4. The main questions of the theme
Define narcotic, sedative, hypnotic, anxiolytic, tranquillizer, analgesic, anticonvulsant agent.
Explain how hypnotics produce adverse effect on normal sleep.
When are hypnotics needed?
What factors determini the choice of hypnotic?
Why have benzodiazepines replaced the other hypnotics?
Classify barbiturates giving examples. Describe the pharmacokinetics and pharmacodynamics of barbiturates. What are their uses, contraindications and drug interactions?
What are the different preparations, doses and uses of benzodiazepines?
What are the advantages and disadvantages of chloral hydrate and paraldehyde as hypnotics?
Explain why bromides are no more used as hypnotics.
Classify analgesics.
What are the main differences between narcotic and non-narcotic analgesics?
Describe the pharmacological effects, mode of action, preparations, doses, uses, contraindications of morphine.
What are the differences between morphine and pethidine?
How is acute morphine poisoning treated?
Describe the characteristics of dependence of morphine and the withdrawal syndrome.
Describe the differences between morphine and codeine.
Name opioid antagonists. How do they act?
Describe the major classes of opioids receptors.
What are the various effects produced by opioid-receptor activation?
Discuss naloxone, nalorphine and naltrexone as narcotic antagonists.
Write notes on “brain’s own opioids”.
What is the difference between convulsions and epilepsy; and between anticonvulsant and antiepileptic?
Are all barbiturates antiepileptics? Which among them possess antiepileptic property?
Classify antiepileptic drugs.
What are the main types of epilepsy and the choice of drugs indicated for each of them?
Describe the pharmacology of phenitoin.
What is the role of benzodiazepines in the treatment of epilepsy?
What is the mode of action of antiepileptic drugs?
Describe the pharmacology of sodium valproate. What is its spectrum of activity, mode of action and adverse effects?
What are the characteristics of parkinsonism?
How can the balance between acetylcholine and dopamine be stored?
What is the basis of the use of anticholinergic and dopaminergic drugs in the treatment of parkinsonism?
Name anticholinergic agents employed in the treatment of parkinsonism.
Describe the pharmacology of levodopa. Why dopamine as such is not used?
What if the role of vitamin B6 in relation to levodopa?
What is the use of dopa decarboxylase inhibitors?
Describe Amantadine.
Describe Bromocriptine.
Antiinflammatory Drugs.
Describe the processes involved in inflammation
List separately the mediators of acute and chronic inflammation.
Name different groups of drugs which act as anti-inflammatory.
Draw the diagram to illustrate various steps that occur in producing inflammation and bronchospasmdue to disturbance of cell membrane. Also indicate the site of action of anti-inflammatory drugs.
Classify non-steroidal anti-inflammatory drugs (NSAIDs). How do they act as anti-inflammatory and analgesic drugs?
Describe the pharmacology of salicylates.
Describe the main features of the different non-narcotis/analgesic-antipyretic/NSAIDs.
Name the various propionic acid derivatives and their formulations and usual anti-inflammatory doses.
What are the adverse effects of phenylbutazone?
Write notes on Diclofenac, Mefenamic acid, and Piroxicam. What are their advantages and disadvantages?
Compare Aspirin and Paracetamol.
What are the uses and adverse effect of Indomethacin?
Discuss the choice of NSAIDs on the basis of activity, frequency of administration and suitability.
What is the aim of therapy in rheumatoid arthritis?
Which drugs are useful in arthritic conditions?
What is the role of simple analgesics, NSAIDs, and corticosteroids?
Discuss the status of gold preparations in rheumatoid arthritis.
What is primary and secondary gout?
What is the chief abnormality in gout?
Is colchicines uricosuric?
Describe drugs which are indicated in acute attack of gout.
Describe drugs used in chronic gout.
Describe the role and mode of action of uric acid synthesis inhibitors.
Explain why aspirin and probenecid should not be given simultaneously?
Write prescriptions for next drugs and note their indications and contraindications (precautions):
Acetaminophen
Alprazolam
Amitriptyline
Amphetamine
Aspirin
Baclofen
Benztropine
Bromocriptine
Carbamazepine
Chlorpromazine
Dantrolene
Diazepam
Ephedrine
Ethanol
Ethosuximide
Flumazenil
Haloperidol
Halothane
Imipramine
Levodopa
Lithium carbonas
Methadone
Morphine
Phehobarbital
Phenytoin
Valproic acid
Antiinflammatory Drugs.
1. An analog of amino acid cysteine the D isomer of which has been used in rheumatoid arthritis.
2. Gold compound.
3. Antimalarial drug that is approved for rheumatoid arthritis.
4. An oxicam that is a nonselective COX inhibitor.
5. A pyrazolone derivative.
6. A naphthylpropionic acid derivative.
7. A potent inhibitor of cyclooxygenase; used to accelerate closure of a patient ductus arteriosus.
8. A simple derivative of phenylpropionic acid.
9. A phenylacetic acid derivative. It is also recommended for prevention of postoperative ophthalmic inflammation and can be used after intraocular lens implantation and strabismus surgery.
10. An enolcarboxamide related to piroxicam that is selective COX2 inhibitor.
11. An agent that blocks COX irreversibly.
12. Antiparasitic drug that increases the magnitude of delayed hypersensitivity or T cell-mediated immunity.
13. Endogenous protein that is approved for the treatment of chronic granulomatous disease.
14. Immunosuppressive agent with efficacy in human organ transplantation and in the treatment of selected autoimmune disorders.
15. Glucocorticoid with very low mineralocorticoid activity and very high topical activity; used for dermatologic conditions.
16. The most potent glucocorticoid drug for systemic use.
17. Active metabolite of a synthetic glucocorticoid; has an intermediate duration of action and low topical activity.
18. A drug used by aerosol in the treatment of asthma.
Aspirin, acetylsalicylic acid |
Oral (regular, enteric-coated, buffered): 81, 165, 325, 500, 650, 800, 975 mg tablets; 81, 650, 800 mg timed- or extended-release tablets |
Diclofenac |
Oral: 50 mg tablets; 25, 50, 75 mg delayed-release tablets; 100 mg extended-release tablets; Ophthalmic: 0.1% solution |
Ibuprofen |
Oral: 100, 200, 400, 600, 800 mg tablets; 50, 100 mg chewable tablets; 200 mg capsules; 100 mg/2.5 mL suspension, 100 mg/5 mL suspension; 40 mg/mL drops |
Indomethacin |
Oral: 25, 50 mg capsules; 75 mg sustained-release capsules; 25 mg/5 mL suspension; Rectal: 50 mg suppositories |
Meloxicam |
Oral: 7.5 mg tablets |
Naproxen |
Oral: 200, 250, 375, 500 mg tablets; 375, 550 mg sustained-release tablets; 375, 500 mg delayedrelease tablets; 125 mg/5 mL suspension |
Phenylbutazone |
Oral: 100 mg tablets and capsules. |
Piroxicam |
Oral: 10, 20 mg capsules |
Gold sodium thiomalate |
Parenteral: 50 mg/mL for injection |
Penicillamine |
Oral: 125, 250 mg capsules; 250 mg tablets |
Chloroquine |
Oral: 250, 500 mg tablets (equivalent to 150, 300 mg base, respectively); Parenteral: 50 mg/mL (equivalent to 40 mg/mL base) for injection |
Cyclosporine |
Oral: 25, 50, 100 mg capsules; 100 mg/mL solution; Parenteral: 50 mg/mL for IV administration |
Dexamethasone |
Oral: 0.25, 0.5, 0.75, 1, 1.5, 2, 4, 6 mg tablets; 0.5 mg/5 mL elixir; 0.5 mg/5 mL, 0.5 mg/0.5 mL solution |
Hydrocortisone acetate |
Parenteral: 25, 50 mg/mL suspension for intralesional, soft tissue, or intra-articular injection |
Prednisolone |
Oral: 5 mg tablets; 5, 15 mg/5 mL syrup |
Beclomethasone |
Aerosol: 40, 80 g/puff in 200 dose containers |
Triamcinolone (acetonide) |
Oral: 4, 8 mg tablets; 4 mg/5 mL syrup; (Parenteral: 3, 10, 40 mg/mL for IM, intra-articular, or intralesional injection (acetonide)) |
Interferon gamma-1b |
Parenteral: 100 mcg vials |
Levamisole |
Oral: 50 mg tablets |
5. Teaching methods – working in pairs, the prescription writing of drugs for concrete situations; training, defining terms, solving problems, answer questions, working out examples (of the slides, of the handbooks and handouts), MCQs.