Pharmacology

Correct Answer - A Ans: A. Thiazide increases the tubular absorption of lithium Drug Interaction: Diuretics + Lithium = Decreased excretion—rise in Li + level - toxicity; Diuretics (thiazide, furosemide) by causing Na + loss to promote proximal tubular reabsorption of Na + as well as Li + → plasma levels of lithium rise. Potassium-sparing diuretics cause milder Li + retention. Management: Reduce dose of lithium and monitor level.

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Correct Answer - C Ans: C. Chronic tophaceous gout Pegloticase: Pegloticase is a medication for the treatment of the severe, treatment of refractory chronic gout. It is a third-line treatment in those in whom other treatments are not tolerated.

Correct Answer - B Ans: B. Pefloxacin Pefloxacin has longer t½: accumulates on repeated dosing achieving plasma concentrations twice as high as after a single dose. Because of this, it is effective in many systemic infections as well. The dose of pefloxacin needs to be reduced in liver disease, but not in renal insufficiency.

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Correct Answer - A Ans: A. Intravenous digoxin Management of AMS follows three axioms: a) further ascent should be avoided until the symptoms have resolved, b)patients with no response to medical treatment should descend to a lower altitude and c) if and when HACO is suspected, patients should urgently descend to a lower altitude. Descent and supplementary oxygen are the treatments of choice and for severe illness, the combination provides optimal therapy. Remarkably, a descent of only 500 to 1000 m usually leads to resolution of acute mountain sickness while high-altitude cerebral edema(HACO) may require further descent. Simulated descent with portable hyperbaric chambers, now commonly available in remote locations, are also effective. Medical therapy becomes crucial when the descent is not immediately possible.

Correct Answer - A Ans: A. Bethanechol Bethanechol is a preferred drug in the treatment of postpartum and postoperative nonobstructive urinary retention, and it also can counteract bladder dysfunction often seen with phenothiazines and tricyclic antidepressants. It can afford symptomatic relief in congenital megacolon and gastroesophageal reflux but is rarely used for these.

Correct Answer - A Ans: A. Rifampicin Overall inhibition of RNA synthesis by rifampicin is caused by a destabilizing effect on the binding of the intermediate oligonucleotides to the active enzyme-DNA complex. Rifampicin itself can only interact specifically with RNA polymerase if the enzyme is free or in a binary complex with DNA.

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Correct Answer - B Ans: B. Trihexyphenidyl * Fluphenazine may block the effects of agents used to treat Parkinson's disease such as levodopa/carbidopa. * Trihexyphenidylis an antispasmodic drug that exerts a direct inhibitory effect on the parasympathetic nervous system. - It also has a relaxing effect on smooth muscle. - It is indicated in all forms of Parkinsonism. * Trihexyphenidyl works as an anticholinergic and is used for the treatment of tremors, spasms, stiffness, and weak muscle control seen in patients with Parkinson’s disease. - It can also be used for the prevention or treatment of similar muscular conditions which are caused by certain central nervous system (CNS) drugs such as fluphenazine, haloperidol, chlorpromazine.