Question 1

Pharmacokinetics is the movement, intensity and duration of drugs and how thy effect the
body, from how they get absorbed through the bloodstream and cells that cause and effect
either by oral, IV, subcutaneous, inhaled, rectal, topical and enteral application and how it is
eliminated from the body.
How that drug is metabolised being through first pass from oral that goes through the liver or
by the direct route of IV where it goes straight into the bloodstream and bypasses the liver or
injection where it goes into the muscular cells before entering the tissues.
The bioavailability of the drugs absorbed into the body and how fast the drug reaches the
systemic system depends on how quickly the body absorbs and metabolises the drug with
the ability of a drug to accumulate at the site of action. High bioavailability drugs work much
faster through IV route to the tissues via the bloodstream.
The liver metabolises drugs and only lets through unharmful substances that are then
distributed to the body to the site of action by the rate and extent of uptake of the drug for
distribution, with minimum effective concentration and elimination from the body.
Drugs can be distributed in plasma interstitial and intracellular tissues to be able to have the
same concentrations of the drug in the body and in the plasma, lipid soluble drugs are the
main type to enter the brain and Cerebrospinal fluid.
The placenta enzymes will inactivate some drugs while enabling lipid and some water-
soluble drugs to enter the placenta.
It needs to be taken into account the patient’s diagnosis if renal, gastrointestinal and hepatic
diseases to be able to achieve a therapeutic response with the medication as some drugs
metabolise differently with each person. The choice of route of entry with drug clearance
and distribution be determined the parameter of the half life of that drug and a schedule to
maintain a steady concentration to achieve and appropriate therapeutic response. Over the
counter medications need to be taken into account as well as age, sex, race, ethnicity,
disease status, body weight, diet and nutrition. Also needing to measure blood pressure to
determine the type of concentration response curve that is needed for a therapeutic effect.
Pharmacodynamics is what the drug does to the body and being able to measure the
affinity and efficacy and bind to a receptor to give an active response to measure the
effectiveness of the drug by leading to tissue response once bound to the receptor.
Different routes of administration can give varying chemical reactions, how the drug binds
with the receptor site to show a physiological response. The different concentrations of the
drug that bind to the receptor depends on the required dose to make and effect that
influences drug effect to occur.
Question 2.
Asthma is an inflammation and tightening of the smooth muscles of the respiratory tubules
causing bronchoconstriction and airflow obstruction causing the airways to become
narrowed and produce extra mucous making it harder to breathe. Some triggers are some
drugs including aspirin, stress, cold, obesity, smoke, cigarette smoke, pollen, dust mites,
mold and spores. Exercise from physical activity, breathlessness, respiratory infections
where excess mucous is secreted in the airways that can block air from the lungs causing
reduced airways from vascular congestion. Some of the symptoms of asthma include
wheezing, dyspnoea, tachypnoea, tachycardia, a non-productive cough with an increase of
goblet cell in mucosa.
The use of accessory muscles with wheezing on inspiration as was as escalation are noted
on a more severe asthma attack.
Depending on the severity of the attack the oxygen levels will change and drop to between
90-94%. For a more severe case the patient will have difficulty in completing full sentences
in one go. The Oxygen levels falling below 90% with signs of exhaustion, respiratory efforts
become harder with a decline in having soft or absent breath sounds.
Bronchodilators increase the diameter of the bronchi making it easier for the air to get into
the lungs causing bronchodilation and relaxation of the bronchial smooth muscle.
Some complications of asthma are pneumonia, respiratory failure due to the oxygen levels
dropping to low causing carbon dioxide to become dangerously high
A fast-acting reliever medication class Adrenergic Bronchodilators named Salbutamol is
used to treat asthma that relax the muscles around the airways making it easier to breathe
within minutes and lasting for between 3-4 hrs. Overdose of this medication can cause
tremors, cardiac dysrhythmia including an increase in rate and force of contractions of the
heart (tachycardia) triggering the cell membrane to stabilise. It can also be used to treat high
potassium levels, exercise-induced bronchoconstriction and COPD.
Pulmicort is a long-term corticosteroid preventer inhaled steroid medication that is directed to
the airways as needs, very little is absorbed through the rest of the body and keep the
airways open for at least twelve hours. This medication is best used with a spacer with the
preventer which assists the repair of the airway cell to stop and reduce airway inflammation,
redness and reduce excess mucous, to rinse the mouth to prevent oropharyngeal
candidiasis from occurring. Other side effects are sore throat, a hoarse voice, tachycardia
and headaches. Pulmicort also prevents an asthma attack from occurring if compliant with
taking it, improves lung function preventing exacerbations of the condition. It can take
between four and twelve weeks to become effective.
Question 3

Patient B is the one with Grave’s Disease due to having High levels of serum thyroxine in the
blood due to producing more of the proteins that bind to thyroxine. Serum thyroxine T4 levels
range between 4.6-12 ug/dl

TSH is produced by the pituitary gland and having low TSH levels between 0.4-4.0mlU/L in
the blood is due to producing excess T3 and T4 levels, sending signals to the pituitary gland
stops producing TSH to try and even out the levels of thyroid hormones. There is an
increased risk of stroke and osteoporosis. Some symptoms include weight loss, tachycardia,
irregular menstruation.

Limiting the intake of iodine and increasing your levels of estrogen by increasing fruit and
vegetable, vitamin C, yoghurt, fresh vegetables are needed for hormone creation Avoiding
fatty foods and reducing the amount of fat in the diet including butter and mayonnaise.

Grave’s disease is most common in women between 20 and 40 years old. A physical
examination may show enlargement in the neck area also an increased heart rate, goitre,
blood tests, ultrasound scan is done on the thyroid for diagnosis.

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Question 4

Blood pressure is the the blood circulatory system that shows the heartbeat and is measured
for elasticity of the arterial walls with the force and rate of the blood moving through the
heart. Baseline blood pressure is 120/80. Hypertension is diagnosed if your systolic reading
is between 130 and 139mm Hg and the diastolic reaches between 80-89 mm Hg this is
considered Stage 1 hypertension. Stage 2 hypertension is when the systolic pressure is 140
mm Hg and the diastolic is 90mm Hg or higher.

Having a high blood pressure puts extra pressure and strain on the arteries of the heart
where the arterioles with resistance of blood flow and is referred as primary hypertension
whereby the extra force needed against the wall of the heart to be able to pump blood
throughout your body.

Inpropper diet, lack of exercise, poor eating habits, alcohol and tobacco and some biological
factors all contribute to hypertension with the blood unable to move freely though you
arteries

Hypertension is the lack of blood flow to the heart and weakening of the wall of blood
vessels with the injury of the muscle from the extra force needed to pump the blood
thoughout the body with the partial narrowing and blockages of the arteries which in turn can
lead to a myocardial infarctio, TIA or stroke. Loss of sight, memory loss (vascular dementia),
bleeding in the brain, acromegley, kidney failure, blood clots in the neck are all contributing
factors for hypertension.

With hypertension it gradually increases the pressure on your arteries forcing the artery walls
to become less elastic and stops the blood from flowing freely that help supply the tissues
and organs oxygen and nutrients needed for the organs.

Perindopril is a long acting Angiotensin Converting Enzyme Inhibitor (ACE) that regulates
blood pressure, it is metabilised in the liver, it reduces blood pressure by reducing
angiotensin ll which lowers the amount of water your body retains and allows the vessels to
widen and relax which lowers your blood pressure.

Ibuprofen a nonsteroidal anti inflammatory medication (NSAID’s) can reduce the

effectiveness of Perindopril. Some side effects are headaches, loss of taste, hyperkalemia,
dry cough and fatigue. ACE inhibitors can cause angioedema (tissues to swell). Swelling in
the throat can occur and be life threatening.

Consultation with your doctor about becoming pregnant about taking Perindopril as it may
harm the baby by crossing the blood barrier through the placenta.

With a decrease in blood pressure the parasympathetic nervous system get signals from the
medull oblongata and that in turn blood pressure decreases, that causes the blood vessels
to dilate so the blood can flow more freely and put less strain on the heart, therefore
restoring homeostatic balance.
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