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PH7.1-9 | Endocrine Pharmacology — Assignment

Grading Rubric — Endocrine Pharmacology — Assignment Rubric

Criterion	Points	Full-marks descriptor
Hypothyroidism Management (PH7.3) — Diagnosis, levothyroxine dosing rationale, interactions, and monitoring	5 pts	Exceeds: Correct diagnosis with full biochemical justification; accurate dose calculation (68 × 1.6 = 108.8, start at 25–50 mcg in older/cardiac patient); identifies ≥2 drug interactions (iron, calcium, antacids) with absorption mechanism (chelation); states TSH monitoring at 6–8 weeks.
Diabetes Optimisation (PH7.1) — Metformin dose adjustment for eGFR 48, add-on drug selection with eGFR rationale, antihypertensive choice, ADRs	5 pts	Exceeds: Correctly reduces metformin to 500 mg BD (eGFR 30–45 threshold) or stops (eGFR-45 conservative threshold) with lactic acidosis mechanism; chooses GLP-1 RA or SGLT2i (eGFR ≥45 for glycaemic; explains dual threshold); correctly recommends ACEi/ARB for proteinuria with RAAS mechanism; lists 2 ADRs for each drug chosen.
Osteoporosis Risk and Management (PH7.2, PH7.5) — Risk factor identification, GIOP prevention, drug selection with renal rationale, escalation criterion	5 pts	Exceeds: Identifies postmenopausal state + steroid use as risk factors with mechanisms (oestrogen deficiency → RANK-L/OPG imbalance; GC → ↑RANK-L + ↓osteoblast lifespan); correctly co-prescribes calcium 1–1.5 g/day + alendronate/risedronate for GIOP; chooses denosumab (no renal restriction, eGFR 48) over oral bisphosphonate with mechanistic justification; states severe disease (T-score ≤−3 + multiple fractures) as anabolic escalation criterion.
Integrated Prescription and Communication (PH7.3, PH7.1, PH7.5) — Safe combined drug list, counselling, interaction identification, patient communication	5 pts	Exceeds: Comprehensive and safe drug list (≥6 drugs with doses); correct levothyroxine timing instruction (fasting, 30-60 min before food; ≥4 hr from iron/calcium) with pharmacokinetic rationale (chelation reduces bioavailability); identifies a clinically significant interaction (e.g., calcium vs levothyroxine, or ACEi + potassium-sparing diuretic risk); patient explanation in clear, non-medical language appropriate to Indian rural context.