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Published by: PROF DR SHAHMURAD on Dec 15, 2010
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Prof. Dr. Shah Murad shahmurad65@gmail.com

At GTTH, in medical OPD, Just as a trial, final year MBBS students injected a drug to 3rd year MBBS student USMAN. Drug injected was in a clinical dose. Route of administration was S/C. After 30 minutes there was dilation of pupil and a rise in systolic blood pressure of USMAN. The drug could be a) Morphine b) Adrenaline c) Atropine d) Acting by blocking ganglia e) Stimulating beta receptors throughout the body

‡ At SURGIMED Hospital, a Physician was discussing autonomic pharmacology with house officers. He asked ´when given to man a drug causes bradycardia, increased GI motility and pupilary constriction. Which one of the following drug produces these combined effects: a) morphine b) Histamine c) anti-histamine d) nor-epinephrine e) neostigmine

‡ In emergency ward of Meo hospital medical officers were treating a comatose patient. They were differentiating effects of adrenaline and nor-adrenaline. One said which was true, ´subcutaneous injection of noradrenaline in manµ cuases: a) Decrease in systolic BP b) Decrease in diastolic BP c) Tachycardia d) Lowers peripheral resistance e) Predominantly alpha-actions

‡ Beta-action of adrenaline include: a) Decreased glycogenolysis in skeletal muscles b) Constriction of arterioles in skin c) Decrease in force of cardiac contraction d) Increase in rate of cardiac contraction e) Constriction of bronchioles

3rd year MBBS students were discussing about ephedrine. There are 5 statements about the drug. Which one is correct: a) It is contraindicated by oral route b) Is especially indicated in patients already taking monoamine oxidase inhibitors c) Causes depression of the CNS d) Stimulates predominantly alpha-receptors e) It is a mixed acting amine, ie; acts directly on receptors and by causing release of transmitter from sympathetic nerves

A 35 years old patient Muhammad Nawaz was admitted in emergency at GTTH at 11 am. He had have breathlessness. A Junior doctor was on duty, who nebulized him with SALBUTAMOL. This drug: a) Is selective beta1 agonist b) Has its actions competitively antagonised by chlorpheneramine c) Produces constriction of blood vessels in skeletol muscles d) Is used in asthma e) Produces accommodation for near vision

A young medical graduate of LM&DC was observing treatment of his 22 years brother-in-law at Jinnah Hospital, Lahore. When injected a drug to that young man, drug has no effect on resting pulse rate, does not produce a dry mouth, and depresses tachycardia, that normally follows the Valsave manoeuvre. What do you think that the drug: a) Would be expected to block the tachycardia induced by inhalation of amyl nitrate b) Could be atropine c) Could be bethanecol d) Could be ipratropium e) Is surely H2 receptor antagonist

The transmitter substance at: a) Parasympathetic postganglionic nerve endings is usually nor-epinephrine b) Parasympathetic ganglia is epinephrine c) Sympathetic ganglia is nicotine d) Parasympathetic preganglionic nerve endings is muscarine e) Parasympathetic postganglionic nerve endings is adrenaline

A 12 years old child was admitted in casualty of sheikh zaid hospital , Lahore. History revealed that he has taken 2 bottles of a drug which was used by his mother for nasal decongestion. It is basically alpha adrenoceptor agonist drug. What will you observe in this patient: a) tachycardia b) mydriasis c) bronchodilation d) vasodilation e) none of the above


years nurse at GTTH was observing management of patient

in shock. Doctor used drug ¶adrenaline· in that patient. Nurse was considering about the drug. Regarding ADRENALINE:

a) It is a catalytic agent b) It is useful drug to relieve constipation c) It is indicated in glaucoma d) It is commonly used by oral route e) It is commonly used in hypertensive patients

Practolol has been withdrawn from general clinical use because it: a) Is a non-selective beta-blocker b) Is dangerous to give it to asthmatics c) Cause hyperurecemia d) Induces thyrotoxicosis e) Causes ocular damage

Salivary secretion is under autononmic control. Sympathetic activity produces a small amount of thick mucus secretion rich in enzyme content, whilst parasympathetic activity produces a copious watery secretion. Ganglion blockade blocks all secretion,and an unpleasant dry mouth results.Which drug of the following has ganglion blocking activity:

‡ ‡ ‡ ‡ ‡

A)adrenaline B)nor-adrenaline C)hexamethonium D)haloperidol E)carbachol

LM&DC graduate of 2005 Dr. Amin is GP at Shadman town , Lahore. He prescribed tablet alpha methyl dopa, in patient who was suffering from««««««..

a) b) c) d) e)

hyperlipidemia Diabetes mellitus hypertension gout Peptic ulcer

Which of the statement is correct:
a) Adrenaline is a rational choice in the treatment of sinus bradycardia b) Noradrenaline is useful in all types of cardiac arrhythmias c) Guanethidine prevents release of noradrenaline from sympathetic neurons d) Pempidine is a useful antihistamine e) Salbutamol produces more tachycardia than isoprenaline

Sympathetic ganglia can be
a) b) c) d) e) Blocked by alpha methyl dopa Stimulated by acetylcholine Stimulated by nicotine Blocked by pempidine Stimulated by bradykinin

‡ 25 years old male patient was admitted in General Hospital Lahore at 4 pm, due to hypersensitivity reaction to some drug ingestion 4 hours before. At emergency he was treated by a drug which causes dilattion of vessels in muscle, constriction of cutaneous vessels, and positive inotropic and chronotropic effects on the heart. The drug given may be: A) isoproterenol B) acetylcholine C) adrenaline D) metaproterenol E) noradrenaline

A 9 years old baby was brought at medicine OPD of the hospital. Mother told physician that child has bed-wetting problem. Which drug may be prescribed for this problem:

a) b) c) d) e)

phenylephrine adrenaline ephedrine antihistamine tricyclic antidepressant

In Opthalmology OPD doctors are used to administered following drug for routine examination of EYE. That drug should be mydriatic but not cycloplegic. Which one of the following drugs has that property:

a) b) c) d) e)

tropicamide pilocarpine phenylephrine homatropine isoproterenol

a) b) c) d) e) Lorazepam Antihistamines Beta blockers Ephedrine Sildenafil

Write short note on:
1) 2) 3) 4) 5) Indications of beta blockers SEs of non-selective beta blockers Dobutamine Contra-indications of epinephrine Clinical uses of Phenoxybenzamine

14 years old Ms. Fahmida was brought at casualty of GTTH, complain with epistaxis. It was due to fragile vessels of the nose. Doctor on duty kept adrenaline swab at her nose. Which of the following effects of adrenaline would be blocked by phentolamine but not by metoprolol:

a) Contraction of radial smooth muscle in the iris b) Cardiac stimulation c) Increase of cAMP in fat d) Relaxation of bronchial smooth muscle e) Relaxation of uterus

Phenoxybenzamine is not used in:

a) b) c) d) e)

Pheochromocytoma Raynaud·s phenomenon Essential hypertension Carcinoid Mastocytosis

28 years male patient, already diagnosed case of pheochromocytoma was admitted in Surgical ward of Meo Hospital. At day-0, surgeon started IV injection of Phentolamine Mesylate for this patient. Phentolamine was used in this patient, because:

a) It has antipsychotic effects b) It increases BP by increasing peripheral resistance c) It decreases BP by blocking -receptors, both
1 and 2

d) It has anxiolytic effect e) It decreases adrenaline presynaptically

28 years Haqnawaz was hypertensive since last 5 years. He came to GP at Mustafabad, Dharampura for his treatment. GP prescribed tablet Minipress (prazosin) 5 mg OD for him, for three days. Regarding PRAZOSIN:

a) It is highly -1 selective blocker agent b) It dilates arterioles more than veins c) It causes postural hypotension d) Dizziness and fainting occurs as ´1st DOSE EFFECTµ e) All are true about prazosin

An accident occured at north canal road, near DYAL HOUSE. Driver of that car was severely injured and shifted to GTTH. There was remarkable blood & fluid loss in the patient. PATIENT IS INFRONT OF YOU. What will you do?

a) Start fresh blood and dextrose saline, immediately b) You will start adrenaline s/c immediately c) You will observe all vital functions then you will decide what to do? d) Immediately inject corticosteroids (SOLUCORTEF) e) Do not think, just administer atropine IV

47 years old patient has benign hypertrophy of prostate. He visited surgical OPD of AADIL HOSPITAL, bediyan road, Lahore. Before surgical treatment of the case, Doctor may prescribe some drugs for this patient. Which drugs should be prescribed:

a) -1 adrenergic blocker like prazosin b) Propranolol c) Atenolol d) Combined propranolol + atenolol e) None of the above

35 years old patient was operated for inguinal hernia. Surgeon decided to operate him under GA. After recovery from anesthesia, on routine investigations at ICU, tachycardia and extrasystoles were observed by doctor. For this patient at this stage, which drugs are helpful:

a) Bethanichol may improve extrasystoles b) Ipratropium may be helpful to control tachycardia c) Beta blockers suppress extrasystoles and tachycardia d) Esmolol is special beta blocker used in this case e) No any drug available to control tachycardia & extrasystoles

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