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CNS Pharmacology - Pharmacology MCQ ACEM Exam | Questions With 100% Correct Answers| Verified
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CNS Pharmacology - Pharmacology MCQACEM Exam | Questions With 100%
Correct Answers| Verified
A young male presents with a high blood pressure, mydriasis and a high temperature.
Which drug has he most likely taken?
1. Adrenaline
2. Atropine
3. Cocaine
4. Naloxone - ANSWER 3. Cocaine
Cocaine is a sympathomimetic stimulant which causes cardiovascular, CNS and peripheral
sympathetic stimulation
Regarding Sodium Valproate, which of the following statements is CORRECT?
1. It is lipid soluble
2. It's VD is 0.6L/kg
3. T1/2 is 40 hrs
4. It has a high first pass metabolism - ANSWER 1. It is lipid soluble
VA is lipid soluble
VA Vd is 0.15L/kg
T1/2 is 9-18hrs
VA is well absorbed in oral administration and has bioavailability of 80%. It is 90% plasma
proteins BOUND.
Approximately 20% of VA is excreted as VA conjugate.
Which of the following statements regarding L-Dopa is CORRECT?
,1. Suddenly stopping it will cause tremor
2. L-dopa's half life is unaffected when given with Carbidopa
3. Ingesting L-dopa with food does not delay its absorption
4. Drug holidays are recommended to improve the the responsiveness to Levodopa - ANSWER
1. Suddenly stopping it will cause tremor
Dopamine DOES NOT cross BBB, but Levodopa - the dopamine precursor DOES.
The rate of ABSORPTION of Levodopa DEPENDS on gastric EMPTYING and pH. FOOD ingestion
DELAYS absorption.
Vast majority of Levodopa (97-99%) metabolised into Dopamine extracerebrally by
DECARBOXYLATION. Administration with decarboxylase INHIBITOR (Carbidopa) may
reduce daily need in Levodopa by 75%.
DRUG HOLIDAYS increase response to Levodopa, but because of potential complications (PE,
depression, DVT, aspiration pneumonia) they are NOT RECOMMENDED.
What is the most common adverse effect of Procainamide?
1. Fever
2. Bradycardia
3. Anaphylaxis
4. Hypotension - ANSWER 4. Hypotension
Nausea, diarrhoea ~10%
Rash, fever, hepatitis <5%
Lupus-like serology ~30% (not indication for stopping if no sxs)
Hypotension is due to GANGLION BLOCKING properties of Procainamide.
A patient complains of muscle pain post-operatively. Which of the following drugs is most likely
to cause this?
1. Suxamethonium
,2. Propofol
3. Ketamine
4. Atracurium - ANSWER 1. Suxamethonium
Myalgia due to depolarizing action of Suxamethonium.
Which of the following muscle relaxants has the longest duration of action?
1. Pancuronium
2. Atracurium
3. Rocuronium
4. Vecuronium - ANSWER 1. Pancuronium
Pancuronium - 35-45min
Atracurium - 20-35min
Rocuronium - 20-35min
Vecuronium - 20-35min
Mivacurium - 10-20min
Which of the following drugs has the greatest MAC?
1. Halothane
2. Nitrous Oxide
3. Methoxyflurane
4. Isoflurane - ANSWER 2. Nitrous Oxide
Halothane - 0.75%
N2O - 100%
Methoxyflurane - 0.16%
, Isoflurane - 1.4%
All the following drugs are anaesthetic agents except?
1. Glycopyrrolate
2. Midazolam
3. Etomidate
4. Propofol - ANSWER 1. Glycopyrrolate
At low dose, which of the following muscle relaxants is most commonly associated
with tachycardia?
1. Atracurium
2. Suxamethonium
3. Gallamine
4. Vecuronium - ANSWER 3. Gallamine
Gallamine increases HR by both VAGOLYTIC action and SYMPATHETIC stimulation.
Atracurium has no effects on autonomic ganglia or on cardiac muscarinic receptors
Suxamethonium causes various cardiac arrhythmias. The drug stimulates all autonomic
cholinoceptors. At low doses, it has more negative inotropic and chronotropic action; at higher
doses it has more positive inotropic and chronotropic effects. Bradycardia is common when a
second dose of the drug is given within 5 minutes.
Vecuronium, Pipecuronium, Rocuronium have little or no CVS effects.
Pancuronium causes a modest increase in HR and a smaller increase in cardiac output,
with little or no change in systemic vascular resistance.
Which of the following drugs is not an amide local anaesthetics?
1. Bupivicaine
2. Lignocaine
3. Prilocaine
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