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Pharmacotherapeutics ( Important Questions and Answers )

Q.n.1 :- Describe Pharmacotherapeutics and scope of pharmacotherapeutics .

Ans .
It is a branch of science in which we study about diseases their causes ,
process of causes development , sympto ms and treatment with the help of
drugs and changes in lifestyle .
pharmacotherapeutic is formed two words pharmacon means drug and
therapy means system to apply .

Scope of Pharmacotherapeutics
1) A person has knowledge about pharmacotheraphetic Can w ork in the field
of treatment .
2) a person has knowledge about pharmacotherapeutics can work in the field
of diagnostic laboratory .
3 pharmacotheraphetic knowledge provide a foundation level for advance
study in the field of disease and their causes.
4) a person has knowledge of pharmacotherapeutics can prevent himself in
other from being sick by getting changes in lifestyle and diet .
5) The person has knowledge of pharmacotherapeutics can make a community
healthy .
6) The person has knowledge of pharmacotherapeutics can work in the field
of epidemiology.
7) The person has knowledge of pharmacotherapeutics can work in the field
of research and development of drug .

Q.n.2:- explain the Rational Use of drugs and standard treatment guidelines .(STG)
Ans
Rational Use of medicine (RUM): It means to provide right drug to a patient in
appropriate dose , for an appropriate time period , which is suitable for
clinical requirement , at lowest cost .
Some factors for rational use of drugs are Following :
a) Evidence based Practice .
b) Individual patient assessment ( each patient is unique , so their treatment
should be according to their specific need )
c) appropriate diagnosis

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d) Benefits VS Risk
e) Dosage and duration
f) Patient Monitoring
g) Patient counselling
h) cost effective medication
i) Continued professional development
Evidence Based medicine ( EBM ) : - It means to use the best available (
science based ) research for treatment , with the help of epidemiology ,
engineering technique and risk-benefit analyses .

Component of Evidence based medicine

1) Best available evidence .
2) clinical knowledge and skills .
3) pateint 's need .

Steps of EBM
1) to ask clinical questions.
2) to find best evidence .
3) Evaluation of evidence , if it is valid and useful or not ?
4) Application of evidence .
5 ) assessment ( evaluation ) of result .

Standard Treatment Guidelines ( STGs)

STGs is a tool that helps and guides prescribers ( doctors , Pharmacists ,
dispensers ) and other health care professionals , who provide primary health
care services , to provide evidence -based medicine and quality of care, at
good cost .

Q.N.3:- Define angina and myocardial infarction and give their Pharmacological
management .
Ans .
Angina is a type of chest pain caused by reduced blood flow ( lack of blood
supply ) to the heart .

Types Of Angina Pectoris

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1) Stable / Chronic : this type of angina follow a regular pattern due to stable
plaque in coronary arteries and occurs when work load of heart increased
due to any reason like exercise ,playing foot ball . It is less dangerous than
unstable Angina . This is relieved by rest and medication .
2) Unstable Angina : This type of angina does not follow a regular pattern due
to unstable ( dynamic ) plaque in c oronary arteries and occurs even at
resting condition , rest and medication is not enough for its relief .
3) Microvascular angina : This type of angina occurs when any one more
smallest coronary arteries are blocked , and it commonly occurs due to
thrombosis part of unstable angina .

Pharmacological management of angina Pectoris

1) Nitrates : Nitroglycerine , Isosorbide Dinitrate , they open the coronary
arteries , and are given by sublingual route to obtain one set of action .
2) ß Blockers : Atenolol , propranolol , they decrease BP and slow down the
heart rate .
3) Calcium Channel Blocker : Amlodipine , Nifedipine , Verapamil . they also act
like ß blockers .
4) Thrombolytic Drugs ( Antiplatelet drugs) : steptokinase , Urokinase , prourokinase
, they prevent blood clotting .

Myocardial Infarction is a condition in which blood supply decreases or stops

to the heart muscles and occurs death of cardiac tissues .

Pharmacological Management of Myocardial

Infarction
The blocked artery of heart is treated by a surgical procedure called
Angioplsty , in which a catheter is inserted with a balloon into the artery and
balloon is inflated at location of blockage to expand the artery . Then a ring
called stent placed there which holds the open the arte ry .
After angioplasty a heart patient requires following medicines :
1) Blood thinners : Aspirin , pradaxa
2) Thrombolytic : streptokinase , urokinase ( these dissolve clots )
3) antiplatelet drugs : clopidogrel ( they prevents the formation of new clots
)

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4) Nitrates : Isosorbide dinitrate , Notroglycerine
5) ß blockers : propranolol
6) ACE Inhibitors : ramipril , captopril , Losartan , valsartan

Q.N.4:- Give the etiopathogenesis and pharmacological management of asthma and

define COPD.
Ans.

Asthma
Asthma is a chronic, inflammatory disorder in which the bronchial Airways
become swollen in narrowed and cause difficulty in airflow or Obstruction in
airflow .

Types Of Asthma
1) Atopic / Extrinsic Asthma : this type of asthma occurs due to Allergens like
dust , feathers , food , Pollen or infections etc. this is occur due to immune
mechanism . ( Hyper Responsiveness ).
2) Non Atopic or Intrinsic Asthma : this type of asthma occurs due to a
irritant like air pollution , cold heat, smoke , room deodorant , stress , anger
etc.
3) Drug Induced Asthma : this type of asthma occurs due to drug like Aspirin .

Etiology
1) Allergens( Dust , animal dander , pollen )
2) Irritant ( smoke , stress , cold )
3) Drugs ( aspirin ) 4) Ach .

Pathogenesis
Exposure to Allergens ( entry of allergens in bronchi )

Recognised by Immune System ( produce T Helper cell , then Produce

Plasma cell )

plasma cell makes Antibodies ( I GE and loaded with Mast cells and
present in bronchial muscles ) .

When next time any the antigen come into , and in contact of antibodies ,
they activate the mast cells and mast cells produce Histamine , Prostaglandin ,
Leukotrienes .

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Now Prostaglandin Causes Blood vessels dilation , inflammation , ( due to it

fluid increased in that area ) .
Leukotrienes , Histamine cause excess production of mucus and constriction
of smooth muscles .
Obstruction In Airflow
Pharmacological Management

Long Term Asthma Medications

1)Inhaled Corticosteroids : Fluticasone , Budesonide , ciclesonide .
2) leukotriene Modifiers : montelukast , Zafirlukast .
3) Long Actingß Agonist : Salmeterol , Formoterol .
4) Theophyllin : it is used daily for bronchodilation .

Quick - Relief Asthma Medications

1) Inhaled short acting ß Agonist : Albuterol
2) Ipratopium

Definition of COPD
According to WHO COPD is a lungs diseas e and defined as chronic
obstruction of lung Airflows that interfere with normal breathing and it is not
fully reversible .

It is also known as
Chronic Obstructive Lung Disease (COLD). Chronic Obstructive Airway Disease
(COAD). Chronic Airflow Limitation (CAL), and Chronic Obstructive Respiratory
Disease (CORD).

Types of COPD
1) Chronic Bronchitis : it refers to inflammation of respiratory tract and
formation of thick mucus, and with the passes of time this mucus blocks the
respiratory tract and cause difficulty in breathing .
2) Emphysema : It refers to damage of alveoli ( air sacs ) in which elasticity of
alveoli destroyed , and it enlarged and some time burst , air is trapped in it .
which increases the concentration of carbon dioxide and causes difficulty in
breathing .

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Q.N. 5:- Give the Pharmacological management of Dysmenorrhea and premenstrual
syndrome .
Ans. Dysmenorrhea
Cramps and pelvic ( Vagina , Cervix , uterus , bladder , Urethra and rectum ) pain with
menstruation is called Dysmenorrhoea .

Pharmacological Management
1) Analgesic : Paracetamol , iburofen , diclofenac , naproxen etc.
2) Antispasmodics : Dicyclomine + Mefinemic acid .

Definition of Premenstrual syndrome

A group of symptoms like unpleasant or uncomfortable that occurs in women typically
days before or during menstruation in women .

Pharmacological managements
1) antidepressant : SSRIs ( selective serotonin reuptake inhibitors ) Fluoxatine , paroxetine
etc.
2) NSAIDs : ibuprofen ,
3) Diuretics : Spironolectone in case of excessive body fluid , salt and bloating ( fluid
retention and swelling )
4) Hormonal Contraceptive pills : these stops ovulation and prevent symptoms of PMS due
to Ovulation .
Q.N.6:- Give the clinical manifestation of Hypo and Hyperthyroidism .
Ans.
Hypothyroidism
: Lake of Thyroid Hormones ( TH ) in blood circulation about 20% to 40 %
which slow down the metabolism is called Hypothyroidism .
Clinical manifestation
1) Constipation
2) depression
3) feeling tiredness
4) high blood cholesterol level
5) dry skin
6) excessive forgetfulness
7) heavy and frequent menstrual cycle
8) Tingling in hands
9) loss of sexual desire

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10) gaining weight
Pharmacological Management
1) Levothyroxine ( T4 )
2) liothyronine ( T3 )
3) combination Of T4 and T 3

Hyperthyroidism
Definition : A condition in which thyroid gland produces more Thyroid
Hormones ( TH ) than requirement of the body is called Hyperthyroidism .
Clinical manifestation
1) Weight Loss
2) Increased appetite
3) changes in menstrual
4) Restless
5) diarrhoea
6) excess sweating
7) sleep problems
8) swollen in thyroid gland etc.
Non Pharmacological Management
1) Exercise
2) Stress management
3) Diet ( decrease intake of foods , fruits , vegetables are rich in iodi ne , zinc
, iron copper selenium , Vitamin A , D .
Pharmacological Management
1) Hormone Inhibitors : Methimazole , Propylthiouracil .
2) glucocorticoids : They inhibit the conversion of T4 to T3 ( T3 is more power
full Hormone )
3) Radioactive Iodine : These drugs destroy thyroid cells and control thyroid
hormones .
*the dosage of RAI should be given carefully , otherwise cause hypothyroid .

Q.N.7:- define Epilepsy and Parkinson's disease.

Ans.
Epilepsy : Epilepsy is a nervous system disorder du e to abnormal electrical
activity in brain cells, it is also called seizure and convulsant .
This disorder results contraction , involuntary movement , shaking of the body
etc.

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Definition of Parkinson's disease
It is a chronic, progressive , neurodegen eration disorder. in which slows down
the voluntary movement of body parts (bradykinesia ) , muscles tone changed
( rigidity) and tremor ( trembling ) at rest .

Q.N.8:- Define peptic ulcer ( with etiopathogenesis ) and discuss its Pharmacological and
non Pharmacological management .
Ans .
Peptic Ulcer Disease
Definition
Peptic Ulcer is a condition in which a wound / Sore developed on the lining of
the Oesophagus , stomach , or small intestine ( beginning part of intestine ) .

Etiology
1) Helicobacter Pylori ( it infects and causes inflammation ) .
2) NSAIDs . ( Inhibit COX 1 )
3) Smoking
4) alcoholism
5) Radiotherapy .

Pathogenesis
 A thick layer of gastric mucus protects the mucosal membrane from
injury due to Stomach acid .
 Prostaglandin Provides an additional defense ( protection ) against acid.

Pathogenesis
Helicobacter pylori release toxin NSAIDs

Cause Inflammation Inhibits COX 1

Damage the defense mechanism Reduce PG Secretion

ulcer Developed Decrease Defense Mechanism

Ulceration Developed

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Clinical Manifestations
1) Pain in stomach 2) Bloating 3) gastrointestinal Disorders
4) Heartburn 5) Appetite change 6) nausea , vomiting
In severe condition
1) Dark or black stool due to bleeding
2) severe pain

Non Pharmacological management

1) Diet : a) avoiding the foods that take a long time in digestion.
b) If blood or water loss occurred due to Diarrhoea or vomiting , they should
be recovered .
2) Cessation of NSAIDs . 3) Quitting smoking .

Pharmacological management
1) Antacids : aluminium hydroxide. magnesium carbonate. ,magnesium
trisilicate. magnesium hydroxide. calcium carbonate. sodium bicarbonate.
2) H2 Blocker : cimetidine (Tagamet) , ranitidine (Zantac)** nizatidine
(Axid)
famotidine (Pepsid) .
3) PPI : Omeprazole ,Esomeprazole ,Lansoprazole , Rabeprazole
Pantoprazole .
4) Protective Drugs : Carafate ( Sucralfate ) Pepto - Bismol ( Bismuth
Subsalicylate ) . It covers the wound and prevent further damage )
5) Antibiotics : Imidazole , azithromycine , amoxicillin etc.

Q.N. 9:- give pharmacotherapy of Viral infection SARS .

Ans.

Viral infection SARS-CoV-2

Definition
Coronavirus Disease is a Highly Contagious disease , which is caused by a
novel Corona virus ( a new strain that has not been identified previously) .
This virus affects the respiratory tract badly and stops air flow , now COVID
19 is called SARS-CoV-2 ( Severe Acute Respiratory Syndrome ) .

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Etiology
The causative agent of COVID 19 is SARS -COV-2

Mode of Transmission
1) Droplets
2) Physical Contact 3) contaminated things ,

Pathogenesis
Entry of Coronavirus

Macrophage Activation

Failure of Immunity

Multiplication of Virus In epithelial cells

inflammation

acute lungs injury

Respiratory failure

multiple organ failure

death

Clinical Manifestation
1) Fever 2) Dry cough 3) weakness 4) sore throat 5) Conjuctivitis
6) Difficulty in breathing 7) chest pain

Non- Pharmacological Management

1) Oxygen Therapy 2) Ventilation 3) fresh air
4) Encouraging , Counselling

Pharmacological Management
1) Antiviral drugs : Remdesivir , Ritronavir , Nirmatrelvir etc.
2) Monoclonal antibodies : Bebtelovimab it is a monoclonal antibody ,
monoclonal is protein made in laboratory that can restore , increase ,
modify , or mimic the immune system .

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Q.N.10:- Write a note on antimicrobial resistance .
Ans.

Introduction
Anti microbial resistance is the ability of microorganism ( like Bacteria viruses , fungus ) to
stop in microbial drug ( antibiotics , antivirus anti malarial etc.) from working against it .
And as a result the standard treatment of chemotherapy became ineffective and thus the
infection persist in the body and increases the risk of transmission to other .
 Antibiotic resistance or anti-microbial resistance leads to higher medical cost ,
prolong hospital stay , and increase mortality rate .

Causes of anti microbial resistance

o it occurs naturally
o Non resistance bacteria multiply by the billions , a few of them will mutate , some
mutation make the bacterium drug resistance .
o Misuse and overuse of antibiotics
o Not taking complete course of antibiotics
o Taking antibiotics in low dose than the prescribed dose
o Taking antibiotics for the infections are commonly self cured

Types of anti microbial resistance

1) Multi drug resistance ( MDR ) : it is anti microbial resistance shown by a species of
microorganism to at least 1 anti microbial drug in 3 or more anti microbial categories
( beta lactam , macrolides , Tetracycline etc.)
2) Extensively drug resistance (XDR) : the bacteria are classified in this category if they are
resistant to all anti microbial agents except in two or less anti microbial categories
3) Pandrug resistance : the bacteria are classified in this are resistant to all anti microbial
agents in all antimicrobial categories .

Q.N.11:- Explain the Objectives of Pharmacotherapeutics and Essential Medicine List

concept .
Ans.

Objectives of Pharmacotherapeutics
1) to provide economical medical treatment .
2) to provide research based drug therapy .

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3) to promote rational use of drugs . (RUM): It means to provide right drug to a
patient in appropriate dose , for an appropriate time period , which is suitable
for clinical requirement , at lowest cost . )
4) to promote Evidence based treatment .
5) to provide effective and best quality drugs .
.
Essential Medicine list :- It is a list of essential medicines that satisfy ( complete ) the basic
healthcare needs of the population .

Selection of essential medicines

1) the satisfactory information about the effectiveness and safety of drug , should be
available on the drug .
2) The drug should be stable in store for long periods .
3) the drug should be available in sufficient quantity .
4) It should be best amongst two or more similar drugs in comparison of safety , quality ,
cost and effectiveness .
5) they should be single compound .
39 Current Essential Medicine List of India 2021
They are called NLEM ( National List of essential medicines )
1) Amikacin Bedaquiline (anti-TB),
2) Bendamustine Hydrochloride (anti - cancer),

Q.N. 12. What is UTI , give its etiopathogenesis and treatment .

Ans.
Definition
UTI is a Bacterial infection of the urinary Tract . It includes Cystitis (
infection of Bladder ) Urethritis ( Infection of Urethra ) Prostatitis (
Infection of Prostate gland ) and Pyelonephritis ( infection of Kidney )
Females are more prone to infection because of short size of Urethra , and
closeness to anus .

Etiology
Bacteria : Commonly UTI is occurs due to E. coli ( Escherichia Coli )
Pathogenesis
Step 1) Entry of Bacteria in preurethral area ,and Colonization ( staying and
increasing their number there )
atep 2 ) after Colonization go upwards to Urinary bladder .

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step 3) Fimbria ( hair like structure upon bacteria ) help the bacteria in
attachment with bladder , and bacterial toxin inhibits the bladder peristalsis
and reduces the urine flow .
step 4) Bacteria penetrate the epithelial cells and go upwards to ureters and
Kidney and infect them .

Pathogenesis of Urinary tract Infection

ascending
upwards

Q.N. 13. Define Conjuctivitis , Scabies , Eczema and alcoholic liver disease .
Ans.
Conjunctivitis
Conjunctivitis is a condition in which inflammation or redness of the conjunctiva occurs .
Conjunctiva is a transparent tissue that lines the inner surface of eye lid and the outer layer
of eye .
Maybe occur due to bacterial or viral infection .bacterial conjunctivitis caused by the
staphylococcal or streptococcal bacteria
Viral conjunctivitis caused by the contagious virus that transmit on exposure to coughing or
sneezing of an individual with upper respiratory tract infection

Scabies
Scabies is a contagious skin disease , caused by the Sacroptes Scabiei Var
Hominis mite (a small spider like creature ) , that makes tunnel beneath the
skin and causes small red bumps and severe itching .

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Eczema
The term Eczema has been derived from the Greak word eckzin which means
to boil over or break out .
Eczema is a group of medical conditions which causes inflammation and
irritation to the skin . It is also called dermatitis , But all type of
inflammations are not eczema .

Alcoholic Liver Disease

The Structural and functional changes ( damage ) of liver due to overconsumption of
alcohol is called ALD .
 Consumption of 60-80 g/ day ( about 75-100 ml/day)
for 10 to 20 years for men .
 20 g /day ( about 25 ml /day ) for women . Women are at the double risk
of getting ALD .

Q.N. 14 . define depression , and give its clinical manifestation and pharmacological and non
pharmacological management .
Ans.
Depression
According to WHO depression is a common mental disorder characterized by
sadness , loss of interest or pleasure , feeling of guilt or Low self worth ,
disturbed sleep or appetite , feeling of tiredness and poor concentration .
Etiology
1) genetic factors
2) biochemical factors : deficiency of neurotransmitter adrenalin , nor
adrenalin , serotonin ,dopamine .
3) External causes ( stress etc. )
4) hormone imbalance ( in menopause , pregnancy , postpartum condition ) .

Clinical manifestation
 Feel of sadness , hopelessness and frustration
 less interest in normal activity like sex , hobbies and sports etc .
 sleep disturbance like insomnia or sleeping too much
 Lake of energy feeling and tiredness
 loss of appetite

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 restlessness
 thinking speaking or body movement become slow
 feeling of worthlessness or guilty , thinking about past failures
 Difficulty in thinking , concentrating , making decision and remembering things
 thinking of death , attempt for suicide or committing suicide.
Non - Pharmacological Management
1) Cognitive behavioral therapy (CBT) : it is a common type of talk therapy
(psychotherapy). You work with a mental health counselor (psychotherapist or
therapist) in a structured way,. CBT helps you become aware of inaccurate or
negative thinking so you can view challenging situations more clearly and
respond to them in a more effective way.
2) Electroconvusive Therapy ( ECT ) : it is a procedure, which is done under
general anesthesia, in which small electric currents are passed through the
brain, intentionally triggering a brief seizure. ECT seems to cause changes in
brain chemistry that can quickly reverse symptoms of certain mental health
conditions.
3) Exercise : some specially designed programs reduce the symptoms of
depression .
4) Monitoring the patients ( his activity ) .
Pharmacological Management
1) Monoamine Oxidase Inhibitors (MAOIs): Phenelzine is an effective
antidepressant which inhibit Monoamine Oxidase Enzyme ( this enzyme
prevents Neurotransmitters to bind with their receptors )
2) Tricyclic Antidepressant ( TCAs )
a) Nor adrenaline and Serotonin reuptake inhibitors : amitriptaline , imipramine .
b) Non adrenaline reuptake inhibitors : amoxapine .
3) Serotonin reuptake inhibitors : Fluoxatine , Citalopram , escitalopram .
4) Atypical Antidepressant : Trazodone , mianserin .

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Q. N. 15 . Define Hypertension and Congestive Heart failure ,( with clinical manifestation )
and their pharmacological and non pharmacological management .
Ans.
Hypertension
Definition : It is a condition in which the force of the blood increase against the walls of
blood vessels especially arteries walls .
Blood vessels

Main cause of Hypertension :

1) Constriction of blood vessels
2) Increase heart rate 3) Increase blood volume

Factors leads to these causes

1)Obesity 2) Stress
3 ) smoking 4) drinking alcohol
5) age , after 50 years 6) family history
7) too much salt in diet 8) Inactive lifestyle

Classification Of BP
Types Systolic BP Diastolic BP
1 Normal Less than 120 Less than 80
2 Prehypertension 120-- 139 80 --89
3 Stage 1 140 -- 159 90--99
4 Stage 2 160--180 100--110
5 Hypertensive crisis More than 180 120 or more

Clinical Manifestation
1) Severe headache
2) Chest pain
3) Bleeding from nose
4) Blurred Vision
5) Difficulty In Breathing
6) Irregular heart beat
7) Confusion
8) Nausea and vomiting
9) Dizziness

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10) Pain in neck and back
11) Seizure

Management of Hypertension
Non Pharmacological Management
1) Dietary Changes : A prehypertension ( elevated ) can be control with
healthy diet , taking a diet low in sodium and high in potassium .
It is called DASH ( Dietary Approaches to Stop Hypertension )
2) Exercise : Physical activity is can lower blower BP by decreasing bad
cholesterol , obesity and overweight .
3) Stress Management : Eliminating Stress is also an important way to manage
BP , because in stress condition in which adrenal gland produces Cortisol
hormone , and it increases blood sugar level to manage stress , that causes
Hypertension .
Stress Can be manage by Exercise and meditation .
4) Stopping Smoking : Smoking Increases Sympathetic nerve activity , which
increases heart rate and causes High BP .
5) Stopping Alcohol : Drinking a lot of alcohol constrict blood vessels and
increases blood pressure .

Pharmacological Management Of Hypertension

1) Diuretics : chlorothiazide , Furesimide , Spironolactone .
2) ß Blocker: Atenolol , Propranolol .
3) calcium channel Blocker: Amlodipine , Nifedipine , Verapamil .
4) Vasodilators : Hydralazine , minoxidil .

Congestive Heart Failure ( CHF) or Hart Failure

Congestive Heart Failure is a condition in which a heart falls to pump
sufficient blood ( output) to fulfill the minimum requirement of the body
tissues .
or
It is a condition in which heart is unable to generate enough cardiac output to
fulfill minimum requirements of the body .

Clinical Manifestation of Congestive heart failure

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1) Breathing problem
2) tiredness weakness in legs
3) swollen in legs , ankle and abdomen .
4) A swollen or hard stomach , loss of appetite
5) nausea .

Non Pharmacological management

1) Diet : He should take healthy diet , and avoid too much salt .
2) fluid : He should take limited fluid substance.
3) alcohol : he should avoid alcoho l .
4) smoking : He should avoid smoking
5) Heavy work : He should avoid heavy work

Pharmacological management
1) ACE inhibitor : Losartan , valsartan captopril , ramipril . ( they make easy the
blood flow.
2) ß Blockers : Propranolol .
3) Diuretics : Chlorthiazide , acetazolamide , spironolactone .

Q.N. 16 :- Define Diabetes discuss its etiology and pharmacological and non
pharmacological management
Ans .

Definition
Diabetes Mellitus is a inherited or acquired disease occurs due to defect
in insulin secretion or insulin action or both , in which blood sugar level is
high for long time .
It is also called Hyperglycemia .

Etiology
1) type 1 Diabetes :
a) autoimmune destruction of beta cells of pancreas .
b) any disease in pancreas c) age
d) genetic factors
e) Beta blockers and Thiazide drugs if used for long term

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2) Type 2 Diabetes
a) Insulin does not function properly .
b) resistances to insulin function
c) Obesity . d) lack of physical activity
e) Genetic factors

Non Pharmacological managements

1) Physical Activity
2) Diet ( should avoid carbohydrates , salt in excess amount)
3) should avoid Sweats

Pharmacological managements
1) type 1 diabetes : It is insulin dependent , insulin is administered to treat
this type of diabetes .

2) type 2 diabetes
1) Hypoglycemic agent s
a) sulfonylurea : they stimulate the release of insulin from pancreas , :
Tolbutamide ,chlorpropamide , glibenclamide
b) biguanides : prevent liver from production of glucose , : metformin ,
phenformin
c) α Glucosidaese Inhibitors : it prevent the absorption of carbohydrates form
intestine : Acarbos , miglitol .
Q.N. 17. Define Psoriasis , Anxiety , GERD and Inflammatory bowel diseases .
Ans .
The scientific study of skin is called dermatology .
Psoriasis
Psoriasis is a chronic autoimmune disorder in which the skin cells build up
rapidly and form thick , pink or red coloured , itchy and dry patches , covered
with white or silvery scales . It is called plaque .
These patches can devel op anywhere on the body . it may be some patches or
can cover a large area of skin .

Anxiety
anxiety is a feeling of fear , uneasiness that may make a person sweat , restlessness ,
tension and have a rapid heartbeat . Like before a test , before making an important
decision .

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GERD (Gastro Oesophageal Reflux Disease)
GERD is a disease in which gastric acid ( stomach acid ) moves up into the
oesophagus and irritates the oesophageal l ining .

Inflammatory Bowel Disease

The prolonged Inflammation of GIT ( specially in intestine) is called IBD .
Types 1) Crohn's Disease : If there is inflammation in intestine it is called Crohn's disease . 2)
Ulcerative Colitis : If there are inflammation and ulceration in large intestine it is called
Ulcerative Colitis .

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