Question 1 (Answer ALL parts): Synarel nasal sprays contain nafarelin acetate, a peptide drug (molecular weight 1322 g/mol), for the management of endometrioss. 1. Discuss why nafarelin acetate is provided as a nasal spray instead of an oral formulation such as tablets. (2 marks)

2. Following are key counselling point that should be provided to patients using nafarelin nasal spray. Explain the likely reasons for each advice. (2 marks) Nasal decongestants should not be administered less than 30 minutes after administering nafarelin. Prime the spray pump prior to first use Gently blow your nose to clear both nostrils before using nasal spray Bend head forward a little and put the spray tip into one nostril. Aim the tip toward the back and outer side of your nose. After spraying tilt your head backwards for a few seconds.

3. Outline the formulation characteristics of Synarel nasal spray and explain the purpose of excipients included in this formulation. (3 marks)

4. Briefly describe ONE approach that can be considered to reduce the dose of naferelin nasal spray and associated side effects. Your answer should explain how the selected approach can increase the bioavailability of nafarelin. (3 marks)