Pharmacology Question and Answers

Part I – General Pharmacological Principles

Part II – Autonomic Nervous System

Part III – Cardiovascular System

Part IV – Central Nervous System

Part V – Hormones

Part VI – Chemotherapy -I

Part VII – Chemotherapy -II

Part VIII – Respiratory System

Part IX- Gastrointestinal Drugs

Part X – Drugs Affecting Blood and Blood Formation

Part XI – Diuretics & Antidiuretics

Part XII – Autocoids & Related Drugs

Part XIII – Dental Pharmacology

Part XIV – Miscellaneous Question And Answers

Pharmacology Miscellaneous Short And Long Essay Question And Answers

Miscellaneous Important Notes

1. Chelating Agents

Miscellaneous Chelating Agents

2. Astringents

  • They are substances that precipitate proteins
  • Affects only the superficial layer
  • Toughen surface making it mechanically stronger
  • Decreases exudation
  • Used in the treatment of
    • Bleeding gums
    • Bleeding piles
    • Alkaloidal poisoning

Miscellaneous Long Essays

Question 1. Define and classify antiseptics. Write in detail about the mechanism of action, different preparations, and uses of phenol.
Answer:

Definition:

  • Antiseptic is an agent that destroys micro-organisms on contact and can be used on living tissues

Classification:

Miscellaneous Antiseptic Classification

Phenol:

Mechanism of Action:

  • It acts by following mechanisms
    • Oxidation of bacterial protoplasm
    • Denaturation of bacterial proteins including enzymes
    • Detergent-like action increases the permeability of the bacterial membrane

Miscellaneous Phenol Mechanism Of Action

Miscellaneous Short Essays

Question 1. Acriflavine
Answer:

  • Acriflavine is an orange-yellow acridine dye
  • It is active against gram-positive bacteria and gonococci
  • It is non-irritant
  • Solutions lose efficacy on exposure to light, so it is stored in amber bottles
  • It does not retard the healing

Uses:

  • 1:1000 solution is used in infected wounds
  • 2% is used in vaginitis and cervicitis
  • Bandage impregnated with acriflavine- vaseline is used in burn dressing

Read And Learn More: Pharmacology Question and Answers

Question 2. Chlorhexidine
Answer:

  • Chlorhexidine is a powerful nonirritating antiseptic that disrupts the bacterial cell membrane
  • It causes the denaturation of intracellular proteins
  • It is more active against gram-positive bacteria

Uses:

  • As an antiseptic in dentistry
  • As oral rinse or toothpaste
  • In acute necrotizing gingivitis
  • Before periodontal surgery to prevent infections
  • Daily use reduces oral infections in immunocompromised patients

Disadvantages:

  • Brownish discoloration of teeth
  • Unpleasant after taste
  • Alteration of taste
  • Occasionally oral ulceration

Question 3. Potassium permanganate
Answer:

  • Potassium permanganate is an oxidizing agent

Properties:

  • Occurs as purple crystals
  • Highly water soluble
  • Liberates oxygen which oxidizes bacterial protoplasm
  • Has germicidal capacity

Uses:

  • Used for gargling, douching
  • Irrigating cavities,-urethra, and wounds
  • Used to disinfect water
  • Used for stomach wash in alkaloidal poisoning

Adverse Effects:

  • High concentration causes burns and blistering
  • Promote rusting of surgical instruments

Question 4. Uses of Antiseptics in Dentistry
Answer:

Miscellaneous Uses Of Antiseptics In Dentistry

Question 5. Bleaching agents
Answer:

  • Bleaching agents are agents used to remove stains from teeth or to improve their whiteness.

Miscellaneous Bleaching Agents

Question 6. Commonly used antiseptics
Answer:

Classification:

Miscellaneous Commonly Used Antiseptics Classification

Question 7. Chelating agents
(or)
Define chelation. Mention four chelating agents
Answer:

  • Chelating agents bind the heavy metal ions and make them nontoxic, the chemical complex formed is called a chelate
  • The process of complex formation is called chelation.

Chelating Agents:

Miscellaneous Chelating Four Agents

Question 8. Dimercaprol
Answer:

  • Dimercaprol is a colorless, oily liquid
  • Developed by the British during World War II as an antidote to lewisite
  • Hence it is known as British Anti-lewisite or BAL
  • Dimercaprol chelates arsenic, mercury, lead, and other heavy metals

Uses:

  • Arsenic and mercury poisoning
  • In lead poisoning along with calcium Disodium edetate

Adverse Effects:

  • Hypertension
  • Tachycardia
  • Vomiting
  • Sweating
  • Burning sensation in the lips and mouth
  • Headache

Question 9. EDTA
Answer:

  • The calcium sodium and Disodium salts of EDTA form stable and highly water-soluble complexes with many
  • divalent and trivalent metallic ions
  • It chelates metals like zinc, manganese, iron, and lead deposits in the bone which are then mobilized, chelated, and excreted through the kidneys

Uses:

  • Lead poisoning
  • Zinc, manganese, and iron poisoning
  • Sbdium edetate in severe hypercalcemia

Adverse Effects:

  • Nephrotoxicity
  • Fatigue
  • Fever
  • Myalgia
  • Dermatitis

Question 10. Thiamin deficiency
Answer:

  • Deficiency of Thiamine results in beri beri

Symptoms:

  • Loss of appetite
  • Weakness
  • Constipation
  • Nausea
  • Mental depression
  • Peripheral neuropathy
  • Irritability
  • Numbness in the legs

Types:

1. Wet Beri Beri

  • Characterized by edema of legs, face, trunk, and serous cavities

2. Dry beri beri

  • Associated with neurological manifestations

3. Infantile Beri Beri

  • Seen in infants

Question 11. Ascorbic add deficiency
Answer:

Deficiency Manifestations:

  • A deficiency of vitamin C leads to scurvy

Features of Scurvy:

  • Spongy and sore gums
  • Loose teeth
  • Anemia
  • Swollen joints
  • Fragile blood vessels
  • Decreased immunocompetence
  • Delayed wound healing
  • Impaired hormonal functions of the adrenal cortex and gonads
  • Hemorrhage
  • Osteoporosis

Question 12. Name two fat-soluble vitamins arid mention two uses of them
Answer:

Miscellaneous Two Fat Soluble Vitamins And Mention Two Uses Of Them

Question 13. What procedure will be adapted so that tenants do not result from your treatment? How will you treat a case of tetanus?
Answer:

Prevention of Tetanus:

  • Pregnant women can be administered two tetanus toxoid injections, 1 ml IM in the third trimester of pregnancy
  • Immunized individuals can be given booster doses to achieve active immunity
  • Tetanus antitoxin can be used for penetrating wounds of the head and face and wounds of devitalized tissues

Treatment of Tetanus:

1. General management

  • Admission and isolation in a quiet room, to avoid minor stimuli which precipitate spasms
  • Wound care includes drainage of pus, excision of necrosed tissue, removal of foreign body, and proper dressing
  • Inj. Tetanus toxoid 0.5 ml IM
    • Antitetanus serum, ATS – 50000 units IV or
    • Human Antitetanus globulin – 3000-4000 units
      • Inj. crystalline penicillin 10 lakh units every 6 hourly for 7-10 days

2. Specific management

  • Mild cases
    • Sedatives- combination of chlorpromazine, phe- nobarbitone and diazepam
  • Seriously ill cases
    • Use of nasogastric tube for feeding purposes and for administration of drugs
  • Dangerously ill cases
    • Sedatives
    • Muscle relaxants
    • Positive pressure ventilation
    • Adequate nutrition
    • Care of urinary bladder, bowel
    • Frequent change of position to avoid bed sores

Question 14. Uses of astringents in dental practice.
Answer:

  • Astringents are substances that precipitate superficial proteins without penetrating the cells when applied to the skin or mucous membrane
  • They form a protective coating and harden the surface

Actions:

  • Check minor hemorrhages
  • Arrest capillary oozing
  • Promote clotting
  • Precipitate protein on the bleeding surfaces.

Uses:

  • As obtundents
  • As styptics
  • As mummifying agent
  • Mouthwashes
  • Paints
  • Lotion and denitrifies in aphthous ulcers, stomatitis, and gingivitis

Types:

  1. Vegetable astringent- Tannic acid
  2. Metallic or mineral astringent- Alum, salts of zinc, copper, iron, aluminum, and silver
  3. Miscellaneous- alcohol

Question 15. Vitamin D.
Answer:

  • It is a fat-soluble vitamin

Miscellaneous Vitamin D

Adverse Effects: Hypervitaminosis D

Characterized by:

  • Generalized decalcification of the bones
  • Hypercalcaemia
  • Hyperphosphataemia
  • Weakness, drowsiness
  • Nausea, abdominal pain
  • Thirst
  • Renal stones
  • Hypertension

Uses:

  • Prophylaxis
  • Nutritional rickets and osteomalacia
  • Vitamin D-resistant rickets
  • Vitamin D-dependent rickets
  • Senile osteoporosis
  • Hypoparathyroidism

Miscellaneous Short Question And Answers

Question 1. Vitamin C / Ascorbic acid
Answer:

Sources:

  • Citrus fruits- Gooseberry, guava
  • Green vegetables
  • Tomatoes and potatoes

Functions:

1. Role in collagen formation

  • It acts as a coenzyme in the hydroxylation of proline and lysine
  • These are required to convert procollagen to collagen

2. It is required for bone formation

3. Role in metabolism

  • Iron metabolism
    • It enhances iron absorption
    • Helps in the formation of ferritin
    • Helps in the mobilization of iron from ferritin
  • Hemoglobin metabolism
    • It is used to reconvert methemoglobin to hemoglobin
    • Required for degradation of hemoglobin to bile pigments
  • Tryptophan metabolism
    • Essential for hydroxylation of. Tryptophan to hydroxytryptophan
  • Tyrosine metabolism
    • Required for oxidation of p-hydroxy phenyl py- rugate to homogenetic acid
  • Folic acid metabolism
    • Required for the formation of tetrahydrofolate, the active form of folic acid

4. Hormonal functions

  • Peptides are derived from glycine
  • Vitamin C is required for the hydroxylation of glycine
  • It is required for the synthesis of steroids hormones

5. It is a strong antioxidant

6. It enhances the synthesis of immunoglobulin

7. Preventive functions

  • It prevents the risk of
    • Cataract
    • Cancer
    • Coronary heart diseases

Question 2. Vitamin B6
Answer:

Vitamin B6 is also known as pyridoxine

Functions:

  • The Coenzyme of Pyridoxine, Pyridoxal phosphate, PLP, is attached to the delta amino group of lysine
  • It participates in reactions like
    • Transamination
    • Decarboxylation
    • Deamination
    • Transsulfuration
  • Synthetic functions
    • Synthesis of niacin Coenzymes from tryptophan
    • Synthesis of serine from glycine
  • Glycogen phosphorylase contains PLP
  • It is needed for the intestinal absorption of amino acids
  • It prevents urinary stone formation

Uses:

  • Prophylaxis in the treatment of pyridoxine deficiency,
  • INH-induced peripheral neuritis and
  • Convulsions in infants

Question 3. Vitamin B12
Answer:

  • It is cyanocobalamine

Coenzyme Forms:

  • 5′- Deoxyadenosyl cobalamin
  • Methylcobalamin

Functions:

1. Synthesis of methionine from homocysteine

  • Vitamin B12 is used as Methylcobalamin in this reaction

2. Isomerization of methylmalonic CoA to succinyl CoA

  • It occurs in the presence of vitamin B12 Coenzyme, deoxyadenosine cobalamin

Dietary Requirements:

  • Adults- 3 micrograms/day
  • Children- 0.5-1.5 micrograms/day
  • During pregnancy and lactation- 4 micrograms/day

Deficiency Symptoms:

  • A deficiency of vitamin B12 leads to

1. Pernicious anemia

  • Characterized by low hemoglobin levels, decreased number of erythrocytes, and neurological manifestations

2. Neuronal degeneration

3. Demyelination of the nervous system

Question 4. The posterior pituitary extract is given by IV drip before delivery only
Answer:

  • The posterior pituitary extract increases the force and the frequency of uterine contractions
  • Induces labor
  • Controls postpartum hemorrhage
  • Thus it is given before delivery

Question 5. Tannic acid
Answer:

  • Tannic acid is a vegetable astringent obtained from many plants
  • It is found in tea, catechu, nutmeg, areca nut, etc
  • They denature the proteins forming protein tannate

Uses:

  • Bleeding gums- as glycerine
  • Bleeding piles – as a tannic acid suppository
  • Alkaloidal poisoning- Precipitates ingested alkaloids as tannates

Question 6. Clove oil
Answer:

  • Clove, oil is a type of obtundent
  • It diminishes sensitivity

Uses:

  • To make excavation painless

Mechanism:

  • It paralyzes the sensory nerves
  • Causes initial irritation followed by numbness

Disadvantage:

  • It may stain the dentin yellow

Question 7. Counter irritants
Answer:

  • Certain irritants produce a remote effect that tends to relieve pain and inflammation in deeper organs
  • These are called counterirritants
  • When counter-irritants are applied to the area of skin supplied by nerves from the same segment as the deeper organs from which impulses are produced, the cutaneous impulses obscure the deeper situations
  • They are generally massaged to relieve
    • Headache
    • Muscular pain
    • Joint pain
    • Pleural or peritoneal pain
    • Colics
  • Drugs commonly used are
    • Turpentine oil
    • Clove oil
    • Eucalyptus oil
    • Mustard seeds
    • Capsicum
    • Methyl salicylate
    • Alcohol

Examples: Vicks vaporub, amruthanjan, iodex.

Question 8. Name four chelating agents.
Answer:

Miscellaneous Four Chelating Agents

Adrenergic System Question and Answer

Adrenergic System Important Notes

1. Adrenergic System Adrenergic receptors

  • They are present at the post-ganglionic sympathetic nerve endings
  • Types are: alpha and beta receptors

Adrenergic System Alpha And Beta Receptors

2. Adrenergic System Adrenergic Drugs

Adrenergic System Adrenergic Drug

3. Adrenergic System Adrenaline

  • Acts on both alpha and beta receptors but predominantly on beta
  • It increases heart rate, the force of contraction, cardiac output, and oxygen consumption
  • On IV administration there is an initial rise in BP due to stimulation of alpha receptors, later there is a fall in BP due to the effect of beta receptors

4. Adrenergic System Uses of adrenaline

  • In syncopal attacks
  • For resuscitation of a failing heart
  • In allergic disorders
  • As bronchodilators
  • To prolong the effect of local anesthesia
  • To control hemorrhage by producing vasoconstrictor

Alpha 2 Adrenergic

5. Adrenergic System Isoprenaline

  • It has a selective beta receptor stimulant effect
  • It stimulates myocardium
  • Produces vasodilatation
  • Relaxes smooth muscles of bronchi and GFT
  • Mainly used as
  • Bronchodilator
  • The cardiac stimulant in heart block

6. Adrenergic System Dopamine

  • It is the precursor of noradrenaline
  • Acts on both alpha and beta receptor
  • Acts on dopamine receptors in the mesenteric and vascular beds
  • Used in the treatment of cardiogenic shock

Alpha 2 Adrenergic

7. Adrenergic System Non catecholamines

Adrenergic System Non Catecholamines

Adrenergic System  Long Essays

Question 1. Discuss pharmacological actions and some important uses of sympathomimetic drugs.
(or)
Classify sympathomimetics and write the therapeutic uses, pharmacological action, and adverse effects of adrenaline.
(or)
Classify adrenergic agents. Discuss the action and uses of adrenaline.

Answer:

Sympathomimetics/Adrenergic drugs:

These are drugs with action similar to that of adrena¬line or sympathetic stimulation.

Alpha 2 Adrenergic

Sympathomimetics Classification:

1. Sympathomimetics Based on mode of action:

  • Direct-acting sympathomimetic.
    • They act directly on a and/or b adrenoreceptors.
    • Example: adrenaline, noradrenaline, and isoprenaline.
  • Indirect-acting sympathomimetic.
    • They act on adrenergic neurons to release noradrenaline which then acts on adrenoreceptors
    • Example: Tyramine.
  • Mixed action was sympathomimetic.
    • They act directly as well as indirectly.
    • Example: ephedrine, dopamine.

Read And Learn More: Pharmacology Question and Answers

2. Sympathomimetics Based on chemical structure.

  • Catecholamines – contain – a catechol nucleus.
    • Example: Adrenaline, noradrenaline, dopamine.
  • Non-catecholamines – lack catechol nucleus.
    • Example: Ephedrine. amphetamine, tyramine.

3. Sympathomimetics Based on therapeutic use.

  • Vasopressor – raises blood pressure.
    • Example: Noradrenaline – phenylephrine, ephedrine.
  • Cardiac stimulants – Adrenaline, dopamine.
  • CNS stimulants – Amphetamine, ephedrine.
  • Bronchodilators. Adrenaline, salbutamol.
  • Nasal decongestants – phenylephrine, ephedrine.
  • Anorectic – fenfluramine.
  • Uterine relaxants – salbultamol, terbutaline.

Adrenaline:

Adrenaline Pharmacological action:

1. Adrenaline Cardiovascular system.

  • Heart
    • Adrenaline is a powerful cardiac stimulant
    • It increases.
      • Heart rate
      • Force of contraction
      • Oxygen consumption.
      • Conduction
      • Cardiac output
  • Blood vessels and blood pressure.
    • Vasoconstriction of vessels of the skin and mucous membrane occurs.
    • It constricts renal, mesenteric, pulmonary, and splanchnic vessels.
    • It dilates blood vessels of skeletal muscles and coronary vessels.
    • It causes an initial rapid increase in BP followed by a fall. This is called a biphasic response.

2. Adrenaline Respiratory system.

  • Adrenaline is a powerful bronchodilator.
  • It is a weak respiratory stimulant
  • Inhibits release of inflammatory mediators.
  • Reduces secretions.

3.  Adrenaline GIT

  • Causes gut relaxation, decreases motility, and constricts the sphincter.

4. Adrenaline Bladder.

  • Causes relaxation of the detrusor muscle and contraction of the trigone sphincter.

5. Contraction of hair follicles.

6. Adrenaline Eye.

  • Adrenaline penetrates the cornea poorly.

7. Adrenaline Uterus.

  • Contracts non-pregnant uterus and relaxes during the last month of pregnancy.

8. Adrenaline CNS

  • Does not cross BBB
  • Activation of aa receptors in the brainstem results in decreased sympathetic outflow.

9. Adrenaline Metabolic

  • Produces glycogenolysis, lipolysis, calorignesis, and transient hyperkalemia.

10. Adrenaline Skeletal muscle.

  • Facilitates neuromuscular transmission.

Adrenaline Uses:

Adrenergic System Uses Of Adrenaline

Adrenaline Adverse Effects:

  1. CVS effects – tachycardia, palpitation, rise in BP, cardiac arrhythmias.
  2. CNS effects – tremors, anxiety, throbbing headache.
  3. Respiratory effects acute pulmonary edema.
  4. Others – pillar, dizziness, weakness restlessness.
  5. Metabolic effects – hyperglycemia, hyperlactatemia, and hypokalaemia.

Question 2. Write all uses of adrenaline and isoprenaline.

Answer:

Uses of Adrenaline:

1. Adrenaline In anaphylactic shock.

  • Adrenaline 0.3 – 0.5 ml of 1:1000 solution is given subcutaneously.
  • It reverses hypotension, laryngeal edema, and bronchospasm.

2. Adrenaline Cardiac arrest.

  • Intracardiac adrenaline into the 4th or 5th intercostal space, 2-3 inches from the sternum is given in cardiac arrest.

3. Adrenaline Control of hemorrhage.

  • Cotton or gauze soaked in adrenaline – 1:10,000 to 1:20,000 concentration is used.

4. Adrenaline Used along with local anesthesia (LA)

  • 1:10,000 to 1:2,00,0000 adrenaline is used
  • It produces vasoconstriction and reduces the rate of absorption of LA.

5. Adrenaline Bronchial asthma.

  • Adrenaline produces bronchodilation.
  • 0.3 – 0.5 ml of 1:1000 solution SC is used.

6. Adrenaline Glaucoma.

  • Adrenaline reduces intraocular pressure.
  • It is used topically

7. Allergic reactions.

Uses of isoprenaline:

  • Used as a cardiac stimulant in heart block and shock.
  • Used in bronchial asthma.
  • Used as a temporary measure to maintain sufficient ventricular rate.

Question 3. Describe the differences in the action of adrenaline, noradrenaline, and isoprenaline. Write their uses indicating the route of administration and usage.

Answer:

Adrenaline, noradrenaline, and isoprenaline are sympathomimetic drugs.

  • Their actions are mediated by α and β receptors.

Adrenaline – Has α1, α2, β1, and β2 actions

Noradrenaline – Has α1, α2, β1 but no β2 action

Isoprenaline – Has β1 and β2 but not an actions

Adrenergic System Differences In Action Of Adrenaline, Noradrenaline And Isoprenaline

Uses Of Noradrenaline

  • It is rarely used in shock to increase BP.
  • 8 mg in 100 – 200 ml saline is used to control local bleeding from the skin and mucous membranes.

Routes Of Administrations

Adrenergic System Route Of Administration

Adrenergic System Short Essays

Question 1. Compare adrenaline and ephedrine.

Answer:

Adrenergic System Compare Adrenaline And Ephedrine

Question 2. Compare adrenaline and noradrenaline.

Answer:

Adrenergic System Compare Adrenaline And Noradrenaline

Question 3. Dopamine

Answer:

It is a catecholamine and the immediate precursor of noradrenaline.

  • It is a central neurotransmitter.
  • It acts on dopaminergic and adrenergic receptors.

Dopamine Actions:

1. Dopamine At low doses.

  • Stimulates vascular Di receptors in renal, mesenteric, and coronary beds.
  • Causes vasodilatation of these vessels.
  • Results in increases in renal blood flow, GFR, and Na+ excretion.

2. Dopamine At moderate doses.

  • Produces positive ionotropic effects.

3. Dopamine At high doses.

  • Causes cardiac stimulation.
  • Results in vasoconstriction and increased BP.

4. Dopamine CNS

  • Does not cross BBB.

Dopamine Uses:

  • In cardiogenic, hypovolemic and septic shock.
  • In severe heart failure with renal impairment.

Dopamine Adverse Effects:

  • Nausea, vomiting.
  • Headache, palpitation.
  • Angina, hypertension, tachycardia.

Dopamine Dose:

  • 2 – 5 pg/kg/min 4

Question 4. Uses of Adrenaline with rationale and route of administration.

Answer:

Uses Of Adrenaline:

Adrenergic System Uses Of Adrenaline With Rationale

Question 5. Beta 2 agonists.

Answer:

  • Beta 2 agonists are drugs that act on β2 adrenergic receptor

Beta 2 agonists Mechanism of Action:

β2 are coupled to the stimulatory G protein of adenylyl cyclase

Produces cyclic adenosine monophosphate (cAMP)

cAMP decreases calcium concentration in cells

This leads to smooth muscle relaxation and bronchodilation

Beta 2 agonists Actions:

  • Smooth muscle relaxation
  • Bronchodilation
  • Vasodilation in muscle and liver
  • Relaxation of uterine muscle
  • Release of insulin

Beta 2 agonists Classification:

  • Short acting – fenoterol, isoprenaline, salbutamol, Terbutaline
  • Long acting – bambuterol, formoterol, salmeterol
  • Ultra long-acting – abediterol, formoterol, olodaterol

Beta 2 agonists Uses:

  • Bronchial asthma
  • COPD

Beta 2 agonists Adverse Effects:

  • Tachycardia
  • Palpitation
  • Tremor
  • Excessive sweating
  • Anxiety
  • Insomnia
  • Agitation

Adrenergic System Short Answers

Question 1. Ephedrine.

Answer:

Ephedrine is an alkaloid obtained from the plant of the genus Ephedra vulgaris.

Ephedrine Mechanism:

  • Act directly on α and β receptors.
  • Act indirectly by release of noradrenaline.

Ephedrine Actions:

  • Crosses BBB, and Causes stimulation.
  • Increases BP
  • Vasoconstriction.
  • Increases cardiac output
  • Relaxation of smooth muscles.
  • Bronchodilator.

Ephedrine Uses:

  • Effective orally
  • Mild bronchial asthma.
  • As nasal decongestant
  • For hypotension during spinal anesthesia.
  • Produces mydriasis.
  • Used in narcolepsy and nocturnal enuresis.

Ephedrine Adverse Effects:

  • Gastric upset, difficult in micturition.
  • Repeated injections cause tachyphylaxis.
  • Insomnia, tremors.

Question 2. Amphetamine.

Answer:

Amphetamine is a synthetic compound.

  • It is effective orally.
  • It has a long duration of action.

Amphetamine Actions:

1. CNS – stimulant

  • Includes alertness, increased concentration, euphoria talkativeness, and increased work capacity.
  • Improves athletic performance.
  • The effect is temporary.

2. Respiration.

  • Stimulates respiratory centers.

3. Suppression of appetite.

Amphetamine Adverse Effects:

  • Drug dependence.
  • High doses caused delirium, hallucinations, and acute psychotic state.
  • Long-lasting behavioral abnormalities.
  • Develops psychosis.

Question 3. The rationale of using xylocaine with adrenaline for local anesthesia.

Answer:

Adrenaline is combined with xylocaine for local anaes¬thesia because adrenaline causes.

  • Vasoconstriction.
  • Reduces rate of absorption of local anesthesia
  • Prolongs its action.
  • Reduces blood loss after extraction.
  • Decreases toxicity.

Question 4. The rationale of using adrenaline in anaphylactic shock.

Answer:

0. 3 – 0.5 ml of 1:1000 solution of adrenaline is used IM in anaphylactic shock because.

  • Adrenaline is an antagonist of histamine, the mediator of anaphylactic shock.
  • Increases BP.
  • Reverse bronchospasm or laryngeal edema.

Question 5. The rationale of using dopamine in shock.

Answer:

Dopamine is used in shock because.

  • It dilates renal, mesenteric, and coronary blood vessels.
  • Increases renal blood flow, GFR, Na+ secretion
  • Improves blood flow to vital organs.
  • Increases blood pressure and causes urine outflow
  • Stimulates the heart and increases the forces of contraction, and cardiac output.

Question 6. Noradrenaline.

Answer:

Noradrenaline is catecholamine.

  • It acts on α1, α2, β1, and β3 receptors.

Noradrenaline Actions:

  • Increases systolic, diastolic and mean BP.
  • Decreases heart rate and force of contraction.
  • Causes vasoconstriction.
  • Stimulates contraction of the uterus.

Noradrenaline Uses:

  • Rarely used as a vasopressor.

Broad Spectrum Antibiotics Question And Answers

Broad-Spectrum Antibiotics Important Notes

1. Tetracyclines

  • The first isolated tetracycline is chlortetracycline
  • They are bacteriostatic
  • Have a broad spectrum of action
  • Effective against bacterial, rickettsial, and chlamydial infections
  • Forms insoluble complexes by chelation with calcium. Magnesium and aluminum
  • Widely used in the treatment of periodontal diseases
  • It interferes with the bacteriocidal activity of penicillin
  • Thus it is not given along with penicillin
  • It potentiates the anticoagulant action of coumarin drugs
  • Has enterohepatic circulation
  • Excreted by kidneys except for chlortetracycline
  • Tetracyclines Classification
    • Group I – tetracycline, Chlortetracycline, Oxytetracycline
    • Group II – Demeclocycline, methacycline
    • Group III – Doxycycline, Minocycline
  • Tetracyclines Adverse effects
    • Photosensitivity
    • Hepatotoxicity
    • Renal toxicity
    • Bone marrow suppression
    • Super infections
    • Hepatic dysfunction
    • Fanconi like syndrome
  • Tetracyclines given to pregnant women cause
    • Discoloration of teeth in the fetus
    • Temporary suppression of bone growth
    • Hepatic necrosis in mother
    • Increased intracranial pressure in infants.

2. Chloramphenicol

  • It inhibits the protein synthesis of bacteria
  • In high concentrations, it inhibits the protein synthesis of the host
  • It is the drug of choice for typhoid
  • Chloramphenicol Adverse effects
    • Bone marrow depression
    • Gray baby syndrome in infants
    • Idiosyncrasy
    • Superinfection

3. Advantages of doxycycline over tetracyclines

  • Has longer half-life
  • Less propensity to cause GI disturbances
  • Better GI absorption
  • High lipid solubility

Read And Learn More: Pharmacology Question and Answers

4. Local drug delivery systems of tetracyclines

  • Activity – 25% tetracycline
  • Atridox – 10% doxycycline

Broad Spectrum Antibiotics Long Essays

Question 1. Explain broad-spectrum antibiotics. Describe the mechanism of action, therapeutic uses, and toxic effects of tetracyclines.
Answer:

Broad-spectrum antibiotics:

  • Broad-spectrum antibiotics are effective against a large number of microorganisms except for fungi and viruses.
  • They are bacteriostatic and bacteriocides
  • They are:
  1. Tetracycline.
  2. Chloramphenicol.

Tetracyclines:

  • Obtained from soil actinomycetes.
  • They are slightly water soluble.

Tetracyclines Anti-bacterial spectrum:

  • Tetracyclines are broad-spectrum antibiotics.
  • They are effective against gram-positive and gram-negative organisms.
  • Also inhibit the growth of Rickettsiae, chlamydia, mycoplasma, and some protozoa.

Tetracyclines Classification:

1. Group -1 short-acting: Tetracycline, oxytetracycline.

2. Group – II – intermediate-acting: Demeclocycline, methacycline.

3. Group – III – long-acting: Doxycycline, minocycline.

Tetracyclines Mechanism of action:

Broad Spectrum Antibiotics Tetracyclines Mechanism Of Action

Tetracyclines Therapeutic uses:

1. Orodental condition

  • Tetracycline – 250 mg QID is used as an adjuvant for chronic periodontitis.
  • Doxycycline – 0.1 – 0.2 g/day for 2 – 4 weeks controls gingival inflammation.
  • Doxycycline polymer gel is placed in the periodontal pockets.
  • Appropriate surgical treatment combined with 2 – 4 week tetracycline therapy stops the progression of juvenile periodontitis.

2. General uses

Used for initial treatment of mixed infections.

  • First choice of drug for:
    • Chlamydial infections.
      • Lymphogranuloma venerum – given for 2 weeks.
      • Trachoma – given topically.
      • Inclusion conjunctivitis.
    • Rickettsial infections – typhus, Q. Fever.
    • Atypical pneumonia.
    • Cholera – reduces stool volume.
    • Brucellosis – combined with gentamicin.
    • Plague – combined with aminoglycoside.
    • Replacing fever.
    • Second choice of the drug too.
      • Penicillin for tetanus, anthrax.
      • Ciprofloxacin for gonorrhea
      • Ceftriaxone for syphilis.
      • Azithromycin for trachoma.

3. Other uses

  • Urinary tract infections.
  • Traveler’s diarrhea.
  • Acne.
  • Protozoal infections – amoebiasis, malaria.
  • Chronic obstructive lung disease prophylactic use.
  • Inappropriate secretion of ADH – demeclocycline is used.
  • Topical use in scaling and root planning procedures.

Tetracyclines Adverse effects:

1. Irritative effects:

  • GIT effects
    • Causes nausea, vomiting, epigastric pain, and diarrhea.
    • Esophageal ulceration occurs.
  • Local effects   
    • Pain at the site of injection.
    • Thrombophlebitis on IV injection.

2. Dose-related toxicity

  • Hepatotoxicity 
    • Resulting in jaundice.
    • Causes acute hepatic necrosis in pregnancy.
  • Renal toxicity   
    • Tetracyclines accumulate and enhance renal failure.
    • Occurs due to the degradation of products which damages proximal renal tables.
  • Phototoxicity

Skin reactions and dermatitis occur due to sun exposure.

  • Effect of Teeth and Bones     

Tetracyclines have chelating properties.

Broad Spectrum Antibiotics Tetracyclines Have Chelating Property

  • Antianabolic effect
  • Reduces protein synthesis.
  • Induces negative nitrogen balance and increases blood urea.
  • Increases intracranial pressure
  • Diabetes insipidus.
  • Vestibular toxicity.

3. Hypersensitivity reactions

Skin rashes, urticaria, glossitis, pruritus, exfoliative dermatitis occurs.

4. Superinfections

Tetracyclines suppress normal flora and cause superinfections.

Question 2. How will you treat a case of superinfection due to tetracycline therapy?
Answer:

Tetracycline:

It is a broad-spectrum antibiotic.

Tetracycline Superinfection:

  • It refers to the appearance of a new infection as a result of antimicrobial therapy.
  • The use of tetracyclines alters the normal microbial flora of the body.
  • Due to it, non-pathogenic components of the flora like Candida predominates and invades the flora.
  • The mouth, skin, vagina, and intestinal are invaded by Candida albicans.
  • It leads to pseudomembranous enterocolitis.

Superinfection Treatment:

  • Tetracycline is discontinued.
  • To treat superinfection antifungal agents like nystatin or clotrimazole are used.

Question 3. List four tetracyclines. Explain pharmacokinetic differences among tetracyclines.
Answer:

Tetracyclines:

1. Group I – short-acting: Tetracycline, oxytetracycline.

2. Group II – intermediate-acting: Demeclocycline, methcycline.

3. Group III – long-acting: Doxycycline, minocycline.

Differences among tetracyclines:

Broad Spectrum Antibiotics Differences Among Tetracyclines

Question 4. Explain the adverse effects of Tetracyclines. Add a note on Doxycycline.
Answer:

Adverse Effects Of Tetracyclines:

1. Irritative effects

  • GIT effects
    • Nausea, vomiting, epigastric pain, diarrhea
  • Local effects
    • Pain at the site of injection
    • Thrombophlebitis on IV injection

2. Dose-related toxicity

  • Hepato toxicity
    • Results in jaundice
    • Causes acute hepatic necrosis in pregnancy
  • Renal toxicity
    • Tetracyclines accumulate and enhance renal failure
    • Occurs due to degradation of products which damages proximal renal tubules
  • Phototoxicity

Skin reactions and dermatitis occurs due to sun exposure

  • Effect on teeth and bones

Tetracyclines have chelating property

Broad Spectrum Antibiotics Effect On Teeth And Bones

  • Antianabolk effect
  • Reduces protein synthesis
  • Increases blood urea
  • Increases intracranial pressure
  • Diabetes insipidus
  • Vestibular toxicity

3. Hypersensitivity reactions

Skin rashes, urticaria, glossitis, pruritis, exfoliative dermatitis

4. Superinfection

Tetracyclines suppress normal flora and cause superinfection

Doxycycline:

  • It is a semi-synthetic tetracycline
  • When given orally it is 95% absorbed
  • Food does not interfere with its absorption
  • The plasma half-life is 18-24 hours
  • So it is given once a day
  • It is primarily excreted in feces as conjugate
  • Phototoxicity, less renal toxicity occurs

Broad Spectrum Antibiotics Short Essays

Question 1. Give reasons for not prescribing tetracycline to a child of 5 – years.
Answer:

Tetracyclines have chelating properties

  • It chelates calcium.
  • Calcium-tetracycline chelate gets deposited in developing teeth and bone.
  • The deformities depend on the time of tetracycline administration.

1. Mid-pregnancy up to 5 months of postnatal life

  • Deciduous teeth are affected.
  • Causes brownish discoloration.
  • Teeth become ill-formed and more susceptible to caries.

2. 2 months – 5 years of age

  • Effects permanent dentition.
  • Causes discoloration of teeth.
  • Permanent interiors are commonly affected.
  • A repeated course is more damaging.

3. Pregnancy and childhood up to 8 years

  • Causes temporary suppression of bone growth.
  • Prolonged use of tetracyclines leads to bone deformities and height reduction.

Question 2. Chloramphenicol.
Answer:

Chloramphenicol is a broad-spectrum antibiotic.

It is obtained from streptomyces venezuelae in 1947.

Chloramphenicol Mechanism of Action:

Broad Spectrum Antibiotics Chloramphenicol Mechanism Of Action

Chloramphenicol Uses:

1. Typhoid fever

  • Given for 14 days.
    • Initially – 500 mg QID till the fever subsides.
    • Later – 250 mg QID up to the 14th day.

2. Meningitis

Used as an alternative to penicillin.

3. Anaerobic infections

Used in combination with penicillin and aminoglycoside.

4. Eye infections

Used for endophthalmitis.

5. Topical use

Used in conjunctivitis, external ear infections.

6. Second drug of choice to

  • Tetracycline for brucellosis, and cholera.
  • Erythromycin for whooping cough.
  • Penicillin for meningococcal infections.
  • Cotrimoxazole for dysentery.
  • Fluoroquinolones for UTI.

Chloramphenicol Adverse Effects:

1. Bone marrow depression.

Occurs in 2 ways.

  • Non-dose-related idiosyncratic reaction     
    • Rare but serious.
    • Manifested as aplastic anemia.
  • Dose-dependent reaction 
    • Occurs due to the inhibition of mitochondrial enzyme synthesis.
    • Characterized by anemia, leukopenia, and thrombocytopenia.

2. Hypersensitivity reactions

Rashes, fever, atrophic glossitis, angioedema.

3. Irritative effects

  • GIT disturbances – Nausea, Vomiting, diarrhea.
  • Pain on injection.

4. Superinfection.

5. Grey baby syndrome

  • Occurs when high doses are given.
  • Baby develops vomiting, refusal of feeds, hypotonic, hypothermia, abdominal distension, irregular respiration, and ashen grey cyanosis.

Broad Spectrum Antibiotics Short Question And Answers

Question 1. Adverse effects of broad-spectrum antibiotics.
Answer:

1. Toxicity

  • Local irritancy
    • Broad-spectrum antibiotics act as irritants and causes.
      • GIT disturbances – nausea, vomiting.
      • Pain at the site of injection.
  • Systemic toxicity 
    • They affect organs.
      • Tetracyclines cause phototoxicity, hepatotoxicity, and renal toxicity.
      • Chloramphenicol causes bone marrow suppression.

2. Superinfection

  • The use of broad-spectrum antibiotics leads to the alteration of the normal microbial flora of the body.
  • Due to it, even non-pathogenic organisms present invade the flora.
  • As a result, a new infection occurs.

Question 2. Doxycycline.
Answer:

Doxycycline is semi-synthetic tetracycline.

  • When given orally, it is 95% absorbed.
  • Food does not interfere with its absorption.
  • The plasma half-life is 18 – 24 hours.
  • So, it is given once in a day.
  • It is primarily excreted in feces as conjugate.
  • Phototoxicity, less renal toxicity occurs.

Question 3. Tetracyclines should not be given with antacids.
Answer:

Tetracyclines have chelating properties.

  • They form insoluble and unabsorbable complexes with calcium and other metals.
  • Milk, iron preparations, non-systemic antacids, and sucralfate reduces their absorption.
  • Hence tetracyclines should not be given with antacids.

Beta Lactum Antibiotics Question And Answers

Beta Lactum Antibiotics Important Notes

1. Beta lactam antibiotics are

  • Penicillins
  • Cephalosporins
  • Monbactem
  • Carbepenems

2. Penicillin

  • Has a wide therapeutic range
  • Is the safest drug
  • Penicillin Classification
    • Natural – penicillin G, procaine penicillin, Benzathine penicillin
    • Acid resistance penicillin – penicillin V, phenoxy ethyl penicillin
    • Penicillinase resistance penicillin
      • Acid labile – methicillin, cloxacillin, nafcillin
      • Acid resistant – fucloxacillin
    • Broad spectrum penicillin – ampicillin, amoxicillin, talampicillin
    • Extended-spectrum penicillin – carbenicillin, ticarcillin
    • Beta-lactamase inhibitors – augmentin, sulbactam
  • Penicillin Adverse effects
    • Anaphylaxis
    • Angioedema
    • Superinfection
    • JarischHerxheimer reaction
  • Penicillin Uses
    • Syphilis
    • Actinomycosis
    • Gonorrhoea
    • Streptococcal infection
    • Abscess
    • Cellulitis

3. Carbenicillin

  • It is neither Penicillinase resistance nor acid resistance
  • It is inactive orally
  • Rapidly excreted in urine
  • It is active against pseudomonas aeruginosa and indole positive proteus

4. Benzathine penicillin

  • It is a long-acting drug
  • Given every 2-4 weeks
  • Remains effective for prophylactic purposes for up to 4 weeks

5. Drugs and their route of administration

Beta Lactum Antibiotics Drugs And Their Route Of Administration

6. Cephalosporins

  • They have a 7-amino cephalosporins acid nucleus which bears a close resemblance to the 6-APA nucleus of penicillin.
  • They are effective against both gram +ve and gram -ve organisms
  • They inhibit bacterial cell wall synthesis
  • Doesn’t undergo any metabolism in the body except cefotaxime
  • Excreted by kidneys except for cefoperazone
  • Generations:.

Read And Learn More: Pharmacology Question and Answers

Beta Lactum Antibiotics Generations

Beta Lactum Antibiotics Long Essays

Question 1. Define antibiotic. Classify penicillin. Explain their mechanism of action, toxicity, and uses of penicillin G or Benzylpenicillin.
Answer:

Antibiotics:

These are substances produced by micro-organisms that selectively suppress the growth or kill other micro-organisms at very low concentrations.

Penicillin:

Penicillin is a beta-lactam antibiotic.

Penicillin Classification:

1. Natural penicillin – penicillin G.

2. Semi-synthetic penicillin

  • Acid resistant – penicillin V.
  • Penicillinase-resistant penicillin.
    • Methicillin, cloxacillin.
  • Extended-spectrum penicillin.
    1. Aminopenicillin – Ampicillin, Bacampicillin.
    2. Carboxypenicillin – Carbenicillin, Ticarcillin.
    3. Ureidopenicillin – peperacillin, mezlocillin.

Penicillin Mechanism of action:

  • Bacterial cell walls consist of peptidoglycan chains.
  • These require transpeptidase enzymes.

Beta Lactum Antibiotics Penicillin Mechanism Of Action

Penicillin Toxicity:

  • Pain and sterile abscess at the site of injection.
  • Thrombophlebitis on IV injections.
  • Hypersensitivity reactions.
    • Frequently rashes, itching, urticaria, and fever occurs.
    • Rarely wheezing, angioneurotic edema, serum sickness, and exfoliative dermatitis occur.
  • Topical use of penicillin causes contact dermatitis.
  • CNS effects – include confusion, muscle twitchings, convulsions, and coma.
  • Suprainfections – occur rarely due to the narrow spectrum of activity of penicillin.
  • Jarisch – Herxheimer reaction.
  • When penicillin is injected into a syphilitic patient; there is sudden destruction of spirochaetes and release of its toxic products known as the Jarisch herxcheimer reaction.
  • It is characterized by fever, myalgia, shivering, exacerbation of syphilitic lesions, and vascular collapse.

Penicillin Uses:

1. Therapeutic uses

  • CO Orodental infections – caused by aerobic and anaerobic micro-organisms.
  • Pneumococcal infections – like pneumonia, meningitis, and osteomyelitis.
  • Streptococcal infections – like pharyngitis, sinusitis, pneumonia, meningitis.
  • Meningococcal infections.
  • Staphylococcal infections.
  • Syphilis.
  • Diphtheria.
  • Anaerobic infections – like pulmonary, periodontal, and brain abscesses.
  • Actinomycosis.
  • Tetanus, gas gangrene, anthrax, trench mouth, rat-bite fever.

2. Prophylactic uses

  • To prevent recurrence of rheumatic fever.
  • Prevent sexually transmitted diseases like gonorrhea and syphilis.
  • Surgical prophylaxis.
  • To protect against agranulocytosis.

Question 2. Describe the antibacterial spectrum and therapeutic uses of ampicillin.
Answer:

Ampicillin:

It is semisynthetic aminopenicillin.

Antibacterial spectrum:

  1. Cocci-strep viridians, enterococci, penumococci, gonococci, meningococci.
  2. Gram negative bacilli – H.influenza, E.coli, proteus, salmonella, shigella.

Ampicillin Uses:

  • Urinary tract infections.
  • Respiratory tract infections like bronchitis, sinusitis, and otitis media.
  • Meningitis.
  • Gonorrhoea.
  • Bacillary dysentery.
  • Typhoid fever.
  • Cholecystitis.
  • Subacute bacterial endocarditis.
  • Septicaemia.
  • Orodental infections.

Question 3. Write the treatment of penicillin in anaphylactic shock.
Answer:

Treatment of Anaphylactic Shock:

  • Penicillin causes anaphylactic reactions.
  • It is more common following parenteral administration than oral.
  • So the history of penicillin allergy must be elicited before injection.
  • A scratch test or intradermal test with 2-10 units may be performed first
  • Treatment of anaphylactic shock is as follows.
  • Put the patient in a reclining position.
  • Administer oxygen.
  • Perform cardiopulmonary resuscitation.
  • Inject adrenaline 0.5 mg IM, repeat every 5-10 min or adrenaline diluted 1:10000 or 1:1,00,000 IV.
  • Administer chlorpheniramine 10 – 20 mg IM.
  • IV hydrocortisone succinate 100 – 200 mg.

Question 4. Define chemotherapeutic agents. Describe newer penicillins.
Answer:

Chemotherapeutic agents:

A chemical of natural or synthetic origin used for its specific action against disease, usually against infection is called a chemotherapeutic agent.

Newer penicillins:

It includes:

Beta Lactum Antibiotics Newer Penicillins

1. Acid-resistant penicillin – phenoxymethyl penicillin – penicillin V.

2. Penicillinase-resistant penicillin – methicillin, cloxacillin.

3. Extended-spectrum penicillins

  • Aminopenicillin – Ampicillm, Bicampicillin.
  • Carboxypenidllm – carbenicillin, ticarcillin.
  • UreidopenidlJin – piperacillin.

4. P-Lactamase inhibitors

Clavulanic acid, sulbactam.

Newer penicillins AIMS:

  • To overcome the disadvantages of penicillin G like.
  • Poor oral efficacy.
  • Susceptibility to penidllanse
  • Narrow spectrum
  • Hypersensitivity reactions.
  • p-lactamase inhibitors.

Question 5. Classify Penicillins. Write the spectrum of action, mechanism of action, therapeutic uses, and adverse effects of Amoxicillin.
Answer:

Penicillin Classification:

  • Natural – penicillin G, procaine penicillin, Benzathine penicillin.
  • Acid resistance penicillin – penicillin V, phenoxy ethyl penicillin
  • Penicillinase resistance penicillin
    • Acid labile – methicillin, cloxacillin, nafcillin
    • Acid resistant – fucloxacillin
  • Broad spectrum penicillin – ampicillin, amoxicillin, talampicillin
  • Extended-spectrum penicillin – carbenicillin, ticarcillin
  • Beta-lactamase inhibitors – augmentin, sulbactam

Amoxicillin:

It is aminopenicillin

Amoxicillin Spectrum Of Action:

  • Cocci – streptococcus viridians, enterococci, pneumococci, gonococci, meningococci
  • Gram negative bacteria – E.coli, proteus, salmonella

Amoxicillin Mechanism Of Action:

  • The bacterial cell wall consists of peptidoglycan chains
  • These require transpeptidase enzymes
  • Penicillin inhibits transpeptidase → which inhibits the synthesis of peptidoglycan → results in the formation of cell wall deficient bacteria → causes lysis bacteriocidal

Amoxicillin Uses:

  • Typhoid
  • Respiratory infections
  • Urinary tract infection
  • Gonorrhoea
  • Subacute bacterial endocarditis
  • The most commonly used antibiotics for dental use
  • Drug of choice for prophylaxis for endocarditis

Amoxicillin Adverse Effects:

  • Adverse effects are rare
  • Diarrhea – due to irritation of the lower part of the intestine and alteration of bacterial flora
  • Skin rashes

Beta Lactum Antibiotics Short Essays

Question 1. Adverse effects of penicillin.
Answer:

1. Penicillin Hypersensitivity reactions

  • It is the more common adverse effect of penicillin.
  • Frequent manifestations are – rashes, itching, urti- cariaand fever.
  • Rarely wheezing, angioneurotic edema, serum sickness, and exfoliative dermatitis occur rarely.
  • An anaphylactic reaction may rarely occur but may create a serious problem.
  • Adrenaline injection is kept loaded to treat anaphylaxis.
  • It is more common with parenteral administration than oral.
  • To prevent it, a history of penicillin allergy is elicited.
  • A scratch test or intradermal test with 2-10 units is done before the use of penicillin.

2. Penicillin Local effects

  • Pain – at the site of injection
  • Nausea – on oral ingestion.
  • Thrombophlebitis – on IV injection occurs.

3. Penicillin CNS effects

  • Large doses cause mental confusion, muscular twitching convulsions, and coma, especially in patients with renal insufficiency IV infections.

4. Penicillin Jarlsch – Herxheimer miction

  • It occurs when penicillin is injected into a syphilitic patient
  • It is due to the release of endotoxins from dead organisms.
  • It is due to the release of endotoxins from dead organisms.
  • It is characterized by shivering, fever, myalgia, exacerbation of lesions, and vascular collapse.
  • It lasts for 12 – 72 hours.
  • Aspirin and corticosteroids provide symptomatic relief.

5. Penicillin Superinfections

It occurs rarely due to a narrow spectrum of activity.

Question 2. Uses of benzylpenicillin (PnG).
Answer:

1. Orodental infections

  • Parenteral penicillin is more effective.
  • It is given at ordinary doses of 0.5 – 2 MU IM-6 hourly in cases of periodontal abscess, periapical abscess, pericoronitis, ANUG, oral cellulitis, etc.

2. Streptococcal infections

  • 0.5 – 5 MU IV 8 hourly for 7-10 days given for pharyngitis, otitis media, scarlet fever, and rheumatic fever.
  • High doses of 10 – 20 MU IV daily for 2 – 6 weeks are used in subacute bacterial endocarditis.

3. Pneumococcal infections

If the organism is sensitive, PnG 3-6 MU IV every 6 hours is used.

4. Meningococcal infections

High doses are needed.

5. Gonorrhoea

6. Penicillin

  • Early and latent syphilis – 1.2 MU of procaine penicillin daily for 10 days.
  • Late syphilis – 2.4 MU of benzathine penicillin weekly for 4 weeks.

7. Diphtheria – 1 – 2 MU procaine penicillin daily for 10 days

8. Tetanus and gas gangrene – 6 – 12 MU dialy.

9. Anthrax – 4 MU 6 hourly for 2 weeks.

10. Actinomycosis – 2 – 4 MU IV 6 hourly for 4 weeks.

Benzylpenicillin Prophylactic use:

  • Penicillin G is used «s prophylactic In.
    • Rheumatic fever
    • Gonorrhoea and syphilis
    • Valvular heart disease
    • Surgical procedures.
    • Agranulocytosis.

Question 3. Extended-spectrum penicillin.
Answer:

  1. Amlnopenicillin – Amptclllln, Bacamplclllln, Amoxicillin
  2. Carboxypenicillin – Carbenicillin, Ticarcillin
  3. Ureidopenicillin -Piperacillin, Mezlocillin.

Extended-spectrum penicillin Uses:

Amlnopenicillin – Urinary tract Infection

  • Respiratory tract infection
  • Dental infections > Meningitis
  • Typhoid
  • Septicaemia
  • Gonorrhoea
  • Bacillary dysentery
  • Cholecystitis
    • Carboxypenicillin – Used as sodium salt.
    • In serious infections like burns, septicemia
    • Ureidopenicillin – In gram-negative infections
    • caused in immunocompromised patients

Extended-spectrum penicillin Adverse effects:

  • Aminopenicillin – Diarrhoea, skin rashes
  • Carboxypenicillin – Edema, CLF, bleeding
  • Ureidopenicillin – Relatively safe.

Question 4. Penicillins act as bacteriocidal agent.
Answer:

Penicillin inhibits the synthesis of bacterial cell walls.

It is more lethal in the phase of rapid multiplication when cell wall synthesis takes place.

Penicillins act as bacteriocidal agent Mechanism:

Beta Lactum Antibiotics Penicillins Act As Bacteriocidal Agent Mechanism

Penicillin also depresses bacterial autolysins which usually function during bacterial cell division.

Question 5. Cloxacillin and staphylococcal infections.
Answer:

Cloxacillin is penicillinase-resistant penicillin.

  • It is resistant to hydrolysis by penicillinase produced by bacteria.
  • It is also acid resistant
  • It is more active against penicillinase-producing staphylococci.
  • It is incompletely absorbed from the oral route especially when taken on an empty stomach.
  • It is more than 90% plasma bound.
  • The plasma half-life is 1 hour.
  • It is given in doses of 0.25 – 0.5 g orally 6 hourly.

Question 6. Cephalosporins.
Answer:

Cephalosporins are semisynthetic antibiotics with a beta-lactam ring.

They have a wider spectrum of activity.

Cephalosporins Classification:

1. Cephalosporins First generation

  • Parenteral – cephalothin, cefazolin.
  • Oral – cephalexin, cefadroxil.
    • They are very effective against gram-positive organisms and less against gram-negative.

2. Cephalosporins Second generation

  • Parenteral – cefamandole, cefuroxime.
  • Oral-cefachlor.
    • They are more active against gram-negative or, paganism and some are active against anaerobes

3. Cephalosporins Third generation

  • Parenteral – cefotaxime, ceftriaxone.
  • Oral – cefixime.
    • They are highly resistant to beta-lactamase.
    • Have good activity against gram-negative organisms.
    • They are rarely used in dentistry.

4. Cephalosporins Fourth generation

  • Parenteral – cefepime, cefpriome.
  • Active against gram-positive and gram-negative organisms.
  • More resistant to b-lactamases.
  • Used in septicemia, nosocomial, and in infections in immune-compromised patients.

Cephalosporins  Adverse reactions

  • Pain at the site of injection.
  • Hypersensitivity reactions.
  • Nephrotoxicity.
  • Bleeding diarrhoea
  • Neutropenia – low WBC count
  • Disulfiram-like reaction with alcohol.

Cephalosporins Uses:

  • Dental infections.
  • Used as an alternative to penicillin.
  • Urinary, respiratory, and soft tissue infections.
  • Surgical prophylaxis.
  • Gonorrhoea
  • Meningitis
  • Septicaemia.
  • Typhoid.
  • Mixed aerobic – anaerobic infections.
  • Nosocomial or hospital-acquired infections
  • Prophylaxis and treatment of infections in neutropenic patients.

Question 7. Semi-synthetic penicillin.
Answer:

Semi-synthetic penicillin Classification:

1. Acid-resistant penicillin – Penicillin V

2. Penicillinase-resistant penicillin – methicillin, clock- oxacillin.

3. Extended-spectrum penicillin.

  • Aminopenicillin – ampicillin, amoxicillin.
  • Carboxypenicillin – carbenicillin, ticarcillin.
  • Ureidopenicillin – peracillin.

4. p-lactamase inhibitors.

  • Clavulanic acid, sulbactam.

Semi-synthetic penicillin Advantages over natural penicillin:

  • Effective orally.
  • Have a wider spectrum of activity
  • Resistance to b-lactamases
  • Hypersensitivity reactions are less.

Question 8. Compare amoxicillin and ampicillin.
Answer:

Beta Lactum Antibiotics Compare Amoxicillin And Ampicillin

Question 9. 3rd generation cephalosporins.
Answer:

  • They are highly resistant to beta-lactamase
  • Active against Gram-negative and pseudomonas
  • Less active against Gram-positive and anaerobes

3rd generation cephalosporins Example

Beta Lactum Antibiotics 3rd Generationscephalosporins Examples

Question 10. Amoxicillin.
Answer:

It is aminopenicillin

Amoxicillin Spectrum of Action:

  • Cocci – streptococcus viridians, enterococci, pneumococci, gonococci, meningococci
  • Gram negative bacteria – E.coli, proteus, salmonella

Amoxicillin Mechanism of Action:

  • The bacterial cell wall consists of peptidoglycan chains
  • These require transpeptidase enzymes
  • Penicillin inhibits transpeptidase → which inhibits the synthesis of peptidoglycan → results in the formation of cell wall deficient bacteria → causes lysis → bacteriocidal

Amoxicillin Uses:

  • Typhoid
  • Respiratory infections
  • Urinary tract infection
  • Gonorrhoea
  • Subacute bacterial endocarditis
  • The most commonly used antibiotics for dental use
  • Drug of choice for prophylaxis for endocarditis

Amoxicillin Adverse Effects:

  • Adverse effects are rare
  • Diarrhea – due to irritation of the lower part of the intestine and alteration of bacterial flora
  • Skin rashes

Beta Lactum Antibiotics Short Question And Answers

Question 1. Probenecid and penicillin are used in chemotherapy.
Answer:

Probenecid is combined with penicillin because.

  • Probenecid competes with penicillin for active tubular secretion.
  • Retards their excretion.
  • Increases plasma concentration of penicillin.
  • Increases duration of action of penicillin. Thus, this combination is used in.
    • Treatment of bacterial endocarditis.
    • Gonococcal infections.

Question 2. Uses of benzylpenicillin or Penicillin G.
Answer:

1. Therapeutic uses:

  • Orodental infections.
  • Pneumococcal infections.
  • Streptococcal infections.
  • Meningococcal infections
  • Staphylococcal infections
  • Syphilis
  • Diptheria
  • Anaerobic infection
  • Actinomycosis.
  • Tetanus and gas gangrene.

2. Prophylactic uses.

  • Rheumatic fever.
  • Agranulocytosis
  • Sexually transmitted diseases like syphilis and gonorrhea
  • Surgical prophylaxis.

Question 3. The rationale for combining amoxicillin and clavulanic acid. Write one indication of this combination.
Answer:

Ciavulanic acid has a beta-lactam ring but no antibacterial activity.

  • The combination of amoxicillin and clavulanic acid causes:
  • Extension of the antibacterial spectrum.
  • Inhibits beta-lactamase-producing organisms.
  • After binding to the b-lactamase enzyme, clavulanic add itself gets inactivated, hence it is called a sudden inhibitor.

Amoxicillin and clavulanic acid Indications:

  • Skin and soft tissue infections.
  • Urinary tract infections.
  • Respiratory tract infections.
  • Orodental infections.
  • Nosocomial infections.
  • Gonorrhoea.

Question 4. D-penicillamine.
Answer:

D-penicillamine is a copper-chelating agent

D-penicillamine Uses:

  • As chelating agent
  • Use in rheumatoid arthritis.

D-penicillamine Adverse effects:

  • Loss of taste.
  • Systemic lupus erythematosus.
  • Myasthenia gravis.

Question 5. Amoxicillin.
Answer:

Amoxicillin is a semi-synthetic penicillin.

Advantages over ampicillin:

  • Good oral absorption.
  • Food does not interfere with absorption.
  • Diarrhea and skin rashes are less.

Amoxicillin Uses:

  • Typhoid
  • Respiratory tract infections.
  • Urinary tract infections.
  • Gonorrhoea.
  • Subacute bacterial endocarditis.

Question 6. Adverse effects of penicillin.
Answer:

  • Hypersensitivity reaction.
  • Pain at the site of injection.
  • Superinfection.
  • CNS effects – hallucination, coma.
  • Jewish Herxheimer reactions.

Question 7. β-lactamase inhibitors.
Answer:

Beta-lactamase inhibitors are the drugs that bind to inactive β-lactamases preventing the destruction of the β-lactam antibiotics.

Beta-lactamase inhibitors:

1. Clavulanic acid

  • Competitively and irreversibly inhibits b-lactamases.
  • It is a progressive inhibitor.
  • It is combined with amoxicillin and ticarcillin.

2. Sulbactam

  • It is combined with ampicillin.
  • It is given parenterally for mixed aerobic-anaerobic infections.

3. Tazobactum

It is combined with piperacillin for parenteral administration.

Question 8. Why penicillin is not combined with sulphonamide?
Answer:

Penicillin is bacteriocidal while sulphonamide is bacteriostatic.

  • Sulphonamide retards the multiplication of bacteria.
  • Penicillin acts on actively multiplying bacteria.
  • Thus combining penicillin and sulphonamide causes antagonism instead of synergism of both drugs.
  • Hence, penicillin is not combined with sulphonamides.

Question 9. Amoxicillin.
Answer:

It is aminopenicillin

Cefixime Mechanism of Action:

  • The bacterial cell wall consists of peptidoglycan chains
  • These require transpeptidase enzymes
  • Penicillin inhibits transpeptidase → which inhibits the synthesis of peptidoglycan → results in the formation of cell wall deficient bacteria → causes lysis → bacteriocidal

Cefixime Uses:

  • Typhoid
  • Respiratory infections
  • Urinary tract infection
  • Gonorrhoea
  • Subacute bacterial endocarditis
  • The most commonly used antibiotics for dental use
  • Drug of choice for prophylaxis for endocarditis

Cefixime Adverse Effects:

  • Adverse effects are rare
  • Diarrhea – due to irritation of the lower part of the intestine and alteration of bacterial flora
  • Skin rashes

Question 10. Cefixime.
Answer:

  • It is third generation cephalosporin
  • Highly resistant to beta-lactamase
  • Have good activity against gram-negative organisms
  • Less active against Gram-positive and anaerobes
  • Rarely used in dentistry
  • Given orally.
  • Dose: 200-400 mg BD
  • Plasma half-life – 3 hours

Cefixime Uses:

  • Respiratory infections
  • Biliary infections
  • Urinary infections
  • Adverse effects
  • Stool changes
  • Diarrhea

Aminoglycosides Question And Answers

Aminoglycosides Important Notes

1. Aminoglycosides

  • They contain amino carbohydrate complexes with glycoside bonding
  • Drug of choice for gram-negative infection
  • Acts by blocking mRNA
  • Aminoglycosides Examples
    • Streptomycin
    • Kanamycin
    • Amikacin
    • Gentamycin
    • Netilmycin
  • Aminoglycosides Adverse effects
    • Ototoxicity
    • Nephrotoxicity
    • Neuromuscular blockade
    • Topically used aminoglycosides
    • Neomycin
    • Gentamycin

Aminoglycosides Long Essays

Question 1. Enumerate aminoglycoside antibiotics. Write antibacterial spectrum mechanism of action uses and adverse effects of gentamicin.
Answer:

Aminoglycosides:

Aminoglycosides are a group of natural and semisynthetic antibiotics having polybasic amino groups linked glycosidically to two or more.

Aminoglycosides Classification:

1. Systemic aminoglycosides

Streptomycin, gentamicin, kanamycin, tobramycin, amikacin, netilmicin.

2. Topical aminoglycosides

Neomycin, framycetin.

Gentamicin:

  • It is obtained from micromonospora purpurea.
  • It is a commonly used aminoglycoside.
  • It is more potent

Gentamicin Anti-bacteial spectrum:

  • It has a broader spectrum of activity.
  • Effective against P.aeruginosa and most strains of proteus, E-coli, klebsiella, enterobacter, and Serratia.
  • Inhibits strep. Faecalis and some staph. Aureus.

Anti-bacterial spectrum Mechanism of action:

Aminoglycosides Anti-Bacteial Spectrum Mechanism Of Action

Read And Learn More: Pharmacology Question and Answers

  1. Blocking initiation of protein synthesis by
  2. Terminating protein synthesis.

Aminoglycosides Adding Incorrect Amino Acid

Gentamicin Uses:

1. In dentistry

Gentamicin 2 mg/kg IM/IV single dose is given to supplement amoxicillin or vancomycin for prophylaxis of bacterial endocarditis.

2. General medical uses

  • Urinary tract infections.
  • Pneumonia – used along with penicillin.
  • Used in preventing and treating. Respiratory infections in critically ill patients.
  • Osteomyelitis, peritonitis, septicaemia.
  • Bacterial endocarditis – used in place of streptomycin.
  • Topical uses.
    • As cream – in bums and infected wounds.
    • As eye drops – in conjunctivitis.

Gentamicin Adverse effects:

1. Ototoxicity

  • The vestibular or cochlear part may be primarily affected.
  • Sensory cells present undergo destructive changes.
  • Tinnitus appears first, followed by deafness.
  • Vestibular dysfunction is characterized by headache, nausea, vomiting, dizziness, vertigo, nystagmus and ataxia.

2. Nephrotoxicity

  • Manifests as tubular damage resulting in loss of urinary concentrating power, low GFR, nitrogen retention, and albuminuria.
  • Effects are reversible.

3. Neuromuscular blockade

Aminoglycosides reduce acetylcholine release from motor nerve endings.

Aminoglycosides Short Essays

Question 1. Neomycin.
Answer:

It is a topical aminoglycoside.

It is a wide-spectrum aminoglycoside.

Neomycin Uses:

1. Topical use

Used for infected wounds, ulcers, burns, external ear infections, and conjunctivitis.

2. Oral use

  • Preparation of bowel before surgery.
  • Hepatic coma.

Neomycin Adverse effects:

  • Highly ototoxic.
  • Oral use causes diarrhoea, steatorrhea and malabsorption syndrome.
  • Skin rashes on topical use.

Aminoglycosides Short Question And Answers

Question 1. Aminoglycoside.
Answer:

Aminoglycoside Classification:

1. Systemic aminoglycosides

Streptomycin, gentamicin, konamydn, amikacin.

2. Topical aminoglycosides

Neomycin, framycetin.

Aminoglycoside Properties:

  • They are not absorbed orally.
  • All are sulphate salts.
  • Highly water soluble.
  • Distribute only extracellularly.
  • Do not penetrate CSF.
  • Excreted unchanged by the kidneys.
  • All are bacteriocidal.
  • Act by inhibiting bacterial protein synthesis.
  • They are more active at alkaline pH.
  • All are active primarily against aerobic gram-negative bacilli.
  • There is partial cross-resistance among them.
  • Have a narrow margin of safety.
  • Exhibit nephrotoxicity and ototoxicity.

Question 2. Streptomycin.
Answer:

Streptomycin is the oldest aminoglycoside.

  • It is obtained from streptomyces griseus.
  • It is not metabolized, so excreted unchanged in the urine.
  • Plasma t½ -2-4hours.

Streptomycin Uses:

  • Tuberculosis.
  • Subacute bacterial endocarditis.
  • Plague, tularaemia, brucellosis.

Streptomycin Adverse effects:

  • Less nephrotoxic.
  • Less ototoxic.
  • Hypersensitivity reactions – rashes, eosinophilia, fever and exfoliative dermatitis.
  • Pain at the site of injection.
  • Rarely paresthesia occurs.

Question 3. Gentamicin.
Answer:

Gentamicin Uses:

1. In dentistry

Gentamicin 2 mg/kg IM/IV single dose is given to supplement amoxicillin or vancomycin for prophylaxis of bacterial endocarditis.

2. General medical uses

  • Urinary tract infections.
  • Pneumonia – used along with penicillin.
  • Used in preventing and treating. Respiratory infections in critically ill patients.
  • Osteomyelitis, peritonitis, septicaemia.
  • Bacterial endocarditis – used in place of streptomycin.
  • Topical uses
    • As cream – in burns and infected wounds.
    • As eye drops – in conjunctivitis.

Gentamicin Adverse effects:

1. Ototoxicity

  • The vestibular or cochlear part may be primarily affected.
  • Sensory cells present undergo destructive changes.
  • Tinnitus appears first, followed by deafness.
  • Vestibular dysfunction is characterized by headache, nausea, vomiting, dizziness, vertigo, nystagmus and ataxia.

2. Nephrotoxicity

  • Manifests as tubular damage resulting in loss of urinary concentrating power, low GFR, nitrogen retention, and albuminuria.
  • Effects are reversible.

3. Neuromuscular blockade

Aminoglycosides reduce acetylcholine release from motor nerve endings

Question 4. Adverse effects of Aminoglycosides.
Answer:

1. Ototoxicity

  • The vestibular or cochlear part may be primarily affected
  • Sensory cells present undergo destructive changes
  • Tinnitus appears first followed by deafness
  • Vestibular dysfunction Is characterized by headaches. nausea, vomiting, dizziness, vertigo, nystagmus and ataxia

2. Nephrotoxicity

  • Manifests as tubular damage resulting in loss of urinary concentrating power, low GFR, nitrogen retention, albuminuria
  • Effects are reversible

3. Neuromuscular blockade

Aminoglycosides reduce acetylcholine release from motor nerve endings

Macrolides Question And Answers

Macrolides Important Notes

1. Macrolides

  • They have large lactone ring
  • They are used as an alternative to penicillin

Macrolides Classification:

Macrolides Macrolides Classification

2. Macrolides Erythromycin

  • Given in patients allergic to penicillin
  • Effective against all penicillin-sensitive organisms and penicillin-resistant streptococci
  • Inactivated by gastric acid
  • Thus available in enteric-coated tablets
  • It is bacteriostatic at low concentrations and bacteriocidal at high concentrations

Macrolides Long Essays

Question 1. Enumerate macrolide antibiotics. Describe the antimicrobial spectrum and therapeutic uses of erythromycin.
Answer:

Macrolide antibiotics:

  • These are antibiotics having a macrocyclic lactone ring with attached sugars.
  • They are
  1. Erythromycin.
  2. Roxithromycin.
  3. Clarithromycin.
  4. Azithromycin.

Erythromycin:

It is isolated from streptomyces erythroid.

Erythromycin Antibacterial spectrum:

  • Erythromycin has a narrow spectrum.
  • It is effective against aerobic gram-positive bacteria and a few gram-negative organisms.
  • Streptococci, pneumococci, staphylococci, gonococci, C.diptheria, B. Pertussis, and some atypical mycobacteria.

Erythromycin Uses:

1. Orodental infections

  • Used in the prevention and treatment of oriental infections including post-extraction infections, periapical abscesses, and other periodontal lesions.
  • Used in patients who are allergic to penicillin.

2. Medical use

  • Atypical pneumonia.
    • Erythromycin – 500 mg 6 hourly oral or IV is used.
  • Legionnaire’s pneumonia.
    • Treated for 10 – 14 days with erythromycin.
  • Whooping cough.
  • Streptococcal infections like pharyngitis tonsillitis and scarlet fever.
  • Staphylococcal infections.
  • Diptheria.
  • Syphilis and gonorrhea.
  • Tetanus, anthrax.

3. Topical use

  • Ointment – for skin infections and boils.
  • Lotions – for acne vulgaris.

4. Prophylactic use

  • In valvular heart disease patients.
  • For rheumatic fever.

Erythromycin Adverse effects:

1. Gastrointestinal disturbances

  • Erythromycin induces gastric contractions, hastens gastric emptying, and promotes intestinal motility.
  • Causes epigastric pain.
  • Rarely diarrhea occurs.

2. Hepatitis with cholestatic jaundice

  • Starts after 2-3 weeks of treatment
  • Symptoms are Nausea, vomiting, abdominal cramps, and mimic acute cholecystitis.

3. Hypersensitivity reactions

Fever, skin rashes.

4. Cardiac arrhythmias in patients with cardiac disease.

5. Reversible hearing impairment

Read And Learn More: Pharmacology Question and Answers

Macrolides Short Essays

Question 1. Difference between amoxicillin and gentamicin.
Answer:

Macrolides Differences Between Amoxicillin And Gentamicin

Macrolides Short Question And Answers

Question 1. Compare penicillin and erythromycin.
Answer:

Macrolides Compare Penicillin And Erythromycin

Question 2. Macrolide antibiotics.
Answer:

Macrolides are antibiotics with a macrocyclic lactone ring to which sugars are attached.

They are:

  1. Erythromycin.
  2. Roxithromycin.
  3. Clarithromycin.
  4. Azithromycin.

They are bacteriostatic at low concentrations and bacteriocidal at high concentrations.

Macrolide antibiotics Mechanism:

Macrolides Macrolide Antibiotics Mechanism

Macrolides Short Question And Answer

Question 1. Azithromycin
Answer:

  • It is a derivative of erythromycin
  • It is acid stable
  • Rapidly absorbed, absorption is decreased by food
  • Has better tissue permeability
  • Longer-acting
  • Better tolerated
  • Plasma half-life – 3 days
  • Free of drug interactions
  • Azithromycin Uses
    • Prophylactic use
    • Treatment of atypical mycobacterial infections in AIDS patients
    • Respiratory infections
    • Genital and skin infections
    • Pneumonias
    • Orodental infection instead of erythromycin
    • Acute exacerbation of chronic bronchitis
  • Azithromycin Adverse effects
  • Mild gastric upset
  • Abdominal pain
  • Headache
  • Dizziness

Drugs Used In Psychiatric Disorders Question And Answers

Drugs Used In Psychiatric Disorders Important Notes

1. Classical antipsychotic drills – block dopamine D2 receptors

  • Chlorpromazine
  • Halo peridot
  • Zudopenthixol
  • Thioridazine

2. Atypical antipsychotic drugs – block 5-HT2 and D4 receptors

  • Clozapine
  • Olanzapine
  • Risperidone

3. Disorders Adverse effects of antipsychotic drugs

Drugs Used In Psychiatric Disorders Adverse Effect Of Anti-Psychotic Drugs

4. Anti-anxiety drugs

Drugs Used In Psychiatric Disorders Anti-Anxiety Drugs

5. Oxazepam

  • It is preferred in elders and in patients with liver disease
  • Duration of action is short
  • Used mainly in short-lasting anxiety

6. Migraine

  • Drugs used for its treatment
    • Mild – simple analgesics + antiemetic
    • Moderate – NSAIDs combination
    • Severe – ergot alkaloids + antiemetic + prophylaxis
  • Drugs used for prophylaxis
    • Propranolol
    • Amitriptyline
    • Flunarizine
    • Valproate
    • Methysergide

7. Chlorpromazine

  • It belongs to the phenothiazine
  • Exhibit antipsychotic action by blocking dopaminergic receptors in CNS
  • They are also potent antiemetics

8. Antidepressants

  • Act by inhibiting the uptake of biogenic amines like noradrenaline, serotonin, and dopamine
  • They are
  • Tricyclic compounds – Imipramine, Amitriptyline
  • MOA inhibitor – Isocarboxazid, Phenelzine

Drugs Used In Psychiatric Disorders Short Essays

Question 1. Chlorpromazine.
Answer:

Chlorpromazine is phenothiazine with an aliphatic side chain.

Chlorpromazine Mechanism of action:

  • Chlorpromazine has potent dopamine D2 receptor-blocking action.
  • It also blocks Dl, D3, and D4 receptors.

Chlorpromazine Actions:

1. Chlorpromazine CNS effects.

  • In normal individuals.
    • Reduces motor activity.
    • Produces drowsiness.
    • Reduces initiative.
  • In psychotic individuals.
    • Reduces irritational behavior, agitation, and aggressiveness.
    • Normalises sleep.
  • Other actions.
    • Cortex – lowers the seizure threshold.
    • Hypothalamus – decreases gonadotropin secretion.
    • Basal ganglia – Acts as a dopamine antagonist
    • Brain stem- depresses vasomotor reflexes.
    • CTZ – Act as antiemetic.

Read And Learn More: Pharmacology Question and Answers

2. Chlorpromazine Autonomic nervous system.

Chlorpromazine has anticholinergic properties.

3. Chlorpromazine CVS

Has a myocardial depressant effect

4. Chlorpromazine Local anesthesia – Has local anesthetic effect.

5. Chlorpromazine Kidney – depresses ADH secretion.

Chlorpromazine Uses:

  • Schizophrenia.
  • Mania.
  • Organic brain syndrome.
  • As antiemetic.
  • Hiccough.
  • Anxiety.

Chlorpromazine Adverse Effects:

1. Chlorpromazine Dose-related.

  • CNS effects – drowsiness, lethargy, mental confusion.
  • CVS effects – postural hypotension, palpitation.
  • Anticholinergic – dry mouth, blurring of vision constipation.
  • Endocrine – amenorrhoea, infertility.
  • Extrapyramidal disturbances – parkinsonism, acute muscle dystonia, akathisia, malignant neuroleptic syndrome, tardive dyskinesia.
  • Others – weight gain, blue pigmentation of skin, corneal ulceration, retinal degeneration, cardiac arrhythmia.

2. Chlorpromazine Hypersensitivity reactions.

  • Cholestatic jaundice.
  • Skin rashes, urticaria, contact dermatitis
  • Agranulocytosis.

Question 2. Classification of antipsychotic drugs.
Answer:

Anti-psychotic drugs/neuroleptics:

These drugs have a therapeutic effect on psychosis.

1. Anti-psychotic drugs Phenothiazines

  • Aliphatic side chain – chlorpromazine, trifluoro- magazine.
  • Piperidine side chain – thioridazine.
  • Piperazine side chain. Trifluoperazine, fluphenazine.

2. Anti-psychotic drugs Butyrophenones

Haloperidol, trifluperiodol, penfluridol.

3. Anti-psychotic drugs Thioxanthenes

Flupenthixol.

4. Anti-psychotic drugs Other heterocyclics

Pimozide, loxapine.

5. Anti-psychotic drugs Atypical antipsychotics

Clozapine, risperidone, olanzapine, quetiapine.

Question 3. Neuroleptoanalgesia.
Answer:

Neuroleptanalgesia is a state of analgesia characterized by quiescence, psychic indifference, and intense analgesia without loss of consciousness.

It is obtained by a combination of.

1. Fentanyl – 0.05 mg – short-acting drug.

2. Droperidol – 2.5 mg/ml – rapidly acting drug.

4 – 6 ml of it is infused IV for 10 min.

Neuroleptoanalgesia Advantages:

The patient is drowsy but cooperative.

Neuroleptoanalgesia Adverse Effects:

  • Respiratory depression.
  • Slight fall in BP and heart rate.
  • Extrapyramidal symptoms may be present.

Neuroleptoanalgesia Uses:

  • Endoscopies.
  • Burn dressing.
  • Angiography.
  • Diagnostic procedures.
  • Minor surgical procedures.

Drugs Used In Psychiatric Disorders Short Question And Answers

Question 1. Four drugs are used in mental depression.
(or)
Anti-depressants.
Answer:

Anti-depressants Classification:

1. Reversible inhibitors of MAO-A.

Moclobemide, clorgyline.

2. Tricyclic antidepressant

  • Na + 5 HT reuptake inhibitors.
  • Imipramine, Trimipramine, Amitriptyline.
  • Predominantly NA reuptake inhibitors
  • Desipramine, nortriptyline.

3. Selective serotonin reuptake inhibitors.

Fluoextine, fluvoxamine, paroxetine.

4. Atypical antidepressants.

Trazodone, minaserin, mirtazapine, venlafaxine.

Question 2. Analeptic drugs.
Answer:

Analeptic drugs are drugs that stimulate respiration and have resuscitative effects in fainting or coma.

Analeptic drugs Uses:

  • Hypnotic drug poisoning.
  • Suffocation on drowning.
  • Respiratory failure due to removal of the hypoxic drive.
  • Apnea in premature infants.

Analeptic drugs Adverse Effects:

  • Convulsion.
  • Postictal depression.

Dental Pharmacology Question And Answers

Dental Pharmacology Important Notes

1. Drugs causing dry mouth

  • Anticholinergic
  • Ganglion blocking agents
  • Antihistamines

2. Drugs causing gingival hyperplasia

  • Phenytoin
  • Nifedipine
  • Cyclosporines

Dental Pharmacology Short Essays

Question 1. Mummifying agents.
Answer:

  • Mummifying denotes the hardening of dead tissue and rendering it resistant to microbial attack and degradation
  • Mummifying agents were used earlier before the use of root canal-filling materials
  • They were used to kill tissues in the tooth pulp, make it hard and dry so it does not get infected later
  • Mummifying agents are

1. Formaldehyde or paraformaldehyde

  • It is mixed with zinc oxide or zinc sulfate + creosote
  • A paste is made by it to fill the root canal
  • Paraformaldehyde releases formaldehyde slowly which
    • Destroys all living tissues of the pulp
    • Hardens it
    • Makes it more resistant to future infection
  • To prevent pain caused by filling, lidocaine may be added to the paste

2. Iodoform + phenol

  • The paste is made of it glycerine
  • Eugenol or cinnamon oil may be added to add frag- nance
  • Liberated iodine or phenol helps to keep the pulp uninfected

3. Tannic acid

  • Mixed with an additive to get a paste form

Question 2. Drugs used in Halitosis.
Answer:

  • Halitosis is an unpleasant odor exhaled in breathing
  • Treatment of halitosis depends on the cause

1. Mouthwashes – containing antibacterial agents including

  • Cetylpyridium chloride
  • Chlorhexidine
  • Zinc gluconate
  • Essential oils
  • Hydrogen peroxide
  • Chlorine dioxide
    • Mouthwashes can temporarily stain teeth
    • Chlorhexidine is a chemical antiseptic
    • It kills volatile sulfur compounds producing bacteria
    • Cetylpyridium chloride has bacteriocidal action which kills the bacteria and microbes present in the mouth causing halitosis
    • Chlorine dioxide effectively reduces plaque, tongue coating accumulation, and Fusobacterium nucleatum count in saliva

2. Cimetidine

  • When the gastric acid in the stomach flows bade up into the food pipe due to indigestion it causes heartburn and bad breath
  • Cimetidine is H2 receptor antagonist
  • It is used to treat the heartburn

3. Ranitidine

  • It is an antacid
  • Inhibits gastric add secretion

Question 3. Dentrifrice.
Answer:

  • It is a substance used with a toothbrush for the purpose of cleaning the accessible surfaces of teeth
  • Used in the form of powder, paste, or gel

Dentrifrice Functions:

  • Minimize plaque build-up
  • Anticaries action
  • Removal of stains
  • Mouth freshener

Dentrifrice Composition:

  • Abrasive
  • Calcium carbonate
  • Calcium phosphate
  • Humectants
  • Maintains moisture
  • Glycerine, sorbitol
  • Preservatives
  • Benzoic acid
  • Thickening agents
  • Methylcellulose
  • Foaming agents
  • Sodium lauryl sulfate
  • Flavoring agents
  • Mint
  • Sweetening agents
  • Mannitol saccharine
  • Desensitizing agents
  • Sodium fluoride
  • Anticalculus agent
  • Pyrophosphates

Question 4. Disclosing agents.
Answer:

  • They are prepared in liquid, tablet, or lozenge form that contains a dye or other coloring agent
  • It is used to identify bacterial plaque for instruction, evaluation, and research

Disclosing agents Purpose:

  • Patient’s education
  • Evaluate the effectiveness of the treatment
  • Evaluate plaque indices
  • Self-evaluation

Disclosing agents Requirements:

  • Color should contrast with the normal color of the oral cavity
  • It should not rinse off immediately
  • It should not have bad taste
  • It should not cause any irritation
  • It should be thin enough

.Read And Learn More: Pharmacology Question and Answers

Disclosing agents Agents:

  • Iodine containing preparation
  • Bismarck brown
  • Merbromin
  • Erythrosine
  • Fast green
  • Two-tone

Dental Pharmacology Short Question And Answers

Question 1. Use of fluorides in caries.
Answer:

  • Fluorides make the tooth more resistant to caries
  • It has weak antibacterial action
  • It can be administered either systemically or locally to the teeth
    • Topical fluoride
    • Placed directly on the teeth
    • It includes

1. Fluoride toothpaste

  • A most common and effective method
  • Salts used in it are sodium fluoride, sodium mon- fluorophosphate or stannous fluoride
  • It should not be swallowed to avoid systemic toxicity

2. Fluoride mouth rinses

  • Sodium fluoride and stannous fluoride are used as daily mouth rinses
  • The rinse solution is held in the mouth for 1-3 minutes and swished around and then discarded

3. Professionally applied fluoride

  • It includes – APF gel and fluoride varnishes
    • Systemic fluoride
      • Circulate through the bloodstream and are incorporated into developing teeth
      • It includes

Water fluoridation

  • It is the upward adjustment of the concentration of fluoride ions in a public water supply in such a way that the concentration of fluoride ion in the water may be consistently maintained at one part per million by weight to prevent dental caries with minimum possibility of causing dental fluorosis

Salt fluoridation

  • Fluoride is added to salt by spraying concentrated solutions of sodium fluoride and potassium fluoride on salt on a conveyor belt

Milk fluoridation

  • Milk is an excellent source of calcium and phosphorous
  • It contains all essentials for the development of bone and teeth

Question 2. Sweetening agents.
Answer:

  • They are substances used to impart a sweet taste to a pharmaceutical preparation
  • They are used in centrifuges to
    • Mask their blandness
    • Improve their taste
    • Make them acceptable
  • Agents used are

1. Saccharin

  • It is an artificial sweetener
  • 500 times more sweet than sugar
  • It is no cariogenic
  • Used as a dilute solution
  • Excreted unchanged within 24 hours
  • It is stable and nontoxic
  • Enhances palatability

2. Sorbitol

3. Glycerol

Question 3. Obtundents.
Answer:

  • Obtundents are agents that diminish dentin sensitivity
  • When applied to the teeth and gums it produces numbness that could dampen toothache
  • They penetrate poorly and do not relieve deep pain

Obtundents Disadvantages:

  • Pulp may shrink
  • Irritants may stimulate the formation of secondary dentin

Obtundents Agents:

Dental Pharmacology Obtundents Agents

Histamines And Antihistamines Question And Answers

Histamines And Antihistamines Important Notes

1. Antihistamines

Histamines And Antihistamines Antihistamines

  • Antihistamines Uses
    • Common cold
    • Anti-allergic
    • Insect bite
    • Idiopathic pruritis
    • Motion sickness
    • Vertigo

Histamines And Antihistamines Short Essays

Question 1. Mention four newer antihistamines with their advantages.
Answer:

  • Newer Antihistamines are:
    • Fexofenadine
    • Loratadine
    • Cetrizine
    • Azelastine
    • Mizolastine
    • Terfenadine

Newer Antihistamines Advantages:

  • Donot impair psychomotor performance
  • Produce no subjective effects
  • No sedation as they poorly cross the blood-brain barrier
  • No anticholinergic side effects

Question 2. Mention four therapeutic uses of HI blockers.
Answer:

Uses of H1 Blockers:

1. Allergic reactions

    • Block the effects of released histamine
    • Control Immediate types of allergies like Itching, urticaria, angioedema
    • Cetrizine has an adjuvant role In seasonal asthma

2. Prurltldes

    • Older H1 blockers are used In Idiopathic pruritus

3. Common cold

    • Provide symptomatic relief by anticholinergic and sedative actions

4. Motion sickness

    • Promethazine and diphenhydramine are used prophylactically in motion sickness
    • It should be taken one hour before the journey

5. Vertigo

    • Inhibits vestibular sensory nuclei in the inner ear

6. Preanasethetic medication

    • Promethazine is used for it
  • It includes the following groups

Histamines And Antihistamines Preanasethetic Medication It Includes Following Groups

7. Cough

    • Provide symptomatic relief

8. Parklsonism

    • Provide symptomatic relief

9. Acute muscle dystonia

    • Due to Its central anticholinergic action

10. As sedative, hypnotic, and anxiolytic

Question 3. Autocoids
Answer:

  • Autocoids are substances formed in various tissues, have complex physiological and pathological actions, and act locally at the site of synthesis
  • They are called local hormones
  • They serve as transmitters or moderators in the nervous system
  • They have brief action and are destroyed locally

Read And Learn More: Pharmacology Question and Answers

Question 4. Antihistamines
Answer:

  • Antihistamines are the drugs that competitively antagonize the action of histamine at H1 receptors

Antihistamines Classification

Histamines And Antihistamines Antihistamines Classification

Antihistamines Uses:

  • Allergic disorders
  • Priorities
  • Common cold
  • Cough
  • Motion sickness
  • Preanasethetic medication
  • Vertigo
  • Parkinsonism
  • Acute muscle dystonia
  • As sedative, hypnotic, anxiolytic
  • To control mild blood transfusion and saline infusion reactions

Question 5. Enumerate two nonsedative Antihistamines and mention four uses of them.
Answer:

Non Sedative Antihistamines:

  • Fexofenadine
  • Loratadine
  • Cetrizine
  • Azelastine
  • Mizolastine
  • Terfenadine

Non Sedative Antihistamines Uses:

  • Allergic rhinitis, conjunctivitis, hay fever
  • Control sneezing and runny nose, red watering eyes
  • Urticaria, dermographism, atopic eczema
  • Acute allergic reactions to drugs and food

Histamines And Antihistamines Short Question And Answers

Question 1. Cyproheptadine
Answer:

Cyproheptadine is a serotonin antagonist

Cyproheptadine Actions:

  • Blocks 5-HT2
  • Blocks H1 receptors
  • Blocks cholinergic receptors
  • Increases appetite

Cyproheptadine Uses:

  • Promote weight gain in children and poor eaters
  • To control intestinal manifestations of carcinoid tumors

Question 2. Non sedative Antihistamines
Answer:

Non Sedative Antihistamines:

  • Fexofenadine
  • Loratadine
  • Cetrizine
  • Azelastine
  • Mizolastine
  • Terfenadine

Non Sedative Antihistamines Uses:

  • Allergic rhinitis, conjunctivitis, hay fever
  • Control sneezing and runny nose, red watering eyes
  • Urticaria, dermographism, atopic eczema
  • Acute allergic reactions to drugs and food

Non-Sedative Antihistamines Advantages:

  • Donot impair psychomotor performance
  • Produce no subjective effects
  • No sedation as they poorly cross the blood-brain barrier
  • No anticholinergic side effects

Question 3. Cetrizine
Answer:

  • Cetrizine is non sedative Antihistamines
  • It can metabolite of hydroxyzine with a marked affinity for peripheral H1 receptors
  • It is well absorbed orally
  • It attains high and long-lasting concentration in the skin

Cetrizine Actions:

  • Inhibits the release of histamine and cytotoxic mediators from platelets
  • Inhibits Eosinophil chemotaxis during the secondary phase of the allergic response

Cetrizine Uses:

  • Upper respiratory allergies, pollinosis, Urticaria, atopic dermatitis
  • Adjuvant to seasonal asthma

Question 4. Ergometrine
Answer:

  • Ergometrine is an amine ergot alkaloid
  • It is a very weak Agonist
  • It has no antagonist action on alpha-adrenergic receptors
  • The emetic potential is low
  • They are rapidly and completely absorbed
  • The plasma half-life is 1-2 hours
  • Onset of action

Histamines And Antihistamines Onset Of Action

Ergometrine Uses:

  • To control and prevent postpartum hemorrhage
  • To prevent uterine atony
  • To ensure normal involution

Question 5. Promethazine
Answer:

  • Promethazine is a highly sedative H1 antagonist

Promethazine Uses:

  • Allergic disorders
  • Pruritis
  • Common cold
  • Preanasethetic medication
  • Parkinsonism

Question 6. Prostaglandins
Answer:

  • Prostaglandins are biologically active derivatives of 200-carbon atom polyunsaturated fatty acids
  • They are major lipid-derived autocoids

Prostaglandins Actions:

Histamines And Antihistamines Prostaglandins Actions

Question 7. Uses of ergot alkaloids
Answer:

Histamines And Antihistamines Uses Of Ergot Alkaloids