INI-CET 2023 - Pharmacology PYQs Practice Questions

Q: Which of the following is true about lithium?

It can cause fine postural tremors at therapeutic dosage. ***It can cause fine postural tremors at therapeutic dosage*** - **Fine postural tremors** are a common and well-known side effect of lithium, even within its therapeutic range. - This side effect can be dose-dependent and may worsen with higher lithium concentrations. *It is also used for treatment of absence seizures* - Lithium is primarily used as a **mood stabilizer** for bipolar disorder and is not indicated for the treatment of **absence seizures**. - **Absence seizures** are typically treated with drugs like ethosuximide or valproate. *It is not teratogenic* - Lithium is known to be **teratogenic**, especially during the first trimester of pregnancy. - It is associated with an increased risk of **Ebstein's anomaly**, a congenital heart defect. *It is not absorbed from the gut* - Lithium is **rapidly and completely absorbed** from the gastrointestinal tract after oral administration. - Its absorption is not significantly affected by food, and peak plasma concentrations are usually reached within 1-3 hours. [Practice more Pharmacology PYQs on OnCourse]

Q: A kid went to a temple with his grandmother and was constantly crying. On examination he had excruciating pain, hypertension, increased heart rate, sweating profusely, priapism and cold clammy skin. What should be the treatment given to the patient?

Phentolamine. ***Phentolamine*** - The symptoms described (hypertension, tachycardia, sweating, priapism, cold clammy skin) are indicative of an **alpha-adrenergic crisis** or **pheochromocytoma crisis**, which results from excessive release of catecholamines (e.g., norepinephrine) [1]. - **Phentolamine** is a **non-selective alpha-adrenergic antagonist** that effectively blocks the effects of excessive catecholamines, thereby reducing blood pressure and heart rate and relieving other alpha-mediated symptoms like priapism [1]. *Atropine* - **Atropine** is an **anticholinergic drug** used to treat **bradycardia** or **organophosphate poisoning**. - It would worsen the patient's condition by potentially increasing heart rate further and would not address the underlying alpha-adrenergic overstimulation. *Pralidoxime* - **Pralidoxime** is an **acetylcholinesterase reactivator** used specifically for **organophosphate poisoning**. - It works by restoring the function of acetylcholinesterase, which is inhibited by organophosphates, and is not indicated for an adrenergic crisis. *Naloxone* - **Naloxone** is an **opioid receptor antagonist** used to reverse the effects of **opioid overdose**. - This patient's symptoms are not consistent with opioid toxicity, and naloxone would have no therapeutic benefit. [Practice more Pharmacology PYQs on OnCourse]

Q: A female was given morphine sulphate during labour for pain but she developed respiratory distress. Which of the following will be the correct antidote?

Naloxone. ***Naloxone*** - **Naloxone** is a pure opioid antagonist that rapidly reverses the effects of **opioid overdose** [1, 3], including **respiratory depression** [2], by competitively binding to opioid receptors [1]. - Its short half-life may necessitate repeated doses, especially with longer-acting opioids like morphine, to prevent recurrence of respiratory depression [1]. *Epinephrine* - **Epinephrine** is an adrenergic agonist used to treat **anaphylaxis** and severe allergic reactions, as it causes **vasoconstriction** and **bronchodilation**. - It is not an antidote for opioid-induced respiratory depression, which primarily results from central nervous system effects rather than allergic reactions. *Pralidoxime* - **Pralidoxime** is a **cholinesterase reactivator** used to treat poisoning by **organophosphates**, which inhibit acetylcholinesterase, leading to cholinergic crisis. - It works by restoring the function of the enzyme, thereby breaking down excess acetylcholine, and is not indicated for opioid overdose. *Atropine* - **Atropine** is an **anticholinergic agent** that blocks muscarinic acetylcholine receptors, used to treat **bradycardia** and **organophosphate poisoning**. - It would not reverse opioid-induced respiratory depression, as it primarily affects the parasympathetic nervous system and does not antagonize opioid receptor effects. [Practice more Pharmacology PYQs on OnCourse]

Q: A child went to temple along with his grandmother. He developed altered sensorium, BP of $150 / 90 \mathrm{~mm} \mathrm{Hg}$, sweating, palpitations, priapism, and mouth secretion all at once. What drug can be given to this patient?

Prazosin. ***Prazosin*** * This patient's symptoms (altered sensorium, **hypertension**, sweating, palpitations, **priapism**, and increased mouth secretions) are highly suggestive of **scorpion venom poisoning**, specifically from the Indian red scorpion (*Mesobuthus tamulus*). * **Prazosin**, an **alpha-1 adrenergic receptor blocker**, is the drug of choice for treating systemic manifestations of scorpion envenomation. It helps to counteract the excessive catecholamine release and the resulting sympathetic overdrive, thereby reducing hypertension and cardiac dysfunction. *Steroid* * Steroids are **anti-inflammatory agents** and immunosuppressants, primarily used in conditions like allergic reactions, asthma, or autoimmune diseases. * They are **not indicated** for the acute management of venom-induced symptoms such as those seen in scorpion envenomation. *Adrenaline* * **Adrenaline (epinephrine)** is a potent **vasoconstrictor** and **bronchodilator**, primarily used in anaphylaxis, cardiac arrest, or severe asthma. * It would be **contraindicated** in this patient as it would further exacerbate the existing hypertension and sympathetic stimulation caused by the scorpion venom. *ASV* * **ASV (Anti-Snake Venom)** is an antiserum used to neutralize the toxins found in snake venom. * It is **ineffective** against scorpion venom and is therefore not an appropriate treatment in this scenario. [Practice more Pharmacology PYQs on OnCourse]

Q: A patient presented with dizziness, cool clammy skin, pinpoint pupil with blue lips and fingernails suffering from respiratory depression. The patient was producing a pink frothy sputum on coughing. The drug used to reverse the effects is?

Naloxone. ***Naloxone*** - This patient's presentation with **pinpoint pupils**, **respiratory depression**, and **pink frothy sputum** is highly suggestive of **opioid overdose**. - **Naloxone** is a competitive opioid receptor antagonist used specifically to reverse the effects of opioid-induced respiratory depression and central nervous system depression. *Atropine* - **Atropine** is an anticholinergic drug used to treat **bradycardia** and **organophosphate poisoning**. - It would worsen opioid-induced respiratory depression and is not indicated for this presentation. *Physostigmine* - **Physostigmine** is a cholinesterase inhibitor used to reverse the effects of anticholinergic toxicity, such as from **tricyclic antidepressants** or **atropine overdose**. - It would not treat opioid toxicity and could exacerbate some symptoms. *Phentolamine* - **Phentolamine** is an **alpha-adrenergic blocker** primarily used to treat hypertensive crises, particularly those due to **pheochromocytoma** or in extravasation of vasopressors. - It has no role in the management of opioid overdose. [Practice more Pharmacology PYQs on OnCourse]

Question 1

Which of the following is true about lithium?

Accepted Answer

It can cause fine postural tremors at therapeutic dosage

Answer

It is also used for treatment of absence seizures

Answer

It is not teratogenic

Answer

It is not absorbed from the gut

Question 2

A kid went to a temple with his grandmother and was constantly crying. On examination he had excruciating pain, hypertension, increased heart rate, sweating profusely, priapism and cold clammy skin. What should be the treatment given to the patient?

Accepted Answer

Phentolamine

Answer

Atropine

Answer

Pralidoxime

Answer

Naloxone

Question 3

A female was given morphine sulphate during labour for pain but she developed respiratory distress. Which of the following will be the correct antidote?

Accepted Answer

Naloxone

Answer

Epinephrine

Answer

Pralidoxime

Answer

Atropine

Question 4

A child went to temple along with his grandmother. He developed altered sensorium, BP of $150 / 90 \mathrm{~mm} \mathrm{Hg}$, sweating, palpitations, priapism, and mouth secretion all at once. What drug can be given to this patient?

Accepted Answer

Prazosin

Answer

Steroid

Answer

Adrenaline

Answer

ASV

Question 5

A patient presented with dizziness, cool clammy skin, pinpoint pupil with blue lips and fingernails suffering from respiratory depression. The patient was producing a pink frothy sputum on coughing. The drug used to reverse the effects is?

Accepted Answer

Naloxone

Answer

Atropine

Answer

Physostigmine

Answer

Phentolamine

Question 6

A patient of schizophrenia is being treated with clozapine. For which rare but serious side effects should he be monitored?

Accepted Answer

Agranulocytosis

Answer

Seizures

Answer

Hepatomegaly

Answer

Renal bleed

Question 7

What is the MOA of thalidomide?

Accepted Answer

Angiogenesis inhibitor

Answer

Inhibits factor Xa

Answer

Prevents folic acid synthesis in bacteria

Answer

Inhibits leukotrienes

Question 8

Which of the following is a new drug approved for Rett syndrome?

Accepted Answer

Trofinetide

Answer

Sodium oxybate

Answer

Memantine

Answer

Lunesta

Question 9

A 52-year-old female patient presents with HER-2 positive breast cancer that has become resistant to trastuzumab treatment. The oncologist is considering the next line of treatment for the patient. Which of the following options would be the most appropriate choice?

Accepted Answer

Lapatinib

Answer

Vemurafenib

Answer

Erlotinib

Answer

Sorafenib

Question 10

A female patient presented with vulvovaginal pruritus. On detailed history taking, it was found that she was on some antidiabetic drugs. Which antidiabetic drug can cause the above-mentioned side effect?

Accepted Answer

Canagliflozin

Answer

Metformin

Answer

Linagliptin

Answer

Liraglutide

INI-CET 2023 — Pharmacology