Assume that you have the position of Dr Johnson, diagnose Verra’s condition and identify the most appropriate treatment.

Q1. Verra is a University student in Northern Finland and lately, during her winter term, has been sluggish with her studies and life. She is not attending her morning gym exercises which she used to enjoy and cannot concentrate on her classes. She has texted to her friend Iida that she has been feeling exhausted, although she oversleeps and not being able to get up early in the morning. She feels like hibernating at home and keeps eating sweets and putting weight. Iida is concerned for Verra as she found out recently that she also doesn’t want to see her boyfriend Fredrik anymore. Iida took it upon her to go to discuss Verra’s situation with the University’s doctor, Dr Johnson, to find out if there is anything medically wrong with her friend, based on her symptoms, and what treatments are available that can possibly help her. Dr Johnson prior to immigrating to Finland for studying medicine had graduated from Middlesex University in London with a BSc Neuroscience. Assume that you have the position of Dr Johnson, diagnose Verra’s condition and identify the most appropriate treatment. Based on the expected learning outcomes from your Neuropharmacology module, you must provide a thorough explanation on: i) Verra’s pathophysiology (12.5 marks), 2.ii) Your choice of treatment (2.5 marks), and 3.iii) How your chosen treatment works (5 marks). Q2. You made plans with your friend Jason to order some pizza and watch the new Transformers movie. When you arrive at Jason’s apartment you smell a distinctive odour in the hall. When you open his door, a smoky cloud lingers in the living room. Jason has invited his cousin Max over and they seem to have been smoking something. Their eyes are red, they seem extremely relaxed, and there are food and candy wrappers all over the place. Jason says that he totally forgot you were coming over, but you should stay and hang out anyway. What have Jason and Max been smoking? Page 4 of 6 1.i) Determine what drug the individual in your case has been using and what led you to believe this. (2 marks) 2.ii) Describe the mode of action of this drug. (12 marks) iii) What would be the drug effects, at a cellular and behaviour level, if Jason and Max were also drinking alcohol instead of pizza? (6 marks) Q3. A 42-year-old man is addicted to heroin for many years, which is complicated by co- abuse of alcohol. He has been known to addictions services since 2006 and achieved only rare short-lived periods of sobriety associated with several drug-related prison sentences and over 15 hospital admissions. On present occasion he is delivered by the emergency services unconscious, his breathing is severely compromised, and his blood pressure is low. 1.i) Explain what drug should be prescribed for this patient to reverse his condition? (5 marks) 2.ii) What symptoms you should expect to see in the patient after administering this drug and why, how would you manage them? (5 marks) 3.iii) Describe the mechanisms of the patient’s addiction. (5 marks) 4.iv) How could development of tolerance to the abused drug, quitting it, and then relapsing have contributed to your patient’s reason for over-dosing and ending up in Emergency. (5 marks) Q4. 22-year-old Ben travelled to a remote village in Brazil, where he participated in a local ceremony that involved drinking a warm herbal beverage. Ben experienced an array of unusual sensations such as “being launched into space by a powerful rocket and meeting beautiful aliens”; however, shortly he developed an acute episode of extreme anxiety “what if I never come back to the Earth again” 1.i) What is the beverage Ben consumed, what are the active components and what is their mechanism of action? (15 marks) 2.ii) What other symptoms can Ben develop if he takes this beverage long-term? (5 marks) Q5. You are in a virtual Neuroscience lab for studies on cocaine. Describe a neurophysiological approach to test the hypothesis that dopamine is involved in cocaine seeking behaviour. Include in your answer: Page 5 of 6 1.i) The anatomical circuit to be tested, and how it will be tested experimentally (include the techniques will be employed in this experiment). (10 marks) 2.ii) The pharmacological effect of cocaine. (5 marks) iii) Typical neurophysiological and behavioural results expected from these experiments (e.g. draw characteristic figures based on the expected results and explain them) (5 marks). Q6. Dr. Roger Walther, Department of Clinical Pharmacology is conducting a study of theophylline in patients with asthma and he needs help. The problem is that clinicians have a difficult time dosing patients with theophylline. Different patients respond differently to the same theophylline dose—some patients respond well and their asthma is controlled. Other patients do not respond well and their asthma is uncontrolled or, just as worrisome, they experience toxic side effects. The question is why do different people respond so differently to theophylline? His clinical colleagues and himself thinks that there are certain patient characteristics that may predict how a patient may respond to theophylline. So they are doing a clinical trial on the dosing of theophylline and trying to identify predictive factors. Basically, when a patient is admitted to the hospital with uncontrolled asthma, they take a detailed history from the patient, and start the administration of theophylline by intravenous infusion at a rate of 0.5 mg per kg body weight per hour for 24 hours. They closely monitor each patient during this time to see if his or her asthmatic condition improves. Then they draw a 5 ml blood sample at 24 hours to determine what the theophylline blood concentrations are after the drug infusion period. From this they have collected data from all walks of life. You are provided with such data profiles of ten patients (patient cards are shown in Supplement Exam Document). You are to assume the role of an expert in drug therapeutics to help Dr Walter Walther. Based on the provided data cards discuss: 1.i) What is the therapeutic range of theophylline concentrations? (2.5 marks) 2.ii) What are the patient factors that influence theophylline blood concentrations and what is the relationship between the theophylline concentration with each factor? (2.5 marks) 3.iii) Why do you think these factors influence theophylline concentration? (12.5 marks) 4.iv) What theophylline dosing adjustments are needed for each patient factor? (2.5 marks).