UPSC-CMS 2018 — Pharmacology

Q: The amount of Ethinyl Estradiol in third generation combined oral contraceptive pills is:

30–35 mcg. ***30–35 mcg*** - **Third-generation combined oral contraceptive pills (COCs)** typically contain **30-35 mcg of Ethinyl Estradiol**. - Third generation is defined by the type of **progestin used** (desogestrel, gestodene, or norgestimate), not the estrogen dose. - This dosage provides effective contraception while minimizing estrogen-related side effects compared to first-generation pills. - Common formulations include **30 mcg or 35 mcg** of ethinyl estradiol. *20–30 mcg* - While some third-generation formulations may contain doses at the lower end (20 mcg), this range overlaps with **ultra-low dose formulations**. - The typical and most common dosage for third-generation COCs is **30-35 mcg**, not this lower range. *10–20 mcg* - This represents **ultra-low dose COCs**, which aim to further reduce estrogen exposure. - These formulations may be associated with **breakthrough bleeding** and reduced cycle control. - Not the standard dose for third-generation COCs. *35–50 mcg* - These higher doses are characteristic of **first-generation COCs** from the 1960s-1970s. - Associated with higher rates of **thromboembolic events** and estrogen-related side effects. - Modern COCs use lower doses for improved safety profiles. [Practice more Pharmacology PYQs on OnCourse]

Q: Herceptin (Trastuzumab) is an immunotherapeutic agent used in the treatment of:

Carcinoma breast. ***Carcinoma breast*** - **Herceptin (Trastuzumab)** is a monoclonal antibody that targets the **HER2 receptor**, which is overexpressed in a significant subset of breast cancers. - Its use is specifically indicated for **HER2-positive breast cancer**, where it helps to inhibit cancer cell growth and proliferation. *Carcinoma rectum* - Treatment for **colorectal cancer** (including rectal carcinoma) typically involves surgery, chemotherapy (e.g., 5-fluorouracil), and radiation, with targeted therapies like cetuximab or bevacizumab for specific mutations. - **HER2 overexpression** is rare in colorectal cancer and Trastuzumab is not a standard treatment. *Ovarian malignancy* - Treatment for **ovarian cancer** usually involves surgery and platinum-based chemotherapy (e.g., carboplatin, paclitaxel), and sometimes bevacizumab. - While HER2 can be expressed in some ovarian cancers, it is not a primary therapeutic target, and **Trastuzumab is not routinely used** for this malignancy. *Carcinoma prostate* - **Prostate cancer** treatment primarily involves hormone therapy, radiation, chemotherapy (e.g., docetaxel), and targeted agents for specific mutations (e.g., PARP inhibitors). - HER2 is not a significant driver of prostate cancer growth, and **Trastuzumab is not indicated** for its treatment. [Practice more Pharmacology PYQs on OnCourse]

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The amount of Ethinyl Estradiol in third generation combined oral contraceptive pills is:

Herceptin (Trastuzumab) is an immunotherapeutic agent used in the treatment of: