S Question

ttt of alzeheimer: tacrine (cholinesterase inhibitor), donepezil

557 Dementia: mental deterioration
Maximum dose of Donepizil
192 Donepzil maximum dose:10 mg/day
304 Maximum dose of Donepizil
Donepzil maximum dose:10 mg/day
Donepezil- what is the maximum dose?
Thiopental sod is ultra short acting general anesthetic due to its high
lipid solubility
Thiopental is highly lipid soluble thus cross the BBB
1435 Procaine is so liable to destruction by heat
431 Procaine is liable to destruction upon sterilization by heat
Procaine HCl is thermolabile
1280 Most IV anesthetics are barbiturates except ketamine
Most IV anasthetics are barbiturates e.g. thiopental, thiamylal,
897
methohexital … an exception is: ketamine
950 Local anesthetic NOT dministered topically is procaine
Lignocaine is long acting because it has amide structure BUT procaine
is NOT
Page 1 of 582
S Question
Lignocaine has longer duration of action because of its amide group
663
which resists hydrolysis
Lidocaine or lignocaine is not taken orally because it undergoes first
1127
pass effect
ketamine HCl (ketalar, ketaject): nonbarbiturate anesthetic, IM, IV,
1453
used for both diagnostic and minor surgical anesthesia
1322 Halothane is inhalational NOT IV
Ethylaminobenzoic acid (benzocaine): local, topical anesthetic,
benzoic acid derivative, rapidly hydrolized in boiling water, insoluble
in water but soluble in mineral acids
Droperidol is used as adjunct to anesthetics
Aromatic esters are: benzocaine, tetracaine, procaine -- aromatic
amides are: lidocaine, bupivacaine, mepivacaine
Adrenaline is given with local anesthetics to enhance their action by
vasoconstriction
Adrenalin is given with local anesthetic to prolong their duration
301 Decompose by heat sterilization: procaine
What casues acute intermittent porphyria… Enflurane, ketamine,
374
propofol, etomifate
Page 2 of 582
S Question
Thiopental Na is ultrashort acting phenobarbital due to its high lipid
solubility
536 Procaine is so liable to destruction upon heat
Procaine is not used topiclly
Procaine hydrolysis gives PABA
Lignocaine has longer duration of action because it has amide group
that resists hydrolysis
Droperidol is used as an adjuvant to anesthesia
Conscious anesthesia: fentanyl + midazolam
Chloral hydrate dose: 0.3-2 gm
Benzocaine is a benzoic acid derivative that is used as local and
topical anesthetic, rapidly hydrolysed in boiling water but in soluble
in water and soluble in mineral acids-- as it reacts with HCl, forms
soluble salts thus be soluble
NO anesthesia characterized by rapid induction
Lignocaine doesn't make CNS stimulation
225 Which one if sterilized by heat will decompose: procaine
Which one if sterilized by heat will decompose: procaine

Page 3 of 582
S Question
The clearance of Lignocaine has been decreased...Ans. Due to
reduced blood supply to the liver
Lignocaine long action due to : amide
When used to treat angina, nifedipine is much more likely than
verapamil and diltiazem to cause tachycardia, because verapamil and
diltiazem significantly decrease intracardiac conduction
Ventricular fibrillation is the most common complication of
myocardial infarction
The most specific laboratory investigation for MI cardiac troponin
The major determinant of myocardial oxygen deman is cardiac output
The best way to prescribe GTN is: (transdermal) absorbed through
the skin
SE of GTN is throbbing headache
Risk factors of athersclerosis: smoking, family history, HTN,
hyperlipidemia, BUT rheumatic fever is NOT RELATED
Pt with angina and have hypertensive crisis should take Na
niroprusside by slow IV infusion instead of diazoxide because of its
cardiostimulating effects
Page 4 of 582
S Question
Pain of angina is due to ischemia of certain area of the myocardium
963 Normal therapeutic dose of glyceryl trinitrate is 0.5-1mg
Nitrogycerin inc c-GMP = vasodilation
Nitrates are given sublingually because (to avoid) 1st pass effect NOT
destroyed by gastric acid
Nifedipine when used in angina is more likely to produce tachycardia
480
than verapamil and diltiazem
GTN: venodilator: dec blood return to the heart: dec preload
GTN tab:0.6mg, spray 400-600mcg/spray
Glyceryl nitrate is absorbed from the skin
Fibrinolytic in MI is C.I. in duodenal ulcer pts
744 CPK level inc in MI
Angina pectoris is due to ischemia of the heart muscle NOT due to MI
1189 Amyl nitrite is the only antianginal inhalation
Propranol in angina..- to block catecholamine action in heart...- beta
189
blocker agonist.

Page 5 of 582
S Question
Which one is wrong regarding the tolerance of nitrates?a) Tolerance
is rare with Isosorbid dinitrate (ISDN) b) Tolerance is high with
259
Isosorbid mononitrate (c)Schedule of taking nitrates causes torleance

Nitroglycerine could be used by which methods ..Oral , Iv ,

261
transdermal
29 Perhexiline interactions
Which one is wrong regarding the tolerance of nitrates? a) Tolerance
is rare with Isosorbid dinitrate (ISDN) b) Tolerance is high with
Isosorbid mononitrate ( c)Schedule of taking nitrates causes torleance
(or someting like this)
347 Which dec risk of MI : atenolod or nifedipine
Propanol in angina - to block catecholamine action in heart - beta
blocker agonist
Nitroglycerine could be used by which methods Oral , Iv ,
transdermal
Betaxolol can make worse which one of the cardiac
condition........Ans. aortic stenosis
516 Ventricular fibrilation is the most common complication of MI
Page 6 of 582
S Question
1397 Alcohol, sildenafil: vasodilators thus C.I. with NTG
134 Prehexilene drug interaction
Tolnaftate is ineffective against candida
Worms that are present in humans but not in animals:: ascaris,
anclystoma, oxyrious -- worms in men and animals:: faschiola,
hetrophes (fish), ?? -- in animals only: ??
Vancomycin is used to treat antibiotic-induced pseudomembranous
1170
colitis
Tubocurarine should not be taken with gentamicin
1082 ttt of methicillin resistent staph is vancomycin
Trimethoprim cause photosensitivity
Tombramycin and streptomycin resemble each other, both are
aminoglycosides
Tobramycin structure is similar to gentamicin
Tobramycin make hearing loss
Tobramycin causes hearing loss by affecting:: both auditory and
vestibular beanches of the 8th cranial nerve may be adversely
affected. Ototoxic damage may be reversible in up to half of the cases

Page 7 of 582
S Question
Ticarcillin is preferred to carbenicillin for pts with CHF , renal failure
or HTN because it is used in smalled doses than carbenicillin
Ticarcillin is preferred than carbenicillin because it is given in smaller
doses
702 Thrush= oral fungal infection (candidiasis)
The purpose of combined drug ttt in TB: dec and delay drug
671
resistence, inc anti-TB effect. NO effect on duration
Tetracyclines side effects : renal damage , hepatic damage , tooth
1399
discolouration
602 Tetracycline should not be taken in pregnancy
Tetracycline is contraindicated in pregnancy
Tetracyclin should not be given to neonates because it leads to
discoloration of teeth
Tetracyclin SE: discolorization of teeth
660 Tetracyclin in C.I in pregnancy
Tetracyclin gives different patterns of absorption and dissolution
because it is amphoteric : forms salts with acids and bases and is
capable of forming internal salt
TB: mantox test, tuberculin test
Page 8 of 582
S Question
Systemic anaerobic infection is ttt by metronidazole
Syphilis ttt: penicillin G, quinolone, chloramphenicol
Synergism between sulfamethoxazole and trimethoprim is because
they block sequential steps in folic acid synthesis pathway preventing
DNA syn
839 sulpha preparations are long acting because of PPB
Sulfonamides SE: rash, fever, blood dyscrasias
Sulfonamides SE: blood dyscrasias, rash, fever, steven-johnson
syndrome
Sulfonamide must have a non substitute amino group essential for
antibacterial activity
Sulfonamide best suited for the topical prophylactic ttt of burns:
mafenide (sulfamylon cr), silver sulfadiazine. NOT: sulfacetamide,
sulfameter, phthalylsulfathiazole, sulfamethoxypyridazine.
Sulfisoxazole causes kernicterus in neonates
Sulfamethoxypyridine is long acting due to plasma protein binding
Sulfamethoxypyridine is long acting as it is highly bound to plasma
1391
protein
Sulfa drugs are not liable to destruction by heat
Page 9 of 582
S Question
Streptococcus viridans: subacute bacterial endocarditis, ttt ampicillin
+ aminoglycoside --- streptococcus pyrogens: throat, scarlet fever,
rheumatic fever --- streptococcus fecalis(enterococci F.): nosocomial
hospital infection
Steven johnson syndrome: SE of sulfisoxazole
Staph. Aureus: bone infection -- clostridium difficile:
1469 pseudomembranous colitis -- Ecoli: UTIs, meningitis -- proteus
mirabilis: UTI, Ps. Auroginosa -- treponema pallidum: syphilis
Spectinomycin is used for ttt of gonorrhea in pts with sensitivity to
penicillin or with resistent gonococci
1394 Slow acetylators develop rapid neuropathy with INH
SE of vancomycin: ototoxicity
959 SE of pentamidine: severe hypotension
SE of nalidixic acif: photosensitivity, visual disturbances (as
amiodarone)
SE of ketoconazole is gynecomastia and hepatotoxicity
435 SE of INH is peripheral neuritis
926 SE of clindamycin: diarrhea
456 Safest sulfonamide to allergic pts is sulfamethizole
Page 10 of 582
S Question
551 Safest sulfonamide to allergic pt is sulfamethizole
Rifampine cause damage to contact lenses , urine discolouration
Rifampicine cause red urine
428 Rifampicin may cause orange colouration of contact lense
Rifampicin is taken before meals, it is taken with INH to dec bacterial
resistance
Rifampicin cause descoloration of lens, urine, sweat
Radial walker test: disinfectant and germicidal action
Quinolone SE: CNS stimulation
Quinolone # DNA gyrase -- erythromycin # protein synthesis --
624 streptomycin # protein syn (# 30S) -- TC # protein syn (30S) --
chloramphenicol # protein syn (50S)
Pyrvinium Pamoate tablets: cause N,V,D - swallowed whole without
chewing, stain stool red for several days, should not be used in pts
with inflammatory conditions of GIT
1162 Pyrivinim pamoate is a dye used in the ttt of pinworn in humans
Pyrazinamide: arthrlgia + hyperuricemia
Pyrazinamide SE: arthralgia ( inc uric acid in blood) --- ethambutol SE:
1260
red-green blindness
Page 11 of 582
S Question
Purulent boils in the ear are usually caused by staph
1074 Pt with ampicillin allergy should not take imipenem
Pt on erythromycin and warfarin for 5 days:: dec warfarin to half for 5
days
1403 Pt allergic to penicillins sould not take carbapenems
748 Pseudomembranous colitis ttt: vancomycin, metronidazole, TC
832 Primaquine cause hemolytic anemia in G6PD deficiency
683 Pregnants allergic to penicillin V should take erythromycin
Postmenoposal vaginal infection is by: E-coli
981 Polymixin B is similar to bacitracin (colistin)
843 Photosensitivity is SE of nalidixic acid, griseofulvin
1287 Photosensitivity is SE of nalidixic acid and griseofulvin
1242 Phenyl murcuric nitrate is nonirritant bacteriostatic
Phenyl Hg nitrate: preservative in eye drops, sporocidal
962 Phenyl Hg nitrate in low doses is sporocidal
Pheny Hg nitrate use: sporocidal
Phenazopyridine is effective as urinary analgesic
Phenazopyridine (pyridium): urinary tract analgesic, causes red urine

Page 12 of 582
S Question
Pentids (penicillin G tablets): take on an empty stomach.. In order to
limit destruction by acid hydrolysis, penicillin G tablets should be
taken on an empty stomach when gastric acid is at its lowest level.
Pentids taken 1hr before or 2hr after meals
Pentamidine: ttt of PCP in HIV
Penicillinase-resistant penicillins: methicillin, nafcillin, cloxacillin,
dicloxacillin
Penicillinase resistant penicillins : methicillin, nafcillin, cloxacillin,
dicloxacillin,fluoxacillin, oxacillin
549 Penicillin should be taken 1/2 hr before food
Penicillin should be administered on empty stomach
Penicillin is recommended on empty stomach BUT NOT diazepam
Penicillin is excreted by tubular secretion from kidney but
aminoglycosides by GF
1328 Penicillin has a B-lactam ring - erythromycin has a lactam ring
Penicillin allergic pts should shift to erythromycin not cephalosporins
Pencillin # transpeptidase enzyme
992 Pencillin # cell wall syn by # of transpeptidase
1141 Oxacillin=penicillinase resistant
Page 13 of 582
S Question
Otitis media, sinusitis are caused by: H.inf, strept.pneumonia,
1087
moraxella --- ttt: amoxicillin, TMP-SMZ, cefixime, cefaclor
892 Nystatine is used for ttt of candida
502 Nystatine is D O C for moniliasis ( candidiasis )
Nystatine can be taken topically NOT ketoconazol, griseofulvin ??
774 Nystatine advice: swish ans swallow
Nystatin # candida albicans -- griseofulvin # tinea capitis --
streptomycin # TB -- penicillin G# gonococci -- dapsone # leprosy
779 Not taken with metronidazole = alcohol
Nitofurantoin is useful against g+,-ve UTIs, more effective in acidic
urine
Niclosamide is used in the ttt of tapeworm
1099 Niclosamide is used in tape worm infections
Niclosamide is used for ttt of tapeworm
Nalidixic acid can cause phototoxic reaction
776 Nalidixic acid absorption is decreased by food, antacids
457 Nafcillin=penicillinase resistant
1393 Na/K acid phosphate : dec urine pH : inc methenamine activity
888 MRSA ttt: vancomycin and may be with rifampicin
Page 14 of 582
S Question
Moxifloxacin is quinolone
Moxifloxacin is quinolone
Most suitable oral sulfisoxazole is acetyl sulfisoxazole
Most important worm in children is Oxyuris (pin worm) ttt by
1389
mebendazole (as ascaris ttt)
Most common SE of ketoconazole are: GIT disturbance and headache
MOA::: sulfonamides # growth by competitive antagonism --
cephalosporines,penicillins: # cell wall synth -- polymixin, nystatin,
amphotricinB: # cell membrane function ---macrolides, TC,
chloramphenicol: # protein synthesis
MO which is dangerous to eye is Pseudomonas aeruginosa
Minocycline SE: giddiness (drowsiness), headache, abdominal cramps,
allergic reactions, CNS effect (vertigo, ataxia), discoloration of teeth,
hepatotoxicity, nephrotoxicity, N,V,D, vestibular toxicity (ataxia,
dizziness, vomiting)
1096 Metronidazole is used for ttt of anaerobic infections
527 Methicillin=pencillinase resistant
Methicillin is used in the ttt of staph, G+ve, used in upper respiratory
infection?? -- only parentral not oral because of insatbility
Page 15 of 582
S Question
886 Metabolism of PAS and INH by acetylation
1443 Meningitis: N.meningitidis -- H. influenza -- strept. Pneumonia, E-coli
Medication used in methicillin resistant staph: vancomycin
Mebendazole is anthelmentic
Mebendazole is anthelmentic
Mantox test:: old tuberculin
LYME disease is caused by spirochetes borrelia carried by ticks ---
783 symptoms: rash, malaise, arthritis --- ttt: doxycyclin, TC - very severe:
IV ceftriaxone
Lice can infest man , dog
1075 Ketoconazole SE: GIT, headache, gynecomastia
Ketoconazole needs acid medium to be activated thus it is C.I. with
1271
famotidine which dec HCl
Ketoconazole is only oral antifungal - amphotericin B : topical ,
1120
injection
ketoconazole is C.I W antacids, H2blockers, PPIs, cisapride,
803 amphotricin B, food.---
ketoconazole+ astemizole/terfinadine= life-threatening reaction
Ketoconazole interact with warfrin
Page 16 of 582
S Question
1331 Ketoconazole can be administered orally
Ketoconazole can be administered orally
Ketoconazol SE: GIT, headache,?? Gynecomastia ??
841 Kanamycin is an aminoglycoside affect 8th cranial nerve
Kanamycin + FeSO4 = deafness due to damage of the 8th cranial
1163
nerve and effect on auditory nerve function
864 K phospahte inc methenamine activity by dec pH of the urine
891 K content of K penicillin G is 1.7 m Eq/ million U
Isoniazide causes peripheral neuritis due to INH-induced pyridoxine
deficiency
INH=isonicotinic acid hydrazine is the most potent anti-TB
INH is metabolized by acetylation
1434 INH cause neuritis on prolonged use on slow acetylators
INH cause lactic acidosis (ttt by NaHCO3), pripheral neuritis (ttt by vit
1004
B6)
Infectious mononucleosis: is assossiated with high insidence of rash
after ampicillin injection

Page 17 of 582
S Question
Impetigo: early vesicular lesions develop into bullae which quickly
rupture leaving thick yellowish crusts, multiple lesions of different
ages are present, often on the face and legs, staph. Aureus is
responsible for 10-20% of impetigo cases esp. children
Impetigo: bacterial infection
Impetigo is contagious and caused by: staph. Aureus
Impetigo is a contagious disease caused by staph. Aureus - it does not
1276
cause endocarditis
771 Impetigo cause all except endocarditis
Hydroxychloroquine is antimalarial used in SLE and rheumatoid
arthritis, C.I in favism
999 Hydroxychloroquine causes photosensitivity
High nitrite indicate bacteria in urine
Hansen: leprosy
Griseofulvin is taken after food
Griseofulvin is prepared in microcrystalline form to inhance solubility
791
and absorption
Griseofulvin is prepared in microcrystalline form to enhance its
825
solubility, absorption
Page 18 of 582
S Question
Griseofulvin is prepared in a microcrystalline form to inc its solubility
807
and absorption
Griseofulvin is LME inducer so interact with OC
1412 Griseofulvin is antifungal which is not used topically
Griseofulvin , nitrofurantoin are given after meals --- penicillins,
tetracyclin, rifampin are given before meals
1304 Giardiasis ttt: metronidazole, quinacrine
Gentamicin is most effective against pseudomonas aerogenosa and
against G- bacteria in general
Gentamicin is active bactericidal against G-ve
Gentamicin is active against g-ve, E-coli, 1st choice against
1180
pseudomonas auroginosa
Gentamicin causes deafness due to auditory and vestibular damage
Gentamicin (aminoglycosides) is more effective in alk urine ---
1244
nitofurantoin and TC: more effective in acidic urine
Gantrisin: take with a large volume of water -- sulfonamides are taken
with a large volume of water to insure a volume of urine adequate to
keep the excretory products in solution. Crystaluria has occurred with
some sulfonamides
Page 19 of 582
S Question
Fluxacillin syrup must be refrigirated
637 Fluoxacillin=penicillinase resistant
1149 Floxacillin syrup must be refrigirated
Fansidar (antimalarial) : sulfadoxime 400+ pyrimethamine 80 ---
cotrimoxazole: sulfasoxazole+ trimethoprime -- otitis media:
erythromycin + sulfasoxazol
Expired tetracycline: fanconi-like syndrome
Erythromycin: would be a good alternative to penicillin V in a
pregnant pt allergic to penicillins. NOT: demeclocyclin, TC,
trimethoprim
Erythromycin is taken as enteric coated tablets as it is destroyed by
1269
HCl of the stomach
Erythromycin interacts with oral anticoagulants and inc levels of
carbamazepine, digoxin,theophylline
Erythromycin interact with: oral anticoagulants, carbamazepine,
digoxin, theophylline
Erythromycin inc the effect of aminophylline
1348 Erythromycin does NOT affect the bioavailability of ketoconazole
E coli is the most common MO in complicate UTI
Page 20 of 582
S Question
1342 Drugs excreted by active tubular secretion = penicillin
Drug which is used in methicillin resistant staph: vancomycin
Drug used in anaerobic infections: metronidazole
Drug that would be most appropriate to treat gonorrhea in a poorly
compliant pt with a documented penicillin allergy: spectinomycin.
NOT: amoxicillin, TC, clindamycin, piperacillin
Drug of choice in H. influenza is ampicillin
Drug of choice for E-coli is co-trimoxazole
471 Drug of choice for E coli is cotrimoxazole
Drug effective against giardiasis: tinidazole
1312 Doses:: erythromycin:0.25-0.5g qid
Dose of chloroquine in malaria: 500mg once weekly
Discarding of outdated tetracycline is important because: it changes
to a more toxic form
Dicloxacillin=penicillinase resistant
Degradation of penicillin is by hydrolysis
Common SE of chloramphenicol: aplastic anemia, gray baby
syndrome
Common SE of chloramphenicol is aplastic anemia
Page 21 of 582
S Question
Coadministration of kaolin with lincomycin cause impairment of
lincomycin absorption
1134 Cloxacillin=penicillinase resistant
Clotrimazole, nystatin: ttt of candidiasis
577 Clotrimazole is bactericidal that # folic a` synthesis
Clostridium difficile: causes enteroclitis
865 Clindamycin: water soluble
Clindamycin is very sol in H2O -- not in ( alc, alc+propylene glycol)
Clarithromycin: macrolide antibiotic
Clarithromycin is active against : mycoplasma chlamydia, legionella,
helicobacter pylori
Ciprofloxacin: enzyme inhibitor: inc theophylline toxicity
1349 Chloramphenicol SE: aplastic anemia
710 Chloramphenicol SE is aplastic anemia
Chloramphenicol is indicated primarily for typhoid fever
555 Chloramphenicol is a polymorphic drug
Chloramphenicol in infants leads to gray syndrom because of
1043 deficient glucuronyl trasferase -- gray syndrome: cyanosis, vascular
collapse, elevated chloramphenicol levels in blood
Page 22 of 582
S Question
695 Chlamydia: asymptomatic in females, dysuria in males
Ceftraixone, cefotaxime: cross BBB: ttt of meningitis
708 Caspofungin # asperagillus
B-lactamase is a plasmid mediated enzyme
Benzyl penicillin is used in pneumonia
Antitubercular drugs: isoniazide, streptomycin, PASA, rifampicin, BUT
420
NOT tobramycin
Antipseudomonal penicillins: carbenicillin, ticarcillin, mezlocillin,
piperacillin
Antipseudomonal penicillins: carbenicillin, ticarcillin, mezlocillin,
piperacillin
969 Antimicrobials: H2O2, isopropyl alcohol, phenol
811 Antibiotic induced ps. Colitis is ttt with vancomycin
ANTHELMENTIC OF CHOICE: tape worm: niclosamide -- thread worm:
thiabendazole
868
-- pin worm, round worm: pyrantel pamoate -- whip worm, hook
worm: mebendazole
613 Ampicillin suspention should be refrigirated 2-8 C but not freezed
874 Ampicillin suspension should be refrigirated
Page 23 of 582
S Question
Ampicillin SE: diarrhea
609 Ampicillin is 1st choice in ttt of H.influenza
Amoxicillin is used in the ttt of otitis media
Amoxicillin + calvulenic acid = cholestatic jaundice and hepatotoxicity
1251 Aminoglycosides cause damage to 8th cranial nerve
Aminoglycosides can be given once daily
Aminoglycosides are effective against pseudomonas infections BUT
684
chloramphenicol is NOT
Aminoglycosides are effective against pseudomonas infection BUT
chloramphenicol is not
Aluminium hydroxide iS C.I. with tetracyclines
Airborne grame +ve legionella pneumophila cause legionnaire's
701
disease, ttt by erythromycin
Advice for pt taking penicillin is take it 2hrs before food or on empty
988
stomach
Acid-stable (oral) penicillins: ampicillin, amoxicillin, penicillin V
(phenoxymethylpenicillin), penicillin G Na and K salts
Acid stable (oral) penicillins: ampicillin, amoxicillin, penicillin V,
penicillin G Na and K salts
Page 24 of 582
S Question
Achromycin V: don't take with milk or antacids -- milk and antacids
reduce the absorption of tetracycline by forming insoluble complexes
(cont.) of all the listed, erythromycin has the lowest degree of toxicity
and the spectrum of action most similar to ampicillin. Demeclocyclin
and TC may # skeletal growth in fetuses
(cont.) deposition of TC in the teeth of fetuses has been associated
with enamel defectscand staining of teeth. Trimethoprim is
teratogenic
(cont. tobramycin) but damage may be continued even after the drug
has been discontinued. Dizzines, vertigo, tinnitus and hearing loss
have been reported
(cont. spectinomycin) or may be given to pts who are allergic to
penicillin & are unable to tolerate or unlikely to comply with a 5-day
TC regimen. It's given as a single 2-gm IM injection and produce a
cure in 90% of pts
(cont. spectinomycin) it's an aminocyclitol antibiotic related to the
aminoglycosides. While it's active against many G+, G- organisms, it's
generally reserved for ttt of gonorrhea in pts who fail ttt with
penicillin, amoxicillin or TC;
Page 25 of 582
S Question
(cont. mafenide) sulfamylon cr applied topically to burns has been
found to be quite effective in # invasion of the affected site by both
G+ & G- bacteria, the cr is usually applied to a thickness of about 1/16
inch bid over the entire burnt surface
(cont. AHA) the lowering of NH3 levels and PH enhances the
effectiveness of the antimicrobial agent with which it's used and inc
the cure rate
(cont. AHA) some pts taking AHA have developed skin rash after
drinking alcohol. AHA chelates iron, which should not be taken
concomitantly. It is available as 250-mg tablets
(cont. AHA) AHA also may prevent the formation of Staghorn renal
calculi and facilitate the dissolution of preexisting stones. It does not
have an antibacterial effect, nor does it acidify urine directly.
Nystatine: ttt of moniliasis (candida albicans)
Vancomycin causes ototoxicity
Rifampin and phenobarbital are CYP enzyme inducers
Nystatin is not absorbed from GIT
Metronidazole used in ttt of anaerobic peritonitis
Ciprofloxacin not to be taken with urine alkanizers
Page 26 of 582
S Question
Case about cephalothin(v.easy) about 5 Q's
Which of the following organism is responsible for the
pseudomembraneous colitis?A. Clostridium dificile
169
b. Clostridium tetani...c. Clostridium perfringes...d.Clostridium
monocytogenes
Drug used for bacterial Vaginosis?
What is the most appropriate advice for a patient who takes
184 Metronidazole? a) Do not take with grapefruit juice...b) Do not drink
alcohol 24h before taking Metronidazole...C) Take it with food
207 Longest half life: doxycycline
which of these medications causes acute renal failure?a) Vancomycin
283
b) Amphotericin B
Which cause of clostridium difficile- tetracycline - macrolides-
264
cephalexin
What should Doxycycline not be taken with?a) Milk b) Iron
289
supplements
222 tubular secretion will increase levels of : penicillin
227 Throat infection: streptococcus pyogenes
272 Tetracycline has an amphoteric structure
Page 27 of 582
S Question
300 Tetracycline disadvanges:-aplastic anemia-Liver and kidney damage
238 Griseofulvine causes failure of which therapy (contraceptives)
228 Dapsone for leprosy
Which combination inh metabolism of other drugs (voriconazole +
131
warfarin)
9 Vancomycin side effect: ototoxicity
44 Tolnaftate: antifungal- keratolytic-astringent-anti-inflamatory
Pseudomembranous colitis is caused by which bacteria? Which drug
82
???
98 Endotoxins released by bacteria causes increase in body temperature
Drugs in pregnancy that does not have enough studies? Ciprofloxacin-
66
Erythromycin-penicillin-Cephalexin
Cephalosporin dose adjustment is a must in .. Renal failure .. Liver
140
failure… CHF .. Pulmonary fibrosis
137 Cause of pertussis … garm +ve bacteria , gram -ve bacteria, anaerobic
76 Ampicillin activity is similar to amoxicillin
Whooping cough.........2 questions.

Page 28 of 582
S Question
Which one is not a side effect of aminoglycosides?...Ans. Anaemia
with increased iron in blood. Because it is not affected by
G6Pdeficiency
Which of these medications causes acute renal failure? a)
Vancomycin b) Amphotericin B
Which cause of clostridium difficile - tetracycline - macrolides -
cephalexin
What should Doxycycline not be taken with? a) Milk b) Iron
supplements
What is the most appropriate advice for a patient who takes
Metronidazole? a) Do not take with grapefruit juice b) Do not drink
alcohol 24h before taking Metronidazole C) Take it with food
Urinary infection.......drug of choice is augmentin....for women.
Tubular secretion will increase levels of : penicillin
Throat infection: streptococcus pyogenes
Tetracycline disadvanges: -aplastic anemia -Liver and kidney damage
Rifampicin monitoring.
Penicillin’s normal allergy. What antibiotics can be used?Ans:
Cephalexin. If it is anaphylactic then Beta-lactams must be avoided.
Page 29 of 582
S Question
Penicillin v structure
Orally Unstable.....Ans. Nystatin
Oral antifungal treatment..... Ans. Fluconazole
Longest half life: doxycycline
Griseofulvine causes failure of which therapy (contraceptives)
Grandular fever.......which should not be used? Ans. Amoxycillin.
E.coli causes what? a) Endocarditis b) Appendicitis c) Traveler’s
Diarrhea
Drug used for otitis media that has systemic involvement: amox,
363
ticarcillin, cefoxitin, erythro, cipro
306 Drug that worsens skin sunburns? Doxycyxline-ketocoazole-....
Drug of Choice for Cellulitis. Can’t take penicillin. What are the
options? .......Ans. Clindamycin
Dapsone for leprosy
Counselling use of antifungal pessaries and creams - what is wrong?
a) Its contraindicated in pregnancy b) excessive use can cause
allergies c) if the course is not finished the fungus might come back.
d) if thrush happens often it can be a sign for diabetes and needs to
be checked by a GP
Page 30 of 582
S Question
Clostridium Difficille infection related question
333 Clarithromycin related something
Chloramphenicol......... Renally cleared., so dose reduction is
necessary.
Case profile. Patient is going to have dental surgery. Ans: Should be
treated with penicillin before surgery
Amphotericin causes wht?..........Ans. Decrease in K+ level.
Amino glycoside contraindicated with furesemide
Penicillin # transpeptidase enzyme so # bactreial cell wall synthesis
790 To kill spores heat at 100 C for 30 min in moist heat for 3 days
Drugs that interact with milk, antacids include tetracycline’s,
94
cephalosporin except erythromycin
1323 Sulfa is not liable to decomposition by heat
Ketoconazole needs the presence of stomach acid for adequate
763
absorption so interact with famotidine
E.coli causes what?a) Endocarditis b) Appendicitisc) Traveler’s
276
Diarrhea
255 Amino glycoside contraindicated with furesemide
Tubocurarine should not be taken in pts on gentamicin
Page 31 of 582
S Question
1345 Penicillin is recommended on empty stomach but not diazepam
Miconazole: antifungal -- glyburide: hypoglycemic
Linezolide : antibacterial, reversible nonselective MAOI, does NOT
1248 need dose adjustment in renal failure also fosinopril does NOT need
dose adjustment in renal failure
579 Sulfonamides are metabolized by acetylation
540 INH, PAS, hydralazine, sulfonamides are metabolized by acetylation
990 B-lactams are metabolized by hydrolysis
Nalidixic acid + phenothiazines = phototoxic reaction
Warfarin, dicumarol both have coumarine structure thus have
anticoagulant activity
Warfarin toxicity: skin necrosis and purple discoloration of the toes,
hemorrhage, ttt by vit K
Warfarin MOA: interfare with vitamin K dependant synth of active
clotting factor II (prothrombin), VII, IX, X, and the anticoagulant
1210
protein C, S (these agents prolong clotting time in vitro only ),
warfarin has optical isomers
Warfarin is safe to be taken with allopurinol
Warfarin is active due to a specific sterioisomer
Page 32 of 582
S Question
Warfarin has optical isomers
Warfarin can be used in different therapeutic forms because it has
optically active centers
TXA2 induce platelet aggregation
Tranexamic acid, aminocaproic acid and aprotinin are all
antifibrinolytic
The PT of pts on antocoagulant therapy with coumarin or
phenindione derivatives will be decreased by: vit K. PT: the time it
takes for fibrin to gel in plasma after addition of Ca and
thromboplastin.
The initiation of therapy with chlorpheniramine maleate would be
least likely to cause therapeutic problems in pts already taking
warfarin because it will not displace warfarin from it plasma protein
binding sites
1351 Streptokinase: 1.5 million IU (IV inf) over 60 min
Streptokinase not given within 6 months from previous
459
administration due to allergy (antibody-antigen reaction)
Streptokinase is given IV, never IM to avoid hematoma
Streptokinase is contraindicated ib pt with peptic ulcer
Page 33 of 582
S Question
Streptokinase in pts receiving simultaneous ttt with platelet
aggregation inhibitors, e.g. aspirin, phenylbutazone, dipyridamole,
and NSAIDs, for elderly pts should not be repeated within 12 months
of last course
Sodium Heparin USP should always be ordered in units rather than
mg because: the use of standard units/ml of preparations gives a
more reproducible dose. Heparin is not a uniform molecular species,
therefore, should be prescribed in units rather than mg
Pt takeing warfarin should avoid phenylephrine as it is alpha agonis
1327
thus increase platelet aggregation
539 Protamine sulfate is antidote for heparin
Platelet aggregation inhibitors: cefotetan, cefoperazone,
690
cefamandole, moxolactam, ketorolac
693 Normal prothrompin time: 12-15 seconds - APPTT: 30-45 seconds
Na heparine is obtained from beef lung
MOA of warfarin: inhibit vit K epoxide reductase

Page 34 of 582
S Question
In treating excessive heparin with protamine sulfate, caution must be
exercised to avoid more protamine than is necessary because
protamine sulfat is anticoagulant, it is unadvisable to give more than
100mg over a short time unless there's a definit need
If a pt receiving heparin suffers from gum bleeding: should be advised
1207
to wait until action of heparin subsides
If a pt on oral anticoagulant therapy experiences mild to moderate
bleeding, the desirability of administering vit K should be weighed
against the underlying need for the naticoagulant therapy because
with use of vit K will make it much more difficult to:s
Hypoprothrombinemia: dec ability of blood to clot -- to reverse
hypoprothrombinemia: adm. Fresh blood plasma
Heparin is the anticoagulant of choice in pregnancy because it does
not cross the placenta
Heparin is anticoagulant of choice in pregnancy; it inhibits conversion
912
of prothrombin to thrombin
Heparin is administered SC
Heparin delay thrombin formation??

Page 35 of 582
S Question
Heparin anticoagulant activity is monitored by activated partial
974
thromboplastin time(APTT)
Coumadin: do not use aspirin without knowledge of your physician or
pharmacist
945 Clofibrate dec platelet aggregation, inc hepatic cancer
443 Chlorpheniramine maleate can be used safely with warfarine
Aspirin should not be taken with coumarin
Aspirin should NOT be taken with coumarin
Aspirin inhibit platelet aggregation
Anticoagulant of choice for use in pregnant pt near the time of
delivery: heparin, it is a high molecular weight mucopolysaccharide
2166
that does not cross the placenta- prothrombin time in mother should
be closely monitored to dec the risk of fetal hemorrhag
Aminocaproic acid, tranexamic acid: antifibrinolysin used in toxic
1122
doses of streptokinase, alteplase (fibrinolytic agents)
Aminocaproic acid is used as antifibrinolytic agent , ttt of
hemmorrhage due to fibrinolytics
Alteplase is thrombolytic agent

Page 36 of 582
S Question
(continue PT) the PT of pts on coumarin drugs is prolonged because
of the reduced activity of several blood factors. Vit K antagonizes the
action of these anticoagulants and therefore shortens PT
(continue protamine) protamine is a strongly basic substance that
combines with the strongly acidic heparin to produce a stable salt and
loss of anticoagulant properties
(continue oral anticoagulant versus vit K) retitrate the pt on the oral
anticoagulant. The adminstration of vit K1 (phytonadione) will correct
oral anticoagulant-induced bleeding within a few hours.. This should
be only in severe hemorrhage cases
(continue heparin) the old equivalence of 100mg=10000U is a poor
approximation because the USP specifies the potency to be not less
than 120U/mg when derived from lung tissue and not less than
140U/mg when derived from other tissues
(continue heparin) potency shoukd be 90-110% of what is stated on
the label. If the physician orders 100mg of heparin, it is not clear
whether he means 10000 or 12000U or some other quantity

Page 37 of 582
S Question
(cont. warfarin interactions) but drugs like: phenylbutazone,
indomethacin, aspirin, tolbutamide have high affinity for plasma
protein binding, so cause therapeutic problems with warfarin
Question about coagulation factors? Thrombin- fibirin- need Ca ions-
...
Advantages of LMW heparins compared with unfractionated
Heparins. Which one does not apply?a) Less osteoporosis..b) Less
231
HIT…...c) Same Method of checking..d) Longer Half life.e) can be given
i.m.
80 Warfarin interacts with voriconazole
359 Warfarin is optical isomer
Question about coagulation factors? Thrombin- fibirin- need Ca ions-
311
…
Monitoring of Heparin............Ans. APTT
Heparin overdosing? What should be used?Ans: Protamine
Advantages of LMW heparins compared with unfractionated
Heparins. Which one does not apply? a) Less osteoporosis b) Less HIT
c) Same Method of checking d) Longer Half life e) can be given i.m.

Page 38 of 582
S Question
Which of the following will increase warfarin activity?a. paracetamol
171
..b. esomeprazole
328 Drug interactions related to Simvastatin, warfarin, CCB.
Remove Ca ions, add citrate salts to prevent blood clotting taken
from volunteer
Chlopheniramine maleate, allopurinol can be given safely with
760
warfrin
Phenobarbitone Na + chloramphenicol= pptn of barbituric acid
Na phenobarbitone + chloamphenicol = pptn of barbituric acid
1448 Zolpidem: fast onset, short duration hypnotic
802 Triazolam (short acting benzodiazepine) : hypnotic in elderly
1417 Thiopental is highly lipid soluble that is cross BBB
Thiopental = ultrashort acting barbiturate
Temazepam: it is metabolized to inactive metabolite in the liver by
glucuronidation. Temazepam is metabolized pricipally in the liver
where most of the drug is directly conjugated to the glucuronide and
excreted in the urine ???
Temazepam: it is metabolized outside the liver (OTL) to active
oxazepam
Page 39 of 582
S Question
Sleep aids: melatonine, tryptiphan (in milk), doxylamine,
535
diphenhydramine
Short acting benzodiazepines: alprazolam, lorazepam, temazepam,
1109
zolpidem, oxazepam, triazolam:: are used with elderly pts
932 Phenobarnitone is a metabolite of primadone
1174 Phenobarbitone Na ( basic ) may ppt in urine
Phenbarbitone is metabolized in liver by CYP450 then oxidation then
conjugation
1380 Normal hypnotic dose of chloral hydrate= 3-2 gm
Nitrazepan= have a t1/2 of 30 hrs produce long daytime sedation
629 which should be avoided in the elderly to avoid falls , fractures due to
accumulation of nitrazepam sedative effects
Nitrazepam is not used for the ttt of insomnia in elderly pts but we
can use oxazepam, lorazepam
Nitrazepam has t1/2=25-35 hr. produce long daytime sedation which
472 should be avoided in elderly pt to avoid falls and fractures due to
sedative effect
Nirtrazepam is NOT use in the ttt of insomnia in elders
Na phenobarbital ( enzyme inducer ) affect OC
Page 40 of 582
S Question
Mechanism of GABA: inhibitory neurotransmitter acting on:: GABA A
inc Cl conductance -- GABA B presynaptic: dec Ca conductance,
postsynaptic: inc K conductance
542 Lorazepam is the most suitable night sedative for elders
Lorazepam is a BZD which is preferred to be used as anxiolytic drug
1332
for elderly pt with history of cirrhosis
GABA is inhibitiry neurotransmitter in brain
Flurazepam: longest duration benzodiazepine (BZD)
Flurazepam is the benzodiazepin which has the least hypnotic effect
and cause hangover sedation as SE
examples of benzodiazepines: triazolam, flurazepam, alprazolam,
temazepam, lorazepam-- flurazepam have FDA approval for use as a
hypnotic but its least effective for this purpose and the most likely to
cause hangover sedation.
Drug-induced neonatal jaundice can be ttt with: phenobarbital.
Although exchange transfusion have traditionally been used to
manage hyperbilirubinemia, this ttt rarely dec the bilirubin to even
1/2 of its pretransfusion level and exposes the neonate

Page 41 of 582
S Question
Diazepam is different from temazepam in that diazepam has longer
duration of action than temazepam
735 Carbamazepine induce its own metabolism on long term use
Buspirone is antianxiety agent, it has very few sedative, muscle
relaxant and anticonvulsant effect
Benzodiazepines preferred as anxiolytic drugs for an elderly pt with a
history of cirrhosis:
lorazepam, oxazepam (NOT: chlordiazepoxide, diazepam,
chlorazepate, prazepam)
Barbiturates:::: long acting: phenobarbital -- intermediate:
amobarbital, butabarbital -- short: pentobarbital, secobarbital --
ultrashort: thiopental
Barbiturate metabolism: oxidation the conjugation with sulfate
Anxiolytic drug with least sedative action: buspirone
(cont. phenobarbital vs. n.jaundice) to the hazards of blood
transfusion. More recently, phenobarbital have been found to be
effective in lowering serum bilirubin levels, it enhances
glucuronidation by stimulating syn of LME,

Page 42 of 582
S Question
(cont. phenobarbital vs. n.jaundice) complete failure of this ttt can
probably be attributed to discontinuing of the drug prematurely
(cont. phenbarbital vs. n.jaundice) and by inducing production of
bilirubin-binding Y protein. The dosage is 5mg q8hrs (beginning 6-
8hrs after delivery) for 3-5days until serum bilirubin level falls below
10mg/dl.
(cont. lorazepam, oxazepam) resulting in drug accumulation and the
risk of oversedation. Lorazepam and oxazepam are metabolized by
glucuronidation which is much less dependant on liver function than
is oxidation, moreover the metabolites are inactive
(cont. lorazepam) chlodiazepoxide, diazepam, chlorazepate,
prazepam all are metabolized in the liver by oxidation to
desmethyldiazepam, an active metabolite with a very long half life,
this process is impaired in the elderly (cirrhosis)
(cont. hypnotics) fluorazepam is metabolized to an active metabolite
(desalkylfuorazepam) which has an extremely long t1/2 (>100hrs).
Fluorazepam require several nights to become maximally effective
(cont. hypnotics) and fluorazepam often cause morning after effects

Page 43 of 582
S Question
(cont. hypnotics) although all of the benzodiazepines have dose-
related hypnotic effects, only fluorazepam, temazepam, lorazepam &
triazolam are FDA approved for this indication. Triazolam has a very
short t1/2 (2-3hrs)
(con. Hypnotics) lorazepam and temazepam have intermediate t1/2
(10-15hrs) all three are rapid acting drugs that are unlikely to cause
morning after effects.
Midazolam.........Ans. Used for Anaesthesia.
In Bipolar, which drugs are not used. Ans. Benzos because it increases
GABA
Diazepam in normal saline= ppn of diazepam- diazepam soln:
461
70%H2O+10%+PEG20%
747 Chlorazepate : ttt of anxiety, alcohol withdrawal
Tocainide (antiarrythmic) SE: pulmonary fibrosis, blood dyscrasias
Terfenadine , astimazole + ketoconazole = life treatening arrythmia
534 Sotalol: monitor CrCl
Sotalol B-blocker antiarrythmic causes torsades de pointes
1172 SA node=the pacemaker of heart
Qunine sulfate relieve night cramps
Page 44 of 582
S Question
Qunidine replace digoxin from plasma protein binding sites causing
859
digoxin toxicity
526 Quinine SE is cinchonism
Quinine is an optical isomer to quinidine
1152 Quinine inc plasma level of digoxin, inc toxicity
Quinidine makes digoxin level inc 2-2.5 folds due to # of metabolism
and displacement from tissue binding sites in pts previously stabilized
on digoxin, dose of digoxin should be halved when adding quinidine --
and pt should be monitored for toxicity
1306 Quinidine is optical isomer of quinine
Quinidine inc levels of:: digoxin, warfarin, nifedipine, haloperidol,
procainamide
899 Quinidine inc digoxin level
Procainamide is DOC for AVRT= atrioventricular reinterent
1049
tachycardia
650 Pacemaker of heart is SA node
Order of impulse: SA node - AV node - bundle of His - Purkinge
1430 Na lactate dec toxicity of quinidine
595 Lignocaine is not taken orally due to 1st pass effect
Page 45 of 582
S Question
Lignocaine is given IV to avoid oral first pass effect
Lidocaine SE: malignant hyperthermia, CNS toxicity, tinnitus, blurred
vision, parathesia, tremor, dizziness, disturbed hearing
Increase QT interval elevation: cisapride, ketoconazole (azoles),
phenothiazine, quinolones
In CHF pt we should adjust the dose of lignocaine because of
decreased blood perfusion of liver so decreased metabolism of
lignocaine
Digitalis does not treat ventricular arrythmia
Cisapride + ketoconazole = prolong QT
481 Bundle of HIS is present in heart
Amiodarone cause: pulmonary fibrosis, yellow deposits on cornea,
827 skin deposits, change in color, CNS effects, thyroid dysfunction,
photosensitivity
Amiodarone cause photosensitivity
Amiodarone cause occular, sight problems
Amiodarone cause occular and sight problems
608 Amiodarone antiarrhythmic causes occular, sight problems

Page 46 of 582
S Question
Adam- Stoke's disease or syndrome disease is caused by heart block.
It is characterised by sudden attacks of unconsciouness, sometimes
with convulsions
Quinine is an isomer of quinidine
Which medication is used to control Arrhythmias secondary to MI..a)
258
Atenolol..b) Verapamil..c) Nitrates
Which medication is used for arrhythmia, hypertension and
257
Angina?a) Verapamil..b) Nifedipine..c) Amlodipine
144 Question abt Amiodarone
Which medication is used to control Arrhythmias secondary to MI a)
Atenolol b) Verapamil c) Nitrates
Which medication is used for arrhythmia, hypertension and Angina?
a) Verapamil b) Nifedipine c) Amlodipine
Systole mean that ventrical contraction
360 Quinine and quinidine … isomers
Erythromycin + aminophylline= inc level of aminophylline so dec
aminophylline dose by 25%
805 Zileuton: # 5-lipoxygenase
Zafirlukast # slow-reacting substance that causes anaphylaxis (SRSA)
Page 47 of 582
S Question
907 Zafirlucast, montelukast: LT receptor antagonists
Types of respiratory volumes: tidal vol, minimum vol, max vol
439 Thyophylline atidote: B-blocker
Theophylline SE: nausea, vomiting, anxiety, tachycardia
Theophylline SE : NV, anxiety, tachycardia, tremors
847 Theophylline is C.I. with cimetidine
Theophylline is C.I. with cimetidine
475 Theophylline by slow IV infusion
Theophylline + ethylene diamine = aminophylline
1228 Theophyllin should be 10-20 mg/L
Theophyllin is potentiated by erythromycin , O.C , cimetidime ,
ceprofloxacine , influenza vaccine - inhibited by rifampin ,
carpamazepine , phenytoin
The respiratory volume: the respiratory air and expiratory air
Terbutaline is a beta2 agonist used in acute attacks of asthma
Terbutaline is a B2 agonist
Sod. Chromoglygate: mast cell stabilizer used for asthma prophylaxis
Salmeterol: long acting B-agonist but slow onset --- albuterol: rapid
1095
acting, short duration
Page 48 of 582
S Question
Salbutamol, acute asthma -- Na chromoglycate: allergic asthma --
1463
corticosteroids, seasonal asthma
Salbutamol is used before inhalation of betamethasone by 10 min
Salbutamol can lower blood pressure
Salbutamol + terbutaline = not logic combination for asthma
1165 Respiration value is determined by vital capacity
937 Ragweed allergy: avoid pyrethrins
Phenytoin: dec theophylline --- interferone: inc theophylline 100%
Oral prednisolone is NOT give to a child with chronic asthma BUT he
766
is given inhaler prednisolone or long acting theophylline
On asthma c-AMP is decreased
Normal adult dose of salbutamol is 1-10 mg
Na chromoglycate is used for seasonal allergy as mast cell stabilizer
Na chromoglycate does NOT cause direct bronchodilation
MOA of methylxanthines: # phosphorylase which converts active 3,5c-
470 AMP to inactive5c-AMP thus inc c-AMP --- catecholamines also inc
3,5c-AMP BUT by activation of adenylcyclase
620 Major respiratory volume is determined by vital capacity
Major respiratory volume is determined by vital capacity
Page 49 of 582
S Question
Long residence of CO2 in body= inc pCO2 (hypoventilation)= dec
HCO3=lactic acidosis
IV infusion of aminophylline is given in: acute asthma case
1068 Inc pCO2 in blood:: most potent respiratory stimulant
Inc P CO2 is the most potent respiratory stimulant
In emergency room the preferred first line therapy of asthma is B
agonist
1339 In asthma::: TLC, FRV, RV, WBC inc --- FEV dec
1444 In asthma there is no increase in cAMP
1130 In asthma c-AMP does not increase
In 10 year old child, which one should be used long term? Answer:
prednisolone tab. Not predisone inhaler or theophylline (can be used)
Drugs that could be given in acute asthma: salbutamol, albuterol,
terbutaline
Doxapram: resp. stimulant in COPD, inc depth of respiration,
1091
DOESNOT inc rate of respiration
Cromolyn Na is given in: prevention of execise induced asthma --
unstable orally
Page 50 of 582
S Question
Corticosteroids in asthma inhibit release of mediators, dec immune
reaction
Corticosteroids are used in asthma as antiinflammatory
553
decongestants
Corticosteroids action in asthma:: dec inflammatory response and dec
airway hyperresponsiveness
Corticosteroids action in asthma is antiinflammatory and dec airway
987
hyperresponsiveness
Chromoglycate: inhibit the release of mediator and cause bronchial
relaxation
Carboxymethylcysteine is mucolytic and dec mucous membrane
1257
hyperplasia
1416 B-bloclers C.I. with asthmatic pts.
B-blockers are C.I. in asthma
Aspirin asthma sensitivity is due to decreased prostaglandin synth
and increased leukotriene synthesis
Aminophylline is theophylline ethylenediamine
927 Aminophylline is a theophylline derivative better to be used rectally
Allopurinol, alcohol, propranolol, cimetidine: inc theophylline
Page 51 of 582
S Question
194 Counseling for usage of inhaled MDI
Which used to treat allergic rhinitis - diphenhydramine - cetirizine-
262
pseudoephedrine
What used as preventer in asthma?-antihistamine-beta agonist-
269
anticholinergics-glucocrticoides
What change in theophylline dose with ciprofloxacin - increase dose
of theophylline by 50%..-decrease dose of theophylline by 30%...-
237
increase dose of ciprofloxacin 50%..- decrease dose of ciprofloxacin
50%
33 Which one is not a preventer in asthma? Terbutaline
50 Theophylline increases by Ciprofloxacin
32 Propranolol contraindicated in asthma
122 Formetrol onset of action: 10 to 20 minutes
110 Dyspnoea meaning shortness of breath
121 Asthma causes Increase in airway resistance
Which used to treat allergic rhinitis - diphenhydramine - cetirizine -
pseudoephedrine
What used as preventer in asthma? -antihistamine -beta agonist -
anticholinergics -glucocrticoides
Page 52 of 582
S Question
What change in theophylline dose with ciprofloxacin - increase dose
of theophylline by 50% -decrease dose of theophylline by 30% -
increase dose of ciprofloxacin 50% - decrease dose of ciprofloxacin
50%
Propanolol should be avoided with asthma patients
Dose of Hydrocortisone in COPD.
Counseling for usage of inhaled MDI
Asthma.......is wht?
27 Theophylline conc. in the body decreases by smoking-ciprofloxacin
Asthma can be triggered by all of the foll. Except … Aspirin.. St. Jones
139
wart…Royal jelly
477 Na cromoglycate is used for seasonal allergy
Oxidation of ethylene glycol gives oxalic acid -- metabolism of
654
ascorbic acid gives oxalic acid
Sumatriptam mimic the serotonin action - C.I. in: CHF, angina, MAOIs
Ritodrine: tocolytic, # oxytocic, relax uterine muscles
793 Prostaglandines group is related to fatty acids
Promethazine is antihistaminic, antimotion sickness

Page 53 of 582
S Question
Promethazine is a potent antimetic, it is also antihistaminic, it is a
890
phenothiazine derivative
528 PG are group of related fatty acids
Pentoxyphylline: hemorrheological, dec blood viscosity, antiplatelet ---
460
ttt of cold extremities, Reynold's disease
1420 Migraine is due to celebral vasodilation
1159 Methylsergide: serotonin antagonist in brain
Hydroxyzine: anxiolytic with high antihistaminic action
1216 Hydroxyzine is an antianxiety antihistaminic
Hydroxyzine has the greatest anthistaminic action (of all anxiolytic
drugs)
1245 Histamine: cardiac stimulation
Examples of sublingual drugs : nifedipine , ergotamine tartarate not
438
maleate ,nitroglycerine , isosorbid , captopril
972 Ergotamine ttt of migraine ---- ergometrine = oxytocic
Ergotamine tartarate and nitroglycerine can be used sublingually
585 Ergotamine causes vasoconstriction

Page 54 of 582
S Question
Ergot alkaloids are used in migraine and prevention of post partum
784 hemorrhage by
stimulation of uterine contraction
Ergot alkaloids are used and migraine and prevent post0partum
hemorrhage by increasing uterine contraction
Ergot alkaloids are are used in migrain and also used as oxytocics
Ergometrin is NOT taken sublingually
Dose of viagra 50mg 1hr before intercourse (range is 25-100 once
daily)
Dihydroergotamine is not taken sublingually (IV) but ergotamine
1429
tartarate is takensublingually and orally
Cyproheptadine is antihistaminic drug with serotonin antagonist and
Ca channel blocking property
Cyproheptadine is antihistaminic / anti 5HT
Cetrizine does NOT cause nausea
Cetrizine does not cause nausea
1231 Azatadine SE = drowsiness
Azadatine: antihistamine that causes drowsiness

Page 55 of 582
S Question
Astimazole: 2nd generation antihistamine, does not cause drowsiness
-- astimazole, terfenadine + ketoconazole=life threatening arrhythmia
Antihistaminics= cyclizine , promethazine, chlorpromazine,
1107
diphenhydramine
Alprostadil is for patent ductus arteriosus in neonates ??
Which of the following is not to be given in pregnancy?which of
168 the following is not to be given in pregnancy?
The option was dinoprost and other drugs
What is the dose for Viagra (sildenafil):a. initiate dose with 25 mg one
hour before sexual activity
162
b.initiate dose with 50mg one hour before sexual activity c. take
100mg once a day d. take 20 mg 4 times a day
Sumatriptan is used for which of the following migraine condition?a.
156 migraine headache with aura..b. migraine headache without...c
.migraine with cluster headache
What is the dose of Sildenafil?a) 25mg 1h before intercourse b) 50mg
275 1h before intercourse c) 100mg 1h before intercourse d) 200mg daily
max.
Page 56 of 582
S Question
Which is not used in migraine prophylaxis…. Ergot, propranolol,
354
pizotifen, clonidine.
Which is not true for cyproheptadine (in relation to migraine, very
355
weird options: used in epilepsy, cns vasoconst veins)
What is the dose of Sildenafil? a) 25mg 1h before intercourse b) 50mg
1h before intercourse c) 100mg 1h before intercourse d) 200mg daily
Migraine...........2 questions
Ergotamine tartarate sublingual - ergotamine maleate is not
427
sublingual
Alprostadil is used in ductus arteriosus
Sulfasalazine metabolized to 5-aminosalicylic acid
Sulfasalazine is used in rheumatoid arthritis and for ulcerative colitis
(Crohn disease
Psoriatic arthritis: inflammation of skin, joints, eye, heart, lung,
kidney, systemic rheumatic autoimmune, ttt: NSAIDs, MTX,
corticosteroids, antimalarial??
Psoriasis: silvery gray scales
Psoriasis does not cause endocarditis
MTX is considered immunosuppressant
796 Methotrexate + salicylate = BMD
Page 57 of 582
S Question
1033 Goeckerman : cooltar + UV (for ttt of psoriasis)
Drugs used for psoriasis: MTX, cool tar 2%, salicylic acid
Dithranol dose: 0.1-1% (psoriasis)
Dithranol 0.1% : for psoriasis ttt topically is better stabilized in ZnO
pastes by addition of 2% salicylic acid
911 Ditharol 1% is used fir ttt of psoriasis
Disease related to destruction of myeline sheath is multiple sclerosis
(MS) ??
486 Cyclosporine: immunosuppressant
1309 Cyclosporine: immunosuppressant
Cyclosporine: cyclic polypeptide immunosuppressant - nephrotoxicity
in 25-30% of pts, synergism with other nephrotoxic drugs may occur,
HTN, hirsutism, gum hyperplasia
Cyclosporine may be administered concurrently with adrenal
715
corticosteroids BUT NOT with other immunosuppressive agents
Cyclosporin oral soln (100mg/ml) is drunk immediately after mixing
909 with milk, chocolate milk or orange juice an IV dosage form is also
marketed

Page 58 of 582
S Question
Butazolidin: take with milk, antacids or meals to decrease gastric
irritation
Psoriasis cha by silvery scales
Methotrixate antidote is folinic acid
Patient on methotrexate perfusion, to prevent toxicity from happing
191
he should take folic acid with methotrexate
219 Lupus: butterfly rash
38 Methotrexate mechanism of action: Folate reductase inhibitor
Lupus: butterfly rash
490 Psoriasis ttt: methotrexate
Psoriasis is characterized by silver , grey scales -- red macule, papule
675 or plaque covered by silvery lamellated scales -- scalp, elbows, knees,
shins are usually affected first
Multiple scelerosis (hypersensitivity type III) ttt: interferon B 1a/1b,
669
baclofen, dantrolone
Methotrexate is effective in the ttt of psoriasis
120 Silvery scales in Psoriasis is due to increased keratinocytes
Urine determinations of catecholamines and their metabolites are
688
useful in diagnosis of pheochromocytoma
Page 59 of 582
S Question
668 Thirst is controlled by hypothalamus
467 The ester group in atropine is liable to destruction
The ester group in atropine is liable to destruction
616 Terbutalin has less cardiac SE than isoproterenol
1266 Sympathomimetic long term use causes hypertension
1204 Sympathetic ganglia are located near the spinal cord
Sympathetic ganglia are located near spinal cord
Suxamethonium is succinylcholine ??
1406 Suxamethonium is short acting depolarizing skeletal muscle relaxant
Suxamethonium is short acting depolarizing seletal muscle relaxant
Suxamethonium is a short-actine skeletal muscle relaxant (
depolarizing )
Succinylcholine should be taken with caution in pts taking
1384
phospholine
Slow IV of adrenaline: inc cardiac output, not diastolic bl pressure
Slow IV infusion of adrenaline: inc cardiac output NOT diastolic blood
pressure
Senokot is a selective neuromuscular stimulant of the colon, restoring
normal rythmic motility
Page 60 of 582
S Question
Pt taking pargyline when prescribing cold remedies to him avoid:
phenylephrine HCl, BUT NOT: chlopheniramine maleate, aspirin,
caffeine, acetaminophen
Pt about to undergo ECT (Electroconvulsive therapy) is usually given
685
succinylcholine
Pralidoxine leads to regeneration of cholinesterase after
523
organophosphorus poisoning
Pheochromocytoma ttt : mixture of alpha and beta blockers
474 Phenylephrine has no diuretic effect
Phentolamine: diagnostic agent for pheochromocytoma
Parathion and malathion are organophosphorus compounds and act
as irreversible anticholinesterases
570 Parasympathomimetics are used in glucoma
961 Organophosphorus compounds irreversibly block cholinesterases
Organophosphorus compounds act by irreversible inhibition of
cholinesterase
664 On long term use of sympatholytics= hypotention may occur
946 Nylidrin is useful as vasodilator

Page 61 of 582
S Question
Norepinephrine acts on postganglionic sympathetic receptors on the
effector organs mainly or presynaptic receptors on the nerve endings
998 Neostigmine does NOT cross the BBB - physostigmine cross BBB
Neostigmine does not cross BBB but physostigmine crosses BBB
Myathenia gravis: antibodies against nicotinic receptors on skeletal
1340 muscles plasma membranes at NMJ act as a competitive antagonis to
Ach binding
Myasthenia gravis is characterised by fatigue and exhaustion of
muscles. Although progressive paralysis of muscles occurs, there are
no sensory effects or atrophy
789 Meprobamate is skeletal muscle relaxant
Mecanism of action of methyl xanthines: # phosphorylase which
convert 3,5 c-AMP(active) to 5cAMP(inactive) so inc c-AMP ---MOA of
catecholamines: also inc 3,5cAMPBUT by activation of adenylcyclase
Malathion: irreversible choliesterase
1215 Malathion is organophosphorus compound
Malathion is an organophosphorus compounds
M.O.A. of B agonist: inc c-AMP by activation of adenylcyclase

Page 62 of 582
S Question
L-isomer of adrenaline is 20 times more active than D-isomer --- L
isomer of atropine is 100 times more potent than D isomer
1025 L-hyoscyamine (atropine) is 100 times more potent than D isomer
933 Levarterenol=L-norepinephrine
Labitolol is alpha and beta blocker
Labetalol is non selective adrenergic antagonist
738 Isoproterenol is B agonist
Hyoscine is a muscarinic antagonist
Glutamic acid by decarboxilation is converted to GABA
Glutamic acid (+ glutamic acid decarboxylase + vitamin B6) = GABA ----
deficiency of vitamine B6 : dec GABA, inc glutamic acid
Function of vagus:: regulate heart rate
Function of vagus: regulation of heart rate
Ephedrine is the least desirable B-agonist in the ttt of bronchial
964
asthma because it is nonselective
Edrophonium is used in the diagnosis of myasthenia gravis
752 Edrophonium is used in diagnosis of myathenia gravis ( M. gravis )
Edrophonium is used in diagnosis of myathenia gravis
682 Dose of atropine: 0.2-2 mg
Page 63 of 582
S Question
Demecarium is a long acting anticholinesterase used to treat primary
494 open-angle glaucoma, glaucoma in aphakia, and accommodative
estropia
Dantrolene: centrally acting skeletal muscle relaxant -- SE: seizures ---
baclofen, orphenadrine, cyclobenzaprine: peripherally acting skeletal
muscle relaxants
Cyclic AMP is a 2ry messenger NOT a mediator in CNS
COMT does NOT metabolize isoprenaline
COMT does not metabolize isoprenaline
Competitive inhibitors cause less enzyme inhibition that non
competitive inhibitors
CNS mediators: acetylcholine, serotonin, dopamine, noradrenaline
BUT c-AMP is not
493 Cholinergic crisis may resulr fro M. gravis ttt
830 Cholinergic crisis may occur in myasthenia gravis
Cholinergic crisis may be observed in M. gravis
Cholinergic crisis causes parkinsonism??
Carbachol is cholinergic agonist
Carbachol is a cholinergic agent
Page 64 of 582
S Question
Bethanechol is similar in action to acetylcholine
B-agonists (adrenaline- like )= stimulate adenyl cyclase so inc cAMP so
inc Ca entry to myocardial cells = positive inotropic action
957 Atropine SE : dry mouth, blurred vision, constipation, tachycardia
Atropine is sol in acids
Atropine is antidote for anticholinesterase amd selectively block
muscarinic receptors
Atropine is antidote for anticholinesterase
Atropine cause hemodynamic alterations as it causes initial
tachycardia
Atropine cause hemodynamic alteration as it cause initial bradycardia
Atropine blocks muscarinic receptors of acetylcholine
846 Atropine + pralidoxine is used for ttt of organophosphorus poisoning
Atropine (d,l hyoscyamine is more potent than d-hyoscyamine) (L
isomer is 100 times more potent than D isomer
Appropriate stimulation of sympathetic nerve: contraction of vascular
smooth muscles
417 Anticholinesterase act by structural similarity to acetylcholine
Page 65 of 582
S Question
Anticholinergic SE (family of atropine): dry mouth, dec sweating, dec
acid secretion,constipation, hypotension, urinary retention, in IOP
(C.I. with glaucoma), dizziness, anxiety,hallucination but don't cause
insomnia
Alpha receptors: constriction of arterioles
All the following drugs are used to treat open angle glaucoma
carbachol, physostigmine, neostigmine, demecarium
Advantage of usage of dopamine in cardiogenic shock is that it
1436
produce dose dependent in cardiac output and renal perfusion
Adrenaline is metabolized by MAO
Adrenaline injection strength is 1:1000 mg/L
Acetyl + CoA + ATP = acetyl CoA + ADP ------ acetyl CoA + choline +
cholinesterase =acetlycholine
(cont. succinylcholine vs. phospholine iodide) the enzyme responsible
for the metabolism of succinylcholine, the action of succinylcholine is
enhanced in pts taking this combination, thereby possibly causing
apnea and death

Page 66 of 582
S Question
(cont. pargyline and phenylephrine) phenylephrine is an adrenergic
stimulant which is normally metabolized in the liver by MAO. In the
presence of a MAOI such as pargyline, accumulation of phenylephrin,
toxically, elevation of pt's blood pressure
Somatic nerve is not included in the ANS
Increase tone of vagal nerve doesn't cause vomiting
Dobutamine acts via B receptor agonism
Atropine dose
Acetyl choline is choline ester
The following molecule is:a. Precursor of dopamine b. Dopamine c.
157 NE d. ????? sorry don’t know Ans as this is the levo dopa molecule we
should be able to understand that it is the precursor of dopamine
294 Organophophorous poison: parathion
295 In anticholinesterase poisoning, first give: pralidoxime
293 Damage of protein and peptides due to:-deamination-oxidation
40 Tubocurarine mechanism of action: blocks postsynaptic ganglia
Sympathomimetic actions except which one? Increased gastric
17
motility
126 Atropine intoxication (symptoms and find exception)
Page 67 of 582
S Question
16 Ach poisononing symptoms except which one? Mydriasis
351 Tubocurarine MOA: compet antag
Sympathetic/parasympathetic question
Suxamethonium (asked twice) why some people have different
350
response to it… alteration in pseuedocholinesterase enzyme
Organophophorous poison: parathion
352 Neostigmine ADR
376 Labetalol MOA
In anticholinesterase poisoning, first give: pralidoxime
340 Doses: atropine
Cholinergic Side effects........which one is not?
Atropine toxicity.............
Succinylcholine should be administered with extreme caution to pts
being treated with phospholine iodide. Phospholine iodide is used in
the ttt of glaucoma, prolonged used of this agent reduces the activity
of pseudocholinesterase,
641 Pt taking phospholine iodide should not take succinylcholine
476 Dipivefrin is used in glucoma

Page 68 of 582
S Question
Antocholiesterases (parasympathomimetics) act in glaucoma by dec
707
IOP, inc drainage of aquous humor
975 Carbacol=cholinergic drug -- probucol=antihyperlipidemic
WBCs (leukocytes): basophils, eosinophils, monocytes, lymphocytes
BUT NOT reticulocytes (unmature RBCs)
The highest count in plasma cells is erythrocytes
The erythrocyte of an iron deficient pt is: microcytic, hypochromic - in
iron deficiency, the iron storage compartment becomes depleted,
this is followed by reduction in the plasma transferrin saturation,
reduction in no and size and Hb content of RBC
Speed of blood is more in arteries than in arterioles
Schilling's test: pernicious anemia
Schilling test is useful for the detection of pernicious anemia. This test
utilizes orally administered vitamin B12 labeled with 57Co and 58Co.
In normal individuals more than 50% of an oral dose of vit B12 is
absorbed from GIT
398 RBCs + hypertonic solution = crenation
Proteins are present in blood more than urine

Page 69 of 582
S Question
Polycythemia: mild polycythemia is normal in persons who exercise
excessively and in persons who live in high altitudespolycythemia
vera:: is a disease state in which the rate of red cell production is far
greater than normal, even though there is no physiological need for
the increased production, it results from some sort of tumor in the
bone marrow
Plasma vol = 55ml/ kg body weight
Plasma represent 55% of blood; i.e. 3500 mL of total blood volume,
851 and 5% of total body
weight
PH of blood=7.4
765 pH of blood = 7.4
1272 Oprelvekin: inhance platelet production
Normal hematocrit value: 35-45%
No of RBCs in blood of healthy person=5*10 ⁶/ml
Na on blood= 137-157 mmol/L --- K in blood: 4.5-5.5 mmol/L ---Cl=98-
100mmol/L ---HCO3=24mmol/L --- urea=3-8mmol/L --- Ca=9-11mg%
if more than 7: tetany

Page 70 of 582
S Question
Na in blood= 137-157 mmol/L --- K in blood= 4.5-5.5 mmol/L -- Cl=98-
703
100mmol/L -- HCO3=24mmol/L -- urea= 3-8 mmol/L -- Ca=9-11mg%
Microcystic anemia: MCV is less than 80 but normal range is 90
425 Metabolic acidosis is due to HCO3 loss
Megaloplastic anemia is due to foilc acid deficiency
1324 Megaloblastic anemia ttt: leucovorin IM
Male hemoglobin: 14-17 g/dl --- female hemoglobin: 12-15 g/dl
565 Maintaining of blood PH is function of lungs and kidney
1418 Hypoproteinemia cause edema
High protein bound drugs: warfarin, clofibrate, salicylates,
1405
barbiturates, sulfonamides, tolbutamides
Hemoglobin quantity in 100ml of blood is 15g
1382 Hemoglobin quantity in 100 ml blood is 15g
522 Hb in blood is 15g
1040 Folic acid can interfer with the diagnosis of pernicious anemia
1265 Filgrastim is a protein
Erythropoiesis is the stimulation of RBC formation from bone marrow
Erythrocytes are the highest count in plasma cells
1117 Direct van den bergh test measures conjugated bilirubin in the blood
Page 71 of 582
S Question
Deficiency in intrinsic factor:: pernicious anemia
732 Decrease protein in plasma causes edema
Dec plasma protein level leads to edema
Blood volume=5-6 L
489 Blood makes up 1/15 of body weight
Blood makes 1/15 of body weight
638 Bilirubin is the end product of hemoglubin decomposition
504 Bilirubin is the end product of hemoglobin metabolism
1020 Average % of hematocrit in blood is 45%
Anemia is caused by: antineoplastics, cytotoxins,
921
immunosuppressants
Agranulocytosis is caused by: chloramphenicol, carbamazepine,
carbimazole, novalgin (metimazole) sulphonamides, clozapine, ACEIs
Agranulocytosis is accompanied by necrotic lesion of mouth, also
687
leukopenia, neutropenia, also sore throat and fever
1072 Agranulacytosis is decrease in polymorphonuclear lymphocytes

Page 72 of 582
S Question
(continue polycythemia vera) phlebotomy whenever the hematocrit
rise above 55% may suffice as the only ttt for pts who do not have
sever thrombocytosis -- phlebotomy: opening a vein to let or draw
blood, also called venesection
(continue polycythemia vera) drugs used include: busulfan (myleran),,
radio active phosphorus 32P
(cont. Schilling test), it has been shown that over 1/2 of an oral dose
soon appears in the blood, normally, only a small amount of
radioactivity appears in the urine, however if a large flushing dose
(1000mcg) of vit B12 is given paentrally within
(cont. Schilling test) which results in poor absorption of the
radioactive B12, most of theradioactivity in those pts will be detected
in the feces
(cont. Schilling test) this absorption occurs in the presence of the
intrinsic factor of Castle, with which the vit must presumably combine
in order to pass through the intestinal walls. By means or radioactive
cobalt-labeled cyanocobolamine,

Page 73 of 582
S Question
(cont. Schilling test) an hour of the tagged oral dose the renal
threshold for B12 is exceeded and radioactivity is observed in the
urine. In pts of pernicious anemia, there is a deficiency in interinsic
factor,
Erythrocyte is non nucleated cell
Drug binding to plasma proteins study it well(many Q's)
Why is 5% Dextrose solution added to blood products? a) binding free
287
iron b) good for storage of the blood to prevent hemodialysis
Which cells are the majority in the blood?a) Erythrocytes b)
274
Polygranulated blood cells c) Platelets d) Lymphocytes
88 Protein concentration is more in blood than in urine
Why is 5% Dextrose solution added to blood products? a) binding free
iron b) good for storage of the blood to prevent hemodialysis
Which one is inert plasma expander... Ans. Dextran
Which cells are the majority in the blood? a) Erythrocytes b)
Polygranulated blood cells c) Platelets d) Lymphocytes
1293 Drop in plasma protein level causes edema
Which drug is given in alternate day and causes osteoporosis ?:
predisolone
Page 74 of 582
S Question
1438 The cause of osteogenesis is genetic defect
Sclerosis is generally caused by overgrowth of fibrous tissue --
571 spondylitis: inflammation
of the vertebrea -- stasis: stoppage of blood flow in a part of the body
787 Rheumatoid arthritis: inflammation of synovial fluid, membrane
Rheumatoid arthritis management: NSAIDs to maintain mobility,
DMARD used after NSAIDs -- DMARD: disease modifying
antirheumatic drug
Penicillamine is a chelating agent used in rheumatoid arthritis
Penicillamine is a chelating agent and used in rheumatoid arthritis
and wilson's disease
501 Penicillamine is a chelating agent
1136 Paricalcitol: vitamin D analogue: ttt of hypoparathyrodism
1254 Parathyroid gland affect Ca absorption
Osteoarthritis is a degenerative disease
Osteoarthritis is a degenerative disease
Manifestation of hypoparathyrodism: hypocalcemia,
1247
hyperphosphatemia
Page 75 of 582
S Question
Leflunomide (immunomodulator, antiinflammatory used in the ttt of
rheumatoid arthritis) : pregnancy category X
400 In rheumatoid arthritis break down of synovial membrane occurs
Hypoparathyrodism ttt : calcitriol, vitaminD --- hyperparathyrodism
ttt: calcitonin, vitaminD analogue
1241 Hypoparathyrodism is ttt by dihydrotachysterol
Etarnecept: parentrally used for rhematoid arthritis NOT for
1446
osteoarthritis
Early morning symptoms of stiffness, regidity: benztropin mesylate
Dose of colchicine is 500mcg orally
Dose of aspirin in rheumatoid arthiritis is 6 gm
Causes of osteoporosis: hyper cortisone secretion,
hypoparathyrodism, drop in estrogen level
Cause osteogenesis is chromosomal --- cause of osteoporosis is
estrogen deficiency
Alendronate is not given to pt sitting or lying down because it cause
626
esophageal ulcer
Rheumatoid arthritis leads to cartilage destruction
NSAIDs improve mobility in rheumatoid arthritis
Page 76 of 582
S Question
Increased PO4 leads to hypocalcemia
220 Rheumatoid arthritis : pannus
232 PTH - calcium – vitamin d question
128 Patient with hypophosphatemia which ion inc. (ca+2 , k+,Na+)
60 Hypophosphataemia increases Ca ion
Rheumatoid arthritis : pannus
Zero order reaction: rate process independent on drug conc or initial
434
dose
1466 Vd of drug inc if amount of drug bound to plasma proteins dec
384 Vd = dose / Czero
902 To prepare buffer system of pH4 we use lactic acid of pKa 3.86
To prepare a buffer system of PH 4 use lactic acid, pka=3.86 - in a
833 system having different pka, the most appropriate will be as equal as
its PH
1275 TI= LD50/ED50
TI= LD50/ED50
Therapeutic index: LD50/ED50
795 t90%= shelf life
t1/2=0.7Vd/Cl
Page 77 of 582
S Question
t1/2 in 1st order kinetics is not affected by drug concentration
405 Steady state is when amount administered = amount excreted
Steady state depend on the half life of the drug??
1235 Solubility depend on isoelectric point
Rate of drug elimination excreted by 1st order kinetics is greatest
670
when blood concentration is at its max
380 Plasma concentration is affected by dose, clearance of drug
381 Plasma concentration = dose / Vd
pka= -log of ionization constant which indiactes relative strength of
acid or base
Ph of 0.001 NaOH is 11 . Ph + POH = 14 . PH + ( - log 0.001 ) = 14 . PH +
395
3 = 14 . PH= 11
PH is equal to pka at half neutralization point
Non-linear pharmacokinetics:: t1/2 inc as dose inc???
NaCl equivalent is amount of NaCl teoretically render the same
osmotic pressurevequivalent to 1 gm of the substance and this value
1065
is used to estimate the amount of NaCl needed to render a solution
isotonic
Loading dose depend on Vd and plasma concn
Page 78 of 582
S Question
1329 LD50 is not variable between species
Laws for calculation of child doses:: Young's rule (year+12) , Clark's
rule, Frid's rule
Knowledge of Vd allowes us to: determine amount of drug in body
based on plasma concn.
Isotonicity is critical in S.C
Initial plasma concn after IV administration depends on dose and
clearance
Initial plasma concentration after IV dose is affected by dose or
clearance
1440 Inc partition coefficient: improve passive absorption of a drug
In loading dose: Vd and desired amount of drug is important
In a lipid soluble drug: dissolution is the rate limiting step
If a fixed dose of drug is eliminated by first order kinetics at fixed
dose interval, time to reach platau level will depend on t1/2
If a drug has a small Vd then it does not accumulate in various tissues
and organs
How can you detect that a certain drug accumulates in tisse: when Vd
is > 1L/Kg
Page 79 of 582
S Question
Hight concentration of drug in plasma = higher bioavailability
Half normal saline is hypotonic
Half normal saline is hypotonic
Given the half life of a drug is 1 year, after 3 years 12.5% are left
Freezing point depression: coligative property
Fick's law (diffusion) = dc/dt= D*S.A*(C1-C2)/L --- noyes witney:=
1294
dc/dt=dc*SA*(Cs-C)/H
479 Drugs with low Vd has less accummulation in tissues
606 Drug with pKa 6.2 will be 50% ionized in small intestine (pH 6.2)
Drug accumulation in tissue is related to Vd
Doubling the drug concn in the blood (that follow 1st order kinetics) =
1147
will not affect the half life
383 dose = Vd * Czero
Dissolution rate is the rate limiting step affecting absorption of oral
1105
drugs
Decay of radioactive atom occurs at 1st order reaction
Conc of 6ppm= 0.00006%
Class A prescription balance sensitivity tests: arm ratio, rider,
558
graduated beam, shift, minmum wt=120mg
Page 80 of 582
S Question
Class A prescription balance sensitivity tests: Arm ratio, Rider,
605
graduated beam, shift --- minimum wt: 120 mg
Calculation of dextrose isotonic solution can be done by freezing
1051
point method
382 C zero = dose / Vd
Bioavailability is the mount or drug available in blood and the rate by
445
which it was made available
611 An isotonic solution is isoosmotic but not vice versa
A specific drug with 1st order biological t1/2 of 4 hrs, this value is
775
independent on the initial drug conc.
A drug which is 20% absorbed from the oral dose is considered poorly
1264
absorbed in terms of bioavailability
Volume of distribution definition
Definition of osmotic pressure
Boric acid has pka 9.24 is very weak acid
7 problems 3 : kinetics and 4 pharmaceutical calculations

Page 81 of 582
S Question
You will be given t ½ 1 hour and will be asked how much time will it
take for the 95% drug to clear from the body?t1/2 = 50% drug in the
blood = 50% drug out of the body..t1/2= 25% of drug in the blood=
172 75% drug out of the body....t1/2= 12.5% of drug in the blood=87.5%
drug out of body...t1/2=6.25% of drug in the blood=93.75% drug out
of body...t1/2=3.125% of drug in the blood=96.875% of drug out of
body
Questions on Css calculations concentration of steady state? And
155
maintainance dose and loading dose.
If the parient is given parentral nutrition then whoe many kilojoule
energy will be produced?The injection content will be given. In that
153
fats will be there proteins/ amino acids will be there and you will be
asked the fats will produce how much energy?
Calculations on volume of distribution Vd and from t1/2 and F
148
bioavailability?
147 Calculations on Fe++ mEq from (FeSO4. 2H2O) injections.
Sucralfate compounding calculation from sample question 2014 (6.67
%)
Conc is 200 mg at t half is 4 hrs .what conc after 16 hrs?
Page 82 of 582
S Question
Bioavaiabiliy determinent in regular immidiate release tablet?
Dissolution - dissintegration- metabolism-.....
Which iron salt has the most „iron in weight to weight“?a)Ferrous
215 fumarate..b) Ferrous succinate...c) Ferrous sulphate, dried..d) Ferrous
glycinate
176 Vd definition
Patient take Iv infusion dose Css affected with (half life – dose and
196
clearance
Elimination constant is 0,173 per hour, how much steady state is left
216
after 16h?a) 25%..b) 50%..c) 75%..d) 87,5%..e) 93.75%
Calculation Make a Solution with 274g Citric acid anhydrous, M=
217 192g/mol. How much Citric acid Monohydrate do you have to use?
(30 gm).
Calculate the infusion dose for a patient 35years old, 70kg, V=9L,
212
Serum concentration=15mg/dL, t=10h, t1/2=1h.Result given in mg/h
Calculate hepatic clearance when renal clearance is86mL/min. Same
213
patient as in 40. Except serumconcentration is 150mg/l.

Page 83 of 582
S Question
The Sensitivity of a balance is 5mg. What is the lowest weight you can
286 measure with this balance if the maximum error is +/- 5%? a) 100mg
b) 50mgc)1000mg
Potassium permanganate 2% dispensed 300ml, doctor want to give
297
dose as 1:1000 using measure of 50ml.-dilute 5o ml to 1L water
247 Half life definition
Drug has a pKa of 4.5:a) if the pH is lower than 4.5, the partition
coefficient will increase b)if the pH is higher than 4.5, the partition
290
coefficient will increase c)if PH is higher than 4.5 ionization will
increase d)if PH is higher than 4.5 solubility will increase
Calculation Patient has to take 300mg/10mL ferrous
something*2H2O three times daily. How much Iron is in a daily dose?
280
M(Water)=18g/mol, M(iron)=55g/mol, Ferrous something 2 H2O
=156g/mol
95 Steady state after continuous IV infusion depends on half-life
68 Sensitivity calculation
70 ppm to %conversion 600ppm to %
69 mmol Kcl calculation
90 Half life 4.9 days, steady state is 15 to 20 days
Page 84 of 582
S Question
Fe2SO4.7H20 atomic weights were given; find out elemental iron
73
present in 300 mg tablet?
72 Creatinine clearance involving AUC and t1/2
71 Concentration conversion
Calculation question on chlorhexidine gluconate, Molecualar weights
81
were given, find amount of chlorhexidine present in 200g?
89 After oral administration, plateau represents Half life
Which iron salt has the most „iron in weight to weight“? a)Ferrous
fumarate b) Ferrous succinate c) Ferrous sulphate, dried d) Ferrous
glycinate
372 What to use for making buffer PH 4… lactic acid with PH 3.86
What is Absolute Bioavailability
The Sensitivity of a balance is 5mg. What is the lowest weight you can
measure with this balance if the maximum error is +/- 5%? a) 100mg
b) 50mg c)1000mg
Some graph is given........calculate clearance...
Some calculation of stock solution
Patient take Iv infusion dose Css affected with (half life – dose and
clearance)
Page 85 of 582
S Question
Half life definition
Elimination constant is 0,173 per hour, how much steady state is left
after 16h? a) 25% b) 50% c) 75% d) 87,5%e) 93.75%
Drug has a pKa of 4.5: a) if the pH is lower than 4.5, the partition
coefficient will increase b)if the pH is higher than 4.5, the partition
coefficient will increase c)if PH is higher than 4.5 ionization will
increase d)if PH is higher than 4.5 solubility will increase
309 Conc is 200 mg at t half is 4 hrs .what conc after 16 hrs?
Calculation. Mostly dilution and allegation method and involved ppm,
331
% to ratio, g to mg etc (basic things)
Calculation Patient has to take 300mg/10mL ferrous
something*2H2O three times daily. How much Iron is in a daily dose?
M(Water)=18g/mol, M(iron)=55g/mol, Ferrous something 2 H2O
=156g/mol.
Calculation Make a Solution with 274g Citric acid anhydrous, M=
192g/mol. How much Citric acid Monohydrate do you have to use?
(30 gm).
Calculate hepatic clearance when renal clearance is86mL/min. Same
patient as in 40. Except serumconcentration is150mg/l.
Page 86 of 582
S Question
40. Calculate the infusion dose for a patient 35years old, 70kg, V=9L,
Serum concentration=15mg/dL, t=10h, t1/2=1h. Result given in mg/h
When dispensing the fluorouracil solution patient should be advised
to: apply with a nonmetalic applicator or fingertips, avoid prolonged
exposure to sunlight, avoid exposure to UV, erythema will occur after
application, do not cover with occlusive dressi
Vincristin: only IV, little BMD
Tamoxifen citrate is indicated primarily for estrogen-dependent
1261
neoplasm
Storage of cisplatin: store from 15-25 C, do not refrigirate, protect
from light, discard unused portion
Storage of cisplatin: at room temperature or from 15-25 C - SE:
proximal renal tubular damage (nephrotoxicity) -- amifostine: ttt of
cisplatin toxicity, protect from nephrotoxicity by cisplatin
Some antineoplastic agents:: alkylating agents: nitrogen mustard,
chlorambucil, cyclophosphamide -- antimetabolites: MTX, 6-MP, 5-FU
Prednisone, 6-MP, chlorambucil Rho (D) immunoglobulin:: useful
immunosuppressants in cancer chemotherapy
917 Nadir: time before BMD max occurs
Page 87 of 582
S Question
MTX is clinically used for psoriasis and RA and leukemia
1182 MTX is antagonist to folic acid
1457 Methotrexate + salicylate = bone marrow depression
678 Mesna: Na-mercapto ethane sulfonate
Mechloethamine (alkylating agent) : potent vesicant --- extravasation
1029
ttt: thiosulfate, ice compresses
Folinic acid is antidote for MTX --- MTX is folic acid analogue used in
leukemia
Folinic acid is antidote for methotrexate --- methotrexate is folic acid
1273
analogue used in leukemia
419 Fluorouracil is an antimetabolite antcancer drug
Filgrastim is granulocyte-colony stimulating factor which stimulates
506
the production of neutrophils
Filgrastim ( granulocyto colonies stimulator) : ttt of BMD with sever
773
neutropenia
etoposide: antineoplastic, have been approved for use in
combination of (ex: cisplatin, vinblastin, bleomycin) in pts with
refractory testicular tumors who have already received appropriate
surgical, chemotherapeutic and radiation therapy
Page 88 of 582
S Question
Doxorubicin causes cardiac cumulative toxicity
Doxorubicin cause cardiac toxicity
Docetaxel: ttt of breast/non-small lung cancer --- monitor: bilirubin,
1156
SGOT, CBC -- SE: edema
Dactinomycin, mithromycin are antibiotics and anticancer due to
659
their cytotoxic effects
Cyclophosphamide: alkylating agent BUT cytarabine is NOT
1191 Cyclophosphamide, methotrexate cause total BMD
Cyclophosphamide, methotrexate = total BMD
Cyclophosphamide SE: hemorrhagic cystitis
Cyclophosphamide SE is hemorrhagic cystitis which is ttt with mesna
941 Cyclophosphamide cause hemorrhagic cystis
Cisplatin SE: proximal renal tubular damage
1450 BMD leads to agranulocytosis
Amifostine: ttt of cisplatin toxicity, protect from nephrotoxicity by
524
cisplatin
758 6-thioguanine cytotoxicity effect by guanine synth
903 5-FU causes marker BMD

Page 89 of 582
S Question
(continue etoposide) the marketed soln is diluted with D5W or 0.9%
saline injection and given IV for a 30-60 min period.. Severe BMD is
the most serious adverse effect, there is a high incidence (30%) of
nausea and vomiting
(continue etoposide) it holds promise in ttt of small cell ling cancer
and other carcinomas - it's a semisynthetic deriv of podophyllotoxin,
an active constituent of podophyllin. It acts as an inhibitor of cell
mitosis
Metastatic bone pain is treated by fentanyl patches
Determination of chemotherapy dose includes all the following
except age factor
Detection of breast cancer attained by mammography
Another case about anticancer drug-i don't remember it- (tough one)
about also 5Q's
All are alkylating agents except cytarabine
241 Doxorubicin: causes cardiac toxicity
Side effect of Daunorubicin........Cardiotoxicity
Patient on methotrexate perfusion, to prevent toxicity from happing
he should take folic acid with methotrexate
Page 90 of 582
S Question
Methotrexate toxicity treat with leucovorin
Doxorubicin: causes cardiac toxicity
(case9) a 55-y-old pt with a 5-y-history of angina and a recent MI is
admitted to the hospital because of malignant HTN, diazoxide should
not be given to this pt because: of its cardiostimulating effects
2544 (cont. case9) the hypotensive effects if diazoxide is cause be
reduction in peripheral vascular resistance via direct arteriolar
relaxation, baroreceptor reflexes are activated; thus leads to cardiac
stimulation with increased heart rate, stroke volume
2545 (cont. case9) and cardiac output. This in turn, will increase
myocardial oxygen demand, a potentially dangerous situation in a pt
with ischemic heart disease.
2546 (cont. case9) the antihypertensive that would be preferred in
this pt would be nitroprusside. NOT: propranolol, trimethaphan,
hydralazine, minoxidil, diazoxide.
2547 (cont. case9) nitroprusside and trimethaphan both dec total

Page 91 of 582
S Question
(case8) a 50-y-old HTN pt has been maintained on spironolactone
with HCTZ, methyldopa, an K-tabs. The pt is admitted to hospital for
elective surgery & is found to be hyperkalemic (serum K:6.4, normal:
3.5-5.5 mEq/L) with no symptoms or ECG changes
2539 (cont. case8)this pt should be treated with rectal sodium
polystyrene sulfonate, NOT WITH: IV Ca, IV NaHCO3, IV
glucose+insulin
2540 (cont. case8) ttt of hyperkalemia can be approached by 3
methods: first, in presence of ECG changes: Ca should be
administered to counteract the effect of xss K on the heart. 2541
(cont. case8) secondly, NaHCO3 or glucose+insulin can be used to
rapidly shift K from extracellular fluid compartment to intracellular
one. Thirdly, excahnge resins or dialysis can be used to remove K
from the body

Page 92 of 582
S Question
(case7) an elderly insulin dependent diabetic is about to be placed on
a B-blocker for his HTN. The B-blocker that would be most
appropriate for this type of pt is: atenolol, metoprolol NOT:
propranolol, pindolol, timolol, nadolol.
2505 (cont. case7) although all B-blockers are likely to mask the
symptoms of acute hypoglycemia (e.g. rapid pulse, tachycardia,
tremors), the cardioselective B-blockers atenolol & metoprolol are
more appropriate in diabetics.
2506 (cont. case7) they have much less of effect on the metabolic and
cardiovascular responses to hypoglycemia than do the nonselective B-
blockers. Therefore, they are less likely to intensify hypoglycemia,
and compromise peripheral circulation.
2507 (cont. case7) atenolol does not potentiate insulin-induced
hypoglycemia and unlike the

Page 93 of 582
S Question
(case6) a diabetic pt tells you that she is planning a four-week trip to
Europe and will not have continued access to a refrigerator in which
to store her insulin.
2492 (cont. case6) you should tell her that insulin will be stable at
room T during the time period in which single vial will be used. In
general all insulins are stable at room T (75 F)
2493 (cont. case6) regular insulin may lose 10% of its activity at room
T after 18 months. Modified insulins will coagulate within a few days
if they ae stored at temperatures above 75 F.
2494 (cont. case6) although that doesn't result in total loss of
potency, it's markedly more difficult to withdraw a uniform dose and
predict onset and duration of action. Traveling diabetics should be
advised to avoid prolonged exposure of their insulin to
2495 (cont. case6) very high T, and that it's not necessary to

Page 94 of 582
S Question
(case5) a diabetic recovering from surgery has his insulin
administered continuously by slow IV infusion in successive 1liter
bottles of D5W. Urinary glucose tests indicated that blood glucose
was markedly elevated after the first liter was administered.
2484 (cont. case5) similar testing after the 2nd and 3rd Ivs were
administered indicated noticeably improved control of blood glucose.
Assuming that the insulin dose was initially adjusted for the stress of
surgery, the hyperglycemia following the 1st
2485 (cont. case5) IV was probably due to: adsorption of insulin on
the bottle and tubing. The theoretical advantage of administering
insulin in IV glucose is that both insulin and glucose are delivered in
constant proportions.
2486 (cont. case5) admn of insulin in this manner, however, can
result in unesirable fluctuations in blood glucose levels. As much as

Page 95 of 582
S Question
(case4) a pt to whom you dispensed a new prescription for
amitriptyline four days ago returns to your pharmacy and compains
that the drug makes her very sleepy, makes her mouth very dry, and
has not helped her depression at all, these symptoms are:
2480 (cont. case4) expected effects of early ttt of the drugs and you
would explain this to the pt. the full therapeutic effect of TCAs often
takes several weeks to develop. During this period many pts
subjectively feel that their depression has worsened
2481 (cont. case4) on the otherhand, the SE of these drugs (sedation,
anticholinergic SE) usually begin shortly after therapy in initiated. The
pharmacist should discuss these anticipated effects with the pt,
2482 (cont. case4) he should also consult the prescribing physician if
it's apparent that an intensified depression may be serious enough to
lead to suicide.

Page 96 of 582
S Question
(case3) a pt who has been stabilized on 300mg of phenytoin per day
is having difficulty swollowing capsules, his physician writes a new
prescription for phenytoin suspension 300mg once daily.
2474 (cont. case3) this change is likely to increase the phenytoin level
because the 300mg dose of suspension contains more of the active
for of phenytoin. Although there are no reported differences in
bioavailability between phenytoin caps and susp,
2475 (cont. case3) this pt's phenytoin level is most likely to increase
because the mg-for-mg conversion is equivalent to an increase in
dose. The caps form of phenytoin is the Na salt which contains only
92% phenytoin, but the susp is free acid,
2476 (cont. case3) and contains 100% phenytoin. In this situation the
pt would be going from a daily dose of 276mg phenytoin (as 300mg
phenytoin Na) to 300mg phenytoin.

Page 97 of 582
S Question
(case2) a pt suffering from acute alcohol withdrawal is given 100mg
of chlordiazepoxide IM because of inadequate response, he's given
100mg IM in 30 minutes and another 100mg IM in another 30
minutes. Later the pt becomes extremely ataxic and stuporous.
2469 (cont. case2) these symptoms (ataxia, stupor) are most likely
due to: delay absorption of relatively large amounts of drug. Because
of the realtively poor aqueous solubility of chlordiazepoxide, the drug
is reconstituted in a special diluent that
2470 (cont. case2) consists primarily of propylene glycol. When
injected IM, the drug is believed to ppt in the injection site forming a
depot from which the drug slowly redissolves and becomes available
for absorption.
2471 (cont. case2) compared to equal oral doses, IM
chlordiazepoxide is absorbed more slowly and produces lower blood

Page 98 of 582
S Question
(case13) a 20-y-old asthmatic pt has been treated with theodur
500mg(theophylline SR)twice daily. Despite a good Css of 16mcg/ml,
the pt has brief episodes of brochospasm several times a week. The
physician would like to give the pt additional
2570 (cont. case13) bronchodilator therapy with an oral B-agonist.
The drugs that could be used: ephedrine, metaproterenol,
terbutaline, albuterol. Of them ephedrine the the least desirable.
2571 (cont. case13) although a number of B-agonists are avialable for
clinical use, only ephedrine, metaproterenol, albuterol, terbutaline
are available in oral dosage forms.
2572 (cont. case13) terbutaline & albuterol selectively stimulate B2-
receptors to a greater degree than B1-receptors. They, therefore, are
somewhat less likely to cause cardiac stimulation. Ephedrine has
weak alpga, B1, B2 agonist activity.

Page 99 of 582
S Question
(case12) an asthmatic pt is stabilized to a therapeutic theophylline
level on an IV aminophylline(dihydrate) unfusion of 50mg/hr. the
physician wishes to put the pt on an equivalent amount of SR
anhydrous theophylline, an appropriate daily dose
2566 (cont. case12) would be approximately 900mg daily in a dose
about 300mg q8hrs. After this pt has been switched from IV
aminophylline to SR theophylline, the most appropriate time to
obtain a blood sample for theophylline level would be:
2567 (cont. case12) 3-5hrs after p.o dose is given. Because both
efficacy & toxicity correlate well with peak drug concons, dosage
adjustments are best guided by peak levels. When using peak concns
as a guide for dose adjustment, care must be taken to avoid
2568 (cont. case12) error due to delayed absorption. Plain, uncoated
tablets and solns are rapid release preparations and peak about 2hrs

Page 100 of 582

S Question
(case11)a 50-y-old pt with CHF is stabilized on digoxin 0.25mg daily,
HCTZ 50mg daily, & low-Na, high-K diet. The pt then develops
polyarteritis, which requires corticosteroid therapy.The glucocorticoid
most appropriate for this pt is:
2563 (cont. case11) dexamethasone. NOT: hydrocortsine, cortisone,
prednisolone, prednisone. Corticosteroids associated with less
mineralocorticoid activity should be used in pts with conditions such
as CHF in which Na-retention is an aggravating factor.
2564 (cont. case11) because all glucocorticoids induce K-loss
regardless of their mineralocorticoid activity, even dexamethasone
should be used with caution in this pt.

Page 101 of 582

S Question
(case10) a 40-y-old male pt with a history of HTN develops a
moderately severe endogenous depression. The physician prescribes
amitriptyline 25mg tid. The pt says he can't tolerate the drug because
of dry mouth, constipation and cardiac palpitations.
2551 (cont. case10) the physician asks you whether there's another
antidepressant that doesn't have the anticholinergic & cardiovascular
SE, you would suggest: trazodone, nomifensine NOT: imipramine,
nortriptyline, trimipramine, maprotiline.
2552 (cont. case10) although none of the cyclic antidepressants are
totally without anticholinergic & cardiovascular SE. trazodone and
nomifensine have huch less of this SE and would be more appropriate
for this pt.
2553 (cont. case10) considering the above situation and assuming
that the physician desires to use a drug primarily inhibits the

Page 102 of 582

S Question
(case1) 6 wks ago, a 32-y-old female pt with a history of recurrent
UTIs was treated with a 10-day course of ampicillin 250mg q6h for an
E-coli UTI, she now presents with signs and symptoms with another
UTI,
2311 (cont. case1) pending culture and sensitivity results, this pt
should be started on: ampicillin. NOT: gentamicin, trimethoprim-
sulfamethoxazole, TC, nitrofurntoin..
2312 (cont. case1) because this pt has a history of recurrent UTIs, the
present symptoms probably indicate a reinfection, therefore,
ampicillin should be the most reasonable choice pending culture and
sensitivity results.
2313 (cont. case1) if this pt had been initially treated with a
sulfonamide or TC, it would be desirable to switch to a different drug
because bacteria frequently develop resistance to these drugs.

Page 103 of 582

S Question
"(case14) a 25-y-old mentally retarded pt is stabilized on phenytoin
300mg/day. The pt has Css=18mcg/ml (normal therapeutic range=10-
20mcg/ml). Because the pt has been recently""cheeking"" his
phenytoin capsules, the physician wants to switch to"
2576 (con. Case14) oral suspension to be sure that the drug is being
taken, the suspension contains 125mg/ml. so the equivalent daily
dose od suspension will be 11.04ml. The cap contains Na phenytoin
(92% phenytoin) and the suspension contains phenytoin acid
2577 (cont. case14) (100% phentoin) the label on the products
indicates content in terms of salt and acid respectively and not in
terms of active drug. Because small changes in dose may result in
dramatic changes in serum drug concentration and clinical
2578 (cont. case14) response, the differences should be considered
when dosage form is changed. In this case the pt is getting
Case is given and asked use of phosphate buffer.
515 Penicillin in a B-lactam ring erythromycin has a lactam ring
Tetracyclines give different absorption and dissolution patterns cause
823 it is amphoteric (form salts with acids and bases, capable of forming
internal salts
Page 104 of 582
S Question
1037 When hexyl resorscinol is exposed to air it will be oxidized
1197 Volatiles oils are rich in terpentines
Volatile oils are terpines
Volatile oil is rich in terpentine
1008 Types of bonds usually seen in complexes are hydrogen bonds
The UV range used in spectrophotometry is 200-400 nm
The structure of sulfonylureas can be substituted at R1 and R2
positions -- 2nd generation have larger substitutions on R1
Sulphonamides must have a nonsubstituted aromatic amine essential
for antibacterial activity (metabolized by acetylation)
Substitution of cephalosporines at C7 inc B-lactamase stability
Substitution od cephalosporines at C7: increase stability to B
lactamase
Structure of estrogen is a steroid
1379 Stearic acid + KOH = soap
Soap is formed by reaction of inorganic base with organic acid
Salicylic acid + cholroform + H2NO3 = pptn of salicylic acid in the
1222
lower layer

Page 105 of 582

S Question
Racemic mexture is optically inactive because it contains equal
amounts of D and Lstereoisomers
Phenyl group in phenyl Hg nitrate leads to less solubility than organic
497
salts
Phenyl group in phenyl Hg nitrate leads to less solibility than other
603
inorganic salts
Phenol, NH4Cl,= acidic -- NaHCO3, amphetamine, acetazolamide =
basic
1268 Phenol is acidic
505 Phenol + (hydration)= 1,2-benzodiol
631 Paraldhyde is acetaldhyde polymer
Paraldhyde is a polymer of acetaldhyde -- paraldhyde is oxidized to
acetic acid
Para amino benzoic acid=PABA--- ethyl amino benzoic
acid=benzocaine
799 Ortho position= 1 and 2 position on benzene
1238 Optically active means that the compound has assymetric C

Page 106 of 582

S Question
Optical enantiomers: due to one assymmetric carbon atom, consider
mirror image e.g: epinephrine --- diastereomers: due to 2 or more
assymetric C atom and not mirror image e.g: ephedrine
541 Optical activity is due to assymetric C atom
Oleic acid exists in cis form : 2 groups fixed around a double bond on
the same side
Number of sterioisomers of a compound with 4 assymetric carbon
814
atoms =16
NHNH- is present in MOAI structure (phenelzine)??
NH-NH- is present in MAOI structure phenelzine
Methylparaben is ester of parahydroxybenzoic acid
Methylcellulose + p-hydroxybenzoic acid is estrification reaction
Lactulose is synthetic disaccharide
Lactic acid= 2-hydroxypropanoic acid
Lactic acid CH3-CHOH-COOH (optically active) + [oxidation]=pyruvic
458 acid CH3-COCOOH (optically inactive) +[ reduction]=lactic acid
(reversible reaction)
429 KOH + organic acid = soap
KOH + organic acid = soap
Page 107 of 582
S Question
Introduction of halogen to acids inc acidity
If salicylic acid is added to chloroform then H2SO4 was added :
1193
salicylic acid will ppt inc the lower layer
824 Glycerine syrup is neutral
1034 Glucose shows no absorbance in the UV region of 200-400 nm
Glucose cannot be detected or measured by the UV light because it
shows no absorbance in this range: 200-400 nm wavelength
Estrification: OH group from acid is replaced by RO from alcohol
Estimation of glucose amount in solution can be done by: action of
1246 glucose peroxidase, colorimetric method, titration BUT NOT by UV
method
Erythromycin structure is a macrocyclic lactone ring attached to a
sugar moiety
815 Ephedrine, levofloxacin, carvedilol are optically active
Ephedrine is optically active , diastereoisomer
1088 End product of glycogen is glucose
Dioctyl Na sulfosuccinate = docusate Na (anionic)
Conformation isomerism: it's orientation of molecules which result
from rotation of atoms about bonds, called rotamers
Page 108 of 582
S Question
Conformation is rotation about a single bond
Compounds containing aldehyde and keto groups , barbiturates ,
caffeine
575 Cis means 2 groups on the same side
Chiral C atom= asymmetric C atom
CH3COOH + ROH=CH3COOR +H2O (OH from acid, H from alcohol)
CH3-(CH2)16-COOH is stearic acid
Celecoxib contains sulfa group, salfasalazine contains sulfa group,
BUT trimethoprim does NOT contain a sulfa group
436 Camphor is ketone
1015 Camphor is ketone
403 Bonds in protein are polypeptide bonds
689 Benzocaine is ethylaminobenzoic acid
Benzene ring structure: easily determined by UV
1267 BaSO4 is the least soluble compound
402 Atropine structure is similar to acetylcholine
1333 Atropine is sol in acid forming atropine sulfate
712 Amphoteric drugs don't change PH: e.g. tetracyclin

Page 109 of 582

S Question
Amoxicillin is more absorbed than ampicillin because it has a para
619
hydroxyl group
Activity of phenol inc with increasing temperature
554 Acetaldhyde polymerization = paraldhyde
32P is radioactive
1398 2ry alcohol is oxidized to ketone - 1ry alcohol is oxidized to aldehyde
1ry alcohol oxidation gives aldehyde --- 2ry alcohol oxidation gives
ketone
1,2 bezodiol formed by hydration of phenol
Zwitter ion structure
Structure of cisplatin
Phenthiazine general structure
Phenobarbitone contains keton group
Oxidation of 2ry alcohol gives ketone
Organic structure conformation detected by NMR
Ketoprofen is propionic acid derivative
Formation of ester occurs by acid alcohol reaction
Equatorial arrangement
c-o-c is ether
Page 110 of 582
S Question
Chlorpheniramine is alkylamine derivative
Ampicillin side chain
Addition of (CH3)4 to NH4 leads to N+
Which of the following functional group is responsible for Atropine
165
instability?a. ether…..b. ester...c. amino..d. heterocyclic ring
UV rays are useful for detection of which of the following molecule?
159
Sorry no idea of options may be it was benzene ring or something
Following structure is present in which one of the folloing
149
molecule?a. Vitamine C...b. Vitamine B...c. Vitamine D..d. Vitamine A
Basic stereo chemistry For example what will be the mixture in final
146 solution if the molecule has more than 1 chiral centers? Enantiomers
or diastereomers etc.
Barbiturate over all is a(an):a. acidic..b: basic...c:neutral...d. non
145
electrolyte
Why amoxicillin is better than ampicillin in absorption? I think due to
P-OH group
What Dextro- means? Ans;: rotate polarize light to right
Question related to sulfoxazole sodium structure?why we use sodium
salt?
Page 111 of 582
S Question
CH3-CH2- group name ? Ethyl- methyl- acetyl -....
Which of this medication dose not have active metabolite-
202
temazepam- fluoxetine -famciclovir-amiodarone
Structure of sodium acetate hydrocortisone ..a) Sodium at the
acetate part to increase solubility...b) a part of the acetate will bind
201 with another part of the hydrocortisone and form a ring...c) Ester part
will hydrolyze in the blood and free the Hydrocortisone (I think it is
the correct answer)
Structure of promethazine and ask which make this antihistamine
different than other antihistamine: a) the Nitrogen atome binds to
two rings which form another ring with each other..b) The Nitrogen in
211
the Amino group comes after 2 carbon atoms..c) big three ring
structure

199 Phenobarbital sodium in aqueous solution: acidic-basic-neutral

Cimetidine structure given and asking which compound derived from:
209
histamine
208 Alcohol structure

Page 112 of 582

S Question
Which one cannot be detected by uv: para hydroxyl benzoic -
254
tartaric – phenothiazines
What is this structure : (given amino acid structure) a) Ketone b)
279
Amino Acid
253 UV range: 200 – 400
The structure to be chiral-rotate 90degree on the plain polarized
249 light..- the conformers could be known by physical properties ..- has a
plain of symmetry ...- D mean plain polarized to rotate to the right
Sulphone formation in vivo due to:-oxidation of marcaptans-oxidation
296
of mercapturic acid
266 Structure of thiazide
267 Structure for epinephrine :- catecholamine- dopamine- thiazide
226 Penicillin v structure
(+ -)racemic means:-different chemical properties- has same physical
263
activity-optical active center
48 UV range: 200 - 400 nm
111 Trans ethylstilbestrol, groups on both sides
23 Tetracycline: both acidic and basic
18 Sulphonyl urea structure
Page 113 of 582
S Question
19 Sulfonamide structure is given: antibacterial activity
Stereochemistry points, select wrong answer: D rotates plane
114 polarized light to right, which is wrong because it represents D-
glyceraldehyde
Select wrong answer about isomerism, Enantiomers are same as
115
diastereomers
25 Pyrrole structure
143 Phenobarbital acid or basic
P-amino benzoic - sodium carbonate- valproic acid- benzoic acid.. is
49
detected by UV
28 Nicotine water solubility due to N
123 Indomethacin SAR and metabolism
Hg binding to Dimercaprol in which way? Antidote of mercury identify
24
structures
20 COOH group: carboxyl
141 Conformers can be differentiated by .. Melting point… boiling point
21 Ampicillin side chain and sulfonamide identification
Why amoxicillin is better than ampicillin in absorption? I think due to
313
p- oh group
Page 114 of 582
S Question
Which one is not an isomeric mixture?
Which one cannot be detected by uv: para hydroxyl benzoic - tartaric
– phenothiazines (I think tartaric)
Which of this medication dose not have active metabolite -
temazepam - fluoxetine -famciclovir -amiodarone
What is this structure : (given amino acid structure) a) Ketone b)
Amino Acid
318 What Dextro- means? Ans;: rotate polarize light to right
Uv range: 200 – 400
The structure to be chiral -rotate 90degree on the plain polarized
light - the conformers could be known by physical properties - has a
plain of symmetry - D mean plain polarized to rotate to the right
Tetracycline has an amphoteric structure
Sulphone formation in vivo due to: -oxidation of marcaptans-
oxidation of mercapturic acid
Structure of thiazide

Page 115 of 582

S Question
Structure of sodium acetate hydrocortisone Choose the right answer
a) Sodium at the acetate part to increase solubility b) a part of the
acetate will bind with another part of the hydrocortisone and form a
ring c) Ester part will hydrolyze in the blood and free the
Hydrocortisone (I think it is the correct answer)
Structure of promethazine and ask which make this antihistamine
different than other antihistamine: a) the Nitrogen atome binds to
two rings which form another ring with each other b) The Nitrogen in
the Amino group comes after 2 carbon atoms
c) big three ring structure
369 Structure of ascorbic acid and asked what is it… lactone
Structure for epinephrine : - catecholamine - dopamine - thiazide
SAR of sulindac… COOH is necessary, prodrug formation was counter
368
productive etc
Radiating Substance......what is the half life. .....Ans. It follows 1st
order kinetics. So calculate according to that
Racemic means: -different chemical properties - has same physical
activity -optical active center

Page 116 of 582

S Question
Question related to sulfoxazole sodium structure?why we use sodium
310
salt?
Polymorphism.....Which is not a property of it?...... Ans. X-ray.
Phenobarbital sodium in aqueous solution: acidic-basic-neutral
342 General structure of: steroid, antihistamine
362 Cis trans isomerms are diasteriomers
Cimetidine structure given and asking which compound derived from:
histamine
307 CH3-CH2- group name ? Ethyl- methyl- acetyl -....
Alcohol structure
Sodium metabisulfite: acidic--glycerol, ethanol, KI, NaCl,:neutral---Na
697
borate: alkaline
1153 Organic acid + inorganic base= soap
635 NaHCO3 is a weak base
820 Na stearate may render benzalkonium soln inactive
468 Lactic acid oxidation gives pyruvic acid
984 Glycerine is alcohol -- gelatin is a protein
1011 Ethylene glycol oxidation gives oxalic acid
1041 Erythromycin structure is lactone ring with sugar moiety
Page 117 of 582
S Question
Which of the following is ion present in vitamine B12?a. Ferrous...b.
167
cobalt...c. magnesium..d. calcium
646 Clindacyn dissolve in H2O NOT alcohol
644 Bear's lambert's law relate the absorption of light to wave length
Wool fat (anhydrous lanolin) -- lanolin contains more water than wool
1458
fat (anhydrous lanolin)
924 With hydrocortisone use simple base or soft parrafin
When a soln, is separated from its solvent by a semipermeable
membrane, solvent will pass through the membrane
837 Types of bonds usually seen in complexes are hydrogen bonds
393 Tweens give o/w emulsions
390 Tweens = polysorbate
Trituration: grinding
568 Trituration is grinding to fine powder
1303 Tragacanth is used to increase viscosity
Titanium dioxide: sunscreen agent
816 Titanium dioxide is sun blocking agent
Thermolabile sterilization technique using aseptic technique by 0.22
1462
microne filter
Page 118 of 582
S Question
The emulsifying agent with chlorhexidine is cetrimide
The emulsifying agent of Ca(OH)2 and olive oil (oleic acid) is Ca oleate
The emulsifying agent in olive-lime water emulsion is : Ca oleate
The drug to be available in the plasma should be in soln form
The base used with hydrocortisone is simple ointment or soft parafin
894 Syneresis:: gels contract, lose fluid
878 Suspensions are not suitable for IV injection
Stool softeners frequently anionic surfactant which is dioctyl Na
sulfosuccinate =docusate Na
801 Stock's law for sedimentation rate ---- fick's law for diffusion rate
Sterilization of water for injection: by distillation, reverse osmosis
Sterilization of soft lenses: boil in water for 15-30 minutes, use
chlorohexidine 0.01% for soft lenses, use benzalkonium Cl 0.02% for
hard lenses
Sterilization of parentrals , oils by dry heat at 170 C for 2 hrs
Sterilization of oils, fats, powders: dry heat at 160 C for 2 hrs
Sterilization of contact lens by soaking in saline or preservative
Sterile H2O for injection is prepared by distillation then autoclaving
???
Page 119 of 582
S Question
Stearyl alcohol, cetyl alcohol are used as stabilizers
1190 Stearyl alc, cetyl alc, cholesterol are used as stabilizers
Stearyl alc, cetyl alc, cholesterol are stabilizers
Steady plasma level depend on infusion rate
1001 Stabilizers: cetyl alcohol, stearyl alcohol, cholesterol
Stability of emulsion depend on method of agitation
SR tablets are swallowed as a whole
392 Spans give w\o emulsions
1098 Sorbitane monostearate gives W/O emulsion
Sorbitane monostearate (nonionic) w/o emulsion--- Na lauryl sulfate
= O/W --- dioctyl Nasulphosuccinate = O/W
Sorbitan monostearate gives W/O emulsion - sorbitan sesqioleate ( in
377
hydrophilicpetrolatum base )
893 Sorbitan monostearate (non ionic surfactant)== gives W/O emulsion
989 Solvent used with hydrocortisone IV injection is propylene glycol ???
Solvent used with HCTZ injection is propylene glycol
1200 Solubilized vit A is a micellized dispersion of vit A an SAA
958 Soda lime sol + air CO2 = CaCO3 ppt
1385 Silica: # moisture deterioration of drugs
Page 120 of 582
S Question
Semithicone is antacid antifoaming agent
SAA is added to tablets to act as a binder and adhesive and improve
dissolution and bioavailability
RX containing: kaolin + aluminium + chalk= astringent
1178 Rose oil + cetrimide is stabilized by aggitation
Rose oil + cetrimide 20 % is stabilized by agitation
569 Rideal walker test = germicidal efficacy of antiseptics
Refractometer depend on density
Refractiometer depend on difference in density between 2
substances
Reduction of particle size do not show difference of disintegration
1413 Reduction in particle size do NOT show difference in Xray
397 Rectal supposotories adults=2g pediatric=1g
691 Rate of emulsion creaming depend on viscosity
873 Rate of emulsion creaming depend on viscosity
396 Rancidity is the oxidation of double bonds in fatty acids
567 Radial Walker test is used to estimate disinfectant/germicidal activity
1415 Pyrogens: bacterial byproducts cause febrile reaction
Pyrogen causes fibrile reaction
Page 121 of 582
S Question
1286 Purified water for injection is prepared by distillation
1459 Prodrug is an inactive form of the drug
Preservatives: chlorobutanol, dehydroacetic acid, K-sorbate, cresol,
1112 thiomersal, benzalkonium. Benzoic acid, benzyl alcohol,
cetylpyridinium, phenol
Preservatives in eye drops : chlorocresol 0.1 % , benzalkonium
chloride 0.02 % ,chlorohexidine 0.01 % , Na edetate 0.1 % , phenyl
416
mercury nitrate 0.002 % , cetrimide 0.005% -% of chlorocresol is 0.05-
0.1%
Polysorbates (tweens) is used as detergents ans solubilizing agents
(o/w emulsifyling agent) high HLB -- sorbitan (spans) are used as
wetting agent (w/o emulsifying agents) low HLB
449 Polysorbate is used as wetting agent
Polysorbate is used as detergent, solubilizing agent --- sorbitan is
854
used as wetting agent
Polysorbate is known as wetting agent
781 Polysorbate 80 assist in dispersion of cooltar
391 Polyoxyalkylenes = spans , tweens

Page 122 of 582

S Question
Polymorphs differ in: melting points, solubility, dissolution rate,
density, stability, BUT NOT PH
Polymorphs differ in: melting point, solubility, dissolution rate,
desitym, stability BUT NOT Ph
1330 Polymorphs differ in solubility and melting point
960 Polymorphism affect the solubility of the drug
Polymorphic drugs are different in all except PH in soln
Plastic which is not affected with autoclaving is PVC
Phenol + mentol + camphor = eutectic mixture
Phenol + menthol + camphor = melt giving eutectic mixture
Pharmacist should suggest to pt that a supp. Made with carbowax
1297 and glycerinated gelatin as base should be dipped in water before
insertion
Petrolatum is soluble in vegetable oil , chloroform , ether .
388
Petrolatum is insouble in water, ethanol, acetone
Oral drug with weak PH is more absorbed from stomach
Oral drug absorption rate is affected by its dissolution not
disintegration rate

Page 123 of 582

S Question
Opthalmic solutions are sterilized by filteration by a 0.22 microbial
531
filter or heat with bactericidal
1023 Olive oil + lime water = calcium oleate ( stabilizer )
1101 Olive oil + lime water = Ca oleate (emulsifier)
1035 Olive oil + lime water = Ca oleate
1451 Olive oil + lime water= Ca oleate (emulsifier)
Oleic acid is monounsaturated fatty acid --- linoleic acid is
polyunsaturated fatty acid
794 Ointment base is made of hydrocarbons
Oily antioxidants:: BHA:butylated hydroxy anisol , tocopherol, BTH:
1392
butylated hydroxy tolwene, ascorpyl palmitate, propyl gallate
Oils, fats, powders are sterilized by heat at 160 DC for 2 hrs
Non ionic cetomacrogen 1000 is compatible with: salicylic acid,
camphor, KI NOT with phenol
Non ionic cetomacrogel is compatible with: salicylic acid, camphor, KI
BUT NOT with: phenol
Non inonic emulsion: cetomacrogel -- anionic: Na lauryl sulfate (soap)
1194
-- cationic: cetrimide, benzalkonium chloride
Needle with smallest diameter carry the greatest number
Page 124 of 582
S Question
1366 NaCl (neutral) does not change PH of the medium
1209 Na stearate (soap) = anionic SAA
399 Na phenbarbitone yields alkaline solution
Na metabisulfite is an antioxident or a reducing agent -- it changes
the PH to acidic -- glycerine (neutral) does not change the PH of the
medium
628 Na metabisulfite is an antioxidant
Na metabisulfite is an antioxidant
Na lauryl sulfate is incompatible with cetrimide BUT compatible with
1414
icthamol
Na lauryl sulfate is an anionic surfactant so its incompatible to
879
cationic SAA
545 Na bisulfite is antioxidant, change pH of medium
934 Na benzoate is used as a preservative
Most volatile oil is menthol
1080 Most vaginal suppositories use a base of PEG
Mineral oils are not miscible with alcohol, chloroform, ether, benzene

Page 125 of 582

S Question
Mineral oil: antioxidant is added to prevent peroxide formation,
1381 mixture of hydrocarbons obtained from petrolatum, immiscible with
castor oil, immiscible with alcohol, specfic gravity is more than 1
Mineral oil is petrolatum derivative (aliphatic hydrocarbon) and
1290
immiscible in alcohol or castor oil
Mineral oil is mon miscible in alcohol
1000 Methyl paraben is used to prevent mould, yeast growth
604 Methyl paraben is ester of hydroxybenzoic acid
Methyl paraben is an ester of benzoic acid and parahydroxy benzoic
acid -- prevent yeast and mould growth
Lyopophopic colloids:: inorganic particles: Au, Ag. Small electrolyte
concn: pptn,, inc concn of particles: constant viscosity
Low diameter of needle: high gauge number
754 Liquid in liquid dispersion system is emulsion
401 Light passes through a solution depending on solute concentration
KI is used as enteric coated tablets to decrease irritation
829 KCl therapy is given by slow IV infusion
Intra-articular: in the joint -- intrasynovial: in the joint fluid --
intrathecal: in the spinal fluid
Page 126 of 582
S Question
Intermittent IV therapy is used to: avoid anticipated stability or
comptability problems, dec the potential of thrombophlebitis, better
diffusion of some drugs into tissues
Insulin needle , boil with H2O for 30 minutes
496 Initial calibration mark on ml graduated pipette in 20 ml
Increase partition coefficient of drug = increase passive absorption
If oral coated tablet is used:: disintegration will be the rate limiting
step
Hydrophilic depend on osmolarity -- hydrophobic depend on partition
coefficient
Horizontal laminar flow is better than vertical laminar flow --- tests
for it: DOP, smoke test, microbial test
HNO3 conc= 0.002% --- phenyl Hg acetate=0.002%
1104 HNO3 conc : 0.002% -- phenyl Hg acetate 0.002%
1069 HLB is important for classification of nonionic SAA
HgCl2: very water soluble --- BaSO4 is the least soluble
915 HgCl2 is very water soluble --- BaSO4 is the least soluble
952 Hexyl resorcinol is oxidized upon exposure to air
737 H2O at pH 9 is best solvent for barbiturates (alkaline water)
Page 127 of 582
S Question
Greatest drug concn gradient between blood and tissue will occur
when drug is administered by IV bolus
Glycerine suppositories: 92% glycerine + Na stearate // 70% glycerine
1205
+ 14% gelatine + H2O
Generic= drug having same ingredient as the brand drug
Gelatin is a protein
For sustained release K= use inner wax matrix
546 Flexible collidion contains camphor+ castor iol
Ficks law of positive diffusion
466 Fick's law for passive diffusion
Fick's law (diffusion) = dc/dt=D*S.A*(C1-C2)/L --- noyes whitney's
law= dc/dt=dc*S.A*(Cs-C)/h
Eutectic mixture: mixture of chemicals in which they melt (liquify) at a
temperature lower than their melting points (menthol + camphor +
phenol)
Ethylpalmitate is not SAA
1239 Ethyl stearate or ethyl palmitate are NOT surface active agents
Ethyl palmitate/ ethyl stearate are not SAA
Ethyl palmitate is not SAA
Page 128 of 582
S Question
Ethanol, KI, syrup are neutral do not change the PH of the medium
but Na metabisulfite is acidic and Na borate is alkaline, KBr alkaline
Emulsion is liquid in liquid dispersion system
666 Emulsifier used with salicylic acid prepartions is wool alcohol???
973 Emulsifier used with salicylic acid preparation is wool alcohol
1139 Econazole nitrate: o/w emulsion, compatible with anionic SAA
Drugs that require pateint package insert: isotretenoin, OC,
821 isoproterenol, ticlopidine, progesterone, estrogen, IUD (intrauterine
device)
Drugs thae can be destroyed by heat in the autoclave: procain,
penicillin, insulin, Ab?, phenylephrine, heparin
Drugs excreted by passive tubular reabsorption = aspirin,
amphetamine
Drug tolerance = reduced pharmacologica response due to repeated
1110
administration
1186 Dressing is used with cortisone to increase absorption

Page 129 of 582

S Question
Dispersion types: 1-molecular (less than 1nm) pass ultrafilter,
semipermeable membrane,
855 ex: oxygen, glucose --- 2- colloidal dispersion: (0.5-1 micron) pass only
filter membrane, ex:
silver solution --- 3-coarse dispersion
1111 Diluted acetic acid is 6% w/v of pure acetic acid
1076 Dilatant viscosity inc by agitation
Diethylether is used to prevent peroxide which is a toxic compound
1224 Creaming in emulsion depends on difference between 2 phases
1183 Cool tar may be mixed with salicylic acid
733 Contact angle is used to measure friction coefficient of powder
853 Conc of chlorohexidine is : 0.01%
Colloids:: 1-lyophyllic colloids, 2-association colloids, 3-lyophobic
colloid --- lyophilic colloid: organic disperse molecules, inc concn: inc
1085
viscosity, may transform from solution to gel, addition og high
electrolytes: pptn. (salting out)
Coal tar is mixed with polysorbate 80 to assist its dispersion

Page 130 of 582

S Question
Clinical investigation of a new drug consists of 4 phases: first phase
include administration of drug by selected clinicians to healthy
volunteers
782 Chlorohexidine is compatible with cetrimide o/w emulsion
901 Chlorohexidine is compatible with cetrimide
1103 Cetyl pyridinium bromide (cetrimide)= cationic emulsifying agent
1249 Cetrimide is used to for O/W emulsion of chlorohexidine
639 Cetrimide gives O/W emulsion
Cetrimide give O/W emulsion
Cetostearyl, and cholestrol : stabilizers
Cetomacrogel/ emulsion wax = W/O emulsion ---Na lauryl sulfate +
cetostearyl alc (anionic) = O/W -- cetrimide + cetostearyl (cationic)
=O/W -- cetomacrogel 1000 + cetostearyl (nonionic)= O/W
Cetomacrogel is incompatible with tannic acid, NH4 salts, phenol
Cetmacrogel= nonionic SAA that is incompatible with tannic acid, NH4
498
salts and phenol
Cellulose acetate phthalate: used in enteric coated tablets
Camphor is not freely dissolved in water, it is insoluble in water,
soluble in alcohol
Page 131 of 582
S Question
1400 Calamine lotion consists of ZnO and ferric oxide
Calamine lotion = ZnO + ferric oxide
CaCl2 will not be active when given orally
Butylated hydroxy tolween (BHT): oily antioxidant -- like it: butylated
hydroxy anisol (BHA) , ascorbyl palmitate..
840 Buffer soln resists PH change
Body placed in hypertonic solution will dec in size
Benzalkonium chloride is a cationic germicidal SAA
Benzalkonium chloride (cationic germicidal surfactant) is inactivated
1108
by soap (anionic SAA)
518 Bendict's soln depends on the reduction of cupric ion to cuoroic acid
Bear's Lambert's law relate the absorption of light by solution to
wave length
BaSO4 is the least sol compound
Base of supp must not melt below 30 C

Page 132 of 582

S Question
Association (amphophilic) colloids: aq, non aqueous medium,
lipophilic and hydrophilic
836 parts in disperse particles, form aggregates at CMC.. Micelle
concentration inc: viscosity inc ,,
addition of electrolytes:: pptn
Aq. Antioxidents: ascorbic acid, sod. Metabisulfite, sod, bisulfite, sod.
871 Sulfite -- indirect
antioxident: EDTA
Antioxidants: ascorbyl palmitate, butylated hydroxy anisole (BHA),
ethylene diamine, K metabisulfite, Na metabisulfite, Na bisulfite
Anions SAA are compatible with icthamol ans econazole nitrate
1003 Anionic surfactants are compatible with econazole nitrate, icthamol
Anionic surfactant like Na lauryl sulfate is compatible with icthamol
Anionic surfactant is compatible with icthamol
Anionic SAA is compatible with econazole nitrate and icthamol ex: Na
lauryl sulphate
An ointment base is made of hydrocarbons
Ampicillin and insulin are stored at 2-8 C but not freezed
623 Amaranth is a coloring agent
Page 133 of 582
S Question
1285 Amaranth is a coloring agent
Aluminium chloride is antiprespirant
1128 Aloes sunscreen oils protect from UV
AlCl3 is locally applied antiprespirant because it precipitates proteins
1422
and dec excretion
Al in Rx is used as astringent
586 Adsorption is a physical phenomenon
810 Adsorption is a physical phenomenon
910 Acacia is sol in H2O and insol in alcohol
A unit dose package: one that contains the exact dose of drug
ordered for a given pt
65% sucrose: # microbial growth
3-coarse dispersion: (greater than 0.5 micron) visible, pass nothing,
1181
ex: emulsion, suspension
0.1% clorohexidine HCl, the emulgent is cetrimide
378 % of chlorocresol is 0.05 - 1 %
Starch used as disintegrant
Simethicone is silicone derivative
Cellulose acetate phthalate used in enteric coated tablets
Page 134 of 582
S Question
Autoclaving(3 Q's)
Which of the following base should be used for the hydrocortisone
164
cream?
There were questions on pH and solubility of the drug For example if
158 we alkalanise the pH then which of the following drug will be
excreated?
How does the uv rays kill microorganism? a. by change in dna
150
structures
Why KCL is given as sustained release dossage form?
What is used to form enteric coated tablet? Cellulose acetate
phethalate
What is the least appropriate drug to be crushed before sollowing?
Aspirin-indoethacin- Omeprazole- Rantidine
210 Ointment base: a)cannot be mixed with water b)monophasic
How is a bitter taste masked?a) Sugar...b) Film...c) enteric and
175
sugar..d) sugar and film..e) film and enteric
Creaming of emulsion directly proportional to the difference in
180
specific gravity between the 2 phases

Page 135 of 582

S Question
What will affect the dose of a transdermal patch.a) the serum
concentration of the drug will decrease as soon as the patch is
260 removed b) absorption can be different on different skin parts of the
body.c) absorption depends on the nature of the drug (lipophility)..d)
humidity can affect the absorption
To move the drug from low concentration to high concentration: - we
265 need to increase partition coefficient - it need energy and specific
carrier
221 Sunscreen ingreditent: titanium dioxide
282 Shelf life of opened Eye drops? → 28days
Parafin liquid - hydrolalphitic carbon... immiscible with alcohol and
250
castor oil
Which is not true regarding alkaloids? PKa less than 7, soluble in
63
alcohol, sparingly sol in water
61 Which Barium salt is soluble in stomach acid?
91 Tragacanth is a gum
85 Rapid onset of action for sublingual route of administration
Question about transdermal patches select wrong answer? Depends
117
only on nature of drug content
Page 136 of 582
S Question
103 Ph affects absorption rate
43 Particle size for suspensions
59 O/W emulsion: cetostearyl alcohol is the surfactant
58 O/W emulsion which base? SLS - Sorbitan oleate
118 Na phenobarbital in aqueous solution becomes alkaline
127 Hydrophilic oint. Is (adsorption base-water removable-water soluble)
93 HLB values for o/w emulsion
92 Fats, oils and powders are sterilized at 160c for 2 hours
87 Dithranol paste with ZnO and 2% salicylic acid
305 Why KCL is given as sustained release dossage form?
Which is not included in tablet testing.....Ans. Tablet Uniformity
Which drug needs to be in tightly closed container (having high vap
361
pressure)
What will affect the dose of a transdermal patch a) the serum
concentration of the drug will decrease as soon as the patch is
removed b) absorption can be different on different skin parts of the
body c) absorption depends on the nature of the drug (lipophility) d)
humidity can affect the absorption

Page 137 of 582

S Question
What is used to form enteric coated tablet? Cellulose acetate
308
phethalate
373 What is not true for alkaloids… PH less than 7
326 Vehicle in ophthalmic (PVA)
To move the drug from low concentration to high concentration: -
we need to increase partition coefficient - it need energy and specific
carrier
Sunscreen ingreditent: titanium dioxide
Storage 2 to 8 for what… all opthalmics drops and sulphonamide
339
suspension.
Potassium permanganate 2% dispensed 300ml, doctor want to give
dose as 1:1000 using measure of 50ml. -dilute 5o ml to 1L water
Parafin liquid - hydrolalphitic carbon - immiscible with alcohol and
castor oil
Ointment base: a)cannot be mixed with water b)monophasic
Moist heat sterilization is better than dry heat.
How is a bitter taste masked?a) Sugar b) Film c) enteric and sugar d)
sugar and film e) film and enteric
Drug absorption is mainly passive absorption.
Page 138 of 582
S Question
Decompose by heat sterilization: procaine
Creaming of emulsion directly proportional to the difference in
specific gravity between the 2 phases
Bioavaiabiliy determinent in regular immidiate release tablet?
315
Dissolution - dissintegration- metabolism
389 Spans = sorbitane esters
Dithranol is used for ttt of psoriasis topically, better stabilized in pasts
448
of ZnO by adding 2% salicylic acid
587 Antibacterial action of phenol increase by increasing temperature
What is the least appropriate drug to be crushed before sollowing?
316
Aspirin-indoethacin- Omeprazole- Rantidine
327 Interaction of SLS and cetylpyridinium Cl … incompatible
828 0.9% NaCl injection makes penicillin more stable
Upon exposure to air, aminophylline soln may develop crystals of
919
theophylline
640 Atropine does not decompose by heat
There is no digoxin loading dose
The most common SE of digoxin is GIT disturbances

Page 139 of 582

S Question
The aortic and pulmonary valves prevent the backflow of blood to the
ventricles
Systole= heart contraction
1138 Orthopenea: dyspnea on lying, relief on standing
951 Most common SE of digoxin is GIT
Mechanism of digoxin is bound to Na/K ATPase pump
Major determinant of myocardial O2 consumption in cardiac output
Left side heart failure leads to dyspnea
656 K is used with digitalis to avoid toxicity
K is used with digitalis to avoid toxicity
Interaction of digoxin and K: hypokalemia or drugs that cause
hypokalemia may lead to cardiac arrhythmia - hyperkalemia reduces
therapeutic effect of digoxin
Inotropic action of B stimulants of cardiac muscle is increased any in
Ca entry
If pt's symptoms are dyspnea, sweating: diagnosis is heart failure
Hypokalemia inc digoxin toxicity
Heart failure + lignocaine= inc lignocaine level due to low hepatic
1337
blood flow thus decrease lignocaine clearance
Page 140 of 582
S Question
658 Erythromycin, verapamil, diltiazem are C.I. with digoxin
Dose of digitalis is 0.125 - 0.25 mg daily
590 Dopamine is first choice in ttt of emergency hypotensive shock
Dobutamine is a B-agonist that is available for IV use as inotropic
agent. Although dobutamine is similar to isoproterenol in terms of
inotropic effects, dobutamine is realtively less potent than
isoproterenol as a stmulator for peripheral B-receptors
1428 Digoxin soft gelatin capsules give greater bioavailability than tablets
550 Digoxin soft capsule provides better bioavailability than tablets
Digoxin is cheifly excreted unchanged by kidney
Digoxin dose must be reduced in elders as they have low renal
1021
function
Digoxin absorption dec by kaolin and cholestyramine and neomycin
1063
and erythromycin and tetracyclin
1133 Digoxin # Na-K ATPase
483 Digitoxin: hepatic clearance --- digoxin: renal clearance
Digitoxin metabolism: bound to serum albumin in liver -- digitoxin is
best oral form and used in renal impairment because it is excreted by
liver
Page 141 of 582
S Question
844 Digitoxin is more lipid slouble than digoxin
Digitalis is C.I. with Ca (displaces K: toxicity)
Digitalis + furosemide + K -- we use K to decrease digitalis toxicity
1423 CHF inc creatine phosphokinase (CPK)
Ca is contraindicated with digitalis because both increase contractility
of the heart which
792
may lead to arrythmia, also Ca replace K from myocardial cells,
leading to digitalis toxicity
1016 Amrinone : used instead of digoxin
0.2 mg lanoxicaps (soft gelatine) = 0.25 mg digitoxin tablets in
513
potency
(cont. dobutamine) that mediate vasodilation. Consequently
dobutamine produces inotropic effects with consequently little effect
on preload, afterload or heart rate.
Blood fastest speed is in artrioles
214 Systole mean that ventrical contraction
Lisinopril maximum dose in mild heart failure: (2.5mg– 10mg – 20mg
173
– 60mg)
181 Common side effect of digoxin: gastrointestinal disturbances
Page 142 of 582
S Question
109 Question about right heart failure
101 Heart conducting system does not involve AV valve
99 Digoxin toxicity does not cause pulmonary edema
100 Blood flow is rapid in arteries
Patient is on Digoxin and sudden increase in Digoxin level. What is the
possible reason? Ans: Dig + Verapamil Drug Interaction
Dobutamine.........Used in HF.
335 Digoxin causes adverse effect in which condition: HypoK+
Common side effect of digoxin: gastrointestinal disturbances
31 Patient profile: Aspirin in CHF patient with asthma ( 4 to 5 questions)
30 Patient profile on digoxin toxicity and celecoxib (4 to 5 questions)
125 Intercation between Digoxin and Furosemide
336 Drug interaction Digoxn and furosemide
Amrinone:ttt of CHF direct mechanism --- amiodarone: antiarrythmic
980
(K channel blocker)-- amiloride : K-sparing diuretic
583 Cimetidine increase digoxin toxicity
672 Emergency minor burn advice: immerse burn in cold water

Page 143 of 582

S Question
Diseases:: cooley's: familial erythroblastic -- down's: mongolism --
680 hansen's: leprosy -- herpes zoster: shingles -- alzeheimer: presentile
dementia
Classifications::: thiothixene: antipsychotic -- protriptyline:
antidepressant -- trimethadione: anticonvulsant -- oxazepam:
677
antianxiety -- trimethobenzamide: antiemetic -- isocarboxazide: MAOI
-- HCTZ: diuretic -- tripelennamine: antihistaminic
0-1 month: neonates--- 1 month-1y: infants --- 1-5y: early childhood ---
786
5-12y: latechildhood
To measure 25 U of 100 U insulin use a special 100 U syringe which
667
has a max capacity of 50 U
The best emergency advise for pt with minor burn is to immerse the
797 burn in cold water until no pain is experience either in or outside the
water
495 Rectal temp is about 1 DF above oral temperature
761 Radial artery: mesure pulsation
755 Na nitroprusside, KCl: slow IV infusion --- diazoxide: rapid bolus IV
770 IV inj: phlebitis, vein inflammation

Page 144 of 582

S Question
Hypodermoclysis: the intentional administration of IV fluids into SC
627
tissue
500 Barium bisulfate is used to X-ray GIT orally or rectally
649 Atresia: absence of a hole
Patient has sore throat, fever and runny nose give
41
dexchlorpheniramine and paracetamol tablets
1363 Safe laxative in pregnancy is methylcellulose
Phenolphthalin, castor oil used as intestinal irritant (stimulant
laxative)
Ph.ph with mineral oil is used as intestinal irritant
648 Methylcellulose is a safe laxative in pregnancy
Metamucil: psyllium husk, inc dietary intake of fibers, used as
laxative, dose is 7g tid, must drink enough water with the tablet
LaxativesMOA::: Mg citrate, Na biphosphate: draw water into
intestinal tract by osmosis - - psyllium: bulk forming by absorbing H2O
904
-- minerla oils: soften stool by lubrication -- Na docusate: soften stool
by dec serface tension --
Dulcolax tablets: should be taken whole and not broken or chewed -
because they are enteric-coated to prevent gastric irritation
Page 145 of 582
S Question
Docusate Na is a SAA. It softens stools by stimulating intestine
secretion. The effect is usually given within 1-3 days after oral
administration or 2-15 minutes following rectal administration.
Dioctyl Na sulfosuccinate = docusate=stool softener (anionic
1118
surfactant)
Colace: do not take with mineral oil -- Colace is a surfactant and may
increase the absorption of mineral oil if given concurrently
537 Ca polycarbophil : ttt of constipation
Bulk-forming laxatives: psyllium, methylcellulose, bran, polycarbophil
525 Bulk laxatives:: psyllium, methylcellulose, Ca polycarbophil
Bulk forming laxatives are used safely in pregnancy like; psyllium,
764
methylcellulose, bran, polycarbophil or stool softener (Na docusate)
Al(OH)3=constipation
1131 Al causes constipation
288 Contraindications for Psyllium?a) Hypokalemia b) Gallstones
Contraindications for Psyllium? a) Hypokalemia b) Gallstones c) Hyper-
something
The glucocorticoid with highest potency is dexamethasone

Page 146 of 582

S Question
Release of glucorticoids is under the control of : circulating cortisone
1404 level in blood, hypothalamus which release corticotrophin releasing
factor by feed back mechanism.
Pt on dogoxin and HTCZ, most appropriate glucocorticoid is
1289
dexamethasone (no Na content and no salt and water retention)
Prednisone, methylprednisolone, dexamethasone, betamethasone ::
450
glucocorticoids
Prednisone oral = 4 times more potent than hydrocortisone IV so if a
451 pt was given 50 mg HC IV every 6 hrs it is equivalent to 50 mg
prednisone once daily
Prednisone dose: 5-60 mg
Prednisolone shows higher activity than hydrocortisone because it
724
differs in conformation at ring A
Important complications of corticosteroids are: dissemination of local
1307 infection, inc susceptibility to infection, masking symptoms of an
infection
1284 High cortisone intake may lead to moniliasis
High cortisone intake may lead to moniliasis
753 Glucocorticoids cause spread of infection
Page 147 of 582
S Question
For corticosteroid creams put occlusive dressing: hydration of the
skin with occlusive dressing such as a plastic wrap, a tight fitting
nappy or one covered with plastic pants, plastic tape pr
dermatological patches can increase penteration up to 10 folds
Fluorinated corticosteroid is C.I. in rosacea (chronis vasodilation on
nose and cheeks causing redness)
947 Fludrocortisone: high mineralo: ttt of addison's dissease
872 Cortisone causes osteoporosis
Corticosteroids: inc susceptibility to infection
Corticosteroids functions include all the following: intermediate in
metabolism, salt and water retention, muscle development,
hemopoesis
Corticosteroid function: metabolism, salt and water regulation,
908
muscle development, hemaptosis
Comparing with hysrocortisone: prednisolone shows higher activity
because it differs in conformation at ring
(glucocorticoids) hydrocortisone (cortisol):: relative potency: 1,
equivalent dose: 20mg, Na-retaining potency: 2

Page 148 of 582

S Question
(cont. glucocorticoids) prednisolone & prednisone:: relative potyency:
4, equivalent dose: 5mg, Na-retaining potency: 1
(cont. glucocorticoids) methylprednisolone:: relative potency: 5,
equivalent dose: 4mg, Na-retaining potency: 0
(cont. glucocorticoids) dexamethasone:: relative potency: 30,
equivalent dose: 0.75mg, Na-retaining potency: 0
(cont. glucocorticoids) cortisone:: relative potency: 0.8, equivalent
dose: 25mg, Naretaining potency: 2
(cont. glucocorticoids) betamethasone:: relative potency: 25,
equivalent dose: 0.6mg, Naretaining potency: 0
235 WHICH MEDICATION LESS LIKELY TO CAUSE COLD: PREDNISOLONE
patient on corticosteroids develops rash on face due to
52
telangiectasias and striae-stevenjohnson
102 Glucocorticoids long-term use causes osteopenia
Which medication less likely to cause cold: prednisolone
Receptors of cough occur in medulla in the brain stem
1002 Expectorant dose of ipecac syrup for adult is 1ml
622 d-methorphan is 1st choice for routine cough suppression

Page 149 of 582

S Question
Cough reaction: receptors in respiratory tract and receptors in
1185
stomach
Bromohexine: depolymerization of mucous
385 Bromhexine , acetyl cystiene are mucolytics
1252 Acetyl cysteine is mucolytic used by inhalation
Acetyl cystein is administered by inhalation
5-carboxymethylcysteine=acetylcysteine is mucolytic, ttt of mucous
gland hyperplasia
676 Ttt of cystic fibrosis: dornase alpha, N-acetylcysteine, pancreatin
Cystic fibrosis is heriditary not contagious characterized by secretion
1356
of viscous sticky mucous from lungs and pancreas
Cystic fibrosis is heriditary NOT contageous characterized by
509 secretion of viscous, sticky mucous from lungs, pancreas, ttt
pulmonase, alpa-dornase
1320 Cystic fibrosis is hereditary related to parents
Cystic fibrosis is hereditary related to parents

Page 150 of 582

S Question
Cystic fibrosis is a heridetary disease of exocrine glands affecting GIT,
respiratory system, usually characterized by COPD, exocrine
pancreatic insuffeciency, abnormally high sweat electrolytes,
pseudomonas infection is the dominant infection..
Cystic fibrosis is a genetic disease: both parents must have the genes
for it
In cystic fibrosis there is change in sweat
In cystic fibrosis both parents have recessive gene
What is the diagnostic test for cyctic fibrosis? FEV1 ratio ..Amount of
160
chloride in sweat etc......
In cystic fibrosis which shows elevated levels (alkaline phosphatase,
129
amino acid)
138 In cystic fibrosis which ion inc. Cl-
64 Cystic fibrosis: both the parents have recessive gene
65 Cystic fibrosis replacement therapy?
Xanthine, uric acid, and adenines are purines # 6-MP
Xanthine, uric acid, adenine all are purines
1022 rRNA: 80% -- t-RNA: 15% -- m-RNA: 5%

Page 151 of 582

S Question
Ribosomes are attached to the endoplasmic reticulum (rough
endoplasmic reticulum)
700 Ribosome is composed of aminoacids
1027 Ribosome is composed of aminoacids
1177 Ribosome is composed of amino acids
1184 Pyrimidines: C, T, U
1053 Purines: A, G
1060 Nevirapine: non nucleoside reverse transcriptase inhibitor (NNRTI)
Kreb's cycle in mitochondria for respiration -- glogi apparatus: stores
(plasma, lysosymes
1024
syn.) --- lysosymes: contain digestive enzymes -- smooth ER: lipid syn --
- rough ER: protein syn
365 RNA that has a specific aminoacid attached.. trna
367 ER has attached what.. ribosome
Metabolism of drugs occurs in the subcellular organ in the
1259
endoplasmic reticulum,ribosomes
With MAOI can take red meat BUT NOT wine, beer, cheese, chicken
liver
1017 Trazodon: TCA with least anticholinergic SE
Page 152 of 582
S Question
1401 Trazodon is TCA with least anticholinergic SE
Tranyl cypromine is MAOI antidepressant
Theophyllin dec Li
The onset of TCA requires 3-4 weeks
TCAs should not be used in pts also taking: guanthidine - TCAs such as
imipramine and amitriptyline may block the uptake of guanthedine
by adrenergic nerves, thereby inhibiting its antihypertensive action.
TCAs are contraindicated in glucoma and it cause sedation and
1439
anticholinergic side effects
866 TCA SE = sedation, anticholinergic
1456 TCA is C.I. with guanthedine
TCA is C.I. with guanithidine
TCA increase the action of MAOI - antidepressants : TCA , MAOI ,
1378 alpha blockers -tranyl cypromine is a MAOI - amphetamine , phenyl
ephrine , ephedrine, tyramine + MAOI = hypertensive crisis
TCA increase action of MAOIs
TCA dec active reuptake of seretonin, norepinephrine
TCA affect neural amine reuptake mechanism
Page 153 of 582
S Question
1073 TCA # reuptake I of NE, 5HT
885 Tachycardia is the SE of TCA
Sibutramine: # reubtake of NE, S, D
Sertraline is SSRI, also fluoxetine
442 Sertraline is SSRI
Sertraline is hepatotoxic
1421 SE of MAOI is tachycardia
SE of MAOI is tachycardia
SE of cyclobenzaprine is similar to amitriptyline --- cyclobenzaprine is
1467
a central skeletal muscle relaxant structurally related to TCAs
SE of antidepressents: antimuscarinic effects, constipation, posural
hypotension, drowsiness, but venlafaxine cause HTN
SE of amitriptyline: dry mouth, constipation, blurred vision
SE of amitriptyline are: constipation, dry mouth, blurred vision,
drowsiness
1045 Red meat is NOT C.I. with MAOIs
Red meat in NOT C.I. with MAOIs
Pts on Li therapy should not restrict Na intake
519 Pt taking tranylcypromine should restrict diet and drugs
Page 154 of 582
S Question
Pseudoephedrine should be taken with caution with Iproniazid
1390 Pseudoephedrine is used with caution with Iproniazid
Procarbazine is MAOI requires dietary percautions
Procarbazine is MAOI
Phenelzine: MAOI, not taken with tyramine
Patients taking Li carbonate is advised not dec Na intake -- Li is C.I.
with naturetics/diuretics
Pargyline:: do not ingest aged cheese, beer or chianti wine -- food and
beverages containing significant amount of tyramine must be avoided
by individuals taking MAOIs such as pargyline because of hepatic
MAO inhibition, ingested tyramine will
Nefazodone: # 5HT reuptake, inc 5HT-- SE: hepatic failure, C.I. with
1142
cisapride, TCA, MAOIs, terfinadine, astemizole
MAOIs in C.I. with guanithidine
MAOIs are : psychotropics, antidepressants, antileptics -- SE:
hallucinations, tremors, hyperthermia, anticholinergic SE., dry mouth,
constipation, failure of ejaculation
MAOI SE is NOT tachycardia BUT it is the SE of TCA
432 MAOI are C.I with guanthidine
Page 155 of 582
S Question
MAOI + cheese=cheese reaction=hypertensive crisis due to tyramine
content which increase norepinephrine concentration
573 MAOI : tranylcyromine, phenelzine, meclobimide, iproniazide
484 Lithium causes nephrogenic diabetes insipidus ttt by vasopressin
Li: ttt of severe bipolar manic depression psychoses --- SE: D. insipidus
705 Li therapy cause diabetes insipidus
Li SE: diabetes insipidus, hypothyrodism?, convulsions
Li is used in bipolar affective disorder
Iproniazide : MAOI antidepressant used with caution with other TCAs
any food containing tyramine, levodopa, sympathomimetic amines,
pithidin, rawoulfia alkaloids- dec action of adrenergic neuron blockers
- inc action of oral hypoglycemic
In dipolar mood disturbance: Li, carbamazepine, Na valproate
718 Imipramine is TCA used for enuresis and hyperkinetic child
512 Imipramine is metabolized by demethylation giving desipramine
730 Imipramine (tofranil): enuresis
Hypertensive crisis caused by tyramine+MAOIs is ttt by alpha blocker
like phentolamine
Page 156 of 582
S Question
1375 Glutithimidine is MAO inducer
Fluoxetin does not cause hepatotoxicity
Early expected effect of amitriptylene is very sleepy sensation, very
1234
dry mouth, and no progress in depression
Doxipen: TCA
Clomipramine is used in occlusive depression disorder
Chlorothiazide is C.I. with amitriptylline (TCA)
Carbamazepine: anticonvulsant -- trazodone: antidepressant --
molindone: antopsychotic -- alprazolam: antianxiety --
1143
isocarboxazide: MAOI -- amiloride: K-sparing diuretic -- clemastine:
antihistaminic -- diltiazem: CCB -- sulfinpyrazone: uricosuric
Bipolar depression can be ttt by: Li, carbamazepine, SSRI, Na
valporate BUT NOT haloperidol
Bicyclic antidepressants; viloxine -- TCA: maprotiline, menserine
Aspirin does NOT interact with MAOI
Antidepressants: amitryptilline, SSRT, NSRI, linezolide,
1230
tranylcypromine, phenelzine, meclobemide, razodone, trazodone
Antidepressants : TCA , MAOI , alpha blockers

Page 157 of 582

S Question
Amphetamine , ephedrine , phenyl ephrine + MAOI = hypertensive
408
crisis
Amitriptylline: ttt of depression with anxiety
Amitriptyline(TCA) is used for deep visceral pain ans post operative
neuralgia - TCAs esp. amitriptyline, clomipramine, doxipen,
imipramine, nortriptyline, and trimipramine are used in pts with
normal or depressed mood,
Amitriptyline (TCA) used in the ttt of deep visceral pain, post
operative neuralgia
529 Amitriptyline # chlorothiazides
(cont. TCA) and for the management of chronic, severe pain as in
cancer; migraine and chronic, daily muscle contraction headaches;
rheumaric disorders; atypical facial pain; post herpetic neuralgia; and
diabetic or other peripheral neuropathy
(cont. MAOI, tyramine) escape its normal deamination and release
excessive amount of norepinephrine from storage granules at nerve
endings. The resultant hypertensive crisis will lead to headache,
fever, and sometimes death due to intracranial bleeding
Paroxetine never used in bipolar disorders
Page 158 of 582
S Question
205 Which one is not antidepressant: quetiapine
187 Tranylcypromine: irreversible non-selective MOA inhibitor
206 S.e of paroxetine: (gynecomastia and sexual dysfunction)
Which food can be taken with MOIS- beer- red wine- chicken liver -
271
red meat
281 Which Antidepressant causes Hypertension? Venlafaxine
8 TCA's MOA: affects uptake of amines
2 MAO A inhibitors: Moclobemide
62 Imipramine - Fluoxetine for nocturnal enuresis
Which is not antidepressant: haloperidol (asked twice: the second
348
one had different option: quetiapine)
Which food can be taken with MOIS - beer - red wine - chicken liver -
red meat
Which Antidepressant causes Hypertension? Venlafaxine
Tranylcypromine: irreversible non-selective MOA inhibitor
S.e of paroxetine: (gynecomastia and sexual dysfunction)
353 Nortryptyline ADR
323 Adverse effect of nortyptiline (constipation)
437 The onset of TCA requires: 3-4 weeks
Page 159 of 582
S Question
406 Oral anticoagulant + imipramine = increase action of imipramine
324 Adverse effect of TCA (constipation)
Trazodon + MAOI = serotonin syndrome --- L-dopa + MAOI =
642 hypertensive crisis --- methylphenidate + MAOI = potentiate CNS
stimulation (2 weeks elapse)
Antihypertensive effect of guanethidine in inhibited by TCAs
543
(amitriptyline)
Use of siver sulfadiazine, mafenide is topically for burns and wounds
Retinoic acid is used therapeutically to accelerate production of
1206
epithelial ceels in the skin
1179 Podophyllum resin for ttt of warts
OTC# lice: pyrethrins, piperonyl butoxide, petrolatum distillate --- RX:
cretamiton
1079 Mite cause scabies
Minocyclin is used in ttt of acne vulgaris and its SE are NVD, vestibular
806
toxicity
Hydrocotisone : ttt of rosacea NOT isotretinoin
404 Epidermis is keratin
Doxycyclin (vibramycin) : ttt of acne
Page 160 of 582
S Question
Benzylperoxide gel : should not come in contact with eye or mucous
517
membrane
Benzoylperoxide (antiacne)= should not come in contact wirh eye or
mucous membrane
759 Al(OH)3 = abrasive removes comedone
Acne vulgaris is made by bacterial inflammation
Acne vulgaris is caused by bacterial infection: propionibacterium acne
What is the most appropriate counselling advice would you give to
163 the patient taking Benzoyl peroxide cream?a. avoid contact with
hair..b. it can cause stain on coloured cloths
303 In impetigo, which is wrong:it can complicate to endocarditis
Which one is a skin condition? All options were incorrect like. OA, RA,
OP, Gout. One left.....which was correct
Some skin conditions and symptoms......which is tht... is tht a drug
allergy, stven jhonson syndrome or anything else?
Counselling of benzoylperoxide (applied twce weekly, may stain
325
yellow, skin peeling and irritation may occur)

Page 161 of 582

S Question
Coal tar should not be used for some UV treatment. Becoz it causes
photosensitive.
Acne....name of the organism
1013 Tazarotene: ttt of acne, psoriasis
1314 Hydrocortisone is NOT suitable for ROSAISIA
When insulin is used as IV infusion with D5W during surgery it may be
446
adsorbed on the bottle and tubing
768 Urine retention is NOT likely in DM which leads to polyuria
1442 Trypsine and lipase inc in pancreatic disease
Tolbutamide: totally metabolized to an inactive form
1441 Tolbutamide is totally metabolized to inactive form
414 Tolbutamide is an oral hypoglycemic
Tolbutamide and fenformin have increased risk of cardiovascular
disease ??
Tolazamide: more slowly absorbed than other
compounds(tolbutamide, acetohexamide, chlorpropamide,
phenformin)
645 Tolazamide is slowly absorbed than other compounds

Page 162 of 582

S Question
The sliding scale (or rainbow scale) is a method of determining insulin
dosing based on periodic determinations of glucose and ketones in
the urine. The physician prescribes the regular insulin dosage as a
function of the number of pluses (+) determined
The parameters of significance in the glucose tolerance curve: 1-the
peak conc of glucose in blood 2-the time required for this peak to
occur 3-& the rate at which the blood glucose level declines with time
The only insulin that can be given intravenously is crystalline (regular)
1218
zinc insulin
The only insulin preparation that can be given IV is crystalline Zn
(regular) insulin. It is used in situations when rapid onset and brief
duration of action is desired. It's so used for the ttt of diabetic
ketoacidosis, in this emergency situation
The most common cause of diabetic ketoacidosis and coma is failure
711
of pt to utilize insulin

Page 163 of 582

S Question
The most common cause for diabetic ketoacidosis and coma in the
diagnosed and treated diabetic is failure of the pt to utilize insulin
properly.. Diabetic ketoacidosis is a direct result of the lack of insulin.
the omission of insulin doses
The most appropriate method to measure a 25U dose from a U100
insulin: use a special U100 syringe that has a maximum capacity of
50U, it is commercially available, the syringe is approximately the
same length as the 1ml-100U syringe
Tes-Tapes:: does NOT give a false +ve test for glucose in the urine of
pts taking cefoxitin (mefoxin) (NOT: benedict's soln, fehling's soln,
clinitest)
Tes-tapes: measure glucose in blood or urine
Test fot presence of glucose: reagent strips impregnanted with
glucose oxidase, peroxidase, orthotolidine, are dipped into urine or
blood; reaction is: glucose is oxidized to gluconic acid, H2O2, the
H2O2+ peroxidase+ orthotolidin= blue substance
Symptoms of hypoglycemia: sweating, tachycardia
618 Sulfonylurea MOA: stimulate insulin secretion
Sulfonylurea mechanism of action:: stimulate insulin secretion
Page 164 of 582
S Question
Regular insulin=lispro insulin its duration of action is less than 12 hrs
Protamine Zn insulin, logest duration, 24-36 hrs -- regular insulin,
shortest duration, 6-8 hrs.
Protamine Zn insulin has duration of action on 36 hrs
1176 Protamine zinc insulin has the longest duration of action =36hrs
Proinsulin is the insulin impurity commonly used to compare the
relative purity of various insulins. Insulin purity is inversely
proportional to proinsulin contamination, which also reflects the
relative concentrations of other non-insulin impurities
Proinsulin (86aa`) is insulin impurity most commonly used to compare
1262
the relative purity of the various insulin products
Polydipsia=escessive thirst
Phenformin: was indicated for obese diabetics whose hyperglycemia
is due to ineffective insulin action
729 Patients with mature once DM can be ttt with tolbutamide and diet
1461 Pancreatitis is characterized by inc amylase level
717 Normal insulin secretion : 50U/day
1166 Normal glucose is 80-120 mg%
Normal blood sugar concn in fasting adult is 100mg/dl
Page 165 of 582
S Question
Normal blood glucose level: fasting=100-110mg/dl or <6.1mmol/L --
random=70- 126mg/dl or3.9-6.9 mmol/L
Mixture of regular insulin and protamine zinc insulin (PZI) in a ration
less than 1:1 would be expected to have about the same duration of
1425
action as PZI because XSS protamine will bind to regular insulin and
convert it to PZI
1071 Metformin, phenformin are biguanides
Metformin is preferred in obese diabetic pt whose hyperglycemia is
454
due to ineffective insulin action
Metformin : biguanide
Long-acting insulins such as PZI and ultralente are use in a relatively
few pts because they provide insulin concns too low to handle acute
glucose challengesrelated to meals; they also produce relatively high
concns at night
Long acting insulins such as PZI and ultralent used in a few pts
636 because it provide insulin concns too low to handle acute glucose
levels related to meals and also produce inc insulin concn at night
Lente insulin : 70% crystalline (ultralente) + 30% amorphous
(semilente)
Page 166 of 582
S Question
699 Insulin Zn suspension has duration 18-24 hrs
Insulin will remain stable at room temperature during the time period
598
in which single vial will be used
426 Insulin secretion: K level drop during glucose utilization
713 Insulin secretion: K level dec during glucose utilization
Insulin secretion dec K level in blood
Insulin purity: content of proinsulin
994 Insulin lente= 70%ultralente(crystaline) + 30% semilente (amorphous)
Insulin lente:24hrs --- insulin protamine Zn=36hrs
1081 Insulin lente: 30% amorphous, 70% crystalline
1352 Insulin lente: 24hrs --- insulin protamine Zn: 36 hrs
Insulin lente same as monotard same as insulin Zn suspension = 18-28
hrs
Insulin lente actes for 24 hrs
966 Insulin is a polypeptide hormone
Insulin inc entering of glucose, fat and amino acids
Insulin does NOT suppress syn of TG --- it stimulates its formation and
1226
storage
Page 167 of 582
S Question
726 Insulin does not suppress lipolysis
452 Insulin does NOT dec syn of TG
856 Insulin and glucagone are adsorbed on IV tubing
741 Insulin administration is subcutaneous
Iletin II contains <,=10ppm proinsulin and is available as a single
species product (either prk or beef)
Ibuprofen increase hypoglycemic effect of insulin -- propranolol
673
increases hypoglycemic effect of insulin
Hypoglycemia: tachycardia, sweating --- hyperglycemia: acetone odor
in breath, ketones in urine
Hypoglycemia: tachycardia, sweating --- hyperglycemia: acetone odor
in breath, ketones in urine
Hypoglycemia: complication most likely to occur after sudden
discontinuation of parentral hyperalimentation (composed of amino
acids or protein hydrolysates, glucose, electrolytes and vitamines
Hypoglycemia may be induced after stopping of hyperalimentation
(consists of amino acids, glucose, electrolytes or vitamins)
Hypoglycemia does NOT cause acetone mouth which is caused by
hyperglycemia
Page 168 of 582
S Question
Glucose tolerance is impaired by thiazides. Hyperglycemia induced by
thiazides in
unimportant in pts with normal carbohydrate tolerance but may
intensify the hyperglycemia in
diabetics or precipitate glycosuria in persons predisposed to diabetes
Glucagon inc glucose level by inc hepatic gluconeogenesis,
glycogenolysis
Glucagon (SC, IM) used in the ttt of acute hypoglycemia when glucose
1151
administration is not available
For insulin dependent pt with HTN: atenolol is the best B-blocker that
1145
could be used (selective and most hydrophilic)
Duration of action of Lente insulin is 24 hours
DM problems: cataracr, renal failure, CV disease, peripheral
931
neuropathy
Diuresis is a symptom of hyperglycemia
Diabetics have highest risk of erectile dysfunction
Diabetes has higher risk of erectile dysfunction
Currently, all commertially available insulin no more than 25ppm
1465
proinsulin
Page 169 of 582
S Question
Compared with the normal glucose tolerance, the blood glucose
versus time curve of a diabetic has: a higher peak that occurs later
and decrease more slowly
938 Chlorpropamide is given once daily ( hypoglycemic )
1388 Chlorpropamide is given once daily
Amylase level is raised in pancreatitis
1150 Amylase level inc in pancreatic disease
749 Amphotricin B, Li, may cause D. insipidus
Acetohydroxiamide acid is used as adjunctive therapy for UTI
Acetohydroxamide acid (AHA, Lithostat) has been approved for as
adjunctive therapy for UTIs. AHA # bacterial urease enzyme so dec
hydrolysis of urea to ammonia and resultant alkalinity in chronic UTIs
due to urease-producing organisms such as Proteus
Acetohexamide: reported to have significant uricosuric properties,
metabolized to compounds having equal or greater hypoglycemic
activity.
1187 Acetohexamide is oral hypoglycemic , have uricosuric effect
Acetohexamide (oral hypoglycemic) have uricosuric effect and its
1116
metabolites have also hypoglycemic effect
Page 170 of 582
S Question
Acarbose # alpha-amylase thus inhibit digestion of complex
511 polysaccharides, acarbose also inhibits alpha-glucosidase thus inhibit
digestion of oligosaccharides
831 1st symptom of DM is excessive thisrt
(Lilly's Iletin I,II insulin): Iletin II is more purified than Iletin I. Iletin I is
a beef/pork mixture. Iletin II is either beef of pork insulin. Iletin I
contains <,=20ppm proinsulin and is available as beef (70%)-pork
(30%) mixture.
(continue insulin syringe) but has a smaller inside-diameter and
consequently will have a capacity of 0.5ml, it is calibrated in a 1U
increment to a max of 50U, that syringe makes it possible for pt to
measure small amounts accurately
(cont. Tes-Tape) the glucose oxidase test for the presence of glucose
in the urine is apparently not affected by cephalosporins
(cont. Tes-Tape) it is well documented in the literature that
cephalosporin antibiotics may cause false positive readings with Cu
reduction tests.

Page 171 of 582

S Question
(cont. Tes-Tape) although Cu reduction methods (e.g. Clinitest) are
more quantitative measures for glucosuria than are glucose oxidase
tests (e.g. Tes-Tapes) they are less specific for glucose.
(cont. Tes-Tape) a diabetic pt has been taking cefaclor 500mg p.o.
q8hrs for UTI. To determine whether this drug is interfering with the
pt's urine glucose testing, a sample of urine is tested by both Clinitest
and Tes-Tape methods, the results are:
(cont. Tes-Tape) 1% with Clinitest and 0.25% with Tes-Tape.
Conclusion: a false positive result with clinitest
(cont. sliding scale) since the sliding scale is generally used to
determine the 24hr insulin requirements of a ketonic diabetic, the
modified insulins (e.g. NPH) are not use, but regular insulin is the one
used.
(cont. sliding scale) by the copper reduction (Clinitest) glucose
determination and the presence of urinary ketones, he amy prescribe
a number of U for each + (e.g 4U for each +) or more variable
schedule.
(cont. regular insulin) the drug is often used in conjunction with
subcutaneouslyvadministered longer acting preparations
Page 172 of 582
S Question
(cont. proinsulin and insulin purity) such as glucagone, somatostatin,
pancreatic polypeptide. Currently, all comercially available insulins
contain no more than 25ppm of proinsulin
(cont. glucose tolerance curve) in a diabetic pt, the blood glucose
peak is higher, occurs later and declines more slowly than a
corresponding blood glucose curve for a normal individual
(cont. diabetic ketoacidosis) or errors in adjusting the insulin dosage
in response to changes in food intake of physical activity is probably
the most common cause of diabetic ketoacidosis. Other common
causes include infections and myocardial infarction
Action of insulin glagrine is glucose utilization by tisues
Which of the following will have higher hypoglycaemic
170
effect?Metformin.Rosiglitazone..Glipizide..insulin
Which of the following has the possible sideeffect of
166
lactoacidosis?Metformin..Pioglitazone..Glibenclamide Insulin
Which of the following is a risk factor for cardiovascular diseases?a)
277 low LDL b) High HDL c) Ratio of total Cholesterol to HDL <3.5 d)
Diabetes
251 Insulin increases glucose uptake
Page 173 of 582
S Question
Select wrong answer regarding diabetic foot problems? Options
67
regarding causative organisms and dressings
75 Lactic acidosis is common with metformin
4 Acarbose maximum dose: 600mg/day
Which of the following is a risk factor for cardiovascular diseases? a)
low LDL b) High HDL c) Ratio of total Cholesterol to HDL d) Diabetes
Normal fasting blood glucose level....Ans. 3-6mmol/L
MOA of Insulin.....Ans. Increase glucose uptake.
Insulin overdose .......symptoms.
Insulin increases glucose uptake
341 Doses: repaglinide
Aspirin increases the hypoglycemic effect of tolbutamide by plasma
415 protein displacement- aspirin decreases the uricosuric effect of
probenicid
Toxic effects of clindamycin may be inc when used with lomotil
Metronidazole is C.I. with alcohol
Metronidazole is C.I. with alcohol
Loperamide: antidiarrheal, if given to a pt with ulcerative colitic it will
produce intestinal perforation
Page 174 of 582
S Question
Lomotil should not be taken with clindamycin because toxic effects of
clindamycin may be enhanced
Lomotil should not be given to pts taking oral clindamycin or
lincomycin because toxic effects of clindamycin or lincomycin will be
enhanced
Lomotil (diphenoxylate + atropine) does NOT cause bronchospasm
1299
and atropine dec the likelihood of opiate abuse
Lomotil (diphenoxylate + atropine) does not cause bronchospasm
E-coli: traveller's disease, treated by bismuth subsalicylate
Diphenoxylate is related to mepiridine, it stimulates opiate center in
GIT causing constipation
Dipenoxylate is related to meperidine and activate opiate center in
1377
the GIT leading to constipation
Citrate is in oral rehydration, used to compat alkalosis and to improve
salty taste of the solution
Citrate in oral rehydration is to compete alkalosis
Bi subsalicylates: prevent and ttt of travellers diarrhea --- ttt: TMP-
889
SMZ, doxycycline, quinolones
Avoid metronidazole with alcohol = disulfiram like reaction
Page 175 of 582
S Question
An advantage of loperamide over diphenoxylate as an antidiarrheal is
the fact that loperamide does not appear to have opiate-like effects.
Loperamide is a schedule V controlled substance.
Advantage of loperamide over lomotil as antidiarrheal is that
loperamide dose not have opiate like effects
(cont. loperamide) it inhibits peristaltic activity by direct effect on
musculature of the intestinal wall. It appears to be devoid of opium-
like effects
(cont. loperamide) even after chronic administration of loperamide,
the injection of narcotic antagonist naloxone does not produce
pupillary dilatation
(cont. clindamycin, lincomycon vs. lomotil) antimobility drugs (e.g.
diphenoxylate) used to treat resulting diarrhea seem to prolong
desease so they should not be used
(cont. clindamycin, lincomycin vs. lomotil) the inflammatory
conditions of the colon (e.g. nonspecific colitis or more severe
pseudomembranous colitis) has been associated with antibiotic
therapy

Page 176 of 582

S Question
(cont. clindamycin, lincomycin vs. lomotil) colitis has been associated
with oral and parentral administration of these drugs and no clear
predisposing conditions have been identified
(cont. clindamycin, lincomycin vs. lomotil) although many antibiotics
have been implicated, there've been a disproportionate no of reports
specifically involving clindamycin and lincomycin
if a patient is given metronidazole what is the most appropriate
152 counselling you would provide?a. avoid alcohol..b. not more than 2
standard drinks...c. take with food
Oral Rehydation Solution Why addind Citrate?a) to mask the salty
193
taste...b) against acidosis...c) against alkalosis..d) provide nutrients
When can you take Diphenoxylate?a) Uncomplicated Diarrhea b)
284
Antibiotics related Diarrhea c) Chronic Diarrhea
233 Citrate in ors: against acidosis
51 Drug for travellers diarrhoea
When can you take Diphenoxylate? a) Uncomplicated Diarrhea b)
Antibiotics related Diarrhea c) Chronic Diarrhea
Oral Rehydation Solution Why addind Citrate? a) to mask the salty
taste b) against acidosis c) against alkalosis d) provide nutrients
Page 177 of 582
S Question
Citrate in ors: against acidosis
The usual dose of chlorhexidine is 0.02, 0.05%
Suitable elderly dose is 1/3-1/2 of the adult dose
Salbutamol dose is 2-8 mg daily --atropine dose: 0.25-2 mg --
chlorothiazide: 0.5-1 gm
Na nitroprusside, KCl: slow IV infusion -- diazoxide: rapid bolus IV
Methotrexate: intrathecal --- thiopental: IV, intrathecal
IV inf: saline, Na nitroprusside, vancomycin, KCl
Doses::: hydralazine:50-200mg -- carbamazepine:0.2-1.2g --
methyldopa:0.5-2g -- colchicine:500mg -- prednisone:5-60mg --
929 aspirin (antiplatelet):75-150mg -- aspirin (antigout): >5g --
chlorocresol: 0.05% -- captopril: 25-50mg -- phenytoin:50-
400mg(max)
Doses:: salbutamol:2-4mg or 10mg -- dithranol:0.1-1% (psoriasis) --
chlorothiazide: 125-
500mg or 1g --atropine: 0.25-2mg -- chloralhydrate: 0.5-2g --GTN:0.3-
877
1.2mg -- cimetidine: 400-
2000 mg -- ranitidine:150-300mg -- aspirin in RA:6g --
HCTZ:12.5,25,50mg
Page 178 of 582
S Question
Dose of aspirin in rheumatic fever: 6g --- dose of atropine: 0.2-2 mg ---
dose of chlorothiazide: 0.5-2g
Tyramine food is C.I. with: pragyline, phenelzine, isocarboxazide,
769
tranylcypromine
Sodium thiocyanate affect iodine uptake
G6PD hemolytic anemia with:: aspirin, dapsone, primaquine, quinine,
601 dimercaprol, sulfonamides, chloramphenicol, nirofurantoin, nalidixic
acid
Critical interactions: cimetidine + theophylline --- sulfonamides in
561
neonates: inc bilirubin: kernicterus
Cetrizine, terfenadine, astemizole:: # metabolism of ketoconazole,
1291
clarithromycin, erythromycin
130 Interaction with st.Jones wart
142 Drugs causing hyperkalemia
1338 When pt taking phenytoin has ataxia, he should reduce the dose
Vigabatrin is enzyme inducer that inc clearance of phenytoin,
carbamazepine,phenobarbital
Valproic acid is used for grandmal and petitmal epilepsy

Page 179 of 582

S Question
ttt of epilepsy: diazepam, succinylcholine, phenobarbitone, NOT
913
phenothiazines
Trigeminal neuralgia is a disorder characterized by sudden attacks of
severe pain along the distribution of the 5th cranial nerve, attacks are
ofen precipitated by stimulation of a trigger zone in the area of the
pain.
The metabolism of folic acid is altered in pts taking in anticonvulsant
1386
drugs
SE of phenytoin: nystagmus, gingival hyperplasia, morbiliform rash
(measles like), SLE, ataxia, hirsutism, steven johnson syndrome
Phenytoin: has narrow therapeutic index, need TDM (therapeutic
drug monitoring)
Phenytoin, diazepam, valproic, phenobarbital all are used in grandmal
except ethosuxamide which is DOC for petitmal epilepsy
Phenytoin should be taken with food to dec gastric irritation
Phenytoin SE: gingival hyperplasia, osteomalacia, hirsutism, ataxia
Phenytoin SE is gingival hyperplasia, ataxia, hirsutism
Phenytoin is taken as a single daily dose or as 3 divided doses
Phenytoin is not used in absence seizures
Page 180 of 582
S Question
Phenytoin dose: 50-400 mg max? increment: 30mg once
Phenytoin can be used once daily and three times daily
Oral anticoagulant + diphenhydramine = increase anticonvulsant
407
toxicity
1316 Maximum dose of phenytoin is 300 mg
Jacksonian epilepsy is associated with focal convulsions
Jacksonial convulsion=focal convulsion.during it consciousness is
often maintained.The seizure can be motor, sensory or autonomic in
nature.It usually begins in part of the limb or face as a localized clonic
spasm, then spreads in somewhat orderly fashion
In epilepsy GABA transmission is low ???
Grandmal epilepsy: Na valproate, phenobarbital, diphenyl hydantoin,
primadone ---petitmal epilepsy: ethosuximide. Chlorzepam.
Trimethadione, Na valproate
Grandmal epilepsy: Na valproate, phenobarbital, diphenyl hydantoin,
primadone --- petitmal epilepsy: ethosuximide, chlorzepam,
trimethadion, Na valproate
Grandmal epilepsy: generalized tonic clonic seizure

Page 181 of 582

S Question
For grand mal benzodiazepines (diazepam) to stop seizures then
phenytoin DOC to maintain
Electroencephalogram monitor deep in the brain
Drug of choice for ttt of status epilepticus is diazepam
422 DOC in ttt of status epilepticus is diazepam or lorazepam
DOC for ttt of trigeminal neuralgia (tic douloureux) is: carbamazepine.
1093 Dilantin+phenobarbitone= drop in dilantin level
Cholrpromazine side effect is photosensitivity
Carpamazepine dose not cause vomiting
Carbamazepine self-induces its own metabolism on long-term use
1427 Carbamazepine is used for the ttt of trigeminal neuralgia
1464 Carbamazepine is the drug of choice for the ttt of trigeminal neuralgia
(cont. trigeminal neuralgia) other drugs that have been effective are
vit B12 in massive doses (1mg), and injection of alcohol into the
ganglion or the branches of the trigeminal nerve

Page 182 of 582

S Question
(cont. trigeminal neuralgia) carbamazepine is remarkably effective in
both relieving and preventing the pain of trigeminal neuralgia.
Anticonvulsants such as phenytoin can be beneficial in some cases.
Phenytoin loading dose
Anti convulsant drug is category D pregnancy? Valporic a-
barbeturate- carpamazipine- BZD
179 Use of ethosuximide: absence seizures
177 Loading dose of phenytoin in status epilepticus: 15-20mg/kg/day
178 Loading dose of phenytoin in epilepsy: 4-5mg/kg/day.
15 Triggers for seizures except which one? I think loud noise
Neural tube defects (spina bifida) : valproic acid-phenytoin-
22
carbamazepine
3 Loading dose of phenytoin in Status epileptics: 15mg - 20 mg /kg
74 Drug causing hyperglycemia.. clonazepam
Use of ethosuximide: absence seizures
Phenytoin Loading Dose
Loading dose of phenytoin in status epilepticus: 15-20mg/kg/day
Loading dose of phenytoin in epilepsy: 4-5mg/kg/day.

Page 183 of 582

S Question
In Epilepsy, what is the mechanism?.....Ans. Decrease in GABA so we
use all the drugs which increases GABA
Hyponatremia.........is side effect of Carbamazepine.
356 Epileptic in preg
Drug not used in gen seizure: ethosuxamide, phenytoin,
357
carbamazeptin, lamotrig
Anti convulsant drug is category D pregnancy? Valporic a-
314
barbeturate- carpamazipine- BZD
Which decreases seizure threshold … options all antiepiletics and
364
ciproflox
Sulfacetamide eye drop is not destryed by heat in the autoclave
Preservatives in eye drops as bacteriocidal: e.g. benzalkonium
chloride 0.02%, chlorohexidine 0.01
Phospholine iodine is stored at 2-8 DC
1460 Phospholine iodide is stored at 2-8 C
Phenyl mercuric nitrate 0.002% is eye drop preservative
Pheny Hg nitrate 0.002% is eye drop preservative bacteriostatic
Loteprednol : ttt of allergic conjunctivitis

Page 184 of 582

S Question
Latanoprost: for open angle glaucomaif the phenytoin dose in
inadequate (fit occur) what is the dose increment? 30 mg/day
Drugs used for open angle glaucoma: carbachol, demecarium,
physostigmine,
1019
neostigmine, pilocarpine, timolol maleate, epinephrine BUT NOT
cyclopentolate (cyclogyl)
Drugs causing occular problems: amiodarone, ethambutole,
780
chloroquine, digoxin
Cycloplegic for kids atropine drops
1281 Cortisone eye drops should be stored at 2-8 DC
1343 Cortisone eye drop should be stored between 2-8 C
Chlorhexidine in eyedrop: 0.2%
Atropine is C.I in narrow angle glaucoma
Advantages of timolol over pilocarpine is: longer duration of activity,
no effect on visual acuity or accommodation, little or no effect on
pupil size
Adrenaline drops has SHORT ACTING mydriatic effect NOT
homatropine
Betaxolol decrease aqueous humor production
Page 185 of 582
S Question
Shelf life of opened Eye drops? → 28days
Pilocarpine in open angle glaucoma cause constriction of the pupil
and produce dimming vision of night
Cortisone eye drop should be stored from 2-8 C
Chlorbutol (preservative in eye drops)= 0.5%
1214 Adrenalin 1% eye drop produce 1-2 hr duration
944 Acetazolamide, timolol: dec aqueous humor formation
1% adrenaline gives short rapid mydriasis but chronically dec IOP by
1371
inc aqueous humor outflow
1% adrenaline = short rapid mydriasis
1132 Tropicamide cause mydriasis for 3-4 hrs
Timolol dec aqueous humor formation thus dec IOP BUT has NO
1426
effect on pupil size or aqueous humor outflow
1036 Refrigirate phospholine iodine ( 2 - 8 )
Physostigmine: short acting anticholinesterase used in the ttt of
1411 primary open angle glaucoma and for emergency ttt of angle-closure
glaucoma -- neostigmine is similar in action to physostigmine
614 Parasympathomimetics: ttt of glaucoma

Page 186 of 582

S Question
Ocusert pilo-20: pilocarpine 20mcg/hr -- ocusert pilo-40: 40mcg/hr --
each enough for 1 week
559 Narrow angle glucoma attacks ttt by parasympathomimetics
Narrow angle glaucoma is present in about 10% of total glaucoma
592
population
Narrow angle glaucoma is present in 10% of total glaucoma
948
population
Narrow angle glaucoma is C.I with atrpine or other anticholinergics
Miotic effect of pilocaropine starts in 15-30 minutes -- max reduction
1106
in IOP in 2-4 hrs -- duration: 4-8 hrs
1279 Homatropine is C.I. with glaucoma
Epinephrine: ttt of chronic open angle glaucoma BUT C.I. in narrow
1173 angle glaucoma due its mydriatic action which may precipitate acute
angle glaucoma
743 Dipivefrin is prodrug of epinephrine, eye drop in glucoma
Dipivefrin is a prodrug of adrenalin
976 Dipivefrin HCl is prodrug of adrenaline used in ttt of glaucoma
Cyclopentolate 1%, tropicamide 3hrs duration shorter than atropine
(2 weeks)
Page 187 of 582
S Question
Cyclopentolate (cyclogyl) is a mydriatic and cycloplegic used for
1055
refraction work and ophthalmoscopy
Carbachol is used as a replacement when resistence or intolerence to
pilocarpine occurs
Belladonna is not recommended in glaucoma because it containes
1192
atropine
Atropine C.I. with glucoma
Preservatives in eye drops : cholrocresol 0.1 % , benzalkonium Cl
0.02% ,chlorohexidine 0.01 % , Na edetate 0.1 % , phenyl Hg nitrate
0.002 % , cetrimide 0.005 % ,chlorambutol 0.5 % - % of chlorocresol
0.05% -1 % (0.1%) -
Preservatives in eye (bactericidal) benzalkonium Cl 0.02%,
chlorohexidine acetate 0.01%- it is sterilized by autoclav or heating
with bactericidal at 100 DC for 30 min or filteration
1376 Percentage of chlorbutol used as preservative in eye drops is 0.5%
826 Chlorambutol 0.5 % is used as preservation in eye drops
Timolol is used for ttt og glucoma as it dec the production of aqueous
1012
humor
552 Guanthidine eye drops 5% used 1-2 times in eye lid edema
Page 188 of 582
S Question
B-blockers: used in glaucoma: timolol, levobunolol, carteolol,
582
metapranolol, betaxolol
Facts and Comparisons: names of several vitamin tablets containing
flouride - relative cost of several commercial antacid liquids --- Facts
and Comparisons lists prescription and some nonprescription drug
products by pharmacological classification
(cont. Facts and Comparisons) those prescription only vitamins that
contain fluoride are listed together so that the pharmacist can
compare formulas and levels of ingredients. Facts and Comparisons
features a cost index, which indicates the relative cost
(cont. Facts and Comparisons) of similar products based upon cost
per ml, per tablet, or other common dosage base
Klinefelter's syndrome is a series of symptoms related to diminished
development of the seminiferous tubules of the testes
If both parents have recessive genes it is enough to produce disease
in children even if the parents have no disease
Uricosuric agents increase excretion of uric acid like probenecic,
sulphipyrazone BUT NOT allopurinol
Uric acid is a derivative of purine
Page 189 of 582
S Question
Tophus is gout
1084 Tophi is characteristic of gout
Pt suffering from gout and taking probenecid should be warned not
to take aspirin
Pt on probenecid therapy should NOT take aspirin or indomethacin or
809
thiazide
409 Probenicid is uricosuric
940 Probenecid is contraindicated with aspirin
Probenecid # excretion of: sulfonamides, sulfonylureas,
1263
indomethacin, naproxen, clofibrate, ASA, pantothenic acid, penicillins
Phenylbutazone is used for gout 7%
Patient taking aspirin should avoid probenecid
880 Not taken with tea = allopurinol
Gout ttt: acute=cholchicine/chronic=allopurinol/ aspirin and
508 corticosteroids and
phenylbutazone are also used
Gout occurs more in men than in women

Page 190 of 582

S Question
Drug used in the ttt of gout and does not affect urate metabolism or
secretion: colchicine. NOT: allopurinol, probenecid, sulfinpyrazone.
Colchicin used in ttt of acute attacks of gout, it interfers with
inflammatory response to gout
Azathiprine or 6-mercapto purine + allopurinol = inc levels of both
drugs BUT 6-thioguanine is not affected bu allopurinol because it's
metabolized by methylation not oxidation
Azathioprine + allopurinol:: increased levels of both drugs -- 6-MP +
allopurinol:: increased levels of both drugs
Aspirin is C.I. with probenecid
Allopurinol: has no effect on warfain plasma protein binding, can be
given safely with warfarine -- also chlopheniramine can be given
safely with warfarin
Allopurinol is NOT taken with tea
Allopurinol inhibits xanthine oxidase, the enzyme which converts
hypoxanthine to xanthine, and xanthine to uric acid
967 Allopurinol does NOT affect warfarin
900 Allopurinol advice: high fluid intake
Allopurinol # xanthine oxidase
Page 191 of 582
S Question
Allopurinol # metabolism of 6-MP NOT 6-TG
1198 1st choice in acute gout attack is colchicine
Hyperuricemia occurs more likely in men
Allopurinol mechanism of action
Regarding Gout, select wrong option: Gout is more common in
86
women
Aspirin is not taken with probenicid - aspirin decreases the uricosuric
412
effect of probenicid- aspirin toxicity = veritigo , tinitus
411 Aspirin decrease uricosuric effect of probenicid
510 Allopurinol is NOT C.I. with warfarine
410 Acetaminophen decrease uricosuric effect of probenicid
36 GTN tablets shelf life once opened
133 GTN shelf life … 3 months , 6 months , 28 days
35 GTN causes increase in adenyl cyclase
Counseling points about hemorrhoids in pregnancy, select the wrong
113 answer: Treat aggressively during pregnancy otherwise they will
relapse after birth?

Page 192 of 582

S Question
Handbook of Nonprescription drugs:: comparison of sodium content
of a group of antacid liquids - active drug in Sominex tablets -- the
chapter that discusses antacids lists commercial products, with the
sodium content of each
(cont. Handbook of Nonprescription Drugs) is listed in the section
discussing sleep aids
(cont. Handbook of Nonprescription Drugs) in the OTC product in
considered. Tablets are present that list commercial products,
manufacturers, ingredients, and levels of ingredients when known.
For example the active drug in Sominex tablets
(cont. Handbook of Nonprescription Drugs) each chapter of the
handbook covers a specific group of the OTC products. Usually the
anatomy and physiology of the body area affected are discussed. Also
the pharmacologic action of ingredients commonly included
197 Interaction with St John’s Wart
Gingko is not/was not used in which disease..a) Chillblains..b) Poor
224
concentration..c) Abdominal spasms
Interaction with St John’s Wort
Ginko Biloba is not used for which condition
Page 193 of 582
S Question
Gingko is not/was not used in which disease a) Chillblains b) Poor
concentration c) Abdominal spasms
Woman taking combined pills for 21 days but the bleeding does NOT
652
occur, she should stop the pills as she may be pregnant
Tamoxifen is antiestrogen
Stein-Leventhal syndrome is a collection of symptoms related to the
hypersecretion of andregens by the ovarian stroma
Skin contraceptive implants: levonorgestrel
RBCs formation is controlled by erythropoietine
956 Posterior pituitary gland secretes ADH, oxytocin
473 Petrolatum dissolvesrubber in condoms and diaphragms
Parathyroid deformation affect absorption of Ca
Norethindrone is used in endometriosis but medroxyprogesterone is
better
Norethindrone is used in endometriosis -- danazole is used in
endometriosis
499 Nonoxynol: SAA, spermicidal: contraceptive
Nilutamide (antiandrogen): delay dark adaptation
566 Metyrapone is useful as a diagnostic agent for pituitary function
Page 194 of 582
S Question
Metyrapone is a diagnostic agent for pituitary function. Metyrapone
is an inhibitor of 11- hydroxylation in the adrenal cortex. Through this
inhibition, metyrapone interfers with the adrenal syn of cortisol and
corticosterone
Mestranol is estrogen not progesterone
Mestranol is estrogen not progesterone
Mestranol is estrogen not progesterone
Mestranol is estrogen
1219 Mestranol : estrogen
Medroxyprogesterone: a progesterone NOT a corticosteroid
993 Long term androgen: hepatic carcinoma, edema, testicular atrophy
Long term androgen ttt= hepatic carcinoma, edema, testicular
atrophy
In-home pregnancy test by Warner Chilcott asseys for the presence of
human chorionic gonadotropine (HCG) -- positive result is indicated
by dark donut shaped brownish ring in the tube
Hypoparathyroid ttt: calcitriol, vit D --- hyperparathyroid ttt:
1038
calcitonin, vit D analogues
FSH, LH reach highest levels during ovulation
Page 195 of 582
S Question
FSH is controlled by the blood estrogen level
884 FSH inc estrogen ---- LH inc progesterone
Estrogen: breakthrough bleeding
Estrogen secretion is controlled by FSH
Estradiol is secreted from the ovarian follicle
Erythropoietin is a glucoprotein secreted by kidney to increase
production of RBCs
Epotein alpha : inc RBCs
Endometriosis: menstrual like bleeding with pain and inflammation,
ttt by danazole (androgen)
During ovulation FSH and LH reach highest peak
Drugs that may cause diabetes insipidus: Li, amphotricin B,
demeclocyclin --- ttt by ADH
1005 Desmopressin ( vaspressin ) is ADH used in ttt of diabetes insipides
Demeclocyclin in ADH antagonist and so cause diabetes insipidus
632
which is ttt by ADH
Demeclocyclin cause D. insipidus and ttt is by ADH
Deficiency in posterior pituitary hormones will cause diabetes
insipidus
Page 196 of 582
S Question
Danazole ttt of endometriosis
722 Danazole is used to treat endometriosis
Danazole is an androgen that inhibits gonadotropin release and so it's
1326
used fot ttt of endometriosis
Cushing's syndrome is a series of clinical symptoms related to the
excessive secretion of cortisol by the drenal cortex
Cushing syndrome: Xss secretion of glucocorticoinds, osteoporosis,
905
inc Bl. Pr.,hyperglycemia
1175 Cretinism is due to deficiency in iodine in children
596 Corpus leutum secrets mainly progesterone
Corpus leuteum secretes mainly progesterone
Congenital adrenal hyperplasia: deficiency of 21-alpha-hydroxylase
Combined pills (estrogen, progesterone) inhibit pituitary
1319
gonadotropins so inhibit ovulation
532 Clomiphen is an antiestrogen
Clomiphen citrate is used clinically to ttt infertility --- tamoxifen
citrate is used primarily to ttt estrogen-dependet neoplasms
Clomid is 50 mg for 5 days

Page 197 of 582

S Question
chlorpropamide: has an antidiuretic effect which may be clinically
useful in diabetes insipidus, may require several weeks to be
eliminated from the body after it is discontinued
Chlorpropamide is not uricosuric, has antidiuretic effect so used in
diabetes insipidus, take several weeks of elimination after stopping of
medication, DOC for D. insipidus is vasopressin
Cause of addison's disease: dec in ACTH secretion… ttt by
719
mineralocorticoids, glucocorticoids
B-estradiol has steroid structure
1126 Antiandrogens: finasteride, nilutamide (delay dark adaptation)
1217 ADH inc tubular permeability thus inc water reabsorption
Addison's disease is hypofunction of the adrenal cortex BUT cushing
syndrome is hyperfunction of the adrenal cortex
Addison's disease is due to the hypofunction of the adrenal glands. It
is characterised by a bronze pigmenation of the skin, progressive
anemia, low blood pressure, diarrhea and severe prostration
Acromegaly is a disease caused by the presence of a pituitary tumor
which results in the production of xss growth hormone

Page 198 of 582

S Question
(cont. metyrapone) this in turn leads to the secretion of of the
precursor 11-deoxycortisol. In the presence of normal pituitary
function, there's a compensatory inc in ACTH production. This
stimulates the adrenal cortex,
(cont. metyrapone) but because of the inhibition 11-hydroxylation,
cortisol production remains low and 11-deoxycortisol is produced in
greater quantities. This response is a measure of the capacity of the
anterior pituitary to produce ACTH
Which is not alike:noregestrel, mestronol, progestin, cyproteron
Tamoxifen side effect is hot flushes
Raloxifene acts on estrogen in bones and lipids
Deficiency in iodine in food leads to cretinism in children
Combined estrogens CI in breast feeding
Dose regimen of progesterone in hormone replacement therapy?
Patient with polydipsia and polyuria, which is wrong:-vasopressin is
302
high
Progesterone doses were given for contraception, endometriosis,
45
HRT: select the wrong answer from 4 doses
47 OC mechanism: inhibits follicular development and ovulation
Page 199 of 582
S Question
46 FSH levels depend on oestrogen
124 Medroxyprogesterone question
Pth - calcium – vitamin d question?
LH sec is regulated by which one: est level in blood, adrenal,
334
menstrual cycle…
Hypothyroidism.....wht are the symptoms?....Ans. Myxoedema
317 Dose regimen of progesterone in hormone replacement therapy
Addison’s disease.............its a disease of adrenal cortex.
Warner Lambent test : test for human gonadotropins --- metyrapon:
1188
diagnostic for pituitary function
589 Menotropin is used for infertility
1158 Erythromycin estolate is better when taken orally
Pamaprom (diuretic) is effective in ttt of PMS, it is derived from
574
theophylline
What is the most cause of HTN: unknown mechanisms
Verapamil: has the most Ca channel blocking activity
Verapamil is C.I. with: digoxin, Ca, disopyramide (48 hr spacing)
Triamterin: K sparing diuretic
Triamterene is a K-sparing diuretic
Page 200 of 582
S Question
Toxicity of thiazides is due to decreased blood volume
Toxicity of thiazide is due to decreased blood volume
Thiazides dec HTN by dec blood volume
Thiazides dec glucose tolerance
1447 Thiazides cause hypokalemia
Thiazides can be related to hyperuricemia
1374 Thiazide SE is gout induction
Thiazide diuretics dec excretion of uric acid
607 Thiazide diuretics cause hyperglycemia, dec glucose tolerance
Thiazide diuretics : dec (Na, Cl, K, Mg), inc (Ca) and alkalosis -- loop
diuretic: dec (Na,Cl, K, Mg, Ca) and alkalosis -- K-sparing: dec (Na), inc
(K, Cl) and acidosis
Thiazide dec glucose tolerance leading to hyperglycemia
Thiazide cause hypokalemia and hypochloremia and systemic
alkalosis
Thiazide cause hypercalcemia(so good in osteoporosis on chronic use
in elderly pts) hyperlipidemia
756 Thiazide antagonizes insulin
1048 Thiazide antagonize insulin
Page 201 of 582
S Question
Thiazide + methyldopa = to relieve salt and water retention
The MOA of amiloride is most similar to triamterene, NOT TO:
spironolactone, HCTZ, metolazone, chlorthalidone. Amiodarone and
triamterene are K-sparing diuretics that exert diuretic effect by
promoting exchage of Na for K in the distal tubules
The main sourse of peripheral resistance=arterioles
The ganglionic blockers are not as other antihypersensives because
they do not selectively block sempathetic ganglia but they also block
1278
parasympatheic ganglia causing unpleasant anticholinergic side
effects
The antihypertensive effect of guanethidine is inhibited by
amitriptyline
563 TCA, corticosteroids may cause HTN
Starting HCTZ dose in mild HTN: 50mg
875 Spironolactone is anti-aldosterone
Site of action of spironolactone: DCT (distal convoluted tubules)
Sensitization to the sunlight may be produced in a pt being ttt with
bendrofluazide
Selective B1 blockers: atenolol, metoprolol, bisoprolol
Page 202 of 582
S Question
Selective B1 antagonists (cardioselective) : atenolol, metoprolol,
979
bisoprolol
SE of thiazide is hyperglycemia
SE of spironolactone: hyperkalemia, gynecomastia, postmenoposal
bleeding
SE of Ca channel blocker is constipation and edema
SE of B-blockers: cold extremities, bronchospasm, inc hypoglycemic
effect of insulin, dec HDL, up-regulation of receptors on long use,
nightmares
488 SE of amlodipine: peripheral edema, pruritis
SE of ACEIs: angioedema ( swollen lips)
SE of ACEIs: 1st dose hypotension and syncope, agranulocytosis,
1202 chronic dry cough, hyperkalemia, cholestatic jaundice -- C.I. of ACEIs:
renal artery stenosis, pregnancy
SE of ACEIs is dry cough
Safe diuretic with sulfonamide sensitivity: ethacrynic acid,
1803
spironolactone
Safe diuretic with sulfonamide sensitivity is spironolactone,
ethacrynic acid
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S Question
Raynaud's disease: pallor or cyanosis of the fingersor toes
Pts arrived in hospital with hypertensive crisis will be ttt with
diazoxide
Pt taking pargyline and have common cold should not take
phenylephrine HCl
Pt on propranolol having cold extremities, nightmares should shif to
896
atenolol
819 Pt on indapamide should take K supplement
Propranolol shows first pass metabolism that when given orally it has
little systemic effect
Propranolol is used with hydralazine to control tachycardia caused by
hydralazine
Propranolol is used with hydralazine to control reflex tachycardia
750
caused by hydralazine
Propranolol is used with hydralazine to control reflex tachycardia
943
caused by hydralazine
Propranolol is not recommended with verapamil
Propranolol incsease hypoglycemic action of insulin also masks the
signs of hypoglycemia
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S Question
Propranolol does not cause tremors or tachycardia -- B-agonists cause
tremors
Prolonged use of spironolactone causes gynecomastia
Primary site of action of K-sparing diuretics is distal tubules
922 Prazocisn causes 1st dose effect: marked hypotenstion with syncope
469 Prazocine SE: 1st dose syncope/ hypotension/ phenomenon
Prazocin is not used as initial antihypertensive ttt
Pindolol: non selective B blocker with intrinsic sympathomimetic
activity-- minoxidil: vasodilator -- enalapril:ACEI -- guanabenz:
centrally acting alpha2 agonist
Pindolol is the only B blocker with sympathomimetic activity ---
916
carteolol, pinbutolol
Perindopril 24mg: dose not appropriate to adults
Patients on propranolol and metoprolol having nightmares may shift
to more hydrophyllic B-blocker like atenolol or nadolol
Pargyline is antihypertensive agent should not taken with food
463
containing tyramine
Overdose of Na.nitroprusside= CN poisoning

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S Question
Nylidrin (Buphenine) is useful as a vasodilator, the vasodilator activity
of nylidrin appears to be a combination of direct musculotropic and B-
agonistic activity. It has been used in a variety of vascular disorders
without proof of efficacy
822 NTG dec preload --- hydralazine dec afterload
Nitroglycerine mainly dec preload
Nitroglycerine inc venous pool of blood
1321 Nitroglycerine dec preload while hydralazine dec afterload
681 Niphedipine is short acting dihydropyridine Ca channel blocker
Na.nitroprusside: CN toxicity, protect from light, slow IV infusion
643 Na prusside is arterular and venular dilator , give by slow IV infusion
1369 Minoxidil is assoc with reflex tachycardia, as hydralazine
Metoprolol is B1 antagonist
Metoprolol is a selective B-blocker -- but it is like propranolol in the
way it crosses the BBB and may cause nightmares, in this case shift to
a more hydrophilic selective B-blocker like atenolol
1154 Metolazone is similar to chlorthalidone
Methyldopa interactions: inc the effect of all antihypertensive agents
MAOIs are C.I. with guanthidine
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S Question
845 Mannitol: ttt of cerebral edema (hexahydric alcohol)
Manitol IV hypertonic 10-25% soln: osmotic diuretic used in:
prophylaxis of acute renal failure, diagnosis of acute oliguria, dec
pressure and vol of intraocular and cerebrospinal fluids
1253 Main source of blood flow resistence is arterioles
Loop/ thiazide diuretics are contraindicated with gout
Loop diuretics: furosimide, bumetanide, ethacrynic acid act by in Na
706
secretion
Loop diuretics: furosemide, bumetanide, ethacrynic acid
584 Loop diuretics inc renal PGs
Loop diuretics cause dose related ototoxicity, alkalosis, hypokalemia
942 Loop diuretic SE: dose related ototoxicity, alkalosis, hypokalemia
Loop diuretic inc the prostaglandind
Lipid solubility order of B-blockers: atenolol, metoprolol, propranolol
Labetalol used in HTN because it blocks alpha and B receptors::
labetalol dec blood pressure by blocking alpha adrenoreceptors in
peripheral arterioles and thereby reducing peripheral resistance. Also
concurrently blocks B-adrenoreceptors,
867 Initial drug therapy of most HTN pts: thiazide diuretics
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S Question
Indomethacin dec antihypertensive effect og B-blockers
Indapamide: thiazide diuretic
455 Indapamide pt councelling is: take K supplement as orange juice
881 Indapamide may cause K loss so pt requires K supplement
Indapamide is contraindicated in pts taking alcohol ??
Indapamide is C.I with alcohol
In HTN we don't use atropine because it dec heart rate
In HTN we do NOT use atropine
In contrast to spironolactone neither amiloride nor amiodarone
inhibit aldosterone.. Metolazone, HCTZ, chlorthalidone are thiazide
diuretics
If pt on captopril or enalapril is suffering from dry cough: this is
because of the drug (ACEIs) -- if the pt above is suffering now from
productive cough then the ttt should be: guifensin NOT
(dextromethorphan and paracetamol)
If a pt taking metoprolol but cannot sleep your advice is: shift to
atenolol, take diazepam
Hypertensive pts should not use carbinoxolone
1123 Hypertensive pts should not use carbenoxolone ( licorice plant)
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S Question
1212 Hypertensive crisis caused by tyramine +MAOIs is treated with an alpha blocker like phentola
842 Hypertension in pregnancy it ttt by methyldopa
Hydrophylic B-blockers: atenolol, nadolol, esmolol -- lipophylic B-
blockers: propranolol, metoprolol, timolol, betaxolol
Hydralazine SE is a syndrome resembling SLE
Hydralazine cause anginal attack due to coronary steal phenomenon
Hydralazine (antihypertensive, vasodilator) may cause ANGINAL
578
ATTACK due to CORONARY STEAL PHENOMENON
704 Hydalazine is antihypertensive of choice in pts with renal insufficiency
HTN pt taking amitriptylene develops depression due to its
anticholinergic effects should shift to trazodone (only inhibits
reuptake of serotonin not NE)
955 HCTZ+propranolol = dec edema
1115 HCTZ is taken in the morning with food or milk
HCTZ interacts with digoxin and lithium --- HCTZ inc Na excretion so
leads to Li toxicity --- HCTZ inc K excretion so leads to digoxin toxicity
HCTZ and hydralazine: most probably antihypertensive of choice in pt
with severe depression
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S Question
HCTZ + propranolol = dec edema
Haloperidol is C.I with guanthidine and alpha methyldopa
Guanthedine, methyldopa, clonidine cause bradycardia but
1311
hydralazine cause reflex tachycardia
1335 Guanthedine interact with TCAs
Guanithidine, methyldopa, clonidine all cause bradycardia BUT
hydralazine causes reflex tachycardia so we use B-blocker with it, it
also causes SLE (systemic lupus erythematosus) and coronary steal
phenomenon causing angina
548 Guanethidine: parasymp. Tone predominate : diarrhea
Guanethidine makes parasympathetic tone predominate thus causes
421
diarrhea
576 Guanabenz is alpha 2 agonist used in the ttt of HTN
Glyceryl trinitrate ( nitroglycerine ) is venules dilator - Na
nitroprusside is arterular and venular dilator - arterular dilators :
daizoxide , minoxidil , hydralazine .
Gentamicin enhances nephrotoxicity of ethacrynic acid
Fenoldopam ( D1 agonist) : ttt of HTN
Ethacrynic acis is used in pts with sulfa allergy
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S Question
1113 Ethacrynic acid is C.I with gentamicin (additive ototoxicity)
464 Erectile dysfunction may be drug indused or HTN ttt SE
Duration of thiazide diuretics: HCTZ: t1/2= 15hrs --- chlorothiazide
1220
t1/2 =3hrs --- chlorothalidone t1/2=50hrs
Drugs that cause iatrogenic HTN: TCA, O.C., clonidine withdrawal,
corticisteroids
Drugs that canNOT be given IV bolus:: prazocin, nitroprusside, KCl
1155 Dose of HCTZ: 0.5-1g
Dose of chlorothiazide is 500 - 2000 mg / day
Don't take NaHCO3 (antacid) in HTN
560 Diazoxide is administered by rapid IV injection
1373 Coon's : inc of hyperaldosteronemia
Codeine, indomethacin = should not be taken in HTN dye to salt and
water retention
1125 Clonidine is prophylactic in migraine ttt
Chlorthalidone: 12.5-50mg with the longest activity, t1/2=40-65hrs
Cells of distal convoluted tubules are sensitive to aldosterone
1258 Captopril SE: renal insufficiency, irritant dry cough
1455 Captopril is ACEI
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S Question
430 Captopril causes hyperkalemia so it is C.I. with K sparing diuretics
453 Bumetanide SE is myalgia
Bradykinins increase vascular permeability to release PGI2 to relax
smooth muscles
Bradykinins increase vascular permeability to release PG12 to relax
smooth muscles
Bradykinine cause potent vasodilation
Bradykinin are peptides: arterial vasodilators, constrict brochi and
intestines, cause pain and inflammation and allergy
Bendrofluazide SE: photosensitivity
1292 Bendrofluazide is a thiazides
B-blockers are C.I. with verapamil
1302 B-blocker and diuretics cause dyslipidemia
949 B-blocker + verapamil = severe bradycardia
544 B bloclers are C.I. with verapamil
Atenolol is the least lipid soluble B blocker
Arterial HTN needs immediate medical attention (responsible for
angina)

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S Question
Antihypertensive that causes angina is: hydralazine (the steal
phenomenon)
Antihypertensive NOT C.I. with amitriptyline: HCTZ ??? --
chlorothiazide is contraindicated with amitriptyline
Antihypertensive effect of alpha methyl dopa is due to its central
alpha agonistic effect, where it's metabolized to alpah methyl
norepinephrine (active)
Amlodipine : least reflex tachycardia
1227 Alpha methyl dopa antagonize TCA
1161 Alpha 2 agonists, reserpine, guanethidine :: cause depression
All ACEIs are prodrugs except captopril and prinivil (lisinopril)
Aldosterone is a mineralocorticoid
Aldosterone hormone is a mineralo corticoid acts on renal tubules
1308
causing salt and water retention
834 Aldosterone = control electrolytes
869 Aldosterone + spironolactone = hyperkalenia
Adverse effect of verapamil..constipation

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S Question
Actazolamide increase K secretion , diuretic , carbonic anhydrase
1396 inhibitor , cause systemic acidosis and urine alkalosis , ttt of systemic
alkalosis
Acetazolamide is rarely used because of systemic acidosis and urine
1223
alkalinization
1140 Acetazolamide is carbonic anhydrase inhibitor
665 Acetazolamide increase K excretion
1160 Acetazolamide causes urine alkalinization
Acetazolamide causes urine alkalinization
1199 Acetazolamide causes systemic acidosis and urinary alkalosis
Acetazolamide causes hyperchloremic acidosis and urinary alkalosis
Acetazolamide caused metabolic acidosis and urinary alkalosis
725 ACEIs may cause severe hypotension
ACEIs cause hyperkalemia so C.I. with spironolactone.. And can be
taken with thiazide diuretics
1315 ACEIs are C.I. is asthma, renal artery stenosis
1st choice for ttt of emergency hypotensive shock is dopamine

Page 214 of 582

S Question
(continue labetalol MOA) notably in the heart, from the reflexly
mediated drive caused by peripheral vasodilatation. Therefore, the
reduction in blood pressure is achieved without cardiac stimulation
Spironolactone is K sparing diuretic
Methyl dopa side effect is severe hypotension
Irbesartan mech of action
Carbonic anhydrase inhibitors cause metabolic acidosis
ACE inhibitors SE is hyperkalemia and increased creatinine
Ace inhibitors mode of action
Where is the pulse taken most commonly?a) Radial artery...b)
190
femoral artery
185 Propanolol should be avoided with asthma patients
183 Captopril side effect: cough
10 Thiazide diuretics MOA: increase excretion of sodium and water
7 Spironolactone: Aldosterone Antagonist
34 Question on Betaxolol use, avoid in CHF?
Question about sartans, select wrong answer, decrease potassium
119
levels and creatinine
96 Ca channel blockers do not cause bronchospasm
Page 215 of 582
S Question
112 ACE inhibitors select wrong answer, increases aldosterone
Where is the pulse taken most commonly? a) Radial artery b) femoral
artery
Patient is on Propranolol, having CNS side effects of Beta-blockers.
What can be done? Ans: Selection of Atenolol because it doesn’t have
lipid solubility so can’t cross Blood Brain Barrier.
Lisinopril maximum dose in mild heart failure: (2.5mg– 10mg – 20mg
– 60mg)
Drug of Choice for diabetes. Ans. ACE/SARTANS
Captopril side effect: cough
ACE Inhibitors side effects.
ACE inhibitor..........mech of action
NaHCO3 is contraindicated with HTN
720 Don't take NaHCO3 with HTN??
Patient with chesty cough, history of hypertension and high
42
cholesterol: Guaiphenesin with honey and glycerol
321 Drug used in HTN and diabetes
322 Drug used in HTN and Angina
694 Metoprolol is similar to propranolol in pharmacological effect
Page 216 of 582
S Question
Haloperidol + alphamethyldopa = life-threatening reaction
1221 Niacin=# lipolysis
1129 Most common side effect of statins in hepatotoxicity
1288 HDL: scavenger of cholesterol protecting arteries
Dose limiting SE of nicotinic acid: flushing of skin (itching) due to inc
PG so give it with aspirin
Cholestyramine interfers with GIT absorption of : chlorothiazide,
warfarin, digoxin, TC, phenylbutazone, phenobarbital
Atherosclerosis: inc in LDL
136 Drug interaction of Warfarin + Simvastatin
TXA2 cause platelet agregation
T-cells, B-cells : 1ry response # antigen
T-cells mature in thymus gland
Specific allergic reaction is by IgE NOT IgG, IgM, IgA, IgD -- IgG is major
in serum plasma, pass placenta --IgM: 1ry produced due to antigen --
IgA: in body secretions -- IgD: 1% antigen receptor??
Lymph glands filter out solids by phagocytosis
Immunoassay is used for all (antidody, enzyme, drug level, receptor
distribution)EXCEPT electrolytes
Page 217 of 582
S Question
Immunity is related to thymus gland
IgG: major in serum, plasma, ONLY pass placenta -- IgM: 1st produced
1354 in response to antigen -- IgA: major in body secretions -- IgE: allergy
spicific -- IgD: (1%) antigen receptor
If a pt has hypersensitivity the the diagnostic lab test can be done is
complete blood picture and differential WBCs
Hypersensitivity::: I: IgE -- II: IgM, IgG : organ specific -- III: non organ
specific -- IV: T-cells
1325 Function of lymph glands: filter out solids by phagocytosis
1044 Filgrastim is a human granulocyte colony stimulating factor
Eosinophils inc in: parasitic infections, allergic conditions --
neutrophils inc in: most bacterial infections -- basophils may be
increased in certain blood dyscrasias -- monocytes: aften greatly
increased in chronic infections such as TB
Anaphylactic reaction occurs after second exposure to the antigen
Anaphylactic reaction occurs after second exposure to antigen
116 Immunoassays do not measure? Electrolytes
55 Hypersensitivity reactions are caused by IGE

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S Question
Drug related anaphylaxis (anaphylctic shick) occurs within few
56
minutes of drug administration
57 Anaphylaxis treatment: epinephrine
IgG: major in serum, plasm, only one pass placenta --- IgM: first
953 produced in response to antigen --- IgA: major in body secretions ---
IgE: allergy specific --- IgD:(1%) (antigen receptor)
Sulfobromophthaline: test for liver function
Mantoux test is with tuberculin PPD NOT diphtheria antitoxin
Lab tests and organs:: creatinine clearance: kidney -- bilirubin: liver --
protein bound iodine PBI: thyroid -- amylase: pancreas -- alkaline
phosphate: liver -- blood urea nitrogen BUN: kidney -- lactic
dehydrogenase: heart -- thymol turbidity: liver
Diagnistic agents:: azoresin: detection of achlorhydria -- congo red:
detection of amyloidosis -- Evans blue: determination of blood
volume -- phenolsulfonphthaline: determination of kidney function
(sulfobromophthaline: test for kidney function) the dye soln is
injected IV & a blood sample is withdrawn after 30 minutes for
comparison with a standard. A normally functioning liver will excrete
most of the dye within that 30-min period
Page 219 of 582
S Question
(phenolsulfonphthaline (phenol red): determination of kidney
function) it is injeected either IM or IV. Approximately 80% of the dye
is excreted within 2hrs. Deficient kidney function causes either
delayed or incomplete elimination of the dye.
(Evans blue: determination of blood volume) after IV injection Evans
blue binds to plasma proteins. A blood sample is withdrawn and
asseyed to estimate total blood volume
(cont. azoresin) the dye is the absorbed and excreted in urine within
two hours. The concn of the excreted dye can be estimated by
comparison of a color chart
(congo red: detection of amyloidosis) congo red is injected into the
blood. Diappearance of the dye from the blood indicated retention by
abnormal amyloid deposits
(azoresin: detection of achlorhydria): a gastric secretion stimulant is
given 1hr before the administration of azoresin. If gastric secretion is
normal, HCl will displace the dye from the resin portion of the
azoresin.
Isoenzyme assay is indicative of tissue necrosis

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S Question
One case study and the question was about when should the Na
solution to be taken for gastric emptying?.......Ans. One day before
colonoscopy
Phenobarbital is used to treat drug-induced neonatal jaundice
954 Liver cirrhosis is progressive fibrosis, scarring of liver
Liver cirrhosis is progressive fibrosis, scarring of liver
Drug induced neonatal jaundice is ttt with phenobarbital
Cholestatic jaundice: erythromycin estolate, ACEIs, (amoxicillin +
clavulenic acid), phenothiazines
Cholestatic jaundice is a SE of: erythromycin estolate,
chlorpromazine, chlorpropamide, TCA, trazodone, sulindac,
methyldopa
Chenodiol is used in dissolving cholesterol gallstones, hepatotoxicity
is the most serious SE, diarrhea is the most common SE
852 Chenodiol dissolves cholesterol gall stones
Bile conjugation occurs in liver
Bile acids act by fat emulsification
Alkaline phosphate level is raised in liver damage
728 Alkaline phosphate level increase in liver diseases
Page 221 of 582
S Question
Alkaline phospahate inc in liver disease
Alkaline phosphate is indicator of liver diseases
Which one doesn’t cause liver damage. Eg. Alcohol, PCT.
248 Lignocaine long action due to : amide
When drug has first pass effect at in the liver that means: it has less
systemic effect
Waste product of protein is urea
Temazepam (BDZ) common metabolism is glucuronidation and alpha-
N- delakylation
Structure of benzaldhyde is metabolized byoxidation
Some drugs show interference between magnitude of activity and
983
plasma concn because they are quickly metabolized
1360 Salicylic acid is conjugated with glycine or glucuronic acid
Phenol salts are conjugates or methylates - conjugated with
1408
glucuronic acid
Phenol is metabolized by glucuronidation and its activity is increased
465
by increased temperature
Phenol is metabolized as phenyl glucuronide

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S Question
P450 inhibitors: cimetidine, erythromycin, fluvoxamine, fluconazole,
838 ketoconazole, omeprazole, ciprofloxacine, fluoxetine, fluvastatin,
nefazodone, verapamil, quinidine
P450 inducers: phenobarbital, fifampin, alcohol, troglitazone, OC,
phenytoin, carbamazepine, prednisone
Metabolized by acetylation: sulfonamides, INH, procainamide
Metabolized by acetylation: INH, hydralazine, sulfonamide,
procainamide
444 Metabolism of procainamide= N-acetyl procaineamide
1359 Metabolism of drugs results in more polar compounds
1424 Metabolism of a drug results in a more polar compound
Lofenalac: is a dietary product used in pts sufferring from
phenyketonuria (PKU). PKU is an inherited disorder characterized by
high plasma level of phenylalanine hydroxylase which converts
phenylalanine to tyrosine.
Favism is due to G-6-PD deficiency
Enzyme induction is done by inc rate of enzyme synthesis and dec
739
rate of enzyme destruction and degradation
End result of protein is uric acid
Page 223 of 582
S Question
(cont. PKU) since aspartam (methyl N-1-alpha-aspartyl-L-
phenylalanine) is metabolized to phenylalanine and aspartic acid and
methanol
(cont. PKU) routine testing of newborns for PKU is common in the US,
ttt is consisting of the following low-phenylalanine diet that is started
early in life. Lofenalac is a complete food except for its low
phenylalanine content
(cont. PKU) it's used in place of usual milk in the diet of children with
PKU. Untreated PKU results in mental retardation. Food, beverages
containing aspartame (Nutrasweet) must bear label warning for
people with PKU,
Metabolism leads to more polar compounds
Intraarterial drugs not metabolized by lungs
12 Phase II metabolism produces which metabolites?
13 Drugs that undergo both Phase I and Phase II reactions?
Which is not a drug metabolism pathway: oxid, hydrolysis,
358
transamination, esterification, reduction
370 What CYP for metabl of celecoxib and NSAID
371 What CYP for metab of amiodarone, verapamil
Page 224 of 582
S Question
740 Waste product of protein is urea
1277 Metabolism of procainamide: N-acetyl procainamide
930 Sulfonamides are metabolized by acetylation
1114 Penicillin metabolism= break B-lactam ring giving penicillamine
200mg FeSO4.2H2O=325mg FeSO4.7H2O=65mg elemental iron
1256 Sb (antimony) K tartarate is antiemetic anthelmentic
Na: the cation most prevalent in the extracellular fluid -- K: the cation
prevalent in the intracellular water
Na polystyrene is a cation exchane resin used in excretion of K
1432 Epson salt: MgSO4 -- gilbert salt: Na2SO4 -- russel salt: KH tartarate
EDTA chelates Ca , Pb -- BAL :arsenic, gold, copper
Colloidal Hg: diagnosis of syphilis -- colloidal Au: diagnosis of paresis --
1097 colloidal Cu: diagnosis of cancer -- colloidal AgCl, AgI, Ag protein::
germicide
Colloidal Hg: diagnisis of syphilis -- colloidal Au: diagnosis of paresis ---
485 colloidal Cu: diagnosis of cancer --- colloidal AgCl, AgI,Ag protein:
germicide
Antimony potassium tartarate is used as: antiemetic, anthelmentic

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S Question
MOA::: benztropin: anticholinergic -- verapamil: antiarrythmic --
asparaginase: antineoplastic -- sulphinpyrazone: uricosuric --
965
tolnaftate: antifungal -- flurazepam: hypnotic -- acetohexamide:
hypoglycemic
935 Tizanidine: ttt of spasticity
SE of cyclobenzaprine would be expected to be most similar to the SE
of amitriptyline. Cyclobenzaprine is an analog of amitriptyline,
available for the ttt of acute voluntary muscle spasm
Muscle fatigue is due to lactic acid accumulation
Exertion of muscle (muscle fatigue) is due to lactic acid accumulation
(cont. cyclobenzaprine) because they are so chemically alike in
chemical structure, cyclobenzaprine & amitriptyline have essentially
the same SE and toxicity.
Vit B6 is used in alcohol toxicity as it decreases alcohol levels
ttt of opiate withdrawal: methadone??
ttt of constipation due to codeine is by stimulant laxative NOT enema
or bulk
ttt of alcohol withdrawal syndrome: chlordiazepoxide, chlorazepate,
diazepam, oxazepam
Page 226 of 582
S Question
Thiazide diuretics enhance the action of amphetamine
Theophylline t1/2 dec in smokers
Theophylline is not used as antiarrythmic
Smocking inc metabolism of theophylline
Side effects of codeine: nausea, vomiting, constipation, repiratory
depression
Respiratory depression cause death in cocaine poisoning
492 Pt with allergy to morphine should not take codeine
Pt suffering from acute alcohol withdrawal is given 100mg of
chlordiazepoxide IM every 30min give two frequent doses then
several hours later the pt will become primarily atoxic and stuperous
due to delayed absorption of relatively large amount of drug
Pt allergic to morphine should not take codeine because they are
chemically related and because codeine is partially (10%)
demethylated to morphine -- but it is OK with meperidine (demerol),
pentazocine(talwin), methadone (dolophene), butorphanol (stadol)
Propoxyphen has poor oral availability due to: poor release from
dosage form,metabolism in liver and gut wall, chemical degradation
in dosage form
Page 227 of 582
S Question
Promethazine is used with meperidine to relieve post-operative pain,
inc its analgesic effect
Phenobarbitone is a metabolite of primadone
Pethidine, opioid, not used as antitussive
Pemoline is used as stimulant drug in hyperkinesis with the
1318
advantage that can be taken once daily
Naloxone: pure opiate antagonist
433 Naloxone: pure antagonist -- nalorphine: mixed agonist-antagonist
647 Naloxone treats opiate toxicity
1047 Naloxone is used to reverse respiratory depression caused by opiates
Nalorphin (narcotic mixed agonist antagonist) has a disadvantage in
1077
ttt of codeine dependence == pptn of withdrawal symptoms
Morphine toxicity cause constipation NOT diarrhea
1387 Morphine cause constipation
709 Methanol oxidation = formic acid = retinotoxic = blindness
Methadone is a narcotic agonist
804 Meperidine + promethazine: postoperative analgesia
Longest acting opioid= methadone
Least addicting = nicotine
Page 228 of 582
S Question
Fentanyl used in chronic bone metastasis
Endorphines, enkephalines are classified as peptides
Early signs of theophylline overdose: tachycardia
D-propoxyphene has 1/2 analgesic activity of codeine
572 D-propoxyphen: analgesic=1/2 codiene - L-propoxyphen: antitussive
Diphenoxylate is related to mepridine as it stimulates opiate center in
817
GIT causing constipation
1168 Dextromethorphan is a narcotic cough suppressant
1233 Dextromethorphan is a narcotic cough suppressant
Constipation due to norphine is ttt by : inc fiber content in diet, stool
1301 softener (Na docusate), stimulant laxative, if constipation persists use
osmotic laxative (Mg citrate or lactulose)
Codeine is partially metabolized to morphine (demethylation) -- 15-
20mg is effective as antitussive
612 Codeine in methylmorphine, heroine is diacetylmorphine
Codeine dose: 30-60mg max: 200mg
Cocaine toxicity is : respiratory failure
1229 Chlordiazepoxide is very effective in the ttt of alcohol withdrawal
1372 Caffeine is of methylxanthines
Page 229 of 582
S Question
1274 Caffeine has diuretic effect
Advantage of naloxone over nalorphine is that it lacks agonistic action
Advantage of naloxone over nalorphine is lack of agonistic action
A potential advantage of pemoline over other stimulant drugs for
uses in hyperkinesis (minimal brain dysfunction) is that pemoline can
be given once daily
(cont. pemoline) pemoline, aschedule IV controlled substance, has
been recently introduced for the ttt of MBD. While it's no more
effective than either dextromethorphan or methylphenidate , it
certainly approaches these drugs in terms of efficacy,
(cont. pemoline) pemoline has a slower onset of clinical activity than
either dextroamphetamine or methylphenidate. Improvement may
not be observed for 3-4 weeks, consequently the drug shouldn't be
discontinued before it has been given a reasonable trial
(cont. pemoline) and has the advantage of a longer t1/2, permitting a
once-a-day dosing, this is desirable because multiple day dosing often
creates problems associated with drug administration while the child
is in school
Page 230 of 582
S Question
(cont. pemoline) although dextroamphetamine was the preferred
drug for MBD for many years, methylphenidate has become the DOC
largely because of unjustified fears that the use of
dextroamphetamine may predisposeone to subsequent abuse
Pethidine(mepridine) take care it comes a lot in exam ,pethidine is
the British name-and Australians adopt the British nomenclature -and
you will find it in comprehensive under the name mepridine because
it is the American name exactly like paracetamol-British- and
acetaminophen-American- which refers to the same compound try to
know everything about it at least 5 Q's in the 2 papers
Pethidine metabolite is toxic
Morphine is synthetic opioid
Methadone is morphine agonist
195 Diphenoxylate similar to pethidine
What is true about Pethidine?a) makes more dependent than other
285 Opioids b) makes less dependent than other opioids c) makes more
spasms in the sphincter of Oddi d) seizures
Treatment of constipation in longterm opioid-treatment..a)
244
Senna...b)Docusate..c) Psyllium..d) Bisacodyl..e) Sodium Picosulfate
Page 231 of 582
S Question
245 Metamucil with opioid cause blockage
Cannaboid- the other name is Tetrahydrocannabinol..- the other
256 name is dancannaboid..- doesn't has medical use..-dronabinol is
isomer of trtrahydrocannabinol
108 Morphine does not need loading dose
132 Group responsible for water solubility of Nicotine … nitrogen
135 Active metabolite of Morphine
79 Acamprostate duration of treatment in alcoholism : at least 3 months
What is true about Pethidine?a) makes more dependent than other
Opioids b) makes less dependent than other opioids c) makes more
spasms in the sphincter of Oddi (or something like that) d) seizures
Treatment of constipation in longterm opioid-treatment a) Senna b)
Docusate c) Psyllium d) Bisacodyl e) Sodium Picosulfate
Opioids doesn’t cause what?..Ans. Diarrhoea
Opiods.....which one is not a side effects of opioids.
Metamucil with opioid cause blockage
Drug that decreases pain, anxiety and load on heart: aspirin, morphin,
346
furosemide, digoxin and ACEI…
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S Question
Diphenoxylate similar to pethidine
Cannaboid- the other name is Tetrahydrocannabinol - the other name
is dancannaboid - doesn't has medical use -dronabinol is isomer of
trtrahydrocannabinol
413 Alcohol + CNS depressant = increase depression
Amphetamine urinary excretion is increased by administration of
105
ammonium chloride
597 Disulfuram, metronidazole interfer with alcohol metabolism
379 Vertigo, tinitus are side effects of aspirin only appear in toxicity
TXA2 could be inhibited by indomethacin
The most essential group in sulindac is: sulfide
1402 Sulindac: NSAID
Sulindac is a prodrug: sulfoxide is reduced to the active sulfuide
936 Pyridium: red discoloration of urine
Piroxicam: ttt of morning stiffness
Piroxicam: drug that is usually given to relief the morning stiffness
pain
Piroxicam is used for morning stiffness because of long t1/2
Piroxicam has a long t1/2: 36hrs
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S Question
Phenylbutazone has long t1/2 (75-100 hrs) and cause aplastic anemia
and blood dyscrasias, it also displace other drugs from plasma
proteins
447 Pentazocin: strong analgesic pain killer
Pentazocin: strong analgesic pain killer
Paracetamol has NO antiinflammtory effects
NSAIDs # PG synthesis
NSAID with longest duration of action: piroxicam
591 Naproxen taken once daily
Naproxen is arylalkanoic derivative useful in arthritis pts who has
698
difficulty in remembering to take the medication during the day
1059 Large doses of acetaminophen may cause hepatic necrosis
Indomethain can cause salt and water retention with HTN pt leading
to frontal headache
Indomethacin: used in chronic arthritis pain ttt
Indomethacin is similar in structure to sulindac
1353 Indomethacin frequent use: headache
Indomethacin cause frontal headache
727 Indomethacin admn immediately after food
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S Question
Indometahcin frequent use:: headache
Indocin (indomethacin) take with milk, meals or antacids or
immediately after food to reduce gastric irritation
In aspirin toxicity we use NaHCO3 to increase excretion
Ibuprofen is less toxic than naproxen
1028 High doses of acetaminophen cause hepatic necrosis
Gold - naproxen - penicillamine - ibuprofen,, of all listed: ibuprofen
has the least SE
858 Dose of sulindac is 100-200 mg
898 Dose of aspirin in rheumatic fever: 6g
Diflunisal is not metabolized into salicylic acid within the body
1395 Diflunisal : prodrug
Dicofenac is phenylacetic acid derivative, sulindac, indomethacin
Chronic use of APC tablets (aspirine + phenacitin + caffeine) leads to
analgesic nephropathy -- it is more associated with phenacitin rather
1018
than aspirin -- it may also be assoc w aspirin, antipyrine, aminopyrine
and phenacetin
Aspirin may induce asthma, may interact with sulfonylureas but NOT
interact with MAOIs
Page 235 of 582
S Question
1061 Aspirin is water insoluble
Aspirin antiplatelet action is due to inhibition of TXA2
Advantage of peroxicam over other NSAIDs is that it is given once
daily -- naproxen : twice daily
Decrease COX activity increases thromoxane production
Aspirin is sparingly soluble in water
If a mother of two children was prescribed 125mg/ml paracetamol in
solution then the child of 8 years old has to take 4times a day and
151
then if she can use the same solution for the otherchild of 2 years old
ehat could be the dose for the second child?
What toxic dose of paracetamol cause? Hepatic and renal failure was
Answer
200 Which one is not cox 2 selective: piroxicam
Which one has higher water solubility:-methyl salicylate-
298
acetylsalicylic acid-salicylamide-sodium salicylate
268 What is the mechanism of aspirin - inhibit cox
236 Paracetamol dose for child 20 kg: 300 mg qid
6 Paracetamol dose in child weighing 20kg: 300mg qid
11 Metabolism for ibuprofen
Page 236 of 582
S Question
Which one is not cox 2 selective: piroxicam
Which one has higher water solubility: -methyl salicylate -
acetylsalicylic acid -salicylamide -sodium salicylate
332 Which is not correct for aspirin: aspirin in soluble in water.
Which doesn’t have active metabolite?...Aspirin
What is the mechanism of aspirin - inhibit cox
Pt complains of tooth ache, he had sports injury and had been on
338 naproxen for one week. What would you do appear from refering to
dentist: Add ibup, give him PCM, replace naproxen with PCM…
Paracetamol dose for child 20 kg: 300 mg qid
320 Child dose (daily) of paracetamol
Some doses of aspirin: normal maximum dose is 4g a day but in
rheumoid arthritis the dose may be oral 2.6-6.5 g a day in divided
doses. In acute rheumatic fever, up to 7.8 g a day in divided doses
may be given ??
Sulindac is prodrug (sulphoxide is reduced to the active sulfide) more
active by prodrug
Salicylates cause: metabolic acidosis, alkaline diuresis, electrolyte
imbalance, GIT bleeding (ttt vit K+ fresh frozen plasma)
Page 237 of 582
S Question
Phenylbutazone has longest t1/2 (100 hrs), cause blood dyscrasias,
also displace some drugs from plasma proteins
Indomethacin SE: Na and water retention, hyperkalemia, aplastic
anemia
Indomethacin is contraindicated with HTN as it cause frontal
headache - indomethacin cause Na and H2O retention - epinephrine ,
nitrates cause throbbing headache
Chronic use of APC (Aspirin 400mg + paracetamol 200mg + caffeine
1282
anhydrous 50mg. )tablets may result in analgesic neuropathy
What toxic dose of paracetamol cause? Hepatic and renal failure was
312
Answer
1350 Aspirin, ibuprofen displace warfarin BUT acetaminophen DOESNOT
1148 Maximum safe dose of paracetamol is 4gm/day
TPN is stored 2-8 C for not more than 24 hrs
1225 TPN fluids should be stored between 2-8 DC
1334 Tetany occur due to hypocalcemia
Storage of fats, formation of scar tissue, polymerization of
aminoacids are called anabolism
Ringer soln: NaCl + KCl + CaCl2 + H2O
Page 238 of 582
S Question
Parentrally administered electrolytes are usually ordered in
1100
milliequivalents
Parentral administration of 1 L of 5% dextrose in H2O provide pt with
657
170-200 kilocalories
Na normal level in blood=135-146 mmol/L -- K normql level in
blood=3.5-5.5 mmol/L
Na level in blood: 135-146 mmol/L - K level in blood: 3.3-5.5 mmol/L
813 Marasmus: protein deficiency
Lytren: an electrolyte supplement used to replenish electrolytes lost
as a consequence of a diarrheal condition NOT: K-lyte, Potassium
Triplex, Kaon, Kayxelate.. Lytren is oral soln containing: dextrose, KCl,
Na, Ca, Mg salts
Low Na intake may cause Li toxicity - low sodium intake may cause
818
lithium toxicity
Lefenalac is a dietary product used in pt with phenylketonuria
kwashiorkor: malnutrition
521 K normal value= 3.5 - 5 mEq/L
K is nor present in dry fruits

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S Question
Hyperkalemia leads to :: bradycardia, paralysis, paresthesias ---
hypokalemia leads to:: dry mouth, tachycardia, muscle cramps
Homopolysaccharides: starch, glycogen, cellulose ---
580
heteropolysaccharides: heparine, hyalouronic acid
514 Glucose and fructose are monosaccharides
Glucose an fructose are monosaccharides
533 Gelatin is a protein
fats provide the largest amount of calories per gram more than
ethanol, anhydrous and hydrous dextrose and proteind. Fats provide
9kcals/g. because of their isotonicity, fat emulsions can be safely
adminstered through peripheral veins
751 Fats provide the greatest number of calories per gram
Fats give the highest calory per gram; 1g=9kcals --1g protein=1g
418
carbohydrate=4kcals --1g dextrose=3.4kcals
Essential amino acids: lysine, leucine, isoleucine, histidine, valine,
1094
phenylalanine, arginine, methionine, threonine, tryptophan
Essential amino acids must be supplied with diet
387 Essential amino acids are to be supplied with diet
Dextrose is used in parentral solution for transfusion
Page 240 of 582
S Question
Carbohydrates and fats are alike because they release energy to the
cell ‫ة‬
Anabolism is: biosynthetic (build up), fat storage, polymerization of
amino acids
1L D5W gives 170-200 kcals
1gm protein= 4kcals -- 1gm carbohydrate= 4kcal -- 1gm fat= 9kcal
(cont. TPN) sudden discontinuation of glucose soln may cause
rebound hypoglycemia in response to the sudden elimination of the
sustained glucose load of the hyperalimentation solution.
(cont. TPN) it's best to maintain the pt on a nominal amount of
dextrose such as D5W or to slowly wean the pt from the TBN soln
(cont. TPN) hyperosmotic nonketotic hyperglycemic causes include
too rapid infusion rate, dextrose soln that are too concentrated and
malfunction of pancreatic secretion of insulin
(cont. TPN) hyperchloremic metabolic acidosis may occur during
hyperalimentation therapy when the total Cl ion content is high. The
amino acids in the protein salts are usually Cl or HCl salts.

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S Question
(cont. TPN) additional amounts of Cl are obtained when NaCl or KCl
are added to the hyperalimentation solns. It may be useful to add
simply Na or K as acetate salts
(cont. Lytren) it's used to supply water and electrolytes in a balanced
proportion in order to prevent serious deficits from occuring to pts
suffering from mild to moderate fluid loss.
(cont. kcal, TPN) hydrous dextrose provides 3.4kcals/g. it's the usual
source of calories in TPN because of its safety, economy and
availability to the body. Proteins provide 3-4kcals/g
(cont. fats, TPN) a commercial example of a fat emulsion in intralipid,
a 10% soybean emulsion. Ethanol provide 7kcal/g it has
disadvantages: too-rapid infusion can cause heart-burn &/or
intoxication, it can't be used in pts with GI disease ex.pancreatiti
TPN solution should be refrigerated
A man on tea and toast diet likely to develop iron deficiency anemia
TPN doesn’t contain Vit-K.
674 Ricinoleic ( castor oil ) of linoleic ( unsaturated )
Oleic acid= monounsaturated organic acid --- linoleic acid= poly
863
unsaturated organic acid
Page 242 of 582
S Question
Oleic acid: monounsaturated fatty acid --- linoleic acid:
731
polyunsaturated fatty acid
630 Linoleic acid: polyunsaturated fatty acid
800 Lanolin contains more water than wool fat
849 Sargamostin: myeloid reconstitution after BM transplantaion
Agent that could be use in osteoporosis=biphosphonates, Ca,
655 estrogen, calcitonin, vitamin D, Na flouride, progesterone, androgens,
calcitriols.
With levodopa we give domperidone to counteract dopaminergic GIT
1433
SE
Vit B6 is C.I. with L-dopa because it is a cofactor in the enzyme dopa-
decaroxylase thus inc the peripheral decarboxylation of levodopa
giving a metabolite unable to cross the BBB -- so pts on L-dopa should
avoid OTC multivitamine preparations
1102 Vit B6 in C.I. with levodopa
Sinemet (carbidopa + levodopa in a ratio, 1:10) carbidopa dec the
1201 dose of L-dopa by about 75% -- L-dopa 1g qid can be replaced by
sinemet 25/250 qid
Selegline is selective MAOI b, used in parkinsonism
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S Question
1255 SE of L-dopa: diplopia, dark urine, o.hypotension
Pt on carpidopa and levodopa complain of dark urine discoloration of
1213
levodopa metabolite
971 Procyclidine is anticholinergic used in parkinsonism
Parkinsonism: inc in Ach, dec in dopamine, assoc with muscle regidity
Parkinsonism may be induced by : haloperidol, resepine,
714
chlorpromazine, methyldopa
1368 Muscle regidity is one of parkinsonism symptoms
L-dopa SE: hypotension
L-dopa is a dopamine precursor used in the ttt or parkinsonism; C.I.
with B6: dec antiparkinsonism action, MAOI: hypertensive crisis,
anticholinergics: synergism
L-dopa does NOT cause HTN
Haloperidol is NOT used in parkinsonism
Haloperidol in C.I. with parkinsonism
Haloperdoil, vit B6: are C.I. with parkinsonism
Four clinical features of parkinsonism: tremor, disturbances of
posture, bradykinesia, rIgidity BUT NOT mental deterioration

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S Question
Ethopropazine is a phenothiazine derivative used in the ttt of
581
parkinsonism due to its atropine like action
Ethopropazine is a phenothiazine derivative that has atropine like
1313
action so used in ttt of parkinsonism
Drugs causing parkinsonism: haloperidol, phenothiazines, reserpine,
heavy metal poisoning, methyldopa
Carbidopa (alpha-methyldopa hydrazine) # peripheral dopa
1070
decarboxylase and does not cross BBB
Bromocriptine: dopamine agonist -- chlorpromazine: dopamine
antagonist
Benztropine mesylate is an anticholinergic that is useful in ttt of
morning stiffness and rigidity assoc with parkinsonism due to its long
duration of action so it can be taken at bedtime
1032 Baclofen is antispastic
All of the following are clinical manifestations of parkinsonism:
tremor, bradykinesia,disturbance of posture, and regidity BUT NOT
mental deterioration

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S Question
A dopamine agonist used to treat hyperprolactinemia: bromocriptine,
it is an ergot alkaloid derivative that acts on the anterior pituitary to
supress prolactin secretion
(continue parkinsonism) or festination (an involuntary increase or
hastening in gait,generally in a stooped position
(cont. parkinsonism) tremor is a rhythmical alternating contraction of
a given muscle group and its antagonist
(cont. parkinsonism) rigidity is an increased muscle tone that is
resistent to passive movement of an extremity
(cont. parkinsonism) postural disturbances are positive disturbances
include difficulty in maintaining an upright position of the trunk while
standing or walking also retropulsion(tendency to walk backwards
(cont. parkinsonism) bradykinesia is slow or etarded movement.
There is a deminishe spontaneous movement, loss of normal
associative movement and slowness in initiation of all voluntary
movements

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S Question
(cont. parkinsonism) aged people with parkinsonism may have
impairment of memory and judgement or have mental disturbances
due to other disease states or social isolation but not due to
parkinsonism
(cont. bromocriptin) The drug may be indicated in the ttt of
amenrrhea and galactorrhea assoc with hyperprolactinemia. It's
available as 2.5mg tablets and the usual therapeutic dose is 1 tab 2 or
3 times daily.
188 Seligiline: selective reversible MAOB inhibitor
182 Benztropine use in parkinsonism: tremors and rigidity
Patient with low dopamine and high ACH..Which symptoms he does
246 not have: - tremors – rigidity – bradykinesia – akathisia –
hyperreflexia
239 Parkinsons due to less dopamine in which are: (substantia nigra)
1 MAO B inhibitors in Parkinson’s: Selegiline
Inc. in dopamine and dec. in ach … name the condition .. Symptoms
14
are except … hyperflexia- bradikinesia -ataxia tremors
Which one of the following is the side effect of Levodopa ....Ans.
Hypertension
Page 247 of 582
S Question
What is Selegiline......Ans. MAO-B
Seligiline: selective reversible MAOB inhibitor
Patient with low dopamine and high ACH Which symptoms he does
not have: - tremors – rigidity – bradykinesia – akathisia –
hyperreflexia
Parkinsons due to less dopamine in which are: (substantia nigra)
In Huntington: not enough GABA
349 Bromocriptine… galactorrhea
Benztropine use in parkinsonism: tremors and rigidity
203 in Huntington: not enough GABA
Physician's Desk Reference:: list products manufactured by Paul B.
Elder Co. - Possible identification of a capsule having a distinctive
color combination
(cont. PDR) the PDR is divided into several sections, one of which lists
pharmaceutical companies with the product manufactured by each.
The PDR has a colored plate reference section that pictures products
for easy indentification
(cont. PDR) that section is subdivided by individual manufaturers

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S Question
Zollinger-Ellison syndrome: marked hypergastrinemia, gastric
hypersecretion, peptic ulceration caused by a gastrin producing
tumor of pancreas or duodenum wall
Theophylline is C.I. with cimetidine
1208 TC, imidazoles, sucralfate should not be taken with food or antacids
662 Sucralfate should not be taken with food or antacids
870 Sucralfate should NOT be taken with food or antacids
Sucralfate is not absorbed from the GIT
Ranitidine would NOT produce iatrogenic (drug-induced) HTN
696 Ranitidine dose is 150 mg bid
1119 Parietal cells in stomach secrete HCl and intrinsic factor
1336 NaHCO3 = systemic antacid
1232 Magaldrate gel is given q1hr in duodenal ulcer
Ketoconazole, FeSO4 should not be taken with antacids
KCL is given in enteric coated tablets to protect gastric mucosa from
588
irritation
K used as SR ( wax matrix ) as it is very irritant to GIT

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S Question
If pt is taking theophyllin and cimetidine theophylline dose should be
decreased or pt could shift to ranitidine or other H2 blocker that have
no effect on hepatic enzymes
1050 Ideal antacid should inc PH of stomach to 3.5
Ideal antacid raises the gastric PH to 3.5 -- rising from 1 to 3.5
neurtalizes 99% of the gastric acid -- any higher PH serves no useful
purpose
HCl secretion receptors: M, H, gastrin … HCl is secreted from parietal
1237
cells
Dose of mesoprostol for ttt of ulcers: 800 mg daily (2-4 divided doses)
Critical interaction between cimetidine and ranitidine???
Cimitidine SE: gynecomastia
Cimetidine is C.I. with: theophylline, phenytoin, warfarine,
carbamazepine
Cimetidine is C.I with theophylline, phenytoin, warfarin,
1410
carbamazepine
Cimetidine is associated with gynecomastia and mental cofusion in
the elderly
Page 250 of 582
S Question
Cimetidine interaction:: inc effect of every thing ( ‫) الحیاة‬- dec the
effect of ketoconazole and phenothiazines -- antacids dec cimetidine
effect
Cimetidine inc dose at bedtime
Cimetidine in elderly cause: mental confusion, gynecomastia--
cimetidine large dose is taken at bedtime
Cimetidine causes gynecomastia in elderly patients
1437 Cimetidine # HME
Antacids: inc L-dopa absorption
Antacids dec A of: cimetidine, ranitidine, INH, digoxin, phenthiazines,
iron, sucralfate, anticholinergics, TC, quinolones
What is the dose for misoprostol for ulcer ?a.20mg 4 times a
161
dayb.200microgram 4times a day
Sucralfate compounding calculation from sample question 2014 (6.67
174
%)
229 Which cells secrete HCL: Parietal cells
5 Misoprostol dose for peptic ulcer: 200mcg qid
Which one of this has no drug interactions?Ans: Omeprazole +
warfarin
Page 251 of 582
S Question
Which cells secrete HCL: Parietal cells
H2 Receptor antagonist + Ketoconazole.......decreases absorption
from gut.
H.pylori infection......
Drugs causing photosensitivity: amiodarone, amitriptyline, doxepine,
fluoxetine,
furosemide, griseofulvin, isotretenoin, ketoprofen, nalidixic acid,
876
naproxen, OC, oral
hypoglycemics, piroxicam, phenothiazines, sulfonamides, TC,
thiazides, trimethoprim
Xerostomia= dryness of mouth
1383 Xerostomia: dryness of mouth
Weak acids, bases are more absorbed from small intestines due to
1062
large surface area
Weak acids and bases are more absorbed from the small intestines
due to large surface area, most drugs are from the duodenum
Venoclysis is assoc with IV infusion
Trypsinogen is produced by pancreas
Thirst is controlled by hypothalamus
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S Question
The substance secreted in the stomach and present in the intestine is:
mucous NOT pepsin
The part of ear responsible for balance is the inner ear
The outer waterproof layer of skin in made of keratin
The epidermis is made of keratin
Tests::: acid fast: mycobacteria -- Rideal walker, phenol coefficient,
1357 chick martin: disinfectants --- mantox, tuberculin, PPD : TB --- Schick's:
diptheria --- Ames: carcinogenicity
Sweat is used for: water excretion, Na excretion, temperature
equlation (the most important)
Sweat function: water excretion, Na excretion, temperature
regulation
Stomatitis: inflammation of the oral mucosa -- blepharitis:
inflammation of the eyelid -- gastritis: inflammation of the stomach
wall -- glossitis: inflammation of the tongue
1445 Stomatitis is inflammation of the oral mucosa

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S Question
Stenosis: narrowing or stricture of a duct or canal -- aortic stenosis:
narrowing of the
882 aortic orifice of the heart -- pyloric stenosis: abstruction of the pyloric
orifice of the stomach
caused by hypertrophy of the pyloric muscle
Steatorrhea:: fatty acide deficiency due to improper secretion of bile
1195
acid
Steatorrhea is excessive loss of fats in feces
Sphingomyelin: building unit of nerve
918 Sarcolemma in striated muscles and nervous tissues
Retro: backward -- retrograde means retrace of a former course
Retinol: reproductive -- retinal: visual -- retinoic: epithelial
991 Respiratory center is located in medulla
Related to body muscles: myalgia, myocardia, myoclonus, myositis
BUT NOT myopia
Radial artery is used to measure pulse rate --- brachial artery is used
1240
to measure blood pressure
Pyuria=pus in urine

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S Question
Prefixes:: cata: downward, dis: apart, infra: below, meso: middle,
1358 retro: backward, celi: abdomen, cephal: head, col: large intestines,
cor: heart, cost:rib
Portagen is dietary product used in the ttt of steatorrhea
Portagen is a dietary product used to treat pts with steatorrhea. It's a
product used when conventional dietary fats may not be well
absorbed , digested or utilized
polyphagia: excessive graving for food -- hirsutism: abnormal
hairiness -- urticaria is commonly called hives -- nystagmus:
involuntary rapid movement of the eyeball which may be horizontal,
vertical, rotarory or mixed
PH of the small intestines: 6.2 -- a drug with pka 6.2 will be 50%
1090
ionized at the small intestine (PH 6.2)
PH of skin is 5.5
Outer layer of skin (stratum corneum) is made up of keratin
Nospital infections=nosocomial
Neutral compound absorbed from lipid biological membrane depends
1092
on partition coefficient

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S Question
Myopia: nearsightedness -- myalgia: pain in a muscle --myocardia
pertains to the heart muscle -- myoclonus is muscular twitching or
conraction -- myositis is inflammation of a voluntary muscle
Meso: middle -- mesobronchitis indicates inflammation of the middle
coat of the bronchi
Meniere's disease: deafness, tinnitus and dizziness, this is a
nonsuppurative disease of the labyrinth
798 Meniere's disease: deafness, tinnitus and dizziness
1078 Major buffer of extracellular fluid is HCO3/CO2 system
Large surface area of small intestine enhance absorption
Ischemia: deficiency of blood in a part of the body -- myocardial
ischemia: deficiency in blood supply to the heart muscle --- icterus:
jaundice
Inner ear is responsible for equilibrium
1064 Ileum is the last part of small intestine
Hypertrophy: an enlargement of overgrowth of an organ --
hyperplasia: abnormal inc in cell number of a tissue -- hyperhidrosis:
1364
excessive sweating/perspiration -- hyperkinesia:(excessive
movement) -- hypersthesia: excessive sensitivity to stimulus
Page 256 of 582
S Question
Hyperhydrosis: excessive hydration or sweat -- hypersthesia:
excessive sensitivity of skin-- lethargy: sleepness -- polyphagia: inc
appetite -- pyuria: inc pus in urine
Hodgkins disease affects lymphoidal tissue. There is a progressive
enlargement of lymph nodes, spleen and other lymphoid tissue
Dyspnea: difficult or labored breathing -- dysphagia: difficulty in
1121 swallowing --dyspepsia: impairment of digestive function -- dysuria:
painful or difficult urination -- dysphoria: restlessness
Dysarthria: difficulty of speech
Diseases and areas::: Adam's-Stoke's disease:heart, addison's disease:
adrenal gland, Bright's disease: kidney- Hodgkin disease: lymph
1310
nodes, myasthenia gravis: muscles, Goiter: thyroid,
acromegaly:pituitary gland, Klinefelter's syndrome:testis
Dis: apart -- disarticulation is amputation or separation of a joint
Cost: rib -- intercostal: located between two ribs
Correct order: Blood-ureter-bladder-urethra
Conjugated proteins are those found in nature combined with a
nonprotein substance. Examples include the lipoproteins such as
licithin and sterols, which consist of proteins combined with lipids
Page 257 of 582
S Question
Colististiken : cofactor liberated from d. mucosa after ingestion of
meat ot fat
Col: large intestine -- coloproctitis: inflamation of colon and rectum
Cholic acid aids in fat absorption
Children 3-10 years old have low acidity skin thus may have skin
infection
Children 3-10 y have low acidity skin thus may have skin infection
Cephal: head -- cephalalgia: headache
Central vein is used for infusion of hypertonic solutions,
postoperative hydration, poor access to peripheral veins
Celi: abdomen -- celiotomy is incision into the abdominal cavity
Cata: downward -- catabolism indicates any destructive process by
which complex substances are converted by living cells into more
simple compounds
Cartilage covers and protects bone from friction during normal joint
788
activity
Car: heart -- the pericardium: the region over the heart
Bile conjugation ocurs in liver
Bacteriuria: greater than 100000 bacteria/ml
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S Question
Axon is part of the neuron that carries impulses away from the nerve
914
cells
1146 Ataxia: poor muscle coordination
Aseptic pencil is used in minor cuts
Areas and diseases::: cushing syndrome: adrenal cortex, Stein-
leventhal syndrome:ovary
1039 Aphasia: inability to communicate
Anatomy of small intestines: duodenum, ileum, jejunum
Amylase, trypsin are secreted from pancrease
Absorption occurs in the ileum
(cont. portagen) its fat content consists of 95% medium-chain TGs,
which are more rapidly absorbed than the long-chain fatty acids
present in conventional food fats. Pts suffering steatorrhea are
excellent candidates to portagen dietary supplementation
970 % of body water at birth is 80%, normal 70%
1026 % of body water at birth is 80%
Which substance is mostly found in the urine?a) Uric acid b) Urea c)
Albumin
Absorption is faster in which part of GIT?.... Ans. Small Intestine
Page 259 of 582
S Question
292 Polypeptides advantage:-selectivity-CNS availability
366 Polypeptide therapy benefit…. Specific target
Polypeptides advantage: -selectivity -CNS availability
Damage of protein and peptides due to: -deamination -oxidation
Reference sources:: facts and comparison, handbook of
ninprescription drugs, physician's desk reference, united states
dispensatory, united states pharmacopea.
The presence of impaired renal function in pt:: dec the requirements
925 for drugs that are diectly excreted or whose active metabolites are
excreted by the kidney
The amount of glomerular filterate reabsorbed: 85-99%
Serum creatinine clearance = 0.6-1.2 mg/ dL
883 Pyelonephritis is accompanied with edema
Oliguria= dec urine excretion
538 Oliguria= dec in urine excretion
1407 Normal CrCl: 80-120 cc/min
More than 80% of water and Na are reabsorbed from the proximal
tubules

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S Question
More than 50% of water is reabsorbed in the proximal tubules --- K
reabsorption in the ascending limb of distal tubules
More than 50% of water are reabsorbed from the proximal tubules by
1361
passive transport
Kidney dysfunction: inc (BUN) blood urea nitogen
K reabsorption occurs in the proximal tubules but K secretion occurs
1157
in the distal tubules
K reabsorption is from the ascending limb of distal tubules
In nephritis there is edema
Glucose is completely reabsorbed after GF
Examples of drugs that don't need dose adjustment in renal failure :
linezolide, fosinopril,digitoxin
Edema occur with nephritis
Drugs excreted by glumerular fileration: TC, aminoglycosides, digoxin,
ethambutol,MTX,
Drugs excreted by GF: ethambutol, aminoglycosides, MTX, digoxin,
procainamide -- drugs excreted by passive tubular secretion: aspirin,
amphetamine -- drugs excreted by active tubular secretion: penicillin

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S Question
Drugs excreted by GF: ethambutol, aminoglycosides, methotrexate,
462
digoxin, procainamide
Dosage adjustment in renal impaired pts is based on serum Cr
995
concentration
651 Degraded TC gives a more toxic form = fanconi like syndrome
Creatinine, inulin: measure GFR
Creatinine clearance is used to assess the hepatic function with
normal value 75-120ml/min
1317 CrCl=100-120cc/min
CaCO3 is given to pt with terminal renal failure to in Ca in serum,
correct hypocalcemia
CaCO3 is given in renal failure to treat hypocalcemia and dec
808
phosphate
1298 CaCO3 is given in renal failure to dec PO4 conc
441 Ca acetate : ttt of hyperphosphatemia in end stage renal failure
Bright's disease is a term used to describe kidney disease
characterized by proteinureaand glomerulonephritis
1066 5% of glomerular filteration returns to blood from distal tubules
556 180 L/day of fluid filtered in GF per day
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S Question
Urine output per day is 1500 L
Glucose reabrosped by tubules
Which substance is mostly found in the urine?a) Uric acid..b) Urea...c)
273
Albumin
252 Which one is mostly reabsorbed from renal tubules: glucose
291 Glomerular filtration due to hydrostatic pressure
230 Aluminum in renal failure used for: phosphate
Which one is mostly reabsorbed from renal tubules: glucose
Renal failure? What are the possible symptoms
Glomerular filtration due to hydrostatic pressure
Aluminum in renal failure used for: phosphate
NaHCO3 inc rate of urinary excretion of penicillin G K, penobarbital
600
Na
594 Na benzoate, Na phenyl acetate, : inc ureagenesis
Thioridazine is a phenothiazine with the least extrapyramidal SE
1007
because it is a piperidine derivative
Thioridazine is a phenothiazine derivative with the least
1031
extrapyramidal SE
1355 Thioridazide is the phenothiazine with the least extrapyramidal SE
Page 263 of 582
S Question
The therapeutic value of the electroconvulsive therapy (ECT) is due to
1046
the convulsion itself
679 Tardive dyskinesia is irreversible SE of phenothiazine
692 Quetiapine (atypical antipsychotic) : SE: cataract
Pt on haloperidol should not take alpha methyl dopa or alcohol
Promethazine is a potent antiemetic
Promethazine is a potent antiemetic
Phenothiazines:: chlorpromazine, thioridazine, fluphenazine,
trifluperazine, perphenazine
Phenothiazines SE is parkinson like
Olanzapine (least extrapyramidal ???) SE agranulocytosis
In antemenetic effect chlorpromazine is greater than promethazine
which is greater than fluperazine
Haloperidol should not be taken with alcohol and alpha methyl dopa
1346 Haloperidol is contraindicated with parkinsonism
Haloperidol is C.I. with methyldopa or guanthedine
887 Haloperidol + alpha methyl dopa= life threatening reaction
Fluphenazine deconate is mainly given IM

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S Question
Fluphenazine deconate is a flophenazine ester, formulated in oil
vehicle and injected deeply into the muscle, the ester slowly diffuses
into circulation and has a prolonged duration of action
Fluphenazine deconate in given IM
Droperidol is butyrophenone derivative that is used as adjunct to
734
anesthesia
Clorpromethazine does NOT cause vomiting
Chlorpromazine: relieve pre-surgical apprehension
Chlorpromazine inc 1 and 1/2 when given IM
Chlorpromazine has longer duration when given IM
Chlorpromazine has long t1/2 when given IM
Chlorpromazine has lonf duration of action when given IM
Chlorpromazine causes extrapyramidal effects
Chlorpromazine bioavailability is increased when taken parentrally IM
Benztropine is given with phenothiazines as benztropine is
anticholinergic thus dec extrapyramidal SE of phenothiazines
1449 Antacid should be taken 1 hr before CPZ or 2 hrs after
564 AlOH3 in C.I with TC, cholropromazine
Page 265 of 582
S Question
1030 All phenothiazines have extrapyramidal SE except thioridazine
Quetiapine block 5HT receptors
223 promethazine : phenothiazine
83 Olanzapine given by IM depot
84 Flupenthixol given by IM injection
26 Drugs causing neuroleptic malignant syndrome?
Which one antipsychotic has the least extra pyramidal side effects?
Some question on Heloperidol
Promethazine : phenothiazine
Increase in DOPA, decrease in Acetyl Choline............Ans. Tardive
Diskinesia.
562 Tardive dyskinesia is irreversible SE of phenothiazines
1057 Haloperidol is NOT used in parkinson's
507 Patient on haloperidol should not take alcohol or alpha methyl dopa
Some phototoxic drugs: amiodarone, sulphonamides, TC, thiazides,
phenothiazines, nalidixic acid
Side effects::: spironolactone:gynecomastia-- nadolol, bronchospasm -
593 - alpha mehyldopa: +ve coomb's test -- sulfisoxazole: steven johnson
syndrome -- rifampicin: discoloration of urine, sweat, contact lens
Page 266 of 582
S Question
SE:::: spironolactone: gyncomastia -- guanethidine: orthostatic
hypotention -- methyldopa: positive coomb's test -- sulfisoxazole :
423
steven's johnson syndrome -- rifampicin: discoloration of body fluids --
dececlocyclin: photosensitivity
SE:: hydralazine: SLE -- prazosin: 1st dose syncope -- guanethidine:
orthostatic hypotention, drug-induced inhibition of ejaculation
Photosensitizers: thiazides, phenothiazines, fluoroquinolone,
amiodarone, TC
Photosensitivity is caused by: TC, nalidixic acid, piroxicam,
1347
chlorpromazine
997 Hydralazine, procainamide SE : SLE
H.M.E inducers: phenobarbitone, glutethimidine, EtOH,
carbamazepine --- H.M.G inhibitors: phenylbutazone,
benzodiazepines, INH, dicumarol, chloramphenicol, estrogen
Drugs that are C.I. with myathenia gravis:: procainamide, quinidine,
1010
aminoglycosides, dtubocurarine, phenytoin
Drugs causing SLE: hydralazine, procainamide, quinidine, TC,
methyldopa, penicillamine, phenytoin, phenothiazines, sulfonamides,
INH, nitrofurantoin, ethosuximide
Page 267 of 582
S Question
Drugs causing gynecomastia: spironolactone, ketoconazole, digitalis,
978
cimetidine
Drugs causing disulfuram like action: sulfonyl ureas (except:
1305 tolazamide, glimepride), cefotetan, cefoperazone, cefamandole,
moxolactam, metronidazole, INH, chloralhydrate, nitrofurantoin
Disulfuram like reaction: metronidazole, sulfonylurea,
968
cephalosporines, cloralhydrate, disulfuram, ketoconazol
1283 Cyclobenzaprine and amitrptyline have the same side effects
1370 Corticosteroids and estrogen caused HTN while ranitidine does NOT
Diseases and symptoms:: Raynaud's disease:cold pallor or cyanosis of
fingers or toes-- Grave's disease: exophthalmus and enlargement of
986
the thyroid gland--herpes simplex:watery blisters on skin and mucous
membranes espicially the lips
1431 Tyrosine is precyrsor of thyroxin
1164 Tyrosine is precursor of thyroxine
785 Tyrosine is a thyroxine precursor
Tyrosine is a precursor of thyroxine
Thyroxine secretion from thyroid gland is regulated by iodine level in
blood
Page 268 of 582
S Question
Thyroxine secretion from thyroid gland is regulated by iodine level in
blood
Thyroxine metabolism: deiodinization, then conjugation, then
1243
excretion
Thyroxin release can be controlled by TSH (thyroid stimulating
hormone)
Thyroxin interactions: inhance effect of anticoagulants, antagonizes
insulin and inc requirements of hypoglycemics, cholestyramine dec
thyroxin absorption
Thyrotoxicosis is ttt by : PTU (propylthiouracil) and carbimazole
Thyroid storm= sudden onset thyrotoxicosis
Thyroid preparation after surgical removal of thyroid
1052
gland:1.6mcg/kg/day
Thyroid hormone: dec vit K dependant clotting factors thus
potentiate warfarin
Thyroid hormone is responsible for: protein synthesis, inc activity of
1367 Na-K ATPase pump to inc O2 consumption, stimulate secretion of
growth hormone
985 Thiocyanate dec iodide uptake in thyroid gland
Page 269 of 582
S Question
1054 Thiocyanate affect iodine uptake in thyroid gland
The bromsulphalein (BSP) excretion test is a measure of thyroid
function
PTU is preferred in ttt of hyperthyrodism because PTU inhibits
peripheral conversion of T4 to T3, which may theoritically make it
more effective in the ttt of thyroid storm
Propylthiouracil, carbimazole:: ttt of hyperthyrodism
Propylthiouracil is the best antithyroid
Propylthiouracil is preferred over carbimazole as antithyroid
Propylthiouracil is better than carbimazole because it blocks
peripheral conversion of T4 to T3 beside inhibition of T4,T3 synthesis
Normal thyroid level is called euthyroid
Myxedema is decreased secretion of thyroid hormone in adulthood
Myxedema coma: is ttt by large initial dose of T4 and T3,
corticosteroids are also given for the posibility of central
hypothyrodism ?? .. T3 is the DOC in acute case because of its quick
onset of action.
Myxedema (dec thyroxin in adults) can be caused by: Li or
amiodarone
Page 270 of 582
S Question
860 Methimazole in pregnants: agranulocytosis
Methimazole in pregnants: agranulocytosis
Li, amiodarone: interfer with thyroid gland function
Li and amiodarone both interfer with the function of the thyroid
gland
Iodine uptake by the thyroid gland is inhibited by high iodine dose
Hypothyroid in adults is called: myxedema
Hypothyrodism due to Li therapy is a rare case
Graves disease: enlragement of the thyroid gland, exophthalmus,
acceleration of pulse rate, sweating, nervousness, psychatric
disturbances, emaciation and increased metabolic rate
Grave's disease is a form of hyperthyrodism --- thyroid storm is
835
sudden onset of thyrotoxicosis
Exophthalmus is seen in Grave's disease hyperthyrodism
Exophthalmus is protrusion of the eye associated with
hyperthyrodism, hyperplasia of thyroid gland
424 Exophthalmos is seen in Grave's disease hyperthyrodism
982 Excessive thyroid secretion causes thyrotoxicosis
742 Excessive thyroid secetion = thyrotoxicosis
Page 271 of 582
S Question
1296 Euthyroid=normal thyroid
Drugs that prevent the uptake of iodine: prechlorates, thiocyanates,
iodine in high doses
Dose of thyroxine=50-150 mcg daily
Dose of thyroid peparation in adult after surgical removal of the
1211
thyroid gland is 1.6 mcg/kg/day
1365 Antithyroids = propylthiouracil , carbimazole
100 mg of thyroxin is equivaent to 25mg of triiodothyronine
97 Thyroid gland releases a hormone, which controls? Rate metabolism
337 Thyroid ADR with which drugs: amiodarone and lithium
1203 When urinary pH inc= excretion of acids inc
621 Vomiting = alkalosis --- diarrhea = acidosis
Urine alkanlinizer is not given when the pt is on erythromycin
Universal antidote: charcoal + MgO + tannic acid
ttt of hyperkalemia:: if there's no ECG change: rectal Napolystyrene
sulfonate -- if there's ECG change: IV calcium -- emergency: IV
NaHCO3 or IV glucose + insulin
Trimethoprim is not C.I. is sulfa allergy but captopril is

Page 272 of 582

S Question
Symptoms of disulfuram reaction: throbbing headache, sweating,
chest pain, hyperventilation, weakness, vertigo, blurred vision, BUT
NOT severe diarrhea
Salicylic acid excretion is increased by alkaline urine and forced
diuresis
Pulmonary toxicity is SE of: bleomycin, amiodarone, nitrofurantoin,
491
pentamidine, bromocriptine
Pts with sulfa allergy could take safely:: etahcrynic acid or
spironolactone as diuretic, sulfamethizol (bec of short t1/2)
Pregnant woman cannot use TC
Pregnancy: X , D , C, B , A
Pregnancy X: Li, vitamin A, isotretinoin, TC, ACEIs, warfarin, alcohol,
finasteride,misoprostol, metronidazole, phenytoin???
Phenytoin , theophylline have narrow therapeutic index
NaHCO3 is given after shock to neutralize lactic acid, regulate
respiration due to CO2 accumulation, replace plasma
NaHCO3 ampoules are sterilized by ultrafilteration - NaHCO3 is used
394
to neutralize lactic acidosis
520 NaHCO3 + 5% dextrose= acidosis as a result of diarrhea
Page 273 of 582
S Question
NaHCO3 : ttt of lactic acidosis , ampoules sterilized by ultrafiltration ,
ttt of acidosis (cardiac arrest )
1144 Na cellulose phosphate : ttt of hypercalciuria
Mephenesin carbamate is antidote for strychnine
In urine PH inc, excretion of salicylic acid inc
In cardiogenic shock we give NaHCO3 to treat ventilation acidosis
In barbiturate or salicylate toxicity give urine alkalinizer as NaHCO3 or
1083
acetohexamide
920 In acidosis ( cardiac arrest ) we give NaHCO3
1089 Idiosyncrasy is NOT dose related
1058 Hypersensitivity and idiosyncrasy is not dose related
Hemodyalisis is used for polar drugs
Hemodialysis for polar drugs
EDTA is used as Ca salt because it binds to body Ca causing Ca loss
Drugs pregnancy category X: isotretenoin, TC, misoprostol,
634 finasteride, chloamphenicol, methimazole, coumadin, metronidazole,
VPA, Li, alcohol
1171 Drugs causing pulmonary fibrosis as SE: tocainide, amiodarone
1468 Disulfuram # oxidation of ethanol to acetic acid
Page 274 of 582
S Question
Dimercaprol is sparingly soluble in H2O when when complexed with
1295 heavy metals form stable non-toxic compound which is excreted from
kidney
Dicobalt edetate is antidote for CN --- Ca edetate is antidote for Pb
(lead)
487 Desferrioxamine chelates iron
Cyanosis = bitter almond breath
923 Cyanide toxicity is due to cytochrome oxidase enzyme
1341 Cool tar cause photosensitization, carcinogenic in rectal, genital, groin
Complex formed between BAL and dimercaprol is stable, stable in
777
water, not toxic, excreted
Charcoal can not adsorb FeSO4, CN, boric acid, DDT
Boric acid is NOT used in neonates
757 BAL or dimercaprol are antidotes for : Hg, Au, Cu, Sb, arsenic
Antidotes:: paracetamol: N-aceycysteine -- ehylene glycol, methanol:
IV ethanol, femopizol --heparine: protamine SO4 -- warfarin: vitamin
599
K + fresh frozen plasma -- TCA (anticholinergic): physostigmine -- BZD:
flumazenil
Page 275 of 582
S Question
Antidotes:: iron:desferroxamine -- lead: calcium EDTA, dimercaprol --
Li: decontamination, ipecac, bowel irrigation, Na polystyrene
sulfonate -- opiates:naloxone, naltroxone -- organophosphates:
atropine, pralidoxime
Antidotes:: cyanide: amylnitrate, Na nitrate, Na thiosulfate -- digoxin:
1135 fab antibodies (digibind), colestyramine, phenytoin or lidocaine (for
arrythmia) -- Mg: CaCl2 10% -- K: NaHCO3, glucose+insulin --
Antidotes:: B-blockers: epinephrine + glucagone (heart stimulant)--
CaCBs: IV Ca + glucagone (heart stimulant)-- glucagone can only be
given SC or IM but not IV
After vomiting alkalosis occur due to HCl loss-- after diarrhea acidosis
occur due to HCO3 loss
Acidification of urine: inc ionization of alkaline drugs (e.g
772
amphetamine): dec reabsorption: inc its excretion
Acidification of urine increases excretion of alkaline drugs like
1454
amphetamine as ionization increases thus reabsorption decreases
736 8.4% NaHCO3 soln is give IV for cardiac arrest
8.4% is alcohol shock to neutralize lactic acidosis ???
977 8.4 % NaHCO3 in alcohol shock to neutralize lactic acidosis
Page 276 of 582
S Question
Increase conc NH4cL increases excretion of amphetamine (basic)
EDTA is comlexing agent
Cool tar has photosenstizing action
Methotrexate overdose is managed by?a.folic acid...b. folinic acid(
154
also known as leucovorin)...c. naltrexone
Drug that worsens skin sunburns? Doxycyxline-ketocoazole-....
186 Methotrexate toxicity treat with leucovorin
Alkalization of urine used to increase elimination of :- acetyl salicylic
234
acid- morphine- dopamine- codeine
37 Drug of choice in Methotrexate toxicity: Folinic acid- folic acid
Which medication should be given with food?
343 Case study: MTX related questions, antidote, increased hydration.
Alkalization of urine used to increase elimination of : - acetyl salicylic
acid - morphine - dopamine - codeine
1006 Nothing will happen if we mix NaHCO3 to D5W
386 NaHCO3 is used to neutralize lactic acidosis
440 K toxicity ttt: NaHCO3, glucose+insulin, Na polystyrene sulfonate
721 In alkalosis we give acetazolamide - in acidosis we give NaHCO3

Page 277 of 582

S Question
Acetycysteine is ineffective in ttt of paracetamol toxicity if taken after
12 hrs
Charcoal is decolorizing agent and adsorbing agent in toxicity
Urine discoloration drugs: rifampin, phenazopyridine, L-dopa, senna,
661
phenolpthalin, sulfasalazine, deferroxamine mesylate
Ketoconazole: ttt of systemic candidiasis -- ranitidine: ttt of peptic
ulcer (PU) -- Na valproate: ttt of absence seizures -- theophylline: ttt
of asthma
Synovitis and ulcerative colitis are related inflammatory disease??
Diclofenac and hydrocortisone are used
Sulfasalazine has poor absorption from the GIT, used for ttt of
1009
ulcerative colitis, regional enteritis
United States Dispensary USD:: discussion of safe dose range and
toxic doses of nitrofurazone - pharmacologic uses of a specific drug
with literature references. The USD usually presents a more detailed
discussion of drug doses, ranges and toxicity than

Page 278 of 582

S Question
cont. USD) that found in USP and NF. For example, the toxicity section
of nitrofurazone lists data obtained in both animals and human
beings -- the USD usually presents detailed discussions of
pharmacology of a drug, often with literature citations
(cont. USD) for example, the section of the action and therapeutic
uses of nitrofuarzone contains several references for further
information although the book emphasizes the USP and NF drugs,
imprtant nonofficial drugs are also discussed
The USP:: qualitative identification of a drug powder suspected to be
imipramine HCl - table listing the solubility of drug in several solvents -
- most drug monographs list identification tests that will aid in the
qualitative identification of a drug
(cont. USP) for example, the USP monograph for imipramine HCl
describes 3 identification tests. The approximate solubilities of
USP/NF articles are listed in a table form. Among the solvents listed
are water, boiling water, chloroform, ether..
996 Tetanus toxoid is given every 10 years
Tetanus toxoid booster dose every 10 years
1056 Tetanus interval is 10 years
Page 279 of 582
S Question
1086 Tetanus antitoxin: does NOT give active immunity
767 Tetanus antitoxin does not give active immunity
Smallpox vaccine must be stored at 0 C (freezed)
Measels vaccine is given to 1 year old child (12-15 month)
762 Measels vaccine is given to 1 y old
Measels vaccine is given to 1 y child
615 Immune serum globulin is injected by IM
Diphtheria vaccine and tetanus toxoid give active immunity
939 Diphtheria gives active immunity
1236 Botulism antiserum is passive immunity
Botulinum antitoxin: passive immunity -- typhoid vaccine: active
immunity
Bacillus Calmette-Guerin (BCG) vaccine: is a viable strain of
Mycobacterium bovis which has been used for immunization against
TB. More recently it has been used as a nonspecific adjuvant or
immunostimulant in cancer chemotherapy
(cont. BCG vaccine) MOA is the activation of macrophages to make
them more effective killer cells in conjunction with lymphoid cells

Page 280 of 582

S Question
(cont. BCG vaccine) macrophages activation with BCG vaccine
appears to inc the rate of clearance of immune complexes (antibody-
soluble tumor antigen) from the blood
329 Which is not active immunity? DPT
Counselling use of antifungal pessaries and creams - what is wrong?a)
Its contraindicated in pregnancy..b) excessive use can cause allergies
270 ..c) if the course is not finished the fungus might come back...d) if
thrush happens often it can be a sign for diabetes and needs to be
checked by
319 Drug used for bacterial Vaginosis?
Vidarabin is used in the ttt of herpes simplex encephalitis
ttt of shingles: acyclovir
ttt of choice for herpes simplex of eye lid and conjunctiva is
idoxuridine, BUT in skin: acyclovir
The diagnostic element in blood for AIDS pt is antibody for HIV
850 detected by ELISA
assay
Reverse transcriptase inhibition: efavirenz, didanosine, zidovudine,
stavudine, nevirapine, abacavir, zalcitabin
Page 281 of 582
S Question
Retrovir=AZT=zidovudine --- SE hematologic suppression,
503
agranulocytosis
Restriction endonuclease: cut double DNA of virus
Restriction endonuclease enzyme: cut DNA
895 PCP (Pneumocystis Pneumonia) in HIV pts ttt by pentamidine
Nelfinavir (cross BBB) # protease
Mononucleasis + ampicillin therapy = rash
Lamivudine is reverse transcriptase inhibitor used in HIV
Herpse simplex: watery blisters on skin and mucous membranes,
espicially the lips
1300 Foscarnet (antiviral) : ttt of CMV (cytomegalo virus) SE: renal failure
1419 Didanosine: longest duration, least BMD
686 Acyclovir is used in the ttt of herpes simplex
Which of this medication does not have an active metabolite-
204
famcyclovir – valaciclovir-acyclovir-lamivudine
Which one of these is act by nucleoside reverse transcriptase in
242
treatment of HIV- lamivudine - atazanavir- indinavir- efavirenz
Which mechanism of efavirenz : non nucleoside reverse transcriptase
243
inhibitor
Page 282 of 582
S Question
240 Shingles : viral infection of nerve root
Question about colony stimulating factor, which is wrong:-it is
299
antiviral
77 NRTI: Lamivudine
78 Cidovofir question, select wrong option?
Which one of these is act by nucleoside reverse transcriptase in
treatment of HIV - lamivudine - atazanavir - indinavir - efavirenz
Which of this medication does not have an active metabolite -
famcyclovir – valaciclovir-acyclovir-lamivudine
Which mechanism of efavirenz : non nucleoside reverse transcriptase
inhibitor
Treatment of Varicella Zoster Virus..Which treatment duration is
correct? Eg. 4 days, 21 days, 7 days, 18 days.......Ans. 7 days
Shingles : viral infection of nerve root
Question about colony stimulating factor, which is wrong:-it is
antiviral
330 MOA of saquinavir… hiv protease enzyme inh.
Classification of Anti-HIV drugs. X drug belongs to which class?

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S Question
Zinc deficiency causes: growth retardation, hair loss, nausea, loss of
appetite
Vitamin H: biotin: ttt of skin disorders
Vitamin E is used as antioxidant (oily)
Vitamin E is insoluble so it is better formulated as suspension in heavy
723
mineral oil
Vitamin E is called tocopherol used as antioxidant found in nut
vitamin D1: cholcalciferol, it occurs naturally in cod liver oil, can be
formed in the skin by action of the UV --- vitamin D2: calciferol, it
does NOT occur naturally, used in the ttt of ricketsia, osteomalacia
625 Vitamin D is used in hypoparathyrodism
1344 Vitamin D is not decomposed by sunlight - but vitamin C does
610 Vitamin D is controls absorption os Ca and PO4
1409 Vitamin C is metabolized to oxalic acid
Vitamin C is aromatic carboxylic acid
861 Vitamin B9: folic acid
Vitamin B6 is a detoxifying agent esp: alcohol and phenytoin
1014 Vitamin B6 dec levels of L-dopa , alcohol , phenytoin
Vitamin B12 contains cobalt
Page 284 of 582
S Question
1362 Vitamin A is soluble in fatty acids
Vitamin A is important for reproduction in man NOT vitamin E
Vit K: phytonadione: ttt of hemorrhage
746 Vit E is sol in: fixed oil, ether, chloroform
Vit E is not proved to be essential for reproduction in man but vit A is
important
633 Vit E is insol so it is better to be formulated in heavy mineral oil
1042 Vit D: calciferol : ttt of ricketssia, and hypoparathyrodism
Vit D is NOT used in hyperthyrodism
Vit C inc iron absorption
Vit C inc Fe absorption by maintaining it in the ferrous state and
forming a soluble and absorbable chelate with iron in the ferric state --
1270
doses of 500-1000mg inc Fe absorption by about 10% -- smaller doses
are not recommended (neglecible inc in A)
Vit B6: pyridoxine: used with INH to dec peripheral neuritis, inc
extracellular metabolism of levodopa, ttt of sideroblastic anemia,
used with cyclizin for ttt of vomiting induced in pregnancy
1067 Vit B6 is contraindicated with levodopa, parkinsonism, phenytoin
1167 Vit B6 dec serum level of phenytoin, alcohol, levodopa
Page 285 of 582
S Question
Vit B1: thiamine: ttt of beriberi -- vit B2: riboflavin: precursor for FAD,
1196 NAD -- vit B3: niacin: antihyperlipiemia -- vit B5: panthothenic acid;
paralytic ileus???
Vit B1 (thiamine) is heat labile
Use of vitamine E in deodorants is antioxidant
Thiamine (B1) deficiency: Wernicke's syndrome or Korsakoff's or beri-
1137
beri with peripheral neuropathy and confusion
547 Thiamin (vit B1) is heat liable
Soluble vit A is used in the form of veg. oil
478 Pregnant women should take foilc acid
Pellagra: niacin deficiency --- scurvy: ascorbic acide deficiency --
906
pernicious anemia: cyanocobolamine deficiency
Nicotinic acid ttt of pellagra, agranulocytosis, dermatitis,
716
hyperlipidemia
812 Mineral oil impair vit K absorption
653 K1=phytonadione --- K2= menadione
GSH (glutathion, antioxidant) protect RBCs, hemoglobin from
482
oxidation
Folic acid with iron is used for folate deficiency in pregnant women
Page 286 of 582
S Question
857 Folic acid is given to pregnants to prevent spina bifida
1169 Fish liver oil contains vitamins A,D
Ferric iron is the iron form least absorbed from intestine
Fat sol vitamins: ADEK
Cod liver oil contains vit A and vit D
Cholcalciferol is vitamin D3 is produced in the skin from 7-
hydroxycholesterol by UV radiation it is main function to inc Ca
absorption from intestine, inc bone formation, mineralization
Cholcalciferol (vit D3): is sterosteroid produced in skin from 7-
778 dehydrocholesterol by UV radiation, it is main function is to inc Ca
absorption from intestine and inc bone formation and mineralization
Ascorbic acid: rapidly absorbed from the GIT, utilized at high rates in
617 common cold and infections, protects from scurvy, reversibly oxidized
to oxalic acid
Ascorbic acid: rapidly absorbed from GIT, it is utilized at increased
rate during infection, protects against scurvy, reversibly oxidized to
oxalic acid ??
Ascorbic acid is a lactone structure
Ascorbic acid is a lactone structure
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S Question
745 Ascorbic acid acidifies urine
Ascorbic acid acidifies the urine
862 1,25-dehydrocholcalciferol enhance Ca absorption
1124 1,25 dihydroxycholcalciferol in Ca absorption
1,25 dihydroxy cholcalciferol aid in Ca absorption
Fat soluble vitamins have pronounced toxicity
Which Calcium form is not given as oral supplement?a) Ca
218 Gluconate...b) Ca Carbonate..c) Ca Lactate..d) Ca Succinate..e) Ca
Chloride
1,25 Dihydroxy-Vitamin D is a) Ergocalciferol b) Cholecalciferol c)
278
Calcitriol
54 Vitamin E is rarely deficient in men
53 Vitamin D has steroid structure
104 Ascorbic acid with methenamine for urinary cystitis
Ascorbic acid REVERSIBLE conversion to oxalic acid is the wrong
106
option
1,25 dihydroxy cholecalciferol: increases Ca absorption + vit D
39
synthesis

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S Question
Which Calcium form is not given as oral supplement? a) Ca Gluconate
b) Ca Carbonate c) Ca Lactate d) Ca Succinate e) Ca Chloride
Vit-D is not destroyed by wht? Ans. Sunlight.
1,25 Dihydroxy-Vitamin D is a) Ergocalciferol b) Cholecalciferol c)
Calcitriol
848 Na in serum is 310-340 mg%
1452 Trimethobenzamide : antiemetic # CTZ
928 Metoclopramide: IV bolus
Metoclopramide is administered before aspirin to inc gastric
emptying and inc aspirin absorption
Metoclopramide is a prokinetic agent used as an antiemetic through:
1250
effect on CTZ, inc rate of gastric emptying
530 Metoclopramide can be given by IV bolus
Metachlorpropamide is antiemetic
Dronabinol: antiemetic, appetite stimulant
Dolasetron, ondansetron, granisetron : antiemetics
Dolasetron C.I. with : hypokalemics, hypomagnesemics,
antiarrythmics

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S Question
Antimony potassium tartarate (tartar emetic) is emetic and
anthelmentic: tartar emetic is intravenously administered
anthelmentic agent which is employed against: schistosoma
japonicum/mansoni/haematobium
(cont. tartar emetic) it was once considered an outstanding emetic.
However, it's no longer used for this purpose because of its slow
action and toxicity. Doses of 200 mg are fatal, usual emetic dose is
30mg
Which drug against Nausea is not used in Pregnancy?
198 a)Pyridoxine...b)Diphenhydramine...c)Metoclopramide...d)Prochloper
azine
Question about metoclopramide antiemetic effects, but need to
107
select the wrong one out of 4 options
Which drug against Nausea is not used in Pregnancy? a)Pyridoxine
b)Diphenhydramine c)Metoclopramide d)Prochloperazine
344 Metoclopramide: which is not the probable ADR (vomiting)
Metoclopramide......which one of the following is not a side effect?
Metoclopramide MOA, Ondansetron MOA, dexamethasone MOA
345
(Antiinfl)
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S Question
375 Metaclop causes ADR that needs monitoring.. tardve dyskinesia
pencillins lose their activity by hydrolysis NOT oxidation, reduction
Nitrates: dec preload -- hydralazine, diazoxide: dec afterload -- Na
nitroprusside: dec preload + afterload

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