SECOND MBBS : PHARMACOLOGY
First Internal Assessment Practical Examination
Date :29/04/21 Duration : 2 ½ hours Total:100 marks
Clinical Pharmacy (40 Marks)
a) Dosage Forms: (10 X 2 = 20 Marks)
(i) Identify the dosage form and enumerate the steps involved in its
usage (4)
What are the advantages and disadvantages of this dosage form ? (4)
Name a device the can be used in conjunction and how does it
help overcome the disadvantages ? (2)
(ii) Identify the dosage form and mention the route of administration (2)
What are the advantages of this route ? (4)
Mention other routes of administration and 2 non cardiovascular uses
of this class of drugs (4)
b) ORS preparation (5 marks)
Enumerate the steps in preparation of ORS
What is the function of Glucose ?
What is Super ORS ?
c) IV drip setting (5 marks)
Describe in detailed steps the setting up of an intravenous infusion
Mention two examples of drugs administered as such.
d) Dose Calculation ( 5 x 2 = 10 marks) .
How many mg per dose of a drug is needed in a child of 8 years
when the adult dose of the drug is 200mg three times a day.
Calculate the loading dose for a drug achieving a target
concentration of 20 mg/L. The Volume of distribution is 1. 75
L/kg. Patient’s weight is 70 kg.
(II) Clinical Pharmacology ( 40 marks)
a) Prescription writing:
Prescribe a single drug for motion sickness ( 3 marks)
Prescribe complete drug therapy for a case of anaphylactic
shock ( 7 marks)
b) Prescription criticism and rewriting ( 5 x 2 = 10marks)
Criticise , correct and rewrite the following prescription for a 60
year old male patient with a blood pressure of 140 / 90 mm Hg .
The patient also gives a history of episodic asthma and
Random Blood Sugar of 220 mmol/l.
Do not criticise the format of the prescription
Inj Furosemide IV 40 mg stat
Tablet Metoprolol 10 mg bd
Tablet Nifedipine 5mg HS
Inj Insulin 15 units before breakfast
Dr. ABC
Reg No : 123
Criticise , correct and rewrite the following prescription for a case
of acute congestive glaucoma
Do not criticise the format of the prescription
Tab. Mannitol (200 mg) Two tablets stat , then one tablet 6 hourly
Inj. Atropine Sulphate 0.2 mg IV
Brinzolamide eye drops (1%) one drop eight hourly
Tab. Acetazolamide (5 mg) One tablet stat
Dr. ABC
Reg No : 123
c) Comment on the following FDCs and mention their therapeutic
use ( 5 x 2 = 10marks)
Diphenoxylate (2.5 mg) + Atropine (0.025 mg)
Tamsulosin (0.4 mg) + Finasteride (5 mg)
d) Graphs and related questions from Animal Experimentation
( 5 x 2 = 10marks)
1.Describe using suitable examples the possible outcomes of
combined actions of drugs.
Demonstrate any one of the above with the help of a well labelled
graph
2. Name the classes of Cholinergic Receptors
Mention an example of an agent that antagonises the action of
Acetylcholine at each of these types of receptors
Draw a well labelled graph to demonstrate the nicotinic action of
Acetylcholine
III. VIVA – (20 Marks)
Case Study (10 X 2 marks)
Case 1.
A 60 year old woman was brought in with complaints of breathlessness ,
and edema feet . There was no h/o suggestive of bronchial asthma. Her
Haemoglobin levels were normal. She was started on a loading dose of a
medication and stabilised on the same at maintenance therapy.
Four months after therapy was started , at a follow-up visit , she was
diagnosed with pulsus bigeminus. On history she complained of nausea
and visual disturbances.
What is your diagnosis and which is the medication she was
administered ? (2)
What therapeutic measures should be undertaken? (4)
If alternate medication should be introduced what is the rationale for its
use in the above condition? (4)
Case 2.
A 33 year old woman presented with ptosis of the right upper eyelid and
complained of muscle weakness that progressed through the day.
No cardiovascular or neurological abnormality was found on examination.
There was no history of any other major illness or use of medication.
What is your probable diagnosis , and can a test be performed to confirm
the same ?
If so, explain the rationale for the specific agent used.(3)
Describe the medical management of this condition (5)
What would be the course of action for a sudden exacerbation of this
condition ? (2)
