Write your response in 1800 words count...

1. An essential component in the management and treatment of respiratory diseases is a control of the inflammatory process. Which of the medications can be used knowing that they can suppress the synthesis of inflammatory mediators and induce the transcription of several anti-inflammatory proteins?

2. Briefly describe the rationale of agents used for bronchodilation in patients with bronchial asthma. What is a mechanism of action of muscarinic antagonists?

How can asthma be managed in pregnancy?

3. What characteristics increase the likelihood that a drug will penetrate the blood-brain barrier and enter the CNS? Give examples of drugs that can cross BBB easily.

How can antiepileptic drugs be used during pregnancy?

4. Briefly explain why current strategies for treatment of Parkinson's disease are directed at increasing dopaminergic activity of neurons in particular areas in brain. What types of drugs can be used in order to increase dopaminergic activity of neurons?

5. Briefly describe the proposed mechanism of CNS depression by benzodiazepines. Give examples of most commonly used benzodiazepines.

What side effects or clinical problems have to be monitored?

6. Opioid analgesics are most effective in the management of diffuse, continuous pain, bus also can be used to relieve sharp, localized and intermittent pain.

What delivery systems are used for opioids delivery? What is a benefit of patient-controlled analgesia? How opioids can cause respiratory depression?

7. 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?

8. Modern surgical procedures require the usage of anesthetics. What is a mechanism of action of inhalational anesthetics? What are most commonly used intravenous anesthetics?

What are characteristics of ideal intravenous anesthetic drug?

Part IIB. Choose the best answer.

1. A 10-year-old girl is wheezing and is having difficulty breathing when exercising. Which of the following can be recommended to prevent these symptoms?

A. Albuterol
B. Zafirlukast
C. Cromolyn
D. Fluticasone

2. A 75 -year-old female comes to ED with an exacerbation of COPD. She is smoker for many years.

Which of the following would be the best choice to relieve the bronchoconstriction that she is experiencing at the time of exacerbation of COPD?

A. Oxygen and Corticosteroids
B. Leukotriene modulators (Singular)
C. Muscarinic antagonists (Spiriva)
D. Any of the above

3. Which of the following inhaled beta-2-agents will exhibit a long half-time and can be used in case of nocturnal asthma.
A. Albuterol
B. Salmeterol
C. Ipratropium
D. Zafilukast
E. Any of the above

4. What characteristics increase the likelihood that a drug will penetrate the blood-brain barrier and enter the CNS?
A. High molecular weight
B. High degree of lipophilicity
C. High degree of binding to plasma proteins
D. B and C

5. The Acetylcholinesterase (AChE) inhibitors used for Alzheimer's disease are relatively free of serious side effects. Which of the following is the most common adverse event associated with the use of Acetylcholinesterase (AChE) inhibitors?
A. Renal insufficiency
B. Hypertension
C. Allergic reactions
D. Gastrointestinal distress

6. Which of the following is correct regarding typical antipsychotics
A. Long-term treatment increases the supersensitivity of dopamine receptors
B. Clinical potency correlates with binding to D2 receptors
C. Long-term treatment reduces the supersensitivity of dopamine receptors
D. Clinical potency depends on the number of nicotinic receptors
E. A and B

7. Which of the following actions is used to differentiate typical antipsychotics from atypical antipsychotics
A. High incidence of extrapyramidal effect with atypical antipsychotics
B. High incidence of extrapyramidal effect with typical antipsychotics
C. Hyperprolactinemia with typical antipsychotics
D. Hyperprolactinemia with atypical antipsychotics
E. B and C

8. A 50-year old female with bipolar depressive disorder needs a treatment. She is actively manic and needs a medication for her mania control. She also has a history of glomerulonephritis (chronic kidney disease). Which of the following would be the most appropriate treatment for her?
A. Lithium
B. Buspirone
C. Carbamazepine
D. Imipramine
E. Any of the above

9. Fluoxetine is commonly used as one of the SSRIs. What type of receptors it binds mostly to, and what side effects are common?
A. Serotonin, alleviation of depression
B. Dopamine, vomiting
C. Acetylcholine, urinary retention
D. Beta-adrenergic, hypotension

10. Respiration is depressed by an analgesic dose of which of the following:
A. Morphine
B. Methadone
C. Meperidine
D. All of the above

Extra

1. A 28-year-old patient is newly diagnosed with depression? He is receiving a prescription for second-generation antidepressant? What is a difference comparing to third- generation antidepressant?

2. What is a benefit of the AChE inhibitors in Alzheimer's disease? Give some examples.

3. What is a mechanism of action of Parkinson's disease drugs? Give some examples.