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Paper I — 2022 February (2019 Scheme) — Q12

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

Question

Therapeutic uses and adverse effects of Neostigmine

Q124 marksShort Answers

Answer

Neostigmine is a reversible anticholinesterase, quaternary (does not cross the blood-brain barrier), with prominent direct skeletal-muscle action.

Therapeutic uses:

  • Myasthenia gravis — first-line symptomatic therapy, allowing acetylcholine to interact repeatedly with the reduced pool of available receptors.
  • Reversal of non-depolarizing neuromuscular blockade — raises ACh concentration at the NMJ enough to out-compete a competitive blocker (given with atropine to block accompanying muscarinic effects).
  • Postoperative urinary retention and paralytic ileus — increases smooth muscle tone in gut/bladder while relaxing the corresponding sphincters, promoting peristalsis/evacuation and bladder voiding.

Adverse effects: muscarinic overactivity — salivation, sweating, bradycardia, bronchospasm, GI cramps/diarrhea; cholinergic crisis (muscle weakness paradoxically worsening) with overdose, distinguishable from a myasthenic crisis by the edrophonium test.

  1. 1Cholinergic System

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  1. 1(2024 March (Supplementary) (2019 Scheme)Short Essay · 8 marks
  2. 2(2023 July (Supplementary) (2019 Scheme)Short Essay · 8 marks
  3. 3A man aged 45 years presented with complaints of gradual onset double vision, drooping eyelids, difficulty in chewing food and weakness of limbs which is accentuated by exercise. The symptoms fluctuate in intensity over time. A provisional diagnosis of Myasthenia gravis is made.2025 March (Supplementary) (2010 Scheme)Essay · 6 marks
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  14. 14Pharmacological management of Myasthenia gravis.2022 July (Supplementary) (2019 Scheme)Short Answer · 4 marks
  15. 15Treatment of organophosphorus poisoning2013 September (Supplementary) (2010 Scheme)Short Note · 3 marks
  16. 16Drug treatment of anti cholinesterase poisoning2013 April (2010 Scheme)Short Note · 3 marks
  17. 17Neostigmine2021 December (Supplementary) (2010 Scheme)Short Note · 3 marks
  18. 18Treatment of organophosphorous poisoning2014 September (Supplementary) (2010 Scheme)Short Note · 3 marks
  19. 19Atropine2015 February (2010 Scheme)Short Note · 3 marks
  20. 20Therapeutic uses and adverse effects of atropine.2016 October (Supplementary) (2010 Scheme)Short Note · 3 marks
  21. 21Neostigmine.2017 August (Supplementary) (2010 Scheme)Short Note · 3 marks
  22. 22Edrophonium2018 February (2010 Scheme)Short Note · 3 marks
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  27. 27Explain briefly why physostigmine is preferred over neostigmine for the treatment of glaucoma.2015 February (2010 Scheme)Short Answer · 1 mark
  28. 28Anti- muscarinic drugs2017 August (Supplementary) (2010 Scheme)Short Answer · 1 mark
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  34. 34Rationale for use of pilocarpine in glaucoma2018 July (Supplementary) (2010 Scheme)Short Answer · 1 mark
  35. 35Two uses and two adverse effects of atropine2014 March (2010 Scheme)Short Answer · 1 mark
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  38. 38Cholinesterase reactivators2015 September (Supplementary) (2010 Scheme)Short Answer · 1 mark
  39. 39Atropine as antisecretory agent2019 February (2010 Scheme)Short Answer · 1 mark
  40. 40The preferred first-line pharmacologic treatment for open-angle glaucoma is:2025 March (Supplementary (SAY)) (2019 Scheme)MCQ (Case) · 1 mark
  41. 41Used in treatment of acute congestive glaucoma2018 February (2010 Scheme)Short Answer · 1 mark
  42. 42Why is benzhexol used in the treatment of drug induced Parkinsonism.2018 February (2010 Scheme)Short Answer · 1 mark
  43. 43Drugs used in Myasthenia gravis2013 April (2010 Scheme)Short Answer · 1 mark
  44. 44Trihexyphenidyl in drug induced extrapyramidal syndrome2021 May (Supplementary) (2010 Scheme)Short Answer · 1 mark
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  46. 46Bronchodilators (of two different groups)2013 September (Supplementary) (2010 Scheme)Short Answer · 1 mark
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  58. 58Drugs used to treat Organophosphorus poisoning2022 February (2019 Scheme)Short Answer · 0.2 marks
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