Gujarat Technological University 2010 M.Pharm Clinical Pharmacy Practice - Question Paper

Q.1 (a) define subsequent terminologies:
1) Essential drug concept 2) Rational drug usage
06
(b) List different kinds of ADR and write a brief note on their mechanisms. 05
(c) discuss the term pharmaceutical care. define its essential components. 05
Q.2 (a) Case study: Mr. BK is a 56 year old man who works long hours as a
business manger in a software company. He has a BMI of 32 kg/m2 and
the nature of his work allows him to take little exercise. He smokes to
relieve his stress and has a diet rich in fat, with numerous business
lunches washed down with plenty of wine. His dad died of an MI at the
age of 61 years, having had a previous MI at the age of 48 years.
1) List the risk factors Mr. BK has for coronary artery disease and
indicate whether they are modifiable or non-modifiable.
2) What tests should be performed to identify any other potential risk
factors Mr. BK might have? What would be considered a "normal"
outcome for every of these?
3) What lifestyle advice would you provide to Mr. BK and why would
these modifications improve any angina symptoms?
06
(b) define different clinical laboratory tests for detection of Asthma. 05
(c) discuss the criteria for selecting the biomedical literature for the critical
appraisal, and briefly define appraisal method for it.
05
Q.3 (a) Case study: Mr. ABC aged 24, presents a prescription to a community
pharmacy subsequent discharge from the local hospital. Mr. ABC's asthma
was 1st detected when he was in high school when he became acutely
short of breath during a football match. After initial treatment Mr. ABC
was free of symptoms, and he has not used his salbutamol inhaler for
many years. Recently he developed severe shortness of breath and was
admitted to hospital. His current prescription lists the subsequent
medication:
Treatment
Salbutamol MDI 200 mcg qds
Beclamethasone MDI 200 mcg qds
Prednisolone 1 tablet 10 mcg every morning for one
week
What counseling would you provide Mr. ABC on his medication?
06
(b) discuss measures for minimizing clinically relevant drug interactions. 05
(c) Which methods are used to detect patient medication non-adherence?
What measures should be taken to improve compliance?
05
Q.4 (a) define the skills needed for effective communication by the
pharmacist in a clinical situation, emphasizing their role in different stages
of verbal and non-verbal communication.
06
(b) define different categories for medication errors. What can Pharmacists
do to improve medication use safety?
05
(c) elaborate the hazards and advantages of self-medication? 05
Q.5 (a) List different Pharmacoeconomics valuation techniques and define in
detail cost-effective analysis with suitable examples.
06
(b) define the role of clinical Pharmacist in healthcare. 05
(c) A 45-year-old businessman has been treated for hypertension with
chlorothiazide 500 mg daily and atenolol 50 mg daily for several years.
He recently presented to his doctor with an acute inflammation of his right
great toe. On exam the toe was hot, swollen and very painful, and a
provisional diagnosis of acute gout was made. Treatment with
indomethacin 50 mg 3 times daily was subsequently commenced.
Several days later he returned complaining of swollen ankles, shortness of
breath, headaches and reduced urine output. At that time, the outcomes of
serum electrolyte investigations were as follows:
Sodium 144 mmol/l (135-145 mmol/l)
Potassium 6.4 mmol/l (3.4-4.8 mmol/l)
Chloride 95 mmol/l (95-110 mmol/l)
Bicarbonate 35 mmol/l (22-32 mmol/l)
Urea 30.2 mmol/l (3.0-8.0 mmol/l)
Creatinine 0.860 mmol/l (0,055-0.120 mmol/l)
What significant abnormalities are present, and what is the underlying
reason for these? What action needs to be taken now?
05
Q. six (a) Name a few disease of the subsequent system/organ induced by drug usage
specifying the drugs responsible for those diseases:
1) CNS 2) CVS 3) Skin
06
(b) elaborate goals of clinical pharmacist for participation in ward-round?
What preparation should be done by clinical pharmacist for successful
round?
05
(c) discuss in detail Naranjo's and WHO causality Assessment scales. 05
Q.7 (a) Name different tests with their normal values associated for the assessment
of the disease of the subsequent organs:
1) Heart 2) Kidney 3) Liver 4) Thyroid gland.
06
(b) define in detail different kinds of costs and results used in
Pharmacoeconomic valuation.
05
(c) Outline the components of drug therapy review. 05

Earning:   Approval pending.