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Subject Title: Pharmacology & Toxicology Subject Code: 0813
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Q. Sub Q. Answer Marking

No N. Scheme

1 Define any EIGHT of the following terms with two examples of each. 16M

1 a) Chemotherapy: 1M def.
It is defined as the use of chemical compounds in the treatment of infectious disease so as Any two
to destroy the microorganisms without damaging the host tissues. correct
Ex. Peniciliins, Cephalosporins, Tetracyclines, Streptomycin, Amoxycillin, etc. examples
1M.
b) Antiemetic:- 1M def.
These are the agents used in treatment of vomiting. Any two
Eg: Phenothiazine, Hyoscine, Meclizine, Promethazine, correct
examples
Domperidone, Ondansetron ,Chlorpromazine etc.
1M.

c) Haemostatic:- 1M def.
These are the pharmacological agents which when administered stop or arrest bleeding Any two
from capillary vessels. correct
E.g. Gelatin sponge, Oxidized cellulose, Fibrinogen, Thrombin, Thromboplastin, examples
Vitamin,K ,Ethamsylate 1M.
d) Antiarrhythmic agents:- 1M def.
These are the agents used to correct cardiac arrhythmia i.e. disturbance in cardiac rhythm. Any two
Eg: Quinidine, Procainamide, Propranolol, Lignocaine, Phenytoin, etc. correct
examples
1M.

e) Vermicidal:- 1M def.
These are the agents which kill parasitic worms. Any two
Ex. Piperazine, Mebendazole, Pyrantel pamoate, Tetramisole Albendazole etc. correct
examples
1M.
f) Autocoids:- 1M def.

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Autocoids are local hormones with high biological activity and naturally found in body as Any two
active or inactive forms. correct
Ex. Histamine, Serotonin, 5 hydroxytryptamine, Bradykinin, examples
Angiotensin, Prostaglandins etc. 1M.

g) Miotics:- 1M def.
These are the agents which produce miosis i.e. constriction of pupil. Any two
Eg. Parasympathomimetics like Physostigmine, Pilocarpine,Carbachol etc. correct
examples
1M.
h) Fibrinolytics:- 1M def.
The drugs which activate blood plasminogen to cause lysis / breakdown of thrombus are Any two
called fibrinolytics. correct
Ex. Urokinase, Streptokinase etc. examples
1M.
i) Analeptics:- 1M def.
These drugs stimulate central nervous system and stimulate the respiratory centre Any two
improving respiration. correct
examples
Examples: Caffeine, Amphetamine, Nikethamide, Doxapram, Bemigride etc.
1M.

j) Expectorants:- 1M def.
These are the drugs which increase the secretion of the respiratory tract, thereby reducing Any two
the viscosity of the mucus and help in its removal from the respiratory tract. correct
Eg: Ammonium chloride, Potassium iodide, Ammonium bicarbonate, Ipecac etc. examples
1M.
k) Diuretics:- 1M def.
These are the pharmacological agents which when administered, increase rate of Any two
formation of urine as well as excretion of urine. correct
Examples: Mannitol, Theophylline, Acetazolamide, Furosemide, Spironolactone, examples
Chlorothiazide etc. 1M.

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l) Disinfectants:- 1M def.
These are the pharmacological agents having bactericidal properties that can be directly Any two
applied on inanimate objects for making them free from microorganisms. correct
Examples: Phenols, Formaldehyde, Cresol, Chlorocresol, etc. examples
1M.

2 Attempt any FOUR of the followings 12M

2 a) Define Pharmacodynamics. Explain different mechanisms of drug action. 1M def.
Pharmacodynamics: It includes the study of mechanism of action and pharmacological Mecha.
effects of drug on biological system. It is what drug does to the body. 2M.
Different mechanisms of drug action:-
1) Physical action: physical property of drugs like adsorptive property or osmotic or
radio-opacity, Radioactivity.
Ex. Bulk laxative ispaghula
2) Chemical Action: Drugs act by chemical reaction
Ex. Antacids directly neutralizes gastric acid.
3) Enzyme inhibition or ion channel blocking: All biological reactions are carried out
by enzymes; if particular enzyme is inhibited there is loss of particular function.
Ex. ACE inhibitors: Enalapril, Captopril.
4) Receptors: Various drugs act by either stimulating or inhibiting receptors in the
body.
Ex. Salbutamol stimulates beta adrenergic receptor and produce bronchodilation
and help in bronchial asthma.
5) By altering metabolic processes: drugs like antimicrobial alter metabolic pathway
in microorganisms. Ex. Sulphonamide interfere with bacterial folic acid synthesis.
OR
1) Stimulation: Certain drugs produce their action by increasing the activity of
specialized cells.eg Caffeine stimulates brain cells, cardiac stimulants like
Digoxin stimulate cardiac cells

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2) Depression: Certain drugs produce their action by decreasing the activity of

specialized cells. E.g. CNS depressants like Diazepam, Phenobarbitone etc.
3) Replacement: Drugs can be used as replacement when production of endogenous
substance is reduced. E.g. Use of Insulin in Diabetes mellitus, also Hormone
replacement treatment
4) Inhibition of Microorganisms: e.g. antibiotics, antifungals etc.
5) Irritation: certain drugs produce changes in cellular structure and affect growth of
cells. G I irritants like Senna glycosides
6) Physical Action:
Drugs like kaolin act in mechanical way because of its adsorption property.
7) Chemical Reaction:
Drugs show their effect due to chemical reaction. E.g. Antacids neutralize gastric
acidity.

2 b) Explain plasma protein binding of drugs and give its significance. Explain
This is the phenomenon seen when the drug gets distributed in the blood plasma. Some 1.5M
drugs have affinity to get bound to plasma proteins depending upon their physicochemical Significa
Properties. So drugs may exist as Free drug (i.e. Unbound) & bound Drugs. Some drugs nce 1.5M
are highly protein bound: e.g. Sulpha drugs, Aspirin, warfarin, diazepam etc.
Significance:
1) Increase in duration of action of drugs:
To maintain dynamic equilibrium between free and bound drug, there would be release of
drug from protein bound fraction. Hence highly protein bound drug would have longer
duration of action and its dose & dosing frequency should be decided accordingly.
2) Possibility of drug interactions: drug interactions can occur when 2 or more drugs
having high protein binding affinity for the same plasma protein are given
simultaneously. This may result in displacement of one drug by the other & may result in
toxicity.
2 c) Define antagonism. Differentiate between competitive and non-competitive 1M Def.
antagonism. 2M for

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Define: The opposite action of two drugs on the same physiological system is called as any four
Antagonism. correct
Competitive antagonism ( Reversible) Non-competitive antagonism points
( Non-reversible)
1) Competitive antagonists bind to 1) Non-competitive antagonist binds
same receptor as agonist. to another site over the receptor
other than agonist.
2) Competitive antagonist chemically 2) Non-competitive antagonist does
resembles with agonist. not resemble with agonist.

3) Same maximal response can be 3) Maximal response cannot be

attained by increasing dose of attained by increasing dose of
agonist. agonist.
4) It reduces affinity 4) Non-competitive antagonist
reduces efficacy.
5) Response depends upon 5) Response depends only on
concentration of both agonist and concentration of antagonist.
antagonist.

6) Examples:Atropine,Propranolol 7) Examples Verapamil , Isoprenaline

etc. , Phenoxybenzamine etc

2 d) Classify oral hypoglycemic with examples. Give Mechanism of action of metformin. 2M

Classification:- Classific
1) Sulfonylureas ation
a) First generation:- Ex. Tolbutamide, Chlorpropamide 1M for
b) Second generation:-Ex. Glibenclamide, Glipizide, Gliclazide MOA.
2) Biaguanides: Metformin, Phenformin
3) Thiazolidinediones: Pioglitazone
4) Meglitinides: Repaglinides

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5) Alpha Glucosidase inhibitors: Acarbose

6) Newer agents: Sitagliptin, Extenaide, Canagliflozin etc.

OR
A. Enhance insulin secretion
1. Sulfonylureas
i) First generation:- Ex. Tolbutamide
ii) Second generation:-Ex. Glibenclamide, glipizide, gliclazide.
2. Meglitinides
Ex. Repaglinide, Nateglinide
3. Glucagon like peptide-1 receptor agonists
Ex. Exenatide, Liraglutide
4. Dipeptidyl peptidase-4 inhibtors
Ex. Sitagliptin, vildagliptin, Sexagliptin
B. Overcome insulin resistance
I) Biguanide: Ex. Metformin
II) Thaizolidinediones: Ex. Pioglitazone
C) Miscellaneous antidiabetic drugs
a) alpha glucosidase inhibitors: Ex. Acarbose, miglitol
b) Sodium glucose cotransport-2:- Dapagliflozin

Mechanism of action:-
Metformin decreases hepatic glucose production, decreases intestinal absorption of
glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and
utilization.
2 e) Define drug metabolism. Explain first pass effect. 1M def.
It is the alteration of drugs within living organism so as to modify its activity or nature. 2M Expl.

It is the chemical transformation of drug from one form to another within the body to

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make it easier for excretion.

First pass effect:-

A first-pass effect is defined as the rapid uptake and metabolism of an agent into inactive
compounds by the liver, immediately after enteric absorption and before it reaches the
systemic circulation.
2 f) Give advantages and disadvantages of intramuscular route of drug administration. 1.5M.
For any
Advantages:-
two
correct
1) Mild irritants, suspensions, colloids and injections with insoluble oily bases can be
points
administered in this route.
each
2) This route also ensures uniform and slow absorption of drugs which includes
drugs with low solubility as well as repository penicillin preparations.

Disadvantages:-

1) If proper care is not taken there is possibility of injury to the nerves.

2) Injected drug may produce local pain and abscess formation.
3) Total volume of drug injected is restricted up to 10 ml.
4) Certain intramuscular injections need more time for absorption as compared to
oral administration.

3 Attempt any FOUR of the followings 12M

3 a) Name the drug producing following effect: 0.5
i) Osteoporosis: Corticosteroids like Beclomethazone, cortisone; Antacids like EACH
Cimetidine,ranitidine; Anticovulsants like
Carbamazepine,phenobarbiotne,phenytoin; Tricyclic Antidepressants
;Anticancer drugs like Methotrexate;Heparin
ii) G6PD deficiency: Quinine, Pamaquine ,Primaquine, Quinidine, Aspirin,

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Sulphonamides, Antibiotics such as Quinolones, Nitrofurantoin

iii) Hypoglycemia: Insulin, Sulphonylureas, Pioglitazone
iv) Hyperplasia of gums:- Phenobarbital, Phenytoin
v) Extrapyramidal effect: Haloperidol and Fluphenazine,Chlorpromazine;
Metoclopramide
vi) Systemic alkalosis: Sodium Bicarbonate, thiazide diuretics etc

3 b) Mention the drug of choice in following condition: 0.5

EACH
i) Rheumatoid arthritis: NSAIDs, Prednisone, Hydroxychloroquine,
Sulphasalazine, Methotrexate,
ii) Candidiasis: Clotrimazole, Nystatin, fluconazole, Amphotericin B
iii) Atherosclerosis: Atorvastatin, Lovastatin, Gemfibrozil, Fenofibrate ,
Nicotinic acid, Ezetimibe etc.
iv) Skeletal muscle spasm: Chlorzoxazone, NSAIDs, Methocarbamol
v) Leprosy: Dapsone,Rifampicin,Clofazimine
vi) Depression: Amitriptyline, Imipramine, Phenelzine ,Fluoxetin

3 c) Mention the drug contraindicated in following condition: 0.5

EACH
i) Gastric bleeding: Aspirin, Clopidogrel, Heparin,Warfarin, Prednisone
ii) Hypokalemia: Diuretics, Chlorthiazide, Digitalis, Theophylline
iii) Edema: NSAIDs like ,Ibuprofen, Prednisone, Corticosteroids,
iv) Mysthenia Gravis: Streptomycin, Kanamycin
v) Lactation: Anticancer drugs, Cyclosporine, Radiopharmaceuticals
vi) Congestive cardiac failure: Calcium channel blockers, Verapamil and
Diltiazem, Quinidine

3 d) Give dose of following drugs: 0.5

i) Omeprazole: 20-40mg/day EACH
ii) Albendazole: 400 mg orally , Less than 60 kg: 15 mg/kg/day orally
iii) Diazepam: 2 to 10 mg orally 2 to 4 times a day orally

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iv) Diclofenac: 50 mg orally 3 times a day

v) Metoprolol: 25 mg or 50 mg orally twice a day
vi) Pioglitazone: 15 mg or 30 mg orally once a day.
3 e) Give adverse drug reaction of following drug: 0.5
i) Rifampicin: Orange-red coloured urine, Hepatotoxiciy, Nephritis EACH
ii) Nitroglycerin: Headache, Dizziness, light headedness, postural hypotension,
flushing
iii) Ibuprofen: Gastritis, allergic reaction, precipitation of bronchial asthma,
nephrotoxicity
iv) Digitalis: Hypokalemia, Cardiac arrhythmia ,Anorexia
v) Insulin: Hypoglycemia, Allergic reaction
vi) Kanamycin: Ototoxicity, Nephrotoxicity, teratogenicity
3 f) Give therapeutic use of following drugs: 0.5
EACH
i) Acyclovir: As antiviral agent in Chicken pox, Herpes
ii) Noscapine: As antitussive agent ,used in cough
iii) Indapamide: Diuretic, Antihypertensive
iv) Cetrizine: As antihistaminic, antiallergic,
v) Loperamide: As antidiarrheal agent
vi) Bisacodyl: As laxative, in treatment of constipation.

4 Attempt any FOUR of the followings 12M

4 a) Classify antiasthmatic agents with examples. 3M
a)Bronchodilators :
i) Sympathomimetic: Salbutamol, Terbutaline, Adrenaline, Isoprenaline, Ephedrine
ii) Xanthines: Theophylline, Aminophylline
iii) Anticholinergics: Atropine
b)Anti-inflammatory agents:
i) Systemic: Hydrocortisone, Prednisolone

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ii) Inhalational: Beclomethasone,Triamcinolone

c) Mast cell stabilizers: Disodium chromoglycate, Ketotifen
d) Other agents: Montelukast
4 b) Give the pharmacological profile of adrenaline. 3M

1. On Heart: - Adrenaline with its action on B-receptors of heart increases heart rate,
force of contraction and cardiac activity.

2. On Blood vessels and blood pressure: - The blood vessels of skin and mucous
membrane are constricted. Adrenaline dilates blood vessels of skeletal muscles by acting
on B-receptors. The net result is thus decrease in peripheral resistance. It show biphasic
response in moderate dose

3. On Smooth muscles:-It causes relaxation of smooth muscles of bronchi, GIT, uterus

etc. It is a powerful bronchodilator

4.Central Nervous system:- Therapeutic doses of adrenaline may give rise to tremors,
restlessness, palpitation and apprehension

5. Metabolism:- It produces hyperglycemia by accelerating glycogenolysis in the liver.

6. Antiallergic action: - Adrenaline is a physiological antagonist of histamine and

counters the bronchoconstriction and hypotension of anaphylactic shock.

7. If combined with local anesthetic prolongs its action locally.

4 c) Define haematinics. Explain: Vitamin B12 injection is given in pernicious anaemia. 1M defn.
2M
Haematinics: Are the drugs which when administered favour erythropoiesis i.e. synthesis
Expln.
of red blood cells and increase the oxygen carrying capacity of the blood.

Eg: cynocobalamine, folic acid, iron etc.

Pernicious anaemia is a type of vitamin B12 deficiency that results from impaired uptake
of vitamin B12 due to the lack of a substance known as intrinsic factor produced by the

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stomach lining.

So Vitamin B12 injection is given in pernicious anaemia because oral absorption is not
possible due to lack of intrinsic factor

4 d) Define epilepsy. Justify: During the treatment of epilepsy antiepileptic drugs should 1M def.
not be withdrawn abruptly. 2M Expl.
Epilepsy is neurological disorder characterized by sudden periodic attacks of motor,
sensory or psychological malfunction. The attacks called as seizures are initiated by the
abnormal & irregular discharges of electricity from millions of neurons in the brain.
Epilepsy is a periodic disturbance in the rhythm of the brain.

The drugs used for the treatment of epilepsy require long term administration in order to
prevent epileptic attacks.
Since the antiepileptics mainly act by depressing the CNS, they may lead to recurrence of
epileptic attack if withdrawn suddenly.
So, during the treatment of epilepsy, drugs should be withdrawn gradually to avoid
withdrawal syndrome.
4 e) Classify Parasympathomimetics with examples. 1.5M
Types
Parasympathomimetics- These are the drugs which produce the actions similar to those
1.5M
seen by the stimulation of parasympathetic nervous system.
Example
Classification:
s
- Methacoline, carbachol, Acetylcholine

- Piolcarpine, Muscarine

olinestrase inhibitors-

a) Reversible :-Neostigmine, physostigmine, pyridostigmine.

b) Ireversible:- Organophosphorus compounds, (malathion, parathion)

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4 f) Discuss the stages of general anaesthesia. Give two examples of parenterally 2M for
administered general anaesthetics. stages
1M for
Stages of anaesthesia
any two
i. Stage of analgesia correct
examples
ii. Stage of delirium or excitement

iii. Stage of surgical anaesthesia

iv. Stage of respiratory paralysis

STAGE 1- Stage of analgesia --- This stage is characterized by loss of pain sensation.
Minor surgical operations and dental extractions are performed in stage

STAGE 2-Stage of delirium --- This stage is characterized by excitement, thus no surgical
procedures are performed in this stage

STAGE 3- Stages of Surgical Anaesthesia:

As more anaesthetic agents gets in deep breathing starts and the patient passes into the
third stage of anaesthesia. The stage extends from the end of second stage until cessation
of spontaneous respiration. The effects of this stage are recognized by following signs:

1. Regular respiration is regained after second stage.

2. Skeletal muscles are relaxed.

3. The gradual loss of reflexes such as eyelid and conjunctival reflexes and

4. The eye balls are roving.

Major surgical operation is done in this stage.

STAGE 4- Stage of respiratory paralysis--- Excessive administration of anaesthetic agent

may lead to this stage. It is characterized by stoppage of breathing, fall of blood pressure

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and cardiac collapse. It leads to the death.

Examples Of general anaesthetic:

By Inhalation: Diethyl ether, Halothane, Trichloroethylene, Nitrous oxide.

By intravenous : Thiopental sodium, Methohexital, Etomidate, Ketamine, Propofol

5 Attempt any FOUR of the following: 12M

5 a) Classify antihypertensives with examples. 3M

Classification (According to site of action):
1. Centrally acting Drugs: Clonidine, Methyl Dopa
2. Drugs acting on autonomic ganglia: Hexamethonium
3. Drugs acting on post ganglionic sympathetic nerve endings
a) Adrenergic neuron blockers; Guanethidine
b) Catecholamine depletors: Reserpine
4. Drugs acting on adrenergic receptors:
a)Alpha adrenergic blockers: Phentolamine
b) Beta adrenergic blockers: Propranolol
5. Vasodilators: Hydralazine
6. Drugs acting reflexly by stimulating baroreceptors: Veratrum
7. Oral Diuretics: Thiazides, Frusemide, spironolactone, amilorideetc
8. Calcium Channel Blockers: Nifedipine, Amlodipine, Felodipine
9. Drugs acting on rennin angiotensin system:
a) ACE inhibitors: Enalapril, Ramipril
b) Angiotensin Receptor Blockers: Losartan, Telmisartan
10.Miscellaneous: MAO inhibitors (Pargyline)
5 b) What is cancer? Give examples of two anticancer drugs. Mention common side 1M def.
effects of anticancer drugs. 1M.any 2
Cancer is uncontrolled growth of abnormal cells. It is characterized by excessive cell correct
growth (in the form of tumor), ability to metastasize & a shift of cellular metabolism. examples

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Examples of anticancer drugs: 1M any 4

Chlorambucil, Cyclophosphamide,Busulphan Methotrexate, 6- side
mercaptopurine, 5-Flurouracil, Cytosine,Radioiodine, Radiophosphorous, effects
Mitomycin, Actinomycin,Vincristine,Vinblastine etc.
Common side effects of anticancer drugs:
 Anemia ,Tiredness.
 Nausea, vomiting.
 Loss of appetite.
 Constipation or diarrhoea.
 Hair loss.(Alopecia )
 Skin changes or reactions, Joint Pain
 Electrolytes changes
 Cardiac side effects
5 c) Classify antibiotics with example. 3M.
Classification of antimicrobial agents can be based on: Their site of action or Chemical
structure or Activity against particular type of organisms.

Based on site of action antibiotics can be classified as:

1. Inhibitors of cell wall synthesis eg Penicillins
2. Inhibitors of cell membrane function eg Polymixin
3. Inhibitors of protein synthesis eg Tetracyclins
4. Inhibitors of nucleic acid synthesis/ function; eg Rifampicin
5. Inhibitors of metabolism eg Sulpha drugs

Or
 Effective against gram +ve bacteria: Penicillin etc
 Effective against gram -ve bacteria: Streptomycin etc
 Effective against both gram +ve & gram -ve bacteria:

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Tetracycline, Chloramphenicol.etc

Effective topically :Framycetin ,Polymixin B,neomycin etc

Any other correct classification can be considered.

5 d) Define analgesics. Justify: Morphine should not be given in abdominal pain. 1M Defn
Analgesics: 2M
These are the pharmacological agents which relieve or suppress the pain sensation. Jstifn
Examples: Narcotic analgesics like Morphine, Codeine etc., Non narcotics like Aspirin,
Paracetamol, Indomethacin, Ibuprofen, Piroxicam, Diclofenac etc.

Justify: Morphine should not be given in abdominal pain.

Morphine is not given in severe abdominal pain before diagnosis is made because
morphine is narcotic analgesic which relieves pain without modifying the underlying
pathological process. It interferes with the diagnosis by masking pain and creates a false
sense of security. It also induces vomiting. Its spasmogenic actions on the G.I.T. and
biliary tract are additional drawbacks.
Therefore morphine is not given in severe abdominal pain before diagnosis is made.

5 e) Give pharmacological profile of aspirin. 3M for

i) Analgesia- aspirin relieve pain by acting centrally as well as peripherally by any six
inhibiting the formation of prostaglandins. Epigastric distress, gastric bleeding points
and ulcers.
ii) Antipyrexia- aspirin reduce body temperature by acting on hypothalamus
(central effect)
iii) Action on Gastrointestinal Tract: Aspirin causes GI irritation,.nausea,
vomiting, dyspepsia, epigastric distress, gastric bleeding and ulcers.
iv) Uricosuric effect- In large doses it inhibits reabsorption of urate by nephron.
This results in uricosuria.
v) Anti-inflammatory- aspirin acts as potent anti-inflammatory agent by

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inhibiting prostaglandin synthesis. It decreases capillary permeability, reduces

exudation of fluid & reduces development of inflammatory edema.
vi) On blood- aspirin reduces platelet aggregation
vii) On respiration- Aspirin stimulates respiration by direct action on medullary
respiratory centre. It increases oxygen consumption by skeletal muscles
thereby increasing plasma CO2 concentration.
viii) Hepatic and renal effects- may damage liver and kidneys in large doses.
ix) Metabolic effects- aspirin causes conversion of large part of energy into heat.
So it may cause hyperpyrexia in large doses. It may also cause hypoglycaemia.
5 f) Give symptoms and management of acute barbiturate poisoning. 1M
Symptoms:- Sympto
Shallow respiration, fall in B.P., cardiovascular collapse, renal shut down, pulmonary ms
complications, bullous eruptions. 2M
Management:- Manage
Gastric lavage: - leave a suspension of activated charcoal in the stomach to prevent ment
absorption of the drug from intestine.
Artificial respiration: Endo tracheal intubation: to treat hypoventilation
Supportive measures: Intravenous fluids to prevent dehydration, to maintain blood
volume and use of vasopressor if needed.
Alkaline diuresis: - with sodium bicarbonate 1meq/kg iv. With or without mannitol (is
helpful only in the case of long acting barbiturates which are eliminated primarily by
renal excretion).
Use of analeptic if needed
6 Give reasons for any FOUR of the following: 16M
6 a) Sulphonamides are not much in use nowadays. 4M
Sulphonamides show a number of side effects such as intolerance, fever, severe skin
rashes, joint pain, toxic hepatitis, toxic nephritis, acute haemolytic anemia. It causes renal
irritation, crystallurea, haematuria and obstruction of urine flow. Bacterial resistance is
also a problem with sulpha drugs.

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 MAHARASHTRA STATE BOARD OF TECHNICAL EDUCATION
(Autonomous)
(ISO/IEC - 27001 - 2013 Certified)
MODEL ANSWER
SUMMER 2019 EXAMINATION
Subject Title: Pharmacology & Toxicology Subject Code: 0813
________________________________________________________________________________________________

Since better drugs are available with fewer side effects for the treatment of diseases,
Sulponamides are not much in use now a days.

6 b) Atropine is given along with neostigmine in myasthenia gravis. 4M

Myasthenia gravis is a skeletal muscle disorder causing muscle weakness and muscle
fatigue. Nicotinic receptors are present in skeletal muscles and muscarinic receptors are
present in heart blood vessels and eye balls. Neostigmine acts on both the receptors. In
myasthenia gravis, only nicotinic action of neostigmine is required. Hence to mask the
muscarinic actions of neostigmine, and thus to avoid the side effects, the muscarinic
blocker atropine is given in combination
6 c) Levodopa is given in combination with carbidopa. 4M
Levodopa is the precursor of dopamine. And is used in treatment of parkinsonism.
Levodopa can cross the blood brain barrier but dopamine cannot.
In brain, L-dopa is metabolized to dopamine thereby replenishing the deficient
neurotransmitter.
The metabolism takes place in the presence of DOPA decarboxylase.
Large amount of L-Dopa gets peripherally converted to dopamine and thus small amount
reaches the brain. To overcome this problem, higher dose of Levodopa is required to
increase the clinically effective level of dopamine in the brain which results in toxicity.
Carbidopa does not cross the blood brain barrier but it inhibits peripherally dopa
decarboxylase. Thus Carbidopa does not interfere with the conversion of L-dopa to
dopamine in the CNS but prevents the conversion of Levodopa to dopamine peripherally.
6 d) Penicillin are called lifesaving as well as life threatening drug. 4M
Penicillin is an antibiotic used in different diseases like Syphillis ,Gonorrhea, Diphtheria,
Gangrene, Tetatus, Meningitis etc. Thus it is a lifesaving drug.
Penicillin in therapeutic dose if randomly administered by parenteral route to an
individual without checking its allergy, then it may produce severe allergic reaction such
as anaphylactic shock. Hence it is a life threatening drug.
6 e) Quinidine is given to patient who is on digoxin therapy. 4M
Quinidine is antiarrythmic drug while Digoxin is Cardiotonic drug.

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 MAHARASHTRA STATE BOARD OF TECHNICAL EDUCATION
(Autonomous)
(ISO/IEC - 27001 - 2013 Certified)
MODEL ANSWER
SUMMER 2019 EXAMINATION
Subject Title: Pharmacology & Toxicology Subject Code: 0813
________________________________________________________________________________________________

Major adverse effect of digoxin is that it causes cardiac arrhythmias like extra systole &
Bradycardia. Quinidine reduces heart rate and automaticity and corrects arrhythmia.
Hence to avoid cardiotoxicity induced by digoxin, quinidine may be given.
(Note: In some cases, Quinidine is found to increase the Digoxin serum concentration and
may induce Digoxin toxicity and thus Digoxin- Quinidine interaction should be avoided
or precautions should be taken.)
6 f) Higher the therapeutic index, safer will be drug. Justify the statement. 4M
Therapeutic index indicates the relative margin of safety of a drug. A dose of the drug
which produces the stated effects in 50% of individuals within the population is called as
‘median dose’. Depending on the stated effect it can be designated as ‘median effective
dose’ (ED50) and median lethal dose (LD50).
Therapeutic Index(TI) = LD50
ED50

The TI indicates how close the effective does is to the lethal dose for 50% of the test
population. Thus, it gives an idea about the margin of safety.
As the ED50 approaches the LD50, the danger of the drug toxicity increases significantly.
Therefore, a drug with larger therapeutic index is safer than one with smaller therapeutic
index. Hence, drug with lesser therapeutic index should be administered cautiously.

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