You are on page 1of 8

THIS PRACTICE EXAM HAS THE SAME FORMAT AS THE END OF SEMESTER EXAM ALTHOUGH THE TOTAL NUMBER

OF MARKS MAY BE DIFFERENT. THE DURATION IS THE SAME - 3 HOURS. U%&t C 'e (%' T&t)e SCH3"3* P+(rm(, ) -.

EXTERNAL

Semester Tw ! "#$3
Pr(,t&,e e/(m

Duration

Re('&%- t&me 2 r3&%- t&me T t() t&me

0 m&%1tes 3 + 1rs 3 + 1rs 0 m&%1tes

Attem4t M(r3s T.4e 6 E/(m O4e% B 3 r O4e% B 3 7Restr&,te'8 %ee' t % m&%(te' w+(t 4erm&tte'

A)) 51est& %s As &%'&,(te' % 4(4er

C) se' B

3 e/(m 9 1%&t -1&'e (%' re('er (re % t 4erm&tte'

S4e,&() I%str1,t& %s

T+&s e/(m&%(t& % 4(4er , %s&sts 6 $ 4(rt A%swer &% ( s&%-)e (%swer : T+ere (re ( t t() 6 ; 4(-es. 3)et

St1'e%ts (re % t 4erm&tte' t wr&te % t+e e/(m&%(t& % r (%. t+er 4(4er '1r&%re('&%- t&me.

D % t , mme%,e t+e e/(m&%(t& % 1%t&) . 1 (re t )' t ' s .

P(-e $ 6 <

A%swer ()) t+ese 51est& %s &% %e (%swer :

3)et.

Most pharmacology courses begin by studying how drugs enter the body, are absorbed, moved around and are finally metabolized and excreted. (a) Describe in detail how this occurs and what the implications could be for drug efficacy (1 mar!s). Medicines can enter the body in many different ways, including through an inhaler, a s!in patch, a pill or a hypodermic needle. "s drugs ma!e their way through the body, many steps happen along the way. #hen you ta!e medicines by mouth, they move through the digestive tract and are ta!en up by internal organs li!e the stomach and small intestine. $ften, they are then sent to the liver, where they might be chemically altered. %he chemical alteration of a medicine by the body is called drug metabolism. Drug metabolites often return to the liver and are chemically altered once again before they exit the body. &inally, they are released into the bloodstream."s the bloodstream carries medicines throughout the body, the drugs can interact with many tissues and organs. "fter a drug's metabolites have circulated in the bloodstream, where they wor! as medicine, the body eliminates them the same way it eliminates other wastes(in the urine or feces

). &ollowing on from 1 above, after having discussed how drugs are delivered, most study courses concentrate on how drugs can potentially affect the body to bring about therapeutic change. *ist and describe five (+) ways that can occur, giving an example of a drug and how it wor!s for at least two of these. (1 mar!s) ,. "nswer the -uestions relating to the supplied information.

Mr .enn %reacle, aged /) years, has had chest pains upon exertion for several years. $ver time, he has developed oedema around his an!les. 0ame a drug that could be used to treat1 2is angina (chest pains) 3 mar!s Nitrates. 0itrates are often used to treat angina. 0itrates relax and widen your blood vessels, allowing more blood to flow to your heart muscle. 4ou might ta!e a nitrate when you have angina5related chest discomfort, before doing something that normally triggers angina (such as physical exertion) or on a long5term preventive basis. %he most common form of nitrate used to treat angina is with nitroglycerin tablets put under your tongue Adverse effects of Nitrates are headache, dizziness, flushing, rapid heartbeat or restlessness may occur as your body ad6usts to the medication.
P(-e " 6 <

2is oedema 3 mar!s Diuretics (water pills)1 Diuretics help rid your body of salt (sodium) and water. %hey wor! by ma!ing your !idneys put more sodium into your urine. %he sodium, in turn, ta!es water with it from your blood. %hat decreases the amount of fluid flowing through your blood vessels, which reduces pressure on the walls of your arteries. 7ide effects1 %he most common side effect of diuretics is increased urination. %his occurs most fre-uently in people ta!ing loop diuretics. &or most people, this side effect improves within a few wee!s of ta!ing a diuretic. 8eople who ta!e diuretics may also have too much potassium in their blood (hyper!alemia) if they ta!e a potassium5sparing diuretic, or too little potassium in their blood (hypo!alemia) if they ta!e a thiazide diuretic. $ther side effects of diuretics may include1 *ow sodium in your blood (hyponatremia) Dizziness 2eadaches 9ncreased thirst Muscle cramps 9ncreased blood sugar 9ncreased cholesterol :ash

Describe for each how it wor!s and if there are any adverse effects or problems with each drug. Mr %reacle was also prescribed aspirin 1 and how does it help his condition; mg daily. #hy was this

<ecause he suffer from a chest pain therefore he will be at high ris! of a thrombotic event, "spirin slows the blood=s clotting action by reducing the clumping of platelets. "spirin !eeps platelets from clumping together, thus helping to prevent or reduce blood clots

3. :ead the following >"7? 7%@D4 carefully, and then answer the -uestions relating to the supplied information. :upert is A+ years old and very obese. 2e is lethargic and does not exercise. 2e recently went to the doctor who ordered tests confirming he has type 99 diabetes.
P(-e 3 6 <

Buestions1 a) #hat type of drug is best for treating this; 0ame one and describe how it wor!s; Metformin is a biguanide medicine. 9t lowers blood glucose mainly by decreasing the amount of sugar (glucose) that your liver releases into the bloodstream. 9t also increases the sensitivity of your body=s cells to insulin (so more glucose is ta!en into cells with the same amount of insulin in the bloodstream.) Metformin has also been shown in studies to lower your ris! of other complications of diabetes (such as heart attac! and stro!e).

b) :upert's younger sister who cares for him as!ed the doctor why he can't ta!e insulin li!e her next door neighbors son who was diagnosed with diabetes at the age of +. #hat would you tell her if you were the doctor; %ype ) diabetes is often treated with oral medication because many people with this type of diabetes ma!e some insulin on their own. %he pills people ta!e to control type ) diabetes do not contain insulin. 9nstead, medications are used to ma!e the insulin that the body still produces more effective

:upert is also having severe reflux (heartburn) with his medications. 0ame a drug that could be used to lessen his symptoms and explain how it wor!s. (, mar!s) 8roton pump inhibitors (889s) reduce the amount of acid made by your stomach.8roton pump inhibitors (889s) are a class (group) of drugs that wor! on the cells that line the stomach, reducing the production of acid. for example 1 pantoprazole

+. 2ow are drugs transported around the body; ?xplain the difference between hepatic first pass and entero hepatic cycle. (C mar!s). 9f someone has advanced liver disease and is not able to synthesize high amounts of proteins, do you thin! that the overall medication dosage levels should be increasedDdecreased; ?xplain your answer (3 mar!s) $nce a drug gets inside the body, lots of things start happening all at once. &or starters, as the chemical moves into the bloodstream, it circulates to body organs and tissues.

P(-e ; 6 <

%hen, after lin!ing up with receptor cells in the brain and other body sites, it eventually migrates to the liver, which brea!s it down and flushes it away. ?nterohepatic circulation 7ubstances that undergo enterohepatic circulation are metabolized in the liver (usually by con6ugation), excreted in the bile, and passed into the intestinal lumen (where the intestinal bacteria brea! some of the con6ugated drug, releasing the unmetabolized drug again) where they are reabsorbed across the intestinal mucosa (thus returns to systemic circulation again) and returned to the liver via the portal circulation. Drugs may remain in the enterohepatic circulation for a prolonged period of time as a result of this recycling process. thus increase in their halflives. &irst pass effect1 "fter a drug is swallowed, it is absorbed by the digestive system and enters the portal circulation. %he absorbed drug is carried through the portal vein into the liver. %he liver is responsible for metabolizing many drugs. 7ome drugs are so extensively metabolized by the liver that only a small amount of unchanged drug may enter the systemic circulation, so the bioavailability of the drug is reduced. "lternative routes of administration (e.g., intravenous, intramuscular, sublingual) avoid the first5pass effect.

(1 mar!s)

C. 8ain and inflammation can be treated in many ways. #rite a brief essay on anti5inflammatory medications. "nti5inflammatory drugs are sometimes called non5steroidal anti inflammatory drugs (07"9Ds). %here are various types and brands. &or example1 aspirin, ibuprofen, diclofenac, etc. Many people ta!e an anti5 inflammatory drug for arthritis, muscular pains, etc. "spirin is also used by many people to protect against blood clots forming. 2owever, these drugs sometimes affect the mucus barrier of the stomach and allow acid to cause an ulcer. "bout ) in 1 stomach ulcers are caused by anti5 inflammatory drugs. 2ow does it wor!; 8rostaglandins are a family of chemicals that are produced by the cells of the body and have several important functions. %hey promote inflammation that is necessary for healing, but also resutls in pain, and feverE support the blood clotting function of plateletsE and protect the lining of the stomach from the damaging effects of acid.

P(-e 0 6 <

8rostaglandins are produced within the body=s cells by the enzyme cyclooxygenase (>$F). %here are two >$F enzymes, >$F51 and >$F5 ). <oth enzymes produce prostaglandins that promote inflammation, pain, and fever. 2owever, only >$F51 produces prostaglandins that support platelets and protect the stomach. 0onsteroidal anti5inflammatory drugs (07"9Ds) bloc! the >$F enzymes and reduce prostaglandins throughout the body. "s a conse-uence, ongoing inflammation, pain, and fever are reduced. 7ince the prostaglandins that protect the stomach and support platelets and blood clotting also are reduced, 07"9Ds can cause ulcers in the stomach and promote bleeding. 07"9Ds also may increase blood pressure in patients with hypertension (high blood pressure) and therefore antagonize the action of drugs that are used to treat hypertension. 07"9Ds increase the negative effect of cyclosporine on !idney function

A. >ompare anti5diarrhoeal and laxative medications. ?xplain how they wor! and give examples to illustrate the different pharmacological mechanisms of each type of drug. 9nclude in your answer diseasesDsymptoms they could be used to treat. "ntidiarrheals are the exact opposite of laxatives. #hile antidiarrheals help to slow bowel movements and control diarrhea, laxatives encourage bowel movements and often induce diarrhea. How do laxatives work? Bulk-forming laxatives are sometimes called fibre supplements. %hey increase the bul! of your faeces in a similar way to fibre. %hey partly wor! by absorbing water (a bit li!e blotting paper). %he increase in the bul! of your faeces stimulates the muscles in your gut to s-ueeze faeces along and out of the body. &ibre is the part of plant food that is not digested. 9t stays in your gut and is passed in the stools (faeces). &ibre adds bul! to the stools. Osmotic laxatives wor! by retaining fluid in the large bowel by osmosis (so less fluid is absorbed into the bloodstream from the large bowel). Stimulant laxatives stimulate the nerves in the large bowel (the colon and rectum 5 sometimes also called the large intestine). %his then causes
P(-e * 6 <

the muscle in the wall of the large bowel to s-ueeze harder than usual. %his pushes the faeces along and out. aecal softeners wor! by wetting and softening the faeces. anti5diarrhoeal <ismuth subsalicylate (8epto5<ismol, Gaopectate) helps to treat diarrhea by influencing how fluid is absorbed by intestinesE it may also reduce inflammation and stop the growth of certain bacteria. *operamide (9modium, Gaopectate) treats diarrhea, but by a different methodE it slows the movement of fluid through your intestines so that more fluid is absorbed. 7imethicone (Has5F, Mylanta Has) helps control excess gas by allowing bubbles in the stomach and intestines to come together more easily, so your body can expel them -uic!ly and with less distress. (1 mar!s)

/. <lood pressure is the produce of cardiac output F total peripheral resistance, and cardiac output I stro!e volume F heart rate 0ame and describe three differently acting drugs that will lower blood pressure by different mechanisms. @se the above formula as a guide. %here are four main types of medicine that doctors use to treat high blood pressure1 2ow do beta bloc!ers affect your body; " beta bloc!er is a medication that slows the heart rate and reduces the force with which the heart muscle contracts, thereby lowering blood pressure. <eta bloc!ers do this by bloc!ing beta5adrenergic receptors, preventing adrenaline (epinephrine) from stimulating these receptors.) %here are several other factors that may contribute to how beta bloc!ers wor!, including suppressing renin, an enzyme released by the !idneys, and decreasing sympathetic activity. <eta bloc!ers can be described as either JselectiveK or JnonselectiveK and JvasodilatingK or Jnonvasodilating.K 7elective beta bloc!ers wor! by bloc!ing the effect of adrenaline in the heart, but not in the lungs or elsewhere in the body. <eta bloc!ers that vasodilate have the effect of relaxing and widening the blood vessels,
P(-e = 6 <

allowing blood to flow more easily through your arteries. %his means the heart doesn=t have to pump as hard and blood pressure is reduced

A!" inhi#itors$ these medicines help to control hormones that affect blood pressure. ">? inhibitors bloc! your body from producing a chemical called angiotensin 99. #hen angiotensin 99 enters your blood stream your blood vessels become narrower. %his gives your blood less space to move in, which raises your blood pressure. "ngiotensin 99 also triggers a hormone that ma!es your body retain water. 2aving more fluid in your body, in a restricted space, will cause your blood pressure to rise. ">? inhibitors lower your blood pressure by reducing angiotensin 99 in your body. %his allows your blood vessels to relax and widen, ma!ing it easier for blood to flow through. 9t also lowers the amount of water your body retains, which lowers your blood pressure.

Angiotensin rece%tor #lockers &or A'Bs($ these also control hormones that affect blood pressure. Most of these medicines have names that end in JartanK !alcium channel #lockers$ these medicines ma!e the artery walls relax, ma!ing them wider, which lowers blood pressure. Most of these medicines have names that in JpineK )hia*ide diuretics$ these medicines remove unwanted fluid from the body, which helps lower blood pressure. $ne of their effects is to ma!e the !idneys pass out more fluid. %hey do this by interfering with the transport of salt and water across certain cells in the !idneys. %hiazide diuretics tend to have only a wea! action on the !idneys so you don=t notice a great increase in urine if you ta!e these (compared with loop diuretics). %hey also have an effect to widen (dilate) blood vessels. " combination of these two effects reduces the blood pressure.

END OF EXAMINATION PAPER

P(-e < 6 <

You might also like