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1. Nalorphine is not useful clinically as an analgesic because:
A _ itis hallucinogenic
B its analgesic activity is too weak
C__ itis poorly absorbed from the gastrointestinal tract
D) itis emetic
2. When treating a patient with severe poisoning by a barbiturate, the
highest priority must be given to:
emptying the stomach and binding unabsorbed drug residues
assisting elimination of the unchanged drug by forced diuresis
maintaining a clear airway and adequate lung ventilation
increasing venous return and cardiac output by the intravenous infusion of fluid
prophylactic antibiotic therapy
increasing the arterial blood pressure by intravenous infusion
of pressor amines
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3. The most suitable muscle relaxant for a gastrectomy during which
the surgeon intends to use diathermy is:
A diazepam
B_ ether
C mephenesin
D _pancuronium
E — suxamethonium
76
Central nervous system pharmacology 77
The following paragraph describes the course of drugs given during a
short operation.
The patient was premedicated with atropine, chlorpromazine and
pentazocine. Anaesthesia was both induced and maintained by inhalation
of halothane. At this stage muscle relaxation was inadequate and was
made adequate by intravenous injection of tubocurarine. The operation
was completed in 20 minutes and the anaesthetic was discontinued.
Neostigmine was then injected. Overenthusiastic postoperative
administration of pentazocine required reversal and the drug of choice
was given intravenously.
Use this information for questions 491-500.
4. Why was chlorpromazine given?
to preclude excessive cardiovascular depression
to minimize pentazocine-induced respiratory depression
to potentiate the analgesic action of pentazocine
to improve muscle relaxation nyoaAw> to sedate and minimize the risk of vomiting
492 Immediately prior to induction of anaesthesia the patient’s pupils
would have been:
<A» dilated
‘B’ constricted
C of normal size
493 If nitrous oxide had been used instead of halothane, the rate of
induction would have been:
A faster
B slower
C about the same
494 Why was the first injection of atropine necessary?
A _ toincrease the heart rate following halothane-induced cardiac
depression
B___to reduce the heart rate following halothane-induced cardiac
stimulation
C to reduce exocrine secretions
D __ to minimize pentazocine-induced respiratory depression
78 Central nervous system pharmacology
495
496
497
498
499
500
Why was the injection of neostigmine necessary?
A __ toaccelerate recovery from the anaesthetic
B_ to overcome the action of atropine
C to overcome the action of tubocurarine
D to potentiate the pentazocine
Recovery from the anaesthetic action of halothane was due to:
A redistribution of the anaesthetic from the brain into other
tissues
B__ excretion of the unchanged drug from the lungs
C acute tolerance
D_ metabolism of the drug
What was the drug of choice for overcoming the action of
pentazocine?
A methylamphetamine
B__nikethamide
C doxapram
D naloxone
In the event of cardiac dysrhythmias occurring, which one of the
following drugs would exacerbate the problem?
A cocaine
B lignocaine
C phenytoin
D procainamide
E propranolol
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Would the combination of drugs used cause respiratory depression
during the operation to the extent of artificial ventilation being
necessary?
Asnsves
B no
If cyclopropane had been used instead of halothane, the likelihood
of cardiac dysrhythmias would have been:
A greater
B — smaller
C about the same
Central nervous system pharmacology 79
Type 2
Many drug molecules are optically active. Which is the pharmacologically
active isomer predominantly responsible for:
501 the respiratory stimulant action of amphetamine
502 the cough suppressant activity of methorphan
503 the respiratory depressant action of halothane
Options for 501-503:
A the Lisomer
B _ the d-isomer
C _bothisomers
Select the mechanism by which nausea and vomiting are induced by:
504 apomorphine
505 cyclophosphamide
506 digoxin
507 disulfiram
508 metronidazole
Options for 504-508:
A – gastric irritation
B labyrinthine stimulation
C inhibition of aldehyde dehydrogenase leading to accumulation of acetaldehyde which stimulates the chemoceptor
trigger zone
D _ stimulation of the chemoceptor trigger zone directly
E _ stimulation of the vomiting centre
Which substance best fits each description?
509 A convulsant that antagonizes the inhibitory transmitter yaminobutyric acid
510 A convulsant that antagonizes glycine at the cell body of the amotoneurone
§11 A CNS stimulant that releases noradrenaline and dopamine
Options for 509-511:
NY bicuculline
B~ doxapram
80 Central nervous system pharmacology
C methylphenidate
D _ nikethamide
E strychnine
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