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The number of milligrams of potassium hydroxide required to neutralize the free acid in 1 gm of substance is expressed by this value is the

defenition of: a. saponification value b. acid value c. iodin value d. solidification value Low acid values or complete absence of acid are important for good suppository bases. Free acids complicate formulation work, because they react with other ingredients and can also cause irritation when in contact with mucous membranes Saponification value represents the number of milligrams of potassium hydroxide required to saponify 1g of fat under the conditions specified. It is a measure of the average molecular weight (or chain length) of all the fatty acids present. Which of the following is least likely to cause addiction (a) morphine (b) heroin (c) codeine (d) tramadol (e) methadone A 56 year old women has been diagnosed with osteoarthritis of the knee. What nonpharmacological treatment would you recommend ? A maintain her ideal body weight B aerobic exercise programs C limit activity to <30 minutes at one time and rest the joint as often as possible In osteoarthritis patient need to do aerobic exercise best rest and total immobility is not require for the patient CPR page num 991 so ans is b and c Which of the following can be dispensed without prescription i) 8mg of codeine ii) 19mg/5mL of codeine solution with acetominophen

iii) 300 mg aceptominophen + 8mg codeine + caffeine Tylenol is also sold as a class of stronger pain relievers containing codeine, known as co-codamols: Tylenol 1 contains 325 mg acetaminophen and 8 mg codeine; Tylenol 2 contains 300 mg/15 mg, Tylenol 3 (300 mg/30 mg), and Tylenol 4 (300 mg/60 mg). In Canada, Tylenol 1, 2 and 3 all include 15 mg caffeine, in addition to the above ingredients; furthermore, Tylenol 1 is sold in Canada without a prescription, while all forms of Tylenol with codeine require a prescription in the US. The strenght of the codein determines if it going to be sold as prescription drug or not.8MG codein is sold without prescription but is an under the counter ie there is need for pharmacist intervention .wheather it is alone or in combination with another drug eg acetaminophen,

These two components in bone are responsible for the hardness and pliability of bone: a) osteoclasts& collagen b) mineralized salts & osteocytes c) mineralized salts & collagen d) collagen& elastic fibers e) collagen& mesenchyme Allopurinol is recommended rather than probenecid in the treatment of hyperuricemia in which of the following situation ? I when patient has large tophi on elbow and knees Ii patient has creatinine clearance of 15 ml/ min Iii patient had leukemia and there is concern regarding renal precipitation of urate AI B iii only C I and ii D ii and iii E all action of glipizide in pancreatic B (or ) cells in the islets of Langerhans

would be most similar to that of... A. Pioglitazone B. Amylin C. Acarbose D. ATP E. GTP In pancreatic beta cells, which are sustained primarily by ATP, the ATP/ADP ratio determines KATP channel activity. Under normal conditions, the KATP channels in pancreatic beta cells are spontaneously active, allowing potassium ions to flow out the cell. In the presence of higher glucose metabolism, and consequently increased levels of ATP, the KATP channels close, causing the membrane potential of the cell to depolarize, thus promoting insulin release. The change from one state to the other happens quickly and synchronously. Soft connective tissue membranes between the cranial bones at birth are: a) an indication of microcephaly b) frontal sinuses c) epiphyseal plates d) cribriform plates e) fontanelles hefontanelles close around 2 yrs of age..

ANs Is E All of the following statements regarding the mixing of insulin are correct EXCEPT: a) just mix before administration b) roll the vials in your hands gently c) shake the vials by your hands vigorously d) in mixing, withdraw the regular insulin first and then the NPH e) if separately injected, inject the NPH first then the regular insulin Paget disease is characterized by a localized increase in bone resorption followed by an abnormal bone formation and results in a bone deformation and fracture, what is treatment: A.Vitamin A B.Calcitonin

C.Niacin D.Vitamin K paget disease id a hperparathyrodism disease characterised by increase in blood calcium level and in decrease in phosphate level its treated by calcitonin and bisphosphonates The chance of hypoglycemia is least when therapy is maintained with I. Acarbose II. Metformin III. Pioglitazone

a) I only b) III only c) I and II only d) II and III only e) All of the above The following is used to induce cervical ripening in pregnancy (a) latanoprost (b) travoprost (c) bimatoprost (d) misoprostol (e) dinoprostone misoprostol...its Cytotec..andits a very well know drug at gyna used for cervical ripening specially before abortion operations... my understand is both can cause, but dinoprostone is more known as an abortificient, where as misoprostol is known for GI and cervical ripening more. Generic product A has a greater AUC than generic product B, containing the same quantity of drug per dose, one can conclude: a) Product B is more bio-available than product A

b) Product A is more bio-available than product B c) Product A has a shorter half-life than product B4. d) Product B has a shorter life than product A e) Product A is more readily excreted in the urine than product B AUC indicates bioavailability not half time area under curve in which the drug is effective A new antidepressant is administrated, when ingested together with fruit juice we can see a decrease in the quantity of drug eliminated unchanged in the urine. When administrated together with antacids the drug increase the elimination rate. We can conclude that this drug is: a) Weak base b) Weak acid c) Hydrophobic drug d) Strong base e) Neutral drug Answer is B Comments: acid+acid---unionized (absorb) Acid+base---ionized (excrete)

Which analgesic has been withdrawn from the market because of cardiac failure side effect (a) celecoxib (b) rofecoxib (c) lumirocoxib (d) dilofenac Aromatised ring (phenolic ring) is present in? A. progesterone B estrogen

C testosterone D androgen E alsdosterone ans = b. the first ring out of the steroid is always aromatic in estrogen, not in any of the other steroids Which of the following is not a cranial suture: a) epiphyseal b) lambdoidal c) coronal d) sagittal e) squamous Chondroblasts produce: a) basement membranes b) bone matrix c) cartilage matrix d) mesothelium e) endothelium A chondroblast is a cell which originates from a mesenchymal stem cell and forms chondrocytes, commonly known as cartilage cells so i think C

A fracture in the shaft of a long bone would be a break in the: a) epiphysis b) metaphysis c) diaphysis d) epiphyseal plate e) mesenchyme The cell type that is responsible for maintaining bone matrix once it has formed is: a) osteoclasts b) chondrocytes c) osteocytes d) fibroblasts e) osteoblasts Which of the following is a urinary tract analgesic? (a) acetylsalicyclic acid (b) naproxen (c) ibuprofen (d) phennazopyridine (e) suldinac Yellow marrow consists of: a) osteoprogenitor cells b) blood cell progenitor cells c) hyaline cartilage d) adipose e) spongy bone Yellow marrow contains less blood vessels and are mostly filled with fatty tissue.If necessity arises the yellow marrow becomes active and is converted into red marrow and starts producing blood cells.

correctstatments regarding the action of insulin and examples of insulin may include: I- fast acting : crystalline and acid regular II- intermediate acting :zinc suspension ,globulin zinc and isophan insulin III-long acting :protamin zinc suspension ,extended zinc suspension and ultralent a-I only b-III only c-I and II d-II and III e- all of them are correct It was mentioned in a question before that crystalline and regular insulin can be given in diabetes coma and ketoacidosis...this means that both should be fast acting... What type of metabolic reaction happens when terfenadine is metabolized to fexofenadine? (a) oxidation (b) hydroxylation (c) reduction (d) demethylation (e) carboxylation

Tramadol acts on (a) NE reuptake only (b) Ne reuptake and mu receptors (c) mu receptors only (d) mu, delta and kappta receptors (e) delta and kappa receptors only

A patient is on Synthroid 50 mcg daily for the treatment of hypothyroidism. Commplains of palpitation and sweating. Serum levels are 0.02 mUL. What is appropriate action?

(a) increase dose of synthroid to 100mcg (b) decrease dose of synthroid (c) treat palpitation and sweating (d) discontinuesynthroid as palpitationand sweating are ADRs (e) none of the above All the following are released from anterior pituitary except (a) acth (b) lh (c) adh (d) prolactin (e) tsh ans = c, posterior pituitary Osteoporosis may occur by which drug? (a) -blockers (b) Ca-blockers (c) Aspirin (d) Prolonged heparin use caused by both heparin and lmwh Risk factor for renal toxicity associated with NSIADs and cox 2 inhibitor include all of the following except A orthostatic hypotension B cirrhosis C volume depletion D diabetes Mellitus E age Osteoporosis is associated with which of the following antiRA drugs? A leflunomide

B prednisone C methotrexate D penicillamine E hydroxychloroquine Which of the following DMARDS has shorter duration of action? A penicillamine B hydroxychloroquine C etanercept D cyclosporine E auranofin Smoking decreases the effect of which of the following drugs? (a) Propranolol (b) Verapamil (c) Enalapril (d) Digoxin Tissue plasminogen activator commonly associated with systemic fibrinolysis? Aalteplase B urokinase C etanercept D streptokinase Which of the following is/are considered autoimmune disorders? I- Graves disease II- Systemic Lupus Erythomatosus III- Osteoporosis a) I only b) III only c) I and II only

d) II and III only e) All are correct Osteoporosis is a disease characterized by loss of bone mass and may be aggravated by: I-Corticosteroids II-Menopausa III-Graves disease a) I only b) III only c) I and II only d) II and III only e) All are correct Action of vitamin D3 is: a) Increased calcium and phosphate absorption by 1,25-dihydroxyvitamin D3

b) Calcium and phosphate excretion may be decreased by 25-hydroxyvitamin D

3and 1,25-dihydroxyvitamin D3

c) Increased calcium and phosphate resorption by 1,25-dihydroxyvitamin D3; bone formation may be increased by 25,24-dihydroxyvitamin D3 d) All of the above The following statements about the parathyroid hormone are true, EXCEPT: a) The parathyroid hormone (PTH) is a single-chain peptide hormone composed of 84 amino acids b) The parathyroid hormone increases calcium and phosphate absorption in intestine (by increased 1,25-dihydroxyvitamin D3 production)

c) The parathyroid hormone increases serum calcium and decreases serum phosphate

d) The parathyroid hormone increases calcium excretion and decreases phosphate excretion in kidneys

the parathyroid glands as a polypeptide containing 84 amino acids. It acts to increase the concentration of calcium (Ca2+) in the blood, whereas calcitonin (a hormone produced by the parafollicular cells (C cells) of the thyroid gland) acts to decrease calcium concentration. PTH reduces the reabsorption of phosphate from the proximal tubule of the kidney,[8] which means more phosphate is excreted through the urine Osteoprosis is caused by, what type of hormonal changes? I-Decrease estrogen II-Decrease in progesterone III-Decrease in androgen A-I only B-III only C-I and II only D-II and III only E-All of the above Risedronate Sodium (actonel) is a bone metabolism regulator indicated in the treatment and prevention of postmenopausal and glucocorticoid-induced osteoporosis. Which of the following statement should discuss with patients: I- Take 1 risedronate tablet with at least 120 mL ( cup) of water II-After taking risedronate, wait at least 30 minutes before lying down. You may sit, stand, or do normal activities like read the newspaper, take a walk, etc. III-Risedronate may be taken with coffee, tea, juice or milk, these does not have effect on

drug absorption. A- I only B- III only C- I and II only D- II and III only E- All are correct drug interaction is present between allopurinol and: a. cyclophosphamide b. mercaptopurine c. doxorubicin d. cisplatin dose of mercaptopurine should be deceased to 2/3 is normal dose with alloprenol as it metabolized by xanthin oxidase which is inhibited by alloprenol Which of the following diuretics may show auricosoric activity a. spirinolactone b. furosemide c. chlortalidone d. triamterene e. chlorothiazide Importance of Vitamin D in osteoporosis: I- Increase the absorption of calcium from the small intestine II- The best vitamin D analog to treat osteoporosis is calcitriol III- Antacids containing aluminum and magnesium may interfere with proper activity of vitamin D. a) I only b) III only c) I and II only

d) II and III only e) All are correct A 55 year old woman receiving bisphosphonates (alendronate) for osteoporosis treatment. A pharmacist counseled her that Do not lie down for 30 min after taking this medication, that may cause; I-Esophageal ulcers II-Mouth ulcer III-stomach ulcers A-I only B-III only C-I and II only D-II and III only E-All of the above Osteoporosis is mainly characterized by: a) Loss of joint movements b) Loss of bone mass c) Imbalance of uric acid d) Hormonal imbalance e) All are correct What the difference between osteoblast, osteoclast ? Osteoblasts are mononucleated cell extended from osteoprogenitor cells and form protein matrix call osteoid which form bone which is not get mineralized and present on bone surface contain type 1 collagen now with the help of prostaglandin osteoblasts act on bone itself and produce alkaline phosphatase which cause mineralization of bone and many matrix protein. Now osteoblasts entrapped into matrix and produce mature osteocytes. Osteoblast is responsible of bone formation while osteoclast is responsible of bone resorption Which of the following statements is FALSE?

a) Glucagon is synthesized in the A cells of the pancreatic islets of Langerhans. b) Glucagon is a peptide identical in all mammals consisting of a single chain of 29 amino acids c) Glucagon is extensively degraded in the liver and kidney as well as in plasma, and at its tissue receptor sites. d) Half-life of glucagon is between 6 and 8 hours, which is similar to that of insulin Potency of action of

a) Miglitol is six times higher than that of acarbose b) Acarbose is more than that of miglitol c) Miglitol and acarbose is equal d) Oral hypoglycemic agents depend on the severity of hyperglycemia A 64-year-old woman with a history of Type 2 diabetes is diagnosed with heart failure. Which of the following drugs would be a poor choice in controlling her diabetes? A. Sitagliptin. B. Exenatide. C. Glyburide. D. Glipizide. E. Pioglitazone Insulin is a polypeptide hence: a) It is resistant to destruction by gastric juice b) It is destroyed by gastric juice c) It is not a polypeptide d) It is metabolized immediately by cellular enzymes B that's why it isnot taken orally Sources of human insulin production are:

a) Recombinant DNA techniques by inserting the proinsulin gene intoE. coli or yeast

b) Postmortem insulin extraction from human autopsy pancreas c) All of the above d) None of the above Which of the following should be contraindicated with patients with hepatotoxicity (choose best answer) A pioglitazone B glyburide C metformin D nateglitinide E acarbose

Diuretic that cause reversible or permananthearin loss. a. hydrochlorthizide b. ethacrynic acid c. mannitol d. acetazolamide. OOP DIURETIC MAIN SIDE EFFECTS IS OH DANG O= OTOTOXICITY H=HYPOKALIMIA D=DEHYDRATION A=ALLERGY N=NEPHRITIS G=GOUT (FUROSEMIDE,ETHACRYNIC ACID,BUMETANIDE )

The following substances are considered to be referred to as eicosanoids: a) Prostaglandins b) Leukotrienes c) Thromboxanes d) All of the above Serious side effects of metamizole (analgin) include the following: a) Agranulocytosis, aplastic anemia b) Salicylism (vomiting, tinnitus, decreased hearing, and vertigo) c) Iatrogenic Cushings syndrome (rounding, puffiness, fat deposition and plethora alter the appearance of the face moon faces) d) All of the above Which of the following NSAIDs is a pyrazolone derivative? a) Ibuprofen b) Indomethacin c) Metamizole (Analgin) d) Diclofenac

Serious side effects of glucocorticoids include the following, EXCEPT: a) Acute peptic ulcers b) Iatrogenic Cushings syndrome (rounding, puffiness, fat deposition and plethora alter the appearance of the face moon faces) c) Salicylism (vomiting, tinnitus, decreased hearing, and vertigo) d) Hypomania or acute psychosis Cushing syndrome is caused by prolonged exposure to elevated levels of either endogenous glucocorticoids or exogenous glucocorticoids. A 40-year-old male with a symmetrically enlarged thyroid gland associated with elevated levels of T3 and T4 is treated with PTU. What is the

principal mechanism of action of PTU? a. Iodide transport into the cell b. Release of T4 and T3 to the blood c. Inhibition of thyroidal peroxidase d. Inhibition of proteolysis of thyroglobulin e. Inhibition of iodination and coupling of thyroglobulin he answer is c. Propylthiouracil is a thioamide that interferes with the production of thyroid hormone. Its primary action is prevention of thyroid hormone synthesis by blocking thyroid peroxidase catalysis leading to interference with iodine organification. E is Methimazolemechanism The common side effect of thyroid hormones is following: a) Increases in basal metabolic rate b) Angina pectoris c) Tremors d) Exopthalmos protrusion of the eye Which of the following glucocorticoids has no fluoride atoms in its chemical structure?

a) Prednisolon b) Dexamethasone c) Fluocinolone d) Triamcinolone but the incorporation of the fluorine can also mean that a drug can have some mineralcorticosteroid as well as glucocorticoid activity as well right? that's why dexamethasone can cause some fluid retention

Osteoporosis is a major adverse effect caused by the glucocorticoids. It is due to their ability to: A. Increase the excretion of calcium. B. Inhibit absorption of calcium. C. Stimulate the HPA axis. D. Decrease production of prostaglandins. answer= B. Glucocorticoid-induced osteoporosis is attributed to inhibition of calcium absorption as well as bone formation. Increased intake of calcium plus vitamin D or calcitonin, or of other drugs that are effective in this condition, is indicated. Glucocorticoids suppress rather than stimulate the HPA axis. The decreased production of prosta-glandins does not play a role in bone formation. Inflammation is:

a) A localized protective reaction of a tissue to irritation, injury, or infection, characterized by pain, redness,swelling, and sometimes loss of function

b) A deficiency of the normal immune response. c) A reaction resulting from an immune reaction produced by an individual's white blood cells or antibodies acting on thebody's own tissues or extracellular proteins. d) All of the above flush, fare and wheal response=inflammation

Most steroid-sparing drugs help the Corticosteroids to suppress the immune system. This means the dose of corticosteroid can be lowered, which helps reduce the sideeffects of the corticosteroid. These steroid-sparing drugs are started at the same time or after the Corticosteroids. Steroid-sparing drugs are generally slower to start working and so it is important to get treatment underway with Corticosteroids which work quicker. Common steroid-sparing (adjuvant) drugs used in PV are: Azathioprine (Imuran)

Cyclophosphamide (Cytoxan, Endoxana) Mycophenolatemofetil (CellCept) Cyclosporin (Neoral) Gold Methotrexate Which of the following glucocorticoids is a short- to medium-acting drug? a) Prednisolon b) Dexamethasone c) Triamcinolone d) All of the above . A 22-year-old male with a five-year history of bronchial asthma has developed increased frequency and severity of acute asthmatic attacks. A low dose of which inhaled steroid could be added to his treatment regimen? a. Prednisolone b. Amcinonide c. Beclomethasone d. Cortisone e. Fluocinolone The answer is c Inhalation therapy minimizes systemic effects of steroids. Of the agents above, beclomethasone is the only one delivered by metered-dose inhaler (MDI). A patient becomes markedly tetanic following a recent thyroidectomy. This symptom can be rapidly reversed by the administration of a. Vitamin D b. Calcitonin c. PTH d. Plicamycin (mithramycin) e. Calcium gluconate (CaG) The answer is e. Administration of intravenous CaG would immediately correct the tetany that might occur in a patient in whom a thyroidectomy was recently performed. Parathyroid hormone would act more slowly but could be given for its future stabilizing effect. Long-term control of a patient after a thyroidectomy can be obtained with vitamin D and dietary therapy. Calcitonin is a hypocalcemic antagonist of parathyroid hormone. Plicamycin (mithramycin) is used to treat Pagets disease and hypercalcemia. The dose employed is about one-tenth the amount used for plicamycins cytotoxic action. The treatment of myxedema coma can include which of the following agents? a. Thyroglobulin b. Levothyroxine c. Lithium

d. Propylthiouracil (PTU) e. Protirelin The answer is b. Myxedema coma is a medical emergency and should be treated as soon as the diagnosis is established. Treatment involves the use of several drugs to correct this condition. It appears that the selection of either LT4, liothyronine, or liotrix is appropriate. LT4, however, is the drug of choice. Supportive treatment of symptoms is also indicated. Maintenance of respiration and administration of fluids and electrolytes, along with glucose if hypoglycemia is diagnosed, should be provided. Because adrenal insufficiency may be present, administration of glucocorticoids is initially recommended. Thyroglobulin, a protein of high molecular weight, is a component of the thyroid gland. Although preparations are available, this drug is not indicatedmin myxedema coma. Protirelin is a synthetic thyrotropin-stimulating hormone that is used in the diagnosis of thyroid function. Hoshimoto disease is the most common form of chronic thyroiditis. It most oftenoccurs in middle aged woman and most patient show evidence of: A. Hyperthyroidis B. Hypothyroidism C. Thyroid carcinoma D. Malignant hyperthyroidism E.Malignanthypothryroidism Which of the following glucocorticoids have one fluoride atom in its chemical structure? a) Prednisolon b) Fluocinolo c) Triamcinolone d) All of the above Fluocinoloneacetonide is a corticosteroid primarily used in dermatology to reduce skin inflammation and relieve itching. It is a synthetic hydrocortisone derivative. The fluorine substitution at position 9 in the steroid nucleus greatly enhances its activity dexamethasone has one prednisolone has no one fluocinolon has 2 fluoride atom Indication of glucocorticoids is: a) Chronic (Addisons disease) and acute adrenocortical insufficiency b) Organ transplants (prevention and treatment of rejection immunosuppression) c) Inflammatory conditions of bones and joints (arthritis, bursitis, tenosynovitis). d) All of the above Correct statements about cortisol (hydrocortisone) include all of the following, EXCEPT: a) Cortisol is synthesized from cholesterol b) ACTH governs cortisol secretion c) Most cortisol is inactivated in the liver

d) The half-life of cortisol in the circulations is normally about 60-90 hours. Immunosupressive effect of glucocorticoids is caused by: a) Reducing concentration of lymphocytes (T and B cells) and inhibiting function of tissue macrophages andother antigen-presenting cells b) Suppression of cyclooxygenase II expression which results in reducing amount of an enzyme available to produceprostoglandins c) Activation of phospholipase A2and reducing prostaglandin and leukotriene synthesis. d) All of the above Which of the following glucocorticoids is an intermediate-acting drug? a) Cortisone b) Triamcinolone c) Butamethasone d) All of the above Iodide preparations can be used in following situations, EXCEPT: a) In thyroid disorders b) In granulomatous lesions e.g. Syphilis c) As an antiseptic d) In iodism Which of the following hormones is produced by the thyroid gland? a) Thyroid-stimulating hormone b) Thyrotropin-releasing hormone c) Triiodothyronine d) Thyroglobulin. Which of the following hormones is produced by the anterior lobe of the pituitary? a) Thyrotropin-releasing hormone (TRH) b) Corticotropin-releasing hormone (CRH) c) Growth hormone (somatotropin, GH) d) Growth hormone-releasing hormone (GHRH) tsh produced by anterior pit, trh by hypothal, Gnrh by hypiothal, GH by anterior pit crh by hypothal, acth by anterior pit

Which one of the following agents is INCORRECTLY paired to a clinical use of the drug? A. Desmopressin: treatment of diabetes insipidis B. Octreotide: treatment of diarrhea associated with vasoactive intestinal peptide tumors

C. Oxytocin: induction of labor D. hCG: treatment of infertility in men and women E. Pegvisoment: treatment of short stature in men and women. Correct answer = E. Pegvisoment is an antagonist at growth hormone receptors and is used to treat acromegaly. Which of the following best describes the effect of propylthiouracil on thyroid hormone production? A. It blocks the release of thyrotropin-releasing hormone. B. It inhibits uptake of iodide by thyroid cells. C. It prevents the release of thyroid hormone from thyroglobulin. D. It blocks iodination and coupling of tyrosines in thyroglobulin to form thyroid hormones. E. It blocks the release of hormones from the thyroid gland. Correct answer = D. Propylthiouracil blocks the synthesis of the thyroid hormones, but it does not affect the uptake of iodide, proteolytic cleavage of thyroglobulin, or release of hormones from the thyroid gland. The thyroid hormones inhibit the secretion of thyroid-stimulating hormone from the anterior pituitary. Symptoms of hyperthyroidism include all of following except: A. Tachycardia. B. Nervousness. C. Poor resistance to cold. D. Body wasting. E. Tremor. Correct answer = C. An individual with hyperthyroidism often experiences excess heat production. 4 Which one of the following hormones is a non-peptide, allowing oral administration? A. ACTH B. Growth hormone C. GnRH D. Thyroxine E. CRH answer= D. Although thyroxine is derived from the amino acid, tyrosine, it is not a pepetide and is stable to stomach acid. A child with asthma is being treated effectively with an inhaled preparation of beclomethasonedipropionate. Which of the following adverse effects is of particular concern? A. Hypoglycemia. B. Hirsutism. C. Growth suppression. D. Cushing's syndrome. E. Cataract formation. C. Growth hormone may be decreased by this treatment. Chronic treatment with the medication therefore may lead to growth suppression, so linear growth should be monitored periodically. Hyperglycemia, not hypoglycemia, is a possible adverse effect. Hirsutism, Cushing's syndrome, and cataract formation are unlikely with the dose that the child would receive by inhalation.

Ritodrine hydrochloride is used in the treatment of A. Parkinson disease B. Bronchial asthma C. Depression D. Hypertension E. Premature labour Ascites is caused by all of the following except A heart failure B tuberculosis C cirrhosis D portal hypotension E cancer THE OTHER NAME OF ASCITES IS PORTAL HYPERTENSION NOT HYPOTENSION Drugs that cause hepatotoxicity except A tetracycline B salicylates C vitamin a D iron E spironolactone

Osteoprosis is caused by, what type of hormonal changes? I-Decrease estrogen II-Decrease in progesterone III-Decrease in androgen A-I only B-III only C-I and II only D-II and III only E-All of the above Long standing hypertension leads to tissue damage in all of the following organ except?

A heart B lungs C kidneys D brain E eyes Ans is b lungs patient with hypertension affects all except lungs such as heart brain eyes, blood vessels 1. Nystatin is used to treat: a. trichomonas infections b. staph. aureus infections c. candidiasis d. e. coli infections e. rickettsial infections

2. oxybate sodium is used to treat: a. dermatitis b. cataplexy c. allergic rhinitis d. tineaversicolor e. eczema

3. immune globulin is administered parenterally to provide passive immunity to patients with which of the following disease states: a. bone marrow transplant b. idiopathic thrombocytopenic purpurea c. AIDS d. kawasaki syndrome

e. all of the above

4. sumatriptan use is contraindicated in patients: I. with a history of ischemic heart disease II. takingphenelzine III. with uncontrolled hypertension

a. I only b. III only c. I and II only d. II and III only e. I,II and III

5. propantheline is contraindicated in patients with: a. glaucoma b. myasthania gravis c. obstructive disease of the GIT d. ulcerative colitis e. all of the above

6. ezetimibe is considered a(n): a. antilipemic b. antiinfective c. NSAIDS d. antiviral e. antihistamine

7. emtricitabine is used primarily as a(n): a. cardiotonic b. antidepressant c. diuretic d. antiviral e. sedative

8. which of the following is used to lower lipid levels: a. trimethadione b. rosuvastatin c. flucytosine d. coumarin e. propranolol

9. drugs that may inhibit metabolism of ziprasidone include which of the following: I. erythromycin II. ketoconazole III. phenobarb

a. I only b. III only c. I and II only d. II and III only e. I, II and III

10. telithromycin is a member of which class of antiinfectives? a. cephalosporin b. penicillin c. aminoglycoside d. ketolid e. sulfonamide The newest agent for the treatment of cataplexy is sodium oxybate (gammahydroxybutyrate [GHB]). Although its mechanism is unknown, it reduces cataplectic attacks and other manifestations of REM sleep [31, 32]. GHB increases slow wave sleep, decreases nighttime awakenings, and consolidates REM sleep [32, 33]. Sodium oxybate is the only medication that will improve both cataplexy and daytime sleepiness. Cataplectic symptoms are improved much faster compared to improvement in daytime sleepiness, which can take up to 6 to 12 weeks. During this time, sodium oxybate should be taken concomitantly with a stimulant such as modafinil. GHB is taken twice; at bedtime and 90 to 120 minutes later. The therapeutic dose is between 6 gm and a maximum dose of 9 gm/day. Its elimination half-life is one to two hours. A significant problem with GHB is the non-medical use to elicit a state of decreased consciousness (it is classified as a Schedule I controlled substance in United States A source of anticarcinogenic drugs is: a. belladonna b. nux vomica c. vincarosea d. cascara e. digitalis vincristine, vinblastine belladonna= atropabelladona= atropine nuxvomica contain strychnine which is spinalcors stimulant cascara is laxative A hypertensive patient who has chronic obstructive pulmonary disease and would be best treated with which of the following b blocking agent?

A timolol B penbutalol C esmolol D acebutalol E propranolol Ans is d because esmolol by nature of its intravenous infusion would not recommend for chronic ambulatory therapy and also it is ultrashort acting so best choice is d A 39-year-old woman is brought to the emergency room complaining of dizziness. She recalls getting up early that morning to do as much shopping as possible and had skipped breakfast. She drank a cup of coffee for lunch and had nothing to eat during the day. She met with friends at 8 p.m. and had a drink at the bar. She soon became weak and dizzy and was transported to the hospital. Following examination, the patient was given orange juice and immediately felt better. Which one the following best completes this sentence? The patient has: A. Blood glucose greater than 70 mg/dl. B. Elevated insulin. C. Elevated glucagon. D. Elevated liver glycogen. E. Presence of an insulinoma. Correct answer = C. The patient's glucagon level will be elevated in response to the hypoglycemia. She is most likely experiencing alcohol-induced fasting hypoglycemia. Blood glucose is expected to be 40 mg/dl or less, insulin secretion depressed because of the low blood glucose, and liver glycogen levels low because of the fast. Insulinoma is unlikely. Glucagon secretion increases rapidly in response to hypoglycemia. Indeed many studies have shown that the glucagon response is the primary essential defense mechanism utilized by the body to restore blood glucose to normal. Patients with diabetes frequently develop defective counterregulatory responses to hypoglycemia associated with reduced or absent glucagon responses. Half life of insulin a.4-6 minutes b.5-10 minutes

c. 2-3 minutes d. upto 10 minutes. Metabolic reactions affected by protein diet include? 1.glycine conjugation 2.hydrolysis. 3.glucuronidation.

Phase2 metabolic reactions require natural endogenous substances which normally supplied by diet. Deficiency of these substances result in the decrease in biotransformation of drugs that undergo these type of reactions.

Now Glycine conjugation is phase 2 reaction, and glycine is a amino acid that requires dietary protein.therefore diet deficient in protein will lead to deficiency if glycine , which will result in decrease in glycine conjugation. Whereas, glucouronidation is also phase 2 reaction but it requires carbohydrates in diet which can provide glucouronic acid. Finally hydroxylation is phase1 and does not require dietary protein. Dose dumping is problem in the formulation of A. Compressed tab B. modified release drug products C. Hard gelatin cap D. Soft gelatin cap E. suppositories Relative or absolute lack of insulin in humans would result in which one of the following reactions in the liver? A. Increased glycogen synthesis. B. Decreased gluconeogenesis from lactate. C. Decreased glycogenolysis. D. Increased formation of 3-hydroxybutyrate.

E. Decreased action of hormone-sensitive lipase Correct answer = D. Low insulin levels favor the liver producing ketone bodies, using acetyl coenzyme A it obtained from excess fatty acids provided by the adipose. Low insulin also causes activation of hormone-sensitive lipase, decreased glycogen synthesis, and increased gluconeogenesis. Which one of the following statements about glucagon is correct? A. High levels of blood glucose increase the release of glucagon from the a cells of the pancreas. B. Glucagon levels decrease following ingestion of a protein-rich meal. C. Glucagon increases the intracellular levels of cAMP in liver cells, causing an increase in glycogen breakdown. D. Glucagon is the only hormone important in combating hypoglycemia. E. Glucagon depresses the formation of ketone bodies by the liver. Correct answer = C. The cAMP cascade initiated by glucagon causes the liver to degrade glycogen, releasing glucose to the blood. High levels of blood glucose decrease the release of glucagon from the cells of the pancreas. Glucagon levels increase following ingestion of a protein-rich meal. In addition to glucagon, epinephrine and cortisol are also important in increasing glucose production in hypoglycemia. Glucagon increases the formation of ketone bodies by the liver. An obese individual with Type 2 diabetes: A. Usually shows a normal glucose tolerance test. B. Usually has a lower plasma level of insulin than a normal individual. C. Usually shows significant improvement in glucose tolerance if body weight is reduced to normal. D. Usually benefits from receiving insulin about six hours after a meal. E. Usually has lower plasma levels of glucagon than a normal individual. Correct answer = C. Eighty percent of Type 2 diabetics are obese, and almost all show some improvement in blood glucose with weight reduction. These patients show an abnormal glucose tolerance test, have elevated insulin levels, and usually do not require insulin (certainly not six hours after a meal). Glucagon levels are typically normal.

-------------Least ototoxic aminoglycoside a-Gentamycin b-Kanamycin c-Amikacin d-Netilmicin Hemolytic anemia with patients with G6PD deficiencyis caused by a-Sulfonamides b-Streptomycin c- Tetracycline d-Penicillin To make space for new stock, you've been asked to combine 4 bottles of cleaning solution z, and then label that bottle with the volume and % concentration. The contents are: -Bottle -Bottle -Bottle -Bottle 1= 2= 3= 4= 200mL 300mL 100mL 400mL of of of of 75% 90% 80% 50%

-What will you type on the new label? A. Solution z, 1L of 78% B. Solution z, 1L of 70% C. Solution z, 1L of 62% D. None of the above You receive a prescription for Temazepam 7.5mg #30. What is the max number of refills this prescription could have? (if the doctor requests) A. 1 Refill B. 11 Refills C. 5 Refills D. No Refills You receive an order for: 3% ointment "H". Your pharmacy stocks 5% and 1% strength ointment "H". Mow much of each will you use to compound this order? A. 40% of 5% + 60% of 1% B. 50% of 5% + 50% of 1% C. 60% of 1% + 40% of 5%

D. 70% of 1% + 30% of 5% What directions should be typed on the label for the following order ? Rx: Amoxicillin suspension 250mg/5mL; Sig; 250mg tid for 7 days. a. Give one teaspoonful three times daily until finished. b. Give one teaspoonful twice daily until finished. c. Give one tablespoonful three times daily until finished. d. Give one-half teaspoonful twice daily until finished. A prescription order reads: 2 Tabs TID X28D How many tablets will be dispensed ? A. 56 B. 112 C. 168 D. 140 2*3*28=168 Your retail pharmacy sells products at: 45% markup over wholesale + a set dispensing fee of $4. A customer brings in a script for: Vardenafil 5mg #10. The total retail cost at pickup for the 10 tablets is $149.00. What is your pharmacy's wholesale cost per/each tablet ? A. $14.50 B. $10.00 C. $18.85 D. $14.90 149-4=145*100/145=100 THIS IS THE COST 100/10 TABLET =10 DOLLAR First, take the $149.00 and back out the $4.00 dispensing fee. That leaves you $145.00 (retail) 2) So now we have 145.00 (retail) and we know (since they told us in the question)

we charge 45% markup over wholesale. 3) To back out 45% from 145.00, you divide 145 by 1.45 145 1.45 = 100 4) With the markup now backed out, that tells us that the wholesale price for 10 tabs = $100 5) Which means each tab's wholesale price is $10.00 While rotating stock you notice an expiration date on a bottle that reads 08/13. What is the last day that product may be used ? A. July 31, 2013 B. August 1, 2013 C. August 31, 2013 D. September 1, 2013 Whcih antibiotic is used in prophylaxis of Endocarditis before dental surgery? a-Dapsone b-Neomycin c-Trimethoprin d-Clarithromycin Which antibiotic in topical form can be used for treatment of acne? a-neomycin b-doxycycline c-Streptomycin Antibiotic used to treat Pseudomembranous colitis caused by C.Difficile with Cephalosporin usea-Rafaximin 2-Daptomycin c-Trimethoprim d-Vancomycin Antibiotic that colors skinpinkish or brownish 1-Dapsone 2-Daptomycin 3-Vancomycin 4-Clofazimine Antibiotic that can cause hypokalemia? 1-Ticarcillin 2-Penicillin 3-Ampicillin Which of the following Cephalosporins can be drug of choice in renal insufficiency? a-Cefuroxime b-Cefaclor c-Cephalexin

d-Cefoperazone 10)Which of the following is insoluble in alcohol a-Esters b-Resins c-Volatile Oils d- Gums 12. Which of the following is not a derivative of the amino acid (Tryptophan)? A. Melatonin B. Serotonin C. Creatine D. Niacin In mammals, melatonin is biosynthesized in four enzymatic steps from the essential dietary amino acid tryptophan, with serotonin produced at the second step. Melatonin is secreted into the blood by the pineal gland in the brain. Known as the "hormone of darkness", it is secreted in darkness in both day-active (diurnal) and night-active (nocturnal) animals.[18] It may also be produced by a variety of peripheral cells such as bone marrow cells,[19][20] lymphocytes, and epithelial cells. Usually, the melatonin concentration in these cells is much higher than that found in the blood, but it does not seem to be regulated by the photoperiod. Usful in the prevention of Thrombosis? a-Propranolol b-Paracetamol c-Ascorbic Acid d-Aspirin Which one among the following is NOT calcium channel blocker? a- Varapamil b-Diltiazem c-Captopril d-Nifedipine Excessive use of binders in tablet may affect a-dissolution b-bioavailability c-disintegration d-all of the above )Most stable and compatible surfactants in pharmaceutical formulation a-Non-ionic agent b-Amphoteric agent c-Anionic agent d-Cationic agent Patient asking for drug information 1. search on internet 2. refer CPS 3. call information center 4. Ask doctor 5. Search medline

for searching recent information about a drug (eg sertraline) what is the best reference source? which of the following is not a drug related problem 1.adverse effects of drugs 2. improper storage condition 3.receiving too little drug 4.receiving inappropriate drug for condition 5.dispensing error.

------------Repolarization is? A) Excessive negative charge in cell B)Sodium ion influx C) Excessive positive charge in cell D) Excessive positive charge outside cell E) Excessive negative and positive charge inside cells would go with A only because we usually take into consideration whats inside the cell. like depolarization is increase in the na+ inside the cell. however A and D are almost with equivalent meaning In final Repolarization potassium ion pumped out of cell....As well Na+ ion out side of cell so ultimately cell contain negative charge...moreover in phase 4 (resting stage) k+ go inside cell and na+ out side the cell... so D is more specific than A... ----------If competitive inhibitor is used for enzyme kinetics measurements the rate of reaction would? A-Increase by increasing concentration of substrate B-Increase if inhibitor is added C-The products obtain are different D-The products formation is decreased

Increasing Substrate Concentration increases the rate of reaction. This is because more substrate molecules will be meet with enzyme molecules, so more product will be formed. in this case vmax is not changed. but increasing concentration of substrate, the affinity of substrate is decreased, answer is A and I think I should not think the way of Vmax. Sterilization by U.V. radiation generally requires a wavelength of: (a) 320 nm (b) 253 nm (c) 150 nm (d) 475 nm (e) 432 nm B is answer Streptococci pneumoniae is the number one cause of all of the following EXCEPT: a) Adult meningitis b) Neonatal meningitis c) Community acquired pneumonia d)otitis media in children S. pneumoniae is one of the most common causes of bacterial meningitis in adults and young adults, along with Neisseria meningitidis, and is the leading cause of bacterial meningitis in adults in the USA. It is also one of the top two isolates found in ear infection, otitis media.[3] Pneumococcal pneumonia is more common in the very young and the very old. Sulfonamide potency is decreased in case of co-administration with: a) Oral hypoglycemic agents b) Local anesthetics derivatives of paraaminobenzoic acid c) Local anesthetics derivatives of benzoic acid d) Non-narcotic analgesics In the folate biosynthetic pathway, sulfa drugs (sulfonamides and sulfones) compete with the natural substrate, para-aminobenzoate (pABA) causing depletion of dihydrofolate (DHF) and subsequent growth inhibition. The sulfa drugs condense

with 2-amino-4-hydroxy-6-hydroxymethyl-7,8dihydropteridine pyrophosphate (DHPPP) forming sulfa-dihydropteroate (sulfa-DHP). Which of the following cephalosporins would be the drug of choice for treatment of menigitits? A Cefaclor B Ceftriaxone C Cefazoline D Cephalexin B 3rd generation of cephalosporin antibiotic can enter BBB. The common adverse effect associated with the quinolone group of antibiotics is : A Hepatic dysfunction B CNS stimulation C Muscle pain D Ototoxicity All of the following are bacterial infections EXCEPT A cholera B plague C rabies D pertussin E tuberculosis All of the following are viral infections EXCEPT A influenza B measles C mumpus D hepatitis E typhoid fever The process of weakening the disease producing capacity of pathogens is known as

A vitulencve B attenuation C pathogenicity D pseudopathogenicity Answer B A: intensity of the disease producing C: disease producing capacity of pathogenicity Vaccines: types STARK: Subunit Toxoid Attenuated [live] Recombinant Killed [inactivated] Endotoxin features ENDOTOXIN: Endothelial cells/ Edema Negative (gram- bacteria) DIC/ Death Outer membrane TNF O-antigen X-tremely heat stable IL-1 Nitric oxide/ Neutrophil chemotaxis-----------

RIP A Rest In Pace Always ( For killed viruses in vaccination)

Rabies Influenza Polio A Hepatitis

Antibiotics to avoid in pregnancy

SAFE Moms Take Really Good Care Sulfonamides, Aminoglycosides, Fluoroquinolones, Erythromycin, Metronidazole, Tetracyclines, Ribavirin, Griseofulvin, Chloramphenicol Bacteriostatic antibiotics

" We'reECSTaTiC " Erythromycin, Clindamycin, Sulfamethoxazole, Trimethoprim, Tetracyclines, Chloramphenicol Naked (nonenveloped) RNA viruses:

''People in CALIfornia and REO are naked''

- Picornoviridae, Caliciviridae, Reoviridae Syphillis: "Trip in the palace got syphillis from Dox and Linda" TryptiumPallidium - syphillius - tx is doxycycline, clindamycin

Lymes: "BoreliaBordoferia loves limes and RAN on the TRACK"

BoreliaBordoferi - Lymes Disease - Rash, Arthralgia, Neurotoxicity, Tx is Tetracycline

Pseudomonas Aerginosa: (nocosomial/hospital) "Amin Amps up the Tazi in the hospital" Aminoglycosides, Ampicillin, ceftazidine, hospital infection

TB: PIRES Pyrazinamide, Isoniazide, Rifampicin, Ethambutol, Streptomycin also: regarding Clostridum:

Taani Bought Difficult Perfume in My Van Clostridumtetani, botilum, difficile, perfringes - treatment is metronidazole and vancomycin. therefore overgrowth of clostridum caused by clindamycin (diarrhoea) can be treated by metronidazole and vancomycin

DOC for Tetracycline:

My Little CRum has acne: Mycoplasma, Lymes, Chlymadia, Ricketssia, Acne

DOC for Erythromycin: MY CHILE separate into MY/ CH/I/LE Mycoplasma, Chlymadia, Influenza, Legionnaires

DOC for Clarithromycin

separate into HOT/CH/I/LE HOT CHILE H Pylori, Chlymadia, Influenza, Legionnaires Haemophilusinfluezae causes...

haEMOPhilus

Epiglottitis Meningitis Otitis media Pneumonia

...and #1 cause of conjunctivitis Lyme disease a tick born infections commonly occur in the months of July-August and in the area of Mississippi river valley, is caused by: A-Treponemapallidum B-B.burgdorferi C-Dermatophyte D-Giardia lamblia BoreliaBorderoferi is an old woman who loves Lymes. She RAN on the TRACK. RAN = rash, arthralgia, neurotoxicity. Track = tetracycline treatment Syphilis infections can occur with; A-E.coli B-Salmonella C-T.pallidum D-Spirochete E-Diphtheria

Trip in the palace got syphillis from Doxy and Linda: T Pallidium - syphillis - doxycycline, clindamycin treatment Which of the following is NOT Gram-positive?a) Listeria monocytogenes b) Streptococcus pneumoniae c) Staphylococcus saprophyticus d) Klebsiella pneumonia e) Streptococcus pyogenes Clindamycin, may cause severe diarrhea, this condition can be treated by: A-Pepto-Bismol B-Loperamide C-OTC antidiarrheal D-Metronidazole E-Oral rehydration salts Drugs used in the treatment of meningitis are all of the following, EXCEPT: a) Penicillins b) Cephalosporins c) Gentamicin d) Streptomycin e) Sulfonamides Streptomycin is not used in the treatment of meningitis. The main treatment of bacterial meningitis may include penicillins, cephalosporins and vancomycin while viral meningitis is mainly treated by acyclovir IV.

The most common cause of urinary tract infections include: A-N.gonnorhea B-E.coli C-Chlamydea D-S.pneumonia E-M.catarhalis How can you get clostriduimtetani? A. By eating smoked fish or improperly canned foods at home B. Infection through infected animal or soil C. Improperly cooking food, at lower temperatures. D. penetration of skin by a rusted nail E. Innoculated with trama into muslcles what are symptoms of Salmonella typhi? A. Typhoid fever ; invasion of lymph nodes, necrosis of intestinal lymphatic tissue, high fever, vommiting, dihhera, peyer's patches. B. Fever, chills, headache, malasia( muscle pains), dihhera, abdominal pain, vommitting, rarely causes septicema C. Severe dihhera D. Dihhera with mucus, pus and blood E. Watery Diherra what are symptoms of botulinum toxin: A. Flaccid muscle paralysis, double vision, general muscle weakness, respiratory paralysis. B. pockets of gas formation under skin, degrades muscles, limp muscles that secrete black fluid. C. general malaise to menegitis to spontaneous abortions

D. Severe dihhera, abdominal cramps, fever E. severe muscle spasms ( lockjaw) what are symptoms of clostriduimdifficilis: A. pockets of gas formation under skin, degrades muscles, limp muscles that secrete black fluid. B. Flaccid muscle paralysis, double vision, general muscle weakness, respiratory paralysis. C. severe muscle spasms ( lockjaw) D. Severe dihhera, abdominal cramps, fever(Your Answer) E. general malaise to menegitis to spontaneous abortions The functions of plasmid are

a.DNA replication b.Protein synthesis c.Cell wall synthesis d.None of the above bacterial resistance Which of the following are the correct statement about Staphylococcus aureus I-It contains techoic acid II-Gram stain test is positive III-It contains lipopolysaccharide layer A-I only

B-III only C-I and II only D-II and III only E-All are correct how can you get bacillus cereus: A. Improperly cooking food, at lower temperatures. B. Infection through infected animal or soil C. By eating smoked fish or improperly canned foods at home D. Innoculated with trama into muslcles E. penetration of skin by a rusted nail A common mnemonic used to remember some encapsulated pathogens is:

"Even Some Super Killers Have Pretty Nice Capsules"

Escherichia coli, Streptococcus pneumoniae, Salmonella, Klebsiellapneumoniae, Haemophilusinfluenzae, Pseudomonas aeruginosa, Neisseria meningitidis, and the yeast Cryptococcus neoformans. which gram positive bacillus prodces neurotoxins that blocks acetylcholine from nerve terminal: A. Clostridium Botulium B. Clostridium tetani C. Bacillus Anthracis D. Listeria monotogenes E. Bacillus Cereus Endospores function to A) help the organism survive periods of drought. B) transmit genetic information from one bacterium to another.

C) help the organism survive exposure to high temperatures. D) all of the above E) both a and c Gram-negative bacteria have what advantage over gram-positive bacteria? A) Gram-negative bacteria are better able to survive environmental changes than are gram-positive bacteria. B) Gram-negative bacteria are able to survive longer without water than can grampositive bacteria. C) Gram-negative bacteria can metabolize a wider variety of nutritional materials than can gram-positive bacteria. D) Gram-negative bacteria are able to resist antibiotics that attack the cell wall while gram-positive bacteria are susceptible to these drugs. E) Gram-negative bacteria have longer life cycles than do gram-positive bacteria. At the end of conjugation, both of the cells involved A) form endospores. B) perish. C) develop organelles. D) have a copy of the plasmid DNA. E) are able to degrade most antibiotics. HIV infects which of the following cells? A) suppresser T-cells B) T4 lymphocytes C) neutrophils D) basophils E) platelets The end result of the viral lytic cycle is

A) lysis of the infected cell. B) immunity of the host cell to further viral infection. C) the release of new viruses. D) both a and b E) both a and c A major outbreak of what disease in 1918-19 killed 21 million people? A) rabies B) influenza C) AIDS D) hepatitis B E) ebola poly d glutamic capsule that prevent phagocytosis: A. Bacillus Cereus B. Clostridium Botulium C. Bacillus Anthracis D. Clostridium Tetani E. Listeria monotogenes A common cause of the common cold is the

A) influenza virus.

B) polio virus. C) rhino virus. D) HIV. E) ebola virus. Erythrocytes will get its ATP energy onlyby

a.Glycolysisb.Krebs cycle c.Electron Transport d.HMP shunt

he following drug contain aminoglycosidic groups that inhibit bacterial protein synthesis: I-Vancomycin (Cell wall synthesis inhibitor) II-Gentamycin (protein synthesis inhibitor) III-Amikacin (Protein synthesis inhibitor) A-I only B-III only C-I and II only D-II and III only E-All of the above .Bacterial ribosomes are composed of

a.Protein and DNA b.Protein and mRNA c.Protein and rRNAd.Protein and tRNA

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