Part 1.

1. A patient requires a quick effect. Two drugs with different half times have been compared. What drug should be used: with longer or with a shorter half time to get a quick effect?

What route of administration would you recommend (oral, intravenous, subcutaneous or other)?

2. Describe the changes in renal elimination of drugs in a patient with significantly reduced renal function (GFR = 30 ml/min). Normal GFR > 60 ml/min.

What is a significance of renal clearance measurement?

3. A patient is enrolled in phase 3 clinical trial. Describe the significance of phase 3 in the process of new drug approval.

What is a goal of postmarketing surveillance (PMS) in a new drug approval process?

What is a difference between brand-name and generic name?

4. Describe the main difference between gene addition therapy and gene repair therapy.

Give some examples.

What are advantages and disadvantages of the use of virus-based vectors (such as retrovirus or adenovirus) for gene therapy?

5. What are main principles of pharmacological suppression?

Explain the rationale for extensive use of corticosteroids in the treatment of autoimmune diseases and in the prevention of graft rejection.

6. Describe the most commonly used herbs for the increase in immune response and for the treatment of depression. Why labeling an herbal supplement as "natural" does not mean it is safe or without any harmful effects?

7. Describe the results of the stimulation of prejunctional or presynaptic alpha-2-receptors on postganglionic sympathetic neurons by using norepinephrine-like agonist.

Part 2. B. Choose the best answer.

1. Which of the following is a feature of receptors?
A. By acting on receptors, drugs can enhance, suppress or block transmission of signals
B. It may require more than one drug molecule to bind to a receptor and elicit a response
C. Specificity of drug binding to receptor is always absolute
D. A and B

2. Drug oxidation is one of the types of chemical reactions observed in drug metabolism. Which of the following is frequently involved:
A. Cytochrome P450/CYP proteins
B. Molecular oxygen and esterases
C. Endoplasmic reticulum in liver
D. A and C
E. All of the above

3. In elderly some altered pharmacokinetics and excretion can be expected. Which of the following can be altered:
A. Increased acid secretion and deesterification
B. Decreased glomerular filtration rate and reduced distribution
C. Increased glomerular filtration rate and increased sulfoxidation
D. All of the above

4. How many milligrams are contained in two grains of drug?
A. 50 mg
B. 100 mg
C. 65 mg
D. 80 mg

5. Human gene therapy is becoming an essential method of treatment for some diseases. The process of successful gene therapy requires the following:
A. After successful gene transfer, life-threatening toxic effects are expected to occur
B. Gene transfer should use germ cells
C. After gene transfer, immune response to the vector should be monitored
D. Transfer to somatic cells is not essential

6. Which of the following describes the action of cyclosporine in prevention of graft rejection?
A. It inhibits graft cell proliferation
B. Selectively enhances B-lymphocytes production
C. Inhibits cytotoxic T-lymphocytes responses
D. Inhibits body's innate immune process

7. Which two of the following are used to treat mild depression and increase immune function?
A. Milk thistle and marigold
B. St. John's wort and Echinacea
C. Licorice and ginger
D. St. John's wort and Kava

8. The kidneys are a common target of toxic injury. Which of the following statements concerning renal injury caused by toxic substances is correct?
A. The blood supply to the kidneys exposes them directly to chemicals absorbed from the small intestines
B. Kidneys are metabolizing organic solvents into toxic metabolites
C. Kidneys have no enzymes to detoxify chemicals or drugs
D. Kidneys are exposed to high levels of toxins due to their concentrating capacity.

9. Which of the following is involved in synthesis of adrenergic agonists such as epinephrine?
A. cAMP formation and G proteins
B. Adenylyl cyclase and G proteins
C. Phospholipase C and calcium
D. Phenylethanolamine-N-methyltransferase

10. A patient was brought to ED due to accidental spray with an insecticide. During physical exam: he has pinpoint pupils and is profusely salivating. Assuming that he has been exposed to a cholinesterase inhibitor, which of the following medications can be used for the treatment of his acute condition?
A. Pilocarpine
B. Atropine
C. Endrophonium
D. Physostigmine

1. A patient is receiving ophthalmic solution of pilocarpine due to elevated intraocular pressure. What is the anticipated effect of pilocarpine eye drops?

2. Describe the mechanism of the action of local anesthetics. What is a mechanism of termination of the action of local anesthetics?