Pharos University in Alexandria (PUA)
Faculty of Pharmacy and Drug Manufacturing
PHR 571 – Fall 2015
Tutorial assignment
Use "Clinical pharmacy & therapeutics, Walker & Whittlesea" or "Essential
Haematology" as a reference textbook.
N.B. Untidy reports lose marks.
1
5106019
‫احمد ماهر عبد الهادي‬
- The PT is responsive to reduction of vitamin K dependent factors, so measuring PT is the
most commonly used monitor of oral anticoagulation therapy.
What does PT stand for? What is the unit used to express this parameter? What is its normal
value?
- Define INR.
- Do you expect the INR of a patient on Warfarin to be less, equal, or higher than one?
Justify your answer.
2
5106082
‫جمال ياسين خليفة‬
- Multiple choice question: Potentiated Warfarin effect would result in………….. ( longer- non
changed- shorter) PT and…………………(higher-lower-non changed) INR value.
Haematological changes in liver disease
- Why would patients with acute and chronic liver disease develop spontaneous bleeding?
- What is the most frequently used indicator (lab test) of defective clotting factor's synthesis
in liver disease? How would the test's result change in such disease?
3
5106205 ‫محمد حسني متولي بركات‬
- Because vitamin K is fat soluble, patients with fat malabsorption, especially in biliary
obstruction or hepatic disease, may become deficient:
What form of Vitamin K would you choose for oral administration to prevent vitamin K
deficiency in malabsorption syndromes; Phytomenadione or menadiol sodium phosphate?
Justify your answer?
Mention one trade name for such vitamin K form in the Egyptian market.
Pharos University in Alexandria (PUA)
Faculty of Pharmacy and Drug Manufacturing
PHR 571 – Fall 2015
4
‫ادهم العضوي‬
5107044
- Why is it important to monitor platelet count during Heparins therapy? How often should it be
performed?
- When do you suspect occurrence of Heparin induced thrombocytopenia (HIT)? What is the clinical
alternative of Heparin in case of HIT?
- Which type of Heparins more occasionally causes HIT?
- State another possible adverse effect for Heparin.
5
‫فاطمة الزهراء محمد نبيل‬
5107185
Specify 4 conditions which may require I.V Iron replacement therapy.
- Some parentral Iron products may require administering a test dose first, before the
therapeutic dose. Mention an example.
Why is this test dose important?
6
5108218
‫كريم حجاج‬
- Some medication classes may interact with oral Iron replacement therapy.
Mention names of three different classes.
What is the possible mechanism of interaction for each class?
7
‫محمد صبري غزاوي‬
5108256
- Mention 3 different conditions where prophylactic iron replacement may be required.
- Mention 3 different diseases in which bleeding may lead to iron deficiency anemia.
8
5108390
‫يمنى حلمي محمد صدقي برغش‬
- What is the route of administration of UFH?
- Mention: generic name (including salt form), trade name, dosage form, storage conditions
and price of UFH in Egyptian market?
Pharos University in Alexandria (PUA)
Faculty of Pharmacy and Drug Manufacturing
PHR 571 – Fall 2015
5109009 ‫احمد حمدي السيد احمد السبع‬
9
- What is the route of administration of LMWHs?
- Mention: generic name (including salt form), trade name, dosage form, storage conditions
and price of one LMWH in Egyptian market?
10
5109019
‫احمد مجدي‬
- Clarify, using a table, two desirable pharmacokinetic features that distinguish LMWHs from
UFH?
- How do these clinical features affect the clinical use of both therapies?
11
5109039
‫اسراء نبيل جنيدي‬
- There are 3 generic names of oral anticoagulants; why is one agent preferred over the
others?
- Concerning the most commonly used oral anticoagulant, mention available strength(s),
dosage form and trade name.
12
5109192
‫فادي جمال سليمان‬
- What is the pharmacokinetic reason that makes drug interactions a potential problem
during Warfarin therapy?
- Mention names of three therapeutic classes of medications that either potentiate or
inhibit the anticoagulant effect of Warfarin? What is the possible mechanism for each of
these interactions?
13
5109226
‫محمد خيري محمد‬
- There are 3 generic names of oral anticoagulants; why is one agent preferred over the
others?
- Concerning the most commonly used oral anticoagulant, mention available strength(s),
dosage form and trade name.
Pharos University in Alexandria (PUA)
Faculty of Pharmacy and Drug Manufacturing
PHR 571 – Fall 2015
14
‫محمد عمر خير هللا‬
5109270
- The major adverse effect of all Heparins is haemorrhage.
Enumerate three factors or conditions that increase the rate of incidence of such adverse
event?
- Locate a possible site of such bleeding in the body.
- Mention the name of the laboratory test that monitors UFH activity? What is the desirable
range of the result?
15
5109442
‫بسام محمد عبدالبديع محمد‬
- What is the laboratory test used to monitor the effect of Warfarin? What is the optimum therapeutic
range of the result?
- Why does Heparin therapy may continue even though warfarin therapy could have been already
started? When should Heparin therapy be stopped?
- How would you interpret results above or below normal for such test?
16
5111029
‫اسراء طارق الحمادي‬
- What is the pharmacokinetic reason that makes drug interactions a potential problem during Warfarin
therapy?
- Mention names of three therapeutic classes of medications that either potentiate or inhibit the
anticoagulant effect of Warfarin? What is the possible mechanism for each of these interactions?
17
5111031
‫اسراء عبدالعزيز محمد شحاتة‬
- Mention three different generic names of medications that either potentiate or inhibit the
anticoagulant effect of Warfarin?
- Assume that, for a patient on Warfarin, his profile lists each of the previous 3 medications in the
patient's history section.
What would be your recommended intervention to prevent the interaction resulting from each
medication?
Pharos University in Alexandria (PUA)
Faculty of Pharmacy and Drug Manufacturing
PHR 571 – Fall 2015
18
‫اسماء صبري عبدالعليم‬
5111042
- Could Warfarin be given during pregnancy? If not, why? What is its pregnancy category?
- What is the appropriate therapeutic substitute, if Warfarin cannot be administered during pregnancy?
- Warfarin's overdose or potentiated activity may lead to a serious adverse event?
What is the expected adverse event?
Mention a generic and trade name for a drug that is given to stop this event?
19
5111071
‫ايمان محمود محروس الهلب‬
- Examine 1 common conventional release solid oral iron products in the Egyptian market. Determine:
trade name, dosage form, iron salt form (anion counter ion), equivalent elemental iron content,
manufacturer's name, price, and minimal therapeutic dose. (5 marks)
You should bring a photocopy of the product's insert or otherwise suitable reference.
20
5111081 ‫اية مجدي احمد الحويط‬
As a pharmacist you are required to contribute in the treatment plan for a patient with iron deficiency
anemia.
- State two drug-drug interactions for ferroton® capsules; what is the mechanism behind each of these
DDIs? What would be your intervention to solve each interaction?
21
5111082
‫اية محمد مقلد‬
- Examine 1 common parenteral iron products in the Egyptian market. For each determine: trade name,
type of parenteral administration, iron salt form (anion counter ion), equivalent elemental iron content,
manufacturer's name, price, and minimal therapeutic dose.
You should bring a photocopy of the product's insert
22
5111089
‫امنية عطية‬
Examine 1 common modified release (M.R) oral iron product in the Egyptian market; determine: trade
name, dosage form, iron salt form (anion counter ion), equivalent elemental iron content,
manufacturer's name, price, and minimal therapeutic dose.
You should bring a photocopy of the product's insert.
Pharos University in Alexandria (PUA)
Faculty of Pharmacy and Drug Manufacturing
PHR 571 – Fall 2015
23
‫بسمة وقفي‬
5111092
Examine one oral iron product available as sachets in the Egyptian market; determine: trade name,
dosage form, iron salt form (anion counter ion), equivalent elemental iron content, manufacturer's
name, price, and minimal therapeutic dose.
You should bring a photocopy of the product's insert.
24
‫بكر علي محمد‬
5111096
Examine one oral iron product available for neonates and infants (below 2 years of age) in the Egyptian
market; determine: trade name, dosage form, iron salt form (anion counter ion), equivalent elemental
iron content, manufacturer's name, price, and minimal therapeutic dose.
You should bring a photocopy of the product's insert.
25
5111103
‫تقى عادل عبد العزيز‬
Examine one oral liquid iron product available for adults' administration in the Egyptian market;
determine: trade name, dosage form, iron salt form (anion counter ion), equivalent elemental iron
content, manufacturer's name, price, and minimal therapeutic dose.
You should bring a photocopy of the product's insert.
26
5111109
‫جيهان حسن محمد‬
- What is the proof of Pancytopenia from the patient's record? Why does this condition may
accompany megaloblastic anaemias?
- Would the patient develop reticulocytosis as a result of his anaemia? What is the
significance of such result in relation to the mechanism of anemia?
27
5111123
‫دينا احمد لطفي‬
- What confirmatory tests can be done to specify diagnosis? Clarify the expected changes if
it’s a case of folate deficiency anaemia?
- What is the expected serum ferritin level of this patient?
- Mention generic names of 2 drugs that can be implicated in causing folate deficiency
anaemia?
Pharos University in Alexandria (PUA)
Faculty of Pharmacy and Drug Manufacturing
PHR 571 – Fall 2015
28
5111127
‫دينا عادل الطباخ‬
"Mild jaundice may be present due to the increased breakdown of Hb found in the
abnormal red cells in folate deficiency anemia" Mention to lab test results that reflect
increased hemolysis?
- Which product would you choose as replacement therapy for folate deficiency anaemia:
Folicap® 0.5 or Folic acid® 5? Why? What could be a possible indication for the other
product?
29
5111135
‫رباب سعيدعفيفي‬
Why patients suffering from perinicious anaemia should administer Vitamin B12 as
replacement therapy?
Could Tri-B® tablets be suitable for them? Why?
Mention the trade names of 2 suitable products with different dosage forms and routes of
administration in the Egyptian market?
30
5111148
‫ريم محمد رأفت‬
How would you monitor success of megaloblastic anemia therapy using lab tests?
- What clinical sign or symptom can differentiate between F.A and V B12 deficiency anaemias?
- What type of anaemia could strict vegetarians develop over long time? Why?
31
5111164
‫سلمى محمد عوف‬
- Define these terms in common use in haematology Anisocytosis, Polycythaemia, and Poikilocytosis.
- What are reticulocytes?
- Why is the reticulocyte count sometimes useful in assessing response to treatment of some
anaemias? Provide an example.
Pharos University in Alexandria (PUA)
Faculty of Pharmacy and Drug Manufacturing
PHR 571 – Fall 2015
32
5111175
‫شادن محمد‬
- What does PCV stand for?
- Mention another name for the PCV test. Why is it always less than one?
- Name two abnormal Haemoglobin types that could be detected by electrophoresis along
with their corresponding diseases.
33
5111185
‫شيماء مصطفى‬
- Interpret (mention the expected result and what does it reflect) the lab values of
the following indices for a thalassemia patient at time of diagnosis; Hb, MCV, MCH,
reticulocyte count.
- Mention one type of amaemia that could be confused with Thalassemia on the
basis of the red cell indices (i.e. a differential diagnosis)? How could a lab test
distinguish between the 2 conditions?
34
5111187
‫صالح الدين وائل‬
- The medication history of a Thalassemia patient includes the following:
Eltroxin (Thyroxine).
Mixtard 30/70 40 IU (Biphasic insulin)
What would be the most probable indication in this case? Why does these
indications develop in Thalassemia patients?
- Target Hemoglobin level after blood transfusions in Thalassemia. What is hemosiderosis
and why does it develop in thalassemia patinets.
35
5111197
‫عبداللطيف محمد‬
- What is the main risk resulting from splenectomy in thalassemia patients? What are the
recommended pharmacological measures to avoid such risk? Mention name of the class and
an example in each.
- Why is Folic acid given in Thalassemia? Which product would you choose, Folicap® 0.5 or
Folic acid® 5?
Pharos University in Alexandria (PUA)
Faculty of Pharmacy and Drug Manufacturing
PHR 571 – Fall 2015
36
5111210
‫علياء سعد خليل‬
- Concerning an injected iron chelator; mention generic name, trade name in Egyptian
market, dosage form, dosage regimen, route of administration and common adverse events.
- Mention Generic and trade names of an oral iron chelator. Why better patient compliance
is achieved with it?
- What procedure could represent a cure for Thalassemia patients?
37
‫عمر عصام‬
5111215
- G6PD deficiency anaemia:
A customer enters your pharmacy to fill a prescription; he tells you: "please take care dr, I
have anaemia El Fool…"
Mention four common drugs implicated in causing haemolysis in G6PD anaemia?
38
5111217
‫عواطف صالح كامل‬
What is the defect in acute porphyria?
How is diagnosis done and what is prognosis?
What could be the triggering factors for this condition?
What is the suitable treatment for this case?
39
5111218
‫غادة عبدالناصر‬
What is the defect in acute porphyria?
How is diagnosis done and what is prognosis?
What could be the triggering factors for this condition?
What is the suitable treatment for this case?
Pharos University in Alexandria (PUA)
Faculty of Pharmacy and Drug Manufacturing
PHR 571 – Fall 2015
40
5111219
‫غادة محمد محمد علي‬
- Why should leukemia patients use mouthwashes regularly?
- Mention one possible hazard that results from the use of prophylactic antibiotics in
leukemia patients.
- What is the reason behind performing gut decontamination in leukemia patients?
Mention 3 drugs that could be used in combination during such a procedure.
- What is CSF? What is its role in leukemia patients?
41
5111220
‫غادة محمود احمد‬
- In acute leukemia patients; I.V antibiotics must be started empirically following a clinically
serious febrile episode even if culture samples' results are still not known. What is meant by
empirical? Mention an example of a standard empirical therapy.
- What is prescribed for the patient for chemotherapy-induced emesis? What are the drugs
that will treat her petechial haemorrhages in skin and mucous membranes?
42
5111223
‫فاطمة رمضان عوض‬
- What does the “Induction" phase of acute Leukemia aim to? How could it be done?
- Postremission "consolidation/Intensification" phase may depend on chemotherapy or a
combination of chemotherapy, radiotherapy and bone marrow transplantation. What is the
importance of this phase in acute Leukemia treatment?
-What is the last phase of acute leukemia treatment? What is its aim?
43
5111224
‫فرح سامي‬
- Concerning chronic myeloid leukemia; explain the term Ph+CML.
Concerning the drug Imatinib mesylate; mention the mechanism of action, 2 indications,
dosage form, trade name, price and route of administration. 4 marks
Pharos University in Alexandria (PUA)
Faculty of Pharmacy and Drug Manufacturing
PHR 571 – Fall 2015
44
5111227
‫كريم خيري حنا‬
Illustrative diagram:
http://www.d.umn.edu/~jfitzake/Lectures/DMED/Antineoplastics/ProteinFunctionInhibitors
/STIMechanism.html
45
5111228
‫كريم فاخر محمد‬
- Examine 1 common conventional release solid oral iron products in the Egyptian market. Determine:
trade name, dosage form, iron salt form (anion counter ion), equivalent elemental iron content,
manufacturer's name, price, and minimal therapeutic dose. (5 marks)
You should bring a photocopy of the product's insert or otherwise suitable reference.
46
5111231
‫كريم محمود الشافعي‬
-What is the drug of choice for treating chronic leukemias? What is the major
advantage of this drug?
What is the mechanism of action of this drug? Mention its trade name, manufacturer name and price in the Egyptian market
47
5111236
-
-
‫لبنى شاكر‬
- What is the proof of Pancytopenia from the patient's record? Why does this condition may
accompany megaloblastic anaemias?
- Would the patient develop reticulocytosis as a result of his anaemia? What is the
significance of such result in relation to the mechanism of anemia?
Pharos University in Alexandria (PUA)
Faculty of Pharmacy and Drug Manufacturing
PHR 571 – Fall 2015
48
5111243
‫مارينا سامي مايكل‬
How would you monitor success of megaloblastic anemia therapy using lab tests?
- What clinical sign or symptom can differentiate between F.A and V B12 deficiency anaemias?
- What type of anaemia could strict vegetarians develop over long time? Why?
49
5111262 ‫محمد عبدالغني عاشور‬
Examine one oral iron product available as sachets in the Egyptian market; determine: trade name,
dosage form, iron salt form (anion counter ion), equivalent elemental iron content, manufacturer's
name, price, and minimal therapeutic dose.
You should bring a photocopy of the product's insert.
50
5111274
‫محمد مصطفى الشربة‬
- What is the main risk resulting from splenectomy in thalassemia patients? What are the
recommended pharmacological measures to avoid such risk? Mention name of the class and
an example in each.
- Why is Folic acid given in Thalassemia? Which product would you choose, Folicap® 0.5 or
Folic acid® 5?
51
5111278
‫محمد نبيه فهمي ابراهيم‬
- What is the pharmacokinetic reason that makes drug interactions a potential problem during Warfarin
therapy?
- Mention names of three therapeutic classes of medications that either potentiate or inhibit the
anticoagulant effect of Warfarin? What is the possible mechanism for each of these interactions?
52
5111289
‫محمود ممتاز‬
- What is the laboratory test used to monitor the effect of Warfarin? What is the optimum therapeutic
range of the result?
- Why does Heparin therapy may continue even though warfarin therapy could have been already
started? When should Heparin therapy be stopped?
- How would you interpret results above or below normal for such test?
Pharos University in Alexandria (PUA)
Faculty of Pharmacy and Drug Manufacturing
PHR 571 – Fall 2015
53
5111293
‫مروة عصام القاضي‬
- Because vitamin K is fat soluble, patients with fat malabsorption, especially in biliary
obstruction or hepatic disease, may become deficient:
What form of Vitamin K would you choose for oral administration to prevent vitamin K
deficiency in malabsorption syndromes; Phytomenadione or menadiol sodium phosphate?
Justify your answer?
Mention one trade name for such vitamin K form in the Egyptian market.
54
‫ميريت جورج‬
5111327
- Why is it important to monitor platelet count during Heparins therapy? How often should it be
performed?
- When do you suspect occurrence of Heparin induced thrombocytopenia (HIT)? What is the clinical
alternative of Heparin in case of HIT?
- Which type of Heparins more occasionally causes HIT?
- State another possible adverse effect for Heparin.
55
5111332
‫ناردين ظريف‬
Examine one oral liquid iron product available for adults' administration in the Egyptian market;
determine: trade name, dosage form, iron salt form (anion counter ion), equivalent elemental iron
content, manufacturer's name, price, and minimal therapeutic dose.
You should bring a photocopy of the product's insert.
56
5111387
‫وسام جمال فوزي‬
Examine one oral iron product available for neonates and infants (below 2 years of age) in the Egyptian
market; determine: trade name, dosage form, iron salt form (anion counter ion), equivalent elemental
iron content, manufacturer's name, price, and minimal therapeutic dose.
You should bring a photocopy of the product's insert.
Pharos University in Alexandria (PUA)
Faculty of Pharmacy and Drug Manufacturing
PHR 571 – Fall 2015
57
5111395
‫ياسمين منير محمدين‬
- What does the “Induction" phase of acute Leukemia aim to? How could it be done?
- Postremission "consolidation/Intensification" phase may depend on chemotherapy or a
combination of chemotherapy, radiotherapy and bone marrow transplantation. What is the
importance of this phase in acute Leukemia treatment?
-What is the last phase of acute leukemia treatment? What is its aim?
58
5111431
‫محمد خالد الشربة‬
- Concerning an injected iron chelator; mention generic name, trade name in Egyptian
market, dosage form, dosage regimen, route of administration and common adverse events.
- Mention Generic and trade names of an oral iron chelator. Why better patient compliance
is achieved with it?
- What procedure could represent a cure for Thalassemia patients?
59
5113376
‫وفاء بسيوني مرعي‬
Examine 1 common modified release (M.R) oral iron product in the Egyptian market; determine: trade
name, dosage form, iron salt form (anion counter ion), equivalent elemental iron content,
manufacturer's name, price, and minimal therapeutic dose.
You should bring a photocopy of the product's insert.