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Paper I — 2022 July (Supplementary) (2019 Scheme) — Q8

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Paper I
2022 July (Supplementary) (2019 Scheme) · 100 marks · 180 min

Question

Selective COX-2 inhibitors (merits and demerits).

Q84 marksShort Answers

Answer

Selective COX-2 inhibitors (Celecoxib, Etoricoxib) selectively inhibit the inducible COX-2 isoform responsible for inflammatory prostaglandin synthesis, while sparing constitutive COX-1, which maintains gastric mucosal protection and normal platelet thromboxane function.

Merits:

  • Substantially lower risk of GI ulceration/bleeding than non-selective NSAIDs, since gastroprotective COX-1-derived prostaglandins are spared.
  • No antiplatelet effect (COX-1/thromboxane A2 spared), so no added bleeding risk from platelet dysfunction.
  • Equivalent analgesic and anti-inflammatory efficacy to non-selective NSAIDs.

Demerits:

  • Increased cardiovascular (thrombotic) risk with prolonged use — COX-2 inhibition suppresses vascular endothelial prostacyclin (an antiplatelet, vasodilator mediator) without the offsetting COX-1/thromboxane suppression that non-selective NSAIDs provide, shifting the hemostatic balance toward thrombosis.
  • Some renal toxicity, similar to non-selective NSAIDs (both COX-1 and COX-2 contribute to renal prostaglandin-mediated blood flow autoregulation).
  • Higher cost than non-selective NSAIDs.
  • Rofecoxib was withdrawn from the market specifically for excess cardiovascular risk, a cautionary example for the whole class.
  1. 1Autacoids

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  1. 1A 65-year-old lady presented with pain in both knees more on the left side. The pain is worsened by walking or standing for some time. X-Ray of knee shows narrowing of joint space, mild effusion and osteophytic projections. A diagnosis of Osteoarthritis of knee is made. She gave past history of ischemic heart disease a year back which was treated by angioplasty and a stent was placed. (2024 March (Supplementary) (2019 Scheme)Essay · 15 marks
  2. 2Enumerate drugs used in Peptic ulcer. Add a note on Prokinetic agents. (4+4)2022 July (Supplementary) (2019 Scheme)Short Essay · 8 marks
  3. 3(2024 June (Supplementary) (2019 Scheme)Short Essay · 8 marks
  4. 4(2023 January (Supplementary) (2019 Scheme)Short Essay · 8 marks
  5. 5Classify drugs used in Bronchial asthma. Discuss the management of Status Asthmaticus. (4+4) (PTO)2022 July (Supplementary) (2019 Scheme)Short Essay · 8 marks
  6. 6Aspirin.2023 July (Supplementary) (2019 Scheme)Short Essay · 8 marks
  7. 7Enumerate four groups of non-steroidal anti-inflammatory drugs with the example each. Describe the pharmacological actions, adverse effects and therapeutic uses of any one of them. (2+2+1+1=6)2015 February (2010 Scheme)Essay · 6 marks
  8. 8Classify non-steroidal anti inflammatory drugs. List the uses of NSAIDs. Mention four differences between aspirin and celicoxib. (2+2+2=6)2013 September (Supplementary) (2010 Scheme)Essay · 6 marks
  9. 9Therapeutic uses of Anti-histamines.2023 July (Supplementary) (2019 Scheme)Short Answer · 4 marks
  10. 10Mention four prostaglandin analogs and their respective clinical indications.2024 December (Supplementary) (2019 Scheme)Short Answer · 4 marks
  11. 11Treatment of Acute attack of gout2022 July (Supplementary) (2019 Scheme)Short Answer · 4 marks
  12. 12Enumerate the Merits and Demerits of selective Cox-2 Inhibitors2025 March (Supplementary (SAY)) (2019 Scheme)Short Answer · 4 marks
  13. 13Pharmacological basis of drugs used in treatment of Acute Migraine2022 February (2019 Scheme)Short Answer · 4 marks
  14. 14Sumatriptan.2024 March (Supplementary) (2019 Scheme)Short Answer · 4 marks
  15. 15Drugs used in migraine prophylaxis.2024 June (Supplementary) (2019 Scheme)Short Answer · 4 marks
  16. 16Therapeutic uses of Prostaglandins.2025 March (Supplementary) (2010 Scheme)Short Note · 3 marks
  17. 17Prophylaxis of migraine2018 July (Supplementary) (2010 Scheme)Short Note · 3 marks
  18. 18Second generation antihistamines2015 September (Supplementary) (2010 Scheme)Short Note · 3 marks
  19. 19Second generation H1 antihistaminic drugs2022 May (Supplementary) (2010 Scheme)Short Note · 3 marks
  20. 20Prophylaxis of migraine2021 February (Supplementary) (2010 Scheme)Short Note · 3 marks
  21. 21Drug therapy of migraine prophylaxis2020 February (Supplementary) (2010 Scheme)Short Note · 3 marks
  22. 22Cetirizine2019 February (2010 Scheme)Short Note · 3 marks
  23. 23Mast cell stabilizers.2025 March (Supplementary) (2010 Scheme)Short Note · 3 marks
  24. 24Uses of prostaglandins2018 July (Supplementary) (2010 Scheme)Short Note · 3 marks
  25. 25Clinical uses of prostaglandins2021 December (Supplementary) (2010 Scheme)Short Note · 3 marks
  26. 26Sumatriptan2024 March (Supplementary) (2010 Scheme)Short Note · 3 marks
  27. 27Sumatriptan2018 February (2010 Scheme)Short Note · 3 marks
  28. 28Histamine releasers2018 February (2010 Scheme)Short Answer · 1 mark
  29. 29H1 receptor blockers2017 August (Supplementary) (2010 Scheme)Short Answer · 1 mark
  30. 30Mention two selective Cox-2 inhibitors.2017 August (Supplementary) (2010 Scheme)Short Answer · 1 mark
  31. 31Anti emetics2017 February (2010 Scheme)Short Answer · 1 mark
  32. 32Clinical uses of prostaglandins2013 April (2010 Scheme)Short Answer · 1 mark
  33. 33Misoprostol in the treatment of Aspirin induced gastritis2024 March (Supplementary) (2010 Scheme)Short Answer · 1 mark
  34. 34Migraine.2016 February (2010 Scheme)Short Answer · 1 mark
  35. 35Mechanism of action of ondansetron2018 July (Supplementary) (2010 Scheme)Short Answer · 1 mark
  36. 36Mast cell stabilizers2013 April (2010 Scheme)Short Answer · 1 mark
  37. 37Anti emetics2016 October (Supplementary) (2010 Scheme)Short Answer · 1 mark
  38. 38Rationale of using low dose aspirin in post myocardial infarction.2018 February (2010 Scheme)Short Answer · 1 mark
  39. 39Non sedative antihistamines2014 March (2010 Scheme)Short Answer · 1 mark
  40. 40Triptans2017 February (2010 Scheme)Short Answer · 1 mark
  41. 41Treatment of migraine.2014 September (Supplementary) (2010 Scheme)Short Answer · 1 mark
  42. 42Non sedative antihistamines2013 September (Supplementary) (2010 Scheme)Short Answer · 1 mark
  43. 43The treatment of migraine.2015 February (2010 Scheme)Short Answer · 1 mark
  44. 44Mast cell stabilizers2023 July (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  45. 45Triptans2024 August (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  46. 46Selective COX-2 inhibitors.2025 August (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  47. 47Non-Steroidal Anti Inflammatory Drugs (NSAIDs)2024 March (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  48. 48Triptans2023 March (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  49. 49 Ondansetron in the treatment of Chemotherapy induced vomiting2025 August (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  50. 50Selective cyclooxygenase – 2 (COX-2) inhibitors2021 December (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  51. 51Cyclo-oxygenase inhibitor2023 July (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  52. 52Prostaglandin analogues2022 October (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  53. 53H2 Antihistamines2021 February (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  54. 54Mast cell stabilizers2021 February (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  55. 55Prostaglandin analogues.2023 July (Supplementary) (2019 Scheme)Short Answer · 0.2 marks
  56. 56Prostaglandin analogues.2022 July (Supplementary) (2019 Scheme)Short Answer · 0.2 marks
  57. 57Domperidone in chemotherapy induced emesis.2023 January (Supplementary) (2019 Scheme)Short Answer · 0.2 marks

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