29.1 The most effective drug in parkinsonism is:
A. Bromocriptine
B. Selegiline
C. Levodopa + carbidopa
D. Biperiden
29.2 In parkinsonian patients levodopa exerts the following effects except:
A. Reduces skeletal muscle contractility
B. Decreases muscle tone
C. Increases locomotor activity
D. Inhibits muscle tremor
29.3 The dopamine D2 receptor has the following feature:
A. It is excitatory in nature
B. It is negatively coupled to adenyl cyclase
C. It is selectively blocked by bromocriptine
D. It is not blocked by metoclopramide
29.4 The usual cardiovascular effect of levodopa is:
A. Bradycardia due to increased vagal tone
B. Rise in blood pressure due to increased
noradrenaline content of adrenergic nerve
endings
C. Fall in blood pressure due to decrease in sympathetic tone
D. Both ‘A’ and ‘B’ are correct
29.5 The following drug/drugs does/do not produce any
overt CNS effect in normal individuals but exert(s)
clear cut therapeutic effect at the same dose in the
presence of a specific neurological/psychiatric
disorder:
A. Chlorpromazine
B. Levodopa
C. Imipramine
D. All of the above
29.6 Loss or alteration of taste sensation can occur a side effect of:
A. Levodopa
B. Captopril
C. Penicillamine
D. All of the above
29.7 Which of the following adverse effects of levodopa
has a delayed onset and increases in severity with
continued therapy:
A. Nausea and vomiting
B. Postural hypotension
C. Cardiac arrhythmia
D. Abnormal movements
29.8 The drug which abolishes the therapeutic effect of
levodopa in parkinsonism, but not that of levodopacarbidopa
combination is:
A. Metoclopramide
B. Pyridoxine
C. Chlorpromazine
D. Isoniazid
29.9 Use of carbidopa along with levodopa in the treatment
of parkinsonism:
A. Inhibits development of involuntary movements
B. Minimises ‘on-off ’ effect’
C. Inhibits occurrence of behavioral abnormalities
D. Accentuates nausea and vomiting
29.10 The following adverse effect of levodopa is not
minimised by combining it with carbidopa:
A. Involuntary movements
B. Nausea and vomiting
C. Cardiac arrhythmia
D. ‘On-off ’ effect
29.11 Though bromocriptine acts directly on dopamine
receptors, it is used in parkinsonism only as a
supplement to levodopa because:
A. It has low efficacy
B. It produces marked dyskinesias
C. Used alone, its effective doses produce intolerable side effects
D. Its therapeutic effect takes long time to develop
29.12 In the treatment of parkinsonism, bromocriptine differs
from levodopa in the following respects except:
A. It does not need conversion to an active metabolite
B. It has a longer duration of action
C. It activates dopamine D2 receptors, with little/antagonistic action on D1 receptors
D. It does not produce behavioral/psychiatric side effects
29.13 Select the antiparkinsonian drug which directly
activates dopaminergic D2 receptors in the striatum:
A. Pramipexole
B. Entacapone
C. Benserazide
D. Selegiline
29.14 Ropinirole differs from bromocriptine in the following respect:
A. It does not directly activate dopamine D2 receptors
B. It produces milder gastrointestinal side effects
C. In early cases of parkinsonism, it is less
likely to need levodopa supplementation
D. Both 'B' and 'C' are correct
29.15 The following drug combination should not be used in parkinsonism:
A. Levodopa + anticholinergics
B. Levodopa + amantadine
C. Bromocriptine + levodopa
D. Amantadine + anticholinergics
29.16 The antiparkinsonian drug which acts by inhibiting the
degradation of dopamine in the brain is:
A. Carbidopa
B. Amantadine
C. Selegiline
D. Bromocriptine
29.17 Tolerance to the antiparkinsonian action develops
most rapidly in the case of:
A. Levodopa
B. Levodopa + carbidopa
C. Amantadine
D. Bromocriptine
29.18 The following drug is added to levodopa therapy of
parkinsonism to attenuate ‘wearing off’ effect:
A. Selegiline
B. Trihexiphenidyl
C. Amantadine
D. Any of the above
29.19 The following is true of selegiline:
A. It does not exert antiparkinsonian action
unless combined with levodopa
B. It overcomes the ‘on-off ’ effect in levodopa treated advanced parkinsonian patients
C. It retards the progression of Parkinson's disease
D. At doses used in parkinsonism it does not
interfere with peripheral metabolism of
dietary amines
29.20 Which of the following drugs has mild antiparkinsonian
action of its own, prolongs levodopa action
and allows reduction of its dose by about 25%:
A. Benserazide
B. Selegiline
C. Amantadine
D. Pyridoxine
29.21 The primary action by which entacapone and tolcapone
enhance the therapeutic effect of levodopa-carbidopa
in parkinsonism is:
A. Inhibition of levodopa methylation in the liver
B. Inhibition of dopamine methylation in the brain
C. Inhibition of oxidative deamination of dopamine in the brain
D. Facilitation of active transport of levodopa across brain capillaries
29.22 Entacapone differs from tolcapone in the following
respect/respects:
A. It is shorter acting
B. It acts only by inhibiting peripheral metabolism of levodopa
C. It is not hepatotoxic
D. All of the above are correct
29.23 The following is true about entacapone except:
A. It acts by inhibiting degradation of dopamine in the brain
B. If prolongs the therapeutic effect of levodopacarbidopa in parkinsonism
C. It can accentuate levodopa induced dyskinesias
D. It can cause diarrhoea as a side effect
29.24 Select the drug that reversibly inhibits the enzyme
COMT and is useful as an adjuvant medication in
advanced parkinson's disease:
A. Pramipexole
B. Entacapone
C. Pergolide
D. Piribedil
29.25 The following drug is effective in chlorpromazine
induced parkinsonism:
A. Trihexyphenidyl
B. Selegiline
C. Bromocriptine
D. Levodopa + carbidopa
29.26 The antiparkinsonian action of central anticholinergics
has the following features except:
A. They control tremor more than rigidity
B. They produce a low ceiling therapeutic effect
C. They are effective in neuroleptic drug induced parkinsonism
D. They are the preferred drugs in advanced cases
29.27 The following category of drugs is not indicated in
early/mild cases of Parkinson's disease:
A. Central anticholinergic
B. MAO-B inhibitor
C. COMT inhibitor
D. Nonergoline dopaminergic agonist
29.28 For majority of patients of parkinsonism the standard drug therapy is:
A. Levodopa
B. Levodopa + carbidopa
C. Levodopa + trihexiphenidyl
D. Bromocriptine
Ans:
29.1 C 29.2 A 29.3 B 29.4 C 29.5 B 29.6D 29.7D 29.8 B 29.9 B 29.10 A 29.11 C 29.12D 29.13 A 29.14D 29.15D 29.16 C 29.17 C 29.18 A 29.19D 29.20 B 29.21 A 29.22D 29.23 A 29.24 B 29.25 A 29.26D 29.27 C 29.28 B
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