CVS CNS Drugs: Frequently Repeated Yielding Topics for your NEET PG

CVS and CNS drugs
Power Mock CVS CNS Drugs

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CVS and CNS drugs are frequently repeated yielding topics for your NEET PG exit exam and AIIMS PG. 100 top picks from areas of  Hypertension, Heart failure, Antipsychotic Agents, Drugs Used in Parkinsonism and Hypnotic Drugs are covered in this PowerMock. 

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NOTE: 
1) CVS CNS Drugs: Starts on 27th September 2016 and ends on 29th September 2016 at midnight.
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Of the pharmacology topics CVS and CNS drugs are frequently repeated yielding topics for your NEET PG exit exam and AIIMS PG. 100 top picks from areas of  Hypertension, Heart failure, Antipsychotic Agents, Drugs Used in Parkinsonism and Hypnotic Drugs are covered in this PowerMock. This is highly recommended for platinum access candidates.

CNS is very important topic for PG examination point of view. The topics that should be more emphasized are Antipsychotics and Antidepressants. Read thoroughly on atypical antipsychotics and their advantage over typical antipsychotics. There is almost always a question on extrapyramidal side effects of typical antipsychotics in NBE exams. Opioids and Partial Antagonists are important topics and you need to remember the names and mechanisms.

Then there are Alcohol sedatives, though it is not very important topic but it is better that you have knowledge about it. In CVS you must focus on Antiarrhythmic and Antianginal drugs. You should also be well versed with the new JNC 8 guidelines for Treatment of Hypertension.

You obviously need not study complete Pharmacology for PG entrance exams. This article aims at providing assistance on most yielding topics to the PG aspirants in preparing pharmacology with a selective approach.

MCQ Challenge 1: A patient is initially treated with atenolol to lower her blood pressure. Which of the following is the mechanism of action of this medication?

A. Alpha-1 receptor blockade
B. Alpha-2 receptor stimulation
C. Calcium channel blockade
D. Selective beta-1 receptor blockade

Ans: D. Selective beta-1 receptor blockade

Atenolol is a selective beta-1 receptor blocker. It acts to decrease cardiac output, decrease heart rate, and decrease contractility, thus decreasing blood pressure.

Metoprolol and esmolol are also selective beta-1 receptor blockers.

Alpha-1 receptor blockers, such as terazosin and doxazosin, are used in the treatment of hypertension and benign prostatic hypertrophy.

Alpha-2 receptor stimulation is a mechanism of action used by clonidine. It is a centrally acting antihypertensive agent that lowers blood pressure and heart rate.

Calcium channel blockade in vascular smooth muscle causes vasodilation, and in the heart, causes a decrease in contractility. Examples of calcium channel blockers include nifedipine, verapamil, and diltiazem.
 
Also know:
Atenolol is an a 1-selective antagonist that is devoid of intrinsic sympathomimetic and membrane stabilizing activity. Atenolol is very hydrophilic and appears to penetrate the CNS only to a limited extent. Atenolol can be used to treat hypertension, coronary heart disease, arrhythmias, and angina pectoris, and to treat or reduce the risk of heart complications following myocardial infarction. It is also used to treat Grave’s disease until antithyroid medication can take effect.

MCQ Challenge 2: Lithium is used in a pregnant woman with bipolar disorder. Which of the following congenital anomaly occurs in foetus?

A. Tetralogy of Fallot
B. Tricuspid atresia
C. Ebstein anomaly
D. Pulmonary stenosis

Ans: C. Ebstein anomaly

Li+ is classified as risk category D. The use of Li+ in early pregnancy may be associated with an increase in the incidence of cardiovascular anomalies of the newborn, especially Ebstein’s malformation.
 
In pregnancy, maternal polyuria may be exacerbated by Li+. Fetal Li+ exposure is associated with neonatal goiter, CNS depression, hypotonia (“floppy baby” syndrome), and cardiac murmur.
 
Common cardiac side effects on long term therapy with Lithium:
  • T wave flattening or inversion
  • U waves
  • Prolonged QT interval
  • Sinus bradycardia
  • Sinoatrial block
  • First-degree atrioventricular block

MCQ Challenge 3: A 68-year old man with renal insufficiency and hypertension is prescribed enalapril. This agent is MOST likely to cause which of the following electrolyte disturbances?

A. Hyperkalemia
B. Hypernatremia
C. Hyperphosphatemia
D. Hypokalemia

Ans: A. Hyperkalemia

The angiotensin-converting enzyme (ACE) inhibitors are indicated for the treatment of hypertension, heart failure, and diabetic nephropathy. These agents may cause hyperkalemia and mild hyponatremia, as well as neutropenia, anaphylactoid reactions, angioedema, chronic cough, and fetal abnormalities. Laboratory evaluation should be performed periodically, especially for patients at risk for the development of hyperkalemia.

Risk factors for the development of hyperkalemia include renal insufficiency, diabetes mellitus, and use of potassium-containing products, including salt substitutes. These agents do not affect phosphate blood levels.

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The references for the above questions were from the following:

Q1) Westfall T.C., Westfall D.P. (2011). Chapter 12. Adrenergic Agonists and Antagonists. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman’s The Pharmacological Basis of Therapeutics, 12e.

Q2) Meyer J.M. (2011). Chapter 16. Pharmacotherapy of Psychosis and Mania. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds),Goodman & Gilman’s The Pharmacological Basis of Therapeutics, 12e.

Q3) Michel T., Hoffman B.B. (2011). Chapter 27. Treatment of Myocardial Ischemia and Hypertension. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman’s The Pharmacological Basis of Therapeutics, 12e.

This article is about CVS and CNS drugs are frequently repeated yielding topics for your NEET PG exit exam and AIIMS PG. CNS is very important topic for PG examination point of view. This article aims at providing assistance on most yielding topics to the PG aspirants in preparing pharmacology with a selective approach. It is a must attend for Platinum Access candidates.

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