QP CODE :303006

Evaluation guidelines for Third year B.pharm degree supplementary examination –August
2014

PHARMACOLOGY-I

Total marks:100

Essay (3x10=30)
Q.No.1. Define adverse drug reaction and classify with example .Mention the mechanism of
adverse drug reaction and drug allergy.

a. Definition and classification - 2+3marks

b. Mechanism of adverse drug reaction -3marks

c.Drug allergy:-2marks

 It is an immunologically mediated reaction producing stereotype symptoms which are

unrelated to the pharmacodynamic profile of the drug, generally occur even with much
smaller doses and have a different time course of onset and duration.

Q.No.2. Classify antidiabetic drugs. Explain the pharmacotherapy of type-I and type-II
diabetic mellitus. Add a note on insulin glargine.

a.Classification - 3marks

b.Pharmacotherapy- 5marks

c.Insulin glargine - 2marks

This long-acting biosynthetic insulin has 2 additional arginine residues at the carboxy terminus
of B chain and glycine replaces asparagine at A 21 . It remains soluble at pH4 of the formulation,
but precipitates at neutral pH encountered on s.c. injection. A depot is created from which
monomeric insulin dissociates slowly to enter the circulation. Onset of action is delayed, but
relatively low blood levels of insulin are maintained for upto 24 hours.

Q.No.3. Classify cholinergic drugs with example. Explain the pharmacology, clinical uses
and adverse effect of cholinergic drugs.

a.Classification - 3marks

b.Pharmacology, clinical uses and adverse reaction- 7 marks

SHORT NOTES (14X5=70 marks)
Q.No.4 Define tachyphylaxis with example. What is the reason for this phenomenon?

a.Tachyphylaxis -2marks

(Tachy-fast, phylaxis-protection) is a rapid development of tolerance when doses of a drug

repeated in quick succession result in marked reduction in response.
b.Example-1mark

This is usually seen with indirectly acting drugs, such a ephedrine, tyramine, nicotine.

c.Reason 3marks

Receptors can undergo dynamic changes with respect to their density (number per cell) and their
affinity for drugs and other ligands. The continuous or repeated exposure to agonists can
desensitize receptors, usually by phosphorylating serine or threonine residues in the C-terminal
domain of GPCRs. Phosphorylation of the receptor reduces the G protein–coupling efficiency
and alters the binding affinity.

Q.No.5 Clinical significance of histamine blockers and 5HT blockers.

a.Histamine Blockers-2.5 marks

 Allergic disorders
 idiopathic pruritus.
 Motion sickness
 Vertigo

b.5HT- Blockers 2.5 marks

 Allergies and is a good antipruritic

 Effective antihypertensive,
 Atypical antipsychotic
 Controlling nausea and vomiting
 It used for migraine prophylaxis, carcinoid and
 Post gastrectomy dumping syndrome.

Q.No.6.explain the pharmacotherapy of chronic bronchial asthma

Pharmacotherapy
1.Bronchodilators-Sympathomimetics:Methylxanthines: Anticholinergics:
2. Leukotriene antagonists-
3. Mast cell stabilizers
4.Corticosteroids
5. Anti-lgE antibody-Omalizumab
Q.No.7.explain various receptor theories. What is meant by silent receptor and spare
receptor.

 Receptor occupation theory-1.5 marks

 Rate theory-1.5 marks
Silent receptors -These are sites which bind specific drugs but no pharmacological response is
elicited. They are better called drug acceptors or sites of loss, e.g. plasma proteins which have
binding sites for many drugs.1 mark
Spare receptors-Receptors are said to be spare for a given pharmacological response when the
maximal response can be elicited by an agonist with out occupancy of the full complement of
available receptors. The higher the spare receptor proportion the greater the tissue sensitivity for
the drug.1 mark
Q.No.8.Discuss briefly about dantrolene and rupatadine

Dantrolene-2.5 marks
 It is a muscle relaxant and acts on the RyR (Ryanodine Receptor) calcium channels in
the sarcoplasmic reticulum of skeletal muscles and prevents their depolarization
triggered opening. Intracellular release of Ca 2+ needed for excitation-contraction
coupling is interfered with. Fast contracting 'twitch' muscles are affected more than slow
contracting 'antigravity' muscles.
 Used orally dantrolene (25-100 mg QID) reduces spasticity in upper motor neuron
disorders, hemiplegia, paraplegia, cerebral palsy and multiple sclerosis.
 Used i.v. ( 1 mg/kg repeated as required) it is the drug of choice for malignant
hyperthermia which is due to persistent release of Ca2+ from sarcoplasmic reticulum
Rupatidine -2.5 marks

 It is a non sedating antihistamine, selective and long-acting new drug with a strong
antagonist activity towards both histamine H 1 receptor and platelet activating factor
receptors.
 It possesses anti-allergic properties by the inhibition of the degranulation of mast cells
induced by immunological and non-immunological stimuli and inhibition of the release
of cytokines like TNF and monocyte

Q.No.9.Briefly describe toxicity studies in animals. (5 marks)

 Acute toxicity:
 Subacute toxicity:
 Chronic toxicity:

Q.No.10.what are the methods of prolonging drug action. (5 marks)

 By prolonging absorption from site of administration

 By increasing plasma protein binding
 By retarding rate of metabolism
  By retarding renal excretion

Q.No.11.Therapeutic uses and adverse effects of glucocorticoids.

Therapeutic Uses -2.5marks

 Arthritis
(i) Rheumatoid arthritis: (ii) Osteoarthritis:

 Rheumatic fever:
 Gout
 Collagen diseases
 Severe allergic reactions
 Autoimmune diseases
 lung diseases
 Infective diseases
 Eye diseases
 Skin diseases
 Intestinal diseases Cerebral edema
 Malignancies Organ transplantation and skin allograft Septic shock,
 To test adrenal-pituitary axis function

Adverse effects 2.5 marks

Glucocorticoid

 Cushing's habitus: characteristic appearance with rounded face, narrow mouth, supra-
clavicular hump, obesity of trunk with relatively thin limbs. Fragile skin, purple striae
 Hyperglycaemia
 Muscular weakness
 Susceptibility to infection
 Delayed healing: of wounds and surgical incisions.
 Peptic ulceration: risk is doubled
 Osteoporosis
 Posterior subcapsular cataract
 Glaucoma
 Growth retardation
 Foetal abnormalities
 Psychiatric disturbances:
 Suppression of hypothalamo-pituitary adrenal (HP A ) axis
Q.No.12.What is p drug concept.Mention some irrationalities in prescription. 5 marks

a.P drug concept- 2marks

A drug you are going to use regularly and with which you become familiar.
The P-drug concept includes:
 the name of the drug
 the dosage form
 the dosage schedule
b. Irrationalities in prescription - 3marks

Q.No.13. Define poison. Explain the general management of poisoning.

Definition-2 marks

Management-3 marks

 Management of vital system

 Toxicological diagnosis
 Decontamination
 Specifc antidotes
 Elimination of toxins

Q.No.14.What is prostaglandins.Name some prostaglandin with its specific therapeutic

uses.

Prosto glandins (PGs) is biologically active derivatives of 20 carbon atom polyunsaturated

essential fatty acids that are released from cell membrane phospholipids. They are major lipid
derived autacoids. 1.5 marks

 Alprostadil is PGE1 and misoprostol is a PGE1 derivative- used to maintain patency of

the ductus arteriosus in neonates awaiting surgery for heart defects. It is also used to treat
erectile dysfunction in men.
 Misoprostol is used to prevent gastric and duodenal ulcers in persons taking NSAIDs.
 Dinoprostone, the same as PGE2, is used for cervical ripening before induction of labor
and for evacuation of the uterine contents.
 Carboprost and latanoprost are PGF2α derivatives. Carboprost is used to control
postpartum bleeding and to terminate pregnancy.
 Latanoprost and other prostaglandin antiglaucoma drugs that increase the aqueous
humor outflow are used to treat glaucoma.
 Epoprostenol is PGI2 (prostacyclin) and treprostinil is a PGI2 derivative; both are used
to treat pulmonary arterial hypertension.
  Bosentan and ambrisentan, endothelin-1 receptor antagonists, and a new formulation of
sildenafil are indicated for pulmonary arterial hypertension. 3.5 marks

Q.No.15.Classify drug interaction with examples.Add a note on food drug interaction.

 Drug interaction-3 marks

 Pharmacokinetic interactions
 Pharmacodynamic interactions
 Food drug interaction -2marks

Q.No.16.What are the steps to be taken to minimize drug exposure to babies during
lactation. 5 marks

Write any 5 steps to minimize drug exposure to babies during lactation.

Q.No.17.Explain synergism and antagonism

Synergism: 2.5 marks

When the action of one drug is facilitated or increased by the other, they are said to be
synergistic. In a synergistic pair, both the drugs can have action in the same direction or given
alone

 Additive
 Supraadditive (potentiation)

Antagonism:2.5 marks

When one drug decreases or abolishes the action of another, they are said to be
antagonistic:effect of drugs A + B < effect of drug A +· effect of drug B

Usually in an antagonistic pair one drug is inactive as such but decreases the effect of the other.
Depending on the mechanism involved, antagonism may be:
 Physical antagonism
 Chemical antagonism
 Physiological/functional antagonism
 Receptor antagonism
 Competitive antagonism
 noncompetitive antagonism
 nonequilibrium (competitive) antagonism