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(BQ) Part 2 book Viva voce in medical pharmacology has contents: Antimalarial drugs, endocrine system, antihelmintic drugs, antihelmintic drugs, drugs acting on skin and mucous membrane, sexually transmitted diseases, chelating agents,... and other contents.
Endocrine System Q.l What is Hormone? Hormone is derived from Greek word "hormaein" means to stir up It is a substance produced by specific cells in the body and is transported through circulation to act on target cells Q.2 Name the hormones released by pituitary gland? Pituitary gland has two portions i Anterior and ii Posterior The hormones produced by anterior pituitary are: Growth hormones ii Prolactin iii Adrenocorticotropic hormone iv Thyroid stimulating hormone v Gonadotropin follicular stimulating hormone (FSH) and Luteinizing hormone (LH) The hormones from posterior pituitary are: Oxytocin Antidiuretic hormone Q.3 Name the hormone released from hypothalamus? The hormones released from hypothalamus are: i Thyrotropin releasing hormone (TRH)-(tripeptide) ii Corticotropin releasing hormone CRH (with 41 amino acids) m Gonadotropin releasing hormone (decapeptide) iv Prolactin release inhibitory hormone PRH (Dopamine) v Prolactin releasing factor (PRF) vi Somatostatin, Growth hormone releasing inhibitory hormone (peptide with 14 amino acids) Endocrine System 99 vii Growth hormone releasing hormone (peptide with 40; 44 amino acids) Q.4 Name the hormones released by placenta These are chorionic gonadotropin, oestrogen, placental lacto gen, prolactin, progesterone, chorionic thyrotropin Q.S Mention the therapeutic use of growth hormone The only approved indication for growth hormone is pituitary dwarfism now produced by recombinant DNA technology Q.6 What are the functions of somatostatin? This is a 14 amino acid peptide inhibits secretion of GH, TSH and prolactin in pituitary, glucagon and insulin in pancreas and almost all gastrointestinal secretions including gastrin and HCl Q.7 What is the therapeutic use of somatostatin or octreolide? Somatostatin used for only acromegaly but its limitation is lack of specificity and rebound after discontinuation so synthetic peptide octreolide is used to treat acromegaly or metastatic carcinoid tumors Q.B How is the prolactin secretion regulated? Prolactin is under inhibitors control of hypothalamus PRIH which is dopamine and acts on lactotrope D2 receptors Dopamine agonist (DA, Bromocriptine, apomorphine) decreases plasma PRL level where as its level is increased by dopaminergic antagonist (CPZ, Haloperidol, metoclo paramide), DA depletor (methyl dopa and reserpine) causes hyperprolactinemia Q.9 What are the therapeutic uses of Bromocriptine? This synthetic ergot derivative with DA agonistic activity is used clinically in i Hyperprolactinemia ii Suppression of lactation and breast engorgement iii Acromegaly iv Parkinsonism v Hepatic coma • 100 Viva Voce in Medical Pharmacology Q.lO What are the gonadotropin hormones secreted by anterior pituitary? What are their chemical nature and therapeutic uses? Anterior pituitary secretes two gonadotropins FSH and LH which are amino acids FSH and LH has mol wt of 32000 and 30000 respectively Their therapeutic uses are: i Amenorrhoea and infertility Hypogonadotropic hypogonadism in males u iii Cryptorchism iv To aid in vitro fertilization Q.ll What is TSH? What is its function and therapeutic uses? These are 210 amino acid, two chainglycoprotein with MW 30000 from anterior pituitary It stimulates thyroid to synthesize T4 and T3, induces hyperplasia and hypertrophy of thyroid follicles and increase blood supply to the gland, promotes iodide trapping and releases more T3 and T4 It is used only to diagnose myxoedema of pituitary dysfunction and primary thyroid disease Q.12 What is the chemical nature of adrenocorticotropic hormone? What is its physiological function? It is 39 amino acid containing single chain polypeptide derived from larger peptide pro-opiomelanocortion Endorphins lipotropins and MSH are also derived from it ACTH promotes steroidgenesis in adrenal cortex increasing availability of cholesterol for conversion to pregnenolone, the rate limiting step in production of gluco, minerals, androgenic steroids slowly inducing steroidogenic enzymes ACTH exerts trophic influence on adrenal cortex through cAMP.It produces metabolic effect like lipolysis, ketosis, hypoglycaemia Q.13 What are the hormones secreted by thyroid gland? The thyroid gland secretes thyroxine (T4); tri-iodothyronine (T3) by follicular cells interfollicular C cells and calcitonin produced by Endocrine System 101 Q.14 How the thyroid hormones are synthesized? Thyroid hormones are synthesized and stored in the thyroid follicles in thyroglobulin molecules as follows: i Iodide trapping: Under the influence of TSH thyroid cells concentrate iodine ii Oxidation of Iodine: Trapped Iodide is oxidised by peroxidase enzyme with H202 to iodinium I+ and combines with tyrosil residues of thyroglobulin apparently without enzymatic intervention to form moniiodotyrosine, di-iodot yrosine still attaches to thyroglobulin chains iii Coupling: Pairs of iodinated tyrosil residues couple to gether to produce T3 and T4, more T4 is formed than T3 iv Storage and release: Thyroglobulin with iodinated tyrosil is transported to the interior of the follicles and remains stored in thyroid colloid till it is taken back into the cells by endocytosis and broken down by lysosomal proteases T4 and T3 are secreted into circulation while MIT and DIT residues are deiodinated v Conversion ofT4 and T3 in periphery: Liver, Kidney convert T4 to T3 T3 is taken up by target tissues almost equal amounts of 3,5,3, T3 and 335 T3 reverse inactive T3 are produced in the periphery Propylthiouracil, Propranolol, amiodarone and glucocorticoids inhibit peripheral conversion of T4 to T3 Q.lS How are the thyroid hormones transported? They are transported in binding three plasma proteins; i Thyroxine binding globulin ii Thyroxine binding pre albumin 'iii Albumin Q.16 What are the therapeutic uses of thyroids? They are used in: i Cretinism n Adult hypothyroidism iii Myxoedema coma iv Nontoxic goitre I 02 Viva Voce in Medical Pharmacology v Papillary carcinoma of thyroid vi Empirically used for refractory anaemia, menstrual disorder, infertility, chronic nonhealing ulcers, obstinate constipation Q.17 What is the relationship between T4 and T3? Thyroid gland secretes more T4 than T3 T4 is major circulating hormone because it is tightly bound to plasma proteins and T3 is faster acting: About 1/3 of T4 is converted to T3 in peripheral tissues Q.18 Name some thyroid inhibitors These are drugs us�d in hyperactive thyroid gland and can be classified as follows: i Inhibiting iodide trapping (Thiocyanate, Perchlorates, Nitrates) ii Inhibit hormone synthesis (Propylthiouracil, Methimazole, Carbimazole) iii Inhibiting hormone release: Iodine, Iodides of Na and K iv Destroy thyroid tissue: Radioactive iodine Q 18.What are the uses of antithyroid drugs? What are their advantages and disadvantages? They are used for remission of Graves' disease, preoperatively to make hyperthyroid patient euthyroid, along with P31• The advantages are: i No surgical risk ii Hypothyroid state is reversible iii Can be used in all ages The disadvantages are: i Prolong therapy ii Drug toxicity iii Patients co-operation required Q.19 What are the therapeutic uses of iodine? This is used for i Preoperative preparation of thyroidectomy patient ii Thyroid storm Endocrine System 103 iii Prophylactic in endemic goitre iv Expectorant v Antiseptic Q.20 Name the drugs which can produce hypothyroidism They are: i Lithium ii Amiodarone iii Sulfonamide iv Phenobarbitone v Phenytoin vi Carbamazepine viii Rifampicin Q 21 What are the t/2 of J131, p23, J12s? The t/2 of P31 is days; P23 is 13 hours; P25 is 60 days Q.22 What are therapeutic uses of P31? This is used for diagnostic and therapeutic purposes (Graves' disease, toxic nodular goitre), metastatic carcinoma of thyroid) Q.23 What are the advantages and disadvantages of radio active iodine? The advantages are: i Simple treatment without surgical risk, if hyperthyroidism is controlled cure is permanent can be used in CCF, angina The disadvantages are: i Hypothyroidism ii Prolong treatment time iii Cannot be given in pregnancy iv Young patients develop hypothyroidism quickly Q.24 How does P-blocker propranolol help in thyro toxicosis? i They overcome the manifestation of sympathetic overactivity n For preparation of thyroidectomy with iodine I 104 Viva Voce in Medical Pharmacology DIABETES MELLITUS, INSULIN, OHG Q.l What is diabetes mellitus? Diabetes mellitus is a metabolic disorder characterized by hyperglycaemia, glycosuria, negative nitrogen balance hyperlipemia and sometimes ketonemia Q.2 What is insulin? Who discovered it? It is a hormone liberated by pancreatic �-islet cells It was discovered by Banting and Best and its structure was worked out by Sanger in 1956 Q.3 What is the structure of insulin? (Achain has Insulin has two polypeptide chain 21amino acid; B chain has 30 amino acid) They are synthesized as single chain peptide of 110 amino acids in � cells to produce proinsulin The connecting C peptide is spit off by proteolysis in Golgi apparatus Q.4 What you mean by I.U insulin? I.U of insulin decreases blood glucose of fasting rabbit to 45 mg%, mg of standard insulin =24 units Q.S.How is the secretion of insulin regulated? Insulin secretion is regulated by: i Chemical: �cells of glucose has glucose sensing mechanism acting as principal regulator, other regulators are amino acids, fatty acids, ketone bodies ii Hormonal: Growth hormone,corticosteroid,thyroxine and PG modify·insulin release iii Neuronal: Richly supplied by sympathetic and vagal nerves a2 receptor activation inhibits, �2 stimulation increases insulin releases, muscarinic activation increases insulin secretion Q.6 What is the mechanism of action of insulin? Insulin acts on insulin receptor present in all the cells,specially in liver and fat cells.The insulin receptor is tetrameric glyco protein with 2a and 2� subunits linked by di -sulfide bonds The a subunits bind insulin whereas �-subunits activate \ tyrosine •kinase Endocrine System 05 Q.7 What is the fate of insulin? Being protein in nature, it is not absorbed orally, Injected insulin or secreted insulin is metabolized in liver, kidney, muscle During biotransformation A and B chains are separated, the disulfide bonds are reduced which are further broken down to constituent amino acids Q.S What are the therapeutic uses of insulin? It is indicated in diabetes mellitus type I and type II: In type II diabetes insulin is required in: i If not controlled by diet or exercise ii Primary and secondary failure of OHG iii Under weight patient Emergencies like infection, trauma, surgery, pregnancy IV v Complications of diabetes like ketosis, gangrene, etc vi Diabetk ketoacidosis vii Hypermolar nonketotic hyperglycaemic coma Q.9 What-are the adverse reactions of insulin? These are hypoglycaemia, local reaction like lipodystrophy, allergy, edema Q.lO How will you treat diabetic ketoacidosis? i Insulin 0.1-0.2 U/kg LV bolus, followed by 0.1 U kg/hr infusion ii LV fluid normal saline to correct dehydration after blood sugar reaches 300 mg%, 5% glucose in 1/2 N saline can be used iii KCl 4-10 mEq/hr Kcl LV to be guided by serum monitoring and ECG iv NaHC03 to tackle acidosis v P04 infusion if values are low vi Antibiotics Q.ll What is Somogyi effect? The problem of Somogyi effect is common in insulin dependent diabetes with aggressive effort to control hyperglycaemia Day time episodes of hypoglycaemia are recognised by sweating, nervousness, tremor, hunger If hypoglycaemia not aborted it worsens diabetic control, with 106 Viva Voce in Medical Pharmacology the results of counter regulatory hormones results in hyperglycaemia with mild ketosis and this phenomenon is called Somogyi effect It should be suspected if there is wide moving of plasma glucose or urine sugar in a short period Q.12 What is insulin resistance? What are their causes? When requirement of insulin is increased by 200 I.U./ day, physiologically it is said to be insulin resistance It may be acute due to infection, trauma, corticosteroid therapy or, due to ketoacidosis or chronic where patient takes conventional beef or pork insulin due to antibodies to insulin Pregnancy or oral contraceptives often produce low grade reversible insulin resistance Q.13 What is human insulin? Human insulin is produced by recombinant DNA technology in E coli (proinsulin recombinant bacterial prb) or precursor yeast recombinant (pyr) or by enzymatic modification of porcine insulin (emp) Q.14 What are the indications of purer/human insulin? In developing countries purer insulin is used for: i Insulin resistance ii Allergy to conventional preparations iii Lipodystrophy iv To tide over surgery, trauma, infection, ketoacidosis, pregnancy Q.15 What are the nondiabetic uses of insulin? i To test completenes of vagotomy ii Hyperemesis gravidarum, anorexia nervosa, cachexia, alcohol intoxication, shock therapy of schizophrenia (outdated) Q.16 Name the oral hypoglycaemic agents Oral hypoglycaemic drugs are of following types: i Sulfonylureas derivative: a 1st generation-Tolbutamide, Chlorpropamide, Aceto hexamide, Tolazamide b 2nd generation-Glibenclamide, Glipizide, Gliclazide Endocrine System 07 ii Biguanide derivatives: Phenformin, Metformin iii Miscellaneous: Acarbose, Guargum Q.17 What is the mechanism of action of sulfonylurea? Sulfonylurea acts on sulfonylurea receptor on the pancreas � cells, causes depolarization by reducing coductance of ATP sensitive K+channel, enhancing Ca2+ influx and degranulation They not act on type I diabetes and pancreatonised animal They reduce glucagon and increases somatostatin release But these are minor action On chronic administration they sensitize the target tissues because of increase in insulin receptors Q.18 What are the adverse effects of sulfonylurea? Following adverse effect may arise with sulfonylurea: i Hypoglycaemia ii Nonspecific effects (nausea, vomiting, flatulence diarrhoea, constipation, headache, paraesthesia, weight gain) iii Hypersensitivity rash, photosensitivity, purpura, tran sient leukopenia, agranulocytisis Chlorpropamide may produce cholestatic jaundice, disulfiram like action with alcohol, dilutional hyponatremia Tolbutamide reduces iodide uptake and hypothyroidism Q.19 What is the mechanism of action of biguanides? They i Inhibit intestinal absorption of glucose, hexose amino acids, B12 ii Suppress hepatic gluconeogenesis iii Enhance binding of insulin to its receptor iv Interfere with mitochondrial respiratory chain and promote peripheral glucose utilization Q.20 What are the adverse effects of biguanides? They may produce i Lactic acidosis ii Vit B12 deficiency Anti leprotic Drugs \ Q.l Name the different drugs used in leprosy The drugs used in leprosy could be: i Sulfone: Dapsone (DDS) ii Phenazine derivative, Clofazimine iii Antitubular drug: Rifampicin, Ethionamide iv Miscelhmeous: Ofloxacin, Minocycline, Clarithromycin _ Q.2 What is the action of Dapsone? Dapsone being sulfonamide inhibits the incorporation of PABA into folic acid of M.leprae due to specificity forM leprae due to difference in the affinity of folate synthetase Q.3 What are the other uses of Dapsone? It may be used in Chloroquine resistant cases of malaria, pemphegious Q.4 Mention some ADR of DDS It may produce haemolytic anaemia, particularly in Glucose 6-P04 deficient patient nausea, vomiting, methemoglobine mia,-rash, fixed drug reaction, hypermelanosis, phototoxicity, exfoliative dermatitisn Hepatitis, agranulocytosis Q.S What is the mechanism of action of Clofazimine? It is a dye with leprostatic and anti-inflammatory properties It probably interferes with template function of DNA Q.6 Mention some ADR of clofazamine Skin discolouration, Acne form eruption, phototoxicity, conjunctival pigmentation, enteritis, intermittent, loose stool, anorexia, weight loss 180 Viva Voce in Medical Pharmacology Q.7 What are the advantages of multi-drug therapy in leprosy? They reduce duration of therapy and quick symptomatic relief and reduce MBL cases non-contagious effective in Dapsone resistance and prevents dapsone resistance Q.B Name the different drugs used in leprosy regimen For multibacillary leprosy: Rifampicin-600 mg/month Dapsone-100 mg daily Clofazimine-300 mg/month supervised 50 mg daily for years Paucibacillary: Rifampicin 600 mg/month and DDS 100 mg daily Alternative regimen: Clofazamine 50 mg +(a) Ofloxacin 400 mg/ (b) minocycline 100 mg/(c) clarithromycin 500 mg (any two of a, b,c) for months Q.9 What is lepra reaction? Lepra reaction occurs with lepromatous leprosy with initiation of chemotherapy It is Jarish-Herxheimer arthus type reaction due to release of antigen from killed bacilli, consists of fever, malaise, lymph node enlargement, skin desquamation, jaundice and anaemia Treatment withdraw DDS Increase clofazamine doses Analgesic, antipyretic, antibitoc, chloroquinine, thalidomide, corticosteroids Q.lO What is reversal reaction? It occurs with tuberculoid leprosy patient as a part of delayed hypersensitivity to M.leprae antigen manifested with cutaneous ulceration multiple nerve involvement with tenderness treated with clofazamine and steroids Antifungal Antibiotic Q.l Name the drugs used for fungal infection The antifungal drugs may be classified as follows: i Antibiotics: a Polyenes (Amphotericin B, Nystatin, Hamycin, Natamycin) b Heterocyclic benzofuran-Griseofulvin , ii Antimetabolite: Flucytosine (5FC) iii Azole: a Imidazole (topical Clotrirrtazole, Econazole, Mico b Triazoles-(Systemic) Fluconazole, Itraconazole nazole) (Systemic: Ketoconazole)'iv Allylamine: Terbinafine v Other topical agents: Tolnaflate,undecylenic acid,Benzoic acid,Quinodochlor,Ciclopirox,Olamine,Sod thiosulfate Q.2 What is the mechanism of action of Amphotericin B? Amphotericin, the polyenes antibiotics have high affinity for ergosterol of fungal cell membranes to orient themselves to produce micropore through which ions,amino acids and water soluble substances move out It is not effective against bacteria as it does not contain sterol in their cell membrane Q.3 Name the therapeutic uses of ampthotericin B It is effective against Candida albicans, cryptococcus, Blastomyces, histoplasma, coccidiodes, Torulopsis, Rhodtorula, Aspergillus, Sporothrix It is also active against Leishmania Q.4 Mention some newer Amphotericin B formulations These are: i Amphotericin B lipid complex (ABCL) 182 Viva Voce in Medical Pharmacology ii Amphotericin B colloidal dispersion (ABCD) iii Liposomal Amphotericin B (small unilamellar vesicles SUV) used for kala-azar and immunocompromised patients Q.5 Mention ADR of Amphotericin B These are chills, fever, aches, nausea, vomiting, nephrotoxi city, anaemia, CNS toxicity (headache vomiting, nerve palsy) Q.6 Name an antifungal discovered in India and its uses Hamycin is developed by Hindustan Antibiotics Ltd topically used for thrush, cutaneous candidiasis, trichomones vaginitis, Aspergillus otomycosis Q.7 Mention some therapeutic uses of Natamycin Natamycin applied topically for Fusarium Keratitis Q.S Mention the source and therapeutic uses of Griseofulvin What is its mechanism of action? It is obtained from Penicillium griseofulvin used for dermato phytosis (Epidermophyton, Trichophylon, Microsporum) It interferes mitosis of multinucleated fungal hypae Q.9 What is Flucytosine (5 FC)? It is narrow spectrum (active against cryptococcus) orally active drug converted to fluorodeoxyuridylic acid, inhibitor of thymidylate inside fungal cell and act as fungostatic Q 10 What is Itraconazole? It is orally active triazole antifungal fungistatic drug, effective in immunocompromised patient also Q.11 Why Itraconazole produces ventricular tachycardia when used with terfenadine, astemazole cisapride? Terfenadine, Cisapride, astemazole are drugs which increase Q.T intervals ltraconazole inhibits CYP-3A4 and blood level of these drugs are increased leading to lethal ventricular arrhythmia Q.12 What is Terbinafine? It is allylamine class of antifungal orally and topically used fungicidal acts as noncompetitive inhibitor of squalene Antifungal Antibiotic 183 epoxidase which ultimately produces ergosterol biosynthesis in fungal cell membrane and accumulates squalene within fungal cells Q.13 Name some topical Antifungals? These are: · i Tolnatate ii Cyclopirox olarnine iii Undecylenic acid iv Benzoic acid v Quiniodochlor vii Sodium thiosulfate Antiviral Drugs Q.1 Why is viral chemotherpay difficult? · Viruses not only take nutrition from the host, but they also direct its metabolic machinery to ·synthesize new virus particle Therefore the chances of interferences with cellular metabolism by antiviral drugs are common Q.2 Name some antiviral drugs? These are i Nonselective antiviral (Ribovirin, Interferon) ii Antiherpes virus: Idoxiridine, Vidarabin, Trifluridine, Acyclovir, Ganciclovir, Foscarnet m Antiretrovirus: a Reverse transcription inhibitors, Zidovidine, Didanosine, Zalcitabine, Stavudine b Protease inhibitors: Saquinavir, Ritonavir, Indinavir, Nelfinavir iv Anti-influenza virus: Amantadine, Rimantadine Q.3 What is the mechanism of action of Idoxuridine? 5-iodo-2-deoxyuridine is antimetabolite of thimidine analogue incorporated within DNA for thymidine and DNA directs wrong viral proteins used against DNA viruses Herpes simplex, Trifluridine is related to idoxuridine Q.4 What is the mechanism of action of Acyclovir? Acyclovir selectively inhibits viral DNA synthesis with low toxicity to host cells It is deoxiginase analogue antiviral drug requires virus specific enzymes for conversion to the active metabolite It is effective against H simplex I and II, Varicella zoster, Epstein-Barr and Cytomegalovirus Antiviral Drugs 185 Ganciclovir is analogue of acyclovir active against all herpes viruses Q.5 What are the therapeutic uses of foscarnet? It is used for CMV retinitis in AIDS patients with CMV infection, Acyclovir resistant H simplex patient Q.6 What is the mechanism of action of Zidovudine? Zidovudine is phosphorylated in the body and selectively inhibits viral reverse transcriptase prevents infection of new cells by HIV irtfection Q.7 What are Didanosine, Zalcitabine, Stavudine? These are antiviral agents, nucleoside analogue intracellularly converted to active triphosphate derivative which inhibit viral reverse transcription and terminate proviral DNA of HIV Q.8 Name some protease inhibitors used for HIV infection These are-saquinavir, ritanavir, Indinavir, Nelfinavir which acts late step of viral cycle produce immature noninfectous virus Q.9 What is the mechanism of action of Amantadine? Mention its therapeutic uses It inhibits uncoating in an early stage and assembly of virus particles Used in prophylaxis treatment of influenza virus and Parkinsonism Q.lO What is the mechanism of action of Ribavirin? Its mono and triphosphate derivatives generated intra cellularly inhibit GTP and viral RNA synthesis effective against Influenza Aand Band respiratory syncytal virus and many DNAand RNAvirus Q.ll What are interferons? They are low molecular weight glycoproteins produced in host c.ells in response to viral infection They are nonspecific antivirals act on multiple steps viral replication viz; penetration, synthesis of viral mRNA; assembly and release They are host specific Their approved indications are: i Chronic hepatitis Band C 186 n Viva Voce in Medical Pharmacology AIDS related Kaposi's sarcoma iii Hairy cell leukemia 1v v Condyloma accuminata H simplex, H Zoster in immunocompromised host vi Rhino viral cold used as prophylactic by nasal spray.-· Index Anodyne hypnotics 33 A a-Adreneric blocking agents 14 Absorption of drugs Acarbose 108 Acetazolamide 38 Antacids 85 Anti RA drug 43 Antianginal drugs action of nitrates 66 therapeutic uses of nitrates 66 adverse effect 38 cyanide poisoning 66 Acetylcholinesterase 15 Acyclovir 184 Adrenal cortex 109 Adrenergic receptors 14 Adrenocorticotropic hormone 100 ideal antianginal agent 66 Antianxiety drug 23 Antiarrhythmic drug quinidine 64 tocainide lignocaine 65 Alcohol amiodarone 65 therapeutic uses 27 Alkaloids of opium 30 Alkylating agents 135 Allopurinol 20 adenosine 65 Antibiotics 156 Anticholinergic group 11 Amiloride 79 Antidepressants 25 Aminoglycosides 169 Antidiarrhoeal agent 84 Aminophylline 59 Amoebiasis 128 Amphotericin B 181 Ampicillin 165 Anabolic steroids 114 Anaemia 88 Anaesthetics local 43 spinal 43 general 43 preanaesthetic medication 46 dissociative anaesthesia 47 neuroleptanalgesia 47 Antidiuretics 79 Antiplatelet drug 96 Antipsychotic drug 22 Antithyroid drugs 102 Antiviral drugs 184 Apparent volume distribution Aspirin 41 Astringents 137 ATD therapy 177 Attenuated vaccines 154 B 13-blockers 17 anaesthetic agents 47 Analeptics 20 13-lactam antibiotics 163 Androgens 116 Barbiturates Angiotensin angiotensin II 52 angiotensin receptors 53 angiotensin converting enzyme 54 ACE inhibitors 54 therapeutic uses 34 poisoning 34 Belladona poisoning 12 Benzodiazepine antagonist 35 Benzodiazepines 35 Biguanide 107 188 Viva Voce in Medical Pharmacology Bioavailability Bisphosphonates 114 Bradykinin 51 Bromhexine 58 Bromocriptine 99 Bronchial asthma 59 Buspirone 24 Colchicine 20 Congestive heart failure 61 Contraceptive 120 Corticosteroids 111 Cycloserine 177 Cyclosporine 147 Cyproterone acetate 115 Cytotoxic drugs 133 Busulfan 135 Butyryl cholinesterase 15 D D-penicillamine 43 c Ca2+ channels 67 Calcitonin 113 Dacarbazine 135 Dales vasomotor reversal 13 Dapsone 179 Calcium 112 Calcium channel blockers prazosin 70 clonidine 70 Cannabis indica 25 Carbonic anhydrase 76 Cardiac arrhythmia 63 Carminatives 81 Castor oil 83 Catecholamine 15 Cell cycle 134 Centchroman 122 Demulcents 137 Desferrioxamine 153 Dhatura 12 Diabetes mellitus 104 Didanosine 185 Diethyl carbamazine 131 Digestants 81 Digitalis signs of improvement 62 adverse reactions of 62 toxicity 62 Dilirium tremans 28 Cephalosporin 165 Dimercaprol BAL 152 Cerebroactive drugs 21 Disinfectant 142 Cheese reaction 26 Chelating agents 152 Chenodiol 82 Chloramphenicol 172 Chloroquine 43, 126 Choline-esterase inhibitors 10 Cholinoceptors muscarinic nicotinic · Ciprofloxacin 163 Cisplastin 136 Clavulanic acid 165 Clofazimine 179 Clomiphene citrate 118 Co-trimoxazole 161 Coagulants 92 antiseptics 142 gerp1icide 142 pediculosis 143 Disulfiram 27 Diuretic 75 Dopamine 29 Dosage Dose response curve Drug abuse 26 Drug addiction 26 Drug administration Drug automation 35 Drug combination Drug excretion Drug habituation 26 Drug tolerance 26 Index H2 receptor blockers 85 E Haematinics 88 Emetics 80 Hallucinogens 25 Emollients 137 Endogenous opioid peptides 32 Enzyme 151 189 Epilepsy 36 Erythrocytic schizontocides 125 Erythromycin 173 Erythropoietin 91 Essential and orphan drugs Ethambutol 177 Expectorants 58 F Halofantrine 127 Helium 146 Heparin 93 Histamine receptors 49 Hofmann elimination 4,13 Huntingtons disease 23 Hyperbaric oxygen 145 Hypertension 69 Hypertrichosis 71 Hypnotics 32 Hypolipoproteinemic drugs HMG-CoA reductase inhibitors 72 Factors modify drug action Fenastride 116 Fibrinolytic agents 95 Flucytosine 182 fibric acid derivative 72 Hypothyroidism 103 Fluroquinolone 162 I Flutamide 116 Idoxuridine 184 Folic acid 90 Imipenem 166 Foscamet 185 Immunosuppressants 147 Infantile spasm 39 G Gallstone 82 Gentamicin 170 Giardiasis 129 Ginkgolide 57 Glaucoma 10 Glimepride 109 Glucagon 108 Glucocorticosteroids 110 Glycopeptide antibiotic 173 Gold salt 42 Insulin 104 Interferon 185 Invermectin 131 Iodine 102 Iron 88 Iron poisoning 89 ltraconazole 182 J Jarisch-Herxheimer reaction 164 Gossypol 123 K Gout 19 Kallidins 51 Gray baby syndrome 172 Kinins Griseofulvin 182 pathological role of 52 Guargum 108 kinin receptors 52 H L 8-Hydroxyquinolines 129 L-asparaginase 136 190 Viva Voce In Medical Pharmacology Lactulose 83 Laxatives 82 Leishmaniasis 130 Lepra reaction 180 Leprosy 179 Leukotrienes 55 Levamisole 131 Lithium 24 M Octreolide 99 Oestrogens 117 On-off effect 30 Opioid receptors 31, 32 Oral rehydration therapy 75 Organophosphorus poisoning 11 Oxytocics 123 p Macrolide antibiotics 173 Malaria 124 Malignant hyperthemia 13 Mannitol 78 MAO 25 Mast cell degranulator 13 Mebendazole 131 Median effective dose Median lethal dose Mefloquine 126 Melanizing agents 138 Melatonin 35 Metals poisoning 152 Methyl polysiloxane 81 Metronidazole 128 Mifepristone 119 Migraine 50 Mineralocorticoids 111 Morphine therapeutics uses 31 Myasthenia gravis 11 Paracetamol poisoning 41 Parasympathomimetric drug 10 Parathormone 113 Parkinsonism 28 Pentamidine 130 Peptic ulcer 84 Peripheral vascular disorder 68 Pharmacology Pharmacopeia Phenytoin therapeutic uses 37 Phosphodiesterase III inhibitors 63 Piperazine 131 Pirenzepine 87 Plasma expander 72 Plasma kinins 51 Platelet activating factors 57 Postcoital pills 120 Potassium channel 67 Praziquantel 132 Prescription N Probencid 20 Narcotic analgesics 30 Procarbazine 136 Natamycin 182 Progesterone 119 Neomycin 171 Progestins 119 Nervous system Prokinetic drugs 81 sympathetic Prostaglandins 55 parasympathetic Protamine sulfate 94 Neuroleptics 23 Proton pump inhibitors 86 Neuromodulator Pseudo-membranous Neurotransmitter NSAID 39 enterocolitis 84 Psychiatric disorders 22 Index 191 Psychostimulant action 21 Sulfasalazine 43 Pyrazinamide 177 Sulfonamide 160 Q Sympathomimetic drugs 14, 16 Sulfonylurea 107 Quinine 127 Quinolones 162 T Tachyphylaxis 13 Tamoxifen 118, 136 R Radioisotopes 144 Receptor al 16 a2 16 Rheumatoid arthritis 42 Tannic acids 137 Tardive dyskinesia 30 Terbinafine 182 Termination of drug action Testosterone 116 Ribavirin 185 Tetracyclines 168 Rifampicin 176 Therapeuti� gases 145 Rubefacients 138 Therapeutic index Therapeutics Thiazide diuretics 77 s Sclerosing agents 93 Sedative 32 Seizures 36 Semisynthetic heparinoids 94 Sequential pills 120 Serotonergic receptors 49 Sildenfil 16 Thiazolideones 108 Thromboxanes 55 Thyroid gland 100 Thyroid hormones 101 Thyroid inhibitors 102 Tocolytics 123 Topical steroids 139 Skeletal muscle relaxants 12 Toxiocology Sleep pattern 33 Trichomoniasis 129 Sodium valproate 39 TSH 100 Somatostatin 99 Tuberculosis 176 Somogyi effect 105 Sources of a drug Stavudine 185 STD diseases syphilis 140 gonorrhoea 140 u Urinary antiseptic 175 Ursodiol 82 chancroid 140 v granuloma inguinale 141 Vaccines 154 trichomoniasis 141 Vertigo 51 herpes 141 VitB12 90 Straub's test 30 Streptomycin 169 Vit D 113 Vit K 92 192 Viva Voce in Medical Pharmacology Vitamins nicotinic acid 149 pyridoxine 149 calcium pantothenate 150 vit C 150 vitA toxicity 150 w Warfarin 94 X Xanthine derivative 60 y Young and dilling formulae z Zalcitabine 185 Zidovudine 185 ... insulin? (Achain has Insulin has two polypeptide chain 21 amino acid; B chain has 30 amino acid) They are synthesized as single chain peptide of 110 amino acids in � cells to produce proinsulin... against malaria are: i Aminoquinolines: Chloroquine, Amodiaquine ii Quinoline: Mefloquine iii Acridine: Mepacrine iv Cinchona alkaloid-Quinine v Biguanides-Prognanil (Chloroguanides) vi Diaminopyrimidines... activation increases insulin secretion Q.6 What is the mechanism of action of insulin? Insulin acts on insulin receptor present in all the cells,specially in liver and fat cells.The insulin receptor