INI-CET 2024 - Pharmacology PYQs Practice Questions

Q: A 30-year-old woman has experienced the loss of her newborn. She is currently producing breast milk leading to discomfort and the risk of developing a breast abscess due to milk stasis and incomplete emptying. Which of the following drugs can be used to prevent this complication?

Cabergoline. ***Cabergoline*** - **Cabergoline** is a dopamine agonist that inhibits prolactin secretion, thereby suppressing lactation and preventing breast engorgement and its complications after childbirth. - It has a longer duration of action compared to bromocriptine, allowing for less frequent dosing and better patient compliance in lactation suppression. *Chlorpromazine* - **Chlorpromazine** is an antipsychotic medication primarily used to treat psychotic disorders; it doesn't suppress lactation. - While it can cause hyperprolactinemia as a side effect due to its antidopaminergic action, it is not used to manage lactation or its complications. *Metoclopramide* - **Metoclopramide** is a dopamine receptor antagonist that *increases* prolactin levels, and is sometimes used to *stimulate* lactation, not suppress it. - It enhances gastrointestinal motility and is primarily used as an antiemetic or for gastric emptying disorders. *Mifepristone* - **Mifepristone** is a progesterone receptor antagonist primarily used for medical abortion and induction of labor. - It is not indicated for the suppression of lactation or the prevention of breast engorgement. [Practice more Pharmacology PYQs on OnCourse]

Q: In which of the following conditions are cannabinoids not commonly used for treatment?

Rett syndrome. ***Rett syndrome*** - Cannabinoids are **NOT commonly used** as an established treatment for **Rett syndrome** - While some research is exploring their potential therapeutic role, they remain **investigational only** and lack FDA approval for this indication - Current management focuses on symptomatic treatment including physical therapy, anti-epileptics for seizures, and supportive care - Unlike the other conditions listed, there is **no established cannabinoid therapy** for Rett syndrome in clinical practice *Dravet syndrome* - **Cannabidiol (CBD/Epidiolex)** is **FDA-approved** and commonly used for treatment of seizures associated with **Dravet syndrome** - Demonstrates significant efficacy in reducing seizure frequency in this severe infantile-onset epilepsy - Represents a major therapeutic advance for this treatment-resistant condition *Tuberous sclerosis* - **Cannabidiol (CBD/Epidiolex)** received **FDA approval in 2018** for treatment of seizures associated with **tuberous sclerosis complex (TSC)** - Commonly used as an adjunctive therapy alongside other treatments like vigabatrin or mTOR inhibitors (everolimus) - Clinical trials demonstrated significant reduction in seizure frequency in TSC patients *Lennox-Gastaut Syndrome* - **Cannabidiol (CBD/Epidiolex)** is **FDA-approved** for seizures associated with **Lennox-Gastaut Syndrome (LGS)** - Commonly used in this severe epileptic encephalopathy characterized by multiple seizure types and developmental delay - Effective in reducing seizure burden in patients refractory to traditional anti-epileptic drugs [Practice more Pharmacology PYQs on OnCourse]

Q: Drug of choice for Enterococcus infection in a patient allergic to penicillin?

Vancomycin. ***Vancomycin*** - **Vancomycin** is a glycopeptide antibiotic that is effective against **Gram-positive bacteria**, including *Enterococcus*, especially in patients with a **penicillin allergy**. - It inhibits **cell wall synthesis** by binding to the D-Ala-D-Ala terminus of peptidoglycan precursors, a different mechanism from penicillins. *Streptomycin* - **Streptomycin** is an aminoglycoside that inhibits **protein synthesis** and is primarily used in **combination therapy** for serious *Enterococcal* infections, but typically alongside a cell-wall active agent (like penicillin or vancomycin) for synergistic killing in endocarditis or other severe infections. - It is not usually recommended as a **monotherapy** for *Enterococcus*, especially in the context of penicillin allergy, as it doesn't provide bactericidal activity on its own against all enterococcal strains. *Cephalosporin* - **Cephalosporins** are **not active** against *Enterococcus spp.* as these bacteria intrinsically lack the **penicillin-binding proteins (PBPs)** that cephalosporins target effectively. - This **intrinsic resistance** makes cephalosporins an inappropriate choice for treating *Enterococcal* infections, regardless of penicillin allergy status. *Rifampicin* - **Rifampicin** is an antibiotic primarily used for **Mycobacterial infections** (e.g., tuberculosis) and some **Staphylococcal infections**, often in combination to prevent resistance. - It has **poor activity** against *Enterococcus* and is not a recommended treatment for *Enterococcal* infections. [Practice more Pharmacology PYQs on OnCourse]

Q: Cannabidiol is not used for

Rett syndrome. ***Rett syndrome*** - **Cannabidiol (CBD)** is not an approved or commonly used treatment for Rett syndrome, which is a **neurodevelopmental disorder** primarily affecting girls. - Treatment for Rett syndrome focuses on managing symptoms with supportive care, **physiotherapy**, occupational therapy, and medications for specific issues like seizures or gastrointestinal problems. *Dravet syndrome* - **Cannabidiol (Epidiolex)** is approved in many regions for the treatment of seizures associated with **Dravet syndrome**, a severe form of epilepsy. - It works by modulating the **endocannabinoid system**, which plays a role in seizure control. *Lennox-Gastaut syndrome* - **Cannabidiol (Epidiolex)** is also approved for the treatment of seizures associated with **Lennox-Gastaut syndrome**, another severe and intractable childhood epilepsy. - Its efficacy in reducing seizure frequency in LGS has been demonstrated in clinical trials. *Tuberous sclerosis complex* - While not as widely established as for Dravet or Lennox-Gastaut, **cannabidiol (Epidiolex)** has shown promise and is approved in some regions for treating seizures associated with **tuberous sclerosis complex (TSC)**. - TSC is a genetic disorder causing benign tumors in multiple organs, often leading to epilepsy. [Practice more Pharmacology PYQs on OnCourse]

Q: Which of the following anti-leprosy drugs can cause skin hyperpigmentation?

Clofazimine. ***Clofazimine*** - **Clofazimine** is known to cause dose-dependent **hyperpigmentation** of the skin, ranging from reddish-brown to dark brown, and can also discolor bodily fluids. - This side effect is due to the drug's accumulation in macrophages and subsequent deposition in the dermis and subcutaneous fat. *Rifampicin* - **Rifampicin** can cause harmless **reddish-orange discoloration** of urine, sweat, tears, and other bodily secretions. - It is not typically associated with **skin hyperpigmentation** (darkening of the skin itself). *Ofloxacin* - **Ofloxacin** is a fluoroquinolone antibiotic primarily used in leprosy treatment as a second-line agent. - Its common side effects include gastrointestinal disturbances and nervous system effects, but **skin hyperpigmentation** is not a characteristic adverse event. *Dapsone* - **Dapsone** is a sulfone drug and a cornerstone of leprosy treatment, but it is not associated with **skin hyperpigmentation**. - Its most notable side effects include **hemolysis**, especially in patients with **G6PD deficiency**, and methemoglobinemia. [Practice more Pharmacology PYQs on OnCourse]

Question 1

A 30-year-old woman has experienced the loss of her newborn. She is currently producing breast milk leading to discomfort and the risk of developing a breast abscess due to milk stasis and incomplete emptying. Which of the following drugs can be used to prevent this complication?

Accepted Answer

Cabergoline

Answer

Chlorpromazine

Answer

Metoclopramide

Answer

Mifepristone

Question 2

In which of the following conditions are cannabinoids not commonly used for treatment?

Accepted Answer

Rett syndrome

Answer

Tuberous sclerosis

Answer

Lennox-Gastaut Syndrome

Answer

Dravet syndrome

Question 3

Drug of choice for Enterococcus infection in a patient allergic to penicillin?

Accepted Answer

Vancomycin

Answer

Streptomycin

Answer

Cephalosporin

Answer

Rifampicin

Question 4

Cannabidiol is not used for

Accepted Answer

Rett syndrome

Answer

Lennox-Gastaut syndrome

Answer

Dravet syndrome

Answer

Tuberous sclerosis complex

Question 5

Which of the following anti-leprosy drugs can cause skin hyperpigmentation?

Accepted Answer

Clofazimine

Answer

Rifampicin

Answer

Ofloxacin

Answer

Dapsone

Question 6

The site of action of the loop diuretic furosemide is:

Accepted Answer

Thick ascending limb of loop of Henle

Answer

Distal convoluted tubule

Answer

Descending limb of loop of Henle

Answer

Proximal convoluted tubule

INI-CET 2024 — Pharmacology