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Basic Pharmacology
What is an emulsion?Additives to parenteral preparationsEffects
of additives to drugsStorage of drugs and potencyDrug
interaction
Discuss the principles of drug interactions using opioids and
MAOIs as examplesDefine potencyPotency, dose response curves and
use of log doseDose response curvesDraw a log dose/effect curveHill
equationED 90ED95How do you express drug safety?What is meant by
the Therapeutic Index?Mechanisms of drug effectWhat is a
receptor?Receptor theory
Spare receptorsEvidence for the existence of receptorsFunctional
properties of receptorsGABA receptorsG-protein-linked
receptorsInteractions of drugs and receptorsTell me about
pharmacogenetic disorders.Pharmacogenetics - examples related to
anaesthesia.Tolerance - tachyphylaxisTransdermal preparationsWhat
is an isomerStereoisomerismPharmacology in neonates
Pharmacology in pregnancy
Pharmacotherapy
Cerebral blood flow and anaesthetic agentsClassify the drugs
used in the treatment of asthmaClassify drugs used in cardiac
failureDefine dissociative anaesthesiaDefine the term "an Hypnotic
drug".Drug induced histamine release and anaphylaxisDrugs acting on
sodium channelsDrugs influencing ligand-gated vs voltage-gated ion
channelsEffects of anaesthetic agents on CNS
Effects of isoflurane, propofol, fentanyl on blood pressure, in
healthy adultsFactors predisposing to thrombogenicity of
drugsInfluence of salbutamol, frusemide, captopril or ranitidine
therapy on anaesthetic agents.Interaction of chemotherapeutic
agents and anaesthesiaMechanisms of anaesthesiaMechanisms of
drug-induced histamine releaseMethods to reduce stress response in
anaesthesiaObtundation of the pressor response to
intubationPrecautions with "prophylactic" antibioticsPro-convulsant
anaesthetic agentsTreatment of anaphylaxisTreatment of
hyperkalaemia
Pharmacokinetics
pH & pKa, Henderson Hasselbach equation.Define
bioavailability
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Determination of, and factors influencing, oral
bioavailabilityFirst-pass metabolismDifference between plasma and
biophase concentrationsEffect site concentrations of drugsWhat is
protein binding?What is meant by the term volume of
distribution?How do you calculate volume of distribution
Definition and clinical significance of volume of
distributionVolume of distribution, clearance and
half-lifeRedistributionSteady stateDefinition of clearance and
estimation of clearanceWhat is clearance?Explain clearanceIntrinsic
clearanceHalflife and time-constantWhat is meant by "loading
dose"?Enzyme substrate interactionsEsterasesElimination half
life
First order and second order kineticsWhat is the difference
between zero and first order kinetics?Why infuse a drug?Infusion
kineticsInfusion regimens to achieve target
concentrationsPharmacokinetics of propofol infusionsWhat do you
understand by the term context sensitive half-life?Kinetics of
drugs in the epidural spaceKinetics of inhalational agentsOutline
pharmacokinetic drug interactionsDrug delivery systemsModellingDrug
handling by the liver
Cytochrome P450Renal failure and drug metabolismPharmacokinetics
in heart failureHow does liver disease affect the way the body
handles drugs.Influence of pregnancy and liver disease on
pharmacokinetics
Inhalation Anaesthetic Agents
Define saturated vapour pressure and boiling pointCan you
explain the concentrating and second gas effects?Please explain the
second gas effect.Describe the uptake of volatile agentsDraw a set
of wash in curves versus time for commonly used volatile
anaesthetic agents.
Draw and explain the FA F1 curve. Does the curve reach unity at
infinity ?What determines uptake of volatile anaesthetic agents
from the alveolus?What factors influence the onset of action of
volatile agent ?Wash-in curves of volatile anaestheticsUptake and
wash-out curvesInduction and recovery with inhalational
agentsDefinition and clinical utility of MAC, MACawake, MACBARMAC
Definition. Tell me about factors effecting MAC.MAC uses and
shortcomingsWhat is MAC 95?Determination of MACQuantitation of
agent potencyDraw or describe the concentration/response curve for
an inhalational agent
Ideal volatile anaesthetic agentWhy is N2O used ?N2O properties
and contra indicationsNitrous oxide - indications
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Adverse effects of nitrous oxide; diffusion hypoxiaHow is
nitrous oxide manufactured?Contraindications to the use of nitrous
oxideSide effects of N2O.EntonoxUptake of nitrous-oxideWhat are the
side effectsof nitrous oxide?
Structure of an etherTell me about the structure-activity
relationships of volatile anaesthetic agents.Metabolism of inhaled
anaestheticsDiscuss the metabolism of
sevoflurane/halothaneMetabolism of halothaneMetabolism of
sevofluraneChemical and biochemical breakdown of agentsSystemic
effects of different agentsRespiratory effects of volatile
anaesthetic agentsInhalation agents and hypoxic drive to
ventilationCardiovascular effects of inhaled anaestheticsEffects of
agents on blood flow in specific tissuesEndocrine and Metabolic
effects
Changes of induction dose in different patient groupsUse in
neonatesUse in pregnant patientsToxicity of volatile
anaestheticsRenal/hepatic toxicityOccupational hazardsWhat volatile
agent are you most familiar with and can you tell me about that
agent?Advantages and disadvantages of enfluraneDraw the structure
of sevoflurane/isoflurane/halothaneIsoflurane, Sevoflurane,
HalothaneComparison of enflurane and isofluraneIsomerisation of
isoflurane.What are the cardiovascular effects of isoflurane?
Central nervous system effects of isofluraneCan you describe the
effects of Isoflurane on respiration?Isoflurane and brain.Discuss
factors affecting awakening from isofluraneIsoflurane vs
sevofluraneSevoflurane - its advantages over other volatile
agentsStructure/activity of sevoflurane.Adverse effects of
sevofluraneDesflurane
Intravenous Hypnotic Agents
Classification of agents
Classification of hypnoticsCharacteristics of intravenous
induction agentsWhat factors determine variation in doses of
induction agents, for example with age and shock?Determinants of an
induction doseInfluence of age, anxiety, hypovolaemia on induction
of anaesthesiaMetabolism of different agentsWhat is the structure
activity relationship of barbiturates?Draw barbituric acid nucleus.
What are the keto and enol forms ?Comparision of Thiopentone and
Methohexitone.What are the contents of an ampoule of Sodium
Thiopentone? Role of each adjuvent.Pharmacokinetics and
biotransformation of thiopentoneTime course of plasma
concentrations of thiopentoneMetabolism of thiopentone
Cardiovascular effects of thiopentoneCompare thiopentone and
propofolComparison of thiopentone and propofol inductionCompare
propofol and midazolam as induction agents
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Tell me about the formulation of Propofol.What are the contents
of a propofol ampoule?Factors determining the effect of
propofolWhat is the induction dose of propofol and what is its
disposition in elderly patients?Propofol uptake and
distributionDraw a concentration/time curve after an IV bolus of
propofolPharmacokinetics of propofol infusions
Calculation of propofol dosage for TIVADraw the plasma
concentration time curve of propofol and the effect site (brain)
concentration time curve.Effects of propofol on cardiovascular
systemNon anaesthetic effects of propofolOffset of action of
propofolKetamineKetamine - advantagesKetamine, mechanism of
actionKetamine, Propofol, ThiopentoneAnalgesic actions of
ketamineCardiovascular effects of ketamineDiscuss the properties of
benzodiazepinesBenzodiazepene kinetics
Benzodiazepine receptorsGaba receptorHow do benzodiazepines
exert their effects in the body?Mechanism of action of
benzodiazepinesDiazepam metabolism.Differences between midazolam
& diazepam.Metabolism of midazolam vs diazepamFormulation and
pharmacology of midazolamStructure of midazolamFlumazenilAlpha-2
agonists in anaesthesia
Neuromuscular Blocking Drugs
What is muscle relaxation and how can it be achieved.Nicotinic
cholinergic receptorsPlease describe the site of action of
neuromuscular blocking agents.Margin of safety of neuromuscular
function.Describe events during onset of depolarising /
non-depolarising neuromuscular blockCharacteristics of depolarising
and non depolarising blockComparison of depolarising and
non-depolarising neuromuscular blockersStructural features of
non-depolarising muscle relaxantsStructure activity
relationshipsClassify muscle relaxants.Absorption and elimination
of quarternary ammonium compoundsAdvantages of newer NMBs
Factors affecting onset of muscle relaxantsFactors determining
onset timeCan you explain the offset of non-depolarising muscle
relaxants?Dose-response curves of neuromuscular blocking
agents.Dose-response curve of different muscle groupDefinitions of
ED95Cardiovascular effectsDrug effects on skeletal muscle
toneIntraocular pressureElimination of NMBsBreakdown of
agentsEffects of antibiotics on neuromuscular blockadeRenal failure
and use of muscle relaxants
Prolonged blockadeSevoflurane CisatracuriumSuxamethoniumTypes of
block with suxamethonium
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Can you classify and list the side effects of Suxamethonium
administration?Contraindications and side-effects of
suxamethonium,Suxamethonium apnoea.Dibucaine number.Site of action
of atracuriumRocuroniumContents of an ampoule of Vecuronium
Vecuronium infusionCompare/contrast pancuronium and
vecuroniumAccount for a case of delayed recovery from
vecuroniumVecuronium vs atracurium kineticsVecuronium, Pancuronium,
SuxamethoniumFormulation of atracuriumMetabolism and chemical
breakdown of atracuriumCardiovascular effects of
atracuriumCis-atracurium vs
atracuriumCisatracuriumMivacuriumLaudanosineExplain the techniques
used to monitor neuromuscular block.
Measurement of muscle relaxant effectUse of peripheral nerve
stimulatorTrain of four ratioAssessment of neuromuscular block.How
do you assess reversal of muscle relaxants?Monitoring of adequacy
of reversal of blockTell me about neuroleptic malignant
syndrome.Dantrolene
Reversal Agents
Antagonism of residual neuromuscular blockCholinesterase and
anticholinesterases
Types of anti-cholinesterase drugs.Explain the mechanism of
action of anticholinesterases.Atropine, Glycopyrrolate,
NeostigmineHow does neostigmine act on
acetylcholinesterase?NeostigmineCompare neostigmine and
edrophoniumNeostigmine like drugsOrganophosphate toxicology
Anticholinergics
Atropine toxicityComparison of atropine and glycopyrrolate
Discuss the pharmacodynamics of atropine.Pharmacology of
atropine and scopolamineSynthesis and release of acetylcholine
Opioids
Mechanism of action of opioidsOpiate receptorsStructure activity
relationships of opioidsEpidural/intrathecal opioidsConversion to
oral opioidsLog dose-response curves for opioidsOpioid
metabolism
Duration of actionDiscuss the clinical uses of long acting
opioids.What are the side effects of opioids ?Describe tolerance to
opioids
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What drug factors influence the side effects of opioids
?Cardiovascular effects of opioidsCodeine bioavailability and
metabolismCodeine, Morphine, Fentanyl, Alfentanil, Remifentanil,
TramadolPentazocineRemifentanil, kinetics and cardiovascular
effectsOnset of action of Fentanyl.
Tell me about the effects of Fentanyl on the cardiovascular
system.Compare fentanyl, alfentanil and
remifentanilPharmacokinetics of pethidine and fentanylMorphine vs
fentanyl vs alfentanilComparison of fentanyl and morphineFate of
I.V. bolus of morphine.Describe the metabolism of morphinePlasma
concentration time graph of morphine.Change of etCO2 with time
after an IV bolus of morphine.Side effects of morphineMorphine
structure and substitutionsTell me about the effects of Morphine on
the cardiovascular system.Comparison of morphine and pethidine
Pharmacology of naloxoneNaloxone pharmacokinetics
Local Anaesthetics
Classification of local anaestheticsDraw the structure of an
ester local anaestheticStructure - Activity - Relationships of
local anaestheticsDescribe the structure/function relationships of
local anaestheticsIsomers of local anaestheticsSignificance of
isomersMechanism of action of local anaesthetics
Describe the site of action of local anaestheticsTopical use of
local anaestheticsContents in an ampouleAdditives to local
anaestheticsEffect of adrenaline and pHKinetics after epidural
injectionSpread of agents administered into the epidural
spaceSignificance of protein bindingSignificance of pKACorrelate
the pKa of local anaesthetics and their activityMetabolism of local
anaestheticsLocal anaesthetic toxicity, toxic dose, blood
levelsSystemic toxicity
Foetal LA toxicityToxicity lignocaine vs bupivacaine (R +
S).Toxicity of amide local anaesthetics (lignocaine, prilocaine and
bupivacaine)Treatment of amide local anaesthetic CVS/CNS
toxicityCardiotoxicity of local anaestheticComparative toxicity of
bupivacaine vs ropivacaineRopivacaineRopivacaine, Lignocaine,
Bupivacaine, Prilocaine, CocaineComparison of bupivacaine with
lignocaineEpidural administration of bupivacaneDiscuss the brain
concentration of bupivacaine after an epidural doseRecognition of
structure of lignocaine.Pharmacokinetcs of lignocaine
Metabolism and protein binding of lignocaine.Effects of
lignocaine on nerve conductionEMLACocaine
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What are the effects of cocaine on the heart ?
Analgesics
NMDA receptorsCodeine TramadolCompare and contrast Paracetamol
and Acetylsalicylic acid.
Give a classification of non-opioid analgesic drugs.How do
N.S.A.I.D.S. work? (mechanisms of action)Side effects nonsteroidal
anti-inflammatory drugs.AspirinToxicity of aspirin and
paracetamolParacetamolWhat is your recommended dose of
paracetamol?What is the toxic dose of paracetamol?Tramadol,
kinetics and effectsPharmacodynamics of tramadol.
Cardiovascular Pharmacology
Drugs acting on calcium channelsWhat drugs are used in cardiac
arrest?Management of myocardial ischaemiaClassify drugs used in
cardiac failureWhat is the structure-activity relationship of
vasopressors?Types of vasoconstrictorsChoice of drugs to treat
hypotension after spinal anaesthesiaCatecholamines:
structure-activity, receptorsMetabolism of catecholamines, MAO
inhibitorsDirect and indirect adrenergic agentsStructure activity
relationships in adrenergic agonistsPharmacology of beta adrenergic
agents
What is the structure-activity relationship in agonistsWhat is
the effect of B2 agonist drugs, how do they work
?AdrenalineDescribe the production of adrenaline in the
body.Termination of effect of noradrenalineDopamineDopamine
receptorsPharmacology of ephedrineChoosing between ephedrine and
metaraminolComparison of ephedrine and metaraminolClassify positive
inotropic drugsClassify inotropesWhat is phosphodiesterase. What
drugs affect it ?
Classification and clinical indications of phosphodiesterase
inhibitorsPDE inhibitors: theophylline, milrinoneAntiarrhythmics:
classification and electrophysiologyPharmacological treatment of
ventricular fibrillationAdenosine, AmiodaroneActions of
adenosine.Tell me about the cardiac effects of Adenosine.Discuss
digoxinWhat are the side effects of digoxin?Beta blockersWhat are
the side effects of sotalol?What can you tell me about
Esmolol?Alpha blockers
2 agonistsa2 agonists pharmcodynamics.The pharmacology of
clonidineEffects of IV clonidine
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Classify the anti-hypertensive drugsTell me about agents that
are used to lower blood pressure.Antihypertensives in
pregnancyDiscuss one parenteral antihypertensive.Renin-Angiotensin
systemClassification of vasodilators.Glyceryl trinitrate and sodium
nitroprusside
How does GTN work ?Pharmacology, metabolism and toxicology of
sodium nitroprussideSodium nitroprusside mechanisms of action and
metabolic toxicity.Pulmonary vasodilatorsNitric
oxideDiureticsClassify diuretics by their site of actionActions of
diuretics,Dose response curve for diureticsComparision of thiazide
& loop diuretics
Gastrointestinal Pharmacology
AntiemeticsClassification of anti-emeticsPharmacology of
anti-emeticsClassify drugs that affect the gastric acidity.What
agents can be used to decrease gastric acidity ?Mechanisms of
altering intraluminal gastric pHDrugs that increase gastric
emptying
Obstetric Pharmacology
What drugs affect uterine motility?Can you tell me about
Ergometrine?Clinical toxicity of Mg
Drugs that affect the uterusOxytocicsOxytocinUterine
relaxants
Endocrine
Drugs that affect blood sugarClassify insulinsInsulin
preparationsClassify oral hypoglycaemicsHypoglycaemic agents
Coagulation
Drugs affecting haemostasisDrugs and haemostasisAnticoagulants
and the reversal of their effectAction of warfarinWhat are the
kinetics of heparin?Explain how Heparin exerts its anticoagulant
effect.Heparin vs LMW heparinHeparin-effects, metabolismDescribe
the anti-platelet agentsHeparin, Protamine, Antiplatelet agentsSide
effects of Protamine
DDAVP, mechanism of action
Fluids
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Dextrose vs dextranHaemmaccelSide effects of sodium
bicarbonateMechanism of action of mannitolColloids; mannitol
Specific Agents
AcetylcholineBradykininsHistamine and antagonistsHistamine and
histamine receptorsDescribe the distribution of histamine
receptorsProstaglandins, synthesis and inhibitionDrugs used to
treat asthmaMethylxanthinesTheophyllineRecognise 5-hydroxy
typamine. What drugs interact with 5HT ?Serotinergic
receptorsSerotonin agonists and antagonists
Tricyclic antidepressantsMonoamine oxidase inhibitorsDescribe
the mechanism of action of anti-convulsantsMechanism of action of
antiepiliptic drugsCan you tell me about Phenytoin?Kinetics and
side effects of phenytionAntibiotics mechanisms of
actionDifferences within the penicillin class of drugsDNA and RNA,
and recombinant drugs
Statistics:
Types of data
Define nonparametric data ?Parametric and non parametric
dataWhat are ordinal data?What are descriptive and inferential
data?Appropriate statistical test for various types of
dataSelection of statistical testsType I and II errorsWhat is a
type II error?Power of statistical testsNull hypothesisOutline a
chi-squared testNormal distribution, Measures of central
tendencyWhat is a standardised normal distribution?
Standard error of the meanRole of SD versus SEMWhat is a t
distribution?Can you define standard deviation and explain
confidence levels?Information from confidence intervals versus
P-valueConfidence intervalsHow does one determine sample size in
statistics?Methods of determination of statistical
significanceTests of significanceMeaning of P values (
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What are some sources of biasBias in clinical researchBasics of
study design and clinical trialsEarly phase (I-II) drug
testingStatistical classification of data relating to trial of
antiemetic drug and test that may be used to analyse the data.
Statistical classification of data relating to trial to assess
potency of inhalational agent and appropriate
statistical test.Statistical determination of analgesic
efficacy
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