UPSC-CMS 2014 — Pharmacology

Q: Absolute contraindication for the use of OCPs is:

Thromboembolism. ***Thromboembolism*** - A **current or past history of thromboembolism** (e.g., DVT, pulmonary embolism) is an **absolute contraindication (WHO MEC Category 4)** for combined oral contraceptive pills (OCPs) due to the significantly increased risk of recurrent thrombotic events. - Exogenous **estrogen** in OCPs increases the synthesis of clotting factors (II, VII, IX, X, fibrinogen) and decreases anticoagulant proteins (protein S, antithrombin), thereby promoting a hypercoagulable state. - Even a remote history of VTE makes OCPs absolutely contraindicated. *Diabetes* - Diabetes **with vascular complications** (retinopathy, nephropathy, neuropathy) or diabetes of >20 years duration is a contraindication (WHO MEC Category 3/4). - However, **uncomplicated diabetes without vascular disease** is not an absolute contraindication for OCPs. - Among the options listed, thromboembolism is the clearest absolute contraindication. *Epilepsy* - Epilepsy itself is **not a contraindication** for OCPs (WHO MEC Category 1). - However, some **enzyme-inducing antiepileptic drugs** (phenytoin, carbamazepine, phenobarbital, topiramate) can reduce OCP efficacy by increasing hepatic metabolism of contraceptive hormones. - In such cases, higher-dose OCPs, alternative methods, or non-enzyme-inducing AEDs should be considered. *Hypertension* - **Severe or uncontrolled hypertension** (≥160/100 mmHg) or hypertension with vascular disease is an absolute contraindication (WHO MEC Category 4). - **Adequately controlled and monitored hypertension** is a relative contraindication (WHO MEC Category 3), not an absolute one. - Among the given options, thromboembolism represents a clearer and more universally accepted absolute contraindication. [Practice more Pharmacology PYQs on OnCourse]

Q: Which of the following is an example of ‘live attenuated vaccine’?

B.C.G.. ***B.C.G.*** - The **Bacillus Calmette-Guérin (BCG)** vaccine is a **live attenuated vaccine** used worldwide for **tuberculosis prevention**. - It contains a live, but weakened, strain of *Mycobacterium bovis*, which stimulates a strong cellular immune response. *D.P.T.* - The **DPT vaccine** is a **combination vaccine** for diphtheria, pertussis (whooping cough), and tetanus. - It is currently available as an **inactivated vaccine**, specifically a **toxoid for diphtheria and tetanus** and either a whole-cell or acellular component for pertussis. *Hepatitis ‘B’* - The **Hepatitis B vaccine** is a **recombinant vaccine**, meaning it is produced using genetic engineering techniques. - It contains only the **surface antigen protein** of the Hepatitis B virus, not the whole virus, making it a non-live vaccine. *Typhoid (TAB)* - The **Typhoid (TAB) vaccine** is an **inactivated (killed) whole-cell vaccine** against *Salmonella Typhi*. - Newer typhoid vaccines, such as the polysaccharide vaccine and conjugate vaccine, are also non-live vaccines. [Practice more Pharmacology PYQs on OnCourse]

Q: The primary route of administration of measles vaccination is:

Subcutaneous. ***Subcutaneous*** - The **measles, mumps, and rubella (MMR) vaccine** is a live attenuated vaccine typically administered via the **subcutaneous route**. - Subcutaneous injection ensures the vaccine is delivered into the fatty tissue just below the skin, allowing for gradual absorption and an effective immune response. *Intravenous* - **Intravenous administration** delivers substances directly into the bloodstream, which is generally avoided for vaccines due to the risk of systemic reactions and rapid clearance. - This route is typically reserved for emergency medications or those requiring immediate systemic distribution. *Intranasal* - **Intranasal vaccines** are administered through the nasal passages and are designed to stimulate mucosal immunity, particularly against respiratory pathogens. - While some flu vaccines use this route, the standard measles vaccine does not. *Intradermal* - **Intradermal administration** involves injecting into the dermis layer of the skin, often used for sensitivity testing or certain vaccines like BCG. - This route requires a smaller volume and specific technique, which is not the primary method for routine measles vaccination. [Practice more Pharmacology PYQs on OnCourse]

3 Previous Year Questions with Answers & Explanations

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Absolute contraindication for the use of OCPs is:

Which of the following is an example of ‘live attenuated vaccine’?

The primary route of administration of measles vaccination is:

UPSC-CMS 2014 - Pharmacology UPSC-CMS Practice Questions and MCQs

Question 1: Absolute contraindication for the use of OCPs is:

A. Diabetes
B. Epilepsy
C. Hypertension
D. Thromboembolism (Correct Answer)

Explanation: ***Thromboembolism*** - A **current or past history of thromboembolism** (e.g., DVT, pulmonary embolism) is an **absolute contraindication (WHO MEC Category 4)** for combined oral contraceptive pills (OCPs) due to the significantly increased risk of recurrent thrombotic events. - Exogenous **estrogen** in OCPs increases the synthesis of clotting factors (II, VII, IX, X, fibrinogen) and decreases anticoagulant proteins (protein S, antithrombin), thereby promoting a hypercoagulable state. - Even a remote history of VTE makes OCPs absolutely contraindicated. *Diabetes* - Diabetes **with vascular complications** (retinopathy, nephropathy, neuropathy) or diabetes of >20 years duration is a contraindication (WHO MEC Category 3/4). - However, **uncomplicated diabetes without vascular disease** is not an absolute contraindication for OCPs. - Among the options listed, thromboembolism is the clearest absolute contraindication. *Epilepsy* - Epilepsy itself is **not a contraindication** for OCPs (WHO MEC Category 1). - However, some **enzyme-inducing antiepileptic drugs** (phenytoin, carbamazepine, phenobarbital, topiramate) can reduce OCP efficacy by increasing hepatic metabolism of contraceptive hormones. - In such cases, higher-dose OCPs, alternative methods, or non-enzyme-inducing AEDs should be considered. *Hypertension* - **Severe or uncontrolled hypertension** (≥160/100 mmHg) or hypertension with vascular disease is an absolute contraindication (WHO MEC Category 4). - **Adequately controlled and monitored hypertension** is a relative contraindication (WHO MEC Category 3), not an absolute one. - Among the given options, thromboembolism represents a clearer and more universally accepted absolute contraindication.

Question 2: Which of the following is an example of ‘live attenuated vaccine’?

A. D.P.T.
B. Hepatitis ‘B’
C. Typhoid (TAB)
D. B.C.G. (Correct Answer)

Explanation: ***B.C.G.*** - The **Bacillus Calmette-Guérin (BCG)** vaccine is a **live attenuated vaccine** used worldwide for **tuberculosis prevention**. - It contains a live, but weakened, strain of *Mycobacterium bovis*, which stimulates a strong cellular immune response. *D.P.T.* - The **DPT vaccine** is a **combination vaccine** for diphtheria, pertussis (whooping cough), and tetanus. - It is currently available as an **inactivated vaccine**, specifically a **toxoid for diphtheria and tetanus** and either a whole-cell or acellular component for pertussis. *Hepatitis ‘B’* - The **Hepatitis B vaccine** is a **recombinant vaccine**, meaning it is produced using genetic engineering techniques. - It contains only the **surface antigen protein** of the Hepatitis B virus, not the whole virus, making it a non-live vaccine. *Typhoid (TAB)* - The **Typhoid (TAB) vaccine** is an **inactivated (killed) whole-cell vaccine** against *Salmonella Typhi*. - Newer typhoid vaccines, such as the polysaccharide vaccine and conjugate vaccine, are also non-live vaccines.

Question 3: The primary route of administration of measles vaccination is:

A. Subcutaneous (Correct Answer)
B. Intravenous
C. Intranasal
D. Intradermal

Explanation: ***Subcutaneous*** - The **measles, mumps, and rubella (MMR) vaccine** is a live attenuated vaccine typically administered via the **subcutaneous route**. - Subcutaneous injection ensures the vaccine is delivered into the fatty tissue just below the skin, allowing for gradual absorption and an effective immune response. *Intravenous* - **Intravenous administration** delivers substances directly into the bloodstream, which is generally avoided for vaccines due to the risk of systemic reactions and rapid clearance. - This route is typically reserved for emergency medications or those requiring immediate systemic distribution. *Intranasal* - **Intranasal vaccines** are administered through the nasal passages and are designed to stimulate mucosal immunity, particularly against respiratory pathogens. - While some flu vaccines use this route, the standard measles vaccine does not. *Intradermal* - **Intradermal administration** involves injecting into the dermis layer of the skin, often used for sensitivity testing or certain vaccines like BCG. - This route requires a smaller volume and specific technique, which is not the primary method for routine measles vaccination.