Pharmacology Short Notes - Based on Shanbhag
Q4. Short Notes
a) Selective COX-2 Inhibitors:
These selectively inhibit cyclooxygenase-2 enzyme involved in inflammation with minimal gastric irritation. Examples:
Celecoxib, Etoricoxib. Less GI toxicity but higher CV risk.
b) Treatment of Chronic Simple Glaucoma:
Drugs lower intraocular pressure. Includes Timolol, Latanoprost, Brimonidine, Acetazolamide. Pilocarpine used less.
c) Newer Hypnotic Drugs:
Non-benzodiazepine GABA-A agonists like Zolpidem, Zopiclone. Fast onset, short duration, less hangover.
d) First Pass Metabolism:
Drugs like propranolol, nitrates undergo hepatic/gut metabolism before systemic circulation, lowering bioavailability.
e) Methyl Alcohol Poisoning Treatment:
Use Ethanol/Fomepizole to block alcohol dehydrogenase. Correct acidosis with bicarbonate. Hemodialysis if needed.
Q5. Explain Briefly
a) N-Acetyl Cysteine in Paracetamol Poisoning:
It replenishes glutathione and detoxifies NAPQI. Alcoholics have lower glutathione stores.
b) Organophosphorus Poisoning Treatment:
Give Atropine + Pralidoxime. Supportive care includes oxygen, fluids, diazepam for seizures.
c) Succinylcholine and Apnoea:
Due to pseudocholinesterase deficiency, metabolism is slow, causing prolonged paralysis.
d) Heparin + Warfarin Together:
Heparin acts immediately; warfarin takes days. Combined use ensures protection from clots.
e) Pethidine and Seizures:
Its metabolite norpethidine is neurotoxic. Accumulates in renal failure or chronic use.
Q6a. Antiepileptics
Mechanism-based Classification:
- Na+ blockers: Phenytoin, Carbamazepine
- Ca2+ blockers: Ethosuximide
- GABA enhancers: Diazepam, Valproate
- Glutamate inhibitors: Topiramate
Pharmacology Short Notes - Based on Shanbhag
- Others: Levetiracetam
Not recommended in pregnancy: Valproate, Phenytoin, Carbamazepine.
Preferred: Lamotrigine, Levetiracetam + Folic acid.
Status Epilepticus: Seizure >5 min.
Treatment: Lorazepam IV, then Phenytoin/Fosphenytoin, then Phenobarbital if needed.
Q6b. Peptic Ulcer and PPIs
Classification:
- Acid inhibitors: PPIs, H2 blockers
- Mucosal protectants: Sucralfate, Misoprostol
- Antacids
- H. pylori regimen: PPI + Clarithromycin + Amoxicillin
PPIs: Inhibit H+/K+ ATPase. Examples: Omeprazole, Pantoprazole
Uses: Ulcer, GERD, ZE syndrome
ADRs: Headache, B12 deficiency, infections.
Q7. Short Notes
a) Beta Blockers: Used in HTN, CHF, angina. ADRs: bradycardia, bronchospasm.
b) Severe Migraine: Triptans, NSAIDs, antiemetics.
c) Non-Ergot DA: Pramipexole used in Parkinsonism. Less fibrotic risk.
d) LMWHs: Enoxaparin, better bioavailability, less monitoring than UFH.
e) Prokinetics: Metoclopramide, Domperidone. Increase GI motility.
f) Parenteral Iron: Iron dextran, sucrose. IM/IV with test dose.
Q8. Explain Briefly
a) Aspirin: Low dose inhibits platelet COX-1 -> antithrombotic effect.
b) SSRIs: Fluoxetine, Sertraline. Used in depression. ADRs: nausea, sexual dysfunction.
c) Folic acid alone in B12 deficiency masks anemia, worsens neuropathy.
d) Typical Antipsychotic ADRs: EPS, NMS, hyperprolactinemia. Treat with anticholinergics.
e) LA in inflammation: Acidic pH reduces drug penetration/effectiveness.
f) Day care drugs: Propofol preferred over thiopentone for quick onset/recovery.
