B2.iii · Dose–Response Relationships

This viva will test your knowledge of drug action. With regards to the action of a drug, what does this graph tell us? (Image removed from report.)

This viva will explore your understanding of basic pharmacology and oxygen. Why are dose-response curves often represented on “Log[dose]” scales?

This viva tested knowledge of dose response curves and Neuromuscular blocking drug pharmacology

This was a general pharmacology viva about drug receptor interactions, receptor classification and concepts of affinity and rate constants. The viva explored knowledge of dose response curves and the concepts of potency and efficacy. The viva went on discuss plasma concentration curves, exponential functions and drug kinetics and compartment distributions.

This Viva tested knowledge of opioid pharmacology including classification and mechanism of action. It then explored pharmacodynamics and dose response curves.

This Viva tested knowledge on cardiovascular pharmacology and pharmacodynamics. It explored the pharmacology of betablockers and pharmacodynamic concepts around agonist and antagonist drugs.

This Viva tested knowledge on basic pharmacology of dose response curves and moved on to concepts around renal clearance.

This Viva will test your knowledge of common β-blockers, and their pharmacology. How would you classify β Blockers? .../12 12. Subsequent questions explored knowledge of haemodynamic properties, receptor mediated effects, esmolol pharmacokinetics and sotalol as an antiarythmic drug. Following which, candidates were asked about the Pressure-Volume loop of the cardiac cycle and changes in that loop following administration of esmolol and labetalol.

The candidates were shown a diagram of a neuromuscular junction and asked to label the various components. Subsequent questions sought knowledge of the processes occurring at the prejunctional / junctional / post junctional nerve terminal, to classify neuromuscular blockers, their mechanisms of action, and the pharmacokinetic properties that influence speed of onset and potency.

This Viva will explore your knowledge of basic pharmacology and poisoning. Q 1. Describe the factors that affect ORAL drug absorption This viva explored basic pharmacology, dose response curves and poisoning as it related to paracetamol, aspirin and organophosphates. Areas of weakness included the depth of knowledge regarding basic pharmacology as it related to concepts such as clearance and bioavailability and first pass metabolism.

This station will explore knowledge of beta adrenoreceptor antagonists A 50 year-old man is admitted to intensive care after a suspected myocardial infarction while undergoing gastrectomy for carcinoma of the stomach. Cardiologists have recommended metoprolol 50 mg orally bd. Describe the pharmacokinetics of metoprolol. What parenteral dose would you use for this patient? Candidates were provided with a clinical scenario of a patient unable to take oral formulation of metoprolol and asked to describe the pharmacology associated with an alternative, intravenous preparation, and contrast it with the oral preparation. Candidates were also asked to discuss metoprolol associated adverse effects and their knowledge of agonist – antagonists relationships. Candidates struggled most with applying, and explaining the relevance of, basic pharmacological principles to account for fundamental clinical applications. Dose response curves were also not covered well.

This viva will discuss dose response curves and the information that can be gained from them. Candidates were asked to draw a dose response curve for morphine and to describe the information that relates to it. Areas of basic pharmacology including ED50/potency, efficacy, effect of competitive and non competitive antagonists were also tested

of this drug. Candidates were expected to discuss administration, bioavailability, metabolism, excretion and half life of captopril. Candidates were then asked to compare it to the longer acting ACE inhibitors and discuss their advantages and/or disadvantages in ICU patients. The Viva then explored the candidate’s knowledge of dosing intervals, plasma concentration times curves and effect time curves in relation to ACE inhibitors. Candidates were expected to know why these curves differed, (avid enzyme binding), and thus why the dosing intervals for ACE inhibitors are so long in relation to their half lives. The concepts of Emax, EC50 and Therapeutic index were required. Candidates were then asked to discuss the mechanism of action of ACE inhibitors and their cardiovascular, endocrine, renal and CNS effects. Drug interactions and adverse effects were expected knowledge. Syllabus, General Pharmacology I and II, ACE inhibitors, C2b2f. References : Katzung B.G.'s'Basic and Clinical Pharmacology' Brunton L.L. Goodman and Gilman’s ' The pharmacological basis of Therapeutics'.