The first-generation sulfonylurea drug chlorpropamide has a…

The first-generation sulfonylurea drug chlorpropamide has a half-life of 25-60 hours and a duration of glycaemic effect of 24-72 h. The structurally related analogue, tolbutamide, has a much shorter duration of action, around 6-24 h.     a. With reference to the structures of the two compounds, and drug metabolism, suggest why chlorpropamide displays longer-lasting effects than tolbutamide. (3 marks) b. Clinical signs of hypoglycaemia developed in a 3-year-old boy 24 hours after he had mistakenly eaten some of the pretty blue-coloured chlorpropamide tablets, thinking they were sweets. Given that chlorpropamide is an acidic drug with a pKa of ~5.2, suggest an approach to treat the patient through enhanced elimination of the drug, with rationale. (2 marks)

PJ, a 60-year-old woman, has just been rushed to the Emergen…

PJ, a 60-year-old woman, has just been rushed to the Emergency Department with a chief complaint of crushing chest pain that keeps radiating to her lower jaw, left shoulder and arm. Initial management of AJ’s presenting condition is likely to include all the following, EXCEPT: