FATIMA JINNAH MEDICAL UNIVERSITY, LAHORE.

PHARMACOLOGY PAST QUESTIONS

COMPILED BY: SYEDA ALEENA ZAHRA (BATCH '23)

GENERAL PHARMA:

• Define biotransformation (metabolism). Enumerate two enzyme inducers.

How do they affect the plasma level of concomitantly administered
drugs?
• Give the significance of different dosage regimens (maintenance and
loading)
• Define first and zero order kinetics with one example each
• What information can be obtained from graded dose response curve?
• Define volume of distribution. Give factors affecting it.
• What is desensitization of adrenoreceptor? Describe major categories
with mechanism involved.
• Define plasma half life of a drug. Enumerate factors which affect plasma
half life. Write it’s clinical applications.
 • Define bioavailability. Discuss different factors affecting it.

ANS:

• A 30 years old male patient went to a Chinese cuisine for lunch and took
mushroom soup. After half an hour he developed nausea, vomiting,
diarrhea and profuse sweating with salivation. Patient is brought to the
emergency. A) What will be the drug of choice for this patient? B) Give
three contraindications, three other clinical uses and three adverse effects
of this drug.
• Enumerate three selective beta 2 adrenergic drugs and give their clinical
uses. What are cardiovascular effects of alpha receptor blocking drugs?
• A 65 years old female patient is suffering from diabetes since the last 10
years. Now her BP is 150/90 mmHg on many times and pulse is 56 beats/
min (bradycardia). Which subgroups of beta blockers will be effective in
this patient? Enumerate 3 drugs of this group. How will these be effective
in this patient?
• Enumerate 2 beta blockers effective in treatment of hypertension with
peripheral vascular disease.
• Enumerate 3 drugs available for the treatment of overactive bladder. Give
their mechanism of action.
• Give six clinical uses of indirectly acting cholinergic drugs.
• Give management of organophosphorus poisoning and write clinical uses
of adrenaline.
• Which drugs are used in open angle glaucoma? Briefly explain their
mechanism of action.
• Name beta blockers with intrinsic sympathomimetic activity.
Describe biphasic action of atropine on heart.
 • A young man 30 years old is brought to the emergency department with
anaphylactic shock, injection epinephrine S/c is given immediately. What
can be the adverse effects of epinephrine if repeated doses are
considered? What are other uses of epinephrine?
• Give the mechanism of action of methylxanthine and side effects of beta 2
agonists.
• Give mechanism of action of a depolarizing muscle relaxants and it’s
adverse effects.
• A farmer, after monitoring pesticide spray on his cotton crop develops
mucsle paralysis and profound salivation. A) How will you manage the
case? B) How does the poisoning differ from nerve gas poisoning?
• A 32 year old male patient is brought to the emergency. He is having
history of fever since last one week and received an injection from a local
dispensary. After that he fainted. On examination his BP is 90/60 mmHg,
respiratory rate is 34/min and he is having cold clammy skin. A) What will
be the drug of choice for this patient? B) Give three non metabolic and
two metabolic effects of this drug C) Give three other uses if this drug.
• In a roadside accident, a male aged 25 years got multiple injuries including
chest injuries also. He was given succinylcholine to relax skeletal muscles
for operation. Discuss the mechanism of action and toxicity of
succinylcholine.

CNS:

• A 28 years old patient underwent caesarian section under general

anesthesia. She was induced with thiopental Na and after that
sevoflurane of as used as inhalational agent during surgery. Later
 on, she developed Hugh grade fever with temperature of 105°F, rigidity of
muscles and heart rate 110 beats/min. A) What will be your diagnosis
about her condition and how will you manage this patient? B) Give four
major acute toxicity effects of inhalational anaesthetic agents.
• A patient with acute oanic attack was prescribed alprazolam, a
benzodiazapine and another patient with generalized anxiety disorder
was prescribed buspirone. Compare benzodiazapines with buspirone as
regards their mechanism of action and toxicity potential.
• A 30 years old married male patient is suffering from loss of appetite,
insomnia, loss of interest in family, since last one month after losing his
job. There is no significant finding on his baseline investigations. Which
group of antidepressant drugs will be effective in this patient?
• Give four clinical uses and four adverse effects of TCAs.
• Give six clinical uses of Valproic acid. Why is it contraindicated in
pregnancy? Name two antiepileptic drugs which can be used safely in
pregnancy.
• What is disulfiram like reaction? Enumerate 2 drugs which can cause
disulfiram like reaction.
• Give five clinical uses of morphine.
• Name the drugs that block both serotonin and norepinephrine
transporters. Give clinical uses of SNRIs and why are they preferred over
TCAs?
• A patient suffering from schizophrenia is taking an antipsychotic drugs.
Give adverse effects of these drugs on autonomic nervous system and
central nervous system.
• What is minimum alveolar concentration? Describe the factors affecting
the rate of induction of inhaled general anesthesia.
• What is MAC value? Give advantages and disadvantages of nitrous oxide.
• Give mechanism of action and clinical uses of Valproic acid.
• What are the effects of local anesthetics on heart and CNS?
• Compare and contrast benzodiazapine with barbiturates.
 • A 39 years old male patient is suffering from auditory hallucinations and
illusions. Patient is obese with 95 Kg weight and is diabetic. A) Which
group of drugs will be contraindicated in this obese patient?
B) Give four differences between typical and atypical antipsychotic drugs.
• A male patient aged 20 year was brought to the hospital with history if
convulsions after taking some drugs. On examination, he was severely
constipated, pinpoint pupils and needle marks on body were found.
Discuss the pharmacological actions of opioids.

CVS:

• A 50 years old male patient is brought to the emergency with the

complaints of swelling, redness and pain in his right leg. Doppler-
ultrasonography confirmed the diagnosis of DVT (deep venous
thrombosis). A) Name two drugs that are effective for the treatment of
this patient. B) Give the mechanism of action of warfarin. C) Give two
adverse effects of warfarin. D) Which drug will be used to counteract the
adverse effects of warfarin?
• A 64 years old patient suffering from diabetes mellitus since last 15 years,
came to doctors clinic with complaint of headache. On examination his BP
is 160/100. He is not taking any antihypertensive drug. On investigation
his serum urea and creatinine is also mildly elevated. There is no
peripheral edema present. Which group of antihypertensive drugs will be
effective for thia patient? Give mechanism of action and four adverse
effects of any of those groups.
• Give the role of nitrates in treatment of cyanide poisoning.
• Give six clinical uses of calcium channel blockers.
• A 42 years old female patient is having high triglyceride and low HDL
level. Age also has elevated liver enzymes. Which antihyperlipidemic drug
will be moat effective in this patient?
• Give mechanism of action and two important adverse effects of Statins.
• A 50 years old male patient diagnosed to be suffering from
supraventricular tachycardia. Cardiologist prescribed the treatment. After
some time patient reported to ophthalmology department with the
complaint of blurring of vision. On examination there is corneal deposit.
A) Which anti-arrhythmic drug is most likely to be responsible for this
adverse effect? B) Give the mechanism of action of this drug. C) Give four
adverse effects of this drug.
• How do the following drugs help in congestive cardiac failure: A)
Furosemide B) Angiotensin antagonists.
• Describe mechanism of action of thiazide diuretic. Enlist six side effects of
thiazide diuretics.
• Name beta blockers indicated in heart failure and their rationale use in
this condition. Write clinical uses of loop diuretics.
• Give mechanism of action and adverse effects of Amiodarone.
• What is the rationale of use of beta blockers in congestive cardiac failure
(CCF)? Enumerate beta blockers used in CCF.
• Enlist two fibrinolytic inhibitors. Give their mechanism of action. Enlist
five clinical uses and two side effects of these drugs.
• A 60 years old female is suffering from angina pectoris. She is treated with
isosorbide dinitrate. A) Enlist beneficial and deleterious effects of nitrates
in angina. B) Which drug will you add to correct the deleterious effects of
nitrates?
• An 80 year old man comes to cardiac clinic with swollen feet, difficulty in
breathing and palpitation. He is diagnosed as a case of congestive cardiac
failure. His cardiologist has to prescribe beta blockers along with other
drugs. Write the names of beta blockers for this case and their rationale
for use.
• A 40 tears old male patient is brought to the emergency suffering from
severe headache, vomiting and dizziness. Patient is having history of
exposure to hydrogen cyanide at his work place. On examination his heart
rate is 105 beats/min and respiratory rate is 38/min. A) What will be the
 role of sodium nitrate in the treatment of this patient? B) Five five
adverse effects of nitrates.
• A 65 years old patient diagnosed to be suffering from congestive cardiac
failure and is taking furosemide + ACE inhibitor. He was brought to the
OPD with complaint of fatigue and muscular cramps. His serum K level is
3.0 mEq/L (normal 3.5-5.5 mEq/L) A) Which diuretic will you recommend
in this patient? B) Give the mechanism of action of this new drug. C)
Enumerate four adverse effects of this new drug.

ENDOCRINOLOGY/REPRODUCTION:

• Doctor has advised an oral contraceptive to a 28 years old lady for gap in
pregnancy. Give two mild, four moderate and four severe adverse effects
of oral contraceptive drugs.
• Classify corticosteroid agonist and antagonist drugs.
• Classify oral antihyperglycemic drugs.
• Describe complications of chronic use of oral contraceptives.
• What are thionamides? Write it’s mechanism of action. Give the rationale
of using beta blockers in hyperthyroidism.
• What are the clinical uses of Prednisone? Write down side effects of
corticosteroids.
• Name the drugs used in prophylaxis of asthma. Give mechanism of action
and side effects of Terbutaline.
 • Give mechanism of action, clinical uses and adverse effects of
glucocorticoids.
• Enumerate thionamides, give their mechanism of action and side effects.
• A)Explain the role of anti IgE antibody in bronchial asthma. B) Enumerate
prokinetic agents, discuss their mechanism of action, uses and side
effects.
• A 60 years old female patient is referred to endocrine clinic. Her lab
findings revealed type II diabetes. A) Enumerate different oral
hypoglycemic agents. B) Give two adverse effects of insulin.

CHEMOTHERAPEUTICS:

• Name first line anti-tubercular drugs. Give the mechanism of action of any
three of them.
• Enumerate four tetracycline drugs. Give their 6 adverse effects.
• Enumerate two drugs for treatment of malaria and give their major side
effects. Enlist drugs used for the treatment for intestinal ameobiasis.
• Give mechanism of action and mechanism of resistance of Penicillins.
• Give mechanism of action and give adverse effects of Flouroquinolones.
• A 20 years old female patient developed abdominal pain and frequent
episodes of loose motions after taking lunch from a local restaurant. Her
stool examination revealed entamoeba histolytica. Give the drug of
choice in this patient. Give mechanism of action of metronidazole. Give
four adverse effects of metronidazole.
• 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? Write two noncancerous
indications of methotrexate.
 • Give the treatment of extra intestinal ameobiasis. Describe mechanism of
action of metronidazole.
• Name topical antifungal agents. Give mechanism of action of
ketoconazole.
• A)Name the drug regimen for complete eradication of Malaria. B) Give
mechanism of action and side effects of chloroquine.
• Give mechanism of action of macrolide antibacterial drugs. Enumerate
clinical uses of clarithromycin.
• Name 2nd line anti T.B. drugs. Give the mechanism of action and adverse
effects of Streptomycin.
• What are the clinical uses and adverse effects of Chloroquine?
• Enumerate azoles used topically and for systemic use. What are their
adverse effects?
• Mr. Brown is travelling to endemic area of malaria for the first time, he
may be having malarial resistance to chloroquine. Enumerate drugs for
chloroquine resistant malaria, write the adverse effects of Chloroquine.
• Write the drugs for acute ameobic dysentery. Enumerate the drugs to
eradicate amoeba in carrier state.
• Give mechanism of action, clinical uses and adverse effects of
metronidazole.
• Name the drugs used for viral hepatitis and discuss mechanism of action,
uses and side effects of Interferons.
• Give mechanism of action of Flouroquinolones. Give the mechanism of
penicillin resistance.

SPECIAL TOPICS:
• What is triple therapy? Give the name of drugs, their doses and duration
of action.
• What is the role of corticosteroids in the treatment of asthma?
• A 60 years old female patient is taking oral antihyperglycemic agents since
last 15 years. Now she has developed feeling if nausea, vomiting, bloating
and loss of appetite due to slowing of gastric emptying. Name a drug
useful in this condition and give it’s mechanism of action.
• Give triple and quadruple therapy of H.Pylori eradication.
• A patient with gout was receiving allopurinol. He complains of mild to
moderate pain. His physician prescribe him acetaminophen instead of
aspirin. A) How aspirin is contraindicated in this patient? B) Write down
mechanism of action and adverse effects of allopurinol and
acetaminophen.
• Name bronchodilators. Describe the role of leukotriene inhibitors in
asthma.
• Give mechanism of action, clinical uses and side effects of Domperidone.
• Classify H1 antihistamine drugs. How do these generations differ from
each other?
• Why does hemolysis occur in Glucose 6 phosphate dehydrogenase
deficiency? Name different drugs causing hemolysis.
• How can you differentiate between COX-1 and COX-2? Write the
machansim of action of aspirin as anti platelet and analgesic.
• A 35 years old man was diagnosed acute bronchitis by physician and given
clarithromycin. Name the group to which it belongs. Give mechanism of
action, uses and adverse effects of clarithromycin. • A)Name the drugs
used in chemotherapy induced vomiting. B) Which combination of drugs
are given in this case along with their mechanism of action.
• Classify anti platelet drugs. Give clinical uses of Aspirin.
• A diagnosed case of Gout comes to you with recurrent attacks of pain and
swelling in right big toe. A) How can you prevent these attacks by
pharmacotherapy? B) Give adverse effects of colchicine.
• Mrs. Alia is unable to sleep after taking meals, most of the time she feels
heart burn and retching. She is diagnosed as a case of reflux esophagitis.
 Enumerate the drugs fir reflux esophagitis and explain their rationale for
use.
• Discuss drugs used for bleeding disorders. Give adverse effects of
prostaglandins.
• Give mechanism of action and toxicity of xanthine oxidase inhibitors.

Best of luck!