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Chapter-11 Gastrointestinal Drugs

Chapter · January 2016

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 11
Gastrointestinal Drugs

Choose the most A. Cardiac stimulation

Appropriate Response B. Fall in blood pressure
C. Uterine relaxation
46.1 Histamine H2 blockers attenuate the gas- D. Bronchospasm (p. 649)
tric secretory response to acetylcholine
and pentagastrin as well because: 46.4 Gynecomastia can occur as a side effect of:
A. H2 blockers block gastric mucosal cho- A. Bromocriptine B. Cimetidine
linergic and gastrin receptors as well C. Famotidine D. Levodopa
B. H2 blockers inhibit the proton pump in (p. 650)
gastric mucosa 46.5 Which histamine H2 blocker has most
C. Acetylcholine and gastrin act partly by marked inhibitory effect on microsomal
releasing histamine in gastric mucosa cytochrome P-450 enzyme?
D. Histamine, acetylcholine and gastrin A. Cimetidine B. Ranitidine
all act through the phospholipase C. Roxatidine D. Famotidine
C-IP3:DAG pathway in gastric mucosa (p. 650)
(p. 647, 648)
46.6 Choose the correct statement about H2
46.2 For healing duodenal ulcer the usual receptor blockers:
duration of H2 blocker therapy is: A. They are the most efficacious drugs in
A. 4 weeks B. 6 weeks inhibiting gastric acid secretion
C. 8 weeks D. 12 weeks B. They cause fastest healing of duodenal
(p. 651) ulcers
46.3 In the intact animal H2 receptor antago- C. They prevent stress ulcers in the stomach
nists potentiate the following action of D. They afford most prompt relief of ulcer
histamine: pain (p. 650)

46.1 C 46.2 C 46.3 D 46.4 B 46.5 A 46.6 C

 Gastrointestinal Drugs 173

(Note: Proton pump inhibitors are the C. Its cationic forms are unable to diffuse out
most efficacious drugs in inhibiting gas- from the gastric parietal cell canaliculi
tric acid secretion. They also cause faster D. All of the above (p. 651, 652)
healing of duodenal ulcers. Antacids and
proton pump inhibitors relieve ulcer pain 46.11 The drug beneficial in NSAID induced
more promptly. However, injected i.v. H2 gastric ulcer?
blockers are extensively used for prophy- A. PGE1 agonist
laxis of gastric erosions and bleeding in B. PGE2 agonist
acutely stressful conditions.) C. PGD2 agonist
D. PGF2alpha agonist (p. 190, 654)
46.7 Ranitidine differs from cimetidine in the
following respect: 46.12 The reason why ranitidine and sucralfate
A. It is less potent combination is incorrect?
B. It is shorter acting A. Ranitidine combines with sucralfate and
C. It does not have antiandrogenic action prevents its action
D. It produces more CNS side effects B. Combination of these two drugs pro-
(p. 650) duces serious side effects like agranu-
locytosis
46.8 Compared to H2 blockers, omeprazole C. Ranitidine increases the gastric pH so
affords the following: sucralfate is not able to act.
A. Faster relief of ulcer pain D. Sucralfate inhibits the absorption of
B. Faster healing of duodenal ulcer ranitidine (p. 656)
C. Hi g h e r e f f i c ac y i n h e a l i n g re f l u x
esophagitis 46.13 Proton pump inhibitors are most effective
D. All of the above (p. 652) when they are given:
A. After meals
46.9 Choose the drug which blocks basal as B. Shortly before meals
well as stimulated gastric acid secretion C. Along with H2 blockers
without affecting cholinergic, histamin- D. During prolonged fasting periods
ergic or gastrin receptors: (p. 652)
A. Famotidine B. Loxatidine
C. Omeprazole D. Pirenzepine 46.14 M1 blocker used in peptic ulcer disease is:
(p. 651, 652) A. Pirenzepine
B. Pyridostigmine
46.10 Omeprazole exerts practically no other
C. Atropine D. Oxybutynin
action EXCEPT inhibition of gastric acid
(p. 117, 649, 654)
secretion because:
A. It transforms into the active cationic 46.15 Antacid drug which can typically cause
forms only in the acidic pH of the gastric diarrhea?
juice A. Sodium bicarbonate
B. Its active forms have selective affinity B. Magnesium hydroxide
for the H+K+ATPase located in the apical C. Calcium bicarbonate
canaliculi of gastric parietal cells D. Aluminium hydroxide (p. 655)

46.7 C 46.8 D 46.9 C 46.10 D 46.11 A 46.12 C 46.13 B 46.14 A

46.15 B
174 KD Tripathi’s MCQs in Pharmacology

46.16 The most efficacious drug for inhibiting B. The pH of 1N solution of the antacid
round the clock gastric acid output is: C. The rate at which the antacid reacts with
A. Omeprazole B. Cimetidine HCl
C. Pirenzepine D. Both ‘A’ and ‘C’ (p. 654)
D. Misoprostol (p. 652) 46.22 As an antacid, sodium bicarbonate has
46.17 Select the drug which is an inhibitor of the following disadvantages EXCEPT:
gastric mucosal proton pump: A. It causes acid rebound
A. Carbenoxolone sodium B. In ulcer patients, it increases risk of per-
B. Sucralfate C. Famotidine foration
D. Lansoprazole (p. 953) C. It has low acid neutralizing capacity
D. It is contraindicated in hypertensives
46.18 The following class of gastric antisecretory (p. 654)
drug also reduce gastric motility and have
primary effect on juice volume, with less 46.23 The following is TRUE of aluminium
marked effect on acid and pepsin content: hydroxide gel EXCEPT:
A. Histamine H2 blockers A. It is a weak and slowly reacting antacid
B. Anticholinergics B. Its acid neutralizing capacity decreases
C. Proton pump inhibitors on storage
D. Prostaglandins (p. 654) C. It interferes with absorption of phos-
phate in the intestine
46.19 The primary mechanism by which pros- D. It causes loose motions as a side effect
taglandins promote ulcer healing is: (p. 655)
A. Inhibition of gastric acid secretion
46.24 Choos e the correct statement about
B. Augmentation of bicarbonate buffered
magaldrate:
mucus layer covering gastroduodenal
A. It is a mixture of magnesium and alu-
mucosa
minium hydroxides
C. Increased bicarbonate secretion in
B. It has a rapid as well as sustained acid
gastric juice
neutralizing action
D. Increased turnover of gastric mucosal
C. Its acid neutralizing capacity is 2 m Eq/g
cell (p. 654)
D. It causes systemic alkalosis (p. 655)
46.20 Choose the antiulcer drug that inhibits
46.25 Antacid combinations of magnesium and
gastric acid secretion, stimulates gastric
aluminium salts are superior to single
mucus and bicarbonate secretion and has
component preparations because:
cytoprotective action on gastric mucosa:
A. They have rapid as well as sustained acid
A. Misoprostol B. Sucralfate
neutralizing action
C. Carbenoxolone sodium
B. They are less likely to affect gastric emp-
D. Colloidal bismuth subcitrate (p. 654)
tying
46.21 The ‘acid neutralizing capacity’ of an ant- C. They are less likely to alter bowel move-
acid is governed by: ment
A. The equivalent weight of the antacid D. All of the above (p. 655)
46.16 A 46.17 D 46.18 B 46.19 B 46.20 A 46.21 D 46.22 C 46.23 D
46.24 B 46.25 D
 Gastrointestinal Drugs 175

46.26 In peptic ulcer, antacids are now primarily 46.31 Choose the correct statement about col-
used for: loidal bismuth subcitrate:
A. Prompt pain relief A. It causes prolonged neutralization of
B. Ulcer healing gastric acid
C. Preventing ulcer relapse B. It has anti-H.pylori activity
D. Control of bleeding from the ulcer C. It relieves peptic ulcer pain promptly
(p. 656) D. All of the above are correct (p. 656)
46.27 Sucralfate promotes healing of duodenal 46.32 Eradication of H.pylori along with gastric
ulcer by: antisecretory drugs affords the following
A. Enhancing gastric mucus and bicarbo- benefit(s):
nate secretion A. Faster relief of ulcer pain
B. Coating the ulcer and preventing the B. Faster ulcer healing
action of acid-pepsin on ulcer base C. Reduced chance of ulcer relapse
C. Promoting regeneration of mucosa D. Both ‘B’ and ‘C’ are correct (p. 657)
D. Both ‘A’ and ‘B’ are correct (p. 656)
46.33 The drugs employed for anti-H.pylori
46.28 Antacids administered concurrently therapy include the following EXCEPT:
reduce efficacy of the following antipeptic A. Ciprofloxacin B. Clarithromycin
ulcer drug: C. Tinidazole D. Amoxicillin
A. Cimetidine (p. 657, 658)
B. Colloidal bismuth
46.34 The following is TRUE of anti-H.pylori
C. Sucralfate
therapy EXCEPT:
D. Pirenzepine (p. 656)
A. It is indicated in all patients of peptic
46.29 The following antiulcer drug DOES NOT ulcer
act by reducing the secretion of or neu- B. Resistance to any single antimicrobial
tralizing gastric acid: drug develops rapidly
A. Magaldrate C. Concurrent suppression of gastric acid
B. Sucralfate enhances efficacy of the regimen
C. Misoprostol D. Colloidal bismuth directly inhibits
D. Omeprazole H.pylori but has poor patient accept-
(p. 656) ability (p. 657, 658)
46.30 The most important drawback of sucral- 46.35 The preferred regimen for preventing
fate in the treatment of duodenal ulcer is: duodenal ulcer relapse is:
A. Low ulcer healing efficacy A. Maintenance antacid regimen
B. Poor relief of ulcer pain B. Maintenance H2 blocker regimen
C. High incidence of side effects C. On demand intermittent H 2 blocker
D. Need for taking a big tablet four times a regimen
day (p. 656) D. Maintenance sucralfate regimen (p. 651)

46.26 A 46.27 B 46.28 C 46.29 B 46.30 D 46.31 B 46.32 D 46.33 A

46.34 A 46.35 B
176 KD Tripathi’s MCQs in Pharmacology

47.1 In a conscious patient of poisoning, use A. Increases lower esophageal sphincter

of an emetic is permissible in case the tone
ingested poison is: B. Increases tone of pyloric sphincter
A. Ferrous sulfate C. Increases gastric peristalsis
B. Sodium hydroxide C. Kerosine D. Increases intestinal peristalsis (p. 664)
D. Morphine (p. 606, 661, 662)
47.7 Which drug is given for metoclopramide
47.2 The most effective antimotion sickness induced dystonic reaction?
drug suitable for short brisk journies A. Pheniramine
is: B. Promethazine
A. Promethazine theoclate C. Chlorpromazine
B. Cinnarizine D. Prochlorperazine (p. 663)
C. Prochlorperazine 47.8 Metoclopramide:
D. Hyoscine (p. 663) A. Inhibit cholinergic smooth muscle
47.3 In case of hill journey, antimotion sick- stimulation in the gastrointestinal tract
ness drugs are best administered at: B. Decrease lower esophageal sphincter
A. Twelve hours before commencing pressure
journey C. Stimulate D2 receptor
B. One hour before commencing journey D. Enhances gastric motility (p. 664, 665)
C. Immediately after commencing journey 47.9 Which drug can lead to prolongation of
D. At the first feeling of motion sickness QT interval?
(p. 664) A. Domperidone
47.4 Chlorpromazine and its congeners sup- B. Metoclopramide C. Cisapride
press vomiting of following etiologies D. Omeprazole (p. 667)
EXCEPT: 47.10 The drug that IS NOT an antiemetic:
A. Motion sickness A. Ondansetron
B. Radiation sickness B. Domperidone
C. Postanaesthetic C. Metoclopramide
D. Uremic (p. 664) D. Cetirizine (p. 662)
47.5 Choose the phenothiazine compound
47.11 Activation of the following type of recep-
which has selective labyrinthine sup-
pressant action, is used for vomiting and tors present on myenteric neurons by
vertigo, but not in schizophrenia: metoclopramide is primarily responsible
A. Triflupromazine for the enhanced acetylcholine release
B. Prochlorperazine and improving gastric motility:
C. Trifluoperazine A. Muscarinic M1
D. Thioridazine (p. 664) B. Serotonergic 5-HT3
C. Serotonergic 5-HT4
47.6 Metoclopramide has the following actions D. Dopaminergic D2 (p. 665)
EXCEPT:

47.1 A 47.2 D 47.3 B 47.4 A 47.5 B 47.6 B 47.7 B 47.8 D

47.9 C 47.10 D 47.11 C
 Gastrointestinal Drugs 177

47.12 Metoclopramide blocks apomorphine anesthesia. Which drug can be injected

induced vomiting, produces muscle dys- intramuscularly to hasten his gastric
tonias and increases prolactin release emptying?
indicates that it has: A. Methylpolysiloxane B. Promethazine
A. Anticholinergic action C. Metoclopramide D. Apomorphine
B. Antihistaminic action (p. 666)
C. Anti 5-HT3 action
D. Antidopaminergic action (p. 665) 47.18 Select the correct statement regarding the
antiemetic efficacy of the three prokinetic
47.13 Activation of the following type of recep- drugs metoclopramide, domperidone
tors present on myenteric neurones by and cisapride:
metoclopramide is primarily responsi- A. Cisapride is the most effective
ble for enhanced acetylcholine release B. Metoclopramide is the most effective
improving gastric motility: C. Domperidone is the most effective
A. Muscarinic M1 D. All three are equally efficacious
B. Serotonergic 5-HT3 (p. 665, 657)
C. Serotonergic 5-HT4
D. Dopaminergic D2 (p. 665) 47.19 Which antiemetic selectively blocks levo-
dopa induced vomiting without blocking
47.14 Select the prokinetic-antiemetic drug
its antiparkinsonian action?
which at relatively higher doses blocks
A. Metoclopramide B. Cisapride
both dopamine D2 as well as 5-HT3 recep-
C. Domperidone D. Ondansetron
tors and enhances acetylcholine release
(p. 666, 667)
from myenteric neurones:
A. Cisapride 47.20 The following prokinetic drug has been
B. Prochlorperazine C. Metoclopramide implicated in causing serious ventricu-
D. Domperidone (p. 665, 666) lar arrhythmias, particularly in patients
47.15 Which prokinetic drug(s) produce(s) concurrently receiving erythromycin or
extrapyramidal side effects? ketoconazole:
A. Metoclopramide B. Cisapride A. Domperidone B. Cisapride
C. Domperidone C. Mosapride
D. All of the above (p. 665-666) D. Metoclopramide (p. 667)

47.16 The progastrokinetic action of the follow-
ing drug(s) is attenuated by atropine:
A. Domperidone B. Metoclopramide
C. Cisapride
D. Both ‘B’ and ‘C’ (p. 665, 666, 667)
47.17 A patient returning from dinner party
meets with road accident and has to be
urgently operated upon under general
47.21 Indicate the drug which D OES NOT
improve lower esophageal sphincter tone
or prevent gastroesophageal reflux, but
is used as first line treatment of gastro-
esophageal reflux disease:
A. Sodium alginate + aluminium hydroxide
gel
B. Omeprazole C. Mosapride
D. Famotidine (p. 659, 660)

47.12 D 47.13 C 47.14 C 47.15 A 47.16 D 47.17 C 47.18 B 47.19 C

47.20 B 47.21 B
178 KD Tripathi’s MCQs in Pharmacology

47.22 Select the drug(s) which afford(s) relief trigger zone/nucleus tractus solitarious,
in gastroesophageal reflux by increas- but has no effect on gastric motility:
ing lower esophageal sphincter tone and A. Ondansetron B. Domperidone
promoting gastric emptying, but without C. Metoclopramide D. Cisapride
affecting acidity of gastric contents: (p. 668)
A. Sodium alginate
B. Metoclopramide 47.28 Granisetron is a:
C. Cisapride A. Second generation antihistaminic
D. Both ‘B’ and ‘C’ (p. 667, 659) B. Drug for peptic ulcer
C. Antiemetic for cancer chemotherapy
47.23 The fastest symptomatic relief as well as D. New antiarrhythmic drug (p. 669)
highest healing rates in reflux esophagitis
are obtained with: 47.29 Ondansetron is effective in the following
A. Prokinetic drugs type(s) of vomiting:
B. H2 receptor blockers A. Cisplatin induced
C. Proton pump inhibitors B. Radiotherapy induced
D. Sodium alginate (p. 659) C. Postoperative
47.24 Prokinetic drugs serve the following D. All of the above (p. 668)
purpose(s) in gastroesophageal reflux 47.30 Ondansetron blocks emetogenic impulses
disease: at the following site(s):
A. Reduce reflux of gastric contents into A. Vagal afferents in intestines
esophagus B. Nucleus tractus solitarius
B. Promote healing of esophagitis C. Chemoreceptor trigger zone
C. Reduce acidity of gastric contents D. All of the above (p. 668)
D. Both ‘A’ and ‘B’ are correct (p. 659)
47.31 Choos e the correct statement about
47.25 Cisapride enhances gastrointestinal ondansetron:
motility by: A. It is a dopamine D2 receptor antagonist
A. Activating serotonin 5-HT4 receptor B. It suppresses postoperative nausea and
B. Activating muscarinic M3 receptor vomiting
C. Blocking dopamine D2 receptor C. It is the most effective antiemetic for
D. All of the above (p. 667) motion sickness
47.26 The most effective antiemetic for control- D. It is not effective by oral route (p. 668)
ling cisplatin induced vomiting is: 47.32 Cancer chemotherapy induced vomiting
A. Prochlorperazine B. Ondansetron that IS NOT controlled by metoclopra-
C. Metoclopramide D. Promethazine mide alone can be suppressed by combin-
(p. 668) ing it with:
47.27 Select the antiemetic that prevents acti- A. Amphetamine B. Dexamethasone
vation of emetogenic afferents in the gut C. Hyoscine D. Cyclizine
and their central relay in chemoreceptor (p. 668)

47.22 D 47.23 C 47.24 A 47.25 A 47.26 B 47.27 A 47.28 C 47.29 D

47.30 D 47.31 B 47.32 B
 Gastrointestinal Drugs 179

48.1 Used as a laxative, liquid paraffin has the 48.5 Which of the following purgatives under-
following drawbacks EXCEPT: goes enterohepatic circulation to produce
A. It interferes with absorption of fat prolonged action?
soluble vitamins A. Docusates
B. It is unpleasant to swallow B. Phenolphthalein
C. It causes griping C. Castor oil
D. It can produce foreign body granulo- D. Mag. sulfate (p. 674)
mas (p. 673, 674)
48.6 The following purgative stimulates intes-
48.2 A 70-year-old patient presented with weak- tinal motility independent of its action on
ness, tiredness and muscle cramps. The mucosal fluid dynamics:
ECG showed Q-T prolongation, flattening A. Castor oil
of T wave and occasional A-V block. His B. Senna
serum K+ was low (2.8 mEq/L). He admit- C. Docusates
ted taking a laxative every day for the past D. Sod.pot. tartrate (p. 675)
several months. Which laxative could be
48.7 Choose the correct statement about lactu-
responsible for the above condition:
lose:
A. Bisacodyl B. Liquid paraffin
A. It stimulates myenteric neurones to
C. Methylcellulose D. Bran (p. 674)
enhance gut peristalsis
48.3 A patient presented with abdominal pain B. Administered orally it acts as a purgative
and frequent unsatisfactory bowel move- within 2-4 hours
ment. For the last one year he has been C. It is an osmotic laxative that produces
using a purgative twice weekly to open soft but formed stools
his bowel. On colonoscopy the colon was D. All of the above are correct
found to be atonic with bluish pigmenta- (p. 675, 676)
tion of the mucosa. Which is the most
48.8 The following laxative lowers blood ammo-
likely purgative that the patient has been nia level in hepatic encephalopathy:
using? A. Bisacodyl
A. Liquid paraffin B. Liquid paraffin
B. Ispaghula C. Lactulose
C. Senna D. Magnesium sulfate (p. 676)
D. Lactulose (p. 675)
48.9 Stimulant purgatives are contraindicated
48.4 The laxative that acts by opening of chlo- in the following:
ride channels: A. Bed ridden patients
A. Docusate B. Before abdominal radiography
B. Anthraquinone C. Spastic constipation
C. Lubiprostone D. Atonic constipation
D. Bisacodyl (p. 675) (p. 676)

48.1 C 48.2 A 48.3 C 48.4 C 48.5 B 48.6 B 48.7 C 48.8 C

48.9 C
180 KD Tripathi’s MCQs in Pharmacology
48.10 Saline osmotic purgatives are used for:
A. Treatment of constipation
B. Prevention of constipation in patients of
piles
C. Avoidance of straining at stools in
patients of hernia
D. Tapeworm infestation: following nic-
losamide administration (p. 676, 677)
48.11 The most suitable laxative for a patient
of irritable bowel disease with spastic
constipation is:
A. Dietary fibre B. Liquid paraffin
C. Bisacodyl D. Senna (p. 676)
48.12 The success of oral rehydration therapy
of diarrhea depends upon the following
process in the intestinal mucosa:
A. Sodium pump mediated Na+ absorption
B. Glucose coupled Na+ absorption
C. Bicarbonate coupled Na+ absorption
D. Passive Na+ diffusion secondary to nutri-
ent absorption (p. 678, 679)
48.13 For optimum rehydration, the molar con-
centration of glucose in ORS should be:
A. Equal to or somewhat higher than the
molar concentration of Na+
B. Somewhat lower than molar concentra-
tion of Na+
C. One third the molar concentration of Na+
D. Three times the molar concentration of
Na+ (p. 679)
48.14 Cyclic nucleotides exert the following
action on salt transport across intestinal
mucosal cells:
A. B o th c y c li c AMP a nd c y c l ic GM P
- –
enhance Cl and HCO3 secretion
B. Cyclic AMP enhances but cyclic GMP
– –
inhibits Cl and HCO 3 secretion
C. Cyclic AMP inhibits but cyclic GMP
–
enhances Na+ and Cl reabsorption
48.10 D 48.11 A 48.12 B 48.13 A
48.18 C 48.19 B
D. B o th c y c li c AMP a nd c y c l ic GM P
enhance Na+ and Cl– reabsorption
(p. 678)
48.15 The concentration of sodium ions in the
standard WHO oral rehydration solution is:
A. 40 m moles/L
B. 60 m moles/L
C. 90 m moles/L
D. 110 m moles/L (p. 679)
48.16 The ‘new formula’ WHO-ORS differs from
the older ‘standard formula’ WHO-ORS in
the following respect(s):
A. It has lower Na+ ion and glucose con-
centration
B. It has higher K+ ion concentration
C. It has no basic salt
D. Both ‘B’ and ‘C’ are correct (p. 679, 680)
48.17 The following is TRUE of ‘new formula’
WHO-ORS:
A. It has Na+ ion concentration of 75 mM/L
B. Its glucose concentration is 75 mM/L
C. Its total osmolarity is 245 mOsm/L
D. All of the above are correct (p. 680)
48.18 The electrolyte composition of standard
WHO oral rehydration solution is based
upon that of:
A. Enterotoxigenic E. coli diarrhea stools
B. Cholera stools in adults
C. Cholera stools in children
D. Rotavirus diarrhoea stools (p. 679)
48.19 Institution of oral rehydration therapy has
the following beneficial effect in diarrhea:
A. Stops further diarrhea
B. Restores hydration and electrolyte bal-
ance without affecting diarrhea
C. Hastens clearance of the enteropathogen
D. Obviates the need for specific antimi-
crobial therapy (p. 680)
48.14 A 48.15 C 48.16 A 48.17 D
 Gastrointestinal Drugs 181

48.20 Apart from diarrhea, oral rehydration 48.25 Sulfa drug used in inflammatory bowel
solution has been employed in: disease includes:
A. Severe vomiting A. Sulfasalazine
B. Burn cases C. Heat stroke B. Sulfamethoxazole
D. Both ‘B’ and ‘C’ (p. 680) C. Sulfinpyrazone
48.21 An adult patient of acute diarrhea pre- D. Sulphadoxine (p. 683)
sents with abdominal pain, fever, mucus 48.26 The primar y role of sulfasalazine in
and blood in stools and is suspected to ulcerative colitis is:
be suffering from Shigella enteritis. What
A. Suppression of enteroinvasive patho-
antimicrobial treatment would be most
appropriate? gens
A. No antimicrobial treatment B. Control of acute exacerbations of the
B. Metronidazole C. Norfloxacin disease
D. Chloramphenicol (p. 682) C. Maintenance of remission
D. Both ‘B’ and ‘C’ (p. 683)
48.22 Antimicrobial treatment DOES NOT alter
48.27 The preferred drug for controlling an
the course of the following diarrhoeas
acute exacerbation of ulcerative colitis is:
EXCEPT:
A. Prednisolone
A. Mild enterotoxigenic E.coli diarrhea
B. Sulfasalazine
B. Campylobacter diarrhea
C. Mesalazine
C. Coeliac disease diarrhea
D. Vancomycin (p. 292, 684)
D. Food poisoning diarrhea (p. 681, 682)
48.28 The following is/are TRUE of mesalazine:
48.23 The following diarrhea is consistently
A. It exerts mainly local antiinflammatory
benefited by antimicrobial therapy:
action in the lower gut
A. Irritable bowel syndrome
B. It is a broad spectrum antidiarrhoeal
B. Cholera
drug
C. Salmonella diarrheas
C. It can be administered as a retention
D. Traveller’s diarrhea (p. 682)
enema
48.24 The therapeutic effect of sulfasalazine in D. Both ‘A’ and ‘C’ (p. 684)
ulcerative colitis is exerted by:
A. Inhibitory action of the unabsorbed 48.29 To be effective in ulcerative colitis,
drug on the abnormal colonic flora 5-aminosalicylic acid has to be given as:
B. Breakdown of the drug in colon to release A. Acrylic polymer coated tablet which
5-aminosalicylic acid which suppresses releases the drug only in the lower bowel
inflammation locally B. A complex of two molecules joined
C. Release of sulfapyridine having antibac- together by azo bond
terial property C. A retention enema
D. Systemic immunomodulatory action of D. Any of the above ways
the drug (p. 683) (p. 684)

48.20 D 48.21 C 48.22 B 48.23 B 48.24 B 48.25 A 48.26 C 48.27 A

48.28 D 48.29 D
 182 KD Tripathi’s MCQs in Pharmacology

48.30 Drug that is useful in treating Crohn’s
disease:
A. Infliximab B. Azathioprine
C. Tacrolimus D. Cyclosporine
(p. 685)
48.31 Mesalazine (coated 5-amino salicylic
acid) differs from sulfasalazine in that:
A. It is more effective in ulcerative colitis
48.35 Choose the correct statement about the
B. It produces less adverse effect
C. It has no therapeutic effect in rheuma-
toid arthritis
D. Both ‘B’ and ‘C’ are correct
(p. 211, 684)
48.32 A 3-year-old child was given one tablet
three times a day to control loose motions.
The diarrhea stopped but next day the
child was brought in a toxic condition
with abdominal distention and vomiting.
He had paralytic ileus, mild dehydration,
low blood pressure and sluggish reflexes. 48.36 The following is TRUE of loperamide
Which antidiarrhoeal drug could have
caused this condition?
A. Iodochlorhydroxyquinoline
B. Furazolidone
C. Loperamide
D. Metronidazole (p. 687)
48.33 A small amount of atropine is added to the
diphenoxylate tablet/syrup to:
A. Suppress associated vomiting of gastro-
enteritis
B. Augment the antimotility action of 48.37 The drug that increases gastrointestinal
diphenoxylate
C. Block side effects of diphenoxylate
D. Discourage overdose and abuse of
diphenoxylate (p. 686)
48.34 The opioid antidiarrhoeal drugs act by the
following mechanism(s):
A. They relax the intestinal smooth muscle
B. They inhibit intestinal peristalsis
C. They promote clearance of intestinal
pathogens
D. All of the above (p. 686)
role of opioid antimotility drugs in the
management of diarrheas:
A. They are used to control diarrhoea
irrespective of its etiology
B. They should be used only as a short-term
measure after ensuring that enteroinva-
sive organisms are not involved
C. They are used as adjuvants to antimicro-
bial therapy of diarrhea
D. They are the drugs of choice in irritable
bowel syndrome diarrhea (p. 687)
EXCEPT:
A. It is absorbed from intestines and exerts
centrally mediated antidiar rhoeal
action
B. It acts on the opioid receptors in the gut
C. It increases tone and segmenting activity
of the intestines
D. It inhibits intestinal secretion by binding
to calmodulin in the mucosal cells
(p. 686, 687)
motility:
A. Glycopyrrolate B. Atropine
C. Neostigmine D. Fentanyl
(p. 107, 110)

48.30 A 48.31 D 48.32 C 48.33 D 48.34 B 48.35 B 48.36 A 48.37 C

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