Paper II
2022 July (Supplementary) (2019 Scheme) · 100 marks · 180 min

Question

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  • (a) Discuss the pharmacological management of Hypertriglyceridemia. Add a note on Atorvastatin. ( 2 mark(s)
  • (b) Insulin Analogues. 2 mark(s)
Q34 marksShort Essays

Answer

a) Pharmacological management of hypertriglyceridemia, with a note on Atorvastatin Fibrates (Fenofibrate, Gemfibrozil) are the most effective agents for lowering triglycerides specifically, activating PPAR-alpha to increase lipoprotein lipase activity and fatty acid oxidation. Omega-3 fatty acids and Niacin are further options, particularly for severe hypertriglyceridemia. Statins primarily lower LDL but also modestly reduce triglycerides, and are used when combined dyslipidemia (raised LDL and triglycerides) is present.

Atorvastatin: inhibits HMG-CoA reductase, reducing hepatic cholesterol synthesis and upregulating LDL receptors, increasing LDL clearance; used for hypercholesterolemia and cardiovascular risk reduction. Adverse effects: myopathy (rare progression to rhabdomyolysis), hepatotoxicity.

b) Insulin Analogues Recombinant insulin molecules with amino-acid substitutions altering onset/duration to mimic physiological secretion more closely than regular/NPH insulin. Rapid-acting (Lispro, Aspart) — faster absorption, dosed with meals. Long-acting (Glargine, Detemir) — smooth, peakless basal profile, once-daily dosing, less nocturnal hypoglycemia than NPH.

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