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(BQ) Part 1 book Viva voce in medical pharmacology has contents: General pharmacology, autonomic nervous system, central nervous system, anaesthetics, anaesthetics, prostaglandins, respiratory system, cadiovascular system, drugs used in gastrointestinal tract,... and other contents.
Viva Voce • zn Medical Pharmacology K Mukhopadhyay Private General Practitioner Dhanbad Former Senior Resident, Department of Pharmacology Institute of Medical Sciences, BHU Medical Officer, Damodar Valley Corporation Additional Professor, Department of Pharmacology College of Medical Sciences Bharat Pur, Nepal JAYPEE BROTHERS MEDICAL PUBLISHERS (P) LTO New Delhi Published by Jitendar P Vij Jaypee Brothers Medical Publishers {P) Ltd EMCA House, 23/23B Ansari Road, Daryaganj New Delhi 110 002, India Phones: 23272143, 23272703,23282021,2324567:2,23245683 Fax: 011-23276490 e-mail: jpmedpub@del2.vsnl.net.in Visit our website: http://www.jpbros.20m.com Branches 202 Batavia Chambers, Kumara Kruppa Road, Kumara Park East, Bangalore 560 001, Phones: 2285971,2382956 Tele Fax: 2281761 e-mail: jaypeebc@bgl.vsnl.net.in 282 lllrd Floor, Khaleel Shirazi Estate, Fountain Plaza Pantheon Road, Chennai 600 008,Phone: 28262665 Fax: 28262331 e-mail: jpmedpub@md3.vsnl.net.in 4-2-1067/1-3, 1st Floor, Balaji Building, Ramkote Cross Road, Hyderabad 500095, Phones: 55610020, 24758498 Fax: 24758499 e-mail: hyd2jpmedpub@sancharnet.in 1A Indian Mirror Street,Wellington Square Kolkata 700 013,Phone: 22451926 Fax: 22456075 e-mail: jpbcai@cal.vsnl.net.in 106 Amit Industrial Estate, 61 Dr SS Rao Road, Near MGM Hospital Parel,Mumbai 400 012, Phones: 24124863,24104532 Fax: 24160828 e-mail: jpmedpub@bom7.vsnl.net.in Viva Voce in Medical Pharmacology © 2004, K Mukhopadhyay All rights reserved No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic,mechanical, photocopying, recording, or otherwise,without the prior written pE>rmission of the author and the publisher This book has been published in good faith that the material provided by author is original Every effort is made to ensure accuracy of material, but the publisher, printer and author will not be held responsible for any inadvertent error(s) In case of any dlspute,.all legal mattersJo be settled under Delhi jurisdiction only First Edition: 2004 Reprint: 2005 ISBN 81-8061-259-7 Typeset at JPBMP typesetting unit Pnnted at Sanat Printers to my father Late Tulsi Das Mukherjee who gave me courage for my education Preface Medical science has rapidly grown and developed in the last couple of decades, and so has emerged its branch Pharmacology The real beauty of the subject Pharmacology is that the clinicians of all specialities and superspecialities use its knowledge to prevent, diagnose and cure diseases This tends to confuse undergraduate students during their viva-voce exams Viva-voce examination environment has been simulated and model questions and their answers have been provided in this book Through this book I have attempted to help students get through their viva-voce exams Many people have helped me put together this book Birds of the same feather flock together I am grateful to Dr (Mrs) Barnali Mukherjee, Dr Jhulan Mukherjee, Dr (Mrs) Shrabani Mukhopadhyay and Dr Angshuman Mukhopadhyay who were professional critics outside and loving family near home I am also thankful to Smt Bina Mukherjee, Shri Basudeb Mukherjee, Smt Kajoli Mukherjee, Shri Baladeb Mukherjee, Shri Abhijit Banerjee, Smt Jayanti Sinha and Shri GCP Sinha for their blessings and encouragement I would like to thank Dr TR Roy and Shri Binod Modi and Dr MM Bandopadhyay for encouraging me to go ahead with writing this book How can I forget to mention my lecturers during my undergraduate and postgraduate studies I am indebted to Prof MS Dey, Prof Robin Chatterjee, Prof BN Das, Prof S Banerjee, Late Prof AK Sanyal, Prof PK Das, Prof SS Gambhir, Prof SB Acharya, Prof SK Bhattacharya, Prof RK Goel, Dr BL Pandey whose lectures were of immense help in preparing this book Special thanks go to my department colleagues, Prof AK Chakraborty, Prof SK Tripathy, Dr Anil Jaiswal for suggestions and encouragement Prof JN Neogi and Prof KK Agarwal of CMS, Nepal also encouraged me to go about writing this book My heartfelt thanks to them Viva Voce in Medical Pharmacology viii I must thank Mr Tarun Duneja, GM (Publishing), Mr Sanjay Chakraborty, Asstt Sales Manager of Jaypee Brothers Medical Publishers to help compile this book I would like to mention my cousins Aditi Banerjee, Lakshmi Chatterjee, Arundhati Banerjee, Nandini Pandit, Anuradha, Mrinal for their unending enthusiasm Finally, kisses and love to my son, Sanak, my niece Esha and Idrija for their giggles and laughter which always seemed to tell me: Arise, Awake and Stop not till the goal is achieved I must acknowledge my mother, Smt Bedbani Mukherjee who went through with infinite patience and always stood by me Thanks! K Mukhopadhyay • '!> Contents General Pharmacology Autonomic Nervous System Central Nervous System 19 a Drugs used in Gout b Analeptics, Psychostimulant, Nootropic c Psychopharmacology d Alcohol e Antiparkinsonian Drugs f Narcotic Analgesic h Anti Epileptics NSAID g Sedative Hypnotics i g Rheumatoid Arthritis Local Anaesthetics Plasma Kinins, Angiotension 28 30 32 36 39 Autocoids 22 27 44 b General Anaesthetics 19 20 42 Anaesthetics a 44 45 48 51 Prostaglandins 55 Respiratory System 58 Cadiovascular System 61 a Drugs in Heart Failure b Antiarrhythmic Drugs c Antianginal Drugs d Antihypertensive e Hypolipoproteinemic Drugs f Plasma Expanders 61 63 65 69 71 72 Water, Electrolytes and Drugs Affecting Renal Function 74 x Viva Voce in Medical Pharmacology 10 Drugs used in Gastrointestinal Tract 80 11 Haemopoietic System , , 88 12 Endocrine System 98 Diabetes mellitus, Insulin, OHG Corticosteroid Drugs Acting on Calcium Metabolims Anabolic Steroids Androgen Oestrogen Contraceptives 109 112 114 ; 116 Progesterone 104 117 119 120 13 Antimalarial Drugs 124 14 Antiamoebic Drugs 128 15 Antihelmintic Drugs 16 Anticancer Drugs 131 133 17 Drugs Acting on Skin and Mucous Membrane 137 18 Sexually Transmitted Diseases 140 19 Antiseptic and Disinfectant 142 20 Radioisotopes 144 21 Therapeutic Gases 145 22 Immunosuppresant and Gene Therapy 147 23 Vitamins 149 24 Enzymes in Therapy .• 151 , 25 Chelating Agents 26 Vaccines and Sera 152 154 27 Antibiotics 156 28 Sulfonamides 160 29 Quinolones 162 30 Tetracyclines 168 31 Chloramphenicol ; 172 32 Macrolide Antibiotics 173 Contents 33 Urinary Tract Infection 34 Anti Tubercular Drugs 35 ·Anti Leprotic Drugs 36 Antifungal Antibiotic 37 Antiviral Drugs Index 175 xi 176 179 181 184 187 General Pharmacology Q.l Define pharmacology, drugs, toxicology, therapeutics, pharmacopeia Pharmacology: It is that branch of medical science which deals with history, source, physical and chemical properties, compounding, biochemical and physiological effects, mec hanism of action, absorption, distribution, biotransformation, excretion, therapeutic uses and side effects of a drug Drug: i A chemical substance used for the purpose of diagnosis prevention, relieve or cure of a disease in man or animals ii WHO has defined drug as "any substance or product that is used or intended to be used to modify or explore physiological systems or pathological states for the benefit of the recipient." Toxicology: Science of poison It is the study of measurement, detection and treatment of poisons Therapeutics: It is branch of medicine concerned with cure of a disease or relief of symptoms Pharmacopeia: A book published by recognised authority of any country containing a list of accepted drugs and formulae for medical preparations with average dose and description of their characteristics test for their identity, purity and potency like IP, BP, USP Q.2 What is prescription? It is written order for one or medical agents along with direction to the pharmacist for the preparation and to the Drugs Used in Gastrointestinal Tract 83 Q.14 What is the mechanism of action of purgatives? All purgatives increase the water content of the faeces, increase volume of colonic content and make it easily propelled, decrease absorption of water and electrolyte, increase propulsion activity Purgatives modify fluid dynamics of mucosal cell and accumulate fluid in the gut lumen in one of the following mechanism: Inhibits Na/K ATPase impairing water absorption, stimulate adenylyl cyclase to increase water secretion They cause structural damage to mucosal cells hindering absorption Q.15 What are the disadvantages of liquid paraffin and dietary fibres Disadvantages of liquid paraffin are: i Bland, unpleasant to swallow ii May pass into mucosa, carried into lymph, may produce foreign body granulomas in the intestinal submucosa, mesenteric lymph nodes iii May tride into lung producing pneumonia 1v Carries away fat soluble vitamins with stool and vitamin deficiency may occur v May interfere with healing in anorectal region and leakage of oil at and sphincter may be embarassing Q.16 What is the mechanism of action of castor oil? Castor oil is bland vegetable oil seeds of Ricinus communis contains triglyceride of Ricinoleic acid which is hydrolysed in the ileum by lipase to ricinoleic acid and glycerol Ricinoleic acid being polar poorly absorbed and irritate GI mucosa Other proposed mechanism producers structural damage to villious tips, decreases intestinal absorption Q.17 What is the mechanism of action of Lactulose? The semisynthetic disaccharides of fructose and lactose which is not digested or absorbed retain water, broken down by colonic bacteria to osmotically more active product It is also used for hepatic encephalopathy Lactulose causes reduction of blood NH3, the breakdown products of lactulose are acidic and reduce pH of stool Ammonia produced by bacteria in gut is ionized to NH4 which is not absorbed + 84 Viva Voce in Medical Pharmacology Q.18 What are the therapeutic uses of purgatives? They are used for: i Functional constipation ii Bed ridden patient iii To avoid straining at stools iv Preparation of bowel in surgery, colonoscopy X-rays v Food poisoning vi Some antihelminths require purgative to propel them out Q.19 What are the dangers of purgative abuse? It may cause flaring of intestinal pathology, fluid an