Department of Pharmacology

Assignment ANS

Que. 1 A 70-year-male presented with the complaints of weak stream of urine, sense of
incomplete bladder voiding, urinary frequency and nocturia. After physical examination and
ultrasound, he was diagnosed to have developed benign prostatic hypertrophy and was
prescribed:
Tab. Terazosin 5 mg, one tab daily at bed time.
He took the medicine as advised and went off to sleep. At night, when he got up to pass urine,
he felt giddy and fainted. On being laid flat on the bed, he regained consciousness within 2
minutes. Later, he was gradually propped up on the bed to the sitting position and then got up
slowly and walked without any problem.
(a) What is the rationale of prescribing terazosin to this patient?
(b) What other medication is used for treatment of BPH?
(c) What precautions could have avoided the fainting episode?

Ques 2. A 48-year-old male went to ophthalmology clinic with eye pain. Two drops of a drug
were instilled in his eye for dilating the pupil to fundoscopy. At the end of three hours the patient
went home with no residual eye drop effect.
(A) Which mydriatic was probably used for testing?
(B) Which mydriatic will you use in children for sufficient cycloplegic action?

Que.2 Short Answer

(a) Dopamine (c) Therapeutic uses of Anticholinesterases

(b) Cardioselective Beta Blockers (d) Tamsulosin

Que-3 Explain Why

(a) Propranolol in thyrotoxicosis (c) Oxybutynin in urinary frequency and urge
(b) Glycopyrrolate is used as preanesthetic incontinence
medication (d) Ipratropium bromide in COPD

Que-4 Write Pharmacotherapy of

(a) Myasthenia gravis
(b) Organophosphate Poisoning
Autacoids based questions
Section 1: Problem-Based Questions (PBQs)

 Case Study 1:
A 50-year-old male presents with seasonal allergies characterized by sneezing, rhinorrhea, and
itchy eyes. He is prescribed an antihistamine.

a) What type of autocoid is involved in his condition?

b) Explain the mechanism of action of antihistamines in managing these symptoms.
c) Suggest an alternative treatment if antihistamines are insufficient.

 Case Study 2:
A 35-year-old female with a history of peptic ulcers is treated with misoprostol.

a) What class of autocoids does misoprostol belong to?

b) How does misoprostol prevent ulcer formation?
c) Discuss potential side effects of this drug
 Case Study-3
A 30-year-old woman has recurrent, unilateral throbbing headaches associated with nausea and
sensitivity to light.
a) Explain the role of serotonin (5-HT) in the pathophysiology of migraine.
b) Describe the pharmacological agents used for acute migraine treatment and their
mechanisms of action.
Section 2: Short Note Questions
a) Mechanism of action and clinical uses of COX-2 inhibitors.
b) Role of antihistamines in allergy management.
c) Drugs used in acute gout and their mechanisms of action.
d) Use of 5-HT1 receptor agonists (triptans) in migraine therapy.

e) Histamine receptors and their pharmacological significance.

Section 3: Reasoning Questions
a) Why are NSAIDs contraindicated in patients with peptic ulcer disease?
b) Why is colchicine preferred in acute gout, and what limits its long-term use?
c) Why are H1-antihistamines more effective for allergic rhinitis compared to H2-
antihistamines?
d) Why & when aspirin is contraindicated in children
Section 4: Pharmacotherapy Questions
 a) A 40-year-old woman presents with chronic urticaria (hives), and after testing, she is prescribed
cetirizine, a second-generation antihistamine.
b) Describe the difference in the mechanism of action and side effects between first-generation and
second-generation antihistamines.
c) Why is cetirizine preferred over first-generation antihistamines for the management of chronic
urticaria?

A 45-year-old man with a history of acute myocardial infarction (MI) is prescribed low-dose aspirin
(acetylsalicylic acid) to prevent secondary thrombotic events.

a) Discuss the role of thromboxane A2 in platelet aggregation and its relevance to MI.
b) How does aspirin reduce the risk of recurrent MI, and what are the potential side effects of
chronic aspirin use?
1. A 55-year-old male, known epileptic on irregular treatment was presented to an emergency
department with a history of GTCS. In the emergency department, the patient had a few episodes of
seizures without regaining consciousness in between the attacks.
a. Identify the emergency situation described above.
b. How will you manage the above given condition.
c. How is Fosphenytoin superior to phenytoin for IV therapy in the management of epilepsy.
2. 1. A 37-year-old female taking phenelzine (MAO inhibitor) for mood disorder, developed severe
headache, palpitation one hour after taking cheese. The blood pressure readings were 180/100 mmHg.
a. Explain the reasons for these signs and symptoms exhibited by the patient.
b. Explain the rationale behind the use of selegiline, a selective MAO B inhibitor in the treatment
of depression.
c. What is the advantage of delivery of selegiline via transdermal route in the treatment of
depression.
3. 70 years old man has been under treatment of parkinson’s disease for the last 5 years. He is
currently receiving tab levodopa 100mg + carbidopa 25 mg two tablets in the morning, afternoon and
night. He now suffer stiffness, shaking and difficulty in getting up from the bed in morning. These
symptoms decrease about half an hour after taking the medicine, but again start worsening by noon.
He notices one sided twitching of facial muscles which is more frequent 1-2 hours after each dose of
levodopa and carbidopa.

a. classify antiparkinson drugs

b. should his medication be stopped or replaced drug or dose should be increased further ?
c. why pyridoxine is not given with levodopa?

4. A person presented in emergency department in stuporous condition. He was unaware of

surroundings and not responding to verbal compounds. His friend gave history of binge drinking in
party after he had severe vomiting. On examination, BP 90/60 mmhg and RBS 80mg/dl.
a. what is he suffering from?
b. how will you manage this case?
c. name the drugs used to manage alcohol dependence?
d. Name any two drugs which results in disulfiram like reaction?

2. Short Notes:
a. Atypical anti psychotics
b. MAO inhibitors
c. Newer anti epileptics
d. Disulfiram like reaction
e. Pre anesthetic medications
 f. Extra pyramidal side effects of anti psychotics
g. Cheese reaction
h. Selective serotonin reuptake inhibitors
3. Explain why:
a. Morphine is contraindicated in head injury
b. Levodopa given along with carbidopa
c. Benzodiazepines are safer as compared to barbiturates
d. LA fails to provide adequate pain control in inflamed tissues (e.g. infected tooth)
e. Succinylcholine produces prolonged apnea in some patients
f. Phenobarbitone is given in neonatal jaundice

4. Pharmacotherapy:
a. Status epileptics
b. Parkinson disease
c. Alzheimer’s disease
d. Acute morphine poisoning
e. Alcohol acute withdrawal
Mrs. Sheela , a 45 years old lady complaints of easy fatigability, weakness and
sometimes palpitations. On investigation, her Hb was found to be 8 g/dl.
a. How will you treat her anemia?
b. What adverse effects would you expect during the treatment?
c. How will you treat iron poisoning?

2. A 55 years old patient comes to you with chief complaints of severe chest
pain. You diagnose the patient with acute episode of angina and prescribe
glyceryl trinitrate (GTN) to him.
a. What are different routes through which the various drugs are administered in
general ?
b. By which route would you prefer to give glyceryl trinitrate (GTN) to this
patient?
c. Advantages and disadvantages of sublingual, intravenous and oral route of
drug administration.

3.26 year old lady diagnosed with sputum positive pulmonary TB became
pregnant, despite the use of combined oral contraceptive pills. She was on
treatment with isoniazid , rifampicin , pyrazinamide and ethambutol.
a. Explain the reason for OCP failure?
b. Enumerate three CYP 450 enzyme inhibitors and enzyme inducers?
c. What set of instructions the doctor should have given to the patient before
prescribing the patient with Anti TB drugs.
4. Short Notes:
a. Significance of plasma half-life.
b. Competitive and non competitive inhibitor
c. Microsomal enzyme inhibitors
d. Zero order kinetics
e. Colony stimulating factor
F. Teratogenicity
5. Explain why:
a. Why a basic drug is given for acidic drug poisoning.
b. Loading dose of chloroquine in treatment of malaria
c. Probenecid is given along with penicillin
d. Why B6 is given along with Isoniazid in treatment of Tuberculosis

5. Pharmacotherapy:
a. Iron deficiency anemia
b. Iron poisoning

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Short Notes on:
A) Methadone b) Albendazole
c) Metronidazole d) Amphotericin B
Give Pharmacotherapy of
a) Neurocysticercosis b) Cerebral Malaria
c) Amoebiasis d) Drugs used in deaddiction of
cocaine
Explain why
1) Artemisin based combination therapy is given in malaria.
2) Suppressive prophylaxis is given in malaria, which drugs are used in
prophylaxis of malaria
3) Steroids are given in neurocysticercosis.
4) Combination therapy is given in Kala-Azar.

1. The patient presented in the clinic with fever since 4-5 days with symptoms
of headache, confusion, vomiting and seizures for 1 day.On asking history he
told that he came from northeast part of the India to Delhi for vacation. Over the
past 12 hours the patient became more lethargic and unresponsive. There are
signs of severe agitation and twitching possibly due to the seizures. Skin was
pale and on USG mild spleenomegaly was found.
A) Diagnose the case b) What treatment would you give in this case

2. The patient experienced her first generalized tonic clonic seizure two weeks
ago, which lasted for a few minutes. Over the past few days, she has two
additional seizures. Along with this she developed a persistent headache, which
is dull and worsening in intesity and occasinal nausea. She also reprots
intermittent confusion and forgetfulness. On asking history patient told that she
had eaten pork in the village. On CT scan and MRI of the brain showing cystic
lesions with a scolex or hole within a hole appearance.
B) Diagnose the case b) What treatment would you give in this case

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 Topic : anticancer, immunomodulators, PNS
1. Interaction : why we give adrenaline before lignocaine administration?
2. Write down about the uses of lignocaine?
3. Explain skeletal muscle relaxants, its types, MOA, indications and
contraindications and its ADR’s
4. Describe the inhalational agents and its properties and its systemic
effect?
5. What is MAC and blood gas coefficient?
6. Explain about dissociative anaesthesia, which drug causes this type of
anaesthesia and its contraindications?
7. Write down about laughing gas and its contraindications?
8. Describe the properties of halothane?
9. Write down about drugs useful for day care surgery?
10. Briefly explain about slow acting intravenous agents?
11. Write down about non depolarizing neuromuscular blockers?
12. Anticancer
13. Explain about tyrosine kinase inhibitors
a) Explain TK inhibitors for CML
14. Classify antimetabolite agents, write down about the MOA of
methotrexate
15. Why we provide folic acid and vitamin B12 during methotrexate
therapy in RA
16. What are the side effects of using anti cancer drugs
17. What are topoisomerase inhibitors, classification, MOA, indication,
contraindications and its uses and side effects
18. Explain about thalidomide, its MOA, indications and its major side
effects
19. Explain about immunomodulators, what are their types and uses
20. Explain about monoclonal antibodies, with examples and its uses in
different conditions
21. Toxicity caused by methotrexate
22. Write down about estrogen receptor positive brease cancer drugs
23. Action of tamoxifen in breast cancer and adverse effects of tamoxifen
24. Monoclonal antibodies for osteoporosis?
25. Calcineurin inhibitors and its action and systemic side effects?
26. Tyrosine kinase inhibitors for RCC?