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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
© BRIHASPATHI ACADEMY ׀SUBSCRIBER’S COPY ׀NOT FOR SALE
PHARMACOLOGY 16
Autonomic Nervous System
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
© BRIHASPATHI ACADEMY ׀SUBSCRIBER’S COPY ׀NOT FOR SALE
PHARMACOLOGY 18
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
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
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 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
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 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
© BRIHASPATHI ACADEMY ׀SUBSCRIBER’S COPY ׀NOT FOR SALE
PHARMACOLOGY 30
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
© BRIHASPATHI ACADEMY ׀SUBSCRIBER’S COPY ׀NOT FOR SALE
PHARMACOLOGY 32
Autonomic Nervous System
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
89. Beta blockers are not indicated in 93. Which of the following reactivates
A. Mild hypertension, pheochromocytoma cholinesterase
and hypertension A. Pralidoxime
© BRIHASPATHI ACADEMY ׀SUBSCRIBER’S COPY ׀NOT FOR SALE
PHARMACOLOGY 33
Autonomic Nervous System
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
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
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
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
A. Ephedrine
B. Dopamine
C. Adrenaline 143. Which of the following drugs is an adrenergic
B. Salbutamol B. Phenoxybenzamine
C. Terburaline C. Phentolamine
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
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?
© BRIHASPATHI ACADEMY ׀SUBSCRIBER’S COPY ׀NOT FOR SALE
PHARMACOLOGY 41
Autonomic Nervous System
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
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
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
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
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
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