Office Use Only

Monash University
Semester One 2014 Examination Period
Faculty of Pharmacy and Pharmaceutical Sciences
EXAM CODES:

PAC3241

TITLE OF PAPER:

Drug Delivery Disposition and Dynamics

EXAM DURATION:

2.5 hours writing time

READING TIME:

10 minutes

THIS PAPER IS FOR STUDENTS STUDYING AT:

Berwick
Caulfield
Parkville

Clayton
Malaysia
Off Campus Learning
Gippsland Peninsula Enhancement Studies
Other (specify)

Open Learning
Sth Africa

During an exam, you must not have in your possession, a book, notes, paper, calculator,
pencil case, mobile phone or other material/item which has not been authorised for the exam
or specifically permitted as noted below. Any material or item on your desk, chair or person will
be deemed to be in your possession. You are reminded that possession of unauthorised materials
in an exam is a discipline offence under Monash Statute 4.1.
No examination papers are to be removed from the room.
AUTHORISED MATERIALS
CALCULATORS
YES
NO
If YES has been selected, only scientific calculators with a "Monash University, Faculty of
Pharmacy and Pharmaceutical Sciences Approved" sticker attached are permitted in
examinations for Pharmacy and Pharmaceutical Science students. No graphic calculators will
be permitted.
OPEN BOOK

YES

NO

SPECIFICALLY PERMITTED ITEMS

If yes, items permitted are:

YES

NO

Candidates must complete this section if required to write answers within this paper

STUDENT ID

__ __ __ __ __ __ __ __

DESK NUMBER

__ __ __ __

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Faculty of Pharmacy & Pharmaceutical Sciences

Unit Code: PAC3241

Semester One Examination 2014

Time allowed: 2.5 hrs

There are TWO SECTIONS in this exam. Section A must be answered in the exam
booklet provided. Section B must be answered using the Multiple Choice Answer sheet.
Section A is worth 80 marks and Section B is worth 20 marks. Answer both sections.
Answer ALL questions.
SECTION A (80 marks) - There are 11 questions in this section. Marks assigned to each
question are as indicated. Answer ALL questions in the exam booklet provided.
Answer a new question on a new page.

Question 1
Describe the rationale behind the following interactions and describe what advice you would
provide to the patient and/or prescriber in these situations:
(a) Oral contraceptives and antibiotics
(b) Verapamil and digoxin
(5 + 5 = 10 marks)
Question 2
Metoclopramide is a medicine used to treat nausea. When metoclopramide is co-administered
with paracetamol, the maximum plasma concentration of paracetamol is increased. When
metoclopramide is co-administered with digoxin, the maximum plasma concentration of digoxin
is reduced. Describe why these differences are observed.
(5 marks)
Question 3
Describe the interaction that occurs between charcoal and various orally administered
medicines. Discuss what approaches can be taken to avoid such an interaction and whether
this approach is suitable for all patients or requires some adjustment for certain patients.
(5 marks)
Question 4
It is recommended that special instructions be adhered to when dosing lithium to pregnant
women and immediately following childbirth. Describe what these special dosing instructions
are, the rationale behind these dosing instructions and what would occur to maternal lithium
concentrations if these dosing instructions are not adhered to.
(5 marks)
EXAMINATION CONTINUES OVER PAGE

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Faculty of Pharmacy & Pharmaceutical Sciences

Unit Code: PAC3241

Semester One Examination 2014

Time allowed: 2.5 hrs

Question 5
You are recommending an over-the-counter non-sedating antihistamine to a patient who has
never taken this medication before. In counselling the patient, you identify that the patient is
taking verapamil for their high blood pressure. Would you expect there to be a drug-drug
interaction, and if so, what patient counselling might you provide?
(5 marks)
Question 6
(a) Define the following drug metabolism concepts and explain how they would influence
response to codeine therapy:
I.

Ultrarapid CYP2D6 metabolism

II.

CYP3A4 enzyme inhibition

(2 + 3 = 5 marks)

(b) Describe the following types of metabolic transformations for codeine, including their impact
on compound polarity and therapeutic response
I.

Phase I

II.

Phase II
(3 + 2 = 5 marks)

Question 7
A patient has been routinely taking Arielieve for 2 years and exhibits steady state plasma
concentrations. Arielieve has an extraction ratio of 0.92 and exhibits a low degree of plasma
protein binding (63%). The fraction of Arielieve excreted unchanged in the urine is 0.1. What
would you expect to occur to the following parameters if the patient was prescribed bugsacillin
(a drug which is thought to significantly displaces Arielieve from plasma proteins)? In your
answer, you should state whether there is an increase, decrease or no change, and the reason
for this.
(a)

Hepatic clearance (1 mark)

(b)

Renal clearance (1 mark)

(c)

Total clearance (2 marks)

(d)

Steady state concentration (total) (2 marks)

(e)

Steady state concentration (unbound) (2 marks)

(1+1+2+2+2 = 8 marks)
EXAMINATION CONTINUES OVER PAGE

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Faculty of Pharmacy & Pharmaceutical Sciences

Unit Code: PAC3241

Semester One Examination 2014

Time allowed: 2.5 hrs

Question 8
Pharmacillin is a new synthetic penicillin used for the treatment of bacterial infections. The
total body clearance is reported to be 12 L/h, the volume of distribution is 17 L, the fraction
excreted unchanged is 0.8, and the fraction unbound in plasma is 0.8. Please note that the
normal glomerular filtration rate is 100ml/min.
a)

Calculate the renal clearance of pharmacillin (1 mark)

b)

Calculate the clearance of pharmacillin via filtration (1 mark)

c)

Calculate the clearance of pharmacillin via active secretion (1 mark)

(3 marks)

Question 9
An 80-year-old female patient who weighs 50 kg is admitted to hospital with heart failure and
possible renal impairment (serum creatinine = 0.14 mmol/L). The admitting doctor decides to
start treatment with quinapril (an ACE inhibitor). The normal dose of quinapril is 20mg daily
and is available in 5mg, 10mg and 20 mg scored tablets.
a)

Calculate the creatinine clearance for this patient

b)

The fraction excreted unchanged for quinapril is 0.8, and the extent of protein binding is
0.97. Calculate an appropriate dose of quinapril for this patient

c)

Discuss the assumptions and limitations of using the Cockcroft and Gault equation for
estimating creatinine clearance in this patient
(1+2+2 =5 marks)

Question 10
Liposomes have been employed as nanocarriers for the delivery of cancer chemotherapeutic
agents. Discuss the challenges and opportunities associated with this drug delivery approach.
(6 marks)
Question 11
Select THREE of the following topics and discuss (a) Factors affecting phase inversion of pharmaceutical emulsions
(b) Formulation considerations of suppositories vs. foam for rectal administration
(c) Oswald ripening phenomenon and pharmaceutical relevance
(d) Liquid crystals as controlled release drug delivery systems
(3 x 6 marks = 18 marks)
EXAMINATION CONTINUES OVER PAGE

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Faculty of Pharmacy & Pharmaceutical Sciences

Unit Code: PAC3241

Semester One Examination 2014

Time allowed: 2.5 hrs

SECTION B

This section is NOT released.

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