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Questions and Answers

What is the use of rifaximin 200 mg TDS for 3 days?

  • To eradicate all types of bacteria
  • To reduce the duration of travellers' diarrhoea (correct)
  • To prevent infections during surgery
  • To treat chronic hepatitis

Which of the following pathogens is associated with severe diarrhoea that requires empirical treatment?

  • Streptococcus pneumoniae
  • Escherichia coli (correct)
  • Helicobacter pylori
  • Clostridium difficile

What is the effect of low doses of aspirin on TXA2 formation by platelets?

  • It enhances TXA2 formation.
  • It inhibits PGI2 formation.
  • It selectively suppresses TXA2 formation. (correct)
  • It has no effect on TXA2 formation.

What is the purpose of cough as a reflex action?

<p>To expel respiratory secretions (D)</p> Signup and view all the answers

What is a common cause of acute cough lasting less than 3 weeks?

<p>Respiratory viral infections (C)</p> Signup and view all the answers

Which substance primarily activates platelets to change shape and release mediator-rich granules?

<p>TXA2 (C)</p> Signup and view all the answers

Which antibiotic is preferred for treating multidrug-resistant cholera strains?

<p>Ciprofloxacin (B)</p> Signup and view all the answers

What type of drugs are classified based on their action on platelet function?

<p>Antiplatelet drugs (D)</p> Signup and view all the answers

In which condition is rifaximin 400 mg BD reported to provide subjective relief?

<p>Irritable Bowel Syndrome (IBS) (C)</p> Signup and view all the answers

Which enzyme is irreversibly inactivated by aspirin?

<p>TX-synthase (B)</p> Signup and view all the answers

Which of the following is NOT a known antimicrobial treatment for symptomatic relief in invasive diarrhoea?

<p>Azithromycin (C)</p> Signup and view all the answers

What is the function of dipyridamole?

<p>It serves as a vasodilator. (B)</p> Signup and view all the answers

How do other NSAIDs compare to aspirin in terms of platelet function?

<p>They are reversible inhibitors of COX. (D)</p> Signup and view all the answers

What is the main treatment recommendation for cholera?

<p>Fluid replacement (C)</p> Signup and view all the answers

What effect do higher doses of aspirin (> 900 mg/day) have on TXA2 and PGI2 production?

<p>They decrease both TXA2 and PGI2 production. (C)</p> Signup and view all the answers

What is the main purpose of TXA2 in the context of platelet function?

<p>To promote platelet aggregation. (C)</p> Signup and view all the answers

Which medications are considered selective β2 agonists used in asthma?

<p>Asthalin (A)</p> Signup and view all the answers

What is the recommended oral dose of β2 agonist therapy?

<p>2–4 mg (B)</p> Signup and view all the answers

What is a main target of action for cytotoxic drugs in cancer treatment?

<p>Nucleic acids (D)</p> Signup and view all the answers

Why are bone marrow and epithelial linings particularly affected by cytotoxic drugs?

<p>They undergo rapid cell division. (D)</p> Signup and view all the answers

What is a common consequence of drug-induced bone marrow depression?

<p>Granulocytopenia (B)</p> Signup and view all the answers

What type of infections is of particular importance due to low pathogenicity in cancer patients?

<p>Opportunistic infections (C)</p> Signup and view all the answers

Which viral infections are mentioned as significant due to chemotherapy effects?

<p>Herpes zoster and cytomegalovirus (A)</p> Signup and view all the answers

What condition can arise from severe bone marrow depression?

<p>Aplastic anemia (C)</p> Signup and view all the answers

What is a key characteristic of an open system in anesthetic delivery?

<p>Anaesthetic and O2 concentrations can be accurately delivered. (D)</p> Signup and view all the answers

Which of the following is NOT a property of a closed system?

<p>High flow rates. (C)</p> Signup and view all the answers

In which system is there a potential for imprecise control of inhaled anesthetic concentrations?

<p>Semiclosed system (C)</p> Signup and view all the answers

Why is it important for an anesthetic system to avoid reactions with rubber tubing or soda lime?

<p>To guarantee stability and safety. (C)</p> Signup and view all the answers

What is a common challenge associated with using a closed anesthesia system?

<p>Imprecision in controlling inhaled anesthetic concentration. (A)</p> Signup and view all the answers

What condition is ideal for quickly adjusting the depth of anesthesia?

<p>Wide margin of safety and potent agents. (B)</p> Signup and view all the answers

Why is it beneficial to have a wide margin of safety in anesthesia?

<p>To prevent any potential drop in blood pressure. (C)</p> Signup and view all the answers

What type of anesthetic system should be used for expensive and explosive agents?

<p>Closed system (A)</p> Signup and view all the answers

What is the primary effect of levodopa in patients with Parkinson's disease?

<p>Marked symptomatic improvement (D)</p> Signup and view all the answers

Which dopamine receptor subtypes are classified as excitatory?

<p>D1, D5 (B)</p> Signup and view all the answers

What happens to dopamine levels in Parkinson's patients treated with levodopa until death?

<p>Higher dopamine levels than untreated patients (B)</p> Signup and view all the answers

What is the role of D2-like receptors in the brain?

<p>To inhibit adenylyl cyclase (C)</p> Signup and view all the answers

Which of the following symptoms resolves first in patients treated with levodopa?

<p>Hypokinesia (C)</p> Signup and view all the answers

What type of receptors are the identified dopamine receptors classified as?

<p>G protein coupled receptors (D)</p> Signup and view all the answers

In the treatment of Parkinson's, D1 and D2 receptors in the striatum regulate what?

<p>Thalamic input to the motor cortex (C)</p> Signup and view all the answers

What is a common effect of levodopa treatment on secondary symptoms?

<p>Gradual normalization of multiple symptoms (D)</p> Signup and view all the answers

What are antianxiety drugs primarily designed to control?

<p>Symptoms of anxiety (C)</p> Signup and view all the answers

How do benzodiazepines compare to barbiturates in terms of dependence liability?

<p>Lower dependence producing liability (B)</p> Signup and view all the answers

What is a key characteristic of benzodiazepines regarding their therapeutic effects?

<p>They have no therapeutic effect on thought disorders (D)</p> Signup and view all the answers

What is one of the properties of benzodiazepines?

<p>They have anticonvulsant properties (B)</p> Signup and view all the answers

Which of the following populations are more susceptible to the respiratory depressant effects of morphine?

<p>Elderly and infants (A)</p> Signup and view all the answers

In patients with unstable personalities, what is a common risk related to drug use?

<p>Addiction to the drug (D)</p> Signup and view all the answers

What is one of the effects of benzodiazepines in relation to overdosage?

<p>They are relatively safe even in gross overdosage (B)</p> Signup and view all the answers

Which class of drugs is effective for treating severe generalized anxiety disorder (GAD)?

<p>SSRIs and SNRIs (A)</p> Signup and view all the answers

Flashcards

Aspirin's effect on COX

Aspirin acetylates COX1 and TX-synthase, making them unable to function.

TXA2's role in platelets

TXA2 is a major arachidonic acid product that activates platelets, causing them to change shape and aggregate.

Low-dose aspirin effect

Low doses of aspirin selectively reduce TXA2 formation by platelets.

High-dose aspirin effect

High doses of aspirin reduce both TXA2 and PGI2 production.

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Aspirin's effect on ADP release

Aspirin inhibits the release of ADP from platelets, thus affecting their sticking to each other.

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Platelet role in atherogenesis

Platelets contribute to the development of atherosclerosis.

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Reversible COX inhibitors

NSAIDs are reversible inhibitors of COX, leading to short-term platelet function inhibition.

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Dipyridamole's function

Dipyridamole is a vasodilator, originally used for angina pectoris.

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Rifaximin for Traveler's Diarrhea

Rifaximin 200mg three times a day for 3 days is effective and superior to placebo, and as effective as ciprofloxacin in treating traveler's diarrhea.

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Invasive Diarrhea Treatment

Severe diarrhea with blood and mucus in stool, fever, and cramps requires empiric treatment with antibiotics like ciprofloxacin, ofloxacin, norfloxacin, cotrimoxazole, or doxycycline to relieve symptoms and eradicate the pathogen.

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Cholera Treatment

Fluid replacement is the most crucial treatment for cholera, but tetracyclines can reduce stool volume. Cotrimoxazole is a good alternative, especially for children.

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Cough Purpose

Cough is a protective reflex to expel and drain respiratory secretions and foreign particles. It's activated by mechano, chemo or stretch receptors.

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Useless Cough

A cough that's not productive (non-productive) should generally be suppressed unless the amount of expectoration achieved is small compared to the effort exerted.

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Acute Cough Cause

The most common cause of acute cough (lasting less than 3 weeks) are respiratory viral infections.

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Rifaximin for Hepatic Encephalopathy

A higher strength rifaximin (550mg) tablet is used to reduce the recurrence of hepatic encephalopathy by suppressing ammonia-forming gut bacteria.

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Rifaximin for Bloating

Rifaximin (400mg twice daily) may relieve bloating, flatulence, and flatus by suppressing gas-producing colonic bacteria.

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Open System Anesthesia

Exhaled gases escape through a valve, and fresh anaesthetic mixture is added. No rebreathing occurs, and flow rates are high.

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Closed System Anesthesia

Patient rebreaths exhaled gas, which is filtered by soda lime to remove CO2. Only needed O2 and anaesthetic are added.

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Semiclosed System Anesthesia

Partial rebreathing is allowed through a partially closed valve. Flow rates are moderate.

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Inhalational Anesthetics

Gases used for general anesthesia, delivered by inhalation. Examples include Halothane, Isoflurane, Desflurane.

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Soda Lime

Chemical substance used in closed systems to absorb CO2 from exhaled gas.

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Flow Rates

The rate at which gas is delivered to the patient in anesthesia.

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Anaesthetic Concentration

The amount of anaesthetic in the gas mixture.

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Margin of Safety

The difference between the actual anaesthetic effect and the potentially harmful levels.

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β2 agonist therapy

Used in asthma to open airways, minimizing heart effects, not suitable for those unable to use inhalers, or used in severe asthma as an alternative/adjuvant treatment.

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Cytotoxic drugs

Drugs targeting rapidly multiplying cells, including cancer cells, but affect other rapidly growing cells too.

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Rapidly multiplying cells

Cells like cancer cells that quickly reproduce, making them a target for cytotoxic drugs.

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Bone marrow depression

Suppression of bone marrow activity, leading to low levels of important components (WBC, platelets).

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Granulocytopenia

Low levels of granulocytes (a type of white blood cell), increasing risk of infections.

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Thrombocytopenia

Low blood platelet count, causing problems with blood clotting.

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Opportunistic infections

Infections caused by organisms with low pathogenicity, that become more dangerous when the immune system is weakened.

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Growth fraction

Percentage of cells within a cancer that are actively dividing. Important in chemotherapy success.

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Levodopa's effect on Parkinson's

Levodopa, a precursor to dopamine, improves symptoms in Parkinson's by increasing dopamine levels in the brain.

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Dopamine's role in the brain

Dopamine, a neurotransmitter, is involved in movement control, motivation, and reward.

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Levodopa's effect on DA levels

Levodopa treatment increases dopamine levels in the brains of Parkinson's patients, especially those who respond well.

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What are the two subtypes of dopamine receptors?

The two main types are D1-like (excitatory) and D2-like (inhibitory), each playing different roles in the brain.

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How do D1 receptors work?

D1-like receptors are excitatory, increasing cAMP and activating protein kinase C.

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How do D2 receptors work?

D2-like receptors are inhibitory, reducing cAMP and opening potassium channels.

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What are the roles of D1 and D2 receptors in the striatum?

Both types are found in the striatum and play a role in the therapeutic response to levodopa, each regulating different pathways.

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Levodopa's effect on normal individuals

Levodopa has little effect on normal individuals and those with other neurological diseases.

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Antianxiety Drugs

A group of medications, primarily mild CNS depressants, used to manage anxiety symptoms. They aim to create a calm state of mind without affecting normal mental or physical functions.

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Benzodiazepines (BZDs)

A common class of antianxiety drugs with properties like relaxation and anticonvulsant effects. They are often used due to their low dependence liability compared to other sedatives.

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What makes BZDs different from antipsychotics?

Unlike antipsychotics, benzodiazepines do not directly address thought disorders like schizophrenia. They focus on calming anxiety and promoting relaxation.

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Do BZDs have side effects?

While BZDs are generally safe, they can cause physical dependence and carry abuse liability. However, their withdrawal syndrome is milder and delayed due to their long half-lives.

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Morphine's use in emergencies

Morphine is a vital medication for emergencies, but its strong respiratory depressant effects require cautious use.

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Who is particularly vulnerable to morphine's effects?

Infants, elderly, and individuals with hypothyroidism, liver or kidney disease are more sensitive to morphine's respiratory depressant effects.

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Unstable personalities and morphine

Individuals with unstable personalities may be more susceptible to addiction with continued morphine use.

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Morphine's role in pain emergencies

Morphine is crucial in emergency settings, but its use requires careful consideration due to its potential side effects and the vulnerability of certain patient populations.

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Study Notes

Pharma Drugs

  • Aulacoids are a type of plant-derived drug.
  • Chemotherapy is a treatment method using drugs.

Cardio Vascular System

  • Anti-Arrhythmics are used to treat irregular heartbeats.
  • Anti-Anginals address chest pain caused by reduced blood flow to the heart.
  • Peripheral vascular disease affects blood vessels outside the heart.
  • Calcium channel blockers control muscle contractions in the heart.
  • Anti-hypertensives lower high blood pressure.

Antiarrhythmic Drugs

  • Class I drugs stabilize cell membranes. (A) Moderately decrease dv/dt of 0 phase; (B) Little decrease in dv/dt of 0 phase; (C) Marked decrease in dv/dt of 0 phase
  • Class II drugs inhibit nerve signals.
  • Class IV drugs block calcium channels.
  • Class III drugs prolong action potential.

Antianginal and Other Anti-Ischemic Drugs

  • Coronary artery disease (CAD) causes reduced blood supply to the heart.
  • Nitrates relax blood vessels, improving blood flow.
  • Beta blockers decrease heart rate and contractility.
  • Calcium channel blockers relax coronary arteries.
  • Other anti-anginal drugs include potassium channel openers, metabolic modulators, and others.

Drugs for Peripheral Vascular Diseases

  • Peripheral vascular disease (PVD) can be occlusive or vasospastic.
  • Cyclandelate is a general smooth muscle relaxant.
  • Xanthinol nicotinate increases blood flow.
  • Pentoxiphylline is a phosphodiesterase inhibitor.
  • Antiplatelet drugs and vasodilators are used to treat PVDs.

Cardiovascular Drugs

  • Voltage-sensitive calcium channels: L-type (long lasting current) and T-type (transient current).
  • Characteristics of each type of channel.
  • Calcium channel blockers: phenylalkylamine (verapamil), benzothiazepine (diltiazem), dihydropyridines (nifedipine, etc.).

Antihypertensive Drugs

  • Diuretics. (examples)
  • Renin-angiotensin system inhibitors. (examples)
  • Beta blockers. (examples)
  • Sympathetic inhibitors. (examples)
  • ACE inhibitors. (examples)
  • Angiotensin (AT1) receptor blockers. (examples)
  • Direct renin inhibitor (examples)
  • Calcium channel blockers. (examples)
  • Vasodilators. (examples)

Blood

  • Coagulants
  • Anticoagulants
  • Fibrinolytics/Thrombolytics
  • Anti-fibrinolytics (examples)
  • Anti-platelets

Drugs Affecting Coagulation, Bleeding and Thrombosis

  • Review of haemostatic, anticoagulant, and coagulant medications.
  • Listing specific clotting factors.

Anticoagulants

  • Classification of anticoagulants (in vitro, in vivo, indirect thrombin inhibitors, direct thrombin inhibitors, oral anticoagulants).
  • Heparin.
  • Low-molecular-weight heparins.
  • Direct thrombin inhibitors. (examples)
  • Coumarin derivatives (examples)
  • Direct factor Xa inhibitors (examples).

Antiplatelet Drugs

  • Antiplatelet drugs inhibit platelet aggregation and prevent blood clot formation.
  • Aspirin inhibits thromboxane synthesis.
  • Phosphodiesterase inhibitors. (example)
  • Purinergic (P2Y12) receptor antagonists. (examples)
  • Glycoprotein II/IIIa receptor antagonists. (examples)

Anti-Cancer Drugs

  • Cytotoxic drugs
  • Different classes of cytotoxic drugs. (examples)

CNS

  • Anaesthetics and sedative hypnotics
  • Anti-epileptics
  • Anti-Parkinsonian drugs
  • Anti-psychotic
  • Anti-mania & bipolar disorder
  • Anti-depressants
  • Anti-anxiety
  • Opioid analgesics
  • CNS stimulants
  • Cognition enhancers

GIT

  • Drugs for peptic ulcer
  • Anti-emetics
  • Laxatives
  • Anti-diarrhoeal

Respiratory System

  • Cough suppressing drugs
  • Bronchial asthma medications

Renal

  • Diuretics
  • Carbonic anhydrase inhibitors
  • Osmotic diuretics
  • Loop diuretics
  • Thiazides
  • K-sparing diuretics
  • Anti-diuretics

Hypolipidemic Drugs

  • HMG-CoA reductase inhibitors (statins).
  • Lipoprotein lipase activators (fibrates).
  • Sterol absorption inhibitors.
  • Bile acid sequestrants.
  • Lipolysis and triglyceride synthesis inhibitors.

Other

  • Anti-amoebic drugs
  • Anti-helminthic
  • Anti-fungal

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