Five-Mark Answer Points: Short Hints for Easy Scoring
UNIT 1: DRUGS ACTING ON GIT
1. Classification of anti-ulcer drugs
Anti-ulcer
drugs are classified as:
-H₂ blockers: Cimetidine, Ranitidine
-Proton pump inhibitors: Omeprazole, Pantoprazole
B. Antacids
-Systemic: Sodium bicarbonate
-Non-systemic: Aluminium hydroxide, Magnesium hydroxide
C. Ulcer protectives
-Sucralfate, Colloidal bismuth subcitrate
D. Prostaglandin analogues
-Misoprostol
-Used in peptic ulcer disease and GERD.
2. H₂-receptor antagonists
Mechanism: Block H₂ receptors on parietal
cells → ↓ gastric acid secretion.
Uses: Peptic ulcer, GERD, Zollinger–Ellison syndrome.
Adverse effects: Gynecomastia (cimetidine), diarrhea, headache.
Drugs: Cimetidine, Ranitidine, Famotidine.
3. Proton pump inhibitors (PPIs)
Mechanism: Irreversibly inhibit
H⁺/K⁺-ATPase pump → profound acid suppression.
Uses: Peptic ulcer, GERD, H. pylori eradication.
Adverse effects: Hypomagnesemia, osteoporosis, diarrhea.
Examples: Omeprazole, Pantoprazole.
4. Antacids
Types:
a) Systemic: Sodium bicarbonate,
b) Non-systemic: Aluminium hydroxide, Magnesium trisilicate
Uses: Acid peptic disorders.
Adverse effects: Constipation (Al), diarrhea (Mg).
5. Prostaglandin analogues
Drug: Misoprostol
Mechanism: ↑ mucus & bicarbonate secretion, ↓ acid secretion.
Uses: NSAID-induced ulcers.
Adverse effects: Diarrhea, uterine contractions.
6. Laxatives
Classification:
a) Bulk forming: Ispaghula
b) Stool softeners: Liquid paraffin
c) Stimulant purgatives: Senna, Bisacodyl
d) Osmotic purgatives: Lactulose
Uses: Constipation, bowel preparation.
7. Osmotic purgatives
Draw
water into intestine → bowel distension → peristalsis.
Drugs: Lactulose
Uses: Chronic constipation, hepatic encephalopathy.
Adverse effects: Flatulence, diarrhea.
8. Antidiarrhoeal drugs
Classification:
a) ORS and Zinc
b) Opioids: Loperamide
c) Adsorbents: Ispaghula
d) ORS: Prevents dehydration.
e) Zinc: Reduces duration and severity.
9. Opioid antidiarrhoeals
Mechanism: ↓ intestinal motility.
Drugs: Loperamide, Diphenoxylate
Adverse effects: Constipation, abdominal cramps.
10. Antiemetics (5-HT₃ antagonists)
Mechanism: Block serotonin receptors in
CTZ.
Drugs: Ondansetron, Granisetron
Uses: Chemotherapy-induced vomiting.
Adverse effects: Headache, constipation.
11. Prokinetic drugs
Mechanism: ↑ GI motility by dopamine
antagonism.
Drugs: Metoclopramide, Domperidone
Uses: GERD, gastroparesis.
Adverse effects: Extrapyramidal symptoms.
12. Antispasmodics
Mechanism: Reduce smooth muscle spasm.
Drugs: Dicyclomine, Drotaverine
Uses: IBS, colic.
Adverse effects: Dry mouth, blurred vision.
UNIT 2: PHARMACOLOGY OF ENDOCRINE DRUGS
13. Antithyroid drugs
Classification:
b) Ionic inhibitors: Thiocyanates
c) Iodides: NaI, KI
d) Radioactive iodine
Uses: Hyperthyroidism.
14. Propylthiouracil
Mechanism: Inhibits thyroid hormone
synthesis and T₄→T₃ conversion.
Uses: Thyrotoxicosis.
Adverse effects: Agranulocytosis, hepatitis.
15. Insulin preparations
Types:
a) Short acting: Regular insulin
b) Intermediate: NPH
c) Long acting: Glargine
Uses: Type-1 and Type-2 diabetes.
16. Oral hypoglycaemic agents
Classification:
a) Sulfonylureas: Glibenclamide
b) Biguanides: Metformin
c) Meglitinides: Repaglinide
d) DPP-4 inhibitors: Sitagliptin, Linagliptin
Used in Type-2 diabetes.
17. Sulfonylureas
Mechanism: Stimulate insulin release.
Uses: Type-2 diabetes.
Adverse effects: Hypoglycemia, weight gain.
Drugs: Glibenclamide, Glimepiride.
18. Metformin
Mechanism: ↓ hepatic glucose production.
Uses: Type-2 diabetes.
Adverse effects: Lactic acidosis, GI upset.
19. Corticosteroids
Classification:
a) Glucocorticoids
b) Mineralocorticoids
Examples: Hydrocortisone, Prednisolone.
20. Glucocorticoids
Uses: Inflammation, autoimmune
diseases.
Adverse effects: Osteoporosis, Cushing’s syndrome.
21. Androgens and anabolic steroids
Promote
male characteristics and protein synthesis.
Uses: Hypogonadism, anemia.
Adverse effects: Virilization, liver toxicity.
22. Uterine stimulants
Drugs: Oxytocin, Ergometrine,
Misoprostol
Uses: Induction of labor, postpartum hemorrhage.
UNIT 3: ANTIMICROBIALS
23. Principles of antimicrobial therapy
Correct
diagnosis, appropriate drug selection, correct dose & duration, avoid
misuse.
24. Mechanism of action of antimicrobials
a) Cell wall synthesis inhibition
b) Protein synthesis inhibition
c) DNA synthesis inhibition
25. Antibiotic resistance
Occurs
due to enzyme production, altered targets, decreased permeability.
26. Sulfonamides & cotrimoxazole
Inhibit
folic acid synthesis.
Uses: UTIs, respiratory infections.
Adverse effects: Stevens-Johnson syndrome.
27. Penicillin classification
Natural,
semisynthetic, extended-spectrum, β-lactamase inhibitors.
28. Penicillin mechanism
Inhibits
bacterial cell wall synthesis → bactericidal.
29. β-lactamase inhibitors
Clavulanic
acid, Sulbactam protect β-lactam antibiotics.
30. Cephalosporins
Classified
into generations.
Third generation: Ceftriaxone used in severe infections.
31. Aminoglycosides
Inhibit
protein synthesis.
Adverse effects: Nephrotoxicity, ototoxicity.
32. Tetracyclines
Broad-spectrum
antibiotics.
Contraindicated: Pregnancy, children.
33. Chloramphenicol
Adverse effects: Aplastic anemia, gray baby syndrome.
34. Macrolides
Inhibit
protein synthesis.
Drugs: Erythromycin, Azithromycin.
35. Quinolones
Inhibit
DNA gyrase.
Drugs: Ciprofloxacin, Levofloxacin.
36. Antitubercular drugs
INH,
Rifampicin, Pyrazinamide, Ethambutol.
37. DOTS
Directly
Observed Treatment Short-course for TB control.
38. Antifungal drugs
Amphotericin-B
disrupts fungal cell membrane.
39. Antiviral drugs (HIV)
HAART
uses combination therapy to suppress viral replication.
40.
Antitubercular drugs are used in combination to treat tuberculosis and to prevent the development of drug resistance.
Classification:
First-line drugs: Isoniazid, Rifampicin, Pyrazinamide, Ethambutol, Streptomycin
Second-line drugs: Fluoroquinolones, Aminoglycosides (amikacin), Ethionamide, Cycloserine
Mechanism of Action:
Isoniazid: Inhibits mycolic acid synthesis → damages mycobacterial cell wall
Rifampicin: Inhibits DNA-dependent RNA polymerase → blocks RNA synthesis
Pyrazinamide: Active in acidic pH; disrupts membrane energy production
Ethambutol: Inhibits arabinosyl transferase → impairs cell wall synthesis
Streptomycin: Inhibits protein synthesis by acting on 30S ribosomal subunit
Pharmacokinetics (Brief):
Most drugs are well absorbed orally
Distributed widely, including lungs and CSF
Metabolized mainly in the liver and excreted via urine
Adverse Effects:
Hepatotoxicity (isoniazid, rifampicin, pyrazinamide)
Optic neuritis (ethambutol)
Ototoxicity (streptomycin)
Rationale for Combination Therapy:
Prevents resistance
Enhances bactericidal effect
Shortens treatment duration
Antitubercular drugs act at different targets of Mycobacterium tuberculosis and are used in combination for effective and safe TB management.
UNIT 4: IMMUNOSUPPRESSANTS & IMMUNOSTIMULANTS
41. Immunosuppressants
Calcineurin
inhibitors, antiproliferative drugs, corticosteroids.
42. Cyclosporine
Inhibits
T-cell activation.
Uses: Organ transplantation.
Adverse effects: Nephrotoxicity.
43. Corticosteroids as immunosuppressants
Suppress
cytokine production and immune response.
44. Antiproliferative drugs
Azathioprine,
Methotrexate inhibit lymphocyte proliferation.
45. Monoclonal antibodies
Muromonab-CD3
used in transplant rejection.
46. Immunostimulants
Enhance
immune response.
Examples: BCG, Interferons.
47. Interferons
Used in
viral infections and cancers.
48. BCG vaccine
Used in tuberculosis and bladder cancer.BCG (Bacillus Calmette–GuĂ©rin) vaccine is a live attenuated vaccine used for the prevention of tuberculosis (TB), especially severe forms in children.
Source and Composition:
BCG vaccine is prepared from a weakened strain of Mycobacterium bovis.
Dose and Route: Given intradermally
Dose: 0.05 mL for infants (<1 year) and 0.1 mL for older children and adults
Common site: Left upper arm
Mechanism of Action:
BCG induces cell-mediated immunity, enhancing macrophage activity to protect against TB infection.
Advantages / Uses:
Prevents severe TB forms like tubercular meningitis and miliary TB
Part of national immunization programs in many countries
Adverse Effects:
Local ulcer and scar formation
Rarely lymphadenitis or keloid formation
BCG vaccine is safe and effective in reducing childhood TB morbidity and mortality.
49. Immunosuppressants vs Immunostimulants
50. Adverse effects of immunosuppressants
Adverse Effects and Contraindications of Immunosuppressant Therapy
Immunosuppressant drugs are used to prevent organ transplant rejection and to treat autoimmune disorders by suppressing immune responses.Adverse Effects:
1. Increased risk of infections due to suppression of immune defenses
2. Malignancies (especially lymphomas and skin cancers) with long-term use
3. Bone marrow suppression causing anemia, leukopenia, and thrombocytopenia
4. Organ toxicity – nephrotoxicity (cyclosporine), hepatotoxicity (azathioprine)
5. Metabolic disturbances such as hypertension, diabetes, osteoporosis (corticosteroids)
Contraindications:
1. Active infections (bacterial, viral, fungal)
2. Malignancy or history of cancer (relative contraindication)
3. Severe hepatic or renal impairment
4. Pregnancy and lactation (with some agents like mycophenolate)
5. Hypersensitivity to the drug Immunosuppressant therapy requires careful patient selection and monitoring due to serious adverse effects and specific contraindications.
51. Classify anticancer drugs with suitable examples.
Classification of Anticancer Drugs:
Alkylating agents Ex. Cyclophosphamide, Chlorambucil, Dacarbazine
Antimetabolites Ex. Methotrexate, 6-Mercaptopurine, 5-Fluorouracil
Plant-derived anticancer drugs Vinca alkaloids: Vincristine, Vinblastine
Taxanes: Paclitaxel
Antitumor antibiotics Ex. Doxorubicin, Daunorubicin, Bleomycin
Miscellaneous agents: Cisplatin, Carboplatin, Etoposide, L-Asparaginase
52. Explain the mechanism of action, therapeutic uses, and adverse effects of alkylating agents.
Mechanism of Action:
Alkylating agents form covalent bonds with DNA, leading to cross-linking of DNA strands, inhibition of DNA replication, and cell death. They are cell-cycle non-specific.
Therapeutic Uses:
Leukemias and lymphomas
Breast cancer
Ovarian cancer
Hodgkin’s and non-Hodgkin’s lymphoma
Adverse Effects:
Bone marrow suppression
Nausea and vomiting
Alopecia
Hemorrhagic cystitis (cyclophosphamide)
Increased risk of secondary malignancy
53. Describe antimetabolite anticancer drugs with special reference to methotrexate.
Antimetabolites:
They are structural analogues of normal metabolites required for DNA synthesis and inhibit cell proliferation during the S-phase.
Methotrexate:
Mechanism of Action:
Inhibits dihydrofolate reductase, preventing formation of tetrahydrofolate → inhibition of thymidine synthesis → impaired DNA synthesis.
Therapeutic Uses:
Acute lymphoblastic leukemia
Breast cancer
Choriocarcinoma
Autoimmune diseases (low dose)
Adverse Effects:
Bone marrow suppression
Oral ulcers
Hepatotoxicity
Nephrotoxicity
54. Discuss plant-derived anticancer drugs (vinca alkaloids and taxanes) with mechanisms and adverse effects.
Vinca Alkaloids (Vincristine, Vinblastine):
Mechanism:
Inhibit microtubule polymerization → arrest cells in M phase.
Uses:
Leukemia, lymphoma, testicular cancer
Adverse Effects:
Peripheral neuropathy (vincristine)
Bone marrow suppression (vinblastine)
Taxanes (Paclitaxel):
Mechanism:
Stabilizes microtubules and prevents depolymerization → inhibits mitosis.
Uses:
Breast cancer
Ovarian cancer
Adverse Effects:
Myelosuppression
Alopecia
Hypersensitivity reactions
55. Explain the pharmacology of antitumor antibiotics, mentioning examples and toxicities.
Antitumor Antibiotics:
These drugs interfere with DNA function and are derived from Streptomyces species.
Examples and Mechanism:
Doxorubicin & Daunorubicin:
Intercalate into DNA and inhibit topoisomerase-II
Bleomycin:
Causes DNA strand breaks via free radical formation
Therapeutic Uses:
Leukemias
Lymphomas
Solid tumors (breast, testicular)
Toxicities:
Cardiotoxicity (doxorubicin)
Bone marrow suppression
Pulmonary fibrosis (bleomycin) Alopecia
END OF THE DOCUMENT
2. Strictly Syllabus-Based 50 Questions (5 marks each) from Pharmacology-III For Practice
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