5 PAGES PHARAMA PAPER DUE BY 24 HRS

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.