FMGE 2022 - Pharmacology PYQs Practice Questions

Q: Which antithyroid drug is safer during the first trimester of pregnancy?

Propylthiouracil. ***Propylthiouracil*** - **Propylthiouracil (PTU)** is the preferred drug for treating hyperthyroidism in the **first trimester of pregnancy** due to a lower risk of teratogenic effects compared to methimazole or carbimazole. - While PTU carries a risk of hepatic toxicity, it is generally favored during early pregnancy to avoid the established teratogenic risks of other thionamides. *Radioactive iodine* - **Radioactive iodine (RAI)** is absolutely contraindicated in pregnancy as it crosses the placenta and can cause permanent **fetal hypothyroidism** or **agenesis of the fetal thyroid gland**. - Its use can lead to the destruction of the fetal thyroid, which is unacceptable given the availability of safer alternatives. *Carbimazole* - **Carbimazole** is converted to methimazole in the body and is associated with a higher risk of **fetal embryopathy** during the first trimester, including aplasia cutis, choanal atresia, and esophageal atresia. - It should generally be avoided in the first trimester if possible, switching to PTU instead. *Methimazole* - **Methimazole** is structurally similar to carbimazole and also carries a significant risk of **teratogenic effects** such as **aplasia cutis**, omphalocele, and choanal atresia when used in the first trimester. - It is often reserved for the second and third trimesters if a thionamide is required, or for patients who cannot tolerate PTU, but ideally avoided in early pregnancy. *Propranolol* - **Propranolol** is a beta-blocker used for symptomatic management of hyperthyroidism (controlling tachycardia, tremor, anxiety) but is not an antithyroid drug and does not treat the underlying hyperthyroidism. - While generally safe in pregnancy, it only provides adjunctive therapy and cannot replace definitive antithyroid treatment. [Practice more Pharmacology PYQs on OnCourse]

Question 1

Which antithyroid drug is safer during the first trimester of pregnancy?

Accepted Answer

Propylthiouracil

Answer

Radioactive iodine

Answer

Carbimazole

Answer

Methimazole

Answer

Propranolol

Question 2

A chronic smoker wants to quit smoking. Which of the following is the MOST appropriate first-line pharmacotherapy for smoking cessation?

Accepted Answer

Varenicline

Answer

Mirtazapine

Answer

Bupropion

Answer

Nicotine replacement therapy

Answer

Clonidine

Question 3

A tourist with a travel history to India presents with complaints of abdominal pain and multiple episodes of watery diarrhea. He reports having food at a local restaurant the previous night. Which of the following antidiarrheal agents is used in this condition?

Accepted Answer

Rifaximin

Answer

Bismuth subsalicylate

Answer

Octreotide

Answer

Loperamide

Answer

Ciprofloxacin

FMGE 2022 — Pharmacology