor agonist tried in hypertensive
p-tyrosine) is a specific Tyrosine Hydroxylase crisis
inhibitor used in Pheochromocytoma.  Given IV

 Amongst adrenergic receptors, α receptors are Nasal decongestants


always excitatory except in intestine while β  Xylometazoline, Naphazoline,
receptors are always inhibitory except in heart. Oxymetazoline, Phenylephrine,
Pseudoephedrine
 α1 agonistic agents i.e. Phenylephrine,  Use: Nasal congestion in common cold,
Ephedrine are active mydriatics. They dilate the sinusitis
pupil by contracting radial muscle of iris. Since  Disadvantage: Long term use causes
α1 receptors are not present on ciliary muscle, atropine rhinitis, anosmia
sympathomimetics do not affect
accommodation. Phenylephrine
 Selective α1 agonist
 Antimuscarinics like Atropine, Homatropine Uses
cause passive mydriasis by blocking M3 1. Glaucoma
receptors on sphincter pupillae. They also cause 2. Nasal congestion
paralysis of accommodation (cycloplegia) by 3. Hypotensive states
blocking M3 receptors on ciliary muscles 4. Supra ventricular tachycardia
5. Fundoscopy/checking errors of refraction –
Dopamine preferred over Atropine since causes only
 Catecholamine mydriasis and no cycloplegia
 Do not cross blood brain barrier
 Short acting (2-5min half life) Methoxamine, Mephentermine, Metaraminol 
used in hypotensive states
Actions
On IV administration, Salbutamol, Terbutaline, Orciprenaline,
 Low doses 1-2 5 mg μg/Kg/min – acts on Salmeterol, Formoterol (selective β2 stimulants) 
dopaminergic receptors  increases renal bronchial asthma
blood flow causing vasodilation 
improves GFR (in acute renal failure) Salbutamol, Isoxuprine, Ritodrine  premature
 2 5-10 mg μg/Kg/min β1 receptors in labour
Heart  Increased CO (in CHF)
 >10 mg μg/Kg/min  α1 receptors  Amphetamines
vasoconstriction increased BP (in Uses
hypotension/shock) 1. Parkinsonism (oculogyric crisis)
2. Narcolepsy(DOC is modafinil)
DOC 3. Hyperkinetic children (ADHD- DOC is
 Cardiogenic shock methylphenidate)
 Hypotensive states 4. Nocturnal enuresis

Dobutamine (selective β1 agonist) Fenfluramine, Dexfenfluramine, Mazindol,


 Major action on β1 receptors  increased Sibutramine (anorectic agents)  obesity
CO  CHF
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PHARMACOLOGY 20
Autonomic Nervous System

These drugs are banned in india because of Nowadays selective α1A blocker preferred like
cardiovascular toxicity. Alfuzosin, Tamsulosin
3. Scorpion bite (Prazosin)
α-ADRENERGIC BLOCKERS 4. Hypertensive emergencies like cheese
reaction in MAO inhibitors, Clonidine
Non Selective
withdrawal, opioid withdrawal,
 Blocks both α1 and α2
postmenopausal states- DOC is
 Phenoxybenzamine (irreversible action-
Phentolamine
forms covalent bond with receptors)
5. Certain cases of peripheral vascular
 Ergot alkaloids, Tolazoline, Phentolamine,
diseases, CHF, secondary shock
Chlorpromazine, Ketanserin, indoramine,
6. Extravsation of Adrenaline/NA during IV
urapidil, methergin
administration causing gangrene –
Phentolamine preferred
Selective
7. Ergotamine – preferred for acute attack of
 α1 selective – Prazosin , Terazosin,
migraine
Doxazosin, Alfuzosin, Tamsulosin (α1A)
8.
 α2 selective – Yohimbine ( Not used)

Actions
β-ADRENERGIC BLOCKERS
1. Vasodilation – decreased BP  first dose
phenomenon (sudden giddiness, syncope) Practolol (Selective β1 blocker) – withdrawn because
most common – avoided by starting low of oculomucocutaneous syndrome
dose given at bed time
2. Reflex tachycardia 1. 1st generation (non selective) – Ex: Propranolol,
3. Nasal congestion/stuffiness, miosis Sotalol, Timolol, Pindolol, Nadolol, levobunolol
4. Diarrhoea and Alprenolol
5. Inhibition of ejaculation 2. 2nd generation (cardio selective) (β1) – Ex: Atenolol,
6. Decreased renal blood flow – decreased Acebutolol, Bisoprolol, Betaxolol, Esmolol,
GFR  Na & H2O retention Celiprolol, metoprolol, nebivolol (most)
7. Lipid lowering 3. 3rd generation (having additional α1 blocking
property) – Labetalol, Carvedilol, dilevelol,
 Exhibits Dale’s Vasomotor Reversal nebivelol, bucindolol; β2 selective – Butoxamine
Phenomenon (Ergotoxine is used as α – (No therapeutic use)
blocker)
 Adrenaline: increased BP is blocked as only fall Shortest acting – Esmolol (ultra short acting β blocker)
in BP is seen since α receptors are blocked Longest acting – Nadolol, Sotalol

Uses β - blockers with ISA (Intrinsic Sympathetic


1. Pheochromocytoma – (tumour of adrenal Activity) – Pindolol, Oxprenolol, Alprenolol,
medullary cells) releasing catecholamines celiprolol, carteolol, acebutolol, penbutolol
For irreparable cases –DOC is
Phenoxybenzamine preferred Actions
2. Benign enlargement of prostate (BEP/BHP) 1. Decreased heart rate, force of contraction,
with HTN– selective α1 blocker preferred CO – work done by heart decreased.
(DOC is prazosin/terazosin) Decreased automaticity of myocardial
Relax bladder trigone, prostatic capsule, and fibres, delays AV conduction membrane
prostatic urethra – increases urine flow rate stabilizing property

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PHARMACOLOGY 21
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2. Re-reversal of vasomotor reversal shown β – blockers should never be given with adrenaline, as
by α-blockers they can aggregate or precipitate hypertension due to
Long term use  ↓ CO  ↓ BP, ↓ Renin unopposed β-action on blood vessels causing
release, ↓central sympathetic out flow vasoconstriction.
3. ↑ bronchial resistance – precipitates
bronchial asthma Ocular β- blockers (used in glaucoma)
4. Behavioural changes, dreams, nightmares,  Timolol, Betaxolol, levo betaxolol,
decreased memory Levobunolol, Carteolol, Metipranolol
5. Delay on recovery from hypoglycaemia, ↑  Sotalol: β– blocker + K+ channel blocker
triglycerides/LDL level (used in arrhythmia)
6. Inhibits tremors
7. ↓ aqueous humor secretion Uses
1. Hypertension (mild to moderate, young
Propranolol individuals)
 Non selective, 2. Angina pectoris
 Food increases bioavailability 3. Cardiac arrhythmias
 High first pass metabolism 4. Myocardial infarction
 Metabolism depends on hepatic blood 5. CHF and hypertrophic cardiomyopathy
flow 6. Dissecting aortic aneurism
 High CNS side effects 7. Pheochromocytoma
 High protein binding (90%) 8. Thyrotoxicosis
9. Anxiety
Atenolol 10. Migraine prophylaxis
 Cardio selective 11. Tremors
 Food – no interference 12. Glaucoma
 Less CNS side effects
 Excreted unchanged by kidney (liver not Adverse effects
required)  Bradycardia, Heart Block, Aggravate
 Min protein binding (5%) Bronchial Asthma, Peripheral Vascular
Celiprolol Disease, Diabetes, Lipid Profile Altered,
 Selective β blocker + weak β2 selective Decreases Exercise Capacity, Cold Hands
agonistic activity And Feet, Abnormal Dreams, Nightmares,
 Safe in bronchial asthma Forgetfulness
 Should not be abruptly withdrawn – abrupt
Non selective β blockers like Propranolol should be withdrawal may result in tachycardia – angina,
avoided in patients receiving treatment for diabetes hypertension
mellitus especially with insulin. If insulin causes
hypoglycaemia, it will be very difficult to diagnose  Propranolol preferred for Thyrotoxicosis,
clinically since symptoms like sweating, palpitation, essential tremors, prophylaxis of migraine,
tremors etc will be masked by β blockers. In such cases anxiety, social phobia, HOCM, aortic dilation in
patient will go in hypoglycaemia but others will not be Marfan
aware of it, phenomenon called a Hypoglycaemia  Labetalol – preferred for Pheochromocytoma,
Unawares. Also there will be delay in recovery from now DOC for aortic dissection
hypoglycemia since β-blockers block glycogenolysis in  Carvedilol – β1+ β2+α1 blocker + antioxidant
liver. property

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PHARMACOLOGY 22
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 Newer β blockers – Nebivolol, Medroxalol, B. Decreased Salivation


bopindolol, nipradilol (also have antioxidant C. Decreased sweating
property, releases NO) D. Mydriasis
 β blockers with ISA are not effective in
migraine prophylaxis Tripathi- Essentials of Medical
 Esmolol – used for controlled hypotension Pharmacology, 7/E, Pg. 120
during surgery, supraventricular tachycardia
 Ganglion blockers: Hexamethonium, 2. Succinylcholine is a/an
Pentolinium, Mecamylamine (tried for A. Intravenous anaesthetic agent
cessation of smoking), Pempidine B. Non – depolarizing muscle relaxant
 Trimethaphan – drug of choice for Dissecting C. Short – acting narcotic
aneurysm of aorta with hypertension- D. Short-acting muscle relaxant
previously
 Nadolol-longest acting, half life 24hrs, Tripathi- Essentials of Medical
accumulated in renal failure Pharmacology, 7/E, Pg. 943
 β blockers with membrane stabilizing activity
are propranolol (max), metoprolol, labetalol, 3. All of the following drugs are non-
acebutalol, pindolol. depolarizing neuromuscular blocking agents
 Acebutalol possesses all the activities except
A. D – tubocurarine
Drugs used in Glaucoma B. Gallamine triethiodide
1. β blockers (noted above) C. Pancuronium bromide
2. Cholinergic agonists adrenergic α2 agonist– D. Succinylcholine
Phenylephrine, Dipivefrine,
Apraclonidine, brimonidine Tripathi- Essentials of Medical
3. Carbonic anhydrase inhibitors – Pharmacology, 7/E, Pg. 347
Acetazolamide (given orally), Dorzolamide
(topically, eye drops), Brinzolamide 4. Neuromuscular blocking agent with onset of
(topically, eye drops) action less than 2 minutes is
4. Prostaglandins – Latanoprost, A. D – tubocuraine
Unoprostone, bimatoprost, trovaprost B. Succinyl choline
5. Osmotic diuretics –hypertonic Mannitol C. Pancuronium
(20%), Glycerol (10%) D. Gallamine
6. Miotics- pilocarpine, physostigmine
Tripathi- Essentials of Medical
Myasthenia gravis Pharmacology, 7/E, pp. 352, 353
1. Cholinergic drugs – Neostigmine,
Pyridostigmine 5. Which of the following group of drugs are
2. Steroids – Prednisolone neuromuscular blocking agents
3. Immunosuppressants – Cyclosporine, A. Choline, adrenaline and amphetamine
Azathioprine B. Glycinium neostigamine and
physostigmine
***** C. Pancuronium, rocuronium
1. The intramuscular administration of 0.6 mg of D. Pirenzipine, propanolol and propantheline
atropine sulphate to a 50 – kg adult may
produce all of the following effects EXCEPT Tripathi- Essentials of Medical
A. Bradycardia Pharmacology, 7/E, Pg. 347
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PHARMACOLOGY 23
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6. Which of the following receptors is activated Tripathi- Essentials of Medical Pharmacology, 7/E,
by acetylcholine and blocked by atropine pp. 184, 629
A. Nicotinic
B. Muscarinic 11. The drug of choice in the management of life
C. Alpha 1 and 2 threatening allergic reaction is
D. Beta 1 and 2 A. Corticosteroids
B. Antihistamines
Tripathi- Essentials of Medical C. Adrenaline
Pharmacology, 7/E, Pg. 100 D. Diazepam

Tripathi- Essentials of Medical


7. The metabolic effects of sympathomimetics Pharmacology, 7/E, Pg. 926
are mediated by
A. All beta – adrenergic receptors 12. Felypressin is a
B. Dopaminergic receptors A. Vasodilator
C. Beta 2 receptors B. Vasoconstrictor
D. Opioid receptors C. Neuroleptic drug
D. Anti-coagulant
Tripathi- Essentials of Medical
Pharmacology, 7/E, pp. 129, 222 Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 596
8. Which of the following is a peripherally
acting muscle relaxant 13. The drug which is used to treat laryngospasm
A. Chlorozoxazone is
B. Methocarbomol A. Atropine
C. Succinyl choline B. Diazepam
D. Cortisopradol C. Neostigmine
D. Succinylcholine
Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 347 Tripathi- Essentials of Medical
Pharmacology, 7/E, pp. 353, 392
9. Beta 2 agonist causes
A. Mydriasis 14. Succinylcholine prevents bronchospasm by
B. Contraction of urinary spinctors A. Depolarizing block
C. Vasoconstriction B. Direct muscle relaxation
D. Bronchial muscle relaxation C. Centrally acting muscle relaxation
D. Dual action
Tripathi- Essentials of Medical
Pharmacology, 7/E, pp. 129, 130 Tripathi- Essentials of Medical
Pharmacology, 7/E, pp. 347, 349
10. The drug which is contraindicated in
haemophilia is 15. Pilocarpine
A. Aspirin A. Lowers the intraocular pressure in
B. Penicillinium glaucoma
C. Amino epsilon caproic acid B. Cleaved by acetylcholinesterase
D. Dipheny 1 hydantoin C. Inhibits sweat and lacrimation
D. Causes tachycardia
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PHARMACOLOGY 24
Autonomic Nervous System

Tripathi- Essentials of Medical Pharmacology, 20. In which of the following categories are
7/E, Pg. 104 ephedrine, tyramine and amphetamine
classified
A. Anticholinesterases
16. Short – acting non – depolarizing muscle B. Alpha – adrenergic blocking agents
relaxant is C. Indirect acting sympathomimetics
A. Succinylcholine D. Direct acting sympathomimetics
B. Pancuronium
C. Mivacurium Tripathi- Essentials of Medical
D. Decamethonium Pharmacology, 7/E, Pg. 129

Tripathi- Essentials of Medical 21. Which of the following is short acting and
Pharmacology, 7/E, Pg. 347 non- depolarizing?
A. Sch
17. An excess of which of the following hormones B. Pancuronium
may be associated with increased sensitivity C. Mivacurium
to epinephrine? D. All of the above
A. Testosterone
B. Parathyroid Tripathi- Essentials of Medical
C. Insulin Pharmacology, 7/E, Pg. 347
D. Thyroid
22. Which one of the following can be blocked by
Tripathi- Essentials of Medical atropine?
Pharmacology, 7/E, Pg. 249 A. Decreased blood pleasure caused by
hexamethonium
18. Scopolamine helps in B. Increased blood pressure caused by
A. Motion sickness nicotine
B. Hypertension C. Tachycardia caused by exercise
C. Decreased secretions D. Tachycardia caused by infusion of
D. A and C acetylcholine

Tripathi- Essentials of Medical Tripathi- Essentials of Medical


Pharmacology, 7/E, pp. 113, 120 Pharmacology, 7/E, pp. 100, 102

19. Which of the following is not an action of


epinephrine when administered 23. Reversal phenomenon is most commonly seen
intravenously in a high dose? with use of
A. Increases liver glycogenolysis A. Epinephrine
B. Causes bronchiolar constriction B. Norepinerphrine
C. Evokes extrasystoles in the heart C. Phenylerprine
D. Produces restlessness and anxiety D. Leuonordefrin

Tripathi- Essentials of Medical Tripathi- Essentials of Medical


Pharmacology, 7/E, pp. 131, 132 Pharmacology, 7/E, Pg. 131

24. Atropine is used in


A. Organophosphate poisoning
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PHARMACOLOGY 25
Autonomic Nervous System

B. Chronic glaucoma C. Carbaryl


C. Syncope D. Tacrine
D. Trigeminal neuralgia
Tripathi- Essentials of Medical
Tripathi- Essentials of Medical Pharmacology, 7/E, Pg. 105
Pharmacology, 7/E, Pg. 111
29. Which of the following drugs undergoes
“Hoffmann elimination?
A. d-tubercurarine
25. If patient is given Noradrenaline what will B. Acetylcholine
happen C. Atracurium
A. Cause increase in B.P, due to its action on D. Acetazolamide
Beta receptors only
B. Cause decrease in B.P, due to its action on Tripathi- Essentials of Medical
Alpha receptors only Pharmacology, 7/E, Pg. 353
C. Cause decrease in cardiac output and relax
bradycardia 30. Dry mouth during antidepressant therapy is
D. None of the above caused by blockade of
A. Muscarinic acetylcholine receptors
Tripathi- Essentials of Medical B. Serotonergic receptors
Pharmacology, 7/E, Pg. 131 C. Dopaminergic receptors
D. GABA receptors

26. In treating Xerostomia, which of the following Tripathi- Essentials of Medical


might be prescribed? Pharmacology, 7/E, Pg. 457
A. Atropine
B. Neostigmine 31. Which one of the following drugs is not a non
C. Scopolamine depolarizing competitive neuromuscular
D. Ephedrine blocker?
A. Doxacurim
Tripathi- Essentials of Medical B. Decamethonium
Pharmacology, 7/E, pp. 103, 107 C. Rocuronium
D. Mivacurium
27. Bleeding from the oral mucosa can be reduced
by topical use of Tripathi- Essentials of Medical
A. Epinephrine Pharmacology, 7/E, Pg. 347
B. Lidnocaine
C. Hydrocortisone 32. Which of the following general anesthetics is
D. Dicoumarol given by intravenous route?
A. Propofol
Tripathi- Essentials of Medical B. Sevofluorane
Pharmacology, 7/E, Pg. 138 C. Naloxane
D. Flumizenil
28. Which one of the following drugs is not a
reversible anticholinesterase drug? Tripathi- Essentials of Medical
A. Edrophonium Pharmacology, 7/E, pp. 378, 382
B. Demecarium
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PHARMACOLOGY 26
Autonomic Nervous System

33. D – tubocurarine blocks the neuromuscular


transmission by Tripathi- Essentials of Medical
A. Blocking acetylcholine receptors Pharmacology, 7/E, Pg. 92
B. Prevent release of acetyl choline
C. Destroys acetyl choline 38. Catecholamines are synthesised from which
D. Inactivate acetylcholine esterase enzyme amino acid
A. Histamine
Tripathi- Essentials of Medical B. Phenylalanine
Pharmacology, 7/E, pp. 102, 347, 348 C. Tryptophan
D. Glycine
34. Therapeutic uses of α – adrenoceptor blockers
include all of the following EXCEPT Tripathi- Essentials of Medical
A. Hypertension Pharmacology, 7/E, Pg. 124
B. Anxiety
C. Peripheral vascular disease 39. Which of the following is not a catecholamine
D. Benign prostatic hypertrophy A. Adrenaline
B. Nor-adrenaline
Tripathi- Essentials of Medical C. Isoproterenol
Pharmacology, 7/E, pp. 140, 143, 144 D. Phenylephrine

35. Which of the following combination of iron Tripathi- Essentials of Medical


can be given both IM and IV Pharmacology, 7/E, Pg. 124
A. Iron dextran
B. Iron Sorbitol Citrate Solution 40. In which of the following categories are
C. Ferrous Sulphate ephedrine, tyramine and amphetamine
D. Ferrous Humourate classified
A. Anticholinesterases
Tripathi- Essentials of Medical B. Alpha – adrenergic blocking agents
Pharmacology, 7/E, Pg. 604 C. Indirect acting sympathomimetics
D. Direct acting sympathomimetics
36. All of the following are endogenous
corticosteroids released by the adrenal cortex Tripathi- Essentials of Medical
EXCEPT Pharmacology, 7/E, Pg. 129
A. Cortisol
B. Cortisone 41. The alpha-receptors function is mediated
C. Dexamethasone mainly by
D. Aldosterone A. ATP
B. NADH
Tripathi- Essentials of Medical C. IP3/DAG
Pharmacology, 7/E, Pg. 289 D. CAMP

37. The highest seat of regulating autonomic


function is located in Tripathi- Essentials of Medical
A. Hypothalmus Pharmacology, 7/E, pp. 125, 127
B. Medulla
C. Spinal cord 42. The β – action are mediated by which of the
D. Midbrain following
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PHARMACOLOGY 27
Autonomic Nervous System

A. Cyclic AMP and adenyl cyclase 46. Epinephrine is formed from norepinephrine
B. Monoamino- oxidase by
C. Adrnosine triphosphatase and NADH A. Acetylation
D. None of the above B. Methylation
C. Decarboxylation
Tripathi- Essentials of Medical D. Deamination
Pharmacology, 7/E, Pg. 127
Tripathi- Essentials of Medical
43. Which of the following regarding the Pharmacology, 7/E, Pg. 124
adrenergic actions mediated by receptors is
not true? 47. An excess of which of the following hormones
A. Stimulation of alpha receptors causes may be associated with increased sensitivity
vasoconstriction and increase in BP to epinerphrine
B. Mydriasis effect is mediated by beta A. Testosterone
receptors B. Parathyroid
C. Cardiac stimulation is mediated by B1 C. Insulin
receptors D. Thyroid
D. Bronchodilation is mediated by B2
receptors Tripathi- Essentials of Medical
Pharmacology, 7/E, pp. 248, 249

Tripathi- Essentials of Medical 48. In which of the following conditions


Pharmacology, 7/E, Pg. 132 increased response to adrenaline is found and
is contraindicated
44. The alpha and beta receptors have opposite A. Hyperthyroidism
action on the following tissues/organs except B. Addison’s diease
A. Contraction of arterioles and veins C. Hyperparathyroidism
B. Contraction of uterus D. None of the above
C. Contraction of intestinal muscles
D. Insulin secretion Tripathi- Essentials of Medical
Pharmacology, 7/E, pp. 248, 249
Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 130 49. Which of the following conditions is complete
contraindications to vasoconstrictors
45. All of the following are the actions of A. Thyrotoxicosis
adrenaline except B. Hypertension
A. Increase in Heart rate and Blood pressure C. MI
B. Increase in gastric motility and increased D. All of the above
contraction of muscles of GIT
C. Dilation of bronchial of uterus Tripathi- Essentials of Medical
D. Increased contraction of uterus Pharmacology, 7/E, pp. 248, 249

Tripathi- Essentials of Medical 50. Which of the following is a contraindication


Pharmacology, 7/E, pp. 130, 131, 132 to adrenergic drugs
A. Bronchial asthma and allergic disorders
B. Hypertension and angina pectoris
C. Parkinsonism and narcolepsy
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PHARMACOLOGY 28
Autonomic Nervous System

D. None of the above


Tripathi- Essentials of Medical
Tripathi- Essentials of Medical Pharmacology, 7/E, Pg. 131
Pharmacology, 7/E, pp. 248, 249
55. Which of the following is not a result of β –
51. Which of the following is not an action of adrenergic stimulation
epinephrine when administered A. Contraction of radial muscle of iris and
intravenously in a high dose? mydriasis
A. Increases liver glycogenolysis B. Cardial stimulation increase rate force and
B. Causes bronchiolar constriction conduction velocity
C. Evokes extrasystoles in the heart C. Bronchodilation and decreased tone of
D. Produces restlessness and anxiety intestinal musculature
D. Liver glycogenolysis leading to
Tripathi- Essentials of Medical hyperglycaemia
Pharmacology, 7/E, pp. 131, 132
Tripathi- Essentials of Medical
52. Vasoopressor action of adrenalina is mediated Pharmacology, 7/E, Pg. 130
by
A. Alpha – receptors 56. All of the following are the result of β2
B. Beta – receptors (a = alpha, b = beta) adrenergic stimulation except one which
C. Both A and B receptors results mainly by b1 adregenic stimulation.
D. None of the above The exception is
A. Increase in cardiac activity
Tripathi- Essentials of Medical B. Bronchial relaxation
Pharmacology, 7/E, pp. 127, 130 C. Liver glycogenolysis
D. Dilation of arteries and fall in BP
53. All of the following results from stimulation
of beta receptors except Tripathi- Essentials of Medical
A. Bronchodilation and intestinal relaxation Pharmacology, 7/E, Pg. 129
B. Tachycardia and vasodilation
C. Vasoconstriction and papillary dilation 57. Beta 2 agonist causes
D. Hyperglycaemia A. Mydriasis
B. Contraction of urinary spinctors
Tripathi- Essentials of Medical C. Vasoconstriction
Pharmacology, 7/E, pp. 127, 130 D. Bronchial muscle relaxation

54. When noradrenaline is given it ultimately Tripathi- Essentials of Medical


results in Pharmacology, 7/E, pp. 129, 131
A. Increased heart rate and decreased blood
pressure due to stimulation of β – 58. Beta 2 adrenetgic receptor stimulating drugs
receptors only are used in
B. Increased heart rate and increased blood A. Bronchial asthma
pressure due to stimulation of α – B. Cardiac asthma
receptors only C. Hypertension
C. Increase in blood pressure and reflex D. Angina pectoris
bradycardia due to vasovagal stimulation
D. None of the above
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PHARMACOLOGY 29
Autonomic Nervous System

Tripathi- Essentials of Medical 63. Which of the following drugs improve renal
Pharmacology, 7/E, Pg. 133 blood flow and BP in patients of shock and
59. The cardiac stimulatory actions of severe CHF (cardiogenic shock)
catecholamines is mainly mediated by A. Dopamine
A. β1 receptors B. Amphetamine
B. β2 receptors C. Ephedrine
C. α1 receptors D. Phenylephrine
D. α2 receptors
Tripathi- Essentials of Medical Pharmacology,
Tripathi- Essentials of Medical 7/E, pp. 137, 138
Pharmacology, 7/E, Pg. 129
64. Felypressin is a
60. The drug of choice in anaphylactic shock is A. Vasodilator
A. Acetylcholine B. Vasoconstrictor
B. Atropine C. Neuroleptic drug
C. Adrenaline D. Anticoagulant
D. Isopreternol
Tripathi- Essentials of Medical
Tripathi 6/e p 129 Tripathi- Essentials of Pharmacology, 7/E, Pg. 596
Medical Pharmacology, 7/E, Pg. 138
65. Which of the following drugs act by relasing
noradrenaline from the nerve terminals in
61. When an alpha blocking agent is given with CNS
the following drugs a vasomotor reversal of A. Dopamine
dale or fall in BP is noticed with B. Ephedrine
A. Adrenaline C. Phenylephrine
B. Acetylcholine D. Amphetamine
C. Nor adrenaline
D. All of the above Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 134
Tripathi 6/e p 129 Tripathi- Essentials of
Medical Pharmacology, 7/E, Pg. 140 66. Which of the following are therapeutic uses of
adrenergic drugs?
A. Hypotensive states as seen in shock
62. The vasopressin action of adrenaline is B. Control of local bleeding and to prolong
reversed by (or) Dale’s vasomotor reversal is duration of action of local anaesthetics
exhibited by adrenaline if following drug is C. Nasal decongestants and in relexation of
given before it bronchial muscles
A. Adregenic drugs like amphetamine D. All of the above
B. α blocking like phenoxylbenzamine and
phenotalmine Tripathi- Essentials of Medical
C. β blocking like propanolol Pharmacology, 7/E, pp. 137, 138, 139
D. β agonists like salbutamol
67. Which of the following adrenergic drugs has a
Tripathi 6/e p 129 Tripathi- Essentials of selective b2 agonist property and is a potent
Medical Pharmacology, 7/E, Pg. 140 bronchoditator
A. Salbutamol and orciprenaline
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PHARMACOLOGY 30
Autonomic Nervous System

B. Ephedrein and phenylepherine


C. Isoprenaline and pronalterol 72. In allergic patients epinephrine reverses the
D. Amphetamine and Ephedrine action of histamine by bronchodilation and
increasing blood pressure. This kind of
Tripathi- Essentials of Medical interaction between epinephrine and
Pharmacology, 7/E, Pg. 136 histamine is called
A. Physiological antagonism
68. The drug which is typically known for B. Compeititive antagonism
tachyphylaxis is C. Physiological agonist activity
A. Amphetamine D. Partial agonist activity
B. Isoproteronal
C. Ephedrine Tripathi- Essentials of Medical
D. Phenyl epherine Pharmacology, 7/E, Pg. 138

Tripathi- Essentials of Medical 73. Which of the following selectively blocks a1


Pharmacology, 7/E, Pg. 134 receptors?
A. Prazosin
69. Which of the following is a endogenous B. Metoprolol
catecholamine? C. Salbutomal
A. Noradrenaline D. Amphetamine
B. Ephedrine
C. Amphetamine Tripathi- Essentials of Medical
D. Isoproteronal Pharmacology, 7/E, Pg. 140

Tripathi- Essentials of Medical 74. Which of the following statements about


Pharmacology, 7/E, Pg. 124 tyramine is false?
A. It is a direct acting amine
70. Which of the following is not a direct acting B. Cheese is the richest source
sympathomimetic drug C. Can precipitate hypertensive crisis
A. Norepinerphrine D. None of the above
B. Phenylepinephrine
C. Salbutamol Tripathi- Essentials of Medical
D. Tyramine Pharmacology, 7/E, Pg. 129

Tripathi- Essentials of Medical 75. Which of the following is not a selective b2


Pharmacology, 7/E, Pg. 129 agonist
A. Salbutamal
71. Which of the following catecholmines have B. Terbutaline
potent bronchodilation property? C. Orciprenaline
A. Nor adrenaline and adrenaline D. Methoxamine
(Isoproterenol)
B. Noradrenaline and Isoprenaline Tripathi- Essentials of Medical
C. Isopernaline and dopamine Pharmacology, 7/E, Pg. 136
D. Adrenaline and Isoproteronol

Tripathi- Essentials of Medical


Pharmacology, 7/E, Pg. 131
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PHARMACOLOGY 31
Autonomic Nervous System

76. Which of the following causes rise in systolic A. Treatment of hypertension and
as well as diastolic blood pressure for Hyperthyroidism
prolonged period B. Myocardial infaraction and angina pectoris
A. Epinephrine C. Migraine and glaucoma
B. Epihedrine D. All of the above
C. Nor epinephrine
D. Dopamine Tripathi- Essentials of Medical
Pharmacology, 7/E, pp. 149, 150, 151
Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 131 81. The antihypertensive effects of beta blockers
is due to
77. Which of the following drugs are the A. Decrease in cardiac output
mainstay in severe bronchial asthma B. Decreased angiotension II
A. Locally acting steroids C. Antitension effect
B. Theophylline D. All of the above
C. Locally acting β2 agonists
D. Oral steroids Tripathi- Essentials of Medical
Pharmacology, 7/E, pp. 145, 149, 563, 564
Tripathi- Essentials of Medical
Pharmacology, 7/E, pp. 136, 138, 222, 229 82. Beta blocker without local anaesthetic effect is
A. Metoprolol
78. Which of the following group of drugs are B. Pindolol
used in the treatment of glaucoma C. Atenolol
A. Beta blockers such as timolol ad betaxolol D. Timolol
and alpha agonists like phenylepinephrine
B. Cholinergic agonists like carbochol Tripathi- Essentials of Medical
pilocarpaine and anticholinesterases like Pharmacology, 7/E, Pg. 153
physostigmine
C. Diuretics like acetazolamide
D. All of the above 83. Which of the following is a contraindication
to adrenaline
Tripathi- Essentials of Medical A. Halothane
Pharmacology, 7/E, pp. 151- 157 B. b- Blockers
C. Both of the above
D. None of the above
79. In which of the following patients beta
blockers are contraindicated Tripathi- Essentials of Medical
A. Asthamatic patients Pharmacology, 7/E, Pg. 133
B. Hyperthyroid patients
C. Hypertensive patients 84. Which of the following b blockers has
D. Migraine patients selective b1 – blocking effect (or) the b-
blockers which is cardioselective
Tripathi- Essentials of Medical Pharmacology, A. Metoprolol and atenolol
7/E, Pg. 147 B. Proponolol and timolol
C. Pindolol and acebutolol
80. In which of the following patients beta D. All of the above
Blockers are given for therapeutic effects
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PHARMACOLOGY 32
Autonomic Nervous System

Tripathi- Essentials of Medical B. Tachycardia and arythmias


Pharmacology, 7/E, pp. 144, 148, 149 C. Anginacpetoris and myocardial infarction
D. Bronchial asthma

85. Which of the following b-blockers are said to Tripathi- Essentials of Medical
have intrinsic sympathomimetic activity Pharmacology, 7/E, pp. 146, 147
A. Metoprolol and atenolol
B. Proponolol and timolol 90. The direct cholinergic agonists or
C. Pindolol and acebutolol cholinomimetic drugs exhibit their action by
D. La betalol and timolol A. Mimic the effects of acetylcholine by
directly binding to choline receptors
Tripathi- Essentials of Medical Pharmacology, B. Binding to acetylcholinesterase and
7/E, Pg. 144 thereby reversibly inhibiting the
hydrolysis of acetylcholine
86. The beta blocker which is having alpha C. By stimulating the release of actylcholine
blocking effect from nerve endings
A. Labetolol D. None of the above
B. Timolol
C. Atenolol Tripathi- Essentials of Medical Pharmacology,
D. Metoprolol 7/E, Pg. 102

Tripathi- Essentials of Medical Pharmacology, 91. Which of the following is not a direct acting
7/E, Pg. 144 cholinergic drug
A. Pilocarpaine
87. Propanolol is contraindicated in B. Edrophonium
A. CHF, heart blocks, and peripheral vascular C. Methanchol
diseases D. Bethenacol
B. Bradycardia, chronic obstructive lung
diseases Tripathi- Essentials of Medical Pharmacology,
C. Hypoglycaemia due to insulin therapy 7/E, Pg. 105
D. All of the above

Tripathi- Essentials of Medical 92. Which of the following is a irreversible


Pharmacology, 7/E, pp. 146, 147 anticholinesterase
A. Praldoxime
88. B – blockers are used in all except: B. Neostigmine
A. Phenochyromocytoma C. Edrophonium
B. Migraine D. Organophosphates like parathion and
C. Thyrotoxicosis malathion
D. Secondary shock
Tripathi- Essentials of Medical Pharmacology,
Tripathi- Essentials of Medical Pharmacology, 7/E, Pg. 105
7/E, pp. 149, 150, 151

89. Beta blockers are not indicated in 93. Which of the following reactivates
A. Mild hypertension, pheochromocytoma cholinesterase
and hypertension A. Pralidoxime
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PHARMACOLOGY 33
Autonomic Nervous System

B. Neostigmine C. Acetylcholine from choline is facilitated by


C. Physostigmine the enzyme choline acetylase
D. Isoflurophate D. All of the above

Tripathi- Essentials of Medical Pharmacology, Tripathi- Essentials of Medical


7/E, Pg. 111 Pharmacology, 7/E, pp. 100, 101, 102

94. Which of the following anticholinesterases 98. Which of the following actions of
has more prominent effect on motor end plate acetylcholine is mediated largely by nicotinic
of skeletal muscle receptors
A. Neostigmine A. Bradycardia
B. Physostigmine B. Smooth muscle contraction
C. Pyradostigmine C. Increased secretions
D. Edrophonium D. Twitching and fasiculations

Tripathi- Essentials of Medical Pharmacology, Tripathi- Essentials of Medical Pharmacology,


7/E, Pg. 107 7/E, Pg. 103

95. Which of the following sites acetylcholine 99. Which of the following is not a function of
exhibits its action through muscarinic acetylcholine given in therapeutic doses
receptors A. Increased secretions like increased
A. Parasympathetic and sympathetic ganglia sweating, salivation, lacrimations,
B. Adrenal medulla salivation and increased gastric secretions
C. All post ganglionic or neuroeffector B. Constriction of smooth muscles and
junction of parasympathetic nervous precipitation of asthma due to bronchio-
system constriciton
D. Neuromuscular junction of skeletal muscle C. Peripheral vasoconstriction and increase
in blood pressure
Tripathi- Essentials of Medical Pharmacology, D. Decreased heart rate and decreased force
7/E, Pg. 100 of contraction

96. The muscuranic receptors can be selectively Tripathi- Essentials of Medical Pharmacology,
blocked by 7/E, Pg. 103
A. Atropine
B. Scopolamine 100. Organophosphate blocks the action of which
C. Curare of the following enzymes
D. Hexamethonium A. Acetylcholinesterase
B. Mono amino – oxidase
Tripathi- Essentials of Medical C. Adenylcyase
Pharmacology, 7/E, pp. 113, 114 D. All of the above

97. Which of the following statements is true


A. Cholinergic receptors closely related in Tripathi- Essentials of Medical Pharmacology,
structure to acteylcholinesterase 7/E, Pg. 105
B. Acetylcholine is a major neurohormonal
transmitter at autonomic as well as somatic
sites
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PHARMACOLOGY 34
Autonomic Nervous System

101. All of the following results in cholinergic


crises except (or) which of the following do Tripathi- Essentials of Medical
not potentiate the action of acetylcholine Pharmacology, 7/E, pp. 104, 142, 471
A. Physostigmine and neostigmine
B. Carbachol and bethenecol 106. All of the following may result in mydriasis
C. Scopolamine secretions except
D. Myasthenic crisis A. Atropine and scopolamine
B. Ephedrine and phenylephrine
Tripathi- Essentials of Medical C. Phenoxybenzamine and dibenamine
Pharmacology, 7/E, pp. 109, 113 D. Ephedrine and Amphetamine

102. Scopolamine helps in Tripathi- Essentials of Medical Pharmacology,


A. Motion sickness 7/E, pp. 127, 129, 132
B. Hypertension
C. Decreased secretions 107. Which of the following produces mydriasis
D. A and C without cycloplegia
A. Ephedrine
Tripathi- Essentials of Medical Pharmacology, B. Atropine
7/E, Pg. 120 C. Pilocarpine
D. Isoproterenol
103. Which of the following are specific antidotes
for anticholinesterase poisoning Tripathi- Essentials of Medical Pharmacology,
A. Atropine 7/E, pp. 134, 135
B. Pralidoxime
C. Both of the above 108. Given below is the pair of drugs which have
D. None of the above opposite action on smooth muscles of GIT but
except one pair which has similar actions
Tripathi- Essentials of Medical Pharmacology, exception is
7/E, Pg. 111 A. Atropine and carbachol
B. Epinerphrine and morphine
104. Which of the following anticholine sterases is C. Pilocarpine
mainly used in the treatment of myasthenia D. Isoproterenol
gravis
A. Physotigmine 109. Which of the following increases muscle tone
B. Neostigmine and contractability of the muscles of GIT
C. Pyridostigmine A. Carbachol
D. Edrophonium B. Atropine
C. Scopolamine
Tripathi- Essentials of Medical Pharmacology, D. Papaverine
7/E, Pg. 109
Tripathi- Essentials of Medical Pharmacology,
105. Which of the following causes miosis of the 7/E, pp. 100, 102, 104
eye
A. Morphine 110. Which of the following cholinergic agonists
B. Pilocarpaine are correctly matched with its
C. Prazosin pharmacological action
D. All of the above
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PHARMACOLOGY 35
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A. Bethenacol used to stimulate atonic Tripathi- Essentials of Medical Pharmacology, 7/E,


bladder particularly in post partum Pg. 120
urinary retention
B. Carbachol releases epinephrine from the 114. The intramuscular administration of 0.6 mg of
adrenal medulla by its nicotinic action atropine sulphate to a 50 kg adult may
C. Pilocarpaine useful in lowering of intra – produce all of the following effects except
ocular pressure in narrow angle and wide A. Bradycardia
angle alucoma B. Decreased salivation
D. All of the above C. Decreased sweating
D. Mydriasis

Tripathi- Essentials of Medical Pharmacology, Tripathi- Essentials of Medical


7/E, Pg. 104 Pharmacology, 7/E, Pg. 120

111. Atropine the prototype of anticholinergic 115. The side effects resulting from scopolamine
exhibits its action by overdosage such as confusion, Hallucinations
A. Competitive antagonism with and other CNS actions are best treated by
acetylcholine for receptor sites in particular A. Physostigmine
with muscaranic receptors B. Neostigmine
B. Inhibiting the release of cholinesterase and C. Levodopa
preventing the degradation of D. Methacholine
acetylcholine
C. By interfering with the uptake of choline Tripathi- Essentials of Medical
by axonal membrane during synthesis of Pharmacology, 7/E, Pg. 110, 111
acetylcholine
D. Blocking all types of muscarinc receptors 116. In which of the following patients Atropine is
strongly contraindicated
Tripathi- Essentials of Medical Pharmacology, A. Acute narrow angle glaucoma
7/E, Pg. 113 B. Peptic ulcers
C. Bronchial asthma
112. Atropine results in tachycardia due to D. Drug induced diarrohea
A. Vagolytic activity
B. Stimulation of β- receptors Tripathi- Essentials of Medical
C. Stimulation of α-receptors Pharmacology, 7/E, Pg. 121
D. Stimulation of cholinergic receptors

Tripathi- Essentials of Medical Pharmacology, 117. Which of the following drugs is preferred in
7/E, Pg. 114 motion sickness
A. Hyoscine
113. Bradycardia is most commonly treated with B. Atropine
which of the following drugs C. Propantheline
A. Epinephrine D. Pirenzepine
B. Atropine
C. A diuretic Tripathi- Essentials of Medical
D. A potent vasodilator Pharmacology, 7/E, Pg. 120

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PHARMACOLOGY 36
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118. Which of the following are ganglion blocking C. Pirenzepine


agents in therapeutic doses D. Probantheline
A. Hexamethonium and mecamylamine
B. Atropine and scopolamine Tripathi- Essentials of Medical
C. Carbachol and methenachol Pharmacology, 7/E, Pg. 120
D. Neostigmine and physostigmine
123. Which of the following drugs are
Tripathi- Essentials of Medical Pharmacology, 7/E, contraindicated in patient with glaucoma
pp. 122, 123 A. Anticholinergic
B. Adrenergic
C. Cholinergic
119. The most common side effect of ganglionic D. Opiates
blocking drugs are
A. Orthostatic hypotension Tripathi- Essentials of Medical
B. Precipitation of peptic ulcer Pharmacology, 7/E, Pg. 121
C. Bradycardia
D. Increased salivation 124. Which of the following are given in the
treatment of glaucoma
Tripathi- Essentials of Medical A. Anticholinestirases
Pharmacology, 7/E, Pg. 123 B. Cholinomimetics
C. b- adrenergic blockers and a- adrenergic
120. The drugs which has potent anti-secretory agonists
action and given to dry secretions of mouth is D. All of the above
A. Pilocarpaine and muscuraine
B. Propantheline ad methentheline Tripathi- Essentials of Medical Pharmacology,
C. Phenylephrine and ephedrine 7/E, pp. 104, 108, 151 153, 154
D. Carbachol and bethnachol
125. All of the following results in dry mouth
Tripathi- Essentials of Medical except
Pharmacology, 7/E, pp. 113, 117 A. Anticholinergics
B. Ganglion blocking agents
C. Adrenergic agonists
121. All of the following drugs result in D. Antihistamines
bronchodilation except Tripathi 6/e p 113, 157, 122,
A. Anticholinergics
B. b2 – Sympathemimetics Tripathi- Essentials of Medical Pharmacology,
C. Anticholinestereases 7/E, pp. 20/e 118, 123 , 165
D. None of the above
126. Which of the following effectively reduces
Tripathi- Essentials of Medical gastric acid secretion
Pharmacology, 7/E, pp. 105, 107 A. H1 histamine receptor antagonists
B. H2 histamine receptor antagonists
C. Anticholinergics
122. The anticholinergic drug most commonly D. NSAIDs drugs
used in the treatment of motion sickness is
A. Atropine Tripathi- Essentials of Medical Pharmacology,
B. Hyoscine 7/E, Pg. 649
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PHARMACOLOGY 37
Autonomic Nervous System

127. Which of the following effectively induces 131. Which of the following is not a side effect of
salivation and may be used for treatment of ganglion blocking drugs
xerostomia? A. Bradycardia and hypotension
A. Adrenergic agonists like ephedrine B. Mydrasiase, cycloplegia (blurring of
B. Cholinergic drugs like pilocarpaine and vision)
neostigmine C. Increased salivation, sweating and
C. Ganglion blocking drugs like urination
hexamethonium D. Constipation and impotency
D. Adrenergic blocking drugs like prazosin
and mecamylamine Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 123
Tripathi- Essentials of Medical
Pharmacology, 7/E, pp. 103, 104
132. Which of the following conditions is complete
128. Pilocarpine contraindication to vasoconstrictors
A. Lowers the intraocular pressure in A. Thyrotoxicosis
glaumoa B. Hypertension
B. Cleaved by acetylcholinesterase C. MI
C. Inhibits sweat and lacrimation D. All of the above
D. Causes tachycardia
Tripathi- Essentials of Medical
Tripathi- Essentials of Medical Pharmacology, 7/E, Pg. 133
Pharmacology, 7/E, Pg. 104
133. Which of the following is a vasoconstrictor?
A. Bupivacaine
129. All of the following have CNS stimulation B. Procaine
except one. The exception is C. Lidocaine
A. Atropine D. Phenylephrine
B. Scopolamine or hyoseine
C. Ephedrine Tripathi- Essentials of Medical
D. Amphetamine Pharmacology, 7/E, Pg. 135

Tripathi- Essentials of Medical 134. Which of the following have weakest alfa
Pharmacology, 7/E, Pg. 113 action
A. Adrenaline
130. Which of the following drugs most closely B. Noradrenaline
resembles atropine in its actions C. Isoprenaline
A. Scopolamine D. Dopamine
B. Physostigmine
C. Carbachol Tripathi- Essentials of Medical
D. Pilocarpaine Pharmacology, 7/E, pp. 130, 131

135. Metabolic effects of adrenaline is/ are


Tripathi- Essentials of Medical A. Glycogenolysis
Pharmacology, 7/E, Pg. 113 B. Hyperlactacidemia
C. Lipolysis
D. All of the above
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PHARMACOLOGY 38
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Tripathi- Essentials of Medical C. Terbutaline


Pharmacology, 7/E, pp. 130, 131, 132 D. Salmeterol

136. Contraindication to adrenalin is/are


A. Hyperthyroid patient 141. Which of the following has selective α2
B. Hypotensive patient agonistic action?
C. Asthmatic patient A. Phenylephrine
D. All of the above B. Methoxamine
C. Clonidine
Tripathi- Essentials of Medical D. Yohimbine
Pharmacology, 7/E, Pg. 133
Tripathi- Essentials of Medical
137. Which of the following is wrong regarding Pharmacology, 7/E, Pg. 136
dopamine?
A. It has D1 and D2 agonist action
B. It has α1 agonist action 142. Which of the following has selective β1
C. It has β1 agonist action agonistic action?
D. It has β2 agonist action A. Salbutamol
B. Dobutamine

Tripathi- Essentials of Medical C. Metoprolol


Pharmacology, 7/E, Pg. 134 D. Butoxamine

138. Which of the following sympathomimetics is Tripathi- Essentials of Medical


effective orally? Pharmacology, 7/E, Pg. 134

A. Ephedrine
B. Dopamine
C. Adrenaline 143. Which of the following drugs is an adrenergic

D. Isoproterenol neuron blocking agent?


A. Phentolamine
Tripathi- Essentials of Medical B. Dobuwolscine

Pharmacology, 7/E, Pg. 134 C. Metoprolol


D. Butoxamine
139. Which of the following sympathomimetics
is/are drug(s) of choice for threatened abortion 144. Which of the followings is non- equilibrium
and dysmenorrhae? type a adrenergic blocking agent?
A. Isoxsuprine A. Ergotamine

B. Salbutamol B. Phenoxybenzamine
C. Terburaline C. Phentolamine

D. All of the above D. Chlorpromazine

Tripathi- Essentials of Medical Tripathi- Essentials of Medical

Pharmacology, 7/E, pp. 134, 136 Pharmacology, 7/E, Pg. 140

145. Which of the following is not effect produced

140. Which of the following has weakest β2 action? by antiadrenergic drugs?


A. Orciprenaline A. Diarrhoea
B. Salbutamol B. Postural hypotension

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PHARMACOLOGY 39
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C. Ejaculation C. No change in coronary flow to the sub-


D. Nasal stuffiness epicardial region
D. Increased flow to sub-endocardial region
Tripathi- Essentials of Medical
Pharmacology, 7/E, pp. 140, 141 Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 145
146. Which of the following is/are cause(s) for
giving phenoxybenzamine, 1 -2 weeks pre- 150. Anthihypertensive action of propranolol
operatively, in phaeochromocytoma? is/are due to the
A. It normalizes blood volume and A. Initial increase then adapted decrease in
distribution of body water total peripheral resistance
B. It controls the rise in BP during surgery B. Reduced NA (noradrenaline) release from
due to outpouring of catecholamines in sympathetic terminals
blood C. Decreased rennin release from kidney
C. Both A and B D. All of the above
D. It causes vasoconstriction, which helps in
maintaining BP Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 145
Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 141 151. Contraindication(s) to β – adrenergic blockers
is/are
147. Which of the following is selective β2 – A. Asthma
adrenergic blocking agent? B. Variant angina
A. Labetalol C. Diabetes
B. Butoxamine D. All of the above
C. Betaxolol
D. Bisoprolol Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 147
Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 144 152. Which of the following drugs is/are
contraindicated in glaucoma?
148. Which of the following is non-selective β – A. Atropine
adrenergic blocking agent with intrinsic B. Pethidine
sympathomimetic activity C. Diazepam
A. Alprenolol D. All of the above
B. Propranolol
C. Metoprolol Tripathi- Essentials of Medical
D. Carevedilol Pharmacology, 7/E, pp. 121, 405, 475

Tripathi- Essentials of Medical


Pharmacology, 7/E, Pg. 144 153. Which of the following is wrong about
labetalol?
149. Effect of propranolol on coronary flow is A. It is non – selective β blocker
A. Reduced coronary flow to the B. It is selective α1 blocker
subepicardial region of heart C. It has weak β1 but no β2 agonistic activity
B. Increased coronary flow to the D. It is 5 times more potent in blocking β than
subepicardial region of heart α receptors
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PHARMACOLOGY 40
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Tripathi- Essentials of Medical Pharmacology, A. Noradrenaline


7/E, Pg. 151 B. Adrenaline
C. Isoprenaline
154. Which of the following is/are advantage(s) of D. Dopamine
cardioselective β blockers over non – selective
β blockers Tripathi- Essentials of Medical
A. They are safe in asthmatics and diabetics Pharmacology, 7/E, Pg. 127
B. They are safe in myocardial insufficiency
C. Both A and B 159. β3 adrenergic receptors are present at which of
D. There is no bradycardia with cardio – the following locations?
selective drug A. Heart
B. Blood vessels
Tripathi- Essentials of Medical C. Adipose tissue
Pharmacology, 7/E, Pg. 147 D. Bronchi

155. Drug of choice for peripheral vascular disease Tripathi- Essentials of Medical
is/ are Pharmacology, 7/E, Pg. 127
A. Prazosin
B. Propranolol
C. Timolol 160. Which of the following drugs has
D. Both B and C cholinomimetic as well antidopaminergic
action

Tripathi- Essentials of Medical A. Metoclopramide


Pharmacology, 7/E, Pg. 144 B. Physostigmine
C. Pilocarpine
D. Carbachol
156. Vasomotor reversal of Dale is are
A. Fall in BP with adrenaline and α blocker Tripathi- Essentials of Medical
B. Rise in BP with adrenaline and β blocker Pharmacology, 7/E, pp. 665, 686, 934
C. Bothof the above EXP: B, C, D, are only cholinomimetics

D. None of the above


161. Which of the following is a reversible
Tripathi- Essentials of Medical anti cholinesterase?

Pharmacology, 7/E, Pg. 134 A. Demecarium


B. Diflos
157. α action of adrenergic drug on the urinary C. Parathion

bladder is D. Malathion
A. Detrusor – relaxation Ref: Satoskar, 20/E, p. 281

B. Trigone – contraction
C. Detrusor – contraction 162. Which of the following reversible
D. Trigone – relaxation anticholinesterases has the shortest
duration of action
Tripathi- Essentials of Medical A. Ambenonium
Pharmacology, 7/E, Pg. 140 B. Edrophonium
C. Neostigmine
158. Which of the following has strongest α (alfa) D. Physostigmine
action?
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PHARMACOLOGY 41
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Tripathi- Essentials of Medical Tripathi- Essentials of Medical


Pharmacology, 7/E, Pg. 108 Pharmacology, 7/E, Pg. 115

167. Which of the following sympathomimetic


163. Which of the statements of NOT drugs is NOT a catecholamine
CORRECT for pralidoxime? A. Adrenaline
A. It relieves the muscarinic as well as B. Nor adrenaline
nicotinic effects of organophosphorus C. Dopamine
poisioning D. mephentaramine
B. It crosses blood brain water
C. When administered 48 hours after Tripathi- Essentials of Medical
poisioning it may be ineffective Pharmacology, 7/E, Pg. 136
D. It is a cholinesterase reactivator.
168. which of the following
Tripathi- Essentials of Medical sympathomimetics is administered in
Pharmacology, 7/E, Pg. 111 combination with local anaesthetics to
prolong local anaesthetic effect
164. Which of the following anticholinergic A. adrenaline
drugs is used for prevention of motion B. isoprenaline
sickness C. methoxamine
A. Hyoscine hydrobromide D. phenylephrine
B. Homatropine
C. Oxyphenonium Tripathi- Essentials of Medical
D. Propantheline Pharmacology, 7/E, Pg. 138

Tripathi- Essentials of Medical 169. Which of the following


Pharmacology, 7/E, Pg. 120 sympathomimetics is used by topical
administration as a nasal decongestant as
165. When used as a mydriatic atropine has well as mydriatic
the followings action on the eyes except A. Adrenaline
A. It blocks muscarinic receptors of circular B. Phenylephrine
muscle of iris C. Metaraminol
B. It cause ciliary muscle paralysis D. Mephentramine
C. There is no loss of light reflex
D. Causes loss of accommodation Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 135
Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 114 170. Which of the following statements is
NOT CORRECT for dopamine
166. Which of the following secretions is not A. Administered only by parental route
inhibited by ATROPINE B. Does not cross the blood brain barrier
A. Lacrimal C. Has a long plasma half-life
B. Salivary D. Destroyed by both MAO and COMT
C. Pancreatic
D. Bronchial Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 134

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PHARMACOLOGY 42
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171. Which of the following beta stimulant C. Has no effect on renin-angiotension


drug is used primarily a uternine system
relaxant. D. Has unfavourable effect on plasma lipid
A. Ritrodrine profile
B. Salmeterol
C. Terbutaline Tripathi- Essentials of Medical
D. Isoprenaline Pharmacology, 7/E, pp. 145, 146

Tripathi- Essentials of Medical 176. Which of the following cardioselective


Pharmacology, 7/E, pp. 134, 136 betablockers has ultra short half-life
A. Esmolol
B. Atenolol
172. Which of the following sympathomimetic C. Metoprolol
drug group is used for its central effects, D. Celiprolol
A. Dopamine
B. Amphetamine Tripathi- Essentials of Medical
C. Mephentaramine Pharmacology, 7/E, Pg. 149
D. Oxymetazoline
177. Which of the following agonists is not an
Tripathi- Essentials of Medical alkaloid?
Pharmacology, 7/E, pp. 134, 135 A. Pilocarpine
B. Muscarine
173. Which of the following drugs is a C. Methacholine
selective alpha -1 blocker? D. Arecholine
A. Phenotolamine
B. Prazosin Tripathi- Essentials of Medical
C. Tolazoline Pharmacology, 7/E, Pg. 102
D. Phenoxybenzamine
178. Which of the following reversible
Tripathi- Essentials of Medical anticholinesterase is used in treatment of
Pharmacology, 7/E, Pg. 140 Glaucoma
A. Neostigmine
174. Which of the following Beta blockers has B. Physostigmine
an intrinsic sympathomimetic action C. Edrophonium
A. Nadolol D. Pyridostigmine
B. Pindolol
C. Esmoidol Tripathi- Essentials of Medical
D. Sotalol Pharmacology, 7/E, Pg. 107

Tripathi- Essentials of Medical 179. Which of the following is used in


Pharmacology, 7/E, Pg. 144 diagnosis of myasthenia gravis
A. Ambenonium
175. Which of the following statements is B. Edrophonium
NOT CORRECT for Propranolol? C. Demecarium
A. Leads to the increased airway resistance D. Prostigmine
B. Crosses the blood brain barrier

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PHARMACOLOGY 43
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Tripathi- Essentials of Medical agonist action with no affinity for alpha


Pharmacology, 7/E, Pg. 108 receptors
A. Dopamine
B. Isoprenaline
180. Pralidoxime is NOT used in the treatment C. Amphetamine
of poisioning caused by which of the D. Mephenteramine
following insectidies.
A. Propoxur Tripathi- Essentials of Medical
B. Parathion Pharmacology, 7/E, pp. 105, 130
C. Malathion
D. Diazinon 185. Which of the following sympathomimetic
drugs causes dilatation of renal blood
Tripathi- Essentials of Medical vessels by acting at specific receptors
Pharmacology, 7/E, pp. 105, 111 A. Dobutamine
B. Dopamine
181. Which of the following atropine C. Nor-epinephrine
substitute is used as mydriatic agent D. Mephenteramine
A. Hyoscine methyl bromide
B. Eucatropine Tripathi- Essentials of Medical
C. Atropine methonitrate Pharmacology, 7/E, pp. 105, 134
D. Benztropine.
Ref: Satoskar, 20/E, p. 1023 186. Adrenaline is used for following
emergency conditions except
182. Atropine sulphate is used as lifesaving A. Acute attack of Bronchial asthma
drug for the following poisioning except B. Anaphylactic shock
A. Mushroom poisoning C. Hypovolaemic shock
B. Poisoning with carbamate insecticides D. Sudden cardiac arrest
C. Poisoning of organophosphorous
compounds Tripathi- Essentials of Medical
D. Curare poisioning. Pharmacology, 7/E, pp. 137, 138

Tripathi- Essentials of Medical 187. Which of the following is a selective


Pharmacology, 7/E, pp. 111, 120 alpha 1 receptor agonist used as a
mydriatic
183. Which of the following betablockers has A. Phenylephrine
cardioselectively blocking action B. Dopamine
A. Propranolol C. Adrenaline
B. Pindolol D. Clonidine
C. Metoprolol
D. Timolol Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 135
Tripathi- Essentials of Medical
Pharmacology, 7/E, pp. 105, 144 188. Adrenaline is a lifesaving drugs in
treatment of anaphylactic shock as it
184. Which of the following sympathomimetic A. Produces physiological effects opposite to
drugs has non-selective beta receptor the of histamine
B. Produces prolonged rise in blood pressure
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PHARMACOLOGY 44
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C. Has a specific effect on antigen antibody C. Ephedrine


reaction D. Amphetamine
D. Improves renal blood flow.
Tripathi- Essentials of Medical
Tripathi- Essentials of Medical Pharmacology, 7/E, pp. 129, 559
Pharmacology, 7/E, Pg. 138
193. Syncopal attack after the administration
189. For treatment of cardiogenic shock with of first dose (first dose phenomenon) is
comprised renal function which is the observed with which of the following
drug choice EXCEPT
A. Dopamine A. Phentolamine
B. Dobutamine B. Prazosin
C. Nor-adrenaline C. Ergotamine
D. Ephedrine D. Phenoxybenzamine

Tripathi- Essentials of Medical Tripathi- Essentials of Medical


Pharmacology, 7/E, Pg. 134 Pharmacology, 7/E, pp. 142, 564
A, B, D -> α blocker which cause first
190. Which of the following sympathomimetic dose phenomenon
drug crosses blood brain barrier and has
marked central effects 194. Which of the adrenergic blocking drugs is
A. Amphetamine known to cause irreversible blocking
B. Isoprenaline action
C. Dobutamine A. Phenoxybenzamine
D. Noradenaline B. Phentolamine
C. Dihyrdoergotamine
Tripathi- Essentials of Medical D. Terazosin
Pharmacology, 7/E, pp. 134, 135
Tripathi- Essentials of Medical
191. Phenylephrine when used as nasal Pharmacology, 7/E, pp. 140, 141
decongesetant has following advantages
except 195. Propranolol has following effects on
A. Effective by topical application myocardium except
B. Effective in nasal allergy A. Bradycardia
C. Does not cause rebound local B. Decreases in cardiac contractility
hyperaemia C. Increase in oxygen consumption
D. Onset of action is quick D. Decrease in automatically

Tripathi- Essentials of Medical Tripathi- Essentials of Medical


Pharmacology, 7/E, pp. 135 Pharmacology, 7/E, Pg. 146

196. Which of the following is mechanism of


192. Which of the following adrenergic action of TIMOLOL in treatment of wide
agonists acts by inhibition of central angle glaucoma
sympathetic outflow A. Decreases production of aqueous humour
A. Clonidine B. Causes miosis
B. Dopamine C. Acts on ciliary muscle
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PHARMACOLOGY 45
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D. Increases drainage of aqueous humour 201. Beta blockers have following effects on
myocardium except
Tripathi- Essentials of Medical A. Tachycardia
Pharmacology, 7/E, Pg. 153 B. Decrease in contractility
C. Decreases in oxygen consumption
197. Atenolol has following action EXCEPT D. Decrease in automatically
A. It is a potent cardioselective beta blocker
B. It is effective as a single daily dose Tripathi- Essentials of Medical
C. It is given orally Pharmacology, 7/E, Pg. 145
D. In therapeutic doses it has central actions

Tripathi- Essentials of Medical 202. Which of the following beta blockers has
Pharmacology, 7/E, Pg. 149 membrane stabilizing action
A. Propranolol
198. Which of the following drugs has both B. Atenolol
beta blocking and sympathomimetic C. Metoprolol
activity? D. Pindolol
A. Metoprolol
B. Propranolol Tripathi- Essentials of Medical
C. Pindolol Pharmacology, 7/E, Pg. 148
D. Timolol
203. Which of the following betablockers
Tripathi- Essentials of Medical DOES NOT HAVE combination of
Pharmacology, 7/E, Pg. 144 membrane stabilizing action and partial
beta agonist action
199. Which of the following drugs has both α1 A. Oxprenoilol
and β blocking action? B. Alprenolol
A. Prazosin C. Sotalol
B. Labetalol D. Acebutalol
C. Esmolol
D. Acebutolol Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 148
Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 144
204. Which of the following is a nicotinic
200. Tachyphylaxis can be demonstrated with action of acetylcholine
which of the following adrenergic A. Stimulation of adrenal medulla
agonists B. Depression of SA node
A. Adrenaline C. Smooth muscle relaxation
B. Nor-adrenaline D. Salivary secretion stimulation
C. Ephedrine
D. Phenylephrine Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 103
Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 134

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PHARMACOLOGY 46
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205. Which of the following betablockers D. Naphazoline


should be contraindicated in asthmatic
patients with hypertension Tripathi- Essentials of Medical
A. Metoprolol Pharmacology, 7/E, Pg. 137
B. Propranolol Used oral, but can cause weight loss,
C. Atenolol haemorrhagic stroke, hence banned
D. Acebutolol
210. Which of the following statements
Tripathi- Essentials of Medical regarding diacetyl Monoxime is
Pharmacology, 7/E, pp. 145, 147 INCORRECT?
A. Crosses blood brain barrier easily
206. Following are the adverse effects of B. Reactivates cholinesterase
cholinergic drugs except C. Useful in carbamate anticholinesterase
A. Flushing polishing
B. Sweating D. Action similar to that of pralidoxime
C. Salivation
D. Tachycardia. Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 111
Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 103 211. Which of the following adverse effects
NOT produced by d-tubocurarine
207. Following cholinergic agonists act at A. CNS depression
Nicotinic receptors EXCEPT B. Bronchoconstriction
A. Acetylcholine C. Hypotension
B. Carbachol D. Tachycardia
C. Pilocarpine
D. Nicotine Tripathi- Essentials of Medical
Pharmacology, 7/E, pp. 350, 351, 352
Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 104 212. Which of the following muscle relaxant is
a neuro muscular blocking agent
208. Scopolamine produces following effect A. Atracurium
except B. Methocarbamol
A. Increase in memory C. Mephenesin
B. Reduced bronchial secretions D. Diazepam
C. Urinary retention
D. Cycloplegia Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 353
Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 116 213. Which of the following has only
muscarinic action?
A. Acetylcholine
209. Which of the following is NOT USED B. Methacholine
topically as nasal decongestant C. Bethanechol
A. Xylometazoline D. Carbachol
B. Oxymetazoline
C. Phenylpropanolamine
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PHARMACOLOGY 47
Autonomic Nervous System

Tripathi- Essentials of Medical Tripathi- Essentials of Medical


Pharmacology, 7/E, Pg. 104 Pharmacology, 7/E, Pg. 111

214. Which of the following reversible


anticholinesterases is lipid soluble and 218. Which of the atropine substitutes can be
crosses the blood brain barrier useful in treatment of bronchial asthma?
A. Neostigmine A. Tropicamide
B. Physostigmine B. Ipratropium bromide
C. Pyridostigmine C. Adiphenine
D. Edrophonium D. Propantheline

Tripathi- Essentials of Medical Tripathi- Essentials of Medical


Pharmacology, 7/E, pp. 105, 107 Pharmacology, 7/E, Pg. 116

215. Irreversible anticholinesterase DFP can


therapeutically be used for actions on 219. Homatropine methyl bromide is
which system preferred over atropine as a mydriatric
A. Neuromuscular because?
B. Eye A. Rapid onset and short duration of action
C. Central effects B. Rapid onset and prolonged duration of
D. Exocrine glands action
C. Does not cause cycloplegia
Tripathi- Essentials of Medical D. Longer duration of action
Pharmacology, 7/E, Pg. 108
Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 118
216. Which of the following atropine
substitutes is used for spasmolytic action 220. For treatment of motion sickness which
on gastrointestinal tract. of the anticholinergic drugs is used
A. Cyclopentolate A. Pirenzepine
B. Oxyphenonium B. Hyoscine hydrobromide
C. Benztropine C. Procyclidine
D. Procyclidine D. Atropine methonitrate

Tripathi- Essentials of Medical Tripathi- Essentials of Medical


Pharmacology, 7/E, Pg. 117 Pharmacology, 7/E, Pg. 120

217. In treatment of organophosphorous 221. Which of the following drugs causes


poisoning, atropine sulphate acts by mydriasis by contraction of radial
A. Antagonizing effect of acetylcholine muscles of the eye
muscarinic receptors A. Homatropine
B. Antagonizing effect of acetylcholine at B. Cyclopentolate
nicotinic receptors C. Phenylephrine
C. Reduces the enzyme activity D. Tropicamide
D. Acts as a cholinesterase reactivator
Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 135
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PHARMACOLOGY 48
Autonomic Nervous System

D. Nadolol
222. Which of the following actions of Tripathi- Essentials of Medical Pharmacology,
epinephrine is not shared by nor- 7/E, Pg. 146
epinephrine?
A. Increase in systolic blood pressure 227. Which of the following sympathomimetic
B. Cardiac stimulant action group of drugs can lead to drug depends
C. Increase in cardiac output and drug abuse
D. Relaxation of bronchial smooth muscle A. Ephedrine
B. Methoxamine
Tripathi- Essentials of Medical C. Metaraminol
Pharmacology, 7/E, Pg. 131 D. Amphetamine

223. Which one of the following is NOT a Tripathi- Essentials of Medical


selective alpha -2 agonist Pharmacology, 7/E, pp. 134, 135
A. Clonidine
B. Alpha methyldopa 228. Which of the following is a muscarinic
C. Guanethedine action of acetyl choline?
D. Guanadenz A. Ganglionic stimulation
B. Depression of SA node
Tripathi- Essentials of Medical C. Contraction of skeletal muscle
Pharmacology, 7/E, Pg. 129 D. Stimulation of adrenal medulla

224. Following Atropine substitutes are used Tripathi- Essentials of Medical


topically as Mydriatrics EXCEPT Pharmacology, 7/E, Pg. 103
A. Cyclopentolate
B. Tropicamide 229. Which of the following statements is
C. Guanethedine appilicable to carbachol?
D. Homatropine A. Is resistant to pseudocholinesterase
B. Is hydrolysed by true cholinesterase
Tripathi- Essentials of Medical C. Does not stimulate autonomic ganglia
Pharmacology, 7/E, Pg. 118 D. Has no miotic effect on topical application

225. Following Atropine substitutes are used Tripathi- Essentials of Medical


topically as Mydriatics Except Pharmacology, 7/E, pp. 100, 104
A. Homatropic
B. Eucatropine 230. Which of the following drugs is
C. Benztropine mesylate prescribed for urinary retention without
D. Tropicamide obstruction
A. Bethanechol
Tripathi- Essentials of Medical B. Acetylcholine
Pharmacology, 7/E, Pg. 118 C. Pilocarpine
D. Physostigmine
226. Which of the following beta blockers
crosses blood brain barrier Tripathi- Essentials of Medical
A. Propranolol Pharmacology, 7/E, Pg. 104
B. Atenolol
C. Sotalol
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PHARMACOLOGY 49
Autonomic Nervous System

231. Which of the following statements 235. Which of the following is NOT an
regarding reversible anticholinesterases peripherally acting muscle relaxant
is INCORRECT? A. Diazepam
Structurally resemble acetylcholine B. Mephenesin
A. Produce temporary inhibition of C. Methocarbamol
cholinesterase D. Dantrolene
B. Combine only with esteratic site of
cholinesterase Tripathi Essentials of Medical
C. Combine only the anionic site of Pharmacology, 7/E, Pg. 357
cholinesterase
D. Used in treatment of myasthenia gravis 236. Which of the following is NOT a
peripherally acting muscle relaxant
Tripathi- Essentials of Medical A. Baclofen
Pharmacology, 7/E, Pg. 105 B. Atracurium
C. Gallamine
232. Which of the following drugs is used to D. Vecuronium
diagnose myasthenic crisis?
A. Edrophonium Tripathi- Essentials of Medical
B. Physostigmine Pharmacology, 7/E, Pg. 347
C. Pilocarpine
D. Pyridostigmine 237. Which of the following has only
muscarinic action
Tripathi- Essentials of Medical A. Dysphagia
Pharmacology, 7/E, Pg. 110 B. Photophobia
C. Sedation
233. Pralidoxime is used in antichloinesterase D. Hyperpyrexia
poisioning because it Ref: Tripathi, 6/E, p. 113
A. Crosses blood brain barrier effectively
B. Reactivator cholinesterase 238. Edrophonium is drug of choice for
C. Very effective in treatment of A. Treatment of myasthenia gravia
organophosphorous poisioning even when B. Treatment of glaucoma
used after prolonged time C. Diagnosis of myasthenia gravis
D. It antagonizes the effect of carbamate type D. Treatment of cholinergic crisis
of insecticides
Tripathi- Essentials of Medical
Tripathi- Essentials of Medical Pharmacology, 7/E, Pg. 108
Pharmacology, 7/E, Pg. 111
239. Atropine used topically has following
234. Which of the following is NOT a action in the eye except
centrally acting muscle relaxant? A. In acts on circular muscle of iris and causes
A. Diazepam passive dilation of pupil
B. Mephenesin B. Contraction of radial muscles of iris
C. Methocarbamol C. It causes paralysis of ciliary muscle of iris
D. Dantrolene D. It can precipitate an attack of glaucoma

Tripathi- Essentials of Medical Pharmacology, Tripathi- Essentials of Medical


7/E, Pg. 347 Pharmacology, 7/E, Pg. 114
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PHARMACOLOGY 50
Autonomic Nervous System

A. It is ready absorbed from conjunctiva


240. Which of the following sympathomimetic B. Causes spasm of ciliary muscles and
drugs increases cardiac output without miosis
any effect on heart rate and blood C. For treatment of Glaucoma it should not
presents be combined with physostigmine
A. Dopamine D. It stimulates muscarine receptors and
B. Dobutamine causes stimulation of exocrine glands
C. Ephedrine
D. Metaraminol Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 108
Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 134 245. Nicotinic action of acetylcholine include
all the following except
241. Propranolol is useful in treatment of A. Stimulation of autonomic ganglia
following conditions except in B. Contraction of smooth muscle
A. Supraventricular tachycardia C. Contraction of skeletal muscle
B. Portal hypertension D. Stimulation followed by depression of
C. Prinzmetal angina CNS
D. Thyrotoxicosis
Tripathi- Essentials of Medical
Tripathi- Essentials of Medical Pharmacology, 7/E, Pg. 103
Pharmacology, 7/E, pp. 149, 150, 151

242. In emergency treatment of 246. Which of the following cholinesters has


hypersensitivity reactions, the NO nicotinic action
sympathomimetic drug used is A. Acetylcholine
A. Adrenaline B. Methacholine
B. Nor-adrenaline C. Carbacol
C. Ephedrine D. Bethanecol
D. Isoprenaline
Tripathi- Essentials of Medical
Tripathi- Essentials of Medical Pharmacology, 7/E, Pg. 104
Pharmacology, 7/E, Pg. 138
247. Which of the following is an irreversible
243. Which of the following sympathomimetic anticholinesterase
drug has CNS stimulant and appetite A. Physostigmine
suppressant action B. Demecarium
A. Ephedrine C. Malathion
B. Amphetamine D. Edroponium
C. Pseudoehedrine
D. Hydroxyl amphetamine Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 105
Tripathi- Essentials of Medical
Pharmacology, 7/E, pp. 134, 135 248. Which of the following drugs has both
direct and indirect sympathomimetic
244. Which statement is NOT TRUE for activity
Pilocarpine A. Adrenaline
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PHARMACOLOGY 51
Autonomic Nervous System

B. Nor-adrenaline Essentials of Medical Pharmacology, 7/E, Pg.


C. Methoxamine 146
D. Ephedrine
253. Which of the following actions caused by
Tripathi- Essentials of Medical scopolamine is qualitatively different
Pharmacology, 7/E, Pg. 129 from atropine
A. Depression of CNS and amnesia
249. Stimulation of alpha I receptor producer B. Inhibition of exocrine gland secretion
following effects EXCEPT C. Antispasmodic action
A. Uterine muscle contraction D. Gastric secretion
B. Bronchodilation
C. Vasoconstriction Tripathi- Essentials of Medical
D. Gut relaxation Pharmacology, 7/E, Pg. 116

Tripathi- Essentials of Medical 254. Which of the following


Pharmacology, 7/E, Pg. 130 anticholinesterases is used topically in
long term treatment of glaucoma because
250. Which of the following drugs rapidly of its very long duration of action
improves myasthenic crisis A. Neostigmine
A. Physostigmine B. Edrophonium
B. Edrophonium C. Ambenonium
C. Azathioprine D. Demecarium
D. Predmsolone Ref: Satoskar, 20/E, p. 284

Tripathi- Essentials of Medical 255. Physostigmine is preferred over


Pharmacology, 7/E, Pg. 110 Neostigmine in treatment of atropine
poisioning as it
251. Which of the following anticholinergic A. Acts both on muscarinic and nicotine
agents is useful for treatment of receptors
Bronchial asthma B. Less toxic than neostigmine
A. Glycopyrrolate C. Crosses blood brain barrier and can
B. Pirenzepine antagonize both central and peripheral
C. Ipratropium bromide effects of atropine
D. Oxyphenonium D. Inhibits cholinesterase reversibly more
specifically
Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 116 Tripathi- Essentials of Medical
Pharmacology, 7/E, pp. 120, 121
252. Depression of AV conduction produced
by beta blockers is enhanced by the 256. Which of the following anticholinergic of
following drugs except is useful in treatment of chronic
A. Digitalis obstruction pulmonary disease
B. Nifedipine A. Dicyclomine
C. Verpamil B. Ipratropium bromide
D. Diltiazem C. Diphenoxylate
D. Oxyphenonium

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PHARMACOLOGY 52
Autonomic Nervous System

Tripathi- Essentials of Medical 261. Which of the following beta adrenergic


Pharmacology, 7/E, Pg. 116 blockers has partial beta agonist action
A. Metoprolol
257. Dobutamine has following actions at B. Acebutolol
therapeutic doses except C. Esmolol
A. Increases cardiac output D. Labetalol
B. Positive inotropic action
C. Peripheral resistance remains unchanged Tripathi- Essentials of Medical
D. Chronotropic action is more than Pharmacology, 7/E, Pg. 149
inotropic action
262. Following drugs are except
Tripathi- Essentials of Medical cardioselective beta blockers except
Pharmacology, 7/E, Pg. 134 A. Metoprolol
B. Esmolol
258. Which of the following is NOT TRUE for C. atenolol
dopamine D. Labetalol
A. Crosses blood brain barrier
B. Not absorbed orally Tripathi- Essentials of Medical
C. Has short half life of few minutes Pharmacology, 7/E, Pg. 144
D. D1 receptor agonist
263. Edrophonium is used in diagnosis of
Tripathi- Essentials of Medical myasthenia gravis because of the
Pharmacology, 7/E, Pg. 134 duration of action lasting
A. 5 to 15 minutes
259. Which one of the following B. 1 to 2 minutes
sympathomimetic amines has affinity for C. 30 to 45 minute
both beta, and beta receptor but not for D. Almost one hour
alpha receptor
A. Phenylephrine Tripathi- Essentials of Medical
B. Isoprenaline Pharmacology, 7/E, Pg. 108
C. Methoxamine
D. Ephedrine 264. Which of the following drugs has
curaremimetic action
Tripathi- Essentials of Medical A. Gentamicin
Pharmacology, 7/E, Pg. 130 B. Quinine
C. Propranolol
260. Phenylephrine the following properties D. Diazepam
except Ref: Tripathi, 6/E, p. 346, 719
A. Nasal decongestant
B. Mydriatic 265. Which of the following secretions is not
C. Vasopressor inhibited by atropine
D. Bronchodilator A. Pancreatic and intestinal
B. Sweat
Tripathi- Essentials of Medical C. Pepsin and Mucus secretions
Pharmacology, 7/E, Pg. 135 D. Lacrimal

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PHARMACOLOGY 53
Autonomic Nervous System

Tripathi- Essentials of Medical 270. Which of the following drugs is useful in


Pharmacology, 7/E, Pg. 103 counteracting central as well as
peripheral effects of poisioning due to
266. In therapeutic doses, metoprolol and tricyclic anti-depressants
atenolol have selective blocking action on A. Physostigmine
A. Beta 1 receptors B. Neostigmine
B. Beta 2 receptors C. Pyridostigmine
C. More on beta1, receptors and less on beta1 D. Ambenonium
receptors
D. More on beta2, receptors and less on beta2 Tripathi- Essentials of Medical
receptors Pharmacology, 7/E, Pg. 110

Tripathi- Essentials of Medical 271. Which of the following statements


Pharmacology, 7/E, Pg. 144 regarding long term use of Propranolol is
NOT CORRECT?
267. Which of the following beta adrenergic A. Association with increased VLDL and
antagonist causes marked CNS side decreased HDL level
effects B. Potentiates hypoglycaemic action of
A. Propranolol insulin
B. Nadolol C. Causes reduction of intraocular pressure
C. Solalol D. Should not be used in patients of
D. Oxprenolol thyrotoxicosis

Tripathi- Essentials of Medical Tripathi- Essentials of Medical


Pharmacology, 7/E, Pg. 145 Pharmacology, 7/E, Pg. 150

268. Which of the following sympathomimetic 272. In treatment of peripheral vascular


agents causes renal vasodilatation by disease tolazoline has which of the
acting on D1 receptors following actions
A. Amphetamine A. Counteracts the local arteriolar
B. Dopamine vasoconstriction and ischaemia
C. Dobutamine B. Counteracts ischaemia by acting at cellular
D. Nor-epinephrine level
C. Increases cardiac output and improves
Tripathi- Essentials of Medical blood flow to the periphery
Pharmacology, 7/E, Pg. 134 D. Causes direct peripheral vasodilation
Ref: Tripathi, 6/E, p. 134
269. Homatropine is preferred over atropine It is also a direct vasodilata
ophthalmic use because it has
A. Shorter duration of action 273. Which of the following is NOT a uses of
B. Longer duration of action Neostigmine
C. More potent as cycloplegic A. Glaucoma
D. Less local irritant action B. Myasthenia gravis
C. Post operative urinary retention
Tripathi- Essentials of Medical D. To antagonic effect of pancuronium
Pharmacology, 7/E, Pg. 118 Tripathi- Essentials of Medical
Pharmacology, 7/E, pp. 108, 109, 110
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PHARMACOLOGY 54
Autonomic Nervous System

A. Atropine
274. Which of the following drugs is most B. Scopolamine
suitable as muscle relaxant for intubation C. Oxyphenonium
of trachea D. Propantheline
A. Pancuronium
B. Succinylcholine Tripathi- Essentials of Medical
C. Gallamine Pharmacology, 7/E, Pg. 120
D. Atracurium
E. Tripathi- Essentials of Medical 279. Alpha-methyl dopa produces
Pharmacology, 7/E, pp. 353, 355 antihypertensive action by which of the
following mechanisms
275. Dantrolene produces muscle relaxation A. It acts on central vasodilation
by which of the following mechanism B. Produces direct vasodilation
A. Competitive blockade at neuromuscular C. Blocks beta receptors
junction D. It is an adrengic neuron blocker.
B. Depolarizing blockade at neuromuscular
junction Tripathi- Essentials of Medical
C. Acting directly on skeletal muscles Pharmacology, 7/E, Pg. 559, 566
D. Acting on central nervous system

Tripathi- Essentials of Medical 280. Advantages of atenolol over Propranolol


Pharmacology, 7/E, Pg. 347 are the following except
A. Safer in asthmatic patients
276. Which of the following action in NOT B. Longer duration of action
produced by Pilocarpine C. Better absorbed by oral route
A. Marked sweating D. CNS effects are less
B. Increased salivation
C. Mydriasis Tripathi- Essentials of Medical
D. Fall in intraocular tension Pharmacology, 7/E, Pg. 149

Tripathi- Essentials of Medical


Pharmacology, 7/E, Pg. 104 281. Salbutamol is used for treatment of
bronchial asthma as it
277. Which of the following anticholinergic A. It is a directly acting bronchodilator
drug is preferred for treatment of Peptic B. Prevents disease of mediators
ulcer C. Antagonizes released mediators
A. Atropine D. Produces bronchodilation by
B. Cyclopentotate sympathomimetic action
C. Oxyphenonium
D. Pirenzepine Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 133
Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 117 282. Which of the following is NOT an
adverse effect of Prazosin
278. Which of the following anticholinergic A. Postural hypotension
agents is used for preventing motion B. Dry mouth
sickness C. Nasal block
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PHARMACOLOGY 55
Autonomic Nervous System

D. Adverse effect on lipid profile Tripathi- Essentials of Medical


Pharmacology, 7/E, Pg. 118
Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 142 287. Which of the following vascular effects of
Dopamine occurs at higher dose but not
283. Which of the following drugs reduces at smaller dose
aqueous humour formation A. Renal vascular dilatation
A. Acetazolamide B. Coronary dilatation
B. Mannitol C. Mesenteric dilation
C. Glycerol D. Peripheral vasoconstriction
D. Pilocarpine
Tripathi- Essentials of Medical
Tripathi- Essentials of Medical Pharmacology, 7/E, Pg. 134
Pharmacology, 7/E, Pg. 155
288. When used topically, sympathomimetic
284. Which of the following statements is agents have following effects on the eye
NOT CORRECT for pilocarpine when except
applied locally in the eye A. Relax radial muscles of iris
A. It causes miosis B. Light reflex is present
B. It causes spasm of ciliary muscles C. Intraocular tension is not raised
C. It is the drug of choice in treatment of D. Mydriasis
acute congestive glaucoma
D. It is not readily absorbed from Tripathi- Essentials of Medical
conjunctiva Pharmacology, 7/E, Pg. 132

Tripathi- Essentials of Medical 289. Which one is non-selective agonist for B1


Pharmacology, 7/E, Pg. 104 and B2 receptors
A. Salbutamol
285. Which of the following actions is present B. Orciprenaline
with Neostigmine and not with C. Isoprenaline
physostigmine D. Prenalterol
A. Muscarinic
B. CNS effect Tripathi- Essentials of Medical
C. Lipid solubility Pharmacology, 7/E, Pg. 130
D. Skeletal muscle stimulant

Tripathi- Essentials of Medical 290. Pilocarpine has following actions when


Pharmacology, 7/E, Pg. 107 used in treatment of acute congestive
glaucoma except
286. Which of the following used topically has A. Causes miosis
longest duration of Mydriatic action B. Spasm of ciliary muscles
A. Tropicamide C. Draining of aqueous humor through canal
B. Eucatropine of schlemm
C. Atropine D. Diminishes formation of aqueous humor
D. Homatropine
Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 104
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PHARMACOLOGY 56
Autonomic Nervous System

291. Which one of the following drugs is a 295. Which of the following is NOT an action
selective alpha1-receptor agonist of atropine
A. Phenylephrine A. It reduces bronchial secretions
B. Ephedrine B. It reduces salivary secretions
C. Clonidine C. Prevents hypotension during induction of
D. Ritodrine anaesthesia
D. Does not produce cycloplegia
Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 135 Tripathi- Essentials of Medical
Pharmacology, 7/E, pp. 114, 115
292. Which of the following is interaction of
phenylephrine with adrenergic receptors
A. Selective alpha1, receptor agonist 296. Advantages of atracurium are the
B. Selective alpha2, receptor agonist following except
C. Beta receptor agonist A. Its metabolism is not altered in liver
D. Agonist for alpha I and alpha 2 receptors disease
B. Its metabolism is not altered in renal
Tripathi- Essentials of Medical disease
Pharmacology, 7/E, Pg. 135 C. Does not produce histamine release
D. It has intermediate duration of action

Tripathi- Essentials of Medical


293. Which of the following drugs can be used Pharmacology, 7/E, pp. 353, 354
diagnosis of Phaeochromocyoma induced
hypertension 297. Dale’s vasomotor reversal occurs
A. Phentolamine A. When adrenaline is given after alpha-
B. Propranolol block
C. Labetalol B. When adrenaline is given after beta-block
D. Terazosin C. When isoprenaline is given intravenously
D. When noradrenaline is given
Tripathi- Essentials of Medical intravenously
Pharmacology, 7/E, Pg. 143
Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 131

294. Which of the following alpha blockers 298. Atropine toxicity produces
also has a 5 HT. receptor blocking action A. Miosis
A. Ergotamine B. Increased sweating
B. Phentolamine C. Rise in body temperature
C. Tolazoline D. Vestibular dysfunction
D. Prazosin
Tripathi- Essentials of Medical
Tripathi- Essentials of Medical Pharmacology, 7/E, pp. 115
Pharmacology, 7/E, Pg. 175
299. Sympathetic stimulation produces
following actions except
A. Increased sweating
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PHARMACOLOGY 57
Autonomic Nervous System

B. Relaxation of intestines Tripathi- Essentials of Medical


C. Mydriasis by paralysis of circular muscle Pharmacology, 7/E, Pg. 354
of iris
D. Lipolysis
304. Alpha blockers have following
Tripathi- Essentials of Medical indications EXCEPT
Pharmacology, 7/E, Pg. 132 A. Treatment of pheochromocytoma
B. Benign prostate hypertrophy
300. Nicotinic receptors are not present in: C. Hypertension caused by clonidine
A. Skeletal neuromuscular junction withdrawal
B. Central nervous system D. Treatment of ischaemic heart disease
C. Adrenal medulla
D. Peripheral arterioles Tripathi- Essentials of Medical
Pharmacology, 7/E, pp. 143, 144
Tripathi- Essentials of Medical
Pharmacology, 7/E, Pg. 102 305. Drug used for diagnostic test for
Myasthenia gravis is
301. The following are use of beta blockers A. Physostigmine injection
EXCEPT B. Pyridostigmine injection
A. Treatment of hyperthyroidism C. Edrophonium injection
B. Secondary prevention of myocardial D. Neostigmine injection
infarction
C. To reduce serum Lipids Tripathi- Essentials of Medical
D. Treatment of glaucoma Pharmacology, 7/E, Pg. 110

Tripathi- Essentials of Medical 306. Alpha blocker used in treatment of


Pharmacology, 7/E, Pg. 147 hypertension is:
A. Phentolamine
302. Skeletal muscle relaxant used for B. Phenoxybenzamine
transient action is: C. Tolazoline
A. Vecuronium D. Prazosin
B. Succinylcholine
C. Pancuronium Tripathi- Essentials of Medical
D. Gallamine Pharmacology, 7/E, Pg. 142
Prazosin side effects less than other mentioned,
Tripathi- Essentials of Medical but can cause reflex Candice stimulation. Hence
Pharmacology, 7/E, pp. 353, 355 routinely not preferred for clomdine
withdrawal cheese reaction Hypertension,
Phentolamine and phenocybenzamme
303. Antidote to reverse action of preferred
pancuronium is
A. Neositgmine 307. Which of the following drugs produces
B. Atropine mydriasis only?
C. Neostigmine + atropine A. Phenylephrine
D. Succinylcholine B. Cyclopentolate
C. Homatropine
D. Atropine
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PHARMACOLOGY 58
Autonomic Nervous System

E. Tripathi- Essentials of Medical


Pharmacology, 7/E, Pg. 135

308. Anticholinergic agent which causes CNS


effect is
A. Atropine
B. Pirenzepine
C. Homatropine
D. Propantheline

Tripathi- Essentials of Medical


Pharmacology, 7/E, pp. 113, 114

309. Which of the following adrenergic drugs


acts on D1 receptors and causes selective
dilatation of renal blood vessels
A. Dobutamine
B. Dopamine
C. Phenylephrine
D. Ephedrine

Tripathi- Essentials of Medical


Pharmacology, 7/E, Pg. 134

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PHARMACOLOGY 59
Autonomic Nervous System

© BRIHASPATHI ACADEMY ‫ ׀‬SUBSCRIBER’S COPY ‫ ׀‬NOT FOR SALE