55 - Drugs causing Megaloblastic anemia

1. Phenytoin (anticonvulsant)

2. Primidone (anticonvulsant)

3. Phenobarbitone (anticonvulsant)

4. Sulfasalazine

5. Nitrous oxide
6. Folate antagonists (inhibitors of Dihydrofolate reductase) like Methotrexate, Pentamidine,     Pyrimethamine, Triamterene, Trimethoprim and Cotrimoxazole.
7. Drugs that inhibit DNA synthesis may cause Megaloblastic anemia
    example : 6a. Purine antagonists = 6-Mercaptopurine, Azathioprine.
                   6b. Pyramidine antagonists = 5 FU, Cytosine arabinoside .

                   6c. Others = Hydroxyurea, acyclovir and zidovudine (AZT, Azidothymidine).
8. Nitrofurantoin (less well documented)
9. Tetracycline (less well documented)
10. Anti-Tuberculosis drugs (less well documented)

54 - Monoclonal antibodies approved for Hematological and Solid tumors

ANTIGEN AND TUMOR CELL TARGETS	ANTIGEN FUNCTION	NAKED ANTIBODIES
Antigen: CD20	Proliferation/differentiation	Rituximab (chimeric)
Tumor type: B-cell lymphoma and CLL
Antigen: CD52	Unknown	Alemtuzumab (humanized)
Tumor type: B-cell CLL and T-cell lymphoma
Antigen: CD25 alpha subunit	Activation antigen	Daclizumab (humanized)
Tumor type: T-cell mycosis fungoides
Antigen: CD33	Unknown	Gemtuzumab (humanized)
Tumor type: acute myeloid leukemia
Antigen: HER2/neu (ErbB-2)	Tyrosine kinase	Trastuzumab (humanized)
Tumor type: breast cancer
Antigen: EGFR (ErbB-1)	Tyrosine kinase	Cetuximab (chimeric)
Tumor type: colorectal; NSCLC; pancreatic, breast
Antigen: VEGF	Angiogenesis	Bevacizumab (humanized)
Tumor type: colorectal cancer

53 - Benzodiazepine interactions with other drugs

Benzodiazepine interactions with other drugs.

Drug Effects Antacids Decreased absorption of benzodiazepines Cimetidine Increased half-life of diazepam and  triazolam Contraceptives Increased levels of diazepam and  triazolam Digoxin Alprazolam and diazepam raise  digoxin level Disulfiram Increased duration of action of sedatives Isoniazid Increased plasma diazepam Levodopa Inhibition of antiparkinsonism effect Propoxyphene Impaired clearance of diazepam Rifampin Decreased plasma diazepam Warfarin Decreased prothrombin time

52 - Drugs causing Fatty liver

1. Antiarrythmics - Amiodarone

2. Antibiotic - Tetracycline ( high-dose, intravenous )

3. Anticonvulsant - Valproic acid

4. Antiviral - Dideoxynucleosides ( eg: Zidovudine ), protease inhibitors ( indinavir, ritonavir )

5. Oncotherapeutics - Asparginase, Methotrexate .

51 - Antimicrobial chemotherapy - Rest of drugs

Inhibitors of nucleic acid synthesis	Quinolones	DNA gyrase	Bactericidal
	Novobiocin	DNA gyrase	Bacteriostatic
	Flucytosine	Fungal thymidylate synthetase	Fungicidal
	Rifampin	DNA-dependent RNA polymerase	Bactericidal
Inhibitors of folate metabolism	Sulfonamides	Pteroic acid synthetase	Bacteriostatic
	Trimethoprim	Dihydrofolate reductase	Bacteriostatic
Inhibitor of mycolic acid synthesis	Isoniazid	Mycobacterial mycolic acid biosynthesis	Bactericidal
Alteration of cytoplasmic membrane	Polymyxins	Bacterial membrane permeability	Bactericidal
	Polyenes	Fungal membrane permeability	Fungicidal
	Azoles	Fungal ergosterol biosynthesis	Fungicidal

50 - Antimicrobial chemotherapy - Protein biosynthesis inhibitors

Streptomycin	30S ribosomal subunit	Bactericidal
Gentamicin	30S ribosomal subunit	Bactericidal
Tetracycline	30S ribosomal subunit	Bacteriostatic
Spectinomycin	30S ribosomal subunit	Bacteriostatic
Chloramphenicol	50S ribosomal subunit	Bacteriostatic
Erythromycin	50S ribosomal subunit	Bacteriostatic
Clindamycin	50S ribosomal subunit	Bacteriostatic
Griseofulvin	Microtubule function	Fungistatic

49 - Antimicrobial chemotherapy - Cell wall synthesis inhibitors

		AGENT Cycloserine	SITE OF ACTION      Peptidoglycan tetrapeptide side chain	EFFECT     Bactericidal
		Phosphomycin	Formation of N-acetylmuramic acid	Bactericidal
		Bacitracin	Membrane carrier molecule	Bactericidal
		Penicillins	Peptidoglycan cross-linking	Bactericidal
		Cephalosporins carbapenems	,     Peptidoglycan cross-linking	Bactericidal
		Vancomycin	Translocation of cell wall   intermediates	Bactericidal

48 - Atypical Antipsychotic drugs

Atypical antipsychotics are those drugs which act as antipsychotics but atypically have a very low risk of producing adverse extrapyramidal neurological side effects . These are

1. Risperidone

2. Quetiapine

3. Arisipiprazole

4. Clozapine

5. Olanzapine

6. Ziprasodine

Click here to read the mnemonic used to remember these drugs .

47 - Drugs causing Parkinsonism

Here is a list of drugs and toxins causing parkinsonism :

1. Fluoxetine
2. Valproate
3. Alpha methyl dopa
4. Neuroleptics
5. Dopamine depleting agents
6. Anti-emetics
7. Lithium carbonate
8. Some selective anti-psychotics

Toxins which cause parkinsonism are :

1. CO ( carbonmonoxide )
2. Cyanide
3. CS2
4. Manganese
5. Methanol
6. MPTP
7. N-Hexane

46 - Molecularly targeted anticancer drugs

These drugs target a specific molecule and function as anticancer agents


1. imatinib
2. tretinoin
3. bexarotene
4. gemtuzumab ozogamicin
5. denileukin diftitox
6. gefitinib
7. erlotinib
8. dasatinib
9. sorafenib
10. sunitinib

45 - Antimitotic agents ( Anticancer drugs )

These drugs are also indirect DNA-interacting agents . examples are :


1. vincristine
2. vinblastine
3. vinorelbine
4. paclitaxel
5. docetaxel
6. etramustine phosphate
7. NAB-paclitaxel ( protein bound )

44 - Antimetabolites drugs ( Anticancer drugs )

These drugs are indirect DNA-interacting agents . examples are :


1. deoxycoformycin (pentostatin) ^

2. 6-mercaptopurine ^

3. 6-thioguanine ^

4. azathioprine ^

5. 2-chlorodeoxy adenosine (cladribine) ^

6. fludarabine phosphate ^

7. asparaginase
8. hydroxy urea
9. capacitabine "

10. cytosine arabinoside "

11. azacytidine "

12. gemcitabine "

13. 5-fluorouracil "

14. methotrexate ~

15. pemetrexed ~
---------------------------------
^ (1-6) Purine analogs and related inhibitors .
" (9-13) Pyramidine analogs
~ (14,15) Folic acid analogs 

43 - Antitumor antibiotics ( Anticancer agents )

These drugs are also direct DNA-interacting agents . examples are :


1. bleomycin
2. actinomycin D
3. mitomycin C
4. etoposide ( VP16-213 )
5. topotecan
6. irinotecan ( CPT II )
7. doxorubicin and daunorubicin
8. idarubicin
9. epirubicin
10. mitoxantrone

42 - Alkylating agents ( Anticancer drugs )

These drugs are direct DNA-interacting agents . examples are :


1. cyclophosphamide*
2. mechlorethamine*
3. chlorambucil*
4. melphalan(L-sarcolysin)*
5. ifosfamide*
 

6. lomustine ( CCNU ) %

7. carmustine ( BCNU ) %

8. streptozocin (streptozotocin) %


9. dacarbazine ( DTIC; dimethyltriazenoimidazole carboxamide ) =

10. temozolomide =


11. oxaliplatin -
12. cisplatin -
13. carboplatin -

14. altretamine ( formerly hexamethyl melamine ) +
15. thiotepa + 

16. procarbazine (N-methyl hydrazine, MIH) !


17. busulfan $
 -----------------------------

* (1-5) Nitrogen mustards 
%  (6-8) Nitrosoureas
=  (9,10) Triazenes
-  (11-13) Platinum coordination complexes
+ (14,15) Ethyleneimines and methylmelamines
! (16) Methylhydrazine derivative
$ (17) Alkyl sulfonate

41 - Drugs Causing Pseudotumor cerebri

1. Hypervitaminosis A

2. Oral contraceptives

3. Tetracyclines

4. Glucocorticoids ( withdrawal )

5. Amiodarone

6. Mineralocorticoids ( withdrawal ) 


I always use a funny mnemonic for this - HOT GLUCOSE AND MINERALS - cause pseudotumor 
 cerebri . use it if u like it or make your own one .  click here  if u wanna read more such mnemonics . 

40 - Drugs causing pancreatitis

Definite Cause :

1. 5-Aminosalicylate
2. 6-Mercaptopurine
3. Azathioprine
4. Cytosine arabinoside
5. Dideoxyinosine
6. Diuretics
7. Estrogens
8. Furosemide
9. Metronidazole
10. Pentamidine
11. Tetracycline
12. Thiazide
13. Trimethoprim-sulfamethoxazole
14. Valproic acid

Probable Cause :

1. Acetaminophen
2. α-Methyl-DOPA
3. Isoniazid
4. l-Asparaginase
5. Phenformin
6. Procainamide
7. Sulindac

 ( DOPA, dihydroxyphenylalanine )

P.S : This question is very frequently asked in PGI chandigarh entrance examination .

39 - Drugs causing myopathy

1. lipid lowering agents :

 

                                1a. fibric acid derivatives

                                1b. HMG CoA reductase inhibitors ( statins )

                                1c. niacin ( nicotinic acid derivatives )

 

2. glucocorticoids

 

3. zidovudine

 

4. Non depolarizing neuromuscular blocking agents

 

5. drugs of abuse :

 

                           5a. alcohol

                           5b. amphetamines

                           5c. cocaine

                           5d. heroin

                           5e. phencyclidine

                           5f. meperidine

 

6. autoimmune toxic myopathy : D – pencillamine

 

7. amphophilic cationic drugs :

 

                                  7a. amiodarone

                                  7b. chloroquine

                                  7c. hydroxychloroquine

 

8. antimicrotubular drugs : colchicine

 

9. miscellaneous drugs :

 

                            9a. cyclosporine

                            9b. cimetidine

                            9c. gold

                            9d. danazol

                            9e. amphotericin – B  

38 - glucose 6 phosphate dehydrogenase deficiency - hemolysis causing drugs

1. all of the following drugs cause definite hemolysis in a glucose-6-phosphate dehydrogenase deficient patient except ?

a. primaquine
b. nitrofurantoin
c. naphthalene
d. ciprofloxacin

answer: d . ciprofloxacin . 

u have to memorise the following drugs to answer questions related to this topic.

Drugs which carry a definite risk of hemolysis in a patient with glucose-6-phosphate dehydrogenase deficiency :

1. antimalarials : primaquine, dapsone/chlorproguanil
2. sulphonamides/sulphones : sulphamethoxazole and others, dapsone
3. antibacterial/antibiotics : cotrimoxazole, nalidixic acid, nitrofurantoin, niridazole
4. antipyretic/analgesics : acetanilide, phenazopyridine (pyridium)
5. other drugs : naphthalene, methylene blue

Drugs which carry a possible risk of hemolysis in a patient with glucose-6-phosphate dehydrogenase deficiency :

1. antimalarials : chloroquine
2. sulphonamides : sulfasalazine, sulfadimidine
3. antibacterials/antibiotics : ciprofloxacin, norfloxacin
4. antipyretic/analgesics : acetylsalicylic acid high dose ( greater than 3 g/d )
5. other drugs : vitamin K analogues, ascorbic acid greater than 1 gram and rasburicase

Drugs which carry a doubtful risk of hemolysis in a patient with glucose-6-phosphate dehydrogenase deficiency :

1. antimalarials : quinine
2. sulphonamides/sulphones : sulfisoxazole, sulfadiazine
3. antibacterial/antibiotics : chloramphenicol, p-aminosalicylic acid
4. antipyretic/analgesics : acetyl salicylic acid less than 3 g/d, acetaminophen, phenacetin
5. other drugs : doxorubicin, probenecid .

37 - pharmacology mcqs - 58 to 68

58q. digoxin is contraindicated in ?

a. SVT

b. AF

c. CHF

d. HOCM

answer: d . HOCM - hypertrophic obstructive cardiomyopathy .

59q. digoxin is not indicated in ?

a. atrial flutter

b. atrial fibrillation

c. high output failure

d. PSVT

answer: c . high output failure .

60q. which of the following drugs is a topoisomerase 1 inhibitor ?

a. doxorubicin

b. irinotecan

c. etoposide

d. vincristine

answer: b . irinotecan . topotecan and irinotecan are campothecin analogues .

61q. the treatment of contacts of meningococcal meningitis ?

a. rifampicin

b. erythromycin

c. pencillin

d. cephalosporins 

answer: a . rifampicin .

62q. SLE like syndrome is most commonly associated with the administration of the following drug ?

a. rifampicin

b. procainamide

c. digitalis

d. phenytoin

answer: b . procainamide .

63q. cyclosporine acts by inhibiting the production of ?

a. IL 1

b. IL 2

c. IL 3

d. macrophages

answer: b . IL 2 .

64q. drugs avoided in G6PD deficiency ?

a. chloramphenicol

b. quinidine

c. nitrofurantoin

d. dapsone

e. streptomycin 

answer: a,b,c,d. here is a list of drugs which cause hemolysis in a  G6PD patient . 

65q. volume of  distribution of drugs is altered in ?

a. obesity

b. athletes

c. pregnancy

d. older age 

e. neonate

answer: a,c,d,e. all except athletes .

66q. the drug of choice to treat severe hypertension due to acute nephritis in children is ?

a. propranolol

b. reserpine

c. frusemide

d. nifedipine

answer: d . nifedipine .

67q. digoxin is eliminated from the body by ?

a. tubular filtration

b. hepatic conjugation

c. glomerular filtration

d. oxidation

answer: c . glomerular filtration .

68q. drug of choice in prinzmetal's angina ?

answer: diltiazem .

36 - pharmacology mcqs - 47 to 57

47q. drug of choice in drug induced parkinsonism ?

a. levodopa

b. benzhexol

c. amantadine

d. carbidopa 

answer: b . benzhexol .

48q. drug of choice for renal colic ?

a. methadone

b. pentazocine

c. voveran

d. piroxicam

answer: c . voveran . this is nothing but diclofenac sodium .

49q. what is the chemical name of heroin ?

answer: diacetyl morphine .

50q. the drug of choice for attention deficit hyperactivity disorder ?

a. haloperidol

b. imipramine

c. methyl phenidate

d. lecithin 

answer: c . methyl phenidate .

51q. drug of choice for insomnia in elderly ?

a. diazepam

b. fluoxetin

c. flurazepam

d. oxazepam

answer: d . oxazepam .

52q. aspirin is used in MI because ?

a. decreases thromboxane synthesis

b. has analgesic effect

c. reduces prostaglandin synthesis

d. reduces cardiac work 

answer: a . decreases thromboxane synthesis .

53q. which is the treatment of choice for myoclonic epilepsy in children ?

answer: valproate .

54q. which of the following is not an amide ?

a. lignocaine

b. procaine

c. mepivacaine

d. dibucaine

answer: b . this is the simplest question ever . just remember all the amides will have two " i " s in their names . as simple as that .

55q. long term  use of lithium causes ?

a. peripheral neuropathy

b. hypothyroidism

c. anaemia

d. jaundice

answer: b . hypothyroidism .

56q. carbamazepine is not used in ?

a. mania

b. partial seizure

c. trigeminal neuralgia

d. migraine

answer: d . migraine . remember that carbamazepine is the drug of choice in trigeminal neuralgia.

57q. all are features of ethambutol toxicity except ?

a. retrobulbar neuritis

b. colour vision defects

c. hyperuricemia

d. hypercalcemia

answer: d . hypercalcemia . other antitubercular drugs which cause hyperuricemia are pyrazinamide . 

35 - P450 microsomal enzyme inducers and inhibitors

A.  microsomal enzyme P450 inhibitors :

1. ketoconazole

2. ciprofloxacin

3. allopurinol

4. omeprazole

5. erythromycin

6. cimetidine

B. microsomal enzyme P450 inducers :

1. rifampicin

2. isoniazid

3. glucocorticoids

4. phenobarbitone

5. phenytoin

6. phenylbutazone

7. chloral hydrate

8. griseofulvin

9. DDT

34 - pharmacology mcqs - 36 to 46

36q. which enzyme is inhibited by aminophylline ?

a. monoamine oxidase

b. alcohol dehydrogenase

c. phosphodiesterase 

d. cytochrome P-450

answer: c . phosphodiesterase .

37q. milk-alkali syndrome may be caused by ingestion of ?

a. calcium carbonate

b. magnesium sulphate

c. aluminium trisilicate

d. aluminium hydroxide

answer: a . calcium carbonate .

38q. drugs used in obesity are ?

a. sibutramine

b. orlistat

c. insulin

d. mephenteramine

e. thyroxine

answer: a and b . sibutramine and orlistat .

39q. which of the following statements are true about isotretinoin ?

a. it is a vitamin A analogue

b. it is used in cystic acne

c. safe in pregnancy

d. used in psoriasis

e. bony hyperostosis is a side effect

answer: a , c , e . its use is unsafe in pregnancy and it is not used in psoriasis .

40q. OCP produces which of the following in the liver ?

a. cholangiosarcoma

b. adenoma

c. cirrhosis

d. atropic changes

answer: b . adenoma . hepatic adenoma is one of the side effects of long standing OCP .

41q. a drug is more likely to cause toxicity in elderly patients due to all of the following reasons except ?

a. decreased renal excretion of the drugs

b. decreased hepatic metabolism

c. increased receptor sensitivity

d. decreased volume of distribution 

answer: d . there is actually increased volume of distribution for fat soluble drugs in elderly individuals. this results in decreased elimination of the drug which leads to toxicity .

the other causes which lead to increased chance of drug toxicity in elderly are ( other than mentioned above in the options )

1. decreased lean body mass

2. decreased total body water 

check out a similar kind of question below

42q. all are reasons for reducing drug dosage in elderly except ?

a. they are lean and their body mass is less

b. have decreasing renal function with age

c. have increased baroreceptor sensitivity

d. body water is decreased 

answer: c. u must be wondering the above question states that receptor sensitivity increases with age and here this question states that it is true . but the statement that receptor sensitivity of the target organs increases with age is true for most of the target organs but not the baroreceptors . infact the sensitivity of the baroreceptors decreases with age . this leads to impaired blood pressure response to standing and volume depletion . therefore dosage should be increased in such situtaions . 

43q. find the true statement ?

a. antimalarial drug safe in pregnancy is chloroquine

b. anticoagulation drug safe in pregnancy is heparin

c. antithyroid drug safe in pregnancy is propyl thiouracil

d. muscle relaxant safe in pregnancy is d-tubocurarine 

e. all the statements are true

answer: e. all are true statements .

44q. a patient was started on antihypertensive medication and landed up in renal failure . which could be the probable offending drug here ?

a. beta blocker

b. alpha blocker

c. calcium channel blocker

d. ACE inhibitor

e. clonidine

answer: d . ACE inhibitor .

45q. PSVT is best treated by ?

a. adenosine

b. lidocaine

c. phenytoin

d. quinidine

answer: a . adenosine . 

46q. which of the following drug is contraindicated in pregnancy ?

a. clonidine

b. enalapril

c. methyl dopa

d. hydralazine

answer: b . enalapril . ACE inhibitors are absolutely contraindicated in pregnancy . 

33 - finasteride mcqs

Q: all  the following statements about finasteride are true except ?

a. it is used in the medical treatment of benign prostatic hypertrophy

b. impotence is well documented after its use

c. it blocks the conversion of dihydrotestosterone to testosterone

d. it is a 5 alpha reductase inhibitor

answer: c . it blocks the conversion of testosterone to dihydrotestosterone but not the reverse . 

such a tricky question , i wonder what the examiners think , that we are geniuses or wat ? anyway more info about finasteride here .

 Finasteride (marketed as Proscar, Propecia, Fincar, Finpecia, Finax, Finast, Finara, Finalo, Prosteride, Gefina, Appecia,Finasterid IVAX, Finasterid Alternova) is a synthetic antiandrogen which acts by inhibiting type II 5-alpha reductase, the enzyme that converts testosterone to dihydrotestosterone (DHT). It is used as a treatment in benign prostatic hyperplasia (BPH) in low doses, andprostate cancer in higher doses. A May, 2008 study indicates that Finasteride reduces the rate of prostate cancer by 30% . It is also indicated for use in combination with doxazosin therapy to reduce the risk for symptomatic progression of BPH. Additionally, it is registered in many countries for androgenetic alopecia (male-pattern baldness).

Finasteride was approved initially in 1992 as Proscar, a treatment for prostate enlargement, but the sponsor had studied 1 mg of finasteride and demonstrated hair growth in male pattern hair loss. On December 22, 1997, the U.S. Food and Drug Administrationapproved finasteride to treat male pattern hair loss.