Repeated Medical PG Question- 79

#PHARMACOLOGY (INI-CET)

Q-  Graph showing three drugs A, B & C. Which of the following drugs shown in the graph below has the highest potency?

A. Drug A

B. Drug B

C. Drug C

D. Both Drug A & B

Answer is A. Drug A

The line on the left is more potent.

Drug A is more potent.

Drug Potency: 

The position of DRC on the dose axis is the index of drug potency which refers to the amount of drug needed to produce a certain response.

A DRC positioned rightward indicates lower potency.

Relative potency is often more meaningful than absolute potency and is generally defined by comparing the dose (concentration) of the two agonists at which they elicit a half-maximal response (EC 50 ). 

Drug potency is clearly a factor in choosing the dose of a drug. 

Q-  Vitamin D toxicity is treated with

     A. Chloroquine

     B. Hydroxychloroquine

     C. Dexamethasone

     D. Ketoconazole

Answer is C. Dexamethasone

Dexamethasone is used in the treatment of hypercalcemia due to vitamin D toxicity. 

Glucocorticoid (Dexamethasone, prednisolone, etc) therapy will decrease plasma calcium levels by blocking the action of vitamin D(1,25 D) which results in reduced intestinal calcium absorption and increased urinary excretion of calcium. 

Other drugs like chloroquine and hydroxychloroquine are less effective in treating hypercalcemia due to vitamin D toxicity.

Q-  A 62-year-old Type 2 diabetic patient presents with complaints of malaise, myalgias, respiratory distress, and increased somnolence. If laboratory examination reveals an anion gap of 26 mmol/L, HCO3- of 17 mmol/L and an arterial blood pH of 7.27. You suspect lactic acidosis. The patient is most likely receiving which of the following?

        A. Glucagon

        B. Glyburide

        C. Metformin

        D. Miglitol

Answer is C.Metformin

Lactic acidosis, characterized by elevated blood lactate, decreased arterial blood pH, decrease bicarbonate, and electrolyte imbalances with an elevated anion gap (normal = 10 -12), is a rare but serious complication of metformin administration. 

The onset of lactic acidosis is usually accompanied by several non-specific signs and symptoms including malaise, myalgias, respiratory distress and increased somnolence. 

There may be associated hypothermia, hypotension, and resistant bradyarrhythmias as the condition progresses.

Option A. Glucagon is a polypeptide hormone produced by the alpha cells of the islets of Langerhans in the pancreas. It stimulates the conversion of glycogen to glucose in the liver. This hormone is available commercially to be administered in an intramuscular injection for the emergency treatment of severe hypoglycemia in diabetic patients when the administration of oral glucose is not possible. The most common adverse effects include pain at the site of the injection as well as hyperglycemia.

Option B. Glyburide is a sulfonylurea associated with the development of hypoglycemia and cholestatic jaundice (a rare complication).

Miglitol (option D) is an alpha-glucosidase inhibitor commonly associated with the development of abdominal discomfort and flatulence.