Which of the following is a pharmacological property of chlorpromazine?
A) antihistamine
B) anti emetic drug
C) cholinesterase inhibitor
D) selective serotonin reuptake inhibitor
The correct answer is B) anti-emetic drug.
While chlorpromazine is primarily known as a "typical" antipsychotic, it is a pharmacological "Swiss Army knife" because it interacts with several different receptor systems in the body.
Why Chlorpromazine fits these categories:
1. Anti-emetic (The Correct Choice)
Chlorpromazine blocks dopamine (D2) receptors in the chemoreceptor trigger zone (CTZ) of the brain.
2. Antihistamine (The "Almost" Choice)
This one is tricky! Chlorpromazine does have antihistamine properties (it blocks H1 receptors), which contributes to its sedative effects. However, in a pharmacological or board-exam context, it is categorized as a neuroleptic/antipsychotic or an anti-emetic, whereas "antihistamine" usually refers to drugs like diphenhydramine.
3. What it is NOT
Cholinesterase inhibitor: Chlorpromazine actually has anticholinergic effects (it blocks acetylcholine receptors), which is the opposite of what a cholinesterase inhibitor does.
SSRI: It does not selectively inhibit serotonin reuptake; that is the mechanism of antidepressants like Prozac (fluoxetine).
| Receptor Blocked | Clinical Effect |
| Dopamine (D2) | Antipsychotic & Anti-emetic |
| Histamine (H1) | Sedation |
| Alpha-1 (alpha1) | Orthostatic hypotension (dizziness upon standing) |
| Muscarinic (M1) | Dry mouth, blurred vision |
📌 Exam tip:
When both antihistamine and anti-emetic are options for chlorpromazine, choose anti-emetic.
Which of the following medications promotes ripening and clation of the cervix during labor?
A) atosiban
B) ntric oxide
C)misoprostol
D) magnesium sulfate
The correct answer is C) misoprostol.
Cervical ripening is a crucial phase of labor where the cervix softens, thins (effaces), and begins to dilate. Misoprostol is a synthetic prostaglandin E1 (PGE1) analog that is highly effective for this process.
How Misoprostol Works
Misoprostol acts by breaking down collagen fibers in the cervix and increasing submucosal water content. This transforms the cervix from a rigid structure to a soft, pliable one that can easily dilate. It also stimulates the smooth muscles of the uterus to contract.
Breakdown of the Options:
C) Misoprostol (Correct): Used for both cervical ripening and labor induction. It can be administered orally or vaginally.
A) Atosiban: This is a tocolytic (an oxytocin antagonist). Its job is to stop preterm labor by inhibiting uterine contractions, not to promote them.
B) Nitric Oxide: While it can cause smooth muscle relaxation, it is not a standard clinical medication for promoting cervical ripening during labor; in some contexts, it's actually studied for its ability to relax the uterus.
D) Magnesium Sulfate: Primarily used as a tocolytic to delay preterm labor or as an anticonvulsant to prevent seizures in preeclampsia. Like Atosiban, it generally inhibits uterine activity rather than promoting cervical changes.
Comparison of Induction Agents
| Medication | Class | Primary Use in Labor |
| Misoprostol | Prostaglandin E1 | Cervical ripening & induction |
| Dinoprostone | Prostaglandin E2 | Cervical ripening |
| Oxytocin | Pituitary Hormone | Stimulating contractions (after ripening) |
📌 Exam point:
Prostaglandins (PGE₁, PGE₂) are drugs of choice for cervical ripening.
The correct answer is D) use of drug for unapproved indications.
"Off-label" use sounds a bit like it might be illegal or "under the table," but it is actually a very common and legal practice in medicine. It occurs when a doctor prescribes a medication that has been FDA-approved (or approved by a similar regulatory body) for one purpose, but uses it for a different purpose that hasn't gone through that specific formal approval process yet.
What constitutes "Off-Label" use?
A drug is considered off-label if it is used in any way that differs from the official package insert. This includes:
Unapproved Indications: Using a drug for a different disease (e.g., using a blood pressure medication to prevent migraines).
Different Dosage: Giving a dose higher or lower than what is officially recommended.
Different Patient Groups: Using a drug for children or pregnant women when it was only officially tested and approved for adult men.
Different Route of Administration: Using a medication as a liquid spray when it was approved as a pill.
Why do doctors do this?
Medicine often moves faster than the legal approval process. If clinical trials or high-quality studies show that a drug is effective for a new condition, doctors may start using it "off-label" years before the manufacturer spends the millions of dollars required to officially update the label.
Why the other options are incorrect:
A) Use of drug without prescription: This is simply illegal or "over-the-counter" (OTC) use, depending on the drug.
B) Use of drug expiration date: This refers to the "shelf life" or potency of the medication.
C) Use of drug outside the hospital: This is just "outpatient" care or home administration.
Common Examples of Off-Label Use
| Drug | Approved Use | Common Off-Label Use |
| Prazosin | High blood pressure | PTSD-related nightmares |
| Gabapentin | Seizures / Shingles pain | Anxiety or Alcohol withdrawal |
| Quetiapine | Schizophrenia | Insomnia (at low doses) |
| Propranolol | Hypertension / Heart issues | Performance anxiety (stage fright) |
📌 Exam tip: Off-label ≠ illegal. It is legal and common when supported by evidence.
The correct answer is C) tamsulosin.
Tamsulosin is one of the most common medications used to manage the symptoms of Benign Prostatic Hyperplasia (BPH), or an enlarged prostate.
How Tamsulosin Works
Tamsulosin is an alpha-1 (α₁) adrenergic receptor antagonist.
In the case of BPH, the enlarged prostate puts pressure on the urethra, making it difficult to urinate.
Reduces the "squeeze" on the urethra.
Improves urine flow.
Decreases the feeling of urgency or incomplete emptying.
Breakdown of the Options:
C) Tamsulosin (Correct): An alpha-blocker used to improve urination in men with enlarged prostates.
A) Donepezil: An acetylcholinesterase inhibitor used to treat Alzheimer’s disease by increasing levels of acetylcholine in the brain.
B) Etanercept: A TNF-inhibitor (biologic) used to treat autoimmune conditions like rheumatoid arthritis or psoriasis.
D) Carbidopa: Always used in combination with Levodopa to treat Parkinson’s disease by preventing the premature breakdown of dopamine before it reaches the brain.
BPH Treatment Options
Clinicians usually choose between two main classes of oral medications for BPH:
| Drug Class | Example | Mechanism |
| Alpha-1 Blockers | Tamsulosin | Relaxes smooth muscle (fast-acting). |
| 5-Alpha Reductase Inhibitors | Finasteride | Shrinks the prostate gland over time by blocking DHT. |
📌 Exam tip: Drugs ending in “-osin” (tamsulosin, prazosin, doxazosin) → BPH treatment.
What is the therapeutic use of salbutamol?
A) antibiotic
B) anti emetic
C) anticoagulant
D) bronchodilator
The correct answer is D) bronchodilator.
Salbutamol (also known as albuterol in the United States) is the classic "rescue inhaler" used to provide quick relief from breathing difficulties.
How Salbutamol Works
Salbutamol is a short-acting beta-2 agonist (SABA).
When these receptors are activated, the muscles relax, causing the airways to open up—a process called bronchodilation. This makes it much easier for air to flow in and out of the lungs.
Therapeutic Uses:
Acute Asthma Attacks: Rapid relief of wheezing and shortness of breath.
COPD: Management of chronic obstructive pulmonary disease symptoms.
Exercise-Induced Bronchospasm: Taken shortly before exercise to prevent the airways from narrowing.
Hyperkalemia (Off-label): In hospital settings, it can be used to help shift excess potassium from the blood into the cells.
Why the other options are incorrect:
A) Antibiotic: These treat bacterial infections (e.g., Penicillin). Salbutamol has no effect on bacteria.
B) Anti-emetic: These prevent nausea and vomiting (e.g., Ondansetron or the Chlorpromazine we discussed earlier).
C) Anticoagulant: These are "blood thinners" that prevent clots (e.g., Warfarin or Heparin). The correct answer is D) bronchodilator.
Salbutamol (also known as albuterol in the United States) is the classic "rescue inhaler" used to provide quick relief from breathing difficulties.
How Salbutamol Works
Salbutamol is a short-acting beta-2 (
$\beta_2$) agonist (SABA). It works by stimulating specific receptors ( $B_2$ receptors) located on the smooth muscle cells lining the airways (bronchioles) in the lungs. When these receptors are activated, the muscles relax, causing the airways to open up—a process called bronchodilation. This makes it much easier for air to flow in and out of the lungs.
Therapeutic Uses:
Acute Asthma Attacks: Rapid relief of wheezing and shortness of breath.
COPD: Management of chronic obstructive pulmonary disease symptoms.
Exercise-Induced Bronchospasm: Taken shortly before exercise to prevent the airways from narrowing.
Hyperkalemia (Off-label): In hospital settings, it can be used to help shift excess potassium from the blood into the cells.
Why the other options are incorrect:
A) Antibiotic: These treat bacterial infections (e.g., Penicillin). Salbutamol has no effect on bacteria.
B) Anti-emetic: These prevent nausea and vomiting (e.g., Ondansetron or the Chlorpromazine we discussed earlier).
C) Anticoagulant: These are "blood thinners" that prevent clots (e.g., Warfarin or Heparin).
Key Facts at a Glance
Feature Description Onset of Action Very fast (5–15 minutes) Duration Short-acting (lasts about 4–6 hours) Common Side Effects Tremors (shaky hands), increased heart rate (tachycardia), and palpitations 📌 Exam tip: β₂ agonists = bronchodilators
Example: salbutamol, terbutaline
Which of the following medication has a side effect metallic taste ?
A)cefuroxime
B)azithromycin
C)ciprofloxacin
D)metronidazole
The correct answer is D) metronidazole.
Metronidazole is an antibiotic and antiprotozoal medication widely known for causing a distinct, often unpleasant metallic taste (dysgeusia) in the mouth.
Why Metronidazole causes a Metallic Taste
While the exact biological reason isn't fully settled, researchers believe the drug or its metabolites are secreted into the saliva. Because metronidazole contains a specific chemical structure (a nitroimidazole ring) that can interact with taste receptors, it leaves a lingering "copper" or "tin-like" sensation.
Important Clinical Note: The "Antabuse" Effect
If you are taking metronidazole, it is critical to avoid alcohol.
Severe nausea and vomiting
Flushing of the face
Rapid heartbeat (tachycardia)
Intense headaches
Breakdown of the Options:
D) Metronidazole (Correct): Used for anaerobic bacterial infections, dental abscesses, and parasites (like Giardia).
Metallic taste is its "trademark" side effect. A) Cefuroxime: A second-generation cephalosporin.
Common side effects are usually GI-related (diarrhea/nausea), but not a metallic taste. B) Azithromycin: A macrolide antibiotic.
It is more likely to cause stomach cramps or "motility" issues than taste changes. C) Ciprofloxacin: A fluoroquinolone.
While it has many side effects (like tendon issues), a metallic taste is not a primary characteristic.
Other Medications Known for "Metallic Taste"
If you encounter this question again, keep these other common "metallic taste" culprits in mind:
Clarithromycin (another antibiotic)
Lithium (used for bipolar disorder)
Metformin (used for Type 2 Diabetes)
Zopiclone (a sleep medication)
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