Autonomic nervous system

      Q1. All the following are the actions of acetylcholine except

1. Increase in heart rate
2. Dilatation of pupil
3. Contraction of detrusor muscle
4. Increased salivation         

Q2. Which of the following is not a cholinergic drug

1. Scopolamine
2. Muscarine
3. Pilocarpine
4. Bethenacol  

Q3. The atropine derivative used in the treatment of bronchial asthma is

1. Homatropine
2. Oxybutynin
3. Pirenzepine
4. Ipratropium  

       Q4. Which of the following statements is not true regarding neostigmine

1. It is a reversible anticholinesterase
2. It crosses the blood brain barrier
3. It is used to treat myasthenia gravis
4. It should not be used in organophosphorus poisoning

Antimicrobials - MCQ

Q1. The tetracycline antibiotic that does not require dose reduction in renal failure is

1. Doxycycline
2. Demeclocycline
3. Minocycline
4. Oxytetracycline

Q2. Which among the following organisms is not inhibited by tetracyclines?

1. Clostridia
2. Actinomyces
3. Campylobacter jejuni
4. Pseudomonas aeruginosa

Q3. All the following are indications for use of metronidazole except

1. Pseudomembranous colitis
2. Ulcerative gingivitis
3. Streptococcal pneumonia
4. H. pylori eradication

Q4. The aminoglycoside with broadest spectrum of action is

1. Streptomycin
2. Amikacin
3. Gentamicin
4. Neomycin

Q5. Which of the following aminoglycoside is not used topically?

1. Gentamicin
2. Framycetin
3. Streptomycin
4. Neomycin

Q6. The common feature of aminoglycoside antibiotics is

1. Time dependent bactericidal action
2. More active in acidic pH
3. Good oral absorption
4. Postantibiotic effect

Antihistamines - Use or misuse ?

Running nose, itchy throat and the prospect of fever and cough in the coming days can make anyone consume one of those over the counter medication known as antihistamines (usually in combination with other drugs) whose colorful labels and ad make sure to give you a sense of having the cure at hand. Whats the big deal? Either it helps or it doesn't. If not the common man atleast the doctors should be aware of the real potential of antihistamines. While very helpful in acute allergy (hay fever etc) they are less useful in chronic rhinitis. Although commonly used for common cold there is no pharmacological basis for their use. Here is what Goodman and Gilman (one of the main textbooks for postgraduate pharmacology) has to say - "Despite persistent popular belief, H₁ antagonists are without value in combating the common cold. The weak anticholinergic effects of the older agents may tend to lessen rhinorrhea, but this drying effect may do more harm than good, as may their tendency to induce somnolence". A 2008 study from the American poison center shows that antihistamines are the 8th common drugs involved in overdosage cases. Also, FDA has removed several antihistamine preparations for use in children less than 6 years because of reported overdoses.

As the saying goes (for cure of common cold) "with medicine 7 days, without medicine a week".

Autacoids - MCQs

Q1. Which of the following is not an autacoid?

1. Histamine
2. Platelet activating factor
3. Insulin
4. Angiotensin

Q2. All the following are indications for use of H1 antihistamines except

1. Hay fever
2. Anaphylactic reaction
3. Allergic rhinitis
4. Anticholinergic poisoning

Q3. The second generation antihistaminic among the following is

1. Fexofenadine
2. Hydroxizine
3. Chlorpheniramine
4. Cyclizine

Q4. The antihistaminic drug withdrawn due to serious adverse effect is

1. Azelastine
2. Loratidine
3. Terfenadine
4. Diphenhydramine

Q5. All the following drugs can be used in motion sickness except

1. Promethazine
2. Cetirizine
3. Meclizine
4. Scopolamine

Antimicrobial MCQs

Q1. Which of the following is not a beta lactam antibiotic?

1. Cefaclor
2. Ampicillin
3. Imipenem
4. Vancomycin

Q2. All the following beta lactams are effective against pseudomonas except

1. Amoxicillin
2. Ceftazidime
3. Piperacillin
4. Carbenicillin

Q3. The penicillin G preparation with the longest duration of action is

1. Potassium penicillin
2. Sodium penicillin
3. Procaine penicillin
4. Benzathine penicillin

Q4. The erythromycin preparation most prone to cause hepatitis is

1. Erythromycin gluceptate
2. Erythromycin estolate
3. Erythromycin stearate
4. Erythromycin ethylsuccinate

Q5. The mechanism of antibacterial action of cephalosporins involves

1. Inhibition of the synthesis of precursors of peptidoglycans
2. Interference with the synthesis of ergosterol
3. Inhibition of transpeptidation reactions
4. Inhibition of beta-lactamases

Woman, Moon and Menstruation - From traditional to modern medicine

Although today's medicine is largely governed by evidence from clinical trials its ultimate scientific utility largely depends on the people who generate and collect the evidence, the doctors who provide treatment based on the generated evidence. While scientific studies are designed to be objective it is hardly possible to eliminate the subjective components completely (and probably not desirable in all cases), more so when the researchers willingly or unwillingly introduce bias based on their preconceived notions.

A naturally acquired trait in today's doctors is to consider all the traditional medical practices to be sham or placebos at the best if not out-rightly harmful. This is especially important in case of Indian doctors who have a well formed traditional medical practice "Ayurveda". While something that is antique does not guarantee it as a beneficial or scientifically sound treatment it should not be right away condemned too. So here is an interesting article from the former Vice Chancellor of Manipal academy of higher education, Manipal., showing how the ancient observation that the moon has an effect on the menstrual cycles is upheld in a modern medical textbook. Read the article "Woman, Moon, and Menstrual cycle - BM Hegde" here. (Its a PDF document).

Have created a couple of pages "About me" (about my blog rather) and "How to read Pharmacology".