Pharmacology exam questions, june 2021 Flashcards
Patients having increased risk of thrombosis can be treated with anticoagulants and/or anti-platelet drugs.
a) Vitamin K is important for normal blood coagulation. Give an example of a drug that interferes with the normal function of vitamin K and explain how this results in inhibition of blood coagulation. (3p)
Warfarin (brand name Coumadin) is an example of a drug that interferes with normal function of vitamin K. Warfarin is an anticoagulant, or blood thinner, that works by blocking the action of vitamin K in the body.
Vitamin K is required for the production of several proteins involved in clotting, including prothrombin, which is necessary for the conversion of fibrinogen to fibrin, the main component of a clot. Vitamin K also helps activate other clotting factors such as factor VII, IX and X.
Patients having increased risk of thrombosis can be treated with anticoagulants and/or anti-platelet drugs.
b)Propose that you have investigated the effect of acetylsalicylic acid on platelet function in a laboratory experiment. The results of the experiment showed that acetylsalicylic acid partially inhibits collagen induced platelet activation. Explain, based on the mechanism of action of acetylsalicylic acid, why the platelet activation induced by collagen was partially inhibited. (3p)
acetylsalicylic acid is a common pain killer and partially inhibit platelet activation by irreversibly inhibiting COX 1/2 as a non competetive antagonist.
Acetylsalicylic acid (ASA) partially inhibits collagen-induced platelet activation by blocking the activity of cyclooxygenase-1 (COX-1). COX-1 is an enzyme that catalyzes the conversion of arachidonic acid to prostaglandin H2, which is a precursor for thromboxane A2. Thromboxane A2 is a potent vasoconstrictor and prothrombotic agent that stimulates platelet aggregation. By blocking the activity of COX-1, ASA prevents the formation of thromboxane A2, thus inhibiting platelet aggregation. Additionally, ASA has been shown to inhibit other pathways involved in platelet activation, such as the glycoprotein IIb/IIIa receptor pathway and the phospholipase C pathway.
Choose the single best answer(5p)
6:1 What is true about digoxin that can be used to treat heart failure?
a)It dilates arteries by relaxing smooth muscle cells
b)It stimulates the Na+/K+ ATPase of the hearts muscle cells
c)It ́s mechanisms of action leads to more calcium inside the hearts muscle cells
d)It blocks the effect of adrenaline
Digoxin increases the force of contraction in the heart by increasing the amount of calcium available to the myocardial cells. This increased calcium availability leads to an increased number of cross-bridges formed between actin and myosin, which increases the strength of contraction. Additionally, digoxin increases the sensitivity of the myocardial cells to calcium, further increasing the force of contraction. Finally, digoxin also increases the rate at which calcium is released from the sarcoplasmic reticulum, which further increases the amount of calcium available for contraction. All these effects combine to increase the force of contraction in the heart.
So C is the best answer
Choose the single best answer:
6:2 Enalapril is used to treat hypertension. Which statement below can be related to enalapril’s effects?
a)Blockade of the angiotensin type 1 receptor
b)Reduction the amount of angiotensin 1
c)Reduction in arterial contraction
d)Increased absorption of sodium in the kidney
ACE-inhibitors
angiotensin converting enzyme: it converts angiotensin I to angiotensin II, which is important in the regulation of blood pressure.
In this case, if the enzyme is inhibited (Enalapril is an example of an inhibitor that could be used), less conversion of angiotensin I to angiotensin II will be obtained → blood pressure is reduced.
Enalapril is an ACE inhibitor, which stands for angiotensin-converting enzyme inhibitor. It works by blocking the action of an enzyme called angiotensin-converting enzyme (ACE). This enzyme is responsible for converting a hormone called angiotensin I into a more potent form called angiotensin II. Angiotensin II causes blood vessels to constrict, which increases blood pressure. By blocking the action of ACE, enalapril prevents the formation of angiotensin II and thus reduces blood pressure. It also helps to relax and widen the blood vessels, allowing for increased blood flow through the arteries. This increased blood flow can help reduce the risk of heart attack and stroke.
The best answer is therefore c
Choose the single best answer:
6:3 What is true about nitrates that are used in coronary artery disease?
a)They will stimulate the production of nitric oxide
b)They will contract arteries
c)They will slow down the heart rate
d)They will improve blood supply to the heart
Nitrates are medications used to treat coronary artery disease, which is a condition in which the arteries that supply blood to the heart become narrowed or blocked.
Nitrates can increase blood flow to the heart. Nitrates are vasodilators, meaning they relax and widen the blood vessels, allowing more blood to flow through them.
The best answer is d
Choose the single best answer:
6:4 Furosemide can be used to treat cardiovascular disease. What is true about its effect?
a)They block water channels in the kidney
b)They reduce urine production
c)They block the re-uptake of Na+ in the kidney
d)They block cyclooxygenases in the kidney
Furosemide is a diuretic medication used to treat cardiovascular disease. It works by increasing the amount of salt and water that the kidneys remove from the blood, which helps to reduce the amount of fluid in the body. This helps to reduce blood pressure, which can help to prevent heart failure, stroke, and other cardiovascular problems.
Furosemide is a loop diuretic, which means it works by inhibiting the reabsorption of sodium and chloride ions in the ascending loop of Henle in the kidneys. This causes an increased excretion of water, electrolytes, and other substances from the body.
The best answer is therefore c
Choose the single best answer:
6:5 Which of the following drug actions can lead to reduced contraction of arteries and reduced arterial pressure?
a)activation of α1-adrenoceptors
b)blockade of calcium channels
c)activation of aldosterone receptors
d)activation of calcium channels
Blocking calcium channels in smooth muscle tissue causes the muscle to relax. This is because calcium is necessary for the contraction of smooth muscle cells. When calcium channels are blocked, the amount of calcium entering the cell is reduced, which prevents the muscle from contracting. This can be beneficial in treating conditions such as hypertension, where relaxation of the smooth muscle cells in the walls of blood vessels can help reduce blood pressure.
The best answer is therefore b
Question 7)
Which receptors does “betablockers” act on in the heart (for full point the correct receptor nomenclature needs to be used)?
Which effects does “betablockers” have on the function of the heart (for full point the cell types and related function must be given)? (3p)
The effects via the sympathetic branch of the autonomic nervous system on the heart is mediated via beta 1 adrenoceptors and it will increase the frequency of the heart by effects on autorhythmic cells, its gonna increase the force by effects on cardiomyocytes
Betablockers act on beta-adrenergic receptors in the heart. These receptors are located on the surface of cardiac muscle cells and are responsible for mediating the effects of the hormones epinephrine and norepinephrine. When these hormones bind to the beta-adrenergic receptors, they cause an increase in heart rate, contractility, and conduction velocity. Betablockers work by blocking these receptors, thus preventing the hormones from binding and reducing their effects on the heart. This can help to reduce blood pressure, slow down a rapid heart rate, and reduce the risk of arrhythmias.
The beta-adrenergic receptors in the heart are divided into two subtypes: β1 and β2.
The β1 receptors are located mainly in the sinoatrial node, atrioventricular node, and ventricular myocardium. They are responsible for increasing heart rate, contractility, and conduction velocity.
The β2 receptors are located mainly in the atria and coronary arteries. They are responsible for vasodilation of the coronary arteries, which increases blood flow to the heart muscle.
In the heart, beta-adrenergic receptors are primarily located on the sinoatrial node (SA node), atrioventricular node (AV node), and ventricular myocytes. Beta-adrenergic receptors are also found in the coronary arteries, where they regulate blood flow to the heart muscle.
Question 8 Budesonide is a drug used in the treatment of asthma.
a. Describe the mechanism of action and pharmacological effect of Budesonide. (3p)
Budesonide works by binding to glucocorticoid receptors in the body. This binding causes a decrease in the production of inflammatory mediators such as cytokines and leukotrienes. This reduces inflammation and swelling in the affected area.
Budesonide also has an anti-proliferative effect, which means it can help prevent the growth of certain cells that can cause inflammation. It also has an immunosuppressive effect, which means it can reduce the activity of the immune system and reduce inflammation.
The pharmacological effects of Budesonide include reduced inflammation, decreased airway hyperresponsiveness, improved lung function.
Question 8 Budesonide is a drug used in the treatment of asthma.
b. How is the drug administrated (first choice)? Mention one common Type A side effect of Budesonide.
Budesonide is administered by inhalation through a nebulizer.
Type A side effects are those that are expected and usually mild. They are usually listed on the drug label and may include things like nausea, headache, dizziness, or drowsiness. These side effects are usually temporary and can be managed with lifestyle changes or over-the-counter medications.
Common side effects of budesonide include nausea, vomiting, headache, stomach pain, indigestion, gas, bloating, diarrhea, constipation, dizziness, drowsiness, dry mouth or throat, sore throat, stuffy nose, sneezing, cough, increased appetite and weight gain.
Question 9.
State which drug group the different drugs belongs to (0.5p/right answer, -0.5p/wrong answer, max=4p, min=0p):
Drug:
Atenolol, Clopidogrel, Cyclosporine, Losartan, Ibuprofen, Loratadine, Tamoxifen, Warfarin
Group:
1. CNS-drugs, 2. Anticoagulantia, 3. Anti-inflammatory drugs, 4. Cancer drugs, 5. Cardiovascular pharmacology, 6. Drugs acting on platelets, 7.Immunosuppressive drugs
Atenol- Cardiovascular pharmacology
Clopidogrel- Anticoagulant and drugs acting on platelets
Cyclosporine- Anti-inflammatory and immunosuppressive drugs
Losartan- Cardiovascular pharmacology
Ibuprofen- Anti-inflammatory and immunosuppressive drugs
Loratadine- Airway pharmacology
Tamoxifen- Cancer drug
Warfarin- Anticoagulant and drugs acting on platelets
Question 10
Mark the true sentence (1,5p)
a) Parkinson is characterized by a degeneration of the mesolimbic dopaminergic pathway.
b) Levodopa should be administered together with carbidopa to increase the bioavailability in the brain.
c) Methylphenidate is a stimulant drug that acts by inhibiting the dopamine receptors in the postsynaptic neuron.
d) Propofol (barbiturate) is extensively prescribed for sleep problems.
e) All the above are correct
Dopamine precursor, give L-dopa (give dopamine directly) but it’s very fast metabolized in our intestine so we give it with carbidopa because it inhibits AADC, carbidopa doesn’t cross the blood brain barrier so when the L-dopa reaches the brain the carbidopa does not cross and we have more L-dopa reaching the brain.
The rest is false.
Therefore B is the correct sentence.
Question 11
Mark is a 40-year-old man who goes to see his physician because he has been having strange thoughts and even having hallucinations that felt very real. His wife has also detected that he has reduced speech, lack of initiative and flattened affect. The physician determines that Mark symptoms and signs are most likely due to schizophrenia, and she prescribes a trial of haloperidol (typical antipsychotic).
a..How is the dopaminergic dysfunction related to the symptoms that Mark is experiencing?
The dopamine hypothesis suggests that excessive dopamine activity in certain brain regions, particularly the mesolimbic pathway, leads to positive symptoms of schizophrenia, such as hallucinations and delusions. Antipsychotic medications, including both typical and atypical antipsychotics, work by blocking the dopamine receptors in the brain, reducing the dopamine transmission and thereby reducing the positive symptoms of schizophrenia.
Question 11
Mark is a 40-year-old man who goes to see his physician because he has been having strange thoughts and even having hallucinations that felt very real. His wife has also detected that he has reduced speech, lack of initiative and flattened affect. The physician determines that Mark symptoms and signs are most likely due to schizophrenia, and she prescribes a trial of haloperidol (typical antipsychotic).
b. Is haloperidol (typical antipsychotic) the best choice for Mark symptoms? (2p
Haloperidol, a typical antipsychotic medication, is often used to treat the positive symptoms of schizophrenia, such as hallucinations and delusions. However, it is not as effective in treating the negative symptoms of schizophrenia, such as flattened affect, reduced speech, and lack of initiative.
The negative symptoms of schizophrenia are thought to be related to a deficiency in the dopamine and/or the glutamatergic system, and antipsychotic medications, including haloperidol, have limited efficacy in treating these symptoms. Other medications, such as antidepressants and stimulants, as well as psychosocial interventions, may be needed to effectively treat the negative symptoms of schizophrenia.
Question 11
Mark is a 40-year-old man who goes to see his physician because he has been having strange thoughts and even having hallucinations that felt very real. His wife has also detected that he has reduced speech, lack of initiative and flattened affect. The physician determines that Mark symptoms and signs are most likely due to schizophrenia, and she prescribes a trial of haloperidol (typical antipsychotic).
c. Could you give an alternative pharmacological approach to haloperidol to treat Mark symptoms?
Atypical antipsychotics: Some atypical antipsychotics, such as risperidone, have been found to be more effective in treating negative symptoms than typical antipsychotics.
