ASSESSMENT MATERIALS TO ACADEMIC SUBJECT PROGRAMM «PHARMACOLOGY»

2023-2024 academic year

31.05.01 General Medicine

Final assessment = average score in practical classes * 4 + average score in final controls * 6 + exam points

The exam includes:

- 4 theoretical questions (maximum 6 points for each question)
- 1 pharmacologic problem (maximum 3 points for each problem)
- 1 situational problem (maximum 3 points for each problem)
- 4 prescriptions (maximum 5 points for each prescription)

The main assessment criteria for midterm control

Theoretical question:
«6 points» - the student revealed the content of the material in the volume provided by the program, presented the
material in a competent language in a certain logical sequence, accurately using the terminology; answered without
leading questions from the teacher.
«5 points» - the student revealed the content of the material in the volume provided by the program, presented the
material in a competent language in a certain logical sequence, accurately using the terminology; answered with
leading questions from the teacher.
«4 points» - the student revealed the content of the material in the volume provided by the program, minor mistakes
were made.
«3 points» - the answer is incomplete or answer contains insignificant mistakes.
«2 points» - the answer contains significant mistakes.
«1 point» - the answer is incomplete and contains significant mistakes.
«0 points» - there is no answer.

Pharmacological Problem:
«3 points» - situational problems were solved correctly and reasonably.
«2 points » - minor mistakes were made, which the student corrects without the help of the teacher.
«1 point» - significant mistakes were made, which the student corrects with the help of the teacher.
«0 points» - wrong solution or the problem is not solved.

Situational Problem:
«3 points» - situational problems were solved correctly and reasonably.
«2 points » - minor mistakes were made, which the student corrects without the help of the teacher.
«1 point» - significant mistakes were made, which the student corrects with the help of the teacher.
«0 points» - wrong solution or the problem is not solved.

Prescription:
«5 points » - the recipe was written out according to the algorithm, without mistakes.
«4 points » - the recipe was written out according to the algorithm, 1 insignificant mistake was made.
«3 points» - the recipe was written out according to the algorithm, more than 1 insignificant mistake were made.
«2 points » - the recipe was written out according to the algorithm, significant mistakes were made.
«1 point» - the prescription algorithm is broken.
«0 points » - the prescription is not written out.
 Theoretical Questions
1. Pharmacology: definition and the content. Its place among other medical sciences. Branches of pharmacology.
2. Drug discovery approaches: the basic approach, screening of compounds, molecular modification, clinical
observations.
3. Drug development: main stages.. The concept of placebo, "blind" control. The concept of brand and generic drugs.
4. Definition and the content of "pharmacodynamics", "pharmacokinetics" and "pharmacotherapy".
5. Ways (routes) of administration of medicinal substances to an organism. Comparison of different routes of
administration of medicinal substances, their advantages and disadvantages.
6. The main mechanisms of drug absorption. Factors affecting absorption. First-pass effect. Bioavailability and
bioequivalence.
7. Distribution of drugs in the body, its variants and quantitative characteristics. Biobarriers (hematoencephalic,
placental and others). Accumulation of drugs. Fractions of drugs in the body.
8. Chemical transformations of drugs in the body. Stages of drug metabolism.
9. Ways and mechanisms of elimination of drugs from the body. Quantitative characteristics of drug elimination.
10. Localization, mechanisms of action and pharmacological effects. Examples.
11. Basic concepts of receptor theory: receptor specificity, affinity, intrinsic activity. The concept of receptor agonists
and antagonists, their varieties. Classification of receptors according to subtypes, mechanism of functioning and
localization. Endogenous ligands.
12. Types of drug action and pharmacological effects of drugs.
13. Drug interactions and their variants (pharmacological and pharmaceutical incompatibility of drugs). Combined
effects of drugs (synergism, antagonism, antidotism) and their variants.
14. Effects of drugs in case of their repeated introduction (cumulation. tolerance, tachyphylaxis).
15. Complications as a result of organotoxic properties of drugs during prolonged use. Teratogenicity, embryotoxicity,
mutagenic and carcinogenic effects.
16. Basic types of drug therapy. Dosages of drugs. Breadth of therapeutic action of drugs. Biological standardization.
17. Role of age, gender, state of organism and biological rhythms for the action of drugs. Dependence of
pharmacological effect on presence of pathological process. Role of factors of external environment for the action of
drugs.
18. Drug addiction. Medical and social aspects.
19. Structure of the prescription. Pharmacopoeia. Classification of drug forms and their characteristics.
20. Local anesthetics. Classification. Mechanism of action. Types of local anesthesia. Doses and concentrations for
different types of anaesthesia. Factors that prolong anesthesia.
21. Anaesthetic activity of local anesthetics. Toxicity: clinical manifestations, principles of therapy local anesthetics
poisoning. Measures to prevent overdose of local anesthetics.
22. Astringent, covering, adsorbing and irritative drugs: classification, mechanism of action, Applications for use.
23. Classification of drugs affecting peripheral cholinergic system. Types and localization of cholinoreceptors.
Pharmacological effects observed upon stimulation of various cholinoreceptor subtypes.
24. Non-selective M-N-cholinomimetics with direct action. Mechanism of action. Main pharmacological effects.
Applications for use.
25. Anticholinesterase drugs. Mechanism of action. Classification. Main pharmacological effects. Applications for use.
26. Toxic effects of anticholinesterase drugs. Treatment of poisoning.
27. M-cholinomimetic drugs. Mechanism of action. Main pharmacological effects. Applications for use. Toxic action of
muscarine and measures of medical aid at poisoning.
28. N-cholinomimetic drugs. Mechanism of action. Main pharmacological effects. Applications for use. Toxic action of
nicotine. Treatment of acute poisoning by nicotine.
29. M-cholinoblockers. Classification. Main pharmacological effects. Applications for use. Toxic action of atropine,
treatment of poisoning.
30. Classification of the peripheral N-cholinoblockers: names of drugs and their pharmacological effects.
31. Peripheral myorelaxants: main pharmacological effects, Applications for use. Breadth of myoparalytic action.
Treatment of poisonings with peripheral myorelaxants.
32. Classification of drugs affecting peripheral adrenenergic system. Types and localization of adrenoreceptors.
Pharmacological effects observed upon stimulation of various adrenoreceptor subtypes.
33. Alpha- and beta-adrenomimetics with direct and indirect action. Main pharmacological effects. Applications for use.
34. Drugs that stimulate alpha-adrenoceptors. Classification. Main pharmacological effects. Applications for use.
35. Drugs that stimulate beta-adrenoceptors. Classification. Main pharmacological effects. Applications for use.
36. Drugs that block alpha-adrenoceptors. Main pharmacological effects. Applications for use.
37. Drugs that block beta-adrenoceptors. Classification. Main pharmacological effects. Applications for use.
38. Concept of general anaesthesia. Classification of drugs for general anaesthesia. Stages of ether anaesthesia.
39. Comparative estimation of inhaled general anesthetics. Complication of ether and halothane anaesthesia, measure of
prophylaxis and first help.
40. Comparative estimation of non-inhaled general anaesthetics. Concept of dissociative anaesthesia.
41. Resorptive and local action of ethyl alcohol. Use in medical practice. Acute poisoning, clinical manifestations and
measures of first aid in poisoning by ethyl alcohol. Principles of treatment of chronic alcoholism, mechanism of action
of disulfiram.
42. Structure of sleep, its violations and types of insomnia. Classification of hypnotic drugs. Mechanisms of action.
Influence on the sleep phases. Side effects.
43. Hypnotic drugs from benzodiazepines and nonbenzodiazepines group. Classification. Main pharmacological effects.
Applications for use.
44. .Acute poisoning by hypnotics and principles of its treatment.
45. Antiepileptic drugs. Efficiency in treatment of various forms of epilepsy. Drugs, which are used to arrest epileptic
status.
46. Antiparkinsonic drugs. Classification. Mechanisms of action.
47. Nociceptive and antinociceptive systems. Opioid receptors, pharmacological effects observed upon stimulation of
various types of receptor. Concept of neuroleptanalgesia and ataranalgesia.
48. Opioid analgesics. Classification. Mechanism of action. Main pharmacological effects. Applications for use.
49. Central and peripheral effects of morphine. Drug addiction to morphine. Acute poisoning by morphine, clinical
manifestations, principles of its treatment. Antagonists of opioid analgesics.
50. Classification and comparative description of non-opioid analgesics. Mechanism of action. Main pharmacological
effects. Applications for use. Comparative description of opioid and non-opioid analgesics.
51. Side effects of non-opioid analgesics. Peculiarities of side effects depending on selectivity to the different types of
cyclooxygenase.
52. Classification of psychotropic drugs. Sedative drugs. Classification. Mechanism of action. Applications for use.
Phenomenon of bromism.
53. General characteristics of tranquilizers, their difference from antipsychotics. Classification after the chemical
structure mechanism of action, applications for use, side-effects. Concept of "daily" tranquilizers.
54. General characteristics of antipsychotics, mechanism of action, pharmacological effects. Applications for use of
antipsychotics, side-effects and their correction. Concept of typical and atypical antipsychotics.
55. Mood-stabilizing (anti-manic, normothymic) drugs: definition, main representatives. Lithium carbonate: mechanism
of the action, therapeutic and adverse effects.
56. Antidepressants: classification after the mechanisms of action, pharmacological effects, applications for use,
side-effects.
57. Classification of psychostimulants. Mechanisms of action. Applications for use. Side effects. Possibility of
development of drug addiction. Mechanism of action of caffeine on central nervous system and cardio-vascular
system.
58. Nootropic drugs: classification, mechanism of action, influence upon the metabolic processes in the CNS,
applications for use.
59. Expectorants and mucolytic drugs. Mechanisms of action. Pharmacological effects. Applications for use.
60. Antitussive drugs with central and peripheral action. Mechanisms of action. Pharmacological effects. Applications
for use.
61. Bronchodilators. Classification after the mechanism of action. Pharmacological effects. Comparative characteristics
of drug groups. The side-effects. Drugs used for the arrest of bronchospasm attack.
62. Principles of treatment of pulmonary edema.
63. Drugs which stimulate and decrease the appetite. Drugs which increase the secretion of gastric glands used for
diagnostic purpose. Drugs of substitutive therapy.
64. Classification and mechanism of action of drugs which decrease the secretion of gastric glands. Applications for use.
65. Gastroprotectors. Mechanisms of action. Applications for use. Drugs for removal of Helicobacter Pylori.
66. Classification, comparative characteristics of antacid drugs. Applications for use.
67. Localization and mechanism of action of drugs, which stimulate and inhibit stomach and intestine motility.
Applications for use.
68. Classification and mechanism of action of emetic and antiemetic drugs. Applications for use.
69. Classification and mechanism of bile expelling drugs, their comparative characteristic. Applications for use.
70. Drugs, used in disorders of the excretory function of pancreas. Applications for use.
71. Classification and mechanism of laxative drugs. Applications for use.
72. Classification of diuretics. Localization and mechanisms of action of diuretics. Their comparative characteristic.
Applications for use.
73. Drugs, which influence tone and contractive activity of myometrium: mechanisms of action, main pharmacological
effects, applications for use. Drugs which decrease the cervix tonicity: mechanisms of action, applications for use.
 74. Cardiotonic agents: classification, mechanism of action, pharmacological effects. Clinical manifestations of
glycosides intoxications , treatment and prophylaxis.
75. Classification of antiarrhythmic drugs. Antiarrhythmic drugs which act through the vegetative innervation of the
heart: classification, mechanism of action, characteristics of drugs, applications of use, side-effects.
76. Comparative characteristics of antiarrhythmic drugs which act directly upon the heart: classification, mechanism of
action, characteristics of drugs, applications of use, side-effects.
77. Classification of antianiginal drugs which is based on the principles of the oxygen insufficiency relief.
Characteristics of this drugs: classification, mechanism of action, applications of use, side-effects.
78. Pharmacological characteristics of antianginal grugs which decrease the myocardium oxygen demand: mechanism
of action, applications of use, side-effects.
79. The principles of drug therapy of acute myocardial infarction.
80. Classification of antihypertensive drugs. Neurotropic antihypertensive drugs with central type of action:
classification, mechanism of action, applications of use, side-effects.
81. Neurotropic antihypertensive drugs with peripheral type of action: classification, mechanism of action, applications
of use, side-effects.
82. The antihypertensive drugs which act upon the vascular wall (myotropic vasodilators, potassium channel activators,
calcium channel blockers): mechanism of action, applications of use, side-effects.
83. The antihypertensive drugs which act upon the renin-angiotensin system: classification, mechanism of action,
applications of use, side-effects.
84. The antihypertensive drugs which act upon the water-mineral exchange: classification, mechanism of action,
applications of use, side-effects. Drugs used for the arrest of hypertensive crisis.
85. Classification and mechanisms of action of the hypertensive drugs. Applications of use, side-effects.
86. The drugs used in insufficiency of cerebral circulation: classification, mechanism of action, applications of use,
side-effects. Principles of pharmacotherapy of migraine.
87. Classification and principles of action of antiatherosclerotic agents.
88. Classification of drugs which affect the blood system. Agents stimulating erythropoiesis: classification, mechanisms
of action, applications for the use.
89. Agents stimulating and inhibiting leukopoiesis, mechanisms of action, applications for the use.
90. Antiplatelet drugs (antiaggregants), mechanisms of action, applications for use.
91. Anticoagulants with direct and indirect action, mechanisms of action, applications for the use, side effects.
92. Fibrinolytic drugs, mechanisms of action, applications for the use.
93. Drugs used in bleeding disorders (сoagulants and antifibrinolytics).
94. Classification of hormones by the chemical structure, mechanisms of their action. Endocrine drugs: sources of
obtaining, types of hormone therapy.
95. Hypothalamic and pituitary hormones, their synthetic analogs and antagonists – effects and application. Effects and
application of melatonin.
96. Thyroid gland hormones` drugs: applications for the use, side-effects. Antithyroid drugs: mechanisms of action,
applications for the use, side-effects.
97. Insulin preparations: mechanism of action, influence upon the metabolism, applications for use. The main
compications of insulin treatment.
98. Non-Insulin pharmacological agents for the treatment of type 2 diabetes: classification, mechanisms of action,
appilcations for use, side-effects.
99. Glucocorticoids: natural hormones and their synthetic analogs: classification, appilcations for use, side-effects.
Mechanisms of anti-inflammatory and antiallergic action. Antagonists of glucocorticoids.
100. Mineralocorticoids, their effects and application. Antagonists of mineralocorticoids, their application.
101. Androgens, antiandrogens and anabolic steroids: drugs, pharmacological effects and applications for use.
102. Estrogens and progestins drugs: pharmacological effects, applications for use. Antagonists of estrogens and
progestins: drugs, pharmacological effects and applications for use.
103. Drugs used for treatment of immediate types of allergic reactions: classification, mechanisms of action, applications
for use, side-effects. Drugs used for treatment of anaphylactic shock.
104. Blockers of H1-histaminic receptors: classification, pharmacological effects, pharmacokinetic and
pharmacodynamic differences, application.
105. Drugs used for treatment of delayed types of allergic reactions: classification, mechanisms of action, appilcations for
use.
106. Immunosuppressive agents: classification, mechanisms of action, appilcations for use, side-effects.
107. Inflammation: the main mechanisms and mediators. Classification of anti-inflammatory drugs. Non-steroidal
anti-inflammatory drugs: mechanism of action, classification (nonselective COX-inhibitors and selective COX-2
inhibitors), application, adverse effects.
108. Steroidal anti-inflammatory drugs: mechanisms of the anti-inflammatory action, application (as an
anti-inflammatory drugs), adverse effects. Slow-acting anti-inflammatory drugs (disease-modifying anti-rheumatic
drugs): the main representatives, mechanisms of action, application, adverse effects.
109. Drugs used in gout: classification, mechanisms of action
110. Antigout drugs: classification, mechanism of action, characteristics of drugs, applications of use, side-effects.
111. Drugs used in the treatment of osteoporosis: classification, mechanism of action, characteristics of drugs,
applications of use, side-effects.
112. Classification of vitamins. Drugs of vitamins group B and vitamin C: influence on metabolism, pharmacological
effects, applications for uses.
113. Drugs of fat-soluble vitamins(D, E, A, K): influence on metabolism, pharmacological effects, applications for uses.
114. Drugs for correction of acid-base balance. An acute poisoning by acids and alkalis, principles of their treatment.
115. The role of Sodium, Potassium, Calcium and Magnesium in the human body. Drugs containing these ions:
application of their drugs.
116. Conception of antiseptics and disinfectants. Inorganic antiseptics and disinfectants: classification, mechanism of
action, applications of use, side-effects.
117. Organic antiseptics and disinfectants: classification, mechanism of action, characteristics of drugs, applications of
use, side-effects.
118. Classification of chemotherapeutic drugs. The main principles of chemotherapy of infectious diseases.
Sulfonamides: classification, type, spectrum and mechanism of action, characteristics of drugs, applications of use,
side-effects. Combined drugs of sulfonamides with trimethoprim.
119. Antibacterial drugs from the groups of nitrofurans, oxyquinolines, quinoxalines: classification, type, spectrum and
mechanism of action, characteristics of drugs, applications of use, side-effects.
120. Antibacterial drugs from the groups of quinolones and fluoroquinolones: classification, type, spectrum and
mechanism of action, characteristics of drugs, applications of use, side-effects.
121. Classification of antibiotics after the type and mechanism of Antibacterial action. Antibiotics of first choice and
alternative antibiotics. Mechanisms of antibiotic resistance: the main mechanisms of resistance development, the main
ways to prevent it.
122. Biosynthetic penicillins: classification, type, spectrum and mechanism of action, characteristics of drugs,
applications of use, side-effects.
123. Semisynthetic penicillins: classification, type, spectrum and mechanism of action, characteristics of drugs,
applications of use, side-effects.
124. Cephalosporins: classification, type, spectrum and mechanism of action, characteristics of drugs, applications of use,
side-effects.
125. Antibiotics from the group of carbapenems and monobactams: mechanism, type and spectrum of action.
126. Antibiotics from the group of macrolides and azalides: classification, type, spectrum and mechanism of action,
characteristics of drugs, applications of use, side-effects.
127. Antibiotics from the group of tetracycline: classification, type, spectrum and mechanism of action, characteristics of
drugs, applications of use, side-effects.
128. Antibiotics from the group of chloramphenicol: spectrum and mechanism of action, applications for use, side-effects.
Antibiotics from the group of polymyxins: spectrum, mechanism of action, applications for use, side-effects.
129. Antibiotics from the group of aminoglycosides: type, spectrum and mechanism of action, characteristics of drugs,
applications of use, side-effects.
130. Antituberculous drugs: classification, mechanisms of action, applications of use, side-effects. Principles of
pharmacotherapy of patients with tuberculosis.
131. Antiviral drugs: mechanisms of action, applications for use. Treatments used for COVID-19.
132. Antimalarial drugs: classification, principles of treatment, individual and public chemoprophylaxis.
133. Antiamebial drugs: classification after the efficiency against amebas of various localization. Drugs which are used
for the treatment of giardiasis and trichomoniasis.
134. Antifungal drugs: classification after the spectrum of action and applications for use Mechanisms of action.
Side-effects.
135. Anthelmintic drugs: classification, mechanisms of action, applications of use, side-effects.
136. Anticanser drugs. Classification. Mechanism of action. Applications for use. Adverse reactions.
137. Emergency management of acute poisoning. Antidotes in Poisoning.
 Pharmacological Problems

Pharmacological task № 1
Determine the drug which caused poisoning and indicate the help measures in this case.
Poisoning may arise after absorption of preparation through mucous membrane or by parenteral introduction. Signs
of poisoning are euphoria, anxiety, psychomotor excitement, decreased feeling of fatigue and hunger, sometimes
hallucinations. Excitation of the central nervous system may be replaced by inhibition of the CNS. Arterial pressure
falls after the period of initial increase. Tachycardia and mydriasis are possible. Death occurs due to paralysis of
breathing.
Pharmacological task № 2
Determine the drug which caused poisoning and indicate the help measures in this case.
Symptoms of poisoning: miosis, hypersalivation, difficulty in breathing due to bronchospasm. Spastic contraction of
the stomach and intestine, vomiting, diarrhoea and stomachache. In serious cases may be arterial hypotension and
excitation of the central nervous system, clonic-tonic cramps or hyperkinesia of Parkinson's type. Death occurs as a
result of acute insufficiency of breathing, due to bronchospasm and paralysis of respiratory musculature.
Pharmacological task № 3
Determine the drug which caused poisoning and indicate the help measures in this case.
Symptoms of poisoning: dryness of mucous membrane of the oral cavity, nasopharynx, which causes disturbance of
swallowing and speech, dryness of the skin, the body temperature is increased, dilation of pupils and photophobia.
Motor and vocal excitation, hallucinations, anxiety, impairement of memory and orientation. Dyspnoe, firstly
decrease and then increase of cardiac rate.
Pharmacological task № 4
Determine the drug which caused poisoning and indicate the help measures in this case.
Symptoms of poisoning: comatous state but normal spinal reflexes, inhibition of breathing (Cheyn-Stoke's
respiration), expressed miosis, bradycardia, hypothermia.
Pharmacological task № 5

Determine the drug which caused poisoning and indicate the help measures in this case.
Symptoms: anorexia, nausea, vomiting, stomachache, bradycardia which is replaced by tachycardia, arrhythmia up
to an atrioventricular blockade, atrial and ventricular extrasystoles. Impairment of colour perception (xanthopsy and
other), weakness, aphasia, delirium, hallucinations, decrease of diuresis are possible. Poisoning develops more
frequently after oral introduction of the drug due to their high ability to accumulate. Death occurs from cardiac arrest.
Pharmacological task № 6
Determine the drug which caused poisoning and indicate the help measures in this case.
Symptoms of poisoning: general weakness, shivering of extremities, feeling of hunger, hypoglycemia. In serious
cases there is loss of consciousness, coma, delirium, and cramps.
Pharmacological task № 7
Determine the mechanisms of drug absorption.
A - the lipid soluble substances are absorbed through the cellular membrane owing to gradient of concentration of the
substances.
B - the substances are absorbed by invagination in the cellular membrane with the subsequent formation of a vesicle.
This is the way of absorption of some proteins and the complex of cyanocobalamin (vitamin B12) with
gastromucoprotein.
C - The absorption depends on hydrostatic pressure. Water, small water-soluble molecules are absorbed through
pores by this way.
D - the absorption is carried out with participation of transport systems of cellular membranes, it can go on against
gradient of concentration with expenditure of energy. Water-soluble polar molecules of sugars, amino acids are
absorbed by this mechanism.
 Pharmacological task № 8
Determine the group of drugs after the following signs.
These drugs narrow the pupils, decrease the intraocular pressure, cause bradycardia, increase the secretion of glands,
stimulate the peristalsis of the gastrointestinal tract, speed up the neuromuscular conduction and the excitation
transmission in the vegetative ganglions. They are used in glaucoma, myasthenia, as the antagonists of
non-depolarizing myorelaxants.
Pharmacological task № 9
Determine the group belonging of the drugs A and B after their mechanisms of action and pharmacological effects.
A) This drug prevents the action of acetylcholine upon the cholinoceptors of effectory organs, causes mydriasis,
increases the heart rate, reduces the tonicity of smooth muscles of the inner organs, inhibits the secretion of bronchial
and digestive glands.
B) This drug inhibits acetylcholine esterase, delays the hydrolysis of acetylcholine, facilitates the neuromuscular
conduction, causes miosis and spasm of accommodation, increases the tonicity of smooth muscles of the inner organs
and skeletal muscles.
Pharmacological task № 10
Determine the drugs (isoprenaline, norepinephrine, ephedrine) after the mechanisms of action.
1.It excites α - and α -adrenoceptors.
2. It stimulates the release of norepinephrine from the endings of adrenergic fibers, inhibits monoamine-oxidase.
3. It excites both α 1- and α 2-adrenoceptors.
Pharmacological task № 11

Determine the drug.

This drug blocks β1 and β2-adrenoceptors, decreases the strength of cardiac contractions, the heart rate, inhibits the
automatism of myocardium, reduces the tonicity of blood vessels (in long taking). It is used in angina pectoris,
cardiac arrhythmias, arterial hypertension. The side-effects: bronchospasm, disorders of atrioventricular conduction,
inhibition of the contractile function of myocardium.
Pharmacological task № 12
Determine the following drug.
A derivative of para-amino benzoic acid, well-soluble in water, non-suitable for the terminal anaesthesia. It is used
for infiltration and conduction anaesthesia as well as for the resorptive action upon the organism. It decreases the
synthesis of acetylcholine, exerts ganglion blocking and spasmolytic action. It also reduces the excitability of
myocardium and of the motor zones of the brain cortex.
Pharmacological task № 13
Determine the drug. Explain the mechanism of its action.
This drug is a derivative of benzodiazepine, it has expressed hypnotic activity. Sleep comes in 20-40 min. and lasts
6-8 hours. This drug slightly changes the structure of sleep. In low doses it exerts tranquilizing action, eliminates
agitation, psychical stress, relaxes skeletal muscles, promotes the action of analgesics. It has large breadth of
therapeutic action, is able to cumulate. It is especially effective in the cases when the reasons of insomnia are
neuroses and emotional exertion.
Pharmacological task № 14
Determine the drug. Explain the mechanism of its action.
An antiepileptic drug, a derivative of hydantoin. It is the main drug for the prevention of major epileptic seizures. It
exerts anticonvulsive action without significant hypnotic and sedative effects. This drug is also effective in treatment
of some forms of cardiac arrythmias. The possible side-effects in the use of this drug are vertigo, tremor, vomiting,
hypertrophical gingivitis (increased growing of gingivae's mucosa), skin rashes.
Pharmacological task № 15
Determine the following drug. Explain the mechanism of its ulcerogenous action. Indicate the measures of
prophylaxis of this complication.
This drug is a derivative of salicylic acid. It is rapidly and well absorbed from the intestine. This drug exerts
analgesic, antipyretic and anti-inflammatory action. It possesses slight anticoagulant activity, exerts significant
inhibitory influence upon the aggregation and adhesion of thrombocytes, that is why it is used for the prophylaxis of
thromboses. The side-effects are ulcerogenous action, noises in the ears, disorders of audition, allergic reactions. This
drug is used as analgesic, antipyretic agent in fever, headache, neuralgia, rheumatism.
 Pharmacological task № 16
Determine the following drug. Explain the mechanism of antipsychotic and sedative action.
This drug is a derivative of phenothiazine. It exerts significant antipsychotic activity, possesses strong sedative
action, decreases the muscular tonicity and motor activity, decreases the body temperature. It also exerts anti-emetic,
anti-hiccup, antihistamine, moderate anti-inflammatory, -antiadrenergic, spasmolytic, hypotensive,
M-anticholinergic action. It potentiates the action of general and local anaesthetics, hypnotic agents, opioid
analgesics. In long taking it causes extrapyramidal disorders such as catalepsy, parkinsonism, affection of the liver,
agranulocytosis, allergic skin reactions, orthostatic hypotension. It is used treatment of psychoses, indomitable
vomiting and hiccup, for premedication.
Pharmacological task № 17
Determine the following drug. Explain the mechanism of its action.
This drug is a tricyclic compound. It does not influence upon the activity of monoaminooxidase (MAO). It
significantly improves the mood, that is accompanied by expressed sedative action. The stimulating influence is
absent. The drug exerts considerable M-anticholinergic and antihistamine action. It does not impair the processes of
sleep. It is used in depressive state accompanied by anxiety, fear.
Pharmacological task № 18
Determine the drug group.
These drugs possess the bronchiolytic effect and are the drugs of first choice for the arrest of bronchial asthma
attacks. The action of these drugs is associated with the activation of adenylate cyclase and accumulation of cAMP,
that results in the decrease of Ca++ concentration in smooth muscle and must cells, relaxation of the smooth muscles
of bronchi and in the reduction of the release of histamine, slow-reacting substance of anaphylaxy - SRS-A from the
must cells. In therapeutical doses they practically do not influence upon the heart, dilate the blood vessels of skeletal
muscles and heart.
Pharmacological task № 19
Determine the drugs which decrease the gastric secretion (atropine, pirenzepine, famotidine, omeprazole) after the
mechanisms of action.
1. Blockade of M1-cholinoceptors of the stomach mainly.
2. Blockade of H2-histamine receptors.
3. Blockade of proton pump in parietal cells.
4. Non-selective blockade of M-cholinoceptors in different organs, including stomach.
Pharmacological task № 20
Determine the following drug from the group of diuretics and its side-effect.
This drug is a benzothiazidine derivative. It blocks the active reabsorption of chlorine ions in the cortical part of the
ascending limb of the Henle's loop and of sodium ions in the initial part of the distal tubules. It also promotes the
excretion with the urine of potassium ions, bicarbonates (due to slight inhibitory influence upon the enzyme
"carbohydrase"), in long taking it delays the excretion of calcium ions and uric acid by kidneys. It is well absorbable
from the gastrointestinal tract and acts during 8-12 hours after the peroral taking (the drug form is tablets by 0,025
and 0,1). The drug is used as a diuretic agent (in various diseases), as antihypertensive drug, in glaucoma, diabetes
inspidus.
Pharmacological task № 21
Name the drugs that belong to this group.
These agents exert significant hypotensive action due to inhibition of the enzyme which transforms angiotensin I into
angiotensin II, that leads to decrease of activation of angiotensin receptors in arteries and in adrenal cortex, as well as
to reduction of inactivation of bradykinin. It results in vasodilation and decrease of elimination of mineralocorticoids,
that causes increase of removal of water and Na+ ions from the organism. Medicines belonging to this group are
among the most popular for the treatment of arterial hypertension and chronic heart failure.
Pharmacological task № 22
Determine the drug, indicate its side-effects.
This drug is the main agent for the arrest of angina pectoris attacks. The onset of its action develops in 2-3 min. and
lasts under 30 min. The drug slightly increases the coronary circulation (especially in subendocardial zones), but the
basic antianginal activity is associated with relaxation of peripheral veins and arteries that leads to decrease of
cardiac work and reduction of myocardial oxygen demand. As a consequence of this the level of blood supply and
oxygenation of the heart becomes adequate and hypoxia is eliminated. Besides, the drug inhibits the central links of
coronary constrictor and cardiac stimulating reflexes.
 Pharmacological task № 23
Determine the following drug and the pharmacological group it belongs to.
This drug is a derivative of dihydropyridine. It blocks calcium channels of membranes and decreases the influx of
Ca++ into the smooth muscle cells of vessels. This drug acts selectively upon the cerebral vessels and does not exert
considerable influence upon the arterial pressure. It also prevents thrombocyte aggregation, decreases blood
viscosity and the amount of atherogenic lipids. The drug is administered parenterally and oraly.
Pharmacological task № 24
Indicate the main effects of the antiarrhythmic drugs which belong to sodium channel blockers.
1. Inhibition of automatism. 2. Prolongation of the effective refractory period. 3. Shortening of the effective
refractory period. 4. Slowing down of impulse conduction through the heart conductive system. 5. Facilitation of
impulse conduction through the heart conductive system. 6. Decrease of myocardium excitability. 7. Increase of
myocardium excitability. 8. Increase of myocardium contractility. 9. Decrease of myocardium contractility or
absence of any influence on it. 10. Decrease of the arterial pressure. 11. Increase of the arterial pressure.
Pharmacological task № 25
Determine the following drug, the ways of its introduction and the agent used in its overdosage.
This drug is the mucopolysaccharide synthetized in the organism by mast cells. It is obtained from cattle lungs. It
exerts anticoagulants action both in the organism and out of it, inhibiting the factors which activate transformation of
prothrombin to thrombin. It also directly inactivates thrombin in combination with antithrombin III. It decreases the
lipid amount in the blood. Its duration of action is 2-6 hours.
Pharmacological task № 26
Determine the following anti-inflammatory drug.
It belongs to derivatives phenylacetic acid. It is one of the most active anti-inflammatory drugs. It possesses
expressed analgesic activity and antipyretic action. It is well absorbable from the gastrointestinal tract. The majority
of the drug amount binds to proteins of the plasma. It is low-toxic and well endured by patients.
Pharmacological task № 27
Divide the following semisynthetic penicillin preparations into 3 subgroups (Carbenicillin, Methicillin, Ampicillin,
Bacampicillin, Amoxicillin, Cloxacillin, Piperacillin, Mezlocillin, Dicloxacillin, Phenoxymethylpenicillin,
Oxacillin, Ticarcillin).
1. Acid-resistant alternative to benzylpenicillin -
2. Penicillinase-resistant penicillins -
3. Extended spectrum penicillins -
Pharmacological task № 28
Indicate the most effective antimycobacterial agents, explain its mechanism of action (Isoniazid, Rifampicin,
Pyrazinamide, Ethambutol, Streptomycin):
1. Antibiotics -
2. Synthetic drug -
Pharmacological task № 29
Determine the following drug.
The drug belongs to polyene antibiotics. It is produced by strains of Streptomyces nodosum. It possesses fungiostatic
action associated with destruction of cytoplasmic membranes of fungi. It is one of the most effective drugs for
treatment of systemic mycoses. The drug does not act upon bacteria, viruses, Rickettsia. It is available for
introduction into cavities of the human body, under brain membranes, by inhaled way, topically. The excretion of the
drug is slow. It has high toxicity and is able to cumulate.
Pharmacological task № 30
Determine the drug.
An alkaloid which is used for treatment of malaria. Except this it also possesses other pharmacological activities:
decreases excitabilty of the myocardium, stimulates rhythmic contractions of the uterus, so it is used during labor.
Adverse reactions: noise and ringing in the ears, decrease of hearing.
 Situational Problems

Situational task № 1
A patient was admitted to the trauma department due to dislocation of the shoulder joint. When taking anamnesis and
examining the patient, hepatic cirrhosis complicated by chronic liver failure was revealed. To reduce the dislocation,
short-term general anesthesia (intravenous sodium thiopental) was used. But instead of the usual duration of action
characteristic of this drug (20-30 minutes), anesthesia lasted for an hour.
Questions: explain the reason of the described condition.

Situational task № 2
Following the doctor's administrations a patient with the diagnosis "myasthenia gravis" began to take neostigmine for
the increase of tonicity of the skeletal muscles. In several days the patient's condition became significantly better, but
he began to complain of hypersalivation, hyperhidrosis, pain in the abdomen, diarrhea, nausea.
Questions: what are the side-effects of neostigmine associated with? What is the mechanism of neostigmine action?
What drugs can be used for prevention of these complications?

Situational task № 3
A 6-year-old child with pronounced psychomotor agitation was delivered to the hospital. On clinical examination,
the following symptoms were revealed: motor and speech excitement, hallucinations, dry mouth, impaired
swallowing, hoarse voice, dry and hot skin, dilated pupils, photophobia, tachycardia. From the anamnesis it is known
that the child ate dark purple berries.
Questions: what is poisoning caused by? What is the mechanism of arisen signs? What measures does child's
treatment include?

Situational task № 4
An injection of a local anaesthetic with addition of epinephrine was made to a patient for infiltrative anaesthesia. The
surgical manipulation dragged on, so the injection was repeated. Sudden the patient felt heart palpitation, pain in the
heart area.
Questions: what is the observed complication caused by?

Situational task № 5
The doctor prescribed propranolol to a patient with arterial hypertension in combination with cardiac
tachyarrhythmia. A week later from the start of taking the drug, the patient began to complain of shortness of breath.
Questions: explain the cause of the side effect of propranolol. What drug should be replaced?

Situational task № 6
A patient with traumatic damage of the facial bones was delivered to the traumatology department. As it was
impossible to carry out the inhaled anaesthesia the surgeon decided to make the operation under the infiltration
anaesthesia.
Questions: choose the anaesthetic, its concentration in solution and the way of prolongation of its action taking into
account the well vascularization in the operation area?

Situational task № 7
An 18-year-old girl appealed to a doctor with complaints of insomnia, which led to increased fatigue, general
weakness, and deterioration of her studies. Clinical examination revealed the following: the patient was irritable,
emotionally unbalanced, pronounced dermographism, pulse and blood pressure changed during the conversation.
The doctor determined that insomnia is associated with a neurosis-like state and vascular dystonia.
Questions: make the most rational choice of hypnotic drug in this situation and explain its mechanism of action?

Situational task № 8
A patient with addressed to a dentist with complaints on increased growing and pain of gingivas. After examination
of the oral cavity the doctor made the diagnosis of hyperplastic gingivitis. From the anamnesis it was known that
before the visit to the dentist the patient took for a long time the drug administrated to him by neuropathologist in
relation with epilepsy.
Questions: indicate an antiepileptic drug that can lead to the development of the described complication during
long-term therapy?
 Situational task № 9
A 70-year-old patient suffering from inoperable lung cancer with multiple metastases receives oral morphine as a
palliative care solution with an immediate release of the active substance, 5 mg q4h.
Questions: calculate an equivalent dose of subcutaneous morphine, which is produced in the form of a 1% solution in
1 ml ampoule and administered bid (the answer should be – the patient should be given a daily dose of morphine
hydrochloride ____ mg or single dose____ mg (____ml) bid)?

Situational task № 10
A dentist introduced 2 ml of 0,5% diazepam solution to a patient for premedication before an operation. The patient
noticed that the emotional tension, fear and anxiety were decreased, he felt sleepiness and muscle relaxation, but was
able to contact with the doctor. After the end of the operation the sleepiness disappeared, but the patient felt
significant muscular weakness. In 2 hours the patient's condition improved.
Questions: explain the mechanism of arisen complication. Administer the specific antagonist of diazepam?

Situational task № 11
A patient with traumatic encephalopathy was delivered to the neurological department with complaints of disorders
of memory, intellect, headache, vertigo. The doctor has caffeine, gamma-aminobutyric acid, mesocarb, piracetam.
Questions: choose the drug of the first choice for treatment of arisen cerebral insufficiency, explain your choice?

Situational task № 12
In a patient suffering from bronchial asthma the bronchospasm attacks usually arise at night, are accompanied by
rumbling in the stomach, sometimes - by spastic abdominal pain. Besides the patient noticed that the attacks are
preceded by slowing down of heart rate. It has been known from the anamnesis that the patient also has been suffered
from chronic gastritis with increased secretory and acid-producing function.
Questions: what group of bronchiolytics should be administrated to the patient in this situation. Explain the
mechanisms of their action?

Situational task № 13
A patient with sharp pain in the abdomen was urgently delivered to a hospital. The clinical examination data allowed
to make the diagnosis of acute pancreatitis. The administered complex pharmacotherapy included aprotinin.
Questions: explain the principle of aprotinin action. Indicate its dosage and the way of introduction?

Situational task № 14
A patient with the initial stage of arterial hypertension took hydrochlorthiazide by 0,025 g twice a day. In 7-8 days the
arterial pressure was slightly decreased, but the patient began to feel pain in the heart area, muscular weakness,
trembling in the extremities.
Questions: explain the reason of the arisen side-effects, indicate drugs for their elimination?

Situational task № 15
A patient 60 years old suffered from arterial hypertension during 10 years. Once in the evening he felt fatigue, sharp
headache, darkening in the eyes, nausea. The patient was urgently delivered to a hospital. The clinical examination
revealed the increase of arterial pressure (210/110 mm Hg). The diagnosis "hypertensive crisis" was made.
Questions: administer the agents which are available for the arrest of hypertensive crisis. Indicate their doses and
ways of introduction?

Situational task № 16
A patient suffering from ischemic heart disease, stable angina pectoris, ventricular extrasystoles, arterial
hypertension, II stage was delivered to a hospital.
Questions: indicate the group of medicines that is most indicated for this patient?

Situational task № 17
In a neurological clinic there is a patient suffering from epilepsy. Sometimes he has clonic convulsion seizures with
loss of consciousness, involuntary urination and defecation, following amnesia.
Questions: determine the drugs which should be administered to the patient for the prevention of epileptic seizures,
explain the mechanism of their action.
 Situational task № 18
Mr DS was admitted to hospital for an emergency laparotomy for a perforated gut. Following the laparotomy Mr DS
has onset atrial fibrillation that the medical team would like to treat pharmacologically. His only other current
medication is thromboprophylaxis with enoxaparin 20 mg once daily.
Questions: 1. What drug would you initially suggest for Mr DS? 2. Enumerate unfavourable adverse reactions of this
drug?

Situational task № 19
A 60-year-old patient was delivered to the hospital in relation with thromboembolism of pulmonary artery which
developed after physical exertion and required intense therapy.
Questions: choose the drugs which are necessary in this situation; explain the mechanism of their action?

Situational task № 20
A female patient adressed to a doctor with complaints of excitability, quick fatiguability, loss of body mass,
palpitation. Investigation revealed shining and buldging eyes, increase of the size of the thyroid gland, sub-febrile
temperature, heart rate - 110 per minute, blood pressure - 140/80 mm Hg, increase of basal metabolism.
Questions: Indicate the character of pathology and drugs should be used in specified situation?

Situational task № 21
Doctor administered Diclofenac sodium in tablets orally to a patient with radiculitis. Phenomenon of radiculitis
decreased, but gastritis symptoms appeared in the patient.
Questions: Explain the mechanism of action of Diclofenac sodium and reasons of this adverse reaction. Indicate
preventative measures?

Situational task № 22
Symptoms of hypochloremic coma with extracellular and intracellular dehydration developed in 7 year old child due
to long lasting vomiting: loss of consciousness, decrease of skeletal muscle tonicity, paleness, tachycardia, decrease
of blood pressure, hypothermia, convulsions, olyguria, decrease of concentration of chlorin, sodium, potassium and
calcium in the blood.
Questions: Indicate the drugs which should be administered immediately for improvement of patient's state.

Situational task № 23
A patient who had been living in the upper north for a long time addressed the doctor with complaints of loosening
and bleeding from the gums. Examination revealed reddening of the skin, pains, and petechia in the calf, weakness
and decreasing of ability to walk, dry and scaly skin.
Questions: indicate the type of hypovitaminosis and the drug which should be used for treatment?

Situational task № 24
A patient (46 years old) has been suffering from gout for several years, there are defigures of the joints of the lower
extremities, specific gouty nodules (tofuses), in the blood - a high content of uric acid, in the urine - a large amount of
urate. An additional examination revealed a decreased activity of glucose-6-phosphatase, an enzyme involved in the
metabolism of purines.
Question: what drug should be indicated in this situation? Explain your choose.

Situational task № 25
Antimicrobial processing of the skin with antiseptic solution were performed before surgical operation.
Questions: determine this antiseptic and concentration of its solution?

Situational task № 26
A mother of a 2 year-old child complained to a dentist that her child had destruction of teeth. On inspection, the
dentist revealed that the incisors were almost destructed, enamel was yellow, teeth ends were saw-like, caries was
present on most teeth. After inquiring from the mother, it was known that she took an antibiotics during pregnancy
without consultation.
Questions: determine the antibiotic which mother had taken and the reason of affection of the child's teeth?
 Situational task № 27
Synthetic antituberculous drug from the group of the most effective agents was administered to a patient who had
been suffering from pulmonary tuberculosis. In one month after the beginning of treatment the complaints connected
with development of polyneuritis (muscular twitch, sensation of "insect crawl", unsteady steps) developed.
Question: Determine the group to which this drug belongs and explain the reason of adverse reactions. Indicate
measures of prevention of polyneuritis arising?

Situational task № 28
A patient addressed to a dentist with complaints of pain in the oral mucosa and aphtae covered with white-gray film.
The dentist inquired the patient and revealed that he was treated from pneumonia with antibiotic not long ago and
gave the diagnosis of candidiasis.
Questions: indicate the drugs which should be used locally and orally in this situation?

Situational task № 29
A patient addressed to a doctor with complaints of dysfunction of the intestine. A doctor revealed symptoms of
enteritis and duodenitis. After laboratory examination the diagnosis of giardiasis was given and treatment with
metronidazole was administered. While treament was going on the patient took an alcoholic drink, after that he felt
unpleasant sensations in the heart area and sharp psychomotor excitement.
Question: Explain a reason of arisen adverse reactions, indicate the drugs which should be used for treatment of
giardiasis?

Situational task № 30
Patient who had been suffering from cancer of pancreatic gland was prescribed Fluorouracil intravenously 10-15
mg/kg of body weight once in a week. However along with improvement of general clinical conditions (Improved
appetite, decreased pain in the loin); nausea, diarrhea, ulcerous stomatitis were developed in a week. Clinically:
leukocytes count less than 3 x 109 /L, Thrombocytes less than 100 x 109 /L.
Questions: Explain the mechanism of action of this drug and reason of appearance of adverse reactions.
 Prescription Tasks
(write prescription, determine pharmacologic group, mechanism of action and applications for the use of this drug)
1. Procaine 51. Famotidine 101. Retinol
2. Lidocaine 52. Pantoprazol 102. Allopurinol
3. Ammonia solution 53. Bismuth tripotassium dicitrate 103. Tetracosactide
4. Neostigmine 54. Domperidone 104. Levothyroxine
5. Rivastigmine 55. Metoclopramide 105. Insulin lispro
6. Atropine 56. Ondasetron 106. Metformin
7. Platyphyllin 57. Mebeverine 107. Gliclazide
8. Tiotropium bromide 58. Pancreatin 108. Ertugliflozin
9. Pancuronium bromide 59. Lactulose 109. Progesterone
10. Epinephrine 60. Ursodeoxycholic acid 110. Testosterone
11. Norepinephrine 61. Loperamide 111. Calcium chloride
12. Phenylephrine 62. Digoxin 112. Potassium chloride
13. Dobutamine 63. Amiodarone 113. Sodium bicarbonate
14. Dopamine 64. Verapamil 114. Dexamethasone
15. Salbutamol 65. Procainamide 115. Methylprednisolone
16.Formoterol 66. Nitroglycerin 116. Fluticasone
17. Doxazosin 67. Isosorbide dinitrate 117. Diphenhydramine
18. Urapidil 68. Clonidine 118. Cetirizine
19. Bisoprolol 69. Moxonidine 119. Desloratadine
20. Metoprolol 70. Ivabradine 120. Alendronic acid
21. Nebivolol 71. Amlodipine 121. Montelukast
22. Carvedilol 72. Captopril 122. Povidone-iodine
23. Nitrazepam 73. Perindopril 123. Benzoyl peroxide
24. Diazepam 74. Losartan 124. Chlorhexidine
25. Zopiclone 75. Zolmitriptan 125. Benzalkonium
26. Sodium valproate 76. Citicoline 126. Ciprofloxacin
27. Lamotrigine 77. Betahistine 127. Levofloxacin
28. Gabapentin 78. Rosuvastatin 128. Nifuroxazide
29. Levodopa 79. Hydrochlorothiazide 129. Clarithromycin
30. Amantadine 80. Indapamide 130. Azithromycin
31. Omnopon 81. Eplerenone 131. Benzathine benzylpenicillin
32. Morphine 82. Furosemide 132. Amoxicillin
33. Fentanyl 83. Torasemid 133. Doxycycline
34. Tramadol 84. Spironolactone 134. Amikacin
35. Ketorolac 85. Dinoproston 135. Meropenem
36. Acetylsalicylic acid 86. Oxytocin 136. Ceftriaxone
37. Ibuprofen 87. Ferrous sulfate 137. Cefepim
38. Paracetamol 88. Molgramostim 138. Rifampicin
39. Diclofenac sodium 89. Clopidogrel 139. Itraconazole
40. Nimesulide 90. Warfarin 140. Fluconazole
41. Chlorpromazine 91. Heparin 141. Isoniazid
42. Clozapine 92. Enoxaparin 142. Acyclovir
43. Haloperidol 93. Rivaroxaban 143. Valacyclovir
44. Amitriptyline 94. Alteplaze 144. Zidovudine
45. Fluoxetine 95. Tranexamic acid 145. Metronidazole
46. Caffeine 96. Etamsilate 146. Levamisole
47. Butamirat 97. Menadion 147. Albendazole
48. Ambroxol 98. Ascorbic acid 148. Methotrexate
49. Acetylcysteine 99. Cyanocobalamin 149. Adalimumab
50. Aminophylline 100. Thiamine 150. Naloxone