Part IIA. Give short answers to the following Questions. Choose 10 out of 14. Total 10 x 4 =
40 pts.
5pages 0.5 (half page) not include questions and references.
1. It is known that heparin acts by increasing the activity of antithrombin, causing a
conformational change. LMWHs inhibit mainly factor Xa. Although low doses of
heparin act primarily by neutralizing factor Xa, at high doses it prevents thrombin-
induced platelet activation and prolongs bleeding time. What are major clinical benefits
using heparin or LMWHs?
2. If patient is taking new oral anticoagulant called direct thrombin inhibitor how is this
drug affecting his coagulation process? How is this action different from warfarin?
3. Laxatives, including lubricants, are commonly used by patients at different age. How
these affect the absorption of fat-soluble vitamins? Give some examples.
4. Briefly present the most common clinical problems that patients experience during
treatment with Histamine H2 Receptor antagonists, such as cimetidine (Tagamet). Does it
interfere with hepatic CYP enzymes? How this can affect the plasma concentration of
other drugs? Give some examples.
5. Briefly present the most common clinical problems that patients experience during
treatment with hypothalamic hormones and analogs, such as GnRH, somatostatin analogs
and dopamine agonists.
6. What are the most common indications for clinical use of mineralcorticoids and
glucocorticoids?
7. Which of the significant adverse effects of estrogen-only administration is significantly
reduced if a progestin is combined with an estrogen?
8. Side effects, such as dry mouth, visual disturbance, constipation, and difficulty in
urination are related to medications or drugs affecting the gastrointestinal system. What
type of receptors are they antagonizing?
9. Methicillin-resistant Staphylococcus aureus (MRSA) is a common nosocomial pathogen
that is increasing in frequency in community settings. Describe the most common
mechanism of resistance by S. Aureus? What treatment can be used?
10. An antibiotic is administered once daily in the intensive care unit to treat sepsis caused by
an abdominal wound. Serum and urine concentrations of the patients are monitored
during the course of therapy. Ten days after therapy is discontinued, the drug is still
detectable in the urine.
Which one antibiotic was administered knowing that it acts by entering the bacterial cell
and inhibiting protein synthesis due to binding to ribosomal sites? To what category of
antibiotics this drug belongs?
11. A patient with advanced renal carcinoma has not responded to traditional
chemotherapeutic agents. Which of the drugs can be added to his regimen to inhibit
tyrosine kinase activity associated with vascular endothelial growth factor and platelet-
derived growth factor?
12. What are consequences of the metabolism of ethanol by the cytochrome P450 system and
also its induction by ethanol?
13. The combination of aspirin with other drugs is likely to relieve pain better than a
maximum analgesic dose of aspirin alone. What medication it can be?
14. A person who has been taking a drug chronically and experiences a withdrawal syndrome
upon discontinuing it finds relief from these symptoms by taking a second drug. How is
this condition called?
Compare this condition to psychological dependence and to drug addiction. Give some
examples of drugs that can cause a life-threatening withdrawal.
