PHARMACOLOGY SOLVED PAST

PAPERS
[SECOND SEMESTER]

Q1. Classify cell wall synthesis inhibitors and discuss the mechanism of action of Penicillin.

CELL WALL SYNTHESIS INHIBITORS

Penicillin Cephalosporin Miscellaneous

Narrow spectrum Wide spectrum Narrow spectrum Wide spectrum

Penicillinase susceptible 1st generation carbapenem ,

aztreonam, vancomycin

Penicillinase resistant 2nd generation, 3rd generation, 4th generation

MECHANISM OF ACTION OF PENICILLIN:

It kills bacteria through the binding of beta-lactam ring to DD-transpeptidase, inhibiting
its cross-linking activity and preventing new cell wall formation. Without a cell wall bacterial cell is
vulnerable and can be destroyed easily.

Q2. Classify cell wall synthesis inhibitors and discuss the mechanism of action of Cephalosporin.

CELL WALL SYNTHESIS INHIBITORS

Penicillin Cephalosporin Miscellaneous

Narrow spectrum Wide spectrum Narrow spectrum Wide spectrum

Penicillinase susceptible 1st generation carbapenem ,

aztreonam, vancomycin

Penicillinase resistant 2nd generation, 3rd generation, 4th generation

MECHANISM OF ACTION OF CEPHALOSPORIN:

 Its mechanism of action is the same as penicillin, inhibition of bacterial cell wall
peptidoglycan synthesis by inhibition of penicillin-sensitive enzymes which makes cell wall vulnerable.

Q3. Classify fluoroquinolones and list their clinical uses.

FLUOROQUINOLONES
--1st generation: nalixidic acid
-- 2nd generation: ciprofloxacin, norfloxacin, ofloxacin, levofloxacin

-- 3rd generation: sparfloxacin, getifloxacin

-- 4th generation: moxifloxacin, gemifloxacin

CLINICAL USES OF FLUOROQUINOLONES :

 Complicated and uncomplicated UTI
 Travelers diarrhea
 Tuberculosis
 Typhoid
 Meningitis
 Prostatitis
 Skin infections
 Respiratory tract infection

Q4. Classify protein synthesis inhibitors and write their mechanism of action.

PROTEIN SYNTHESIS INHIBITORS

I I
Drugs acting on 30s ribosomal subunit Drugs acting on 50s ribosomal subunit
Aminoglycoside, Tetracycline, Glycycline Linezolid, Macrolides, Clindamycin,

Chloramphenicol

MECHANISM OF ACTION OF PROTEIN SYNTHESIS INHIBITORS :

They exert their antimicrobial effect by inhibiting the protein synthesis by bining to
0s ribosomal unit.
Q3. Name 1st and 2nd line drugs used in the treatment of pulmonary tuberculosis.

1st LINE DRUGS:

 Rifampin
 Isoniazid
 streptomycin

2nd LINE DRUGS:

 Fluoroquinolones
 Capreomycin
 Cycloserine

Q4. Classify tetracyclines and write down their adverse effects.

TETRACYCLINES:
-SHORT ACTING [6-8 HOURS]

Chlorotetracycline, tetracycline, oxytetracycline

-INTERMEDIATE ACTING [10-12 HOURS]

Demeclocycline, methacycline

-LONG ACTING [16-18 HOURS]

Doxycycline, minocycline

ADVERSE EFFECTS OF TETRACYCLINES :

 Nausea
 Vomiting
 Diarrhea
 Hepatic toxicity
 Photo toxicity
 Dizziness
Q5. Write down mechanism of action and adverse effects of corticosteroids.

MECHANISM OF ACTION :
They bind to intracellular receptors which then act to modulate gene transcription in target
tissues.

ADVERSE EFFECTS:
 High blood pressure
 Diabetes
 Acne
 Infected easily

Q6. Write down the side effects of 1st line drugs used in treating tuberculosis.

SIDE EFFECTS:
 Rashes
 Hepatotoxicity
 Nephrotoxicity
 Ototoxicity
 Anemia
 Hypersensitivity

Q7. Enlist 1st line drugs used in tuberculosis. Define MDR and write the names of drugs used in
MDR TB.

1ST LINE DRUGS USED IN TB:

 Rifampin
 Isoniazid
 Streptomycin

MDR:
Multidrug-resistant TB [MDR TB] is caused by TB bacteria that are resistant to at least isoniazid and
rifampin, the two most potent TB drugs.

DRUGS USED IN MDR TB:

 Levofloxacin
  Moxifloxacin

Q8. Name drugs used for treating malaria. Which drug is used for prophylaxis and treatment of
MDR falciparum?

DRUGS USED FOR TREATING MALARIA:

 Primaquine
 Chloroquine
 Mefloquine
 Quinine and quinidine
 Artemisinin

DRUGS USED FOR TREATING MDR FALCIPARUM:

 Mefloquine
 Artemisinin

DRUGS USED IN PROPHYLAXIS:

 Doxycycline
 Primaquine
 Mefloquine
 Chloroquine

Q9. List drugs used in the treatment of asthma and write the mechanism of action of
ipratropium bromide.

DRUGS USED IN TREATING ASTHMA

RELIEVERS PREVENTOR OR CONTROLLERS

Short-acting B2 agonists, inhaled or oral corticosteroids,

Methylxanthine, anticholinergics long-acting B2 agonist, leukotriene modifiers,

Mast cell stabilizers

MECHANISM OF ACTION OF IPRATOPIBROMIDE:

It inhibits the effect of acetylcholine at muscarinic receptors and block the vagally
mediated contraction of airway smooth muscle and decreases mucosal secretions.
Q10. Enlist the drugs used in an acute asthma attack.

DRUGS USED IN ACUTE ASTHMA ATTACKS:

 Salbutanol
 Hydrocortisone
 Prednisolone
 Ipratropium
 Aminophylline
 Omalizumab

Q11. Write down the mechanism of action and adverse effects of corticosteroids.

MECHANISM OF ACTION OF CORTICOSTEROIDS:

They bind to intracellular receptors which then act to modulate gene transcription in target
tissues.

ADVERSE EFFECTS OF CORTICOSTEROIDS:

 Acne
 Increased appetite
 High BP
 Mood swings
 Easy bruising
 Osteoporosis
 Depression

Q12. Classify drugs used in type 2 diabetes. Write the mechanism of action and adverse effects
of Metformin.

DRUGS USED IN THE TREATMENT OF DIABETES MELLITUS:

 Metformin
 Sulfonylureas
 Glitazones
 Glinides
 Gliptin
 Gliflozins
MECHANISM OF ACTION OF METFORMIN:
It alters the energy metabolism of the cell. It opposes the effect of glucagon and inhibits
hepatic gluconeogenesis which results in a glucose-lowering effect.

ADVERSE EFFECTS OF METFORMIN:

 Nausea
 Diarrhea
 Stomachache

Q13. List down oral drugs used in the treatment of diabetes mellitus.

ORAL DRUGS USED IN THE TREATMENT OF DIABETES MELLITUS:

 Acarbose
 Alogliptin
 Bromocriptine
 Chloropropamide
 Glipizide

Q14. Classify drugs used in the treatment of peptic ulcer. Write down mechanism of action of
omeprazole.

DRUGS USED IN THE TREATMENT OF PEPTIC ULCER:

 ANTACIDS: Calcium Carbonate, Magnesium Hydroxide
 MUCOSAL PROTECTIVE AGENTS: Sucralfate
 HISTAMINE -2 RECEPTOR ANTAGONIST: Roxatidine, Loxatidine
 PROTON PUMP INHIBITORS: Omeprazole, Esomeprazole
 ANTI-H.PYLORI DRUGS: Tetracyclines, Amoxicillin
 PROSTAGLANDIN ANALOGUES: Misoprodol

MECHANISM OF ACTION OF OMEPRAZOLE:

It is metabolized in the liver. It inhibits the final common pathway or step in the gastric acid
secretion.
 Q15. Classify oral hypoglycemic drugs. Write the mechanism of action of sulfonylureas.

ORAL HYPOGLYCEMIC DRUGS

SULFONYLUREAS THIAZOLIDINEDIONES BIGUANIDES ALPHA-GLUCOSE INHIBITORS MEGLITINIDES

1st generation: Pioglitazone Metformin Acarbose Repaglinid

tolazamide e
Rosiglitazone Phenformin Miglitol
2nd generation: Nateglinide
glyburide

3rd
generation:glyclazipe

MECHANISM OF ACTION OF SULFONYLUREAS:

They close ATP-sensitive K-channels in the beta-cell plasma membrane and initiate a chain
of events that results in insulin release.

Q16. Write down steps involved in formation of thyroid hormone.

FORMATION OF THYROID HORMONE:

1. Thyroglobulin synthesis
2. Uptake and concentration of iodide [I-]
3. Oxidation of iodide [I-] to iodide [I]
4. Iodination of thyroglobulin
5. Formation of MIT and DIT
6. Secretion

Q17. Write down the adverse effects of chloramphenicol.

ADVERSE EFFECTS OF CHLORAMPHENICOL:

 Bluish tone to the skin.
 Change in blood pressure and heart rate
 Eating problems and bloating
 Irregular breathing
 Passage of loose green stools
  Sore throat and fever

Q18. Write down the mechanism of action and therapeutic uses of NSAIDs.

MECHANISM OF ACTION OF NSAIDs:

NSAIDs are weak organic acids that irreversibly acetylate and thus inactivate
cyclooxygenase.

THERAPEUTIC USES OF NSAIDs:

 Reduce inflammation
 Relieves pain
 Reduces fever

Q19. Write down the mechanism of action, pharmacokinetics and toxicities of aspirin.

MECHANISM OF ACTION OF ASPIRIN:

Aspirin is a weak organic acid that irreversibly acetylates and thus inactivates
cyclooxygenase.

PHARMACOKINETICS OF ASPIRIN:
It is rapidly deacetylated by esterases in the body to produce salicylate after oral
administration.

ADVERSE EFFECTS OF ASPIRIN:

 Gastrointestinal problems
 Antiplatelet effect
 Renal effect
 Cardiac effect
 Q20. Classify diuretics. Write down the mechanism of action of thiazide.

DIURETICS

THIAZIDE DIURETICS LOOP DIURETICS POTASSIUM SPARRING CARBONIC ANHYDRASE OSMOTIC

DIURETICS INHIBITORS DIURETIC
FUROSEMIDE AMILORIDE ACETAZOLAMIDE SMANNITOL
TORSEMIDE TRIAMERENE
CHLOROTHIAZIDE

HYDROCHLOROTHIAZIDE

MECHANISM OF ACTION OF THIAZIDE:

They increase the concentration of Na+ and Cl- in the proximal convoluted tubule to be
effective. Therefore decreasing renal functions which reduce diuretic effects.

Q21. Classify drugs used in treatment of hyper thyroidism. Write down the mechanism of action
and adverse effects of Methimazole.