- 1. Pattern of Examination 3
- 2. Questions for Theory Paper 4
- 3. Topics for Prescription Writing 29
- 4. Topics for Pharmacy Practical 30
- 5. Topics for Experimental Practical 31
- 6. Topics for Theory Viva 32
- 7. Drug of Choice 34
- 8. Explain Why 38
- 9. Doses of Some Important Drugs in Children 45
- 10. Important Points 50
1. PATTERN OF EXAMINATION
PHARMACOLOGY | Marks |
---|---|
Theory Paper I | 40 |
Theory Paper II | 40 |
Internal Assessment (Theory) | 15 |
Internal Assessment (Prac.) | 15 |
Prescription Writing | 10 |
Pharmacy Practical | 5 |
Clinical Case | 5 |
Experimental Pharmacology | 10 |
Theory Viva | 10 |
Total | 150 |
Note:
Paper I = | * General Pharmacology |
* Autonomic Nervous System | |
* Somatic Nervous System | |
* Autacoids | |
* Respiratory System | |
* CNS and CVS | |
* Kidney | |
Paper II = | * Autacoids |
* Hormones | |
* Blood and GIT | |
* Antimicrobial Drugs | |
* Anticancer Drugs |
2. QUESTIONS FOR THEORY PAPER
A. GENERAL PHARMACOLOGY
SN: | Half life of a drug (2005) |
SN: | Active transport |
SN: | Effect of food on absorption of drug |
SN: | Luminal effect |
SN: | Prodrug (1993) |
SN: | Why particle size of drug in a solid form is important in case of certain drugs like aspirin |
SN: | Clinical significance of volume distribution. |
EW: | Basic drugs are absorbed only when they reach intestine (2005) |
SN: | Types of adverse drug reactions (2004) |
EW: | Acidic drugs are poorly absorbed in alkaline medium |
EW: | Lipid soluble drugs are largely secreted unchanged |
EW: | Newborns are more susceptible to many drugs |
SN: | Factors affecting drug metabolism |
SN: | Clinical pharmacology |
LQ: | Routes of drug administration |
LQ: | Systemic routes of drug administration |
SN: | Pharmacogenomics (2004) |
DW: | Parenteral vs oral therapy |
EW: | Oral dose of some drugs are several fold higher than their parenteral done |
EW: | Action is faster via nasal route |
SN: | Fate of drug in body. Illustrate with example |
SN: | Microsomal enzyme induction |
SN: | First pass metabolism |
SN: | Discuss how drugs act through receptor |
EW: | A potent agonist antagonizes the action of full agonist |
DW: | Drug potency and efficiency |
SN: | Advantages and disadvantages of fixed done ratio combination |
SN: | Bioequivalence (2004) |
SN: | Factors modifying drug action |
SN: | Placebo |
DW: | Tolerance and resistance of drug |
SN: | Side effects |
SN: | Drug allergy |
SN: | Drug dependence |
EW: | Fixed dose combinations of drugs are often considered to be of disadvantage (2005) |
SN: | Tubular secretion of drugs |
SN: | Drug tolerance (2005) |
SN: | Clearance |
SN: | Plateau principle |
SN: | Principles of drug action |
SN: | Name drug which act by inhibiting enzymes |
SN: | Teratogenicity |
SN: | Essential medicines (2005) |
SN: | First dosage phenomenon (1991) |
SN: | Inverse agonist (1998) |
EW: | Half life of a drug varies for drugs undergoing zero order kinetics (2006) |
SN: | Polypharmacy (2006) |
SN: | Drug tolerance (2006) |
SN: | Pharmacovigilance (2006) |
SN: | Fixed dose drug combinations (2007) |
SN: | Drugs modulating cytochrome P450 enzymes (2007) |
SN: | Drug-dependence (2007) |
SN: | Therapeutic window (2008) |
SN: | Bioavailability (2008). |
B. AUTONOMIC NERVOUS SYSTEM
LQ: | Enumerate anticholinergic agents. Discuss their adverse effects and give their therapeutic based uses (2003) |
EW: | Pralidoxime is used in organophosphate poisoning and not in carbamate poisoning (2004) |
SN: | Uses and adverse effects of neostigmine |
SN: | Myasthenia gravis (2000) |
SN: | Treatment of organophosphorus poisoning |
SN: | Classification of anticholinergic drugs |
SN: | Uses of anticholinergic drugs |
SN: | Pralidoxime in organophosphorus poisoning (2005) |
SN: | Motion sickness |
DW: | Atropine and dopamine |
DW: | Adrenaline and ephedrine |
EW: | Large doses of acetylcholine causes increase in BP in atropinised animals |
EW: | Fenfluramine is used as anorectic over amphetamines |
SN: | Dopamine cardiogenic shock |
EW: | BAL is used in arsenic poisoning (2004) |
SN: | Anorectic agents |
SN: | Uses of α-blockers |
SN: | Effects of α blockers |
EW: | It is desirable to give phenoxybenzamine for 1–2 weeks preoperatively and continue it during surgery |
SN: | Propranolol |
SN: | Name cardioselective β blockers. How do these differ from nonselective in clinical terms |
SN: | Adverse effects of β blockers |
SN: | Uses of β blockers |
EW: | Acetylcholine is not used therapeutically |
SN: | Side effects of acetylcholine |
EW: | Pilocarpine is effective in acute congestive and simple glaucoma |
SN: | Pilocarpine |
EW: | Neostigmine but not physostigmine is used in myasthenia gravis |
SN: | Anticholinesterase |
SN: | Cholinergic drugs in Alzheimer's disease (2004) |
EW: | Atropine methonitrate is preferred to atropine sulphate as spasmolytic |
SN: | Mydriatics |
TS: | Adrenaline in anaphylactic shock |
SN: | Cardiac and metabolic effects of synthetic amines |
SN: | Classify adrenergic drugs |
SN: | Dopamine |
LQ: | Classify adrenergic blocking agents. Discuss indications and contraindications with reasoning of β adrenergic blocking agent |
EW: | Propranolol but not atenolol is used for treatment of tremors (2003) |
SN: | Beta adrenergic blockers in angina pectoris (2004) |
DT: | Benign hyperplasia of prostate (2005) |
EW: | Atropine is preferred for refraction testing in children (2006) |
TS: | Tamsulosin in benign prostatic hypertrophy (2006) |
Que: | Discuss rationale for the use of finasteride in benign prostatic hyperstrophy (2006) |
EW: | First dose of prazosin should preferably be administered at bed time (2007) |
Que: | Give rationale for the therapeutic use of oximes in organophosphorus poisoning (2007) |
Que: | Give rationale for the use of BAL in arsenic poisoning (2007) |
Que: | Give rationale for the use of sildenafil in erectile dysfunction (2007) |
Que: | Give rationale for the use of finasteride in prostatic disease (2007) |
Que: | Give the rationale for the therapeutic use of sildenafil in erectile dysfunction (2008). |
C. SOMATIC NERVOUS SYSTEM
SN: | Peripherally acting muscle relaxants (classification) |
TS: | Lignocaine |
SN: | Bupivacaine |
EW: | oxethiazine is a good anaesthesia for gastric mucosa while other local anaesthetise are not |
DW | Competitive and depolarizing block |
SN: | Beclofen |
SN: | Uses of centrally acting muscles relaxants |
SN: | Classify local anaesthetics |
EW: | d-tubocuranine produces significant fall in BP |
EW: | Neuromuscular blockers not absorbed orally |
EW: | Thiopentone sodium and succinylcholines solutions should not be mixed in the same syringe |
TS: | Dentrolene |
LQ: | Centrally acting muscle relaxants |
TS: | Diazepam |
EW: | Addition of vasoconstrictor to local anaesthetic |
DW: | Procaine and lignocaine |
SN: | Uses of local anaesthesia |
SN: | Epidural anaesthesia |
SN: | Spinal anaesthesia (1998) |
EW: | Pralidoxime is ineffective as antidote to carbamate poisoning (2006) |
Que: | Give rationale for the therapeutic use of tizanidine in spastic disorders (2007) |
EW: | Dose of skeletal muscle relaxant should be lowered in patients receiving high doses of gentamicin (2007). |
D. AUTACOIDS
TS: | Ondansetron as an antiemetic (2002) |
SN: | 5-HT antagonist |
LQ: | Angiotensin converting enzyme inhibitors |
SN: | Enalapril |
DW: | H1, H2 and H3 receptors |
SN: | Name the actions of histamine not antagonised by antihistamine |
SN: | H1 antagonist and their use |
SN: | Cetrizine |
SN: | Second generation antihistaminics (2001) |
SN: | Cinnarizine |
EW: | Enalapril is preferred over captopril |
SN: | Uses of ACE inhibitors |
TS: | Prostaglandin in obstetrics |
EW: | Aspirin is used in children having patent ductus arteriosus |
EW: | Prostaglandins are not considered as neurotransmitters |
SN: | Leukotrienes |
TS: | Prostaglandins for inducing therapeutic action |
EW: | Finasteride is used in benign hypertrophy of prostate (2001) |
SN: | Ondansetron in chemotherapy induced vomiting (2004) |
Que: | Discuss the drug treatment of migraine (2006) |
Que: | 5 HT3 antagonists in vomiting (2006) |
Que: | Give rationale for the therapeutic use of sumatriptan in migraine (2007). |
E. RESPIRATORY SYSTEM
SN: | Ipratropium bromide in chronic obstructive pulmonary disease (2005) |
TS: | Salbutamol (1991) |
SN: | Terbutaline |
EW: | Aminophylline is given by slow IV injection |
SN: | Sodium chromoglycate |
SN: | KI (potassium iodide) |
SN: | Mucolytics |
SN: | Name the drug of choice in prophylaxis of chronic bronchial asthma |
TS: | Inhalational steroids in bronchial asthma |
SN: | Antitussives |
SN: | Treatment of cough |
SN: | Give a plan of action for treatment of bronchial asthma (1998) |
EW: | Antihistamine not used for treatment of bronchial asthma |
EW: | Salbutamol is preferred over isoprenaline for treatment of acute bronchial asthma |
EW: | Inhalation, administration of β2 agonist is preferred to oral administration is asthma |
EW: | Aminophylline is not used in treatment of angina pectoris |
TS: | Corticosteroids in bronchial asthma |
SN: | Treatment of status asthmatics (2001) |
TS: | Ephedrine in cough syrup (2006) |
Que: | Discuss the drug treatment of status asthmaticus (2007) |
TS: | Leukotriene antagonists in bronchial asthma (2007) |
TS: | Sodium chromoglycate in bronchial asthma (2008). |
F. HORMONES
LQ: | Classify oral contraceptives. Discuss the mechanism of action, adverse effects and contraindication of oral contraceptives (2005) |
SN: | Mechanism of action of insulin |
EW: | Regular insulin is not combined with lente insulin (2005) |
EW: | Mifepristone is used for therapeutic abortion (2005) |
EW: | Insulin induced hypoglycemia may be affected by concurrent administration of salisalates |
SN: | Classify drugs used in diabetes mellitus with mechanism of action and side effects |
SN: | Management of diabetic ketoacidosis |
SN: | Insulin resistance |
EW: | Oral hypoglycemic agents are ineffective in juvenile diabetes mellitus |
TS: | Human insulin |
SN: | Oxytocin (2005) |
SN: | Mechanism of action of steroidal hormones |
SN: | Bromocriptine |
LQ: | Thyroid hormones and their uses |
SN: | Management of thyrotoxicosis |
SN: | Classify drugs used in thyroid disorders. Discuss status of iodine |
SN: | Myxoedema coma |
SN: | Antithyroid drugs |
LQ: | Carbimazole |
EW: | Iodides are not used for long-term treatment of hyper-thyroidism |
EW: | Prophylthiouracil is preferred over methimazole in treatment of thyroid storm |
EW: | Lugol's iodine has a limited use as an antithyroid drug Describe the rationale the drug treatment of hyperthyroidism (2001) |
SN: | Radioactive iodine |
SN: | Potassium iodide in thyrotoxicosis (2002) |
SN: | Raloxifene in osteoporosis (2005) |
SN: | Diabetic ketoacidosis (2002) |
SN: | More purified insulin preparations |
LQ: | Oral hypoglycemia drugs |
TS: | Sulfonylureas |
Que: | Describe the mechanism of action of sulfonylureas (2001) |
SN: | Treatment of sulfonylurea induced hypoglycemia |
SN: | Pharmacological basis of use of tolbutamide in maturity onset DM (NIDDM) |
EW: | Biguanides not used in underweight patient with NIDDM |
SN: | Mechanism of action of biguanides |
SN: | Status of oral hypoglycemics in DM |
Que: | Describe the rationale the drug treatment of postmenopausal syndrome and osteoporosis (2001) |
TS: | Biguanids in diabetes mellitus (2002) |
SN: | Antiandrogens (2002) |
LQ: | Corticosteroids (actions and uses) |
SN: | Clomiphene in treatment of infertility (2005) |
SN: | Anti-inflammatory effects of corticosteroids |
EW: | Glucocorticoids, mechanism of action |
DW | Synthetic and natural adrenal corticosteroids |
DW | Hydrocortisone and dexamethasone |
SN: | Prednisolone |
SN: | Replacement therapy |
EW: | Corticosteroids are administered in tubercular meningitis |
TS: | Corticosteroids in autoimmune diseases |
TS: | Corticosteroids in eye diseases |
SN: | Explain effect of sudden withdrawal of steroids in bronchial asthma and mechanism involved |
EW: | Corticosteroids cause less suppression of pituitary axis if given at 7.00 in morning |
SN: | Side effects of androgens |
SN: | Rosiglitazone in diabetes mellitus (2005) |
EW: | Use of anabolic steroid is on decline |
SN: | Uses of anabolic steroids |
TS: | Anabolic steroids |
SN: | Antiandrogens |
EW: | Use of short-term high dose estrogen is not recommended to test pregnancy |
SN: | Delayed puberty in girls |
TS: | Antiestrogens, e.g. clomiphene citrate |
TS: | Tamoxifen citrate |
EW: | Progestins added to estrogens in oral contraceptive pills whereas estrogen alone can produce contraception |
SN: | Long-term antifertility agents. |
EW: | Progesterone is added with oestrogen for hormone replacement therapy (2002) |
SN: | Female contraception |
SN: | Oral contraceptives |
SN: | Postcoital pill |
LQ: | Classify adrenocorticosteroids. Discuss the pharmacological actions, side effects, contraindications and therapeutic uses of glucocorticoids (2004) |
EW: | Estrogen in high doses is effective as postcoital contraception |
EW: | Ethinyloestradiol and not estradiol is used in oral contraception preparation |
SN: | Mechanism of injectable contraceptives |
SN: | Side effects of hormonal contraceptives |
SN: | Male contraceptives |
SN: | Postcoital (emergency) contraception (2001) |
SN: | Oxytocin |
SN: | Uterine stimulants |
SN: | Tocolytics |
SN: | Calcium antagonists and calcium channel blockers |
EW: | Vitamin D should be considered as hormone |
Que: | Describe the rationale the drug treatment of hyperthyroidism (2001) |
DT: | Thyrotoxicosis crisis (2005) |
EW: | Bisphosphonates are often prescribed to postmenopausal women (2006) |
EW: | Lispro insulin is used in infusion pump devices (2006) |
Que: | Discuss rationale for the use of progesterone with oestrogen in hormone replacement therapy (2006) |
Que: | Discuss rationale for the use of mifiprestone for termination of early pregnancy (2006) |
SN: | Selective oestrogen receptor modulators (2006) |
Que: | Classify drugs used in diabetes mellitus. Describe the pharmacology of oral hypoglycemic drugs (2007) |
TS: | Bisphosphonates in osteoporosis (2007) |
TS: | Tamoxifen in breast cancer (2007) |
SN: | Emergency contraceptives (2007) |
Que: | Explain why oxytocin and not ergometrine is used for augmenting the labour (2008) |
Que: | Give the rationale for the use of propranolol in thyrotoxicosis (2008) |
Que: | Give the rationale for the use of alendronate in osteoporosis (2008) |
TS: | Rosiglitazone in diabetes mellitus (2008) |
SN: | Emergency contraception (2008) |
G. CENTRAL NERVOUS SYSTEM
SN: | Objectives of general anaesthesia |
SN: | Factors affecting the partial pressure of anaesthetic attained in brain |
SN: | Classify intravenous anaesthetics. Outline their role in anaesthetic practice |
EW: | N2O is not considered as complete anaesthetic in abdominal operations |
ENU | General anaesthetics |
SN: | N2O |
SN: | Ether |
EW: | Enflurane is preferred over methoxyflurane |
SN: | Halothane |
EW: | Plasma concentration of phenytoin rises disproportionably at higher doses (2005) |
SN: | Recovery with thiopentone is rapid |
EW: | Neurolept analgesic should not be used in person with parkinsonism |
EW: | Dose of d-Tc is reduced to half in treatment with ether |
SN: | Complications of general anaesthesia |
SN: | Preanaesthetic medication |
SN: | Acute alcohol intoxication |
TS: | Disulfiram |
SN: | Disulfiram |
SN: | Treatment of methyl alcohol poisoning |
LQ: | Benzodiazepines |
EW: | Benzodiazepines are preferred over barbiturates as hypnotics (2003) |
EW: | Dose of phenobarbitone sodium is increased in treatment of neonatal jaundice |
TS: | Barbiturates |
SN: | Acute barbiturate poisoning |
SN: | Uses of diazepam |
EW: | Benzodiazepines are preferred over barbiturates as hypnotics |
SN: | Flumazenil |
SN: | Classify antiepileptic drugs |
SN: | Levodopa and carbidopa combination in parkinsonism (2005) |
TS: | Phenobarbitone as antiepileptic drug |
SN: | Phenytoin |
SN: | Carbamazepine |
SN: | Treatment of epilepsy |
SN: | Treatment of GTCS |
SN: | Treatment of status epilepticus |
TS: | Levodopa in parkinsonism |
DT: | Status epilepticus (2005) |
SN: | Advantages of carbidopa over levodopa |
TS: | Bromocriptine in epilepsy |
SN: | Treatment of drug induced parkinsonism |
SN: | Selegiline |
EW: | Combination of L-dopa and carbidopa is ineffective in drug-induced parkinsonism |
SN: | Classify antipsychotic drugs |
SN: | Mechanism of action of chlorpromazine |
SN: | Olanzapine in schizophrenia (2004) |
EW: | Chlorpromazine is not used as local anaesthetic instead of being more potent than procaine |
SN: | Enumerate drugs in order of preference which you would like to give in treatment of psychoses |
SN: | Haloperidol |
LQ: | Classify drugs used in mental illness. Give actions and adverse effects of chlorpromazine |
SN: | Pimozide |
EW: | Chlorpromazine is not used routinely for anxiety though it has antianxiety activity |
EW: | Chlorpromazine is not used in motion sickness |
SN: | Treatment of psychoses |
SN: | Classify antianxiety drugs. Discuss diazepam |
SN: | Buspirone |
LQ: | Antidepressants |
EW: | Tricyclic antidepressants are preferred over noradrenaline inhibitors for endogenous depression |
EW: | Use of physostigmine in treatment of overdose of tricyclic anti-depressants |
TS: | Fluoxetine in depression |
SN: | Treatment of endogenous depressions |
SN: | Lithium carbonate |
SN: | Opioid analgesics, uses and adverse effects |
TS: | Morphine as analgesic |
EW: | Morphine is contraindicated in head injury and bronchial asthma |
SN: | Acute morphine poisoning |
SN: | Pethidine |
TS: | Tramadol as analgesic |
SN: | Cardiac asthma |
SN: | Pentazocine |
SN: | Naloxone |
LQ: | Classify NSAIDs. Give uses and adverse effects |
SN: | Aspirin |
EW: | Aspirin causes gastric bleeding |
SN: | Phenylbutazone |
SN: | Indomethacin |
SN: | Ibuprofen |
SN: | Mephenamic acid |
SN: | Diclofenac sodium |
SN: | Ketorolac |
SN: | Treatment of acute paracetamol poisoning |
TS: | Gold in rheumatoid arthritis |
SN: | Treatment of rheumatoid arthritis |
SN: | Treatment of acute gout |
SN: | Chronic gout |
SN: | Allopurinol |
EW: | Allopurinol is preferred over probenecid for chronic gout |
SN: | Pyritinol |
LQ: | Classify the drugs used in treatment of psychosis. Discuss the mechanism of action, side effects with their management and therapeutic uses of haloperidol (2004) |
Que: | Give rationale for the use of diazepam in tetanus (2006) |
Que: | Give rationale for the use of sodium bicarbonate in salicylate poisoning (2006) |
Que: | Discuss the drug treatment of status epilepticus (2006) |
EW: | Ethanol is used in methanol poisoning (2007) |
EW: | Plasma concentration of phenytoin rises disproportionately at higher doses (2007) |
Que: | Classify antidepressant drugs. Write the mechanism of action, adverse effects and therapeutic uses of fluoxetine (2007) |
Que: | Discuss the drug treatment of paracetamol poisoning (2007) |
EW: | Thalidomide is used for lepra reaction (2007) |
Que: | Give rationale for the use of hydroxychloroquine in systemic lupus erythematosis (2007). |
Que: | Explain why diazepam though a drug of choice for status epilepticus is not recommended for maintenance therapy of epilepsy (2008) |
Que: | Explain why halothane is frequently combined with nitrous oxide for general anesthesia (2008) |
LQ: | Enumerate commonly used opioids. Write the mode of action, indications and contraindications for the use of morphine (2008) |
Que: | Give the rationale for the therapeutic use of combining levodopa with carbidopa in parkinsonism (2008) |
Que: | Discuss the drug treatment of generalized tonic clonic seizures (2008) |
Que: | Discuss the drug treatment of acute gout (2008) |
TS: | Clozapine in schizophrenia (2008) |
SN: | Midazolam (2008). |
H. CARDIOVASCULAR SYSTEM
LQ: | Classify antihypertensive drugs. Discuss the mechanism of action, side effects and therapeutic uses of enalapril (2005) |
EW: | Enalapril should not be give concurrently with triamterene (2003) |
SN: | Treatment of atrial fibrillation |
LQ: | Classify antiarrhythmic drugs give mechanism of action |
EW: | Paroxysmal tachycardia due to quinidine occurs only in patients of atrial fibrillation |
TS: | Lignocaine as antiarrhythmic drugs |
LQ: | Cardiac glycosides |
SN: | Digoxin induced cardiac toxicity |
SN: | Drug treatment of cardiogenic shock |
SN: | Drug treatment of congestive heart failure |
TS: | Vasodilatation in CHF |
EW: | Alteplase is used in the treatment of myocardial infarction (2002) |
EW: | Digitalis is used in atrial fibrillation |
TS: | Digitalis in CHF |
SN: | Amiodarone |
TS: | Verapamil in arrhythmia |
EW: | Verapamil is not given with propranolol |
SN: | Lignocaine in ventricular arrhythmias (2005) |
EW: | There is marked difference in action of verapamil and nifedipine whereas both are calcium channel blockers |
SN: | Treatment of angina pectoris |
EW: | Aminophylline is not used in treatment of angina pectoris |
EW: | Propranolol is not used in vasospastic angina |
EW: | Streptokinase is used in the treatment of myocardial infarction (2004) |
SN: | Classify antianginal drugs |
TS: | Glycerol trinitrate |
EW: | Nifedipine causes headache |
TS: | Calcium channel blockers as antianginal drugs |
SN: | Amlodipine |
EW: | Drug free period is advocated for transdermal nitroglycerine therapy in patients suffering from angina pectoris (2003) |
TS: | Dipyridamole |
SN: | Management of myocardial infarction |
SN: | Classify antihypertensive drugs |
EW: | Dopamine is used in the management of shock (2004) |
TS: | Calcium channel blockers in hypertension |
TS: | Thiazides in hypertension |
SN: | Indications and drawbacks of using furosemide in hypertension |
SN: | Use of hydralazine in HT |
SN: | Treatment of hypertension |
SN: | Hypertension in pregnancy |
Que: | Discuss the therapeutic status of thrombolytic agents in myocardial infarctions (2001) |
SN: | Cavedilol in hypertension (2004) |
DT: | Hypertensive emergencies (2004) |
Que: | Give rationale for the therapeutic use of adenosine in the treatment of paroxysmal atrial tachycardia (2007) |
TS: | ACE inhibitors in heart failure (2007) |
EW: | Digoxin is contraindicated in Wolf-Parkinson-White syndrome (2006) |
Que: | Enumerate drugs for the treatment of congestive heart failure Discuss the mechanism of action, therapeutic uses and adverse effects of enalapril (2006) |
Que: | Give rationale for the use of carvidelol in heart failure (2006) |
Que: | Give rationale for the use of adenosine in supraventricular tachycardia (2006) |
Que: | Explain why digoxin but not adrenaline is used in congestive heart failure (2008) |
Que: | Give the rationale for the therapeutic use of dopamine in cardiogenic shock (2008). |
I. KIDNEY, BLOOD AND GIT
SN: | Classify diuretics, also give uses |
EW: | Furosemide is used in the treatment of acute pulmonary edema (2004) |
SN: | Frusemide |
SN: | Complications of diuretic therapy |
SN: | Potassium sparing diuretics |
EW: | Thiazides are used in diabetes insipidus (2004) |
SN: | Drug treatment of microcytic hypochromic anaemia |
EW: | Furosemide is also known as a high ceiling diuretic (2005) |
SN: | Management of acute iron poisoning |
EW: | Both folate and Vitamin B12 deficiency produces several common manifestations |
EW: | Vitamin B12 is preferred over folic acid for treatment of pernicious anaemia |
SN: | Folic acid |
EW: | Vitamin B12 is administered parenterally in patients of pernicious anaemia (2002) |
SN: | H. pylori infection (2002) |
EW: | Use of folinic acid with methotrexate |
SN: | Vitamin K |
SN: | Warfarin (2002) |
EW: | Vitamin K1 used to reverse overdose of oral anticoagulants |
SN: | Anticoagulants |
EW: | Oral anticoagulants take days to act while heparin takes minute |
SN: | Heparin |
SN: | Oral anticoagulants |
SN: | Treatment of bleeding due to oral anticoagulants |
EW: | Cefoperazone should be used cautiously in patients on anticoagulant therapy (2005) |
EW: | Oral anticoagulants should not be used in pregnancy |
SN: | Fibrinolytic therapy |
SN: | Streptokinase |
EW: | Streptokinase has little or no benefit if infused after 12 hours of onset of symptoms in MI |
TS: | Antifibrinolytics |
TS: | Aspirin as antithrombotic drugs |
SN: | Uses of antiplatelet drugs |
SN: | Clofibrate |
SN: | Gemfibrozil |
EW: | Clofibrate is used in hyperlipoproteinemia |
TS: | Lovastatin as hypolipidemic drug |
SN: | Statins in dyslipidemia (2005) |
SN: | Uses of plasma expanders |
Que: | Discuss the therapeutic status of Sulfasalazine in ulcerative colitis (2001) |
SN: | Classify drugs used for treatment of peptic ulcer |
SN: | Ranitidine |
TS: | Omeprazole in peptic ulcer |
SN: | Erythropoietin in chronic renal failure (2005) |
EW: | Loperamide should be avoided in treatment of infective diarrhoea (2004) |
SN: | Five important properties of an ideal antacid |
EW: | Magnesium trisilicate is used in treatment of peptic ulcer |
EW: | Aluminium hydroxide is used with Mg(OH)2 in antacid gel |
Que: | Describe the rationale the drug treatment of H.pylori associated upper gastrointestinal disorders (2001) |
TS: | Carbenoxolone sodium |
EW: | Mesna is used with ifosfamide (2005) |
SN: | Cinnarizine |
SN: | Metoclopramide |
TS: | Domperidone |
SN: | Cisapride |
SN: | Stimulant purgatives |
SN: | Bisacodyl |
SN: | Purgative abuse |
SN: | Treatment of diarrhoea |
SN: | Oral rehydration therapy |
EW: | Use of glucose in ORS |
SN: | Diphenoxylate |
Que: | Describe the mechanism of action of purgatives (2001) |
Que: | Describe the rationale the drug treatment of H.pylori associated upper gastrointestinal disorders (2001) |
Que: | Describe the mechanism of action of purgatives (2001) |
DT: | Postoperative paralytic ileus (2005) |
SN: | Rofecoxib as anti-inflammatory (2005) |
EW: | Ketoconazole should not be used with cisapride (2006) |
EW: | Low molecular weight heparins are preferred over unfractionated heparin preparations (2006) |
Que: | Discuss rationale for the use of corticosteroids in ulcerative colitis (2006) |
Que: | Discuss the drug treatment of peptic ulcer (2006) |
TS: | Folic acid in anaemia (2006) |
EW: | Thiazide diuretics cause calcium retention while loop diuretics cause increase in calcium excretion (2007) |
TS: | Statins in dyslipidemia |
EW: | Heparin and Warfarin are started together in acute thrombo-embolic states (2007) |
Que: | Explain why acetazolamide is not preferred as a diuretic agent (2008) |
Que: | Give the rationale for the therapeutic use of mannitol in cerebral oedema (2008) |
TS: | Terlipress in bleeding oesophageal varices (2008) |
Que: | Explain why ondansetron is preferred over prochlor-perazine for the treatment of cancer chemotherapy induced emesis (2008) |
Que: | Discuss the drug treatment of peptic Ulcer with H. pylori infection (2008) |
SN: | Plasma expanders (2008). |
J. ANTIMICROBIAL DRUGS
SN: | Classify antimicrobial drugs |
Que: | Describe the factors which govern the selection of an antimicrobial drug for treatment of infections (2001) |
SN: | Drug resistance |
EW: | Penicillin is lethal to bacterial cell but practicaly non-toxic to mammalian cell (2002) |
SN: | Suprainfection |
SN: | Advantages and disadvantages of combined use of antimicrobials |
Que: | Describe the mechanism of action of aminoglycoside antibiotics (2001) |
SN: | Prophylactic use of antimicrobials |
Que: | Describe the mechanism of action of aminoglycoside antibiotics (2001) |
SN: | Adverse effects of sulfonamides |
SN: | Uses of cotrimoxazole |
EW: | Sulphadoxine is combined with pyrimethamine (2004) |
SN: | Trimethoprim |
SN: | Ciprofloxacin, uses and adverse effects |
SN: | Mechanism of action of penicillins |
SN: | Adverse effects of penicillin specially hypersensitivity |
SN: | Uses of penicillins |
SN: | Semisynthetic penicillin |
SN: | Ampicillin |
SN: | Amoxicillin |
Que: | Discuss the therapeutic status of metronidazole in anaerobic infections (2001) |
SN: | Beta lactamase inhibitors |
SN: | Sulbactam |
LQ: | Cephalosporins, classification, mechanism of the action, uses and adverse effects |
SN: | Third generation cephalosporins |
LQ: | Classify tetracyclines, mechanism of action, uses and adverse effects of tetracyclines also give precautions before prescribing tetracycline |
SN: | Chloramphenicol |
LQ: | Give properties, mech. of action, toxicities and uses of aminoglycoside antibiotics |
SN: | Streptomycin |
SN: | Amikacin |
SN: | Neomycin |
SN: | Erythromycin |
SN: | Roxithromycin |
SN: | Nitrofurantoin |
SN: | Treatment of urinary tract infections |
SN: | Fluoroquinolones in tuberculosis (2005) |
SN: | Classify antitubercular drugs |
SN: | Isoniazid |
SN: | Rifampicin |
SN: | Acyclovir in herpes infections (2005) |
SN: | Ethambutol |
SN: | Pyrazinamide |
SN: | Treatment of tuberculosis |
SN: | Short course chemotherapy |
SN: | Lamotrigine in epilepsy (2004) |
TS: | Corticosteroids in treatment of tuberculosis |
TS: | Fluoroquinolones in tuberculosis (2002) |
SN: | Clofazimine |
TS: | Rifampicin in leprosy |
SN: | Multibacillary leprosy (2002) |
SN: | Treatment of leprosy |
SN: | Multidrug therapy of leprosy |
TS: | Amphotericin B in fungal infections |
SN: | Azole anti-fungal agents (2001) |
SN: | Griseofulvin |
DT: | Multi-bacillary leprosy (2005) |
SN: | Clotrimazole |
TS: | Ketoconazole |
SN: | Fluconazole |
SN: | Acyclovir |
SN: | Zidovudine |
SN: | Interferon α |
EW: | Classify drugs used in the treatment of malaria. Discuss the pharmacology of chloroquine and mefloquin (2002) |
SN: | Classify antimalarial drugs |
SN: | Radical treatment of malaria |
LQ: | Chloroquine |
TS: | Mefloquine |
TS: | Quinine |
SN: | Pyrimethamine |
SN: | Primaquine |
SN: | Classify antiamoebic drugs |
SN: | Metronidazole |
SN: | Metronidazole in the management of pseudomembranous colitis (2002) |
SN: | Imipenem in combination with cilastatin (2002) |
TS: | Chloroquine as antiamoebic drug |
SN: | Diloxanide furoate |
TS: | Mebendazole |
SN: | Albendazole |
TS: | Pyrantel pamoate |
SN: | Ivermectin |
SN: | Niclosamide |
SN: | Praziquantel |
EW: | Cisapride should not be used in patients receiving erythromycin (2001) |
EW: | Use of mefloquin is restricted to areas where chloroquine resistance is prevalent (2001) |
SN: | Directly observed treatment strategy (DOTS) for tuberculosis (2005) |
SN: | Quinine in cerebral malaria (2005) |
Que: | Enumerate aminoglycoside antibiotics. Discuss their mechanism of action, anti-bacterial spectrum, therapeutics uses and side effects (2006) |
TS: | Fluoroquinolones in tuberculosis (2006) |
SN: | Irrational use of antimicrobial agents (2006) |
SN: | Macrolide antibiotics (2006) |
EW: | Anaerobic microorganisms are resistant to aminoglycoside antibiotics (2007) |
Que: | Discuss the drug treatment of MDR tuberculosis (2007) |
TS: | Cyclosporine in renal transplants (2007) |
SN: | Albendazole (2007) |
Que: | Explain why ketoconazole is useful in treatment of Cushing's syndrome (2008) |
Que: | Give the rationale for the use of diloxanide furoate and metronidazole in amoebiasis (2008) |
Que: | Discuss the drug treatment of chronic, recurrent urinary tract infection in females (2008) |
LQ: | What is HAART? Write the mode of action, adverse effects and clinically important drug interactions of nevirapine (2008) |
TS: | Ivermectin in filariasis (2008) |
TS: | Artemisinin in malaria (2008) |
SN: | Post antibiotic effect (2008) |
K. ANTICANCER DRUGS
SN: | Classify anticancer drugs |
SN: | General toxicity of cytotoxic drugs |
SN: | Ondansetron in chemotherapy induced vomiting (2004) |
SN: | Tamoxifen in the treatment of carcinoma breast (2002) |
SN: | Nucleoside reverse transcriptase inhibitors (2005) |
SN: | Cyclophosphamide |
SN: | Methotrexate |
SN: | Methotrexate in rheumatoid arthritis (2005) |
SN: | Vincristine |
SN: | Rubidomycin |
SN: | 5-FU (5-Fluorouracil) |
SN: | Tamoxifen in breast cancer (2004) |
DT: | Emesis due to cancer chemotherapy (2005) |
Que: | Discuss the drug treatment of HIV infection (2007) |
SN: | Paclitaxel (2007) |
Que: | Explain why dexrazoxane pretreatment is given with doxorubicin therapy (2008) |
Que: | Give the rationale for the use of filgrastim in cancer chemotherapy (2008). |
L. MISCELLANEOUS DRUGS
SN: | Vitamin A (2002) |
EW: | Deficiencies of folic acid and vitamin B12 have many common features (2001) |
SN: | Action of kaolin on GIT |
SN: | Astringents |
DW: | Irritants and counter irritants |
SN: | Mechanism of counter irritation pain relief |
SN: | Keratolytics |
SN: | Melanizing agents |
SN: | Sunscreens |
SN: | Treatment of acne vulgaris |
SN: | Topical steroids |
DW | Antiseptics and disinfectants |
SN: | Role of antiseptics in hospitals |
SN: | Cetrimide |
SN: | Drug of choice for mercury poisoning |
SN: | Penicillamine |
SN: | Desferrioxamine |
DW | Retinol and retinoic acid |
SN: | Vitamin E |
DW | Calcitonin and vitamin D |
SN: | Hypervitaminosis A |
SN: | TAB vaccines |
SN: | Hepatitis B vaccine |
SN: | DPT vaccine |
Que: | Discuss the drug treatment of scabies (2006). |
Note:
LQ: | Long Questions |
SN: | Short Note |
DW: | Difference Between |
EW: | Explain Why |
TS: | Therapeutic Status |
DT: | Drug Treatment |
Que: | Question |
ENU: | Enumeration |
Nm: | Normal |
Abn: | Abnormal |
3. TOPICS FOR PRESCRIPTION WRITING
- Treatment of pulmonary tuberculosis
- Treatment of bronchial asthma
- Treatment of peptic ulcer
- Treatment of scabies
- Treatment of infective diarrhoea
- Treatment of congestive heart failure
- Treatment of non-productive cough
- Treatment of hypertension
- Treatment of malaria (Both presumptive and radical)
- Treatment of migraine
- Treatment of meningitis
- Treatment of myocardial infarction
- Treatment of pneumonia
- Treatment of sinusitis
- Treatment of UTI.
4. TOPICS FOR PHARMACY PRACTICAL
You are provided raw material and allowed to prepare the drug and you are supposed to know:
- Method of preparation
- Uses
- Leading questions
Drugs
- Calamine lotion
- Mendel's paint
- ORS
- Carminative mixture.
5. TOPICS FOR EXPERIMENTAL PRACTICAL
An experimental animal, e.g. frog, rabbit, cat's ileum to provided to you and you are asked to demonstrate the effects of various drugs on these animals or organs of the animals:
- Frog's heart
- Rectus abdominis of frog
- Ileum of cat
- Rabbit's eye.
6. TOPICS FOR THEORY VIVA
- Various routes of drug administration
- First pass metabolism
- Plasma half life
- Plateau principal
- Drug potency and efficacy
- Side effects of drug
- Muscarinic and nicotinic receptors
- Treatment of migraine
- Cholinergic and anticholinergic drugs
- Atropine
- Adrenaline in anaphylactic shock
- Centrally acting muscle relaxants
- Uses and limitations of local anaesthetics
- Spinal anaesthesia and its complications
- Epidural anaesthesia
- Treatment of bronchial asthma
- Oral hypoglycemia
- Management of diabetes mellitus
- Complications of diabetes mellitus
- Uses of steroids
- Anabolic steroids
- Tocolytics
- Calcium metabolism
- Stages of general anaesthesia
- Preanaesthetic medication.
- Disulfiram
- BZDs
- Treatment of epilepsy
- Lithium carbonate
- Morphine
- Paracitamol poisoning
- Treatment of rheumatoid arthritis
- Digitalis
- Treatment of cardiac arrhythmias
- GTN
- Nifedipine
- Treatment of hypertension
- Various iron preparations
- Treatment of anaemias
- Plasma expanders
- Treatment of peptic ulcer
- Treatment of constipation, diarrhoea
- Indications of use of antimicrobial drugs
- Ciprofloxacin, ofloxacin
- Amoxycillin uses
- Cephalosporins
- Uses and limitations of tetracyclines
- Gentamycin, erythromycin
- Doses and adverse effects of antitubercular drugs
- Local and systemic antifungal drugs
- Antiviral drugs
- Antimalarial drugs
- Cyclophosphamide
- Methotrexate
- 5-FU
- Sunscreens
- Vitamin E.
7. DRUG OF CHOICE
1. Actinomycosis | Penicillin-G (IM) |
2. Acute congestive glaucoma | Pilocarpine nitrate (drops) |
3. Acute LVF | Morphine (IV) |
4. Acute severe asthma | Aminophylline (IV) |
5. Alcohol addiction | Disulfiram |
6. Amoebiasis | Metronidazole (oral) |
7. Amoebic liver abscess | Metronidazole, emitine, chloroquine |
8. Anaphylactic shock | Adrenaline (SC) |
9. Asthma | Salbutamol (inhalation), Aminophylline |
10. Belladonna poisoning | Phyostigmine (IV) |
11. Brucellosis | Tetracycline (oral) |
12. Burkitt's lymphoma | Cyclophosphamide (oral) |
13. Campylobacter enteritis | Fluoroquinolones |
14. Chlamydia | Tetracycline (oral) |
15. Chanceroid | Cotrimoxazole (oral) |
16. CHF | Digoxin (oral) |
17. Chronic congestive glaucoma | Pilocarpine nitrate (topical) |
18. Chronic gout | Probenecid (oral) |
19. Chronic gout | Probenecid (oral)/Allopurinol |
20. Chronic myeloid leukemia | Busulfam (oral) |
21. Cirrhotic edema | Spironolactone (oral) |
22. Clostridium difficale | Vancomycin |
23. Cryptococcal meningitis | Fluconazole |
24. Cyanide poisoning | Sodium nitrate (IV) |
25. Cystinuria | Penicillamine |
26. Diazepam poisoning | Flumazenil (IV) |
27. Digitalis induced tachycardia | Phenytoin |
28. Diphtheroids | Vancomycin (IV) |
29. Dissociated analgesia | Ketamine (IV), Ethylate (IV) |
30. Drug induced parkinsonism | Trihexyphenidyl |
31. Endogenous depression | Imipramine, trazodone |
32. Endometriosis | Danazol (oral) |
33. Enteric fever | Ciprofloxacin (oral) |
34. Estrogen dependent breast cancer | Tamoxifen |
35. Fibrinolysis | Alteplase (rt-PA) (IV) |
36. Filariasis | Diethylcarbamazine citrate (oral) |
37. Gameticidal | Primaquine (oral) |
38. Genital herpes | Acyclovir (topical) (oral) |
39. Gonorrhoea | Procaine, penicillin (IM) |
40. Gout (acute attack) | NSAID (Indomethacin) |
41. Grand mal epilepsy | Phenytoin (oral) |
42. Guinea worm infestation | Niridazole (oral) |
43. H. influenzal meningitis | Chloramphenicol (IV) |
44. H. influenzal pneumonia | Chloramphenicol (oral) |
45. H. nana infestation | Praziquantel (oral) |
46. H. simplex keratoconjunctivitis | Idoxuridine (topical) |
47. Heparin antagonist | Protamine sulphate |
48. Hg poisoning | Dimercaprol (IV) |
49. Hookworm infestation | Pyrantel pamoate (oral), Mebendazole |
50. Hydatid disease | Albendazole |
51. Hypertensive emergency | Sodium nitroprusside (IV), GTN (IV), Diazoxide (IV) |
52. Insecticide poisoning | Pralidoxime and atropine (IV) |
53. Iron poisoning | Desferrioxamine |
54. Kala azar (resistant) | Pentamidine (IM) |
55. Legionnaire's pneumonia | Erythromycin (oral) |
56. Lepra reaction | Clofozemine (oral) |
57. Listerosis | Penicillin-G (IM) |
58. Lymphogranuloma venerum | Tetracycline (oral) |
59. Male contraceptives | Gossipol (oral) |
60. Malignant hyperthermia | Dentrolene (IV) |
61. Mania-depressive | Lithium carbonate (oral) |
62. Meningococcal pneumonia (prophylaxis) | Rifampicin (oral) |
63. Methecillin resistance | Vancomycin (IV) |
64. Methotrexate poisoning | Folinic acid (IV) |
65. Methyl alcohol poisoning | 4-methyl pyrazole (IV) |
66. Microprolactenemia | Bromocriptine |
67. Migraine (prophylaxis) | Propranolol (oral) |
68. Monilial vaginitis | Nystatin (oral) |
69. Morphine poisoning | Naloxone (IV) |
70. Motion sickness | Hyoscine (oral, IV) |
71. Myasthenia gravis | Neostigmine (oral) |
72. Mycoplasmal pneumonia | Erythromycin (oral) |
73. Myxoedema coma | Liothyronine (IV) |
74. Nephrogenic diabetes Inspidus | Thiazide |
75. Neurocysticercosis | Praziquantel (oral) |
76. Neurogenic diabetes mellitus | ADH (intranasal) |
77. Neurolept analgesia | Fentanyl droperidol (IV) |
78. Noctural enuresis | Imipramine (oral) |
79. Obssessive-compulsive/phobic state | Trazodone (oral) |
80. Obstetric local analgesia | Bupivacaine |
81. Organophosphate poisoning | Atropine (IV) |
82. Paraoxymal supra-ventricular tachycardia | Verapamil (IV) |
83. Pb poisoning | Calcium disodium EDTA |
84. PCM poisoning | N-acetylcystine (IV), |
85. Penicillinase resistance | Methecillin (IM/IV) |
86. Peptic ulcer | Omeprazole (oral) |
87. Petit mal epilepsy | Ethosuximide (oral) |
88. Pneumococcal pneumonia | Penicillin (IM) |
89. Pneumocystitis carinii | Pentamidine + Cotrimoxazole (IV) |
90. Postmenopausal syndrome | Estrogen (oral) |
91. Postpartum hemorrhage | Methyl ergotamine |
92. Radical cure | Primaquine (oral) |
93. Raised intracranial pressure | Mannitol (IV) |
94. Refractory CHF | Amrinone (IV) |
95. Relapsing fever | Tetracycline |
96. Rheumatic fever | Aspirin (oral) |
97. Rheumatoid arthritis | NSAID (Aspirin) |
98. Roundworm infestation | Albendazole (oral) |
99. Scabies | Benzyl benzoate (topical) |
100. Schizophrenia | Chlorpromazine |
101. Shigella enteritis | Norfloxacin (oral) |
102. Spastic constipation | Dietary fibre |
103. Strongyloides stercoralis | Thiabendazole |
104. Syphilis | Benzathine-Penicillin (IM) |
105. Tapeworm infestation | Praziquantel (niclosamide) (oral) |
106. Thyrotoxicosis | Carbimazole + Ppt surgery |
107. Tobacco amblyopia | Hydrocobalamine |
108. Transient insomnia | Triazolam, Temazepam |
109. Trichomonial, vaginitis | Metronidazole (oral) |
110. Trigeminal neuralgia | Carbamazepine (oral) |
111. Trypanosomiasis | Pentamidine |
112. Tuberculosis | INH + R + Z + E (oral) |
113. Type III hyperlipidemia | Gemfibrozil |
114. Type IV hyperlipidemia | Nicotinic acid (oral)/Gemfibrozil |
115. Type V hyperlipidemia | Nicotinic acid (oral) Gemfibrozil |
116. Ulcerative colitis | Sulfasalazine (oral) |
117. Uterine contraceptive | Gossypol (oral) |
118. Uterine relaxant | Ritodrine (IV), Salbutamol |
119. Ventricular Es | Lidocaine (IV) |
120. Ventricular tachycardia | Lidocaine (IV) |
121. Visceral leishmaniasis | Sodium stibogluconate (IM) |
122. Whip worm | Mebendazole/Albendazole |
123. Whooping cough | Erythromycin (oral) |
124. Wilson's disease | d-penicillamine (oral) |
125. Yersenia enterocolitis | Cotrimoxazole |
8. EXPLAIN WHY
SOME EXAMPLES (SOLVED)
- Rationale for combined used of Al hydroxide with Mg hydroxide in antacid gel.
BECAUSE:
- Mg(OH)2 is laxative and Al2(OH)3 constipating. Combination annual each others effect and bowel movement is not affected.
- Mg(OH)2 hastens gastric emptying while Al2(OH)3 decrease gastric emptying. Combination has no effect on gastric emptying.
- Mg trisilicate in treatment of peptic ulcer.
BECAUSE:
- Mg trisilicate produces silica by reacting with HCl. Silica produced is gelatinous, it is absorbed and inactivates pepsin and protects ulcer base by forming coating over it and prevents contact of HCl to ulcer base.
- Has good ANC.
- Does not increases pH more than 3.
- ACH is not used therapeutically.
BECAUSE:
- (i) It is irritant, (ii) Because of evanescent and nonselective action and degrades fastly (t½: 2 to 5 min).
- Atropinic drugs also prevent laryngospasm.
- Atropinic drugs have no action on laryngeal muscles as they are skeletal muscles. Atropinic drugs reduce respiratory secretions that reflexly predispose to laryngospasm and hence prevent laryngospasm.
- Ephedrine is orally active while adrenaline is not.
- Ephedrine is resistant to MAO (monoamine oxidase) so it is not degraded by liver and hence is orally active.
- Sch first causes stimulation and then paralysis of skeletal muscles.
- Sch is a depolarizing blockers and has intrinsic activity for NM receptors. It depolarizes muscle end plate by opening Na+ channels and initially producing twitching and fasciculations. It does not dissociate rapidly from receptor then all Ach gets depleted and hence causes paralysis.
- D-TC causes fill in BP.
BECAUSE:
- Ganglionic blockade,
- Histamine release and
- Reduces venous return.
- Sch in some individual causes prolonged apnoea.
- Normally pseudocholinesterase breaks Sch into succinic acid and choline. In some individuals pseudocholinesterase is absent hence Sch is not hydrolysed and causes prolonged apnoea by phase II blockade resulting in muscle paralysis and apnoea lasting hours.
- Oxethazine is a good anaesthetic for gastric mucosa while other LA are not.
- Oxethazine is a good, potent topical anaesthetic. It has unique property to ionise to a very small extent even at low pH. It is therefore highly effective in anesthesing gastric mucosa by acting on receptors from inside.
- Salbutamol is preferred over isoprenaline in treatment of bronchial asthma.
BECAUSE:
- Salbutamol is highly β2 selective whereas isoperaline is β1 + β2 selective isoprenaline causes tachycardia via β1 receptor whereas this disadvantage is not encountered with salbutamol.
- Salbutamol is safer and longer acting than isoprenaline.
- Aminophylline is given by slow IV injection.
- Rapid IV injection of aminophylline causes precordial pain syncope and even sudden death due to marked fall in BP. Ventricular arrhythmias or asystole hence given by slow IV injection.
- Antihistamines are ineffective in bronchial asthma.
BECAUSE:
- LT and PAF are more important mediators than histamine which are not antagonised by antihistamines.
- Concentration at site may not be sufficient to block high concentration of histamine.
- They do not have bronchodilator action.
- Halothan causes malignant hyperthermia.
- Due to intracellular release of Ca++ from sacroplasmic reticulum causing persistent muscle contraction and increased heat production hence cause malignant hyperthermia.
- Morphine causes vasodilatation.
BECAUSE:
| ↓BP |
- Neurolept analgesic should not be used in person with parkinsonism.
- In parkinsonism extrapyramidal symptom are due to ↓ in dopamine. Droperidol in neurolept analgesic is a dopamine antagonist it will further aggravate parkinsonism so it is not given in parkinsonism.
- Antipsychotic drugs are ineffective in motion sickness.
- These drugs act via dopaminergic pathway through CTZ which is not involved in motion sickness. Hence, ineffective in this condition.
EW:Half life of a drug varies for drugs undergoing zero order kinetics (2006)SN:Polypharmacy (2006)SN:Drug tolerance (2006)SN:Pharmacovigilance (2006). - Oxazepman used in elderly and in patients with liver disease as antianxiety.
- Its hepatic metabolism is in significant and of short duration of action hence used. Also used in short lasting anxiety cases.
- Why there is not antidote for acute barbiturate poisoning.
- In barbiturate poisoning patient is in comatose. If antidote used in attempt to awaken the patient (e.g. Metrazole) then it is dangerous because it may precipitate convulsion and morbidity and mortality is increased, hence no antidote.
- Gastric lavage is done in morphine poisoning even if drug is injected.
- Morphine is a basic drug, it is partitioned to gastric acid juice. To prevent its diffusion back into blood gastric lavage is done with KMnO4.
- Morphine is contraindicated in bronchial asthma.
BECAUSE:
- Morphine can precipitate attack of bronchial asthma by histamine release
- It depresses respiratory and cough centre, hence contraindicated.
- Overdose of pathidine produces many excitatory effects while it is equally sedative as morphine.
- In overdose of pathidine, its metabolite norphathidine accumulates which has excitatory action.
- Why morphine is used in acute left ventricular failure.
BECAUSE:
- It decreases preload on heart by causing peripheral pooling of blood.
- It tends to shift blood from pulmonary to systemic circulation.
- It calms air hunger by causing respiratory depression.
- It cuts sympathetic innervation by calming the patient → Reduces cardiac work.
- Aspirin causes gastric bleeding.
- It is a acidic drug and remains unionised and diffusible in gastric acid juice → enters mucosal cell and ionise and become indiffusible (ion trapping).
- Further aspirin particles coming in contract with gastric mucosa promote local back diffusion of acid → focal necrosis of mucosal cells → acute ulcers, erosive gastritis, congestion and microscopic bleeding → gastric bleeding.
- PCM has no anti-inflammatory property.
- At the site of inflammation peroxidase is formed, which inhibits PCM and hence it is not able to inhibits cox in presence of peroxidase → no anti-inflammatory property.
- KCl is given in diabetic ketoacidosis.
- K+ is lost in urine during ketoacidosis and serum K+ is usually normal due to exchange with intracellular stores when insulin therapy is started, ketoacidosis subsides and K+ is driven intracellular → dangerous hypokalemic can occur hence KCl is given in diabetic ketoacidosis.
- Biguanides not used in underweight patients with NIDDM.
- They have anorectic action and can further reduce weight and complications may appear so not given in underweight patients with NIDDM. Biguanides also inhibit intestinal absorption of glucose, amino acids and vitamin B12.
- Progesterone is added to estrogen in OC while later alone can promote contraception.
BECAUSE:
- Progesterone ensure prompt bleeding at the end of cycle and blocks the risk of developing endometrial carcinoma due to estrogen hence it is added with estrogen.
- Both estrogen and progesterone synergist to inhibit ovulation.
- Estrogen in high doses is effective as post-coital contraception.
- High dose of estrogen with or without progesterone given for few days and then discontinued induces bleeding → the postcoital pill may thus dislodge a just implanted blastocyst or may interfere with fertilization or implantation.
- Estrogen is favourable to sperm penetration.
BECAUSE:
- Increase rhythmic contraction of fallopian tubes and uterus.
- Induces a watery secretion from cervix.
- Estrogen component of OC is mainly responsible for venous thromboembolism.
BECAUSE:
- Increase blood coagulation factors,
- Decrease antithrombin III
- Decrease plasminogen activator in endothelium, and
- Increase platelet aggregation.
- Oxytocin is given by slow IV infusion and in low doses.
BECAUSE:
- Because of its shorter t½ and slow IV infusion, intensity of action can be controlled and action can be quickly terminated.
- Low concentrate allow Normal relaxations between contraction → foetal oxygenation does not suffer.
- Lower segment is not contracted → foetal descent is not compromised.
- Ergotamine and methyl ergotamine are preferred over oxytocin to stop bleeding.
- Because they cause sustained tonic contraction → the perforating arteries are compressed by myometrial mesh work → bleeding stops which is not achieved by oxytocin. Hence preferred over oxytocin.
- Estrogen is contraindicated during pregnancy.
BECAUSE:
- It increases incidence of vaginal cancer is ? offspring.
- Increases incidences of genital abnormalities in ? offspring.
Hence it is contraindicated in pregnancy.
- Caffeine and ergotamine are given in migraine.
BECAUSE:
- Caffeine constricts cerebral vessels → reduces headache.
- Caffeine ↑es absorption of ergotemine.
- They act synergistically.
- Doxycycline is safest in renal failure.
BECAUSE:
- Ninety percent drug is excreted in feces as conjugated.
- t½ is not affected by renal failure.
- It does not aggravate azootemia.
- Higher levels are maintained longer → less toxicity.
- Tetracycline should not be given to children.
BECAUSE:
- It has antianabolic effect.
- Tetracycline forms orthophosphate complex which gets deposited in developing bones and teeth and cause brown discoloration of teeth.
- Defective enamel causes hypoplasia of teeth.
- Increases risk of caries.
- Tetracycline should not be given to pregnant women.
- Because it crosses placenta and temporarily suppresses bone gowth → retardation of fetal bone growth and it also causes ↑ in intracranial pressure in some infants.
- Penicillin is not toxic to man but is toxic to microorganism.
- Penicillin inhibits peptidoglycan cell wall synthesis and human beings have no cell wall. Also it is needed in low concentration hence not toxic to man.
- Tetracycline is not given in sore throat.
BECAUSE:
- Sore throat is usually viral in origin where it is ineffective.
- Resistance develops and it is also costly and other more effective antibiotics are available.
- NaHCO3 is not the antacid of choice.
BECAUSE:
- In the intestine it is unable to neutralize HCO3¯ and hence causes systemic alkalosis.
- Short duration of action.
- ↑ es pH >2.5 and hence impair digestion.
- Produces CO2 in stomach → abdominal discomfort.
- It may worsen CHF and edema by ↑ ing Na+ load.
9. DOSES OF SOME IMPORTANT DRUGS IN CHILDREN
Method of calculation of drug dose in children in general, Clark's rule is applicable if adult dose is known
- SA × Adult dose1.7
- SA of child in M2 × 60 = % of Adult dose.
A. ANALGESICS, ANTIPYRETICS AND ANTI-INFLAMMATORY DRUGS
- Acetylsalicyclic acid—30–65 mg/kg/day 6 hr oral
- Codeine phosphate—3 mg/kg/day qid
- Dextropropoxyphane hydrochloride—2–4 mg/kg/day bd
- Diclopherol Na—2–5 mg/kg/day tds
- Ibuprofen—20 mg/kg/day tds
- Indomethacin—3 mg/kg/day tds
- Morphine SO4—0.1–0.2 mg/kg/day SC
- Nimesulide—5 mg/kg 8–12 hr
- Paracetamol—30–60 mg/kg/day 4–6 hr oralor 10 mg/kg/day injectionor injection 5 mg/kg/day single dose
- Pethidine hydrochloride—1–2 mg/kg/dose IM or IV.
B. ANTHELMINTICS
- Albendazole—200 mg single dose (1–2 yrs)400 mg > 2 yrs children and adult.
- Levamisol—2 mg/kg single dose at night for ascariasis.
- Mebendazole—100 mg bd × 3 days for ascariasis200 mg bd × 3 days for tapeworms repeat after 2 weeksfor hydatid cyst—30 mg/kg/day 8 hrly oral × 4 weeks
- Niclosamide—1 gm empty stomach followed by next dose after 1 hr
- Parziquntel—50 mg/kg/day 8 hrly oral × 10–14 days
- Pyrantel pamoate—11 mg/kg single dose
C. ANTIBIOTIC AND CHEMOTHERAPEUTIC AGENTS
- Aminoglycosides
- Amikacin*—7.5 mg/kg/dose IV/IM
- Gentamycin sulfate*—2.5 mg/kg/dose IM/IV
- Kanamycin sulfate*—2.5 mg/kg/dose IM/IV
- Neomycin sulfate—12.5 mg/kg/dose oral in diarrhea and 3 g/m2/day 6 hrly in hepatic coma
- Streptomycin—30–40 mg/kg/day 12 hrly.* every 12 hr for infants below 0–7 days and 8 hrly for infants > 7 days.
D. CEPHALOSPORINS
- Cefadroxil—15 mg/kg/dose 12 hr oral
- Cefazolin Na—20 mg/kg/dose IM IVIV should be given over 15–20 min
- Cefixime—8 mg/kg/dose oran once or twice
- Cefotaxime Na—50 mg/kg/dose
- Ceftazidime—50 mg/kg/dose IM IV
- Ceftriaxone Na—50–75 mg/kg/dose
- Cephlexin—7–12 mg/kg/dose 6 hr orally.
E. LINCOSAMIDES
- Clindamycin hydrochloride0–7 days—5 mg/kg/dose 8 hr oral IV> 7 days—5 mg/kg/dose 6 hrly
- Lincomycin hydrochloride5–10 mg/kg/dose 12 hrly IM IV
F. MACROLIDES
- Azithromycin dihydrate—10 mg/kg/day single dose empty stomach × 3 days
- Erythromycin—5–12.5 mg/kg/dose 6–8 hrly5 mg/kg/dose IV as infusion over 8 hr with normal saline or Ringer lactate
- Roxythromycin—2.5 mg/kg/dose 12 hrly.
G. PENICILLINS
- Amoxicillin—25–50 mg/kg/day 8 hr orally
- Ampicillin with salbutam—150 mg/kg/day 8 hr IM or IVCotanin 100 mg ampicillin/50 mg salbactum
- Cloxacillin*—12.5 mg/kg/dose oral or IV
- Methicillin Na*—25 mg/kg/dose
- Penicillin G (aquous)*—25,000 units/kg/dose IM IV.* Preterm infants = upto 70 mg—every 12 hrlyTerm upto 7 days—8 hrlyand preterm infant > 2 daysand term baby > 7 days—6 hrly
H. SULPHAS
- Sulphonamide—100–150 kg/day 8 hrs oral
- Timethoprim + Sulfamethoxazole (Cotrimoxazole)Neonates—2 mg/kg/days loading dose followed by 1.2 mg/kg/day 12 hrlyChildren—5–8 mg/kg or TMP or 25–50 mg/kg of SM2/day 12 hrly oral.
I. MISCELLANEOUS ANTIMICROBIALS
- Chloramphenicol—25 mg/kg/dose oral IM IV
- Ciprofloxacin—5–10 mg/kg/dose 12 hravoide in children < 12 years because of cartilage toxicity
- Furazolidine—2 mg/kg/dose every 6–8 hr
- Nalidixic acid—50 mg/kg/day 6–8 hr oral
- Norfloxacin—7.5–10 mg/kg/day 12 hr oral
- Ofloxacin—7.5 mg/kg/dayIV dose—5 mg/kg/dose 12 hrly
- Tetracycline hydrochloride—3–6 mg/kg/dose 6 hr oral + Avoid children < 8 years.
J. ANTICONVULSANTS
- Carbamazepine—10–20 mg/kg/day 8 hr oralless than 1 year 200 mg1–5 years—400 mg5–10 years—600 mg> 10 years 800–100 mg.
- Clonazepam—0.02 mg/kg/day 12 hrly oral
- Diazepam—0.2–0.3 mg/kg/dose
- Ethosuximide—20–70 mg/kg/day 12 hrly
- Phenobarbitone Na—3–10 mg/kg/day or single dose at night 12 hours oral
- Phenytoin sodium—4–12 mg/kg/day 12 hrly or single oral dose
- Prednisolone—2 mg/kg/day 8 hrly for 2–6 hours
- Valproate Na—15 mg/kg/day 8–12 hrly orally.
K. ANTIEMETICS
- Domperidone—0.2–0.4 mg/kg/dose 4–8 hrly
- Metochlorpromide HCl—0.1 mg/kg/day 6–8 hr oral or IM
- Ondansetron HCL dihydrate—5 mg/m2 IV prior to procedure followed by 4 mg oral × bd × 5 days
- Triflupromazine—0.5 mg/kg/day 8 hr oral.
L. ANTIHISTAMINES
- Astemizole—0.2–1 mg/kg/dose singl dose oral
- Cetrizine dihydrochloride5 mg for < 30kg10 mg > 30 kg oral od
- Chlorphenamine maleate—0.5 mg/kg/dose 8 hr oral.
M. ANTIHYPERTENSIVES
- Atenolol—1–2 mg/kg/dose single dose
- Captopril—3 mg/kg/dose 8 hrly
- Methyldopa—10–40 mg/kg/dose 8–12 hrly
- Nifedipine—0.5–1 mg/kg/dose 8 hrly oral
- Propranolol 2–4 mg/kg/dose 8 hrly oral
- Na nitroprusside—0.5 to 8 mcg/kg/mt
- Verapamil—2–4 mg/kg/dose 8 hrly oral.
N. ANTILEPROTIC
- Clofazime—1–2 mg/kg/daily and4–6 mg/kg once a month
- Diaminodiphenyl sulphone (DDS)—1–2 mg/kg/dose.
O. ANTIMALARIAL DRUGS
- Chloroquine PO4—10 mg of base/kg statefollowed 5 mg/kg 6 hr later and once a day oral × 2 hrly
- Mefloquine—15–25 mg/kg/single dose
- Quinine sulphate—25 mg/kg/day 8 hrly × 7 days.
P. ANTITUBERCULAR (ANTI-TB)
- Isoniazid—5–10 mg/kg/day single dose
- Rifampicin—10 mg/kg/day single dose empty 8 hrly
- Pyrazinamide—20–35 mg/kg/day single dose
- Ethambutol—25 mg/kg/day single dose oral × 4 weeks then 15 mg/kg/hrlyStreptomycin sulfate—20–40 mg/kg/day IM daily.
Q. MISCELLANEOUS DRUGS
- Adrenaline—0.01 ml/kg/dose of 1:1000 solution SC.
- Aminophyline—15–20 mg/kg/dose 8 hrly oralFor status asthmatics—5–7 mg/kg loading dose IV followed by 0.09 mg/kg/hr.
- Metronidazole—15–20 mg/kg 8 hrly oral and 20 mg/kg/dose 8 hrly IV for anaerobic infant
- Human hepatitis B specific globulins—0.06–0.1 ml/kg IM at the time of exposure
- Tetanus antitoxinsProphylactic—3,000–5,000 units SC 1 hrlyTherapeutics—10,000 units IM IV.
- Salbutamol—0.1–0.4 mg/kg/dose 8 hrly
- Digoxin—Digitalizing dosePremature—0.04 mg/kg/dayFull term—0.06 mg/kg/day< 2 years children—0.06 mg/kg/day> 2 year children—0.04 mg/kg/day oralThe daily maintenance digoxin is about 1/4 of initial digitalizing dose.
- Furosamide—2–4 mg/kg/day 12 hrly oralIV dose is 1.2 of oral dose
- Lithium carbonate—10–15 mg/kg/day 8 hrly oral to maintain blood 1 eml b/w—0.75 to 1 mEq/l.
- Ranitidine—2–4 mg/kg/day 12 hrly.
10. IMPORTANT POINTS
- Potency of the drug refers to the amount of drug needed to produce a given response.
- Efficacy of the drug refers o the maximal response that can be produced by the drug.
- ED50 is the dose of drug required to produce 50% of the maximum response. It is a measure of potency of drug.
- Zero order kinetics = rate of elimination = constant, CL ↓ with ↑ in concentration of drug.• Ethyl alcohol• Tolbutamide• Theophylline• Propanolol• Phenytoin• Warfarin• AspirinFollow the zero order kinetics
- First order kinetics = Rate of elimination is directly proportional to concentration of the drug.CL remains constant.
- Uses of microsomal enzyme induction:
- Cong. Nonhemolytic jaundice (phenobarbitone)
- Cushing's syndrome = Phenytoin may reduce the manifestation.
- Chronic poisonings
- Liver disease
- Bioavailability is a measure of fraction of administered dose of a drug that reactes the systemic circulation in the unchanged form (100% of drug injected IV)
- Steroid hormones act on cytoplasmic receptor → nucleus, thyroid hormones act on nuclear reception while others act on cell membrane receptors.
- National essential drug list (1996) = 279 drugs included.
- P-450 enzyme inhibitors:
- Ciprofloxacin
- Omeprazole
- Metronidazole
- Erythromycin
- Ketoconazole
- Cimetidine
- Autonomic drugs =
- = produce actions similar to Acetylcholine
- Anticholinesterases (Anti Ches) = (-) Che thus protects the Acetylcholine from hydrolysis = produce cholinergic effects and potentiates Acetylcholine• Physostigmine• Edrophonium• Neostigmine• TacrineReversible• Melathion• Parathione• Tabun• Carbaryl• PropoxurIrreversible
- Anticholinergic drugs = block actions of Ach on ANS and act via muscarinic receptors in CNS.
- Atropine
- Hyosine
- Homatropine
- Ipratropium bromide
- Cyclopentolate
- Tropicamide
- Glycopyrolate
- Pirenzepine
- Telenzepine
- Benzhexol (trihexy phenidyl).
- Pralidoxime (2-PAM) = in Anti-cholinesterase poisoning (organophosphorus poisoning) (also atropins) 2 mg IV till pupil dialates at an interval of 10 min. upto 200 mg in one day)
- First line antitubercular drugs are tuberculocidal except ethambutol
- 2nd line drugs are tuberculostatic
- Other uses of rifampin
- Leprosy
- Systemic fungal infection with amphotericin B)
- Prophylaxis of meningococcal meningitis
- Legionella infection
- Brucellosis (with doxycyclins).
- Side effect of various ATT drugs.
- Arthralgia = INH and pyrazinamide
- Hyperuricemia = ethambutol, pyrazinamide
- Optic neuritis = isoniazid, Ethambutol
- Hepatitis = Inn, rifampicin, pyrazinamide
- Peripheral neuropathy = Streptomycin INH, Ethambutol, ethionamide
- Ototoxicity and renal toxicity = Streptomycin (CI in pregnancy)
- Pigmentation = Rifampicin
- Cataract, red green colour blindness ethambutol
- Neutrosychiatric manifestation = Cycloserine
Thiazetaxone is CI in AIDS patients. - Treatment of TB in pregnanacy
- INH + Rifampicin = 9 monthsAdd E if resistance to INH suspected
- Pyridoxine 50 mg daily
- It should cover delivery and perpeuriam
- In case of active lesion T should continuous 6 months following delivery or until the disease is amsted
- Effective ATT reduces infectively upto 90% in 48 hours.
- Drug and their mechanism of action.
- Inhibition of cell wall synthesis ← inhibition of mycolic acid synthesis → Isoniazid (INH)= Penicillins, cephalosporinsCycloserine, vancomycin, bacitracin
- Inhibition of protein synthesis• Tetra-cycline• Clinda-mycin• Aminoglycoside → Misreading of m RNA code• Streptomycin• Chloram-phenicol• Mupirocin• Erythro-mycin• Griseofulvin
- Interfere with intermediatory metabolism= Sulfonamides, trimethoprim, ethambutol, PAS
- Inhibition of nucleic acid synthesis= Quinolines, flucyosine, rifampin
- Inhibition of HMG GA reductase= Lovastatin, merastatin, simvastatin.
- Drugs causing gynaecomastia:
- Calcium channel blockers
- Digitalis
- Ketoconazole
- Griseofulvin
- INH
- Ethionamide
- Estrogen
- Testosterone
- Methyldopa
- Phenytoin
- Reserpine
- Cimetidine
- Amiodarone
- Clomiphine.
- Agents inducing theophylline metabolism (↓ its plasma level, toxicity)
- Rifampicin
- Phenytoin
- Phenobarbitone
- Smoking
- ➩ Agents which inhibit theophyline metabolism (enhance toxicity)
- Erythromycin
- Ciprofloxacin
- Oral contraceptives
- Cimetidine
- Allopurinol.
- PCM produces highly reactive toxic minor metabolite = N-acetyl benzoquinone amine Antidote = N-acetyl cystine.
- Lipid insoluble alpha blockers (do not cross BBB)AtenololNadololSotalol = Excreted in urine so should not be used in renal failure.
- Septran (TMP-SMI) is Doc for:
- Moraxella catarrhalis
- Haemophilus
- Nocardia
- Enterobacter
- Wipple's disease = T. septran 1 bd (DS) × 1yr
- Penicillin G is Metabolized by kidney (mainly)
- DOC for PSVT = Adenosine (2nd verapamil)
- Red man Syndrome = Pruritis, flushing, erythema of head and upper toxo = Caused by vancomycin
- Drug raising intracranial pressure:Steroids, hypervitaminosis A, oral contraceptive, tetracyclines amiodarone, quinolones.
- Oral anticoagulants act by interfering with prothrombin, factor VII, IX, X
- Non-selective α blockers = Ergotamine, Dihydroxyergotamine (DHE) chlorpromazine phentolamine, ergotamine
- Non-selective β blockers = (β1 + β2) = Propranolol, sotalol, Timolol, oxprenololLabetalol and Carvedilol = with α blocking property = (α + β blocker)
- β1 blocker (cardioselective)Atenolol, Metoprolol, Esmolol, Betaxolol, Bisoprolol
- Bone marrow suppression is the most serious toxicity of anticancer drugs with often limits the dose. Infections and bleeding are usual complications.Anticancer drugProminant side effects1. Actinomycin D2. Bleomycin3. Busulphan4. Cyclophosphamide5. Doxorubicin6. Methotrexate7. Vincristine8. MelphalanAlopecia, BMSPulmonary fibrosisPulmonary fibrosis, hyperuricemiaAlopecia, hemorrhagic cystitisCardiotoxicityBMS, acute renal failure, HistotoxicityAlopecia, Peripheral neuropathyPulmonary fibrosis
- ACE inhibitors and angiotensin antagonists (Losartan) are contraindicated in pregnancy.
- T3 & T4
- Thyroid secretes more T4 than T3
- T4 = More tightly bound to plasma protein (15 times) = major circulatory hormone
- T3 = 5 times more potent than T4
- 1/3rd of T4 is converted T3 is in peripheral tissues
- T3 is more avidely bound to nuclear receptors than T4
- Diabetic ketoacidosis treatment =
- Insulin
- IV fluid = to combat dehydration
- KCl = to prevent hypokalemia as K+ is driven intracellularlly with insulins therapy)
- Sodium bicarbonate = if pH < 7.1
- Antibiotics
- Phosphate
- Indications of purer/human insulins:
- Insulin resistance
- Allergy to conventional preparations
- Injection site lipodystrophy
- Short-term of insulin (Diabetic)
- Pregnancy
- Uterine
- Edrophonium 2 mg IV
- 1.5 mg neostigmine (IM) = improve = “Myasthenia gravis”
- Side effects of phenytoin = Megaloblastic Anaemia, osteomalacia, Pancytopenias and H5 = Hypertrophy of gums, Hirsutism, hyperglycemia, hypersensitivity hydantoin Syndrome.
- Side effect of cisplatin = vomiting
- Side effect of cisapride = Diarrhoeas
- Tamsulosin = α1 A antagonist (DYNAPRESS)
- +ve intopic action = ↑ in force of contraction (↑ myocardial contractibility)
- Erythromycin:Treatment of choice in:
- Pertusis
- Mycoplasma pneumonia infection
- Legionnaire's disease (Azithromycin)
- Diphtheria carriers → erythrasma
- Chancroid
- Treatment of choice of cholera
- Adults: Doxycycline 300 mg single dose = DOC(or tetracycline 500 mg tid × 3d)
- Children: Septran (Sulfamethoxazole + Trimethoprim)
- Pregnant women: Furazolidine 100 mg q id × 3d
- 5HT receptor
- 5HT1:
- 5HT2: 5HT2A = Ketanserine, cyproheptadine (Antagonists)
- 5HT3 : Ondensetron (Antagonist)
- 5HT4 : Cisapride (Agonist)