PHARMACOLOGY PAST YEAR QUESTION

PHARMACOLOGY PAST YEAR QUESTION

CASE 1- Patient with heart burn went to the hospital was given ANTACID for immediate relieve.

1) How does it provide immediate relieve

Neutralize HCL that already secreted in the stomach

2) Why give coz advantages

Magnesium Hydroxide diarrheoa rapid acting

Aluminium Hydroxide constipation sustain effects

3) How to detect H.Pylori?

Urease test: give urea (-/+ve)-ammonia+O2

4) Drug used tp cure

Omeprazole: PPI /lanoprazole/ranitidine bismuth citrate

Clarithromycin:antimicrobial

Amoxicilin:penicillin based

CASE 2-Boy with URTI given antibiotic + Paracetamol

1) Reason to give PCM. What MOA?

PCM is antipyretic and analgesic. As an antipyretic, it is effective to the brain. By inhibiting cyclo oxygenase I (cox I) it reset the thermoregulatory by increase body sweat. It also have poor inflammatory effects.

2) Patient accidentally taken 14 tablets of PCM and was taken to the hospital within 4hour. What measure should be taken?

a) Gastric lavage: food can stay up to 4 hour in the stomach

b) Acetylcystein+methionine: liver damage due to PCM toxicity (depletion of glutathione leading to hepatic necrosis

3) Investigation should be taken?

Lung Function Test: coagulation,plasma protein, ALP,ALT, INR

CASE 3- 51 years old man having severe osteoarthritis on right knee and has underwent knee replacement surgery. After 4 days, he complained of increase pain and swelling of calf of right leg. A Doopler Ultrasound demonstrated a thrombosis in the deep vein in the left extending up to popliteal vein of right leg was started on 12 hourly injectionof LMWheparin (5mg IV) + Enoxaparin (20-25 SC) simultaneously started on oral tablets Warfarin 5mg (once/day)

1) What investigation to check the drugs are working?

Heparin- APTT (intrinsic pathway)

Warfarin- INR (Extrinsic pathway) + PT

2) Why warfarin take longer?

Warfarin effects Vit K clotting factor (2,7,9.10) in the liver. Some already flow in the blood therefore it is establish after 3-4days of Heparin

3) Complication of DVT: pulmonary embolism

4) Platlete function:

a) What is X: aspirin (NSAIDS)

b) Disadvantage of endothelial COX

Inhibit prostaglandin2. This will lead more thromboxane than prostacyclin leading to platlete aggregation which cause thrombus formation.

c) Pharmacological effect of X.

Inhibit thromboxane II, lead to inhibiton of platlete aggregation

Antiinflammatory and analgesic function

Good SLE patient.

d) Stage measure to have effect on platlet but no endothelial without inhibiting COX

Aspirin (200mg) + clopidogrel (100mg)

Aspirin: unable to inhibit, irreversible inhibition

Clopidogrel: antiinflammatory, inhibit ADP platlet aggregation

CASE 4- Myocardial cell.

1) What is Na+K+ATPase inhibitor

Digoxin

2) Pharmacological effect for CCF

+ve inotropic effect

-ve gonadotropic (decrease HR-allow to fill properly= vagomymetic effect

3) why not use adrenaline

It produce the same effect but increase HR

4) not use in post use of CCF

low therapeutic index cause extrasystole cardiac arrhythmia (excess of Ca2+)

it doesn’t increase survival time, only use to relieve symptom

5) drug use in Atrial Fibrillation and in CCF? Why?

-digoxin: it delay AV conduction 9vagomymetic effect)

-verapamil: Ca Channel blocker (-ve inotropic)

-B-adrenergic blocker: -ve inotropic effect delay AV

6) Uncontrol HT lead to CCF

a) Drug for CCF

b) What the mode of action of ACE inhibitor?

c) 2 drugs acting on myocardial to increase Stroke volume in Acute heart failure

d) 2 signs of right sided heart failure

CASE 5- Asthma

MDI (metered dose inhaler)

Spacer spacehaler

Rotahaler (Dry powder inhaler)

1) What are the advantage/disadvantage MDI?

2) What are advantage/disadvantages spacer spacehaler?

3) How to prevent oral candidiasis?

CASE 6- Myasthenia Gravis

1) What are the symptoms of MG

Bilateral ptosis,muscle weakness, unable to swallow

2) What type of receptor does it effect?

Nicotinic receptor

3) How to prevent it? Drug?

Inhibit the enzyme cholinesterase

Drug:neostigme

4) What happen in cholinergic crisis?

=excess of neotigme

5) What test should be done?

Adrenophonia test

Tensilone test