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Pharmacology Teaching and Research


 


0840



Questions: Drugs Affecting the Endocrine System, Anthelmintic Drugs and Anti-cancer Drugs


    


Regarding the metabolism and pharmacokinetics of estrogens:

1.       Exhibit a high bioavailability when taken orally

2.       Transdermal administration reduces first-pass metabolism

3.       Breast tenderness is an adverse effect

4.       Post-menopausal bleeding can occur

5.       Endometrial cancer is increased with the use of estrogen therapy

A = 3,4,5    B = 2,3,4,5    C = 1,2,5    D = 1,2,4,5      E = All of above 

Match Column A and B:

Column A                                                               Column B

 

Glucocorticoids                            A.      Adverse effect of sulfonylureas

Weight gain                                   B.       Most potent estrogen

Metformin                                      C.      α-glucosidase inhibitor

Acarbose                                       D.      Reduce inflammatory response

Estradiol                                        E.       Increase glucose uptake and reduce

                                                                   insulin resistance

Tamoxifen                                      F.       Estrogen-Receptor modulator

Progestogen                                 G.       Decrease Na +-reabsorption in                                                                            kidneys

Oxytocin                                        H.      Contraction of uterine muscle

Somatotropin                                I.        Treatment of GH-deficiency in                                                                              children

Regarding the metabolism and pharmacokinetics of estrogens:

1.       Exhibit a high bioavailability when taken orally

2.       Transdermal administration reduces first-pass metabolism

3.       Breast tenderness is an adverse effect

4.       Post-menopausal uterine bleeding can occur

5.       Endometrial cancer is increased with the use of estrogen therapy

A = 3,4,5        B = 2,3,4,5         C = 1,2,5           D = 1,2,4,5      E = All of the above 

Estrogens and progesterone are female sex hormones and are used therapeutically alone or in combination to,

- induce normal pubertal development in hypo-estrogenic states

- suppress ovulation and induce cervical changes (in hormonal contraceptives)

- treat abnormal uterine bleeding

- treat menopausal symptoms and provide hormonal replacement when indicated

- medically prevent benign ovarian cysts by the suppression of pituitary gonadotropins.

Estrogens:

Estradiol

Ethinylestradiol

Progestogens:

Norethindrone

Norgestrel

Norgestimate

Levonorgestrel

Desogestrel

Drospirenone


Testosterone is the major androgen and is used for replacement therapy in deficiency states:

- primary hypogonadism (testicular deficiency from orchitis)

- secondary hypogonadism due to a lack of gonadotrophic stimulation.

The following statements are true regarding the mechanism of action of repaglinide and nateglinide:

    1.     Inhibit the pancreatic B-cells to produce insulin

    2.     Have a rapid onset and short duration of action

    3.     described as postprandial glucose regulators

    4.     combination therapy with metformin has no effect on                                     glycemic control

    5.    should not be used in combination with sulfonylureas due to                        overlapping of  mechanism of action

               A = 1,3             B = 2,5         C = 1,3,4      D = 1,3,5    E = 3,4,5 

The following are true regarding the pharmacokinetics and adverse effects of sulfonylureases:

   1.     Metabolized in the liver

   2.     Bind to serum proteins when given orally

   3.     Duration of action ranges from 4 – 10 hours

   4.     Gain of weight

   5.     Hyperinsulinemia

        A = 3,4,5           B = 1,2,4,5        C = 2,4,5           D = 1,4,5      E = 1,2,3,5 

The following durations of action is correctly associated with each hypoglycemic agent:

     1.     Glipizide – 6 hours

     2.     Glimepiride – 3 hours

     3.     Nateglinide – 2 hours

     4.     Metformin – 6 hours

     5.     Acarbose – 24 hours

               A = 1,2             B = 3,4       C = 2,4,5      D = 3,4,5      E = 1,2,4,5 

Insulin preparations include:

     1.    Lispro

     2.    Aspart

     3.    Glulisine

     4.    Glargine

     5.    Detemir

      A = 1     B = 1,2         C = 1,2,3      D = 1,2,3,4   E = All of the above

Write three (3) adverse (side) effects of α-glucosidase inhibitors.                  Name two drugs classified as short-acting glucocorticoids.                          Name four (4) intermediate acting glucocorticoids.                                          

Diabetes mellitus is a chronic metabolic disorder characterized by an absolute or relative deficiency of insulin often associated with peripheral insulin resistance.

Type 1 Diabetes:

Autoimmune disorder characterized by beta-cell destruction and consequent insulinopaenia.

Type 2 Diabetes:

Heterogeneous disorder characterized by insulin resistance and relative deficiency of insulin. 

A number of insulins and analogues as well as blood glucose lowering drugs are available to manage diabetes.

Rapid Acting / Short Acting Insulins:

Insulin lispro

Insulin glulisine

Regular insulin

Insulin aspart

Intermediate Acting Insulin:

Neutral Protamine Hagendorn (NPH) Insulin

Long Acting Insulins:

Insulin glargine

Insulin  detemir

The following drug is a mineralocorticoid:                         

1.    Fludrocortisone

2.    Betamethasone

3.    Prednisolone

4.    Cortisone

5.    Dexamethasone

A = 1      B = 2             C = 3           D = 4            E = 5 

The following are adverse effects of adrenocorticoids:

1.      Osteoporosis

2.      Glaucoma

3.       Hypotension

4.      Hyperkalemia

5.       ncreased appetite

  A = 1,2,4   B = 1,2,5    C = 2,4,5     D = 4,5        E = 1,4,5 

Regarding aldosterone:

1.    Cause reabsorption of sodium

2.    Increase reabsorption of potassium which is lost in urine

3.    Elevated levels result in hypokalaemia   

4.    Hyperaldosteronism is treated with spironolactone

5.    Released by adrenal medulla

A = 1,3,4        B = 2,3,5,  C = 3,4,5      D = 1,4,5      E = 2,3,4,5

The following statements are true regarding glucocorticoids:

1.    Stimulate gluconeogenesis

2.    Stimulate protein anabolism

3.    Raise plasma glucose levels

4.    Enhance vasoconstriction action

5.    Decrease blood levels of haemoglobin

A = 1,4,5          B = 2,4,5       C = 2,3,5       D = 1,3,4       E = 2,3,4,5

Regarding the duration of action of glucocorticoids:                                       

1.    Hydrocortisone – short acting

2.    Prednisone – short acting

3.    Dexamethasone – long acting

4.    Betamethasone – intermediate acting

5.    Methylprednisolone – intermediate acting

A = 1,4,5        B = 1,2              C = 1,2,3          D = 1,3,5            E = 1,2,3,4 

The following are true regarding prolactin related drugs:

1.       Primary function is to stimulate and maintain lactation

2.       Bromocriptine can be used in the treatment of hypoprolactinaemia

3.       Nausea is an adverse effect of cabergoline

4.       Psychiatric problems are not considered as an adverse effect

5.       Bromocriptine and cabergoline can be used in the treatment of                    pituitary microadenomas

A = 1,3        B = 2,4        C = 1,3,5        D = 2,3,4     E = 2,4,5  

The following are true regarding hypothyroidism and its treatment:

1.       Autoimmune destruction by the thyroid results in hypothyroidism

2.       Decreased TSH-levels indicate hypothyroidism

3.       Levothyroxine is used to treat hypothyroidism

4.       T 4 steady-state condition is reached 6-8 weeks after first                               administration of levothyroxine (T 4)

5.       Tachycardia results from T 4 toxicity levels

    A = 1,3,4  B = 1,3,4,5    C = 2,3,4,5     D =  1,4,5      E = all of the above

Oxytocin is a hormone produced by the hypothalamus and secreted the pitiutary gland.  Oxytocin is responsible for contractions of the womb during labor  - stimulates the uterine muscles to contract - initiates labor. 

Synthetic oxytocin (drug or medicine) can be used to induce labor.

Oxytocin also promotes lactation by moving milk into the breasts.

For males oxytocin assists with movement of sperm.

Somatotropin is a human growth hormone inportant for the growth of bones and muscles.  Purified Somatotropin can be used in the treatment of Growth-hormone deficiency.  It can be administered subcutaneously or IM.

Somatostatin is a hormone produced in the hypothalamus and pancreas and inhibits growth hormone secretion and insulin secretion.

Purified Somatostatin and synthetic analogs of somatstatin such as Octreotide are used to treat abnormal growth - use to treat acromegaly.

The following are true regarding somatostatin:

1.      Classified as a gonadotropin-releasing hormone  related drug

2.      Supresses GH

3.     Found in neurons

4.     Inhibits the release of insulin

5.     Has an analogue known as octreotide

a.)    1     b.)    1,2    c.)     1,2, 4     d.)  2,3,4,5      e.) 1,3,4,5

Name the adverse effects of Ocreotide.




Examples of antiandrogens include:

1.    Ketoconazole

 2.    Finansteride

3.    Etonogestrel

 4.    Bicalutamide

 5.    Norethindrone

  A = 2,3,4          B = 1,2,4   C = 3,4,5      D = 1,3,4      E = 1,2,4,5

Progestrogens cause:

 1.    Decrease in hepatic glycogen

2.    Increase in Na + reabsorption

3.    Increase in body temperature

4.    Decrease in certain plasma amino-acids

5.    Decrease in excretion of urinary nitrogen

 

    A = 3,4          B = 1,4,5      C = 2,3,5      D = 1,3,5      E = 4,5 

Following are examples of selective estrogen-receptor modulators (SERM):

            1.    Tamoxifen

               2.    Raloxifen

               3.    Toremifene

               4.    Flutamine

               5     Clomifene

   A = 3,4,5          B = 1,2,3       C = 1,2,3,5           D = 2,4,5      E = 1,4,5 

Regarding estrogens:

     1.     Estradiol is the least potent estrogen

     2.     Estrone is the primary circulating estrogen after menopause

     3.     When taken orally estradiol is rapidly metabolized in the liver

     4.     Ethinylestradiol is well absorbed after oral administration

     5.    To reduce first-pass metabolism estrogens may be administered via the transdermal route

               A = 1,4   B = 1,2,5      C = 1,2,3      D = 2,3,4,5           E = 1,2,4,5 

The following are true regarding the therapeutic use and pharmacokinetics of progestogens:

1.        Is rapidly absorbed after oral administration

2.        It has a long life-time in plasma

3.        Oral medroxyprogesterone acetate has a half-life of 40 – 50 days

4.        Used for control of dysfunctional uterine bleeding

5.        Use in treatment of dysmenorrhea

A = 1,3,5     B = 1,4,5   C = 2,3           D = 4,5           E = 2,4,

The following are true regarding the therapeutic use and pharmacokinetics of progestogens:

1.       Is rapidly absorbed after oral administration

2.       Has a long life-time in plasma

3.       Oral medroxyprogesterone acetate has a half-life of 40 – 50 days

4.       Used for control of dysfunctional uterine bleeding

5.       Use in treatment of dysmenorrhea

A = 1,3,5         B = 1,4,5        C = 2,3        D =  4,5      E = 2,4,5 

The following are true regarding glucocorticoids:

1.       Assist the body to combat stress caused by infection

2.       Cause a modest rise in blood pressure

3.       Cause an increase in lymphocytes

4.       Increase the blood levels of haemoglobin

5.       Elevated glucocorticoid levels results in feedback inhibition of                      corticotrophin production

A = 1,3,4       B = 2,3,5       C = 1,4,5      D = 1,2,4,5          E = All of the above

The following are true regarding sulfonylureas:

1.       Glyburide is a primary sulfonylureas drug

2.       Stimulate the release of insulin from B-cells

3.       Reduce hepatic glucose production

4.       Decrease the peripheral insulin sensitivity

5.       Duration of action ranges from 12 – 24 h

A = 1,4,5      B = 1,2,3,5        C = 1,3,4      D = 2,3,4,5      E = All of the above

Symptoms of Type 1 diabetes could include:

1.       Excessive thirst

2.       Excessive hunger

3.       Excessive production and passage of urine

4.       Increased mass

5.       Ketoacidosis

A = 1,2,3         B = 2,4,5         C = 1,2,3,5          D = 2,3,4,5            E = All of the above 

The following are true regarding the mechanism of biguanides:

     1.     Inhibit gluconeogenesis

     2.     Improve peripheral glucose uptake

     3.     Reduce hyperlipidemia

      4.     Should never be used in combination with insulin

      5.     Hyperglycemia may occur when metformin is taken in                                   combination with insulin

    A = 1,2,3        B = 2,3,4      C = 1,2,5      D = 1,2,4,5   E = All of the above 

The following are true regarding insulin preparations:

1.             Peak levels of insulin lispro are obtained 30 – 90 minutes after                       injection

2.              Insulin glargine is an example of long-acting insulin

3.              Insulin detemir has long-acting properties

4.              Insulin gluisine is described as pregnancy category C drug

5.              Lispro and aspart are classified as rapid-acting insulin

A = 1,2,3          B = 2,3,4      C = 1,4,5      D = 1,3        E = All of the above 

Regarding spironolactone:

1.             Stimulates sodium absorption

2.             Is an antihypertensive drug

3.             Is used against hyperaldosteronism

4.             Is useful in treatment of hirsutism

5.             Adverse effects include hypokalemia

 A = 3,4       B = 2,3,4    C = 2,4,5     D = 1,3,4,5   E = All of the above. 

The following are true regarding hormones released by the adrenal gland:

1.      Glucocorticoids are steroid that reduce inflammation throughout the           body

2.     Epinephrine causes an increase in heart rate, muscle strength, blood          pressure and sugar  metabolism

3.     Aldosterone regulates salt and water metabolism

4.     Cortisol favours normal metabolism and assist in resistance to                    stress

5.      Dehydroepiandrosterone stimulates the syntheses of male and                     female hormones

A = 1         B = 1,2          C = 1,2,3      D = 1,2,3,4        E = All of the above

 The following are functions of cortisol:

1.               Inhibits normal metabolism

2.               Maintains blood sugar levels and blood pressure

3.               Sustain stress in the body

4.               Act as an inflammatory agent

5.               Regulate fluid balance in the bod

A = 2,3,4      B = 2,5  C = 1,3,4      D = 3,4,5     E = 1,3,4,5

The following are true regarding glucocorticoids:

1.      Assist the body to combat stress caused by infection

2.      Cause a modest rise in blood pressure

3.      Cause an increase in lymphocytes

4.       Increase the blood levels of haemoglobin

5.      Elevated glucocorticoid levels results in feedback inhibition of corticotrophin production

     A = 1,4,5   B = 2,3,5        C = 1,4,4,5      D = 1,2,4,5   E = All of the above 

Glucocorticoids and mineralocorticoids are hormones released by the adrenal cortex of the adrenal gland.  Cortisol is the main human glucocorticoid.  

Glucocorticoids reduce inflammatory response and is use to treat allergies.  High doses of glucocorticoids can stimulate gastric acid and pepsin production.  

Aldosterone is a mineralocorticoid acting on the kidneys to stimulate reabsorption of sodium, bicarbonate ans water.  It also decreases the absorption of potassium lost in urine.

Drugs or medicines classified as glucocorticoids include:

cortisone, hydrocortisone, prednisone, methylprednisolone, trimcinolone, betamethasone, and dexamethasone.

Glucocorticoids are classified as:

short-acting, intermediate acting and long acting.

Fludrocortisone is an example of a mineralocorticoid.

A number of adverse effects have been identified due to long term corticosteroid therapy.

Ketoconazole and spironolactone (drugs or medicines) are glucocorticoid antagonists.

The following are true regarding the pharmacokinetics of the thyroid hormone:

1.          Only T 4 and not T 3 is absorbed after oral administration

2.          Food and aluminium-containing antacids can decrease the                           absorption of T 3 but not T 4

3.          T 4 can be converted into T 3 by a deionidase

4.          Both T 3 and T 4 are metabolized by the P-450 system

5.          Phenytoin decelerates the metabolism of thyroid hormones

A = 1,2         B = 2,3        C = 3,4     D = 4,5        E = 1,5 

The following are true regarding the thyroid gland:

1.       Triiodothyroxine also known as T 4 is the most active hormone                     released by the thyroid gland

2.       Hypothyroidism results in poor resistance to cold

3.      Excess heat production is a result of hypothyroidism

4.      Calcitonin, a serum calcium-lowering hormone is released by the                  thyroid

5.       An inadequate secretion of the thyroid hormone is known as                        hyperthyroidism

A = 1,3,5  B = 2,4  C = 2,4,5    E = 3,4,5       F = 1,3,4 

Discuss the following regarding oxytocin.

1.     Adverse effects

2.     Pharmacokinetics

3.     Contra-indications

4.     Drug interaction

The following statements are true regarding oxytocin:

1.          Stimulates the ejection of milk from mammary glands following                    pregnancy

2.          Released from the posterior pituitary in response to low plasma                   osmolality

3.          Administered intravenously to induce labour

4.          Water retention is an adverse effect

5.          Antidiuretic and pressure activities are higher than those of                           vasopressin

A = 1,3,4       B = 2,3,4      C = 1,3,4,5      D = 1,2,3,4          E = all of the above

Leuprolide and goserelin (drugs or medicines) are synthetic analogs of gonadorelin which is a Follicle Stimulating Hormones and LH-hormone.  Leuprolide and Goserelin can be used in the treatment of,

i.)           prostatic cancer

ii.)          endometrioses

iii.)         precocious puberty

The following drugs can be used for the treatment of prostatic cancer:

1.     Leuprolide

2.     Bromocryptine

3.     Cabergoline

4.     Goserelin

5.     Ocreotide

A = 1,2       B = 1,4      C = 2,3,4    D = 3,4,5     E = All of the above


































The following statements are true:

1.              Thyroxine controls body functions such as heart rate,                                    temperature and metabolism

2.              Estrogen facilitates the strengthen of bones

3.              Progesterone prepares the breasts for milk production

4.              Testosterone is responsible for body and muscle development

5.              Oxytocin affects uterine contractions in pregnancy and birth

A = 1  B = 1,2                   C = 1,2,3              D = 1,2,3,4       E = All of above 

Group of agents which bind with estrogen receptors (in breast, uterus, bone) and act as a agonist to enhance estrogen activity in some tissue (beneficial effect of estrogen on bone) and minimize deleterious effect on the breast and endometrium (protect against hormone-stimulated cancers).

Tamoxifen

Raloxifene

Toremifene

Clomophene (Clomofene)

The following are applicable to the mechanism of α-glucosidase inhibitors:

1.       Taken after meals

2.       Delay digestion of carbohydrates which results in lower glucose                   levels

3.       Stimulates insulin release

4.       Do not cause hypoglycaemia during monotherapy

5.       Hypoglycaemia may develops when used in combination with                      sulfonylureas or insulin

 A = 2,4,5         B = 1,3,4           C = 3,4,5          D =  2,3,4,5         E = 1,2,4,5 

Drugs or medicines are available to control blood glucose levels (prevent blood glucose levels from going to high), preventing hyperglycemia.  

These drugs are classified as,

Class - Biguanides:

Prevent the production of glucose in the liver (reduce hepatic gluconeogenesis).

Drug - Metformin.


Class - Sulphonylureas:

Stimulate insulin release by the pancreas.

Reduce hepatic glucose production.

Drugs - Glyburide, Glipizide, Glimepiride.


Class - Glinides (Meglitinide):

Stimulate insulin release by pancreas.

Drugs - Nateglinide, Repaglinide.


Class - Thiazolidinediones (Glitazones):

Reduce cellular insulin resistance.

Drugs - Pioglitazone, Troglitazone, Rosiglitazone.


Class - Alpha Glucosidase Inhibitor:

Delay digestion of carbohydrates which results in lowering of glucose levels.

Drugs - Acarbose, miglitol.

The following are applicable to the mechanism of α-glucosidase inhibitors:

1.        Taken after meals

2.        Delay digestion of carbohydrates which results in lower glucose                     levels

3.        Stimulates insulin release

4.        Do not cause hypoglycaemia during monotherapy

5.        Hypoglycaemia may develops when used in combination with                       sulfonylureas or insulin

A = 2,4,5           B = 1,3,4         C = 3,4,5         D = 2,3,4,5      E = 1,2,4,5

The following are true regarding sulfonylureas:

1.       Glyburide is a primary sulfonylureas drug

2.       Stimulate the release of insulin from B-cells

3.       Reduce hepatic glucose production

4.       Decrease the peripheral insulin sensitivity

5.       Duration of action ranges from 12 – 24 h

A = 1,4,5     B = 1,2,3,5      C = 1,3,4     D = 2,3,4,5      E = All of the above

Common adverse effects of insulin includes:

1.       Hyperglycemia

2.       Increased weight

3.       Lipodystrophy

4.       Allergic reactions

5.       Local injection site reactions

A = 2,3,4,5    B = 2,4,5     C = 1,4,5         D = 2,3,4        E = 1,3,4 

Symptoms of Type 1 diabetes could include:

1.       Excessive thirst

2.       Excessive hunger

3.       Excessive production and passage of urine

4.       Increased mass

5.       Ketoacidosis

A = 1,2,3         B = 2,4,5    C = 1,2,3,5       D = 2,3,4,5      E = All of the above

Adverse effects of glucocorticoid therapy include:                                            

1.    Osteoporosis

2.    Decreased growth in children

3.    Increased risk of infection

4.    Peptic ulcers

5.    Glaucoma

 A = 1,2,5       B = 1,2,3          C = 3,4,5      D = 1,2,4,5     E = All of the above 

The following are true regarding pituitary hormones:

1.       ACTH stimulates the adrenal gland to produce cortisol

2.       LH and FSH control reproductive functioning and sexual                                characteristics

3.       LH is part of the gonadotrophins and is known as interstitial cell                   stimulating hormone in males

4.       Prolactin is only present in women

5.       ADH affecting water retention in the liver.

      A = 1,3,4              B = 1,2,3       C = 2,4,5        D =  2,3,4,5     E =  1,3,4,5 

Regarding spironolactone:

1.    Antihypertensive drug

2.    Stimulate sodium reabsorption

3.    Antagonize aldosterone synthesis

4.    Useful in treatment of hirsutism in women

5.    Hyperkalaemia is an adverse effect

A = 2,3,4     B = 1,4,5         C = 1,3,4,5       D = 2,3,4,5  E = All of the above 

Common adverse effects of long-term corticosteroid therapy include:

1.    Increased growth in children

2.    Decreased risk of infection

3.    Decreased appetite

4.    Hypertension

5.    Hypokalaemia

A = 1,4,5          B = 2,3,5      C = 4,5    D = 1,2,3,4   E = All of the above 

Regarding hyperthyroidism:

1.             Excess thyroid hormones in circulation results in toxic adenoma                  and goiter

2.              TSH-levels are increased to reduce the synthesis or release of                      thyroid hormones

3.              Lower thyroid levels can be achieved by removing part of the                       tyroid

4.              Formation of T 3 and T 4 can be inhibited by the administration                     of propylthiouracil

5.              Propranolol can diminish the sympathetic stimulation                                     associated with hyperthyroidism

A = 1,2,3,4    B = 3,4,5      C = 2,3,4,5    D = 1,3,4,5  E = all of above 

The thyroid gland releases two hormones: Triiodothyroxine (T3) and Thyroxine (T4).

These hormones play an important role in controlling metabolism in the body.

An excess production of these hormones result in hyperthyroidism.

Little production of these hormones result in hypothyroidism.

Hypothyroidism is treated with Levothyroxine.

Discuss the following regarding Levothyroxine:

1. Pharmacokinetics

2. Drug Interactions

3. Adverse Effects

The following are true regarding vasopressin:

1.        Major use is to treat diabetes insipidus

2.        Use in management of cardiac arrest

3.        Water intoxication is an adverse effect

4.        Can be modified to desmopressin that is free of pressure effects

5.        Released by the posterior pituitary

A = 1          B = 1,2      C = 1,2,3       D =   1,2,3,4        E = all of the above 

Prolactin is a hormone secreted by the pituitary gland with primary function to enhance breast development and it initiates lactation.  Hyperprolactinemia results in a symptoms such as galactorrhea which can be treated with Prolactin Inhibitors that are dopamine agonists and it inhibits the release of Prolactin.

Medicines or drugs classified as Prolactin Inhibitors include:

i.)    Bromocriptine

ii.)    Quinagolide

iii.)   Cabergoline

The following are prolactin inhibitors:                  

1.    Somatostatin

2.    Bromocryptine

3.    Quinagolide

4.    Cabergoline

5.    Ocreotide

 A = 1,3      B = 2,3,4             C = 1,5         D = 1,2               E = 1,4,5 


Hyperthyroidism could result in:

1.    Cardiac arrhythmias

2.    Increased body mass

3.    Nervousness

4.    Tremor

5.    Inhibition of heat production

A = 1,2,3          B = 1,3,4           C = 2,4,5      D = 3,4,5      E = 2,3,4,5

Adverse effects of gonadotropin-releasing hormone treatment in women include:

1.    Hot flushes

2.    Diminished puberty

3.    Diminished libido

4.    Depression

5.    Ovarian cysts

 A = 1,2,3          B = 2,3,4        C = 1,4,5        D = 1,2,4,5      E = All of the above

Regarding aldosterone:

1.    Cause reabsorption of sodium

2.    Increase reabsorption of potassium which is lost in urine

3.    Elevated levels result in hypokalemia

4.    Hyperaldosteronism is treated with spironolactone

5.    Released by adrenal medulla

 A = 1,3,4        B = 2,3,5,  C = 3,4,5      D = 1,4,5      E = 2,3,4,5 

Adverse effects of gonadotropin-releasing hormone treatment in women include:

1.    Hot flushes

2.    Diminished puberty

3.    Diminished libido

4.    Depression

5.    Ovarian cysts

 A = 1,2,3     B = 2,3,4        C = 1,4,5       D = 1,2,4,5      E = 1,2,3,4,5


True statements regarding the pharmacokinetics of thyroid hormones include:

1.    Both T 3 and T 4 are absorbed after oral administration

2.    Food and calcium preparations increase the absorption of both T 3 and T 4

3.    T 3 can be converted into T 4

4.    Both T 3 and T 4 are metabolized by the P 450 system

5.    Phenobarbital can accelerate the metabolism of both T 3 and T 4

 A = 1,4,5          B = 1,3,4         C = 2,4,5      D = 1,3,4,5     E = All of the above

Synthetic analogues of gonadorelin include:

1.    Insulin

2.    Leuprolide

3.    Goserelin

4.    Estradiol

5.    Somatostatin

 A = 1,2,3         B = 2,3        C = 3,4,5       D = 1,4,5      E = 1,2,3,4

Common adverse effects of long-term corticosteroid therapy include:

1.    Increased growth in children

2.    Decreased risk of infection

3.    Decreased appetite

4.    Hypertension

5.    Hypokalaemia

A = 1,4,5          B = 2,3,5      C = 4,5    D = 1,2,3,4   E = 1,2,3,4,5

A rise in testosterone levels in men could result in:

1.    Bone pain

2.    Hot flushes

3.    Oedema

4.    Gynecomastia

5.    Increased libido

 A = 1,2      B = 1,2,4      C = 1,2,3,4          D = 2,4,5        E = 1,2,3,4,5


The following statements are true regarding glucocorticoids:

1.    Stimulate gluconeogenesis

2.    Stimulate protein anabolism

3.    Raise plasma glucose levels

4.    Enhance vasoconstriction action

5.    Decrease blood levels of haemoglobin

 A = 1,4,5          B = 2,4,5       C = 2,3,5       D = 1,3,4       E = 2,3,4,5


The following statements are true regarding oxytocin and vasopressin:

1.    The two substances are not structurally related

2.    Hypertension is an adverse effect of oxytocin treatment

3.    Hyponatremia is a therapeutic effect of vasopressin

4.    Vasopressin is an antidiuretic hormone

5.    Oxytocin is used in obstetrics to stimulate uterine contraction

 A = 2,4,5       B = 1,2,5      C = 3,4,5      D = 1,2,3,4        E = 1,2,4,5

The following are true regarding the pharmacokinetics and adverse effects of sulfonylureases:

1.    Metabolized in the liver

2.    Bind to serum proteins when given orally

3.    Duration of action ranges from 4 – 10 hours

4.    Gain in weight

5.    Hyperinsulinemia

A = 3,4,5         B = 1,2,4,5              C = 2,4,5           D = 1,4,5      E = 1,2,3,5 

True statements regarding the pharmacokinetics of thyroid hormones include:

1.    Both T 3 and T 4 are absorbed after oral administration

2.    Food and calcium preparations increase the absorption of both T 3 and T 4

3.    T 3 can be converted into T 4

4.    Both T 3 and T 4 are metabolized by the P 450 system

5.    Phenobarbital can accelerate the metabolism of both T 3 and T 4

A = 1,4,5          B = 1,3,4         C = 2,4,5      D = 1,3,4,5     E = All of the above