THIRD BHMS
PHARMACOLOGY QUESTION BANK
question bank according to CBDC syllabus
M - MCQ | S - SAQ | L - LAQ | V - VIVA/PRACTICAL | Ø - NON
PHARMACOLOGY
1. Introduction to Pharmacology
A] Explain the fundamental principles of pharmacokinetics
-Pharmacokinetics deals with how the body affects a drug. It includes:
–Absorption: The process by which a drug enters the bloodstream.
–Distribution: The transport of the drug throughout body fluids and tissues.
–Metabolism: The chemical alteration of the drug, usually in the liver.
–Excretion: The removal of the drug or its metabolites from the body, mainly through the kidneys.
B] Define key pharmacodynamic terms
-Pharmacodynamics deals with how drugs affect the body.
–Agonists activate receptors to produce a response.
–Antagonists block receptors and prevent a response.
–Therapeutic Index indicates the safety margin of a drug; it is the ratio between the toxic and effective doses.
C] Recognize drug classifications and their mechanisms of action
-Drugs are grouped into classes based on their chemical structure, mechanism of action, or therapeutic use.
-Understanding classifications helps in predicting how drugs work, their effects, and possible side effects.
1. Based on Mechanism of Action
-Receptor Action: Some drugs act by binding to specific receptors on cell surfaces.
–Agonists activate receptors (e.g., salbutamol → β₂ agonist).
–Antagonists block receptors (e.g., propranolol → β-blocker).
-Enzyme Inhibition:Drugs may inhibit enzymes to prevent certain biochemical reactions.
–E.g: Aspirin inhibits cyclooxygenase (COX) to reduce inflammation.
–E.g: ACE inhibitors (like enalapril) block angiotensin-converting enzyme to lower blood pressure.
-Ion Channel Modulation:Some drugs open or close ion channels, altering membrane potential.
–E.g: Lidocaine blocks sodium channels, producing local anesthesia.
-Transporter Inhibition:Drugs can inhibit transporters that move molecules across cell membranes.
–E.g: SSRIs (like fluoxetine) block serotonin reuptake transporters.
-Action on DNA or RNA:Certain drugs interfere with nucleic acids, preventing cell replication.
–E.g: Anticancer drugs (methotrexate) and antibiotics (ciprofloxacin). ––
2. Based on Chemical Structure
-Drugs with similar chemical structures often have similar actions.
–E.g: β-lactam antibiotics (penicillins, cephalosporins).
–E.g: Benzodiazepines (diazepam, lorazepam).
3. Based on Therapeutic Use
-Drugs classified by their main clinical use or effect.
–E.g: Antihypertensives (for high blood pressure).
–E.g: Antipyretics (reduce fever).
–E.g: Analgesics (relieve pain).
D] Participate in clinical settings, reviewing patient medications under supervision
-Observe and learn how drugs are prescribed and administered in real clinical situations.
-Review patient medication charts under the guidance of a qualified professional.
-Identify possible drug interactions, duplications, or inappropriate doses.
-Understand the importance of monitoring patient responses and reporting adverse effects.
-Gain practical experience in applying pharmacological knowledge to safe and effective patient care.
2. Definition and Scope of Pharmacology
-Pharmacology is defined as the science that deals with the interaction between chemical substances (drugs) and living systems to produce therapeutic or toxic effects.
-Scope of Pharmacology – It includes understanding drug actions, uses, and safe application in patient care.
A] States the primary components of pharmacology
a) Drug Actions – What drugs do to the body.
b) Mechanisms of Action – How drugs produce their effects.
c) Therapeutic Uses – The clinical purpose for which drugs are used
B] Lists the subdivisions of pharmacology and their relevance
a) Pharmacokinetics – Absorption, distribution, metabolism, and excretion of drugs.
b) Pharmacodynamics – Mechanisms and effects of drugs on the body.
c) Pharmacotherapeutics – Use of drugs for prevention and treatment of diseases.
d) Toxicology – Study of harmful and adverse effects of drugs.
e) Clinical Pharmacology – Application of drug knowledge in patient care.
f) Chemotherapy – Use of drugs against infections or cancer.
g) Pharmacogenetics – Effect of genetics on drug response.
C] Explains how pharmacokinetics and pharmacodynamics influence drug therapy
-Pharmacokinetics determines how much drug reaches the site of action and for how long.
-Pharmacodynamics determines the intensity and nature of the drug’s effect.
-Together, they help in selecting the correct dose, route, and frequency for safe and effective therapy.
D] Describes how adverse effects or drug interactions impact patient care
-Adverse effects may reduce drug compliance or cause harm.
-Drug interactions can enhance or reduce drug effects, leading to toxicity or treatment failure.
-Awareness helps in monitoring patients and adjusting medications appropriately.
E] Interprets drug concentration time curves or other pharmacokinetic data
-The curve shows how drug concentration changes in the body over time.
-Helps determine absorption rate, half-life, peak concentration, and duration of action.
-Used to adjust dosing schedules and maintain drugs within the therapeutic range
3. Drug Nomenclature and Classification Systems
a) olol: Beta-blockers (e.g., propranolol, atenolol)
b) pril: ACE inhibitors (e.g., lisinopril, enalapril)
c) Es-: Refers to an S-enantiomer (e.g., esomeprazole)
d) Levo-: Refers to a levorotatory isomer (e.g., levothyroxine)
e) cillin: Penicillin derivatives (e.g., ampicillin)
f) statin: HMG-CoA reductase inhibitors (e.g., atorvastatin)
4. Routes of Drug Administration
-The route of drug administration refers to the path by which a drug is brought into contact with the body. It plays a major role in determining the onset, intensity, and duration of the drug’s action.
A] Types of Routes
1. Enteral Routes (through the gastrointestinal tract)
-Oral Route: The most common, convenient, and economical method. Absorption occurs mainly in the small intestine.
–Example: Tablets, capsules, syrups.
-Sublingual and Buccal Routes: Drugs are placed under the tongue or inside the cheek for rapid absorption, bypassing the liver.
–Example: Nitroglycerin, buprenorphine.
-Rectal Route: Useful for patients who are vomiting or unconscious. About 50% of the drug bypasses the liver.
–Example: Suppositories, diazepam.
2. Parenteral Routes (bypasses the gastrointestinal tract)
-Intravenous (IV): Provides rapid and complete absorption. Used in emergencies for immediate action.
–Example: IV fluids, antibiotics.
-Intramuscular (IM): Used for moderately rapid absorption or for depot preparations.
–Example: Vaccines, iron injections.
-Subcutaneous (SC): Suitable for drugs requiring slow and steady absorption.
–Example: Insulin, heparin.
-Intradermal: Used for diagnostic purposes such as allergy testing or the tuberculin test.
3. Topical Routes
-Transdermal: Drug applied on the skin for systemic absorption over time.
–Example: Nicotine or fentanyl patches.
-Local Application: Drugs applied to eyes, ears, nose, or skin for localized effects.
–Example: Eye drops, nasal sprays, creams, ointments.
-Inhalation: Drugs inhaled into the lungs for rapid absorption and local or systemic effects.
–Example: Asthma inhalers, nebulizers.
4. Other Specialized Routes
-Intrathecal: Drug injected into the spinal fluid for central nervous system effects.
–Example: Chemotherapy drugs.
-Intra-articular: Injection into a joint cavity for local anti-inflammatory action.
–Example: Corticosteroids.
-Vaginal: Drugs used locally for infections or contraception.
–Example: Antifungal pessaries, contraceptive rings.
B] Factors Affecting the Choice of Route
1. Drug-Related Factors
-Can the drug survive the environment of the GI tract (e.g., oral vs. IV)?
-Is the drug lipid or water soluble?
-Does the drug require bypassing the liver (e.g., sublingual, parenteral)?
-Does the drug require rapid action (IV) or sustained release (transdermal)?
-Consciousness: Is the patient conscious and cooperative (oral vs. IV/IM)?
2. Patient-Related Factors
-Age: Pediatrics and geriatrics may require specific routes (e.g., rectal for children)
-Physical Condition: Difficulty swallowing (requires non-oral routes like IV, SC)
-Preferences and Compliance: Does the patient prefer certain methods for better adherence (e.g., patches over injections)?
-Vomiting/NPO (Nil Per Os): Oral route is contraindicated
3. Disease or Condition Factors
-Site of Action: Does the drug act locally (topical, inhalational) or systemically (oral, IV)?
-Urgency: Emergency conditions often require IV for rapid effect
-Target Organ: Routes like intrathecal are used for CNS delivery due to the blood-brain barrier