PHARMACOLOGY & THERAPEUTICS– TOPICAL

PAST QUESTIONS (2007-23)

Compiled By:
Noor Fatima, Bilal Akbar, Rabeet Habib, Abdurrahman Anjum &
Shahab Zafar from AIMC Batch 25
Syeda Quratulain SMC, Maham Mansoor FMU, Fiza Zulfiqar KMMU,
Ifrah Maryam KEMU, Amina SIMC

 GENERAL PHARMACOLOGY
Introduction
1. A) A 20 year old male patient has been brought to ER with the history of large
quantity of Aspirin intake; considering its pharmacokinetic characteristics , how
its excretion can be enhanced?
B) Define drug antagonism and enumerate its various types; differentiate
between competitive and Non- competitive antagonism with examples.
[Annual 2021]
2.

a) Define receptors what are the differences between receptors and inert binding
site? (3)
b) Where in the body are special carriers? What is their role in transport of drugs
across cell membrane? (4)
[Supple 2016 held in 2017)
7.

3. Enlist three types of G-proteins and their receptors/effectors/signaling pathways. (4)

[Annual 2015]

4. What is effect of pH on lipid solubility of a drug which is a weak acid or base? How
this knowledge is used in manipulation of drug excretion in urine? [Supple 2014
held in 2015]

5. Name 7 common routes of drug administration and give 2 examples of drugs for
each. (7) [Supple 2014]

6. Define receptor. What are targets for drug action? (4) [Annual 2012]

7. What are important features of drug binding to plasma proteins? (3) [Annual 2012]

8. What is the role of drug ionization in crossing the cell membrane? (3) [Supple 2011]

9. Explain the basis of alkalinization of urine in salicylate (weak acid poisoning).

[Annual 2008]

Pharmacokinetics
1.
a. Define bioavailability. How is it calculated? (2)
b. Name three factors which affect bioavailability and briefly explain them. (5)
[Supple 2018 held in 2019]

2. Define plasma half-life. How plasma half-life of a drug is affected by drug’s clearance
rate and volume of distribution. (3) [Annual 2018]

3. What do you understand by bioavailability? [Annual 2017]

4.

a) What is apparent volume of distribution of a drug? What is its significance?

b) How will apparent volume of distribution be affected by a drug which avidly binds
the molecules in the peripheral tissues?
[Annual 2016]
5.

a) What is the loading dose? What is its relationship with half-life of a drug and
how is it calculated? (3)
b) Area Under Curve (AUC) of time-concentration curve is used to calculate
bioavailability. Define bioavailability. When a drug is given by oral route,
bioavailability is less than 100%. Give two reasons for that. (4) [Annual 2016]

6. Write a short essay on therapeutic window. (3) [Supple 2015 held in 2016]

7. Define bioavailability of a drug. Enlist four factors affecting bioavailability after oral
administration of a drug. (3) [Annual 2015]
8.

a) A 30-year-old man is brought to your clinic by his friends. He agitated ad found

under weight. His blood pressure, heart rate, temperature and respiration are all
raised. The friends gave history of chronic methamphetamine use. Patient is
treated symptomatically and also given ammonium chloride parenterally. What is
the role of ammonium chloride in this case? (4)
b) Define volume of distribution. (3)
[Annual 2014]

9. Pharmacologist is testing a new drug for treatment of a disease. He gave 40 mg of

this drug orally at an interval of 8 hours that is equal to drug’s half-life. No other
interactive substances are given that can interfere with its pharmacological effects.
a) Write down formula and time to calculate the time drug will reach the steady
state plasma concentrations.
b) With help of quantal dose response curve, how will he able to determine the
therapeutic index of this drug. [Annual 2014]
7.

10. Define volume of distribution. [Annual 2013]

11. What is zero order kinetics? [Annual 2013]

12. Define therapeutic index. [Annual 2013]

13. What is drug clearance? Give its role in drug elimination. (1+2)
[Annual 2011, Annual 2010]

14. Define bioavailability. What is its clinical significance? (1+2)

[Supple 2010, Annual 2009]

15. Define plasma half-life of drug. Give factors affecting it. (3.5) [Supple 2009]

16. What is therapeutic window? Give clinical significance. (3.5) [Supple 2009]

17. Give one example of drug that shows the following types of drug tolerance:
pharmacodynamic tolerance, cross-tolerance, pharmacokinetic tolerance [Annual
2008]

18. Define bioavailability. [Supple 2008]

19. Define volume of distribution. [Supple 2008]

20. Define plasma half-life of the drug. What knowledge can be derived from the plasma
half-life of a drug? [Annual 2007]

21. Define the following:

 a) Bioavailability
b) Volume of distribution
[Supple 2007]
22. A patient with cardiogenic shock is given continuous intravenous infusion of
dopamine.
Explain with the help of diagram the time course for the attainment of steady state
concentration after continuous intravenous infusion. [Supple 2022]

23. A)The oral route of administration is the most likely to have a low bioavailability. How
will you explain this effect with example and what measures are usually taken to
avoid this effect?
B)How the adjustment of dosage would be done when the drug elimination is altered
by disease? [Annual 2023]

24.a 30 years old patient diagnosed with rheumatoid arthritis is brought to

emergency with a history of intake of large quantity of aspirin.Considering its
pharmacokinetic properties how can the excretion of aspirin be enhanced?
B)What are orphan drugs? Enlist two main difficulties faced by drug manufacturers in
the manufacture of such drugs. [Supple 2023].

25.Most drugs in clinical use obey first order kinetic s rule. Name three important
drugs that follows zero order kinetics. [Supple 2023]

Pharmacodynamics
1. The graded dose-response curve expresses an individual’s response to increasing
doses of a given drug and it includes some parameters like intrinsic efficacy, potency,
maximal efficacy and slope of graph. Explain these terms with example. (4) [Annual
2018]

2. Patient may require administration of more than one drug at a time for one disease
or concurrent illness. So, role of drug-drug interactions is very important. What are
different types of pharmacodynamic drug-drug interactions? Explain with examples.
(7) [Supple 2017 held in 2018]
7.

3. What do you understand by orphan drugs? [Annual 2017]

4. What is a receptor? Explain briefly the concept of pare receptor with examples. (1+3)
[Annual 2011, Annual 2010]

5. How partial agonists act as antagonists? Explain with examples. (4) [Supple 2011]

6. What are various types of drug antagonism. Explain each with examples. (4) [Supple
2010, Annual 2009]
What is therapeutic window? Give clinical significance. (3.5) [Supple 2009]
7. Give one example of drug that shows the following types of drug tolerance:
pharmacodynamic tolerance, cross-tolerance, pharmacokinetic tolerance [Annual
2008]
8. A) Explain types of pharmacological antagonism with drug examples and graphs.
B)What are ligands for tyrosine kinase receptor? Give its downstream signalling
mechanism and importance of its down regulation. [Annual 2022]
9. Dopamine acts by binding to Gs protein coupled receptor. Give downstream
signalling mechanism of this receptor after activation by dopamine. [Supple
2022]

10. Explain the four receptor families with the help of diagram, involved in the
transmembrane signalling of drug. [Annual 2023]

11. A)Describe the differences between pharmacological antagonist and allosteric

inhibitor. How can you differentiate these two experimentally? [Supple 2023]

Drug Metabolism
1. What do you understand by enzyme induction? [Annual 2017]
2. Drug interaction is a common problem in medical practice. Write 5 common
examples of drugs which can induce P450 mediated metabolism in humans and 5
examples of drugs which can inhibit it. (4) [Supple 2015 held in 2016]

3. Define first-pass effect. What are sites of first-pass effect for orally administered
drugs? Name 2 drugs with extensive first pass effect. [Supple 2014 held in 2015]

4. Name 3 drugs that exhibit extensive 1st pass effect. [Annual 2008]

Pharmacogenomics
1. Give factors which contribute to differences in drug responsiveness in individuals. (2)
[Supple 2013]

2. Write three examples where genetic defects in phase 1 metabolism of drugs account
for the individual differences in drug response. (5) [Supple 2013]

3. Write short essay on idiosyncrasy. [Supple 2007]

4. Define Tachyphylaxis. [Supple 2007, Supple 2008]

 AUTONOMIC NERVOUS SYSTEM

Introduction to ANS Pharmacology

1. Give in tabulated form the sites, structural features and post-receptor mechanisms of
muscarinic receptor types 1,2 and 3. [Annual 2010]

2. How do different drugs or toxins affect the cholinergic transmission presynaptically?

[Annual 2011]
7.

3. Illustrate the various steps of synthesis of acetylcholine at cholinergic junction and

how it is released and also indicate the drugs which can block each step. [Supple
2022]

4. A 58 years old female presents to the eye department with the complaint of loss of
vision. She’s examined by a consultant and diagnosis of blepharospasm is made. She
is treated with several injections of botulinum toxin type A in her orbicularis oculi
muscle of each eyelid and is sent home after a few hours. Two days later she reports
of dramatically improved vision.

A) How did botulinum toxin improve her vision? How long can her vision be
expected to stay normal after this single treatment? [Supple 2023]

Cholinoceptor-Activating & Cholinesterase-Inhibiting Drugs

1. What are ophthalmic uses of cholinergic agonists? (3) [Supple 2016 held in 2017]

2. A patient is suffering from diplopia, ptosis, difficulty in speaking and swallowing with
severe muscle weakness. He is diagnosed as a case of Myasthenia Gravis. Name two
cholinergic drugs for treatment of this patient. Give role of edrophonium in diagnosis
of Myasthenia Gravis. (3) [Annual 2015]

3. Name six indirectly acting cholinomimetic drugs. [Supple 2014]

4. A farmer was spraying insecticide on his crop. He was found unconscious by his
coworkers and brought to emergency department. On examination, he was salivating
profusely, his breath was shallow with wheezing. BP was 130/85 mm Hg, pulse was
68 bpm, pupils were constricted. I/V line was maintained and he was given atropine
and pralidoxime intravenously. [Supple 2015]
a) What is possible agent for his signs and symptoms? How does it act?
b) What is rationale for giving atropine and pralidoxime?
c) Enumerate adverse effects of atropine.
5. Mr. Ditta, a 50-year-old man gets exposed to an organ phosphorus compound poison
while spraying his cotton crop due to opposite wind direction and brought to
hospital. The signs observed were miosis, sweating, bronchoconstriction, salivation
vomiting, diarrhea and convulsions.
What immediate measures will you take and the drugs be given to save the patient?
[Annual 2013]

6. A field working after spraying the cotton crop is showing signs and symptoms of
excessive cholinergic stimulation because he had his skin contaminated with the
thiophosphate (malathion/parathion) insecticide. In what aspects do you expect
malathion to differ from parathion as an insecticide? [Annual 2011]

What is pharmacological basis of muscarinic agonists for their use in eye and GIT
problems? [Annual 2010]

7. Explain why neostigmine is preferred to physostigmine in myasthenia gravis.

[Supple 2007]

8. Write down clinical uses of parasympathomimetics with one example of drug for
each use. [Annual 2022]

9. A 43 year old person is brought to emergency with signs and symptoms of

organophosphorus compound poisoning.
A) Write down the management of the patient. [Annual 2023]

Cholinoceptor Blockers and Cholinesterase Regenerators

1. Write pharmacological basis for the use of atropine as a pre-anesthetic agent (1.5)
[Annual 2018]
7.

2. Enlist five clinical applications of antimuscarinic drugs and name one important drug
for each. (3) [Supple 2016]
3. A young man was given promethazine intravenously in an operation theatre for a
minor surgery. He stood up after the surgery but fainted. His heart rate was observed
raid (110 bpm) and blood pressure only 105/65 mm Hg. What autonomic effects the
drug had and why the heart rate increased and blood pressure dropped? [Supple
2014]

4. Write down different clinical uses of antimuscarinic drugs with examples. [Annual
2012]

5. What are the pharmacologic effects of atropine on different smooth muscles of

body? [Supple 2011]

6. Classify antimuscarinics according to their clinical use. [Annual 2009]

7. Name two oximes. How these are useful in organophosphate poisoning? [Supple
2009]

8. What are oximes? Explain their role in poisoning with organophosphorus

compounds. [Annual 2007]

9. Enumerate 5 anti muscurinic drugs used in opthalmology. [Annual 2023]

10. Tabulate the effects of ganglion blockers on the central nervous system and heart.
[Supple 2023]

Sympathomimetics

1. A 12-year-old boy suffering from meningitis was administered an antibiotic

intravenously. Within few minutes, he developed angioedema, bronchospasm and
severe hypotension; indicative of anaphylactic reaction. Epinephrine was immediately
administered intramuscularly, with marked relief. Activation of which receptors, by
 epinephrine, is important in reversing the pathophysiologic process underlying
anaphylaxis? Briefly explain the role of each. (6)
Why norepinephrine is not used in this condition? (1)
[Supple 2018 held in 2019]

2. Enlist the therapeutic uses of sympathomimetic drugs. (2) [Annual 2018]

3. A middle-aged man was admitted to cardiology ICU. He has cardiogenic shock after
acute myocardial infarction. He was given intravenous infusion of dopamine along
with other medications. [Annual 2017]
a) Why dopamine was given by intravenous route and in infusion form?
b) Briefly describe dose-dependent actions of dopamine on CVS.
c) Why dopamine is preferred over norepinephrine in some shocks. What is the
advantage of norepinephrine over dopamine?

4. Enumerate cardiovascular uses of sympathomimetic agents. Give atleast one

example of each. (4) [Supple 2016 held in 2017]

5. A patient was given injection of an antibiotic. Few months later, he developed

angioedema, bronchospasm and severe hypotension. He was immediately given I/M
injection of epinephrine with marked improvement. [Annual 2016] a) Enumerate
four clinical applications of epinephrine. (4)
b) How epinephrine improved the condition of above-mentioned patient? Explain
with reference to receptors involved. (3)

6. A 19-year-old girl, a new resident of a pine tree locality has developed

breathlessness, dyspnea and wheeze suggestive of acute attacks of asthma. Enlist the
sympathomimetics that can be given in her case.
Enumerate mechanism of action of terbutaline at receptor level.
Enumerate therapeutic uses of clonidine. [Annual 2014]

7. Enlist five clinical uses of sympathomimetic drugs with one drug example of each
use. [Supple 2008]
7.

8. Justify the use of epinephrine in anaphylactic shock. [Annual 2022]

Adrenoceptor Blockers

1. A 45 year old woman, who is a known patient of chronic open angle glaucoma ,
reported to you for aggravation of her symptoms; which drug will be instilled to
lower her intraocular pressure immediately? Tabulate the groups useful for her along
with their possible mechanisms of lowering intraocular pressures.[Annual 2021]
2. How different autonomic drugs decrease intraocular pressure in open angle
glaucoma? (2) [Annual 2018]

3. Write pharmacological basis for the use of prazosin in benign prostatic hyperplasia
(1.5) [Annual 2018]

4. A 70 years old male patient complains of urgency and frequency of micturition. On

examination he has enlarged prostate (BPH) for which surgical treatment is advised.
As he is not willing for surgery, which group of drugs may be prescribed to relive the
symptoms? Give two examples. (2)
What are other indications and adverse effects of this group of drugs? (5) [Supple
2017 held in 2018]

5. A 30-year-old male is diagnosed as a case of essential mild hypertension and is

advised one B-adrenoceptor blocking drug. Classify these drugs based on relative
blocking activity for B1 and B2 receptors and give one/two examples for each group
as applicable. (4) [Supple 2016]

6. Enlist four clinical uses of alpha-receptor blockers. Give one drug of choice for each
indication. (4) [Annual 2015]
7. Write down the clinical uses of alpha-adrenoceptor blockers with examples. [Annual
2012]

8. How different autonomic drugs lower intraocular pressure? [Supple 2011]

9. Enumerate 7 important uses of propranolol with order of preference. [Annual 2009]

10. What could be the answer of a medical student who was asked to enumerate 7 uses
of beta adrenoceptor blockers? [Supple 2009]

11. Enumerate alpha 1 selective blockers along with their clinical uses. [Supple 2022]

12. A 30 year old patient brought to medical emergency with severe headache and
palpitations. His blood pressure was 160/ 100 and 89 pulse rate. Pheochromocytoma
was diagnosed on the basis of imaging And elevated plasma and urine levels of
norepinephrine,epinephrine and their metabolites normetanephrine amd
metanephrine.
A)Classify alpha blockers according to receptor selectivity and write down the role of any
specific alpha blocker in pheochromocytoma.
B) Why beta blockers should not be used prior to establishing an effective alpha receptor
blockade in this patient? [Annual 2023]

13. A)Classify beta blockers according to their selectivity, giving one main use and one
example for each type.
B) 57 years old diabetic, non hypertensive office superintendent comes to you with
urinary retention, diagnosed as benign prostatic hyperplasia. After initial
management, which drug would you prefer giving to him and why? Give its two
main adverse effects. [Supple 2023]
7.

 CARDIOVASCULAR SYSTEM
Drugs used in Hypertension

1. A 60 years old hypertensive and diabetic patient comes to you in outdoor

patient department with complaints of pain in joints of toe specially big
toe. On history it has been revealed that he has been recently switched to
a new anti hypertensive drug by a family physician his blood pressure
reassure is 122/ 84 mm HG with heart rate of 74 per minute . His diabetic
profile is under normal limits.

A) What was the drug prescribed? Enumerates it’s side effects.

B) Considering his diabetic status prescribe him an alternative and antihypertensive
drug. (annual 2022 held in 2023)
2. A 37 years old businessman presents with the blood pressure of 150/95
mmHg. He has been generally healthy, is a non smoker but take a few
drinks of alcohol daily . He is moderately observe and has a sedantery
lifestyle. He has a family history of hypertension and his father died o f
myocardial infarction at age 54 . Total cholesterol is marginally raised and
high density lipoprotein (HDL)cholesterol levels are low . Normal fasting
glucose is 105 milligram /DI. Chest X-ray is normal. Electrocardiogram
shows left ventricular enlargement .
A) How would you treat this patient? Justify your choice of drug.
B) What lifestyle/ behavioural changes would you advise to this patient.
(supply 2022 held in 2023)

3. A 50 year old Type-2 Diabetic patient presents in the OPD with raised
blood pressure; to lower his blood pressure which drug groups should be
preferred and how they prevent diabetic nephropathy?[Annual 2021]

4. A middle-aged man presents with blood pressure of 150/100 mm Hg. He

has sedentary lifestyle and family history of hypertension. Apart from
lifestyle changes, he is advised to take Amlodipine 5 mg twice daily. To
which group of drugs does Amlodipine belong? Enumerate cardiovascular
 uses of this group with mechanism of beneficial effect for each indication.
(7) [Supple 2018 held in 2019]

5. A 50 years old patient has complaint of frequent headache. He visited

outpatient department and his clinical examination revealed blood
pressure of 160/100 mm Hg. Name four groups of drugs out of which
physician may choose to start initial therapy as a single agent. Briefly write
the mechanism of antihypertensive effects of each.

6. Which one of these groups may adversely affect lipid profile of patient?
[Annual 2017]

7. A 50-year-old man come to OPD with history of headache. His BP is 150/90

mm Hg. He is advised low salt diet and to keep record of his BP. In spite of
taking low salt diet, his BP is not controlled. [Supple 2015]
A) Name four groups of drugs which may be used as monotherapy for his
hypertension.
B) Which two groups of drugs are preferred in case of diabetes too? Explain their
mechanism of antihypertensive effects.

8. A general practitioner decides to administer short acting oral nifedipine

preparation to a 65-year-old hypertensive with BP 180/100 mm to bring
down his BP. What can be the risk? [Supple 2013]

9. Which drugs may be useful in a 35-year-old newly diagnosed patient with

mild hypertension? How will they lower bp? [Supple 2011 ]

10. Which drugs may be useful in a 35-year-old newly diagnosed patient with
mild hypertension? How these will lower his blood pressure? [Supple
2011)
Drugs used in the Treatment of Angina Pectoris

1. A) 55 years old female patient came to emergency department with sudden on set
of severe chest pain. The pain is sharp and compressing in nature radiating towards
left arm. Baseline lab test ECG was done. The patient is diagnosed as a case of
angina of effort/classical angina and angina pectoris . Enlist three major and
antianginal groups of drugs along with one example of each.
B) explain the mechanism of action of digoxin and enlist its adverse effects. (annual
2022 held in 2023)

2. Name three groups of drugs commonly used in Angina of Effort along with their
mechanism of antianginal effect. Which group of drugs is contraindicated in
vasospastic angina? [Annual 2016]

3. A 60-year-old patient suffering from Angina of Effort is treated with metoprolol (a

beta blocker). Enlist beneficial and deleterious effects of beta blockers in the treatment
of angina. Which drug is combined with beta blocker to correct the deleterious effect?
(4) [Annual 2015]

4. 65-year-old male complains of precordial pain radiating towards his shoulder even
after moderate exercise. Pain is relieved after 5-10 minutes of rest. His is diagnosed of
stable angina. What treatment should be given to subside pain and secondly to prevent
further attacks? [Supple 2014]

Drugs used in Heart Failure

1. Mr M is being treated with thiazide diuretics and ACE inhibitors for chronic
congestive heart failure but there is no improvement in his clinical condition. It is
decided that AC inhibitors be replaced with digoxin.
A) What are mechanical and electrical effects of digoxin ,also give its adverse effects .
B) Explain different pharmacokinetic and pharmacodynamics drug interaction of
warfarin.(Annual 2021 held in 2022)
2. Enumerate beta blockers which can be given in chronic heart failure along with their
mechanism. (1+2) [Annual 2018]
3. Tabulate briefly the effects of therapeutic dosage of Digoxin on SA node, atrial
muscle, AV node and Electrocardiogram. [2016 Supple]

4. Treatment is being planned for 60-year-old female with chronic congestive heart
failure. Write specific indications for administration of Digoxin to patient of CCF to
improve clinical condition. How ACE inhibitors work and what edge do they have over
Digoxin? [Supple 2013]

5. A 40-year-old patient has been diagnosed with congestive heart failure. Enumerate
the different drug groups commonly used for heart failure to select proper
management for him. [Annual 2010]

6. Explain the reason for clinical usefulness of digoxin in atrial fibrillation. [Supple 2010]

Antiarrhythmic Drugs

1. A) Classify antiarrhythmic drugs giving at least one example of each.

C) Discuss the role of Aspirin as a platelets aggregation inhibitor , giving its mechanism
of action and at least 3 recognised adverse effects. (Annual 2023)
2. Name drug of choice in ventricular tachycardia, its cardiac effects along with toxicity.
(2+2) [Annual 2018]

3. Enumerate Class II antiarrhythmic drugs and write their clinical uses. [Annual 2012]
Diuretics & Other Drugs That Act on the Kidney

a A patient 45 years of age comes to you with history of passing stones in urine
frequently. He Is a known case of heart disease ,for which he is on warfarin and
loprin. Now for his recent problem of idiopathic hypercalciuria he is advised to
take thiazide.
Write about the pharmacodynamics of thiazide. (supply 2021 held in 2022)
b Enumerate four clinical indications of loop diuretics with rationale for use in
each condition. What are their adverse effects? (4+3) [Supple 2017 held in
2018]
 c Classify diuretics according to the site of action. Give in a tabulated form the
effects of Carbonic Anhydrase Inhibitors, Loop Diuretics, Thiazides and
Potassium Sparing Diuretics on urinary electrolytes (Na+, K+, Ca2+, HCO3-) and
blood pH. [2016 Supple held in 2017]

d Enlist the effects of Carbonic Anhydrase Inhibitors, Loop Diuretics, Thiazides and
Potassium Sparing Diuretics on urinary electrolytes (Na+, K+, Ca2+, HCO3-) and
blood pH. (3) [Supple 2016]

e Enlist six side effects of thiazide diuretics. [Annual 2015]

f elderly man was diagnosed with CHF. The symptoms included

breathlessness on walking, swollen ankles. Patient was prescribed
Bendroflumethiazide 10 mg daily. Soon after starting treatment he felt
unusually fatigued and lethargic. [Annual 2014]
A) Why a thiazide diuretic was prescribed and what alternative drug
treatments are available?
B) Why he had breathlessness and swollen ankles?
C) What is the possible cause of patient’s fatigue and lethargy and how
might they be corrected?
g
a) A 40-year-old lady reported to your clinic with unexplained tiredness. She had a
healthy look but moderately overweight and gave family history of hypertension
and myocardial infarction. Bp was 150/110 mm Hg. Her total cholesterol, HDL
cholesterol, blood sugar and chest x ray were normal. What measures and drugs
are advised for this patient?
b) Enumerate toxic effects of potassium sparing diuretics.
[Annual 2013]

h Write down the clinical uses and adverse effects of loop diuretics. [Annual 2012]

i Explain the reason for clinical usefulness of thiazide diuretics in mild to

moderate hypertension. [Supple 2010]
 RESPIRTORY SYSTEM
1. A Teenager girl with a history of Asthma requireing daily inhaled corticosteroid therapy and
allergies to house dust, cats, mites, grasses and Ragweed presents to emergency
department, in pollen season, complaining of cold complicated by worsening shortness of
breath and audible inspiratory and expiratory wheezing. She appears frightened and refuses
to lie down but is not cyanotic. Her pulse is 120 BPM and respirations are 32/min. Her
mother states that she has used her Albuterol inhaler several times a day for past 3 days and
twice during previous night. She toook an additional 2 puffs on her way to emergency
department, but her mother states that “the Inhaler didn’t same to be helping so I told her
no to take anymore”. What emergency measures are indicated? How should her long term
management be altered? (Supply 2023)
2. A 19 year old female presents in emergency with shortness of breath and cough. On
oscillation, she has bilateral vision. She has been mistakenly given salbutemol
intravenously. Which side effects you expect to see in this patient? (Annual 2023)
3. What is role of corticosteroids in chronic asthma? (Supply 2022)

4. The use of theophylline, once a main stay of asthma treatment, has almost seized
with demonstration of greater efficacy of inhaled adrenoceptor agonists for acute
asthma and of inhaled anti inflammatory agents for chronic asthma. In spite of this
decline, theophylline is still used in some countries because of its low cost.
What are reasons for decline in use of theophylline? Give its mechanism of action in
asthma. (Annual 2022)

5. An asthmatic patient presents in the pulmonary OPD with complaint of recurrent

attacks of asthma. Which inhalational corticosteroids to the patient are to be
started? Enumerate respiratory corticosteroids with surface activity.[ Annual 2021]

6. A 19-year-old moves from a small town to your city, and is now your patient. He has a
history of asthma and his previous primary care physician was managing it with
albuterol and theophylline. What is the main mechanism that accounts for the
beneficial effect of these drugs? (3) [Annual 2018]

7. What is the route of administration of ipratropium in COPD and why is it considered

better than atropine in this condition? (3) [Supple 2017 held in 2018]
8. Which drugs/drug groups are used for long term control of asthma? Briefly write the
mechanism of action of each in controlling asthma. (4) [Annual 2017]

9. Enumerate three groups of bronchodilators available for treatment of acute

bronchospasm. Which group is considered as first-line therapy? Give its mechanism
of action, adverse effects and preferred route of administration. (7) [Supple 2016
held in 2017]

10. A 12-year-old is brought to emergency room with shortness of breath and wheezing.
His pulse rate and respiration are increased and he is restless. His father gave
previous history of asthma. What emergency measure will you take to treat and what
is long term control? [Annual 2016]

11. Classify drugs for the prevention and treatment of bronchial asthma with two
examples for each group. [Supple 2016]

12. A patient is suffering from bronchial asthma. Enlist steroids used by inhalation route.
Give mechanism of beneficial effects of steroids in asthma. [Annual 2015]

13. An eight-year-old boy has mild persistent bronchial asthma (broncho-constrictive

episodes more than 2 times/week). Long term control with low dose inhaled
corticosteroids can be achieved but the parents do not agree to administer
corticosteroids (due to steroid phobia). The physician decided to give cromolyn by
inhalation regularly, to avoid broncho-constrictive episodes. By what mechanism will
cromolyn achieve long-term control? [Supple 2013]

14. Write down the role of methylxanthines in bronchial asthma and its common adverse
effects too. [Annual 2012]

15. A physician is intended to prescribe some agonist for his 30-year-old known
asthmatic patient. Name them with their preferred route of administration and
important adverse effects. [Supple 2011]
16. A 10-year-old child suffers from a severe attack of asthma whenever he runs while
playing with his friends. How can you manage him? [Annual 2011, Annual 2010]

17. A 25-year-old girl is suffering from an acute severe attack of bronchial asthma. Which
drugs may be used for her treatment? [Supple 2010]

18. A 25-year-old is suffering from an acute severe attack of bronchial asthma. Which
drugs may be useful for her treatment? Give their usefulness. [Annual 2009]

19. A 25-year-old girl is suffering from an acute severe attack of bronchial asthma.
Enumerate four drugs that may be used in the treatment along with their routes of
administration. [Supple 2009]

20. A mother brought her 10 years old child with complains of severe breathlessness,
wheezing and cough. She stated that attacks occurred in spring season. Case was
diagnosed to be as bronchial asthma. [Annual 2008]
a. Name the drug used to terminate the acute attack of bronchial asthma.
b. Enlist common adverse effects of inhaled steroids used in this disease.
c. What prophylactic therapy is required before the seasonal attack?

21. A 20-year-old female patient was injected aminophylline to control and acute attack
of bronchial asthma. What is the mechanism of action of the drug? Briefly give its
effects on organ system. [Supple 2008]

 CENTRAL NERVOUS SYSTEM

Sedative-Hypnotic Drugs

1. At her annual physical examination of 53 years old middle school teacher complaints
that she has been having difficulty falling sleep and after falling sleep she awakens
several times during The night . These episodes now occur almost nightly and are
interfering with the ability to teach.
 A) Enumerate the newer hypnotics that can be prescribed her for short time. By what
mechanism
They produce their effects and how they differ from barbeturates?
B) write down adverse effects of anti psychotics with brief description ( annual 2021
held in 2022)
2. A young patient presented to emergency room with convulsions for which he was
given I/V Diazepam. [Annual 2016]
a) Briefly describe its mechanism of action and enumerate six organ level effects of
this class of drugs.
b) If there is overdose with diazepam, what will be the consciousness level and how
it can be reversed?

3. A 50 years old man complains of disturbed sleep and prescribed a sedative hypnotic
drug, these drugs are classified into different groups. Classify and name one common
drug for each group. [Supple 2016]

4. A 30-year-old female was brought to the emergency with convulsions. A relative gave
past history of such attacks. She was immediately given IV of diazepam. Later EEG
was taken and she was prescribed valproic acid orally. [Supple 2015] a) Enumerate
indications of Diazepam.
b) What are the adverse effects of diazepam and valproic acid?

5. Write down the mechanism of action, clinical sues and adverse effects of
benzodiazepines. [Annual 2012]

6. Enumerate clinical uses of benzodiazepines. [Supple 2009, Annual 2010]

7. What is the rationale for clinical uses of benzodiazepines?

[Annual 2009, Supple 2010]

Alcohols
1. Write short note on mechanism of action of ethanol on CNS. [Supple 2016]
2. A 25-year-old man consumed a heavy quantity of whisky while sitting with his friends
in a bar. He felt nauseating and lost consciousness. He was rushed to the hospital and
blood alcohol concentration levels checked which was 400 mg/dl. [Supple 2014] a)
What pharmacologic and other measures will you take to save the patient?
b) If patient dies, what would be the cause of death?

Antiseizure Drugs
24 years old patient brought to emergency room with history of fall and body stiffness
with loss of consciousness and jerks followed by confusion and tiredness. He is
labelled as case of Grand mall epilepsy . Physician prescribed him phenytoin along
with other measures to be taken?

A. What are the various drug interactions and adverse effects produced by Phenytoin?
B. Give clinical uses of opoids analgesics with example of specific opoids for each.
(supply2021 held in 2022)
1. A 12 year old , school going child has been diagnosed as suffering from Absence
Seizures; which drug group will be preferred for him from the useful drug list and
why?[Annual 2021]
2. Enlist clinical uses of antiseizure drugs other than epilepsy. (2.5)
[2018 Supple held in 2019]

3. A young patient presented in emergency with tonic-clonic seizures. After initial

control, he was discharged on valproic acid. Write down mechanism of action,
clinical uses and drug interactions of valproic acid. (2+3+2) [Supple 2017 held in
2018]

4. Write clinical uses and drug interactions of carbamazepine. [Supple 2016 held in
2017]

5. A 30-year-old female was brought to the emergency with convulsions. A relative

gave past history of such attacks. She was immediately given IV of diazepam. Later
EEG was taken and she was prescribed valproic acid orally. [Supple 2015] a)
Enumerate indications of Diazepam.
 b) What are the adverse effects of diazepam and valproic acid?

6. A 35-year-old epileptic female has been prescribed phenytoin to control her Grand
Mal seizures. What adverse effects do you expect to see in this patient with the
continued use of phenytoin? [Supple 2013]

7. Write down four therapeutic uses of carbamazepine. [Supple 2008]

8. Give therapeutic classification of anti-epilepsy drugs. [Annual 2007]

General Anesthetics

1. What factors influence he uptake and distribution of inhaled anesthetics? How does
solubility of an anesthetic agent effect its onset of action? [Supple 2013]

Local Anesthetics

j 64 years old woman is scheduled for elective total knee arthroplasty .

A) what local anesthetics agents would be most appropriate if surgical anesthesia was
to be administered using a spinal or an epidural technique and what potential
complications might arise from their use.

4. What anesthetics would be most appropriate providing post operative analgesia via
an indwelling epidural nerve catheter ?(supply 2022 held in 2023)
a Give reasons for the use of vasopressor drugs with local anesthetic lignocaine.
[Annual 2012]

Drugs used in Parkinsonism & Other Movement Disorders

b A) What do you understand by the term neuro degenerative diseases of the

central nervous system? Name four diseases .how do they affect the human
body?
B) Tabulate the drugs used in Parkinson’s disease . give their mechanism of
action and adverse effects (supply 2022 held in 2023)
c Give the rational for the combination of Carbidopa with levoDopa. (Annual
2023)
 d A 57 years old man with a strong family history of Parkinson’s disease sees a
neurologist for an evaluation. On examination, the neurologist notes a slight pill
rolling tremor and subtle gait abnormalities. He explains that because it is not
yet possible to reverse the degenerative process, drugs are used to increase
dopamine activity in corpus striatum. Briefly explain mechanism of action of
drugs increasing dopamine functions in Parkinson disease. (4) [Annual 2018]

Antipsychotic Agents & Lithium

1. Write short notes on 1.Mac value 2.autonomic adverse effects of anti psychotics.
(annual 2022 held in 2023)
2. A 40 year old schizophrenic patient was well maintained on Thioridazine for the last 3
years, but now he has developed choreathetoid movements of the muscles of the
lips and buccal cavity. Why this trouble has developed and how it may be
managed?[Annual 2021]
3. Enlist adverse pharmacological effects of typical antipsychotics with reference to
receptors. (4.5) [2018 Supple held in 2019]

4. Enumerate the therapeutic uses of antipsychotic drugs. (3) [Annual 2018]

5. A 26-year-old man is referred to psychiatric OPD. History-taking revealed that he has

both positive and negative symptoms of psychosis including suicidal tendency. He is
prescribed chlorpromazine. After 4 months, he is again brought to OPD. His father
tells the doctor that despite strict compliance many symptoms still persist and some
other symptoms are added to the picture. This time he is switched to clozapine and
advised blood white cell count weekly. [Annual 2017]

a) What are the adverse effects of chlorpromazine?

b) Why the patient is switched to clozapine and how does it work? What are the
adverse effects of clozapine?
c) Why doctor has advised blood white cell count on weekly basis? What other
drugs can be given to the patient if serious adverse effects of clozapine appear?

6. Write the neurologic and autonomic adverse effects of older antipsychotic drugs.
[Supple 2016 held in 2017]
7. A patient suffering from schizophrenia is taking an antipsychotic drug. Enlist adverse
effects of these drugs on autonomic nervous system and central nervous system.
Give mechanism of the side effects. [Annual 2015]

8. A 24-year-old patient presents in OPD psychiatric unit. He complains of feeling very

low, having suicidal thoughts and disturbed sleep for past 6 months. He says that
people can hear his thoughts, song lyrics refer to him and he hear voices in his head.
His family members claim that its increasing day by day and he stopped going to
work. He looked shabby and unkempt. [Annual 2014] a) Classify drugs that can be
used in this condition.
b) Name common adverse effects of these drugs.
9. A 25-year-old patient has been taking therapeutic doses of morphine and
chlorpromazine since many months. What will be their adverse effects on his CNS?
[Supple 2011]

10. What are the differences between typical and atypical antipsychotic drugs? [Supple
2009, Annual 2010]

11. Explain the MOA of typical and atypical antipsychotic drugs.

[Annual 2009, Supple 2010]

12. A 40-year-old lady was suffering from schizophrenia and taking chlorpromazine for
the last 1 year. Enlist 6 common side effects of the drug which may appear during
treatment. [Supple 2008]
13.
a) Enlist four features of clozapine in treatment of schizophrenia.
b) Why regular monitoring of blood count is required during clozapine therapy?
[Annual 2008]

Antidepressants

1. A young lady became depress after her divorce . She took a drug for few months on
advice of her pharmacist friend. She feels no improvement in mood and visits a
 primary care physician who prescribes her fluoxetine once weakly preparation . She
soon comes in emergency department with hyperthermia, muscle rigidity, tremor
and agitation
Give pharmacological reasons of this life threatening situation. ( Annual 2023)
2. A 30 years old female gives you a history of fatigue, very early wakeup, insomnia and
loss of weight and appetite, after a divorce a few weeks back. She is diagnosed as a
case of major depression and prescribed fluoxetine. [Annual 2013] a) What edge
does I have over other antidepressant drug groups? b) Enlist its adverse effects.

3. A 30 years old male has been prescribed benzodiazepines for Generalized Anxiety
Disorder (GAD) by a psychiatrist. [Supple 2010, Annual 2011]
a) What are the advantages and disadvantages of benzodiazepines?
b) Which other class of drugs is being considered as drugs of first choice for GAD?
c) Name at least four serotonin selective reuptake inhibitors (SSRIs). What is the
reason of preferring SSRIs over other antidepressants?
3.
a) Describe three comparative features of tricyclic antidepressants and SSRIs.
b) Explain the result of concurrent administration of MAO inhibitors and tricyclic
antidepressants.
[Annual 2008]

Opioid Analgesics & Antagonists

1. Enumerate the central effects of morphine (annual 2022 held in 2023)

2. Explain three different mechanisms by which tramadol exerts its effects. (3) [Annual
2018]

3. Enlist six contraindications and cautions to the use of opioids. [Annual 2015]

4. A 25-year-old patient has been taking therapeutic doses of morphine and

chlorpromazine since many months. What will be their adverse effects on his CNS?
[Supple 2011]
 DRUGS WITH IMPORTANT ACTIONS ON BLOOD,
INFLAMMATION, & GOUT
Drugs used in Coagulation Disorders
1. Enumerate Lower Molecular Weight Heparins; what is their mechanism of
actions?[Annual 2021]
2.Write toxic effects of heparin. [Supple 2014] 2.
a) A 60-year-old male has had a major surgical procedure after which he remained in
bed for about a fortnight. Now he complains of discomfort in the right calf muscle.
On examination there is erythema, edema and the calf is tender to touch.
Ultrasound reveals deep venous thrombosis in the right lower extremity. Heparin is
administered to this patient. How will heparin produce its anticoagulant effect and
what are its toxic effect and its contraindications? (4)
b) How does argatroban differ in its action from heparin and what are its approved
indications? (3)
[Supple 2013]

3. How do the following produce their beneficial effect?

a) Streptokinase in coronary thrombosis
b) Aspirin in post myocardial infarction patients
[Annual 2008]
4.

a) Name low molecular weight heparin.

b) What is the treatment of heparin overdose?
[Annual 2008]

5.
a) A 50 years old lady came to your hospital with complains of constant precordial
pain for last few hours. On ECG findings, she was diagnosed with unstable angina.
She was administered heparin but stopped due to gums bleeding. List four adverse
effects of the drug and name the specific antidote.
 b) Enlist four antiplatelet drugs. [Supple 2008]

NSAIDs, Acetaminophen, and Drugs Used in Rheumatoid Arthritis & Gout

1. A 4o year old man presents with complaints of bilateral morning stiffness in his wrists
and knees and pain in these joints on exercise. On physical examination, the joints are
slightly swollen. His laboratory findings favor the diagnosis of Rheumatoid arthritis. Classify
the drugs used for Rheumatoid Arthritis. Why Meloxicam is preferred drug over piroxicam?
(Supply 2023)

2. A45 year old man presented with complaint of bilateral stiffness in his hand,wrist,elbow
and feet, knee joints with pain. All joints appeared swollen, warm and tender ,DMARDs
therapy started
a)What are the two different types of DMARDs? Enumerate four drugs from each type.
b)What are the advantages and disadvantages of cox-2 inhibitors over cox-1 inhibitors?
(Annual 2023)
3. A 38 year old man presents with an cute onset of pain, swelling erythema of the left first
metatarsophalangeal joint. On investigations he has high serum uric acid, leucocyte and C
reactive protein (CRP) levels. A diagnosis of acute goute is made.

A) 1) enlist the drugs that can be used in acute attack of gout.

2) can allopurinol be used in acute attack? Justify your answer.
B) write down the principal mechanism of action of methotrexate in treatment of
Rheumatoid arthritis. (Annual 2022)

4. A 52 year old female has been diagnosed as a patient of Rheumatoid arthritis. The
children decides to use Non-steroidal anti-inflammatory agents for her.
a) By what mechanisms will these drugs suppress the pain and inflammation ?
b) For what other clinical conditions are these drugs useful?
c) What adverse effects may be experienced during long-term treatment?[Annual 2021]

5. A 38-year-old woman presents with complaint of bilateral morning stiffness in her

wrists. On examination, these joints are slightly swollen. Laboratory findings are
negative except for elevated ESR. With a diagnosis of Rheumatoid arthritis, she is
started on a non-steroidal anti-inflammatory drug regimen. Enumerate
 pharmacological actions and explain mechanism of action of this group. Which
adverse effects are expected with chronic use of this group? (3+4) [2018 Supple held
in 2019]

6. Name four disease-modifying antirheumatic drugs (DMARDs) along with their

mechanisms. (4) [Annual 2018]

7. Compare aspirin and acetaminophen regarding mechanism of action,

pharmacological actions, uses and adverse effects. (7) [Supple 2017 held in 2018]

8. Enlist two drugs that can cause hyperuricemia and enumerate four drugs used to
treat hyperuricemia. [Annual 2017]

9. What is the mechanism of action of allopurinol? Give it four side effects. [Annual
2017]

10. A woman presented with acute gout was treated with Indomethacin followed by
allopurinol. Explain the mechanism of action of both drugs in gout. Why allopurinol is
not given in an acute attack? Name another use of allopurinol apart from gout.
[Supple 2017]

11. A) Aspirin is prototype of salicylates and other NSAIDs. It is used as antiplatelet,

analgesic, antipyretics and anti-inflammatory in various doses. Write briefly the
mechanism of action of the above effects. (4)
B) Name the disease modifying anti-rheumatic drugs (DMARDs/Slow Acting ARDs)
and enlist the toxic effects of any two when used for Rheumatoid Arthritis. (3)
[Annual 2016]

12. A) Disease modifying antirheumatic drugs are divided into non-biologic and biologic
agents. Enlist four examples of each group. (4)
B) Write short essay on the antigout mechanism of action of allopurinol. (3)
[Supple 2016]
 13.
a) Enlist four cardiovascular applications of aspirin. Give mechanism of
cardioprotective effects of aspirin in these applications. (4)
b) A patient suffering from headache and myalgia is treated with paracetamol
(acetaminophen). Enlist indications where paracetamol is preferred to aspirin as
an analgesic and antipyretic. (3) [Annual 2015]

14. Compare aspirin and acetaminophen regarding:

a) Pharmacological action
b) Indications
c) Adverse effects
[Supple 2015]

15. The eicosanoids are an important group of endogenous fatty acid derivatives that are
produced from arachidonic acid. The major families of eicosanoids are leukotrienes,
prostacyclins, prostaglandins and thromboxanes. Enlist the clinical applications of
prostaglandins and the specific agent used for each purpose. [Supple 2014]

16. Write briefly the antigout mechanism of action of colchicine. [Supple 2014]

17. have a number of clinical applications and are widely used. Write short essay on the
inflammatory and immunosuppressant mechanism of these agents. [Annual 2013]
18.
a Write a short essay note on the anti-inflammatory mechanism of NSAIDs.
b Enumerate the adverse effects of aspirin.
[Annual 2013]
19.
a) Enumerate drugs of acute attack & prophylaxis of gout. (3)
b) Write down the mechanism of action and pharmacological effects of NSAIDs. (4)
[Annual 2012]
20. A 35-year-old known patient of gouty arthritis is unable to excrete uric acid properly.
Which useful drugs can be given to him and how these will act? (7) [Supple 2011]

21. What is the pharmacokinetics of aspirin? Give the mechanism of action of aspirin for
its different pharmacological effects. (2+2) [Annual 2010]
22.
a. A 40-year-old lady is taking NSAIDs for arthritis since many months. What are
various strategies for prevention of drug induced gastritis? (4)
b. What is the rationale for the use of allopurinol for lowering of urates? (3)
[Annual 2009]
23.
a) How do NSAIDs exert their anti-inflammatory actions? (3.5)
b) Write down the mechanism of action of allopurinol. (3.5) [Supple 2009]
24. A child was brought to emergency six hours after ingestion of toxic dose
acetaminophen with vomiting and diaphoresis. Besides supportive treatment, he was
prescribed N-acetylcysteine.
a) What is the rationale of using N-acetylcysteine in this case?
b) Enlist two differences between aspirin and paracetamol. [Annual 2008]
25.
a) Name two drugs used in chronic gout.
b) Can allopurinol be given in acute gout?
[Annual 2008]
26. four common pharmacological effects of aspirin & write the mechanism of action.
[Supple 2008]

27. Describe the mechanism of action and clinical uses of allopurinol. [Annual 2007]

 ENDOCRINE DRUGS
Hypothalamic & Pituitary Hormones

1. Give rationale for the use of oxytocin in antepartum and postpartum period (2)
[Annual 2018]
 Thyroid & Antithyroid Drugs

1. A 29 year old young expecting mother in her third month of pregnancy is diagnosed
with hyperthyroidism. Which drug would be your first choice in this case and why?
Give it’s mechanism of action and adverse effects.
B)Tabulate clinical uses of estrogens and progesteins.

2. Write mechanism of action and the adverse effects of Thioamides .[Annual 2021]
3. A middle-aged woman complaints of weight gain, decreased appetite, constipation,
lethargy and fatigue. On examination she has pale, puffy face and decreased deep
tendon reflexes. Laboratory investigation reveals low T3, T4 and elevated TSH level.
Considering his diagnosis of hypothyroidism, what should be prescribed to her?
Write the mechanism of action of this drug and adverse effects if taken in excess.
[Supple 2017 held in 2018]

4. A 25-year-old patient receiving medication for hyperthyroidism develops rash,

pruritis, fever, diarrhea, bitter taste in mouth and feeling of anxiety.
a) Which antithyroid drug is most likely to have caused these symptoms?
b) Explain its mechanism of action. [Annual 2014]

5. Write the role of B-blockers in hyperthyroidism. [Annual 2012]

Corticosteroids & Antagonists

1. A patient was suffering from severe symptomatic gout and was prescribed a
glucocorticoid for short duration. If patient keeps on taking it for prolonged period,
which adverse effects are expected? (7) [Annual 2016]

2. A 30-year-old man complains of loss of appetite, tiredness, dizziness and weight loss
of 6 months duration. His physician got routine blood tests and found hyponatremia,
hyperkalemia & acidosis. A standard ACTH stimulation test confirmed diagnosis of
autoimmune Addison’s disease and patient was prescribed hydrocortisone &
fludrocortisone. Enlist the adverse effects and contraindications of hydrocortisone.
[Supple 2014]
3. Glucocorticoids have a number of clinical applications and are widely used. Write
short essay on the inflammatory and immunosuppressant mechanism of these
agents. [Annual 2013]
4. A 45-year-old lady is taking prednisolone since last 6 months. What could be the
possible adverse effects in her due to glucocorticoids? [Annual 2009]

5. What could be the adverse effects of glucocorticoids in a 45-year-old lady who has
been taking them since last 6 months for some chronic problem? [Supple 2009]

6. Name five glucocorticoids which belong to intermediate or long acting group.

[Supple 2008]

Gonadal Hormones & Inhibitors

1. A 26 year old female visit gynae OPD to seek advice for contraception. Her interest is
to take some oral preparation for birth control.
What are the types of preparations used for oral contraception?
Explain mild moderate and severe toxicities of oral contraceptive pills.
(Annual 2023)
2. Give rationale for the use of hormonal therapy in postmenopausal women (2)
[Annual 2018]

3. A middle age woman having four children visited family planning clinic for prevention
of next pregnancy. She was advised oral contraceptive pills containing estrogen and
progesterone. What are other clinical uses of oral contraceptive pills?
Enumerate mild, moderate and severe effects of these pills. [Annual 2017]

4. Enlist 6 contraindications and cautions to the use of oral contraceptives. [Annual

2015]

5. Write the clinical uses and the different ranges of adverse effects seen with the
continued use of oral contraceptive pills. [Supple 2013]
6. A 35-year-old married lady without any child due to anovulation wishes to become
pregnant. Which may be the useful drug and how will it act? [Supple 2011]

7. What is the rationale for the use of clomiphene in infertility? [Annual 2008]

Pancreatic Hormones, Antidiabetic Agents, & Glucagon

1. Explain diagrammatically the mechanism of action of sulfonylureas. (Annual 2023)

2. Classify insulin types according to it’s duration of action.
What do you understand by the abbreviation SERM. Give their uses and differences
in adverse effects.(annual 2022)

3. Name rapid acting insulins. How does the change in their structure affect their
pharmacokinetics and what added benefits do these formulations have over
regular insulin? Write their clinical use. [Annual 2021]

4. A 45-year-old woman presents to family physician with symptoms of fatigue, weight

loss, increased thirst and frequent urination. Her random blood sugar is 300 mg/dl
and fasting blood sugar 180 mg/dl. Treatment with glimepiride does not control
blood sugar level after six months of regular medication. He is planned to switch
over to insulin therapy. Name the principle types and briefly describe the
characteristics of available insulin preparations. What are the most common
complications of insulin therapy and how to combat it? (4+3) [2018 Supple held in
2019]

5. Give rationale for the use of biguanides as first line therapy for type II diabetes (3)
[Annual 2018]

6. A type II diabetic patient was well controlled on an oral antidiabetic drug. He

required surgery for hip fracture. Before surgery he was switched over to insulin.
[Supple 2016 held in 2017]
a) What are the actions of insulin on liver, skeletal muscle and adipose tissue? (3)
b) Enumerate four types of insulin preparations with at least one example of each
type. (4)
7. A 50-year-old man presented with symptoms of polydipsia, polyuria and dyspnea of
few months’ duration. His pulse and bp were normal and lab tests revealed raised
fasting and random sugar levels. He also gave familial history of diabetes. Name
various drug groups of oral hypoglycemics with one example each. [Supple 2016]

8. A 60-year-old patient is suffering from type II Diabetes Mellitus. Enlist 3 second

generation sulfonylureas which can be used in this patient. Give mechanism of action
of these drugs. [Annual 2015]

9. A 12-year-old boy had history of weight loss, fatigue, polyuria, nocturia. His physical
examination is normal and blood sugar level was 280 mg/dl.
a Which treatment strategy is available in this case of type I Diabetes Mellitus?
b What are complications of this treatment and how they can be dealt with?
[Supple 2015]

10. Write down different insulin preparations and their duration of action. Which drug
other than insulin is used in the management of insulin dependent Diabetes Mellitus.
Also justify its use. [Annual 2012]

11. A 48-year-old known type II diabetic patient is not responsive to insulin therapy.
Which and how an oral drug can be effective in this case? [Supple 2011]

12. A 45-year-old newly diagnosed diabetic patient is frequently showing post meal rise
in his blood glucose levels. [Annual 2010] a Which rapidly acting insulin analog can
be used for more physiologic insulin replacement? (1.5) b What are their structural
characteristics? (2) c
Give their advantages over human insulin. (3.5)

13. A 30-year-old male is suffering from type I Diabetes Mellitus? What may be the role
of oral antidiabetic drugs in him? [Annual 2009]

14. A 30-year-old male is suffering from type I Diabetes Mellitus. Why he should not be
treated with oral antidiabetic drugs? [Supple 2009]
15. Classify and enumerate insulin preparations. [Annual 2008]

16. Write briefly the hypoglycemic mechanism of action of sulfonylureas. [Supple 2008]

17. Enumerate some sulfonylureas. Describe the mechanism of action. [Annual 2007]

 CHEMOTHERAPEUTIC DRUGS
Beta-Lactam Antibodies & Other Cell Wall Synthesis Inhibitors

1. Give rational for combination of amoxicillin and clavulanic acid.( 2022)

2. What are the clinical uses of Vancomycin? [Annual 2021]

3. Write down clinical uses of penicillin antibiotics. (4) [Annual 2018]

4. A 65-year-old elderly patient suffering from lobar pneumonia. His sputum culture is
positive for beta-lactamase positive staphylococci. [Annual 2014]

a) What drugs can be used to treat this infection?

b) Explain mode of action of penicillins.

5. Write clinical uses and precautions for penicillin antibiotics. (2) [Annual 2012]

6. A 10-year-old boy is having cough and fever (chest infection). He had acquired this
infection while staying with his mother, who is admitted in hospital for some chronic
ailment. The culture sensitive of his sputum shows staphylococci which are resistant
to penicillins and other B-lactams. By what mechanism do microorganism develop
resistance against B-lactam drugs? (4) [Supple 2012]
6.

a) A 20-year-old patient suffering from endocarditis caused by methicillin-resistant

staphylococci (MRSA). Which inhibitor of bacterial cell wall synthesis may be the
1st choice for treatment? Enumerate its other uses. (4)
 b) What is the drug of choice for corynebacterial infection in a 6-year-old child? Give
important adverse effects of this drug. (3)
[Annual 2011]

7. Classify penicillins. Write down their mechanism of action and common adverse
effects. [Supple 2011]

8. Enumerate 4 drugs of 3rd generation cephalosporins. Enlist their therapeutic uses. (4)
[Supple 2009]

9. Enumerate antimicrobials that inhibit cell wall synthesis. [Annual 2007]

Chloramphenicol, Tetracyclines, Macrolides, Clindamycin, Streptogramins &

Linezolid

1. How erythromycin differ from azithromycin regarding its spectrum of activity? 2023
2. Give two examples of drugs used as topical antibiotics in acne.2022
3. Write down the clinical uses of tetracyclines and their adverse effects. (4) [Annual
2017]

4. A patient suffering from meningitis was treated with chloramphenicol. Explain the
adverse effects of this antibiotic. (4) [Supple 2016 held in 2017]

5. A patient suffering from community acquired pneumonia is treated with

erythromycin. Give antimicrobial spectrum of erythromycin. Write two
pharmacokinetic differences between azithromycin and erythromycin. (3+2) [Annual
2015]

6. Write down adverse effects of tetracyclines and which other drugs also produce
Fanconi syndrome? (2) [Annual 2012]

7. Write antimicrobial spectrum of tigecycline. (3) [Supple 2012]

8. Enumerate adverse effects of tetracyclines. (3) [Supple 2010, Supple 2009]

 9. Write down 6 clinical uses of tetracyclines. [Supple 2008]

10. Name microorganisms against whom erythromycin is considered as drug of choice.

[Annual 2007]

Aminoglycosides

1. What is mechanism of action, pharmacokinetic and adverse effect of

aminoglycosides. (2023)
2. Define “Empirical therapy”? Why aminoglycosides are better avoided in patient
taking furosemide? (2022)

3. A young man is admitted in ICU with burns over 30% of his body. He is febrile and
blood cell count shows leukocytosis. It is decided to treated with empiric
combination therapy including an aminoglycosides once daily. Which concepts form
the basis of once daily dosing protocol of aminoglycosides? Briefly explain the
mechanism of action of this group of antibiotics. (3+4) [Supple 2018 held in 2019]

4. Aminoglycosides have concentration dependent killing and significant post-antibiotic

effect. Define post-antibiotic effect. Give reasons why certain antibiotics show this
effect. (3) [Annual 2018]
5. A patient admitted in ICU for burns becomes febrile. Considering the danger of
sepsis, he is treated with tobramycin once daily dosing. Due to which properties of
aminoglycosides are administered as a single large daily dose? Write down their
clinical uses and adverse effects. (2+5) [Supple 2017 held in 2018]

6. An elderly patient had gram negative infection for which he was treated with an
aminoglycoside. Enumerate six clinical uses of this group of antibiotics. (3) [Supple
2016 held in 2017]

5.
a) A 30-year-old female presents to medical clinic with history of foul smelling,
mucopurulent vaginal discharge after sexual contact and one miss period. Her
urine test is found positive for chlamydial infection. What would be empiric
 approach to treat the patient (including posology) and the antibiotic
contraindicated, if she is pregnant? (3)
b) Write down short essay on the antimicrobial mechanism of action of
aminoglycosides. (4) [Supple 2016]

7. Enlist four common side effects of aminoglycosides. (2) [Annual 2015]

Sulfonamides, Trimethoprim & Fluoroquinolones

1. Give rational for combination of sulphamethoxazole and Trimethoprim.(2023)

2. Enumerate 4 fluoroquinolones. Give their mechanism of action and adverse effects.
(2022)
3. What is the antimicrobial mechanism and adverse effects of Fluoroquinolones?
[Annual 2021]
4. A 30 years old male is suffering from diarrhea and is not responding to routine
antidiarrheal drugs. He is suspected to be suffering from a pathogenic gram-negative
bacillus and is prescribed ciprofloxacin. Enlist the antimicrobial spectrum and adverse
effects of this antibiotic. (4) [Annual 2016]

5. A 55-year-old lady attended your clinic with complains of dysuria, chills and fever for
four days. She gave a history of urinary tract infection resolved with cotrimoxazole.
Now she is advised a course of ciprofloxacin. Write down antimicrobial mechanism of
action of this drug and enlist the antibacterial spectrum. [Supple 2013]

6. A 40-year-old male is admitted in emergency with life threatening anaerobic

infection. Which 4th generation fluoroquinolones may be given to him? What are the
other clinical uses of fluoroquinolones? (4) [Supple 2010]

7. Write a short essay on the mechanism of action of cotrimoxazole? (4) [Supple 2014]

Antimycobacterial Drugs
1. A young patient came to pulmonology OPD with complaints of chronic
productive cough, hemoptysis and low grade fever. He was diagnosed as case
of pulmonary tuberculosis.
Name first line drugs along with their mechanism of action and adverse effects in the
tabulated form. (Supply 2023)
2. A 60 year old man presents to emergency department with the two month history of
fatigue, weight loss (10 kg), fever, night sweats and productive cough. A chest x-ray
shows a right apical infiltrate. His first apical spectrum smear shows many acid fast
Bacilli.(Annual 2023)
What is first line therapy for the patient. Give adverse effect of any two of them?
3. A 34 year old male presents with complaints of low grade fever, night sweats, cough
and marked weight loss (10 kg). Chest X-ray shows right apical lung infiltrates. And on
sputum examination, acid fast Bacilli are seen. The patient is started on first line
antitubercular drug therapy including isoniazid, Rifampicin and pyrazinamide. Few
months after treatment, he complaints of numbness and tingling sensation in arms.
I- Name causative drug and write down its mechanism of action.
Ii- Give reason for these adverse effects and how can these be prevented.
(Annual 2022)

4. Tabulate the first preferred regimen for drug-susceptible tuberculosis with its
duration of the therapy . Why do we need to give pyridoxine with isoniazid? [Annual
2021]
5. Name the alternative drugs for tuberculosis. (3) [Annual 2018]

6. A middle-aged man with three months history of low-grade fever and productive
cough was diagnosed to have pulmonary tuberculosis. Treated was started with a
combination of drugs. Name first line ant tuberculous drugs. Enumerate their
important adverse effects. Why they are always given in combination? [2017 Supple
held in 2018]

7. A young patient came to pulmonology OPD with complaints of chronic productive

cough, hemoptysis and low-grade fever. He was diagnosed as a case of pulmonary
tuberculosis. Name first line ant tuberculous drugs. Write down important adverse
effects of each. [Annual 2016]
8. For treatment of pulmonary TB, four drugs are given for three months and then two
drugs are given for nine months. [Supple 2015]
a) What is the reason for giving drugs in combinations?
b) Name 1st line anti-tuberculous drugs with important adverse effects of each.

9. A young male patient reported to the emergency department with one-month

history of productive cough, fever, chest pain and weight loss. His chest x-ray and
sputum were found positive for pulmonary TB. Enlist 3 drugs as 1st line agents and 3
for the 2nd line agents to treat this patient. [Annual 2013]

10. Write clinical uses of rifampicin. [Supple 2013]

11. What is mechanism of action and basis of resistance of following? (7)

a) Isoniazid
b) Ethambutol
[Supple 2011 + Annual 2010]

8. A 20-year-old female has been diagnosed as patient of pulmonary tuberculosis.

Which three bactericidal may be selected? Briefly give their mechanism of action and
adverse effects. [Supple 2010]
9. A 16-year-old girl has been diagnosed as a fresh case of pulmonary TB. Enumerate
atleast 4 drugs from the agents of first line therapy. Explain the rationale for
prescribing pyridoxine along with isoniazid. [Supple 2010, Annual 2009]

10. Explain the rationale for prescribing pyridoxine along with isoniazid. (3.5) [Supple
2009]

11. A 30-year-old lady came to medical OPD with history of productive cough, low grade
fever, anorexia and weight loss for last 88 weeks. She was diagnosed as a case of
pulmonary TB and put on ant tuberculous therapy (4 drugs) by the physician.
[Annual 2008]
a) Explain the pharmacological basis of multi-drug therapy in TB
 b) What is the rationale of using pyridoxine with isoniazid?
c) What is the duration of four-drug regimen?

12. What is the rationale behind the use of multidrug therapy in TB? [Annual 2007]

Antifungal Agents

1. Describe mechanism of action of systemic antifungal drug amphotericin- B and its

adverse effects
2. Write down infusion related adverse effects of amphotericin B and how can these
be prevented?
3. neutropenic patient presents with cough, fever and difficulty in breathing. After
extensive investigations, a diagnosis of fungal pneumonia is suspected. It is
decided to start with amphotericin B followed by fluconazole. Briefly describe:
a) Adverse effects of amphotericin B. (5)
b) Mechanism of action of fluconazole. (2)
[Supple 2018 held in 2019]

2. A patient attends dermatology out-patient department with complains of dark

colored round itchy patches on skin. He is prescribed topical terbinafine for four
weeks and he gets complete relief. What was the diagnosis? What is the mechanism
of action and adverse effects of terbinafine if it is administered orally? [2017 Supple
held in 2018]

3. Write a note on terbinafine mentioning its mechanism of action, clinical use with
route of administration and adverse effects. (3) [Annual 2017]

4. Enumerate antifungal drugs used topically for mucocutaneous infection. Give

mechanism of action for each of them. (7) [Annual 2016]
5. The incidence of human fungal infections has increased due to advances in surgery,
cancer chemotherapy and HIV epidemic. Liposomal amphotericin B is one of the
 highly effective drugs for serious systemic infection. Enlist the antifungal spectrum
and toxic effects of this drug. [Annual 2013]

6. Name the azole antifungal drugs. What is their spectrum of activity and which of
these is used topically? [Supple 2013]

7. Write names of azoles, mechanism of action and adverse effects. [Annual 2012]

8. A 45-year-old patient having black ulcer on his left leg which got infected due to
some fungi. What various types of azoles can be used against it? (3.5) [Annual 2010]

9. A chronically ill female of 20 years suffered from systemic candida infection.

Enumerate useful drugs against candida albicans. Write down mechanism of action
of any of these. (4) [Supple 2010, Supple 2009]

10.

a) Describe mechanism of action of azole anti-fungal drugs

b) What is the major use of fluconazole?
[Annual 2008]

11. Write down the antifungal spectrum of azoles [Supple 2008]

12. Write briefly the mechanism of action of amphotericin B as antifungal. [Annual 2007]

Antiviral Chemotherapy & Prophylaxis

1. A woman 55-year-old age is a known case of hypertension and type 2 diabetes

develops Herpes zoster over right lumber region. By diagnosing a case of Herpes
Zoster anti herpes typical preparation is prescribed. Enumerate anti herpes agents,
give their mechanism of action. (Annual 2023)

2. A 62 year old retired and divorced office worker, homeless and from a low
socioeconomic background presents with a 2 month history of fatigue, weight loss
(10 kg), fever and night sweats and a productive cough. His friend states that he
 habitually takes cheap alcohol whenever available and lives in shelters or with a few
friends that he has. His chest x-ray shows right apical pulmonary infiltrates and his
sputum smear is strongly positive for acid fast Bacilli. On suspension, his HIV test is
done which comes out positive.
A) Which drugs should be started for treatment of his tuberculosis and HIV? Justify
your choice.
B) Does this patient have heightened risk of developing medication toxicity? Why and
with which drug? (Annual 2022)

3. A) Describe diagrammatically the antiviral drugs acting at different steps in the life
cycle of a virus. [Annual 2021]
4. A 30 years old nursing mother is diagnosed as suffering from genital herpes. She had
a history of this viral infection. Previously she responded to a drug used topically but
now oral valacyclovir is also added by the physician.
a) What is the mechanism of action of valacyclovir? (2)
b) Which anti-retroviral agents are used in pregnancy? (2)
c) Describe mechanism of action and uses of INF-alpha. (3)
[Annual 2018]

5. Classify anti-retroviral agents according to mechanism of action.

[2017 Supple held in 2018]

6. Draw a diagram of lifecycle of HIV and sites of action of antiviral agents. (4) [Annual
2017]

7. The antiviral chemotherapy began in early 1950s when the search for anticancer
drugs generated several new compounds. These antiviral drugs act at different sites
of viral life cycle. Name the major sites and give one example of the drugs which act
at that site. (7) [Supple 2016]

8. Enlist four drugs for treatment of chronic Hepatitis B virus infection and two drugs for
treatment of Hepatitis C virus infection. [Annual 2015]
 9. What is the mechanism of action of acyclovir? Why it is less toxic to normal human
cells? [Supple 2015]

10. Name the drugs used to treat chronic hepatitis B & C. (4+3) [Supple 2014]

11. Name drugs used for the treatment of herpes virus infection. What is their
mechanism of action? [Supple 2013]

12. Enumerate drugs for herpes virus and write their clinical uses. [Annual 2012]

13. A 30-year-old female is suffering from painful genital herpes lesion. What agents are
useful to treat her infection? (3.5) [Annual 2010]

14. A 25-year-old hepatitis C positive case is admitted in a hospital. Which drugs can be
used for him? Give adverse effects of any one of these. (4)
[Supple 2010, Annual 2009]

15. How is interferon effective as an antiviral agent? [Annual 2008]

16. Write briefly the mechanism of action of amantadine as antiviral. [Annual 2007]

Clinical Use of Antimicrobials

1. Define “Empirical therapy”. (Supply 2022)

2. Define the following terms with examples:
a) Concentration dependent killing
b) Time dependent killing
3) Post antibiotic effect [Annual 2017]

3. Name drugs used for treatment of Salmonellosis (Typhoid fever) and write down
mechanism of action of any one of them. (3) [Annual 2016]
4. A) Give two mechanisms by which resistance may develop to antimicrobial drugs
 (with one example for each)
5. Explain the basis for following drug combinations
[Annual 2008]

18. A 25-year-old young man came to your hospital with history of persistent highgrade
fever for the last 10 days. On examination there was relative bradycardia and fever
and splenomegaly. Widal test was positive and patient diagnosed as suffering from
typhoid fever. Enlist four drugs from different group of antibiotics for the disease.
[Supple 2008]

19. A 50-year-old lady was admitted to intensive care unit and treated for community
acquired pneumonia with ceftriaxone and azithromycin. She improved but develops
diarrhea and eight bowel movements after a few days. The toxin assay confirmed a
case of clostridium difficile associated colitis. What is the drug of firs choice and the
alternative drugs? (2) [Supple 2014]

Antiprotozoal Drugs
1. Give clinical use of chloroquine. (Annual 2023)
2. Enumerate antimalarial drugs used for chemoprophylaxis.(Supply 2022)
3. Enumerate 3 drugs used for Trypanosomiasis. Give mechanism of action of
pentamidine. (Annual 2022)
4. Write the clinical uses of Metronidazole. [Annual 2021]

5. Enumerate:
a) Clinical uses of metronidazole. (3.5)
b) Adverse effects of chloroquine. (3.5)
[2018 Supple held in 2019]
6. A) After backpacking trip in the mountains, a 24-year-old man develops diarrhea
and malaria. Doctor prescribes him a drug which has antimalarial and antiamebic
effects as well. Enumerate the toxicities of this drug. (2)
B) Write down the prevention of malaria in travelers. (2)
[Annual 2018]
 7. A patient of hepatic amebic abscess was treated with metronidazole and diloxanide
furoate for 10 days. Write down the mechanism of action of metronidazole.
Enumerate its clinical uses and adverse effects. Why diloxanide furoate was given to
this patient? (7) [Annual 2017]

8. A) Enumerate four drugs used for the treatment of chloroquine resistant malaria.
What is the role of primaquine as antimalarial agent? (3.5)
B) Enumerate seven clinical uses of metronidazole. (3.5)
[Supple 2016 held in 2017]

9. A 40 years old male presented with history of intermittent rigors, high fever and
swats for a week. His temperature recorded was 104 F and examination revealed
enlarged spleen. A blood smear showed presence of Plasmodium falciparum. Name
different chemical groups with drug examples to treat this patient. (7) [Supple 2015
held in 2016]

10. A patient suffering from amebiasis is treated with metronidazole. He is also using
alcohol. Give mechanism of action of metronidazole and its interaction with alcohol.
[Annual 2015]

11. A) Mr. Shams is diagnosed with case of acute malaria. He did not respond to
chloroquine. How would you treat his chloroquine resistant malaria?
B) What are clinical uses and adverse effects of quinine?
[Annual 2014]

12. A 40-year-old man presented with history of chills, fever and sweats. The
examination reveals high temperature and enlarged spleen. The blood smear shows
ring form of plasmodium falciparum. Name the major drugs for the treatment and
prophylaxis of this infection. (7) [Supple 2014]

13. Write briefly the clinical application of chloroquine. [Supple 2013]

 14. Write down clinical uses of metronidazole. [Supple 2013, Supple 2011, Annual
2007]

15. What is mechanism of action and basis of resistance of Chloroquine? (7) [Supple
2011 + Annual 2010]

16. What is the mechanism underlying the chloroquine resistance in plasmodium

falciparum? [Supple 2010 + Annual 2009]
17. Explain the rationale of combining diloxanide furoate with metronidazole. [Supple
2009]

Antihelminthic Drugs

a Mebendazole is widely used in treatment of Nematode infections but is

contraindicated in pregnant patient because of possible embryotoxicity.
Tabulate drugs used for bacterial, anti cancer, protozoal and viral infections
which are associated with greater risk compared with benefits in pregnancy
(FDA category X), giving one example each. (Annual 2022)
b Mrs. Akbar Ali, a pregnant female has been diagnosed with neurocysticercosis.
Which drug will you prefer in this case and also which drug is used to combat
meningeal irritation during course of treatment? [Annual 2012]

Cancer Chemotherapy
1. Enlist 2 adverse effects of anti cancer drug “Bleomycin”. (Annual 2023)
2. Enumerate anthracycline antibiotics. How these antibiotics exert their cytotoxic
action? (Supply 2022)
3. Classify anti cancer drugs according to cell cycle specificity. (Annual 2022)
4. A 27 year old female patient , diagnosed with choriocarcinoma is administered
methotrexate. Describe mechanism of action of methotrexate ; enumerate its other
uses. [Annual 2021]
5. A) Explain four advantages of using a combination of anticancer drugs. (4)
B) Explain three non-neoplastic uses and three adverse effects of methotrexate. (3)
[Supple 2017]

3. A patient suffering from acute lymphocytic leukemia is treated with

methotrexate in combination with other drugs. Give mechanism of action of this
 drug. Which drug is given as rescue therapy to protect normal cells from high
dose toxicity of methotrexate? Enlist two non-cancerous indications of
methotrexate. (4)
[Annual 2015]

4. Enumerate adverse effects of antineoplastic agents common in majority of

patient groups. [Supple 2015]

5. A 45-year-old patient with malignant tumor was administered vincristine, a

prototype of vinca alkaloids. [Annual 2014] a) Enlist four indications. b)
Enumerate its adverse effects.
[Annual 2014]

6. Write short essay on the acute and delayed toxic effects of alkylating agents used
in the treatment of cancer. [Supple 2014]
7. Enumerate the general adverse effects of anticancer drugs. [Supple 2013]

8. Classify anticancer drugs. Enumerate the uses of methotrexate. (7) [Supple 2011]

9. List the adverse effects of antineoplastic drugs due to their action on rapidly
dividing healthy cells. (3) [Supple 2010, Annual 2009, Supple 2009]
10.

a. Describe the mechanism of action of alkylating agents in cancer

chemotherapy.
b. Name two agents that cause hemorrhagic cystitis.
c. Adverse effects of alkylating agents are seen in which organs? [Annual
2008]

11.Classify cell cycle specific anticancer drugs and give one example for each.
[Supple 2008]

12.Enumerate anticancer drugs that act as spindle poison. Outline their general
mechanism of action. [Annual 2007]
 GASTROINTESTINAL SYSTEM

1. How do proton pump inhibitors act? Enlist their four main clinical uses. (Supply
2023)
2. A 33 year old male presents to physician with complain of epigastric pain and heart
burn for last one month. He says that pain is aggravated by eating junk food.
Physician Starts tablet Cemitidine 400 mg twice daily before meals to control his
symptoms. Explain how Cimetidine reduces gastric acid release? Enlist its clinical uses
and adverse effects. (Annual 2023)
3. Enumerate proton pump inhibitors. Give their important aspect of pharmacokinetics.
(Supply 2022)
4. Write down about antiemetic subclasses with their mechanism of action. (Annual
2022)
5. A 35 year old female with severe epigastric pain was taken to ER where a diagnosis of
acid peptic disease was made and symptomatic management was done ; she was
discharged on proton pump inhibitors. Explain mechanism of action of proton pump
inhibitors; also enlist their other clinical uses. [Annual 2021]

6. A young female student complains of nausea, epigastric distress and heartburn after
each meal. Classify drugs available to treat her acid peptic disease. (3) Explain
mechanism of action and enumerate adverse effects of proton pump inhibitors. (4)
[Supple 2018 held in 2019]

7. A 50 years old male to emergency department with severe burning chest pain
radiating into his neck. His electrocardiogram was normal and test for troponin was
negative, but H. pylori stool antigen was positive. [Annual 2018]
a. Which different drug therapies can you give to treat this patient? (2)
b. Write down mechanism of action and uses of metoclopramide. (2)

8. A patient presenting with vomiting and diarrhea was given ORS for rehydration and
metoclopramide for control of vomiting. What is its mechanism of action and other
clinical uses? (4) [Supple 2017 held in 2018]
9. Name two drugs/drug groups used for motion sickness. Write adverse effects of
each. (3) [Annual 2017]

10. A young patient with history of acid hypersecretion, gastrointestinal ulceration and
malabsorption presents to your clinic. He is diagnosed as a case of gastrinoma. You
prescribe omeprazole as being excellent acid suppressant. Write down its mechanism
of action and toxicity. (4) [Supple 2016 held in 2017]
11. Classify drugs used for acid peptic disease. (4) [Annual 2015]

12. A lady presented with dyspepsia and heartburn. The physician diagnosed peptic ulcer
disease and prescribed omeprazole which provides rapid relief. She continued to take
the drug for a month and had no dyspepsia for other six months. However, over the
next few months her symptoms reappeared and grew progressively worse.
On a return visit to her, the ulcer showed the presence of H. pylori. [Annual 2014] a)
What drugs should be prescribed on the second visit? b) Why did the ulcer relapse?
a. What drugs can be prescribed to relieve the symptoms of peptic ulcer?

13. One third of western population is suffering from dyspepsia and 50% of them are
patient of GERD or acid peptic disease. Name various drug groups used in the
treatment of acid peptic disease and give two examples of each group. [Annual
2013]

14. Write the clinical uses of omeprazole. [Supple 2013]

15. Compare metoclopramide with domperidone. [Annual 2012]

16. How omeprazole will act in patients of acid peptic disease? [Supple 2011]

17. How domperidone is useful in different clinical conditions?

[Annual 2011, Annual 2010]
14. What is thee mechanism of action of metoclopramide? Give its common adverse
effects. [Supple 2010, Annual 2009]

15. Enumerate two proton pump inhibitors. Write down their mechanism of action.
[Supple 2009]
16. Describe the mechanism of antiemetic and prokinetic effects of metoclopramide.
[Annual 2008]

17. How do the following produce beneficial effects?

a. Omeprazole
b. Metoclopramide [Supple 2008]
18. Enumerate H₂ receptor blockers. Describe their clinical uses. [Annual 2007]