1 sorbitan monostearate gives W/O emulsion - sorbitan sesqioleate ( in hydrophilic

petrolatum base )

2 % of chlorocresol is 0.05 - 1 %
3 Vertigo, tinitus are side effects of aspirin only appear in toxicity
4 plasma concentration is affected by dose, clearance of drug
5 plasma concentration = dose / Vd
6 C zero = dose / Vd
7 dose = Vd * Czero

8 Vd = dose / Czero
9 bromhexine , acetyl cystiene are mucolytics
10 NaHCO3 is used to neutralize lactic acidosis
11 essential amino acids are to be supplied with diet
12 petrolatum is soluble in vegetable oil , chloroform , ether . Petrolatum is insouble in
water, ethanol, acetone
13 spans = sorbitane esters
14 tweens = polysorbate
15 polyoxyalkylenes = spans , tweens
16 spans give w\o emulsions
17 tweens give o/w emulsions
18 NaHCO3 ampoules are sterilized by ultrafilteration - NaHCO3 is used to neutralize lactic
acidosis
19 Ph of 0.001 NaOH is 11 . Ph + POH = 14 . PH + ( - log 0.001 ) = 14 . PH + 3 = 14 . PH
= 11
20 rancidity is the oxidation of double bonds in fatty acids
21 rectal supposotories adults=2g pediatric=1g
22 RBCs + hypertonic solution = crenation

23 Na phenbarbitone yields alkaline solution

24 in rheumatoid arthritis break down of synovial membrane occurs
25 light passes through a solution depending on solute concentration

1
26 atropine structure is similar to acetylcholine
27 bonds in protein are polypeptide bonds
28 epidermis is keratin
29 steady state is when amount administered = amount excreted
30 oral anticoagulant + imipramine = increase action of imipramine
31 oral anticoagulant + diphenhydramine = increase anticonvulsant toxicity
32 amphetamine , ephedrine , phenyl ephrine + MAOI = hypertensive crisis
33 probenicid is uricosuric
34 acetaminophen decrease uricosuric effect of probenicid
35 aspirin decrease uricosuric effect of probenicid
36 aspirin is not taken with probenicid - aspirin decreases the uricosuric effect of probenicid
- aspirin toxicity = veritigo , tinitus
37 alcohol + CNS depressant = increase depression
38 tolbutamide is an oral hypoglycemic
39 aspirin increases the hypoglycemic effect of tolbutamide by plasma protein displacement
- aspirin decreases the uricosuric effect of probenicid
40 preservatives in eye drops : chlorocresol 0.1 % , benzalkonium chloride 0.02 % ,
chlorohexidine 0.01 % , Na edetate 0.1 % , phenyl mercury nitrate 0.002 % , cetrimide 0.005% -
% of chlorocresol is 0.05-0.1%
41 anticholinesterase act by structural similarity to acetylcholine
42 fats give the highest calory per gram; 1g=9kcals --1g protein=1g carbohydrate=4kcals --
1g dextrose=3.4kcals
43 fluorouracil is an antimetabolite antcancer drug
44 antitubercular drugs: isoniazide, streptomycin, PASA, rifampicin, BUT NOT tobramycin
45 guanethidine makes parasympathetic tone predominate thus causes diarrhea
46 DOC in ttt of status epilepticus is diazepam or lorazepam
47 SE:::: spironolactone: gyncomastia -- guanethidine: orthostatic hypotention --
methyldopa: positive coomb's test -- sulfisoxazole : steven's johnson syndrome -- rifampicin:
discoloration of body fluids -- dececlocyclin: photosensitivity
48 exophthalmos is seen in Grave's disease hyperthyrodism

2
49 metabolic acidosis is due to HCO3 loss
50 insulin secretion: K level drop during glucose utilization
51 ergotamine tartarate sublingual - ergotamine tartarate is not sublingual
52 rifampicin may cause orange colouration of contact lense
53 KOH + organic acid = soap
54 captopril causes hyperkalemia so it is C.I. with K sparing diuretics
55 procaine is liable to destruction upon sterilization by heat
56 MAOI are C.I with guanthidine
57 naloxone: pure antagonist -- nalorphine: mixed agonist-antagonist
58 zero order reaction: rate process independent on drug conc or initial dose
59 SE of INH is peripheral neuritis
60 camphor is ketone
61 the onset of TCA requires: 3-4 weeks
62 examples of sublingual drugs : nifedipine , ergotamine tartarate not maleate ,
nitroglycerine , isosorbid , captopril
63 thyophylline atidote: B-blocker
64 K toxicity ttt: NaHCO3, glucose+insulin, Na polystyrene sulfonate
65 Ca acetate : ttt of hyperphosphatemia in end stage renal failure
66 sertraline is SSRI
67 chlorpheniramine maleate can be used safely with warfarine
68 metabolism of procainamide= N-acetyl procaineamide
69 bioavailability is the mount or drug available in blood and the rate by which it was made
available
70 when insulin is used as IV infusion with D5W during surgery it may be adsorbed on the
bottle and tubing
71 pentazocin: strong analgesic pain killer
72 dithranol is used for ttt of psoriasis topically, better stabilized in pasts of ZnO by adding
2% salicylic acid
73 polysorbate is used as wetting agent

3
74 prednisone, methylprednisolone, dexamethasone, betamethasone :: glucocorticoids
75 prednisone oral = 4 times more potent than hydrocortisone IV so if a pt was given 50 mg
HC IV every 6 hrs it is equivalent to 50 mg prednisone once daily
76 insulin does NOT dec syn of TG
77 bumetanide SE is myalgia
78 metformin is preferred in obese diabetic pt whose hyperglycemia is due to ineffective
insulin action
79 indapamide pt councelling is: take K supplement as orange juice
80 safest sulfonamide to allergic pts is sulfamethizole
81 nafcillin=penicillinase resistant
82 lactic acid CH3-CHOH-COOH (optically active) + [oxidation]=pyruvic acid CH3-CO-
COOH (optically inactive) +[ reduction]=lactic acid (reversible reaction)
83 streptokinase not given within 6 months from previous administration due to allergy
(antibody-antigen reaction)
84 pentoxyphylline: hemorrheological, dec blood viscosity, antiplatelet --- ttt of cold
extremities, Reynold's disease
85 diazepam in normal saline= ppn of diazepam- diazepam soln: 70%H2O+10%+PEG20%
86 drugs excreted by GF: ethambutol, aminoglycosides, methotrexate, digoxin,
procainamide
87 pargyline is antihypertensive agent should not taken with food containing tyramine
88 erectile dysfunction may be drug indused or HTN ttt SE
89 phenol is metabolized by glucuronidation and its activity is increased by increased
temperature
90 fick's law for passive diffusion
91 the ester group in atropine is liable to destruction
92 lactic acid oxidation gives pyruvic acid
93 prazocine SE: 1st dose syncope/ hypotension/ phenomenon
94 MOA of methylxanthines: # phosphorylase which converts active 3,5c-AMP to inactive
5c-AMP thus inc c-AMP --- catecholamines also inc 3,5c-AMP BUT by activation of
adenylcyclase
95 drug of choice for E coli is cotrimoxazole

4
96 nitrazepam has t1/2=25-35 hr. produce long daytime sedation which should be avoided in
elderly pt to avoid falls and fractures due to sedative effect

97 petrolatum dissolvesrubber in condoms and diaphragms

98 phenylephrine has no diuretic effect
99 theophylline by slaw IV infusion
100 dipivefrin is used in glucoma
101 Na cromoglycate is used for seasonal allergy
102 pregnants should take foilc acid

103 drugs with low Vd has less accummulation in tissues

104 nifedipine when used in angina is more likely to produce tachycardia than verapamil and
diltiazem
105 bundle of HIS is present in heart
106 GSH (glutathion, antioxidant) protect RBCs, hemoglobin from oxidation
107 digitoxin: hepatic clearance --- digoxin: renal clearance
108 lithium causes nephrogenic diabetes insipidus ttt by vasopressin
109 colloidal Hg: diagnisis of syphilis -- colloidal Au: diagnosis of paresis --- colloidal Cu:
diagnosis of cancer --- colloidal AgCl, AgI,Ag protein: germicide
110 cyclosporine: immunosuppressant
111 desferroxamine chelates iron
112 SE of amlodipine: peripheral edema, pruritis
113 blood makes up 1/15 of body weight
114 psoriasis ttt: methotrexate
115 pulmonary toxicity is SE of: bleomycin, amiodarone, nitrofurantoin, pentamidine,
bromocriptine
116 pt with allergy to morphine should not take codeine
117 cholinergic crisis may resulr fro M. gravis ttt

118 demecarium is a long acting anticholinesterase used to treat primary open-angle

glaucoma, glaucoma in aphakia, and accommodative estropia
119 rectal temp is about 1 DF above oral temperature

5
120 initial calibration mark on ml graduated pipette in 20 ml
121 phenyl group in phenyl Hg nitrate leads to less solubility than organic salts
122 cetmacrogel= nonionic SAA that is incompatible with tannic acid, NH4 salts and phenol
123 nonoxynol: SAA, spermicidal: contraceptive
124 barium bisulfate is used to X-ray GIT orally or rectally
125 penicillamine is a chelating agent
126 nystatine is D O C for moniliasis ( candidiasis )
127 retrovir=AZT=zidovudine --- SE hematologic suppression, agranulocytosis
128 bilirubin is the end product of hemoglobin metabolism
129 phenol + (hydration)= 1,2-benzodiol
130 filgrastim is granulocyte-colony stimulating factor which stimulates the production of
neutrophils
131 patient on haloperidol should not take alcohol or alpha methyl dopa
132 gout ttt: acute=cholchicine/chronic=allopurinol/ aspirin and corticosteroids and
phenylbutazone are also used
133 cystic fibrosis is heriditary NOT contageous characterized by secretion of viscous, sticky
mucous from lungs, pancreas, ttt pulmonase, alpa-dornase
134 allopurinol is NOT C.I. with warfarine
135 acarbose # alpha-amylase thus inhibit digestion of complex polysaccharides, acarbose
also inhibits alpha-glucosidase thus inhibit digestion of oligosaccharides
136 imipramine is metabolized by demethylation giving desipramine
137 0.2 mg lanoxicaps (soft gelatine) = 0.25 mg digitoxin tablets in potency
138 glucose and fructose are monosaccharides
139 penicillin in a B-lactam ring erythromycin has a lactam ring
140 ventricular fibrilation is the most common complication of MI
141 benzylperoxide gel : should not come in contact with eye or mucous membrane

142 bendict's soln depends on the reduction of cupric ion to cuoroic acid
143 pt taking tranylcypromine should restrict diet and drugs.
144 NaHCO3 + 5% dextrose= acidosis as a result of diarrhea

6
145 K normal value= 3.5 - 5 mEq/L
146 Hb in blood is 15g
147 pralidoxine leads to regeneration of cholinesterase after organophosphorus poisoning
148
149 amifostine: ttt of cisplatin toxicity, protect from nephrotoxicity by cisplatin
150 bulk laxatives:: psyllium, methylcellulose, Ca polycarbophil
151 quinine SE is cinchonism
152 methicillin=pencillinase resistant
153 PG are group of related fatty acids
154 amitriptyline # chlorothiazides
155 metoclopramide can be given by IV bolus
156 opthalmic solutions are sterilized by filteration by a 0.22 microbial filter or heat with
bactericidal
157 clomiphen is an antiestrogen
158 gelatin is a protein
159 sotalol: monitor CrCl
160 sleep aids: melatonine, tryptiphan (in milk), doxylamine, diphenhydramine
161 procaine is so liable to destruction upon heat
162 Ca polycarbophil : ttt of constipation
163 oliguria= dec in urine excretion
164 protamine sulfate is antidote for heparin
165 INH, PAS, hydralazine, sulfonamides are metabolized by acetylation
166 optical activity is due to assymetric C atom
167 lorazepam is the most suitable night sedative for elders
168 antihypertensive effect of guanethidine in inhibited by TCAs (amitriptyline)
169 B bloclers are C.I. with verapamil
170 Na bisulfite is antioxidant, change pH of medium
171 flexible collidion contains camphor+ castor iol
7
172 thiamin (vit B1) is heat liable
173 guanethidine: parasymp. Tone predominate : diarrhea
174 penicillin should be taken 1/2 hr before food
175 digoxin soft capsule provides better bioavailability than tablets
176 safest sulfonamide to allergic pt is sulfamethizole
177 guanthidine eye drops 5% used 1-2 times in eye lid edema
178 corticosteroids are used in asthma as antiinflammatory decongestants
179 acetaldhyde polymerization = paraldhyde
180 chloramphenicol is a polymorphic drug
181 180 L/day of fluid filtered in GF per day
182 dementia: mental deterioration
183 class A prescription balance sensitivity tests: arm ratio, rider, graduated beam, shift,
minmum wt=120mg
184 narrow angle glucoma attacks ttt by parasympathomimetics
185 diazoxide is administered by rapid IV injection
186 critical interactions: cimetidine + theophylline --- sulfonamides in neonates: inc bilirubin:
kernicterus
187 tardive dyskinesia is irreversible SE of phenothiazines
188 TCA, corticosteroids may cause HTN
189 AlOH3 in C.I with TC, cholrpromazine
190 maintaining of blood PH is function of lungs and kidney
191 metyrapone is useful as a diagnostic agent for pituitary function
192 Radial Walker test is used to estimate disinfectant/germicidal activity
193 trituration is grinding to fine powder

194 Rideal walker test = germicidal efficacy of antiseptics

195 parasympathomimetics are used in glucoma
196 sclerosis is generally caused by overgrowth of fibrous tissue -- spondylitis: inflammation
of the vertebrea -- stasis: stoppage of blood flow in a part of the body

8
197 D-propoxyphen: analgesic=1/2 codiene - L-propoxyphen: antitussive
198 MAOI : tranylcyromine, phenelzine, meclobimide, iproniazide
199 pamaprom (diuretic) is effective in ttt of PMS, it is derived from theophylline
200 cis means 2 groups on the same side
201 guanabenz is alpha 2 agonist used in the ttt of HTN
202 clotrimazole is bactericidal that # folic a` synthesis
203 hydralazine (antihypertensive, vasodilator) may cause ANGINAL ATTACK due to
CORONARY STEAL PHENOMENON

204 sulfonamides are metabolized by acetylation

205 homopolysaccharides: starch, glycogen, cellulose --- heteropolysaccharides: heparine,
hyalouronic acid
206 ethopropazine is a phenothiazine derivative used in the ttt of parkinsonism due to its
atropine like action
207 B-blockers: used in glaucoma: timolol, levobunolol, carteolol, metapranolol, betaxolol
208 cimetidine increase digoxin toxicity
209 loop diuretics inc renal PGs
210 ergotamine causes vasoconstriction
211 adsorption is a physical phenomenon
212 antibacterial action of phenol increase by increasing temperature
213 KCL is given in enteric coated tablets to protect gastric mucosa from irritation
214 menotropin is used for infertility
215 dopamine is first choice in ttt of emergency hypotensive shock
216 naproxyn taken once daily
217 narrow angle glaucoma is present in about 10% of total glaucoma population
218 side effects::: spironolactone:gynecomastia-- nadolol, bronchospasm -- alpha mehyldopa:
+ve coomb's test -- sulfisoxazole: steven johnson syndrome -- rifampicin: discoloration of urine,
sweat, contact lens
219 Na benzoate, Na phenyl acetate, : inc ureagenesis
220 lignocaine is not taken orally due to 1st pass effect

9
221 corpus leutum secrets mainly progesterone
222 disulfuram, metronidazole interfer with alcohol metabolism
223 insulin will remain stable at room temperature during the time period in which single vial
will be used
224 antidotes:: paracetamol: N-aceycysteine -- ehylene glycol, methanol: IV ethanol,
femopizol --heparine: protamine SO4 -- warfarin: vitamin K + fresh frozen plasma -- TCA
(anticholinergic): physostigmine -- BZD: flumazenil
225 NaHCO3 inc rate of urinary excretion of penicillin G K, penobarbital Na
226 G6PD hemolytic anemia with:: aspirin, dapsone, primaquine, quinine, dimercaprol,
sulfonamides, chloramphenicol, nirofurantoin, nalidixic acid
227 tetracycline should not be taken in pregnancy
228 phenyl group in phenyl Hg nitrate leads to less solibility than other inorganic salts
229 methyl paraben is ester of hydroxybenzoic acid
230 class A prescription balance sensitivity tests: Arm ratio, Rider, graduated beam, shift ---
minimum wt: 120 mg
231 drug with pKa 6.2 will be 50% ionized in small intestine (pH 6.2)
232 thiazide diuretics cause hyperglycemia, dec glucose tolerance
233 amiodarone antiarrhythmic causes occular, sight problems

234 ampicillin is 1st choice in ttt of H.influenza

235 vitamin D is controls absorption os Ca and PO4
236 an isotonic solution is isoosmotic but not vice versa
237 codeine in methylmorphine, heroine is diacetylmorphine
238 ampicillin suspention should be refrigirated 2-8 C but not freezed
239 parasympathomimetics: ttt of glaucoma
240 immune serum globulin is injected by IM
241 terbutalin has less cardiac SE than isoproterenol
242 ascorbic acid: rapidly absorbed from the GIT, utilized at high rates in common cold and
infections, protects from scurvy, reversibly oxidized to oxalic acid
243 sulfonylurea MOA: stimulate insulin secretion
244 amoxicillin is more absorbed than ampicillin because it has a para hydroxyl group

10
245 major respiratory volume is determined by vital capacity
246 vomiting = alkalosis --- diarrhea = acidosis
247 d-methorphan is 1st choice for routine cough suppression
248 amaranth is a coloring agent
249 quinolone # DNA gyrase -- erythromycin # protein synthesis -- streptomycin # protein
syn (# 30S) -- TC # protein syn (30S) -- chloramphenicol # protein syn (50S)
250 vitamin D is used in hypoparathyrodism
251 alendronate is not given to pt sitting or lying down because it cause esophageal ulcer

252 hypodermoclysis: the intentional administration of IV fluids into SC tissue

253 Na metabisulfite is an antioxidant
254 nitrazepan= have a t1/2 of 30 hrs produce long daytime sedation which should be avoided
in the elderly to avoid falls , fractures due to accumulation of nitrazepam sedative effects
255 linoleic acid: polyunsaturated fatty acid
256 paraldhyde is acetaldhyde polymer
257 demeclocyclin in ADH antagonist and so cause diabetes insipidus which is ttt by ADH
258 vit E is insol so it is better to be formulated in heavy mineral oil
259 drugs pregnancy category X: isotretenoin, TC, misoprostol, finasteride, chloamphenicol,
methimazole, coumadin, metronidazole, VPA, Li, alcohol
260 NaHCO3 is a weak base
261 long acting insulins such as PZI and ultralent used in a few pts because it provide insulin
concns too low to handle acute glucose levels related to meals and also produce inc insulin concn
at night
262 fluoxacillin=penicillinase resistant
263 bilirubin is the end product of hemoglubin decomposition
264 cetrimide gives O/W emulsion
265 atropine does not decompose by heat
266 pt taking phospholine iodide should not take succinylcholine
267 trazodon + MAOI = serotonin syndrome --- L-dopa + MAOI = hypertensive crisis ---
methylphenidate + MAOI = potentiate CNS stimulation (2 weeks elapse)
268 Na prusside is arterular and venular dilator , give by slaw IV infusion

11
269 bear's lamert's law relate the absorption of light to wave length
270 tolazamide is slowly absorbed than other compounds
271 clindacyn dissolve in H2O NOT alcohol
272 naloxone treats opiate toxicity
273 methylcellulose is a safe laxative in pregnancy
274 atresia: absence of a hole
275 pacemaker of heart is SA node
276 degraded TC gives a more toxic form = fanconi like syndrome
277 woman taking combined pills for 21 days but the bleeding does NOT occur, she should
stop the pills as she may be pregnant
278 K1=phytonadione --- K2= menadione
279 oxidation of ethylene glycol gives oxalic acid -- metabolism of ascorbic acid gives oxalic
acid
280 agent that could be use in osteoporosis=biphosphonates, Ca, estrogen, calcitonin, vitamin
D, Na flouride, progesterone, androgens, calcitriols.
281 K is used with digitalis to avoid toxicity
282 parentral administration of 1 L of 5% dextrose in H2O provide pt with 170-200
kilocalories
283 erythromycin, verapamil, diltiazem are C.I. with digoxin
284 dactinomycin, mithromycin are antibiotics and anticancer due to their cytotoxic effects
285 tetracyclin in C.I in pregnancy
286 urine discoloration drugs: rifampin, phenazopyridine, L-dopa, senna, phenolpthalin,
sulfasalazine, deferroxamine mesylate
287 sucralfate should not be taken with food or antacids
288 lignocaine has longer duration of action because of its amide group which resists
hydrolysis
289 on long term use of sympatholytics= hypotention may occur
290 acetazolamide increase K excretion
291 emulsifier used with salicylic acid prepartions is wool alcohol???

12
292 to measure 25 U of 100 U insulin use a special 100 U syringe which has a max capacity
of 50 U

293 thirst is controlled by hypothalamus

294 multiple scelerosis (hypersensitivity type III) ttt: interferon B 1a/1b, baclofen, dantrolone
295 rate of drug elimination excreted by 1st order kinetics is greatest when blood
concentration is at its max
296 the purpose of combined drug ttt in TB: dec and delay drug resistence, inc anti-TB effect.
NO effect on duration
297 emergency minor burn advice: immerse burn in cold water
298 ibuprofen increase hypoglycemic effect of insulin -- propranolol increases hypoglycemic
effect of insulin
299 ricinoleic ( castor oil ) of linoleic ( unsaturated )
300 psoriasis is characterized by silver , grey scales -- red macule, papule or plaque covered
by silvery lamellated scales -- scalp, elbows, knees, shins are usually affected first
301 ttt of cystic fibrosis: dornase alpha, N-acetylcysteine, pancreatin
302 classifications::: thiothixene: antipsychotic -- protriptyline: antidepressant --
trimethadione: anticonvulsant -- oxazepam: antianxiety -- trimethobenzamide: antiemetic --
isocarboxazide: MAOI -- HCTZ: diuretic -- tripelennamine: antihistaminic
303 mesna: Na-mercapto ethane sulfonate
304 tardive dyskinesia is irreversible SE of phenothiazine

305 diseases:: cooley's: familial erythroblastic -- down's: mongolism -- hansen's: leprosy --

herpes zoster: shingles -- alzeheimer: presentile dementia
306 niphedipine is short acting dihydropyridine Ca channel blocker
307 dose of atropine: 0.2-2 mg
308 pregnants allergic to penicillin V should take erythromycin
309 aminoglycosides are effective against pseudomonas infections BUT chloramphenicol is
NOT
310 pt about to undergo ECT is usually given succinylcholine

311 acyclovir is used in the ttt of herpes simplex

312 agranulocytosis is accompanied by necrotic lesion of mouth, also leukopenia,
neutropenia, also sore throat and fever

13
313 urine determinations of catecholamines and their metabolites are useful in diagnosis of
pheochromocytoma

314 benzocaine is ethylaminobenzoic acid

315 platelet aggregation inhibitors: cefotetan, cefoperazone, cefamandole, moxolactam,
ketorolac
316 rate of emulsion creaming depend on viscosity
317 quetiapine (atypical antipsychotic) : SE: cataract
318 normal prothrompin time: 12-15 seconds - APPTT: 30-45 seconds
319 metoprolol is similar to propranolol in pharmacological effect
320 chlamydia: asymptomatic in females, dysuria in males
321 ranitidine dose is 150 mg bid
322 sodium metabisulfite: acidic--glycerol, ethanol, KI, NaCl,:neutral---Na borate: alkaline
323 naproxen is arylalkanoic derivative useful in arthritis pts who has difficulty in
remembering to take the medication during the day
324 insulin Zn suspension has duration 18-24 hrs
325 ribosome is composed of aminoacids
326 airborne grame +ve legionella pneumophila cause legionnaire's disease, ttt by
erythromycin
327 thrush= oral fungal infection (cndidiasis)
328 Na in blood= 137-157 mmol/L --- K in blood= 4.5-5.5 mmol/L -- Cl=98-100mmol/L --
HCO3=24mmol/L -- urea= 3-8 mmol/L -- Ca=9-11mg%
329 hydalazine is antihypertensive of choive in pts with renal insufficiency
330 Li therapy cause diabetes insipidus
331 loop diuretics: furosimide, bumetanide, ethacrynic acid act by in Na secretion
332 antocholiesterases (parasympathomimetics) act in glaucoma by dec IOP, inc drainage of
aquous humor
333 caspofungin # asperagillus
334 methanol oxidation = formic acid = retinotoxic = blindness
335 chloramphenicol SE is aplastic anemia

14
336 the most common cause of diabetic ketoacidosis and coma is failure of pt to utilize
insulin

337 amphoteric drugs don't change PH: e.g. tetracyclin

338 insulin secretion: K level dec during glucose utilization
339 parkinsonism may be induced by : haloperidol, resepine, chlorpromazine, methyldopa
340 cyclosporine may be administered concurrently with adrenal corticosteroids BUT NOT
with other immunosuppressive agents
341 nicotinic acid ttt of pellagra, agranulocytosis, dermatitis, hyperlipidemia
342 normal insulin secretion : 50U/day
343 imipramine is TCA used for enuresis and hyperkinetic child
344 cause of addison's disease: dec in ACTH secretion… ttt by mineralocorticoids,
glucocorticoids
345 don't take NaHCO3 with HTN
346 in alkalosis we give acetazolamide - in acidosis we give NaHCO3
347 danazole is used to treat endometriosis
348 vitamin E is insoluble so it is better formulated as suspension in heavy mineral oil
349 prednisolone shows higher activity than hydrocortisone because it differs in conformation
at ring A
350 ACEIs may cause severe hypotension
351 insulin does not suppress lipolysis
352 indomethacin admn immediately after food
353 alkaline phosphate level increase in liver diseases
354 patients with mature onse DM can be ttt with tolbutamide and diet
355 imipramine (tofranil): enuresis
356 oleic acid: monounsaturated fatty acid --- linoleic acid: polyunsaturated fatty acid
357 decrease protein in plasma causes edema

358 contact angle is used to measure friction coefficient of powder

359 droperidol is butylophenone derivative that is used as adjunct to anesthesia
360 carbamazepine induce its own metabolism on long term use

15
361 8.4% NaHCO3 soln is give IV for cardiac arrest
362 H2O at pH 9 is best solven for barbiturates (alkaline water)
363 isoproterenol is B agonist
364 enzyme induction is done by inc rate of enzyme synthesis and dec rate of enzyme
destruction and degradation
365 waste product of protein is urea
366 insulin administration is subcutaneous
367 excessive thyroid secetion = thyrotoxicosis

368 dipivefrin is prodrug of epinephrine, eye drop in glucoma

369 CPK level inc in MI
370 ascorbic acid acidifies urine
371 vit E is sol in: fixed oil, ether, chloroform
372 chlorazepate : ttt of anxiety, alcohol withdrawal
373 pseudomembranous colitis ttt: vancomycin, metronidazole, TC
374 amphotricin B, Li, may cause D. insipidus
375 propranolol is used with hydralazine to control reflex tachycardia caused by hydralazine
376 fats provide the greatest number of calories per gram
377 edrophonium is used in diagnosis of myathenia gravis ( M. gravis )
378 glucocorticoids cause spread of infection
379 liquid in liquid dispersion system is mulsion
380 Na nitroprusside, KCl: slow IV infusion --- diazoxide: rapid bolus IV
381 thiazide antagonizes insulin
382 BAL or dimercaprol are antidotes for : Hg, Au, Cu, Sb, arsenic
383 6-thioguanine cytotoxicity effect by guanine synth.
384 Al(OH)3 = abrasive removes comedone
385 chlopheniramine maleate, allopurinol can be given safely with warfrine
386
387 radial artery: mesure pulsation
16
388 measels vaccine is given to 1 y old
389 ketoconazole needs the presence of stomach acid for adequate absorption so interact with
famotidine
390 bulk forming laxatives are used safely in pregnancy like; psyllium, methylcellulose, bran,
polycarbophil or stool softener (Na docusate)
391 pH of blood = 7.4
392 oral prednisolone is NOT give to a child with chronic asthma BUT he is given inhaler
prednisolone or long acting theophylline
393 tetanus antitoxin does not give active immunity
394 urine retention is NOT likely in DM which leads to polyuria

395 tyramine food is C.I. with: pragyline, phenelzine, isocarboxazide, tranylcypromine

396 IV inj: phlebitis, vein inflammation
397 impetigo cause all except endocarditis
398 acidification of urine: inc ionization of alkaline drugs (e.g amphetamine): dec
reabsorption: inc its excretion
399 filgrastim ( granulocyto colonies stimulator) : ttt of BMD with sever neutropenia
400 nystatine advice: swish ans swallow
401 a specific drug with 1st order biological t1/2 of 4 hrs, this value is independent on the
initial drug concn.
402 nalidixic acid absorption is decreased by food, antacids
403 complex formed between BAL and dimercaprol is stable, stable in water, not toxic,
excreted
404 cholcalciferol (vit D3): is sterosteroid produced in skin from 7-dehydrocholesterol by UV
radiation, it is main function is to inc Ca absorption from intestine and inc bone formation and
mineralization
405 not taken with metronidazole = alcohol
406 drugs causing occular problems: amiodarone, ethambutole, chloroquine, digoxin
407 polysorbate 80 assist in dispersion of cooltar
408 chlorohexidine is compatible with cetrimide o/w emulsion
409 LYME disease is caused by spirochetes borrelia carried by ticks --- symptoms: rash,
malaise, arthritis --- ttt: doxycyclin, TC - very severe: IV ceftriaxone

17
410 ergot alkaloids are used in migraine and prevention of post partum hemorrhage by
stimulation of uterine contraction

411 tyrosine is a thyroxine precursor

412 0-1 month: neonates--- 1 month-1y: infants --- 1-5y: early childhood --- 5-12y: late
childhood
413 rheumatoid arthritis: inflammation of synovial fluid, membrane
414 cartilage covers and protects bone from friction during normal joint activity
415 meprobamate is skeletal muscle relaxant
416 to kill spores heat at 100 C for 30 min in moist heat for 3 days
417 griseofulvin is prepared in microcrystalline form to inhance solubility and absorption
418 Ca is contraindicated with digitalis because both increase contractility of the heart which
may lead to arrythmia, also Ca replace K from myocardial cells, leading to digitalis toxicity
419 prostaglandines group is related to fatty acids
420 ointment base is made of hydrocarbons
421 t90%= shelf life
422 methotrexate + salicylate = BMD
423 the best emergency advise for pt with minor burn is to immerse the burn in cold water
until no pain is experience either in or outside the water
424 Meniere's disease: deafness, tinnitus and dizziness
425 ortho position= 1 and 2 position on benzene
426 lanolin contains more water than wool fat
427 stock's law for sedimentation rate ---- fick's law for diffusion rate
428 triazolam (short acting benzodiazepine) : hypnotic in elderly
429 ketoconazole is C.I W antacids, H2blockers, PPIs, cisapride, amphotricin B, food.---
ketoconazole+ astemizole/terfinadine= life-threatening reaction
430 meperidine + promethazine: postoperative analgesia
431 zileuton: # 5-lipoxygenase
432 minocyclin is used in ttt of acne vulgaris and its SE are NVD, vestibular toxicity
433 griseofulvin is prepared in a microcrystalline form to inc its slubility and absorption

18
434 CaCO3 is given in renal failure to treat hypocalcemia and dec phosphate
435 pt on probenecid therapy should NOT take aspirin or indomethacin or thiazide
436 adsorption is a physical phenomenon
437 antibiotic induced ps. Colitis is ttt with vancomycin
438 mineral oil impair vit K absorption
439 marasmus: protein deficiency
440 number of sterioisomers of a compound with 4 assymetric carbon atoms =16
441 ephedrine, levofloxacin, carvedilol are optically active
442 titanium dioxide is sun blocking agent
443 diphenoxylate is related to mepridine as it stimulates opiate center in GIT causing
constipation
444 low Na intake may cause Li toxicity - low sodium intake may cause lithium toxicity
445 pt on indapamide should take K supplement
446 Na stearate may render benzalkonium soln inactive
447 drugs that require pateint package insert: isotretenoin, OC, isoproterenol, ticlopidine,
progesterone, estrogen, IUD (intrauterine device)
448 NTG dec preload --- hydralazine dec afterload
449 tetracyclines give different absorption and dissolution patterns cause it is amphoteric
(form salts with acids and bases, capable of forming internal salts
450 glycerine syrup is neutral
451 griseofulvin is prepared in microcrystalline form to enhance its solubility, absorption
452 chlorambutol 0.5 % is used as preservation in eye drops
453 Amiodarone cause: pulmonary fibrosis, yellow deposits on cornea, skin deposits, change
in color, CNS effects, thyroid dysfunction, photosensitivity
454 0.9% NaCl injection makes penicillin more stable
455 KCl therapy is given by slow IV infusion

456 cholinergic crisis may occur in myasthenia gravis

457 1st symptom of DM is xssive thisrt
458 primaquine cause hemolytic anemia in G6PD deficiency

19
459 to prepare a buffer system of PH 4 use lactic acid, pka=3.86 - in a system having different
pka, the most appropriate will be as equal as its PH

460 aldosterone = control electrolytes

461 Grave's disease is a form of hyperthyrodism --- thyroid storm is sudden onset of
thyrotoxicosis
462 association (amphophilic) colloids: aq, non aqueous medium, lipophilic and hydrophilic
parts in disperse particles, form aggregates at CMC.. Micelle concentration inc: viscosity inc ,,
addition of electrolytes:: pptn
463 types of bonds usually seen in complexes are hydrogen bonds
464 P450 inhibitors: cimetidine, erythromycin, fluvoxamine, fluconazole, ketoconazole,
omeprazole, ciprofloxacine, fluoxetine, fluvastatin, nefazodone, verapamil, quinidine
465 sulph preparations are long actine because of PPB

466 buffer soln resists PH change

467 kanamycin is an aminoglycoside affect 8th cranial nerve
468 hypertension in pregnancy it ttt by methyldopa
469 photosensitivity is SE of nalidixic acid, griseofulvin
470 digitoxin is more lipid slouble than digoxin
471 mannitol: ttt of cerebral edema (hexahydric alcohol)

472 atropine + pralidoxine is used for ttt of organophosphorus poisoning

473 theophylline is C.I. with cimetidine
474 Na in serum is 310-340 mg%
475 sargamostin: myeloid reconstitution after BM transplantaion
476 the diagnostic element in blood for AIDS pt is antibody for HIV detected by ELISA
assay
477 plasma represent 55% of blood; i.e. 3500 mL of total blood volume, and 5% of total body
weight
478 chenodiol dissolves cholesterol gall stones
479 conc of chlorohexidine is : 0.01%
480 polysorbate is used as detergent, solubilizing agent --- sorbitan is used as wetting agent

20
481 dispersion types: 1-molecular (less than 1nm) pass ultrafilter, semipermeable membrane,
ex: oxygen, glucose --- 2- colloidal dispersion: (0.5-1 micron) pass only filter membrane, ex:
silver solution --- 3-coarse dispersion
482 insulin and glucagone are adsorbed on IV tubing
483 folic acid is given to pregnants to prevent spina bifida
484 dose of sulindac is 100-200 mg
485 qunidine replace digoxin from plasma protein binding sites causing digoxin toxicity
486 methimazole in pregnants: agranulocytosis
487 vitamin B9: folic acid
488 1,25-dehydrocholcalciferol enhance Ca absorption
489 oleic acid= monounsaturated organic acid --- linoleic acid= poly unsaturated organic acid
490 K phospahte inc methenamine activity by dec pH of the urine
491 clindamycin: water soluble
492 TCA SE = sedation, anticholinergic
493 initial drug therapy of most HTN pts: thiazide diuretics
494 ANTHELMENTIC OF CHOICE: tape worm: niclosamide -- thread worm: thiabendazole
-- pin worm, round worm: pyrantel pamoate -- whip worm, hook worm: mebendazole.
495 aldosterone + spironolactone = hyperkalenia
496 sucralfate should NOT be taken with food or antacids
497 aq. Antioxidents: ascorbic acid, sod. Metabisulfite, sod, bisulfite, sod. Sulfite -- indirect
antioxident: EDTA
498 cortisone causes osteoporosis
499 rate of emulsion creaming depend on viscosity
500 ampicillin suspension should be refrigirated
501 spironolactone is anti-aldosterone
502 drugs causing photosensitivity: amiodarone, amitriptyline, doxepine, fluoxetine,
furosemide, griseofulvin, isotretenoin, ketoprofen, nalidixic acid, naproxen, OC, oral
hypoglycemics, piroxicam, phenothiazines, sulfonamides, TC, thiazides, trimethoprim
503 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:0.3-1.2mg -- cimetidine: 400-
2000 mg -- ranitidine:150-300mg -- aspirin in RA:6g -- HCTZ:12.5,25,50mg
21
504 suspensions are not suitable for IV injection
505 Na lauryl sulfate is an anionic surfactant so its incompatible to cationic SAA
506 not taken with tea = allopurinol
507 indapamide may cause K loss so pt requires K supplement
508 stenosis: narrowing or stricture of a duct or canal -- aortic stenosis: narrowing of the
aortic orifice of the heart -- pyloric stenosis: abstruction of the pyloric orifice of the stomach
caused by hypertrophy of the pyloric muscle
509 pyelonephritis is accompanied with edema
510 FSH inc estrogen ---- LH inc progesterone
511 tachycardia is the SE of TCA
512 metabolism of PAS and INH by acetylation
513 haloperidol + alpha methyl dopa= life threatening reaction
514 MRSA ttt: vancomycin and may be with rifampicin
515 Bi subsalicylates: prevent and ttt of travellers diarrhea --- ttt: TMP-SMZ, doxycycline,
quinolones
516 promethazine is a potent antimetic, it is also antihistaminic, it is a phenothiazine
derivative
517 K content of K penicillin G is 1.7 m Eq/ million U
518 nystatine is used for ttt of candida
519 sorbitan monostearate (non ionic surfactant)== gives W/O emulsion
520 syneresis:: gels contract, lose fluid
521 PCP in HIV pts ttt by pentamidine
522 pt on propranolol having cold extremities, nightmares should shif to atenolol
523 most IV anasthetics are barbiturates e.g. thiopental, thiamylal, methohexital … an
exception is: ketamine
524 dose of aspirin in rheumatic fever: 6g
525 quinidine inc digoxin level
526 allopurinol advice: high fluid intake
527 chlorohexidine is compatible with cetrimide

22
528 to prepare buffer system of pH4 we use lactic acid of pKa 3.86
529 5-FU causes marker BMD
530 laxativesMOA::: Mg citrate, Na biphosphate: draw water into intestinal tract by osmosis -
- psyllium: bulk forming by absorbing H2O -- minerla oils: soften stool by lubrication -- Na
docusate: soften stool by dec serface tension --
531 cushing syndrome: Xss secretion of glucocorticoinds, osteoporosis, inc Bl. Pr.,
hyperglycemia
532 pellagra: niacin deficiency --- scurvy: ascorbic acide deficiency -- pernicious anemia:
cyanocobolamine deficiency
533 zafirlucast, montelukast: LT receptor antagonists
534 corticosteroid function: metabolism, salt and water regulation, muscle development,
hemaptosis

535 cyclosporin oral soln (100mg/ml) is drunk immediately after mixing with milk, chocolate
milk or orange juice an IV dosage form is also marketed
536 acacia is sol in H2O and insol in alcohol
537 ditharol 1% is used fir ttt of psoriasis
538 heparin is anticoagulant of choice in pregnancy; it inhibits conversion of prothrombin to
thrombin
539 ttt of epilepsy: diazepam, succinylcholine, phenobarbitone, NOT phenothiazines
540 axon is part of the neuron that carries impulses away from the nerve cells

541 HgCl2 is very water soluble --- BaSO4 is the least soluble
542 pindolol is the only B blocker with sympathomimetic activity --- carteolol, pinbutolol
543 nadir: time before BMD max occurs
544 sacrolema: in striated muscles and nervous tissues
545 upon exposure to air, aminophylline soln may develop crystals of theophylline
546 in acidosis ( cardiac arrest ) we give NaHCO3
547 anemia is caused by: antineoplastics, cytotoxins, immunosuppressants
548 prazocisn causes 1st dose effect: marked hypotenstion with syncope
549 cyanide toxicity is due to cytochrome oxidase enzyme
550 with hydrocortisone use simple base or soft parrafin

23
551 the presence of impaired renal function in pt:: dec the requirements for drugs that are
diectly excreted or whose active metabolites are excreted by the kidney

552 SE of clindamycin: diarrhea

553 aminophylline is a theophylline derivative better to be used rectally
554 metoclopramide: IV bolus
555 doses::: hydralazine:50-200mg -- carbamazepine:0.2-1.2g --methyldopa:0.5-2g --
colchicine:500mg -- prednisone:5-60mg -- aspirin (antiplatelet):75-150mg -- aspirin (antigout):
>5g -- chlorocresol: 0.05% -- captopril: 25-50mg -- phenytoin:50-400mg(max)
556 sulfonamides are metabolized by acetylation
557 DM problems: cataracr, renal failure, CV disease, peripheral neuropathy

558 phenobarnitone is a metabolite of primadone

559 levarterenol=L-norepinephrine
560 Na benzoate is used as a preservative
561 tizanidine: ttt of spasticity
562 pyridium: red discoloration of urine
563 ragweed allergy: avoid pyrethrins
564 chlorpropamide is given once daily ( hypoglycemic )
565 diphtheria gives active immunity
566 probenecid is contraindicated with aspirin
567 cyclophosphamide cause hemorrhagic cystis
568 loop diuretic SE: dose related ototoxicity, alkalosis, hypokalemia
569 propranolol is used with hydralazine to control reflex tachycardia caused by hydralazine
570 acetazolamide, timolol: dec aqueous humor formation
571 clofibrate dec platelet aggregation, inc hepatic cancer
572 nylidrin is useful as vasodilator
573 fludrocortisone: haigh mineralo: ttt of addison's dissease
574 narrow angle glaucoma is present in 10% of total glaucoma population
575 B-blocker + verapamil = severe bradycardia

24
576 local anesthetic NOT dministered topically is procaine
577 most common SE of digoxin is GIT
578 hexyl resorcinol is oxidized upon exposure to air
579 IgG: major in serum, plasm, only one pass placenta --- IgM: first produced in response to
antigen --- IgA: major in body secretions --- IgE: allergy specific --- IgD:(1%) (antigen receptor)
580 liver cirrhosis is progressive fibrosis, scarring of liver
581 HCTZ+propranolol = dec edema
582 posterior pituitary gland secretes ADH, oxytocin

583 atropine SE : dry mouth, blurred vision, constipation, tachycardia

584 soda lime sol + air CO2 = CaCO3 ppt
585 SE of pentamidine: severe hypotension
586 polymorphism affect the solubility of the drug
587 organophosphorus compounds irreversibly block cholinesterases
588 phenyl Hg nitrate in low doses is sporocidal
589 normal therapeutic dose of glyceryl trinitrate is 0.5-1mg
590 ephedrine is the least desirable B-agonist in the ttt of bronchial asthma because it is
nonselective
591 MOA::: benztropin: anticholinergic -- verapamil: antiarrythmic -- asparaginase:
antineoplastic -- sulphinpyrazone: uricosuric -- tolnaftate: antifungal -- flurazepam: hypnotic --
acetohexamide: hypoglycemic
592 insulin is a polypeptide hormone
593 allopurinol does NOT affect warfarin
594 disulfuram like reaction: metronidazole, sulfonylurea, cephalosporines, cloralhydrate,
disulfuram, ketoconazol
595 antimicrobials: H2O2, isopropyl alcohol, phenol
596 % of body water at birth is 80%, normal 70%
597 procyclidine is anticholinergic used in parkinsonism
598 ergotamine ttt of migraine ---- ergometrine = oxytocic
599 emulsifier used with salicylic acid preparation is wool alcohol

25
600 heparin anticoagulant activity is monitored by activated partial thromboplastin time
(APTT)

601 carbacol=cholinergic drug -- probucol=antihyperlipidemic

602 dipivefrin HCl is prodrug of adrenaline used in ttt of glaucoma
603 8.4 % NaHCO3 in alcohol shock to neutralize lactic acidosis
604 drugs causing gynecomastia: spironolactone, ketoconazole, digitalis, cimetidine
605 selective B1 antagonists (cardioselective) : atenolol, metoprolol, bisoprolol
606 amrinone:ttt of CHF direct mechanism --- amiodarone: antiarrythmic (K channel blocker)
-- amiloride : K-sparing diuretic
607 polymixin B is similar to bacitracin (colistin)
608 excessive thyroid secretion causes thyrotoxicosis
609 some drugs show interference between magnitude of activity and plasma concn because
they are quickly metabolized
610 glycerine is alcohol -- gelatin is a protein
611 thiocyanate dec iodide uptake in thyroid gland
612 diseases and symptoms:: Raynaud's disease:cold pallor or cyanosis of fingers or toes--
Grave's disease: exophthalmus and enlargement of the thyroid gland--herpes simplex:watery
blisters on skin and mucous membranes espicially the lips

613 corticosteroids action in asthma is antiinflammatory and dec airway hyperresponsiveness

614 adice for pt taking penicillin is take it 2hrs before food or on empty stomach
615 sovent used with hydrocortisone IV injection is propylene glycol ???
616 B-lactams are metabolized by hydrolysis
617 respiratory center is located in medulla
618 pencillin # cell wall syn by # of transpeptidase
619 long term androgen: hepatic carcinoma, edema, testicular atrophy
620 insulin lente= 70%ultralente(crystaline) + 30% semilente (amorphous)
621 dosage adjustment in renal impaired pts is based on serum Cr concentration
622 sarcolema: in striated muscle and nervous tissue
623 tetanus toxoid is given every 10 years

26
624 hydralazine, procainamide SE : SLE
625 neostigmine does NOT cross the BBB - physostigmine cross BBB
626 hydroxychloroquine causes photosensitivity
627 methyl paraben is used to prevent mould, yeast growth
628 stabilizers: cetyl alcohol, stearyl alcohol, cholesterol
629 expectorant dose of ipecac syrup for adult is 1ml
630 anionic surfactants are compatible with econazole nitrate, icthamol
631 INH cause lactic acidosis (ttt by NaHCO3), pripheral neuritis (ttt by vit B6)
632 desmopressin ( vaspressin ) is ADH used in ttt of diabetes insipides
633 nothing will happen if we mix NaHCO3 to D5W
634 thioridazine is a phenothiazine with the least extrapyramidal SE because it is a piperidine
derivative
635 types of bonds usually seen in complexes are hydrogen bonds
636 sulfasalazine has poor absorption from the GIT, used for ttt of ulcerative colitis, regional
enteritis
637 drugs that are C.I. with myathenia gravis:: procainamide, quinidine, aminoglycosides, d-
tubocurarine, phenytoin
638 ethylene glycol oxidation gives oxalic acid
639 timolol is used for ttt og glucoma as it dec the production of aqueous humor
640 tazarotene: ttt of acne, psoriasis
641 vitamin B6 dec levels of L-dopa , alcohol , phenytoin
642 camphor is ketone
643 amrinone : used instead of digoxin
644 trazodon: TCA with least anticholinergic SE
645 chronic use of APC tablets (aspirine + phenacitin + caffeine) leads to analgesic
nephropathy -- it is more associated with phenacitin rather than aspirin -- it may also be assoc w
aspirin, antipyrine, aminopyrine and phenacetin
646 drugs used for open angle glaucoma: carbachol, demecarium, physostigmine,
neostigmine, pilocarpine, timolol maleate, epinephrine BUT NOT cyclopentolate (cyclogyl)
647 average % of hematocrit in blood is 45%

27
648 digoxin dose must be reduced in elders as they have low renal function
649 rRNA: 80% -- t-RNA: 15% -- m-RNA: 5%
650 olive oil + lime water = calcium oleate ( stabilizer )
651 kreb's cycle in mitochondria for respiration -- glogi apparatus: stores (plasma, lysosymes
syn.) --- lysosymes: contain digestive enzymes -- smooth ER: lipid syn --- rough ER: protein syn
652 L-hyoscyamine (atropine) is 100 times more potent than D isomer
653
654 % of body water at birth is 80%

655 ribosome is composed of aminoacids

656 high doses of acetaminophen cause hepatic necrosis
657 mechloethamine (alkylating agent) : potent vesicant --- extravasation ttt: thiosulfate, ice
compresses
658 all phenothiazines have extrapyramidal SE except thioridazine
659 thioridazine is a phenothiazine derivative with the least extrapyramidal SE
660 baclofen is antispastic
661 Goeckermann: cooltar + UV
662 glucose shows no absorbance in the UV region of 200-400 nm
663 olive oil + lime water = Ca oleate
664 refrigirate phospholine iodine ( 2 - 8 )
665 when hexyl resorscinol is exposed to air it will be oxidized
666 hypoparathyroid ttt: calcitriol, vit D --- hyperparathyroid ttt: calcitonin, vit D analogues
667 aphasia: inability to communicate
668 folic acid can interfer with the diagnosis of pernicious anemia
669 erythromycin structure is lactone ring with sugar moiety

670 vit D: calciferol : ttt of ricketssia, and hypoparathyrodism

671 chloramphenicol in infants leads to gray syndrom because of deficient glucuronyl
trasferase -- gray syndrome: cyanosis, vascular collapse, elevated chloramphenicol levels in
blood
672 figrastim is a human granulocyte colony stimulating factor

28
673 red meat is NOT C.I. with MAOIs
674 the therapeutic value of the electroconvulsive therapy (ECT) is due to the convulsion
itself
675 naloxone is used to reverse respiratory depression caused by opiates
676 thiazide antagonize insulin
677 procainamide is DOC for AVRT= atrioventricular reinterent tachycardia
678 ideal antacid should inc PH of stomach to 3.5
679 calculation of dextrose isotonic solution can be done by freezing point method

680 thyroid preparation after surgical removal of thyroid gland:1.6mcg/kg/day

681 purines: A, G
682 thiocyanate affect iodine uptake in thyroid gland
683 cyclopentolate (cyclogyl) is a mydriatic and cycloplegic used for refraction work and
ophthalmoscopy
684 titanus interval is 10 years
685 haloperidol is NOT used in parkinson's
686 hypersensitivity and idiosyncrasy is not dose related
687 large doses of acetaminophen may cause hepatic necrosis
688 nevirapine: non nucleoside reverse transcriptase inhibitor (NNRTI)
689 aspirin is water insoluble
690 weak acids, bases are more absorbed from small intestines due to large surface area
691 digoxin absorption dec by kaolin and cholestyramine and neomycin and erythromycin
and tetracyclin
692 ileum is the last part of small intestine
693 NaCl equivalent is amount of NaCl teoretically render the same osmotic pressure
equivalent to 1 gm of the substance and this value is used to estimate the amount of NaCl needed
to render a solution isotonic
694 5% of glomerular filteration returns to blood from distal tubules
695 vit B6 is contraindicated with levodopa, parkinsonism, phenytoin
696 inc pCO2 in blood:: most potent respiratory stimulant

29
697 HLB is important for classification of nonionic SAA
698 carbidopa (alpha-methyldopa hydrazine) # peripheral dopa decarboxylase and does not
cross BBB
699 metformin, phenformin are biguanides
700 agranulacytosis is decrease in polymorphonuclear lymphocytes
701 TCA # reuptake I of NE, 5HT
702 pt with ampicillin allergy should not take imipenem
703 ketoconazole SE: GIT, headache, gynecomastia

704 dilatant viscosity inc by agitation

705 nalorphin (narcotic mixed agonist antagonist) has a disadvantage in ttt of codeine
dependence == pptn of withdrawal symptoms
706 major buffer of extracellular fluid is HCO3/CO2 system
707 mite cause scabies
708 most vaginal suppositories use a base of PEG
709 insulin lente: 30% amorphous, 70% crystalline
710 ttt of methicillin resistent staph is vancomycin
711 in barbiturate or salicylate toxicity give urine alkalinizer as NaHCO3 or acetohexamide
712 tophi is characteristic of gout
713 colloids:: 1-lyophyllic colloids, 2-association colloids, 3-lyophobic colloid --- lyophilic
colloid: organic disperse molecules, inc concn: inc viscosity, may transform from solution to gel,
addition og high electrolytes: pptn. (salting out)
714 tetanus antitoxin: does NOT give active immunity
715 otitis media, sinusitis are caused by: H.inf, strept.pneumonia, moraxella --- ttt:
amoxicillin, TMP-SMZ, cefixime, cefaclor
716 end product of glycogen is glucose
717 idiosyncrasy is NOT dose related
718 PH of the small intestines: 6.2 -- a drug with pka 6.2 will be 50% ionized at the small
intestine (PH 6.2)
719 doxapram: resp. stimulant in COPD, inc depth of respiration, DOESNOT inc rate of
respiration

30
720 neutral compound absorbed from lipid biological membrane depends on partition
coefficient

721 dilantin+phenobarbitone= drop in dilantin level

722 essential amino acids: lysine, leucine, isoleucine, histidine, valine, phenylalanine,
arginine, methionine, threonine, tryptophan
723 salmeterol: long acting B-agonist but slow onset --- albuterol: rapid acting, short duration
724 metronidazole is used for ttt of anaerobic infections
725 colloidal Hg: diagnosis of syphilis -- colloidal Au: diagnosis of paresis -- colloidal Cu:
diagnosis of cancer -- colloidal AgCl, AgI, Ag protein:: germicide
726 sorbitane monostearate gives W/O emulsion

727 niclosamide is used in tape worm infections

728 parentrally administered electrolytes are usually ordered in milliequivalents
729 olive oil + lime water = Ca oleate (emulsifier)
730 Vit B6 in C.I. with levodopa
731 cetyl pyridinium bromide (cetrimide)= cationic emulsifying agent
732 HNO3 conc : 0.002% -- phenyl Hg acetate 0.002%
733 dissolution rate is the rate limiting step affecting absorption of oral drugs
734 miotic effect of pilocaropine starts in 15-30 minutes -- max reduction in IOP in 2-4 hrs --
duration: 4-8 hrs
735 antihistaminics= cyclizine , promethazine, chlorpromazine, diphenhydramine
736 benzalkonium chloride (cationic germicidal surfactant) is inactivated by soap (anionic
SAA)
737 short acting benzodiazepines: alprazolam, lorazepam, temazepam, zolpidem, oxazepam,
triazolam:: are used with elderly pts
738 drug tolerance = reduced pharmacologica response due to repeated administration
739 diluted acetic acid is 6% w/v of pure acetic acid
740 preservatives: chlorobutanol, dehydroacetic acid, K-sorbate, cresol, thiomersal,
benzalkonium. Benzoic acid, benzyl alcohol, cetylpyridinium, phenol
741 ethacrynic acid is C.I with gentamicin (additive ototoxicity)
742 penicillin metabolism= break B-lactam ring giving penicillamine

31
743 HCTZ is taken in the morning with food or milk
744 acetohexamide (oral hypoglycemic) have uricosuric effect and its metabolites have also
hypoglycemic effect
745 direct van den bergh test measures conjugated bilirubin in the blood
746 dioctyl Na sulfosuccinate = docusate=stool softener (anionic surfactant)
747 parietal cells in stomach secrete HCl and intrinsic factor
748 ketoconazole is only oral antifungal - amphotericin B : topical , injection
749 dyspnea: difficult or labored breathing -- dysphagia: difficulty in swallowing --
dyspepsia: impairment of digestive function -- dysuria: painful or difficult urination -- dysphoria:
restlessness

750 aminocaproic acid, tranexamic acid: antifibrinolysin used in toxic doses of streptokinase,
alteplase (fibrinolytic agents)
751 hypertensive pts should not use carbinoxolone
752 1,25 dihydroxycholcalciferol in Ca absorption
753 clonidine is prophylactic in migraine ttt
754 antiandrogens: finasteride, nilutamide (delay dark adaptation)
755 lidocaine or lignocaine is not taken orally because it undergoes first pass effect
756 Aloes sunscreen oils protect from UV
757 most common side effect of statins in hepatotoxicity
758 in asthma c-AMP does not increase
759 Al causes constipation
760 tropicamide cause mydriasis for 3-4 hrs
761 digoxin # Na-K ATPase
762 cloxacillin=penicillinase resistant
763 antidotes:: cyanide: amylnitrate, Na nitrate, Na thiosulfate -- digoxin: fab antibodies
(digibind), colestyramine, phenytoin or lidocaine (for arrythmia) -- Mg: CaCl2 10% -- K:
NaHCO3, glucose+insulin --
764 paricalcitol: vitamin D analogue: ttt of hypoparathyrodism
765 thiamine (B1) deficiency: Wernicke's syndrome or Korsakoff's or beri-beri with
peripheral neuropathy and confusion

32
766 orthopenea: dyspnea on lying, relief on standing
767 econazole nitrate: o/w emulsion, compatible with anionic SAA
768 acetazolamide is carbonic anhydrase inhibitor
769 oxacillin=penicillinase resistant
770 nefazodone: # 5HT reuptake, inc 5HT-- SE: hepatic failure, C.I. with cisapride, TCA,
MAOIs, terfinadine, astemizole
771 carbamazepine: anticonvulsant -- trazodone: antidepressant -- molindone: antopsychotic -
- alprazolam: antianxiety -- isocarboxazide: MAOI -- amiloride: K-sparing diuretic -- clemastine:
antihistaminic -- diltiazem: CCB -- sulfinpyrazone: uricosuric
772 Na cellulose phosphate : ttt of hypercalciuria

773 for insulin dependent pt with HTN: atenolol is the best B-blocker that could be used
(selective and most hydrophilic)
774 ataxia: poor muscle coordination
775 doubling the drug concn in the blood (that follow 1st order kinetics) = will not affect the
half life
776 maximum safe dose of paracetamol is 4gm/day
777 floxacillin syrup must be refrigirated
778 amylase level inc in pancreatic disease

779 glucagon (SC, IM) used in the ttt of acute hypoglycemia when glucose administration is
not available
780 quinine inc plasma level of digoxin, inc toxicity
781 organic acid + inorganic base= soap
782 metolazone is similar to chlorothalidone
783 dose of HCTZ: 0.5-1g
784 docetaxel: ttt of breast/non-small lung cancer --- monitor: bilirubin, SGOT, CBC -- SE:
edema
785 K reabsorption occurs in the proximal tubules but K secretion occurs in the distal tubules
786 erythromycin estolate is better when taken orally
787 methyl sergige: serotonin antagonist in brain
788 acetazolamide causes urine alkalinization

33
789 alpha 2 agonists, reserpine, guanethidine :: cause depression
790 pyrivinim pamoate is a dye used in the ttt of pinworn in humans
791 kanamycin + FeSO4 = deafness due to damage of the 8th cranial nerve and effect on
auditory nerve function
792 tyrosine is precursor of thyroxine
793 respiration value is determined by vital capacity
794 normal glucose is 80-120 mg%
795 vit B6 dec serum level of phenytoin, alcohol, levodopa

796 dextromethorphan is a narcotic cough suppressant

797 fish liver oil contains vitamins A,D
798 vancomycin is used to treat antibiotic-induced pseudomembranous colitis
799 drugs causing pulmonary fibrosis as SE: tocainide, amiodarone.
800 SA node=the pacemaker of heart
801 epinephrine: ttt of chronic open angle glaucoma BUT C.I. in narrow angle glaucoma due
its mydriatic action which may precipitate acute angle glaucoma
802 phenobarbitone Na ( basic ) may ppt in urine
803 cretinism is due to deficiency in iodine in children
804 protamine zinc insulin has the longest duration of action =36hrs
805 ribosome is composed of amino acids
806 rose oil + cetrimide is stabilized by aggitation
807 podophyllum resin for ttt of warts
808 gentamicin is active against g-ve, E-coli, 1st choice against pseudomonas auroginosa
809 3-coarse dispersion: (greater than 0.5 micron) visible, pass nothing, ex: emulsion,
suspension
810 MTX is antagonist to folic acid
811 cool tar may be mixed with salicylic acid
812 pyrimidines: C, T, U
813 cough reaction: receptors in respiratory tract and receptors in stomach

34
814 dressing is used with cortisone to increase absorption
815 acetohexamide is oral hypoglycemic , have uricosuric effect
816 Warner Lambent test : test for human gonadotropins --- metyrapon: diagnostic for
pituitary function
817 amyl nitrite is the only antianginal inhalation
818 stearyl alc, cetyl alc, cholesterol are used as stabilizers
819 cyclophosphamide, methotrexate cause total BMD
820 belladonna is not recommended in glaucoma because it containes atropine

821 if salicylic acid is added to chloroform then H2SO4 was added : salicylic acid will ppt in
the lower layer
822 non inonic emulsion: cetomacrogel -- anionic: Na lauryl sulfate (soap) -- cationic:
cetrimide, benzalkonium chloride.
823 steatorrhea:: fatty acide deficiency due to improper secretion of bile acid
824 vit B1: thiamine: ttt of beriberi -- vit B2: riboflavin: precursor for FAD, NAD -- vit B3:
niacin: antihyperlipiemia -- vit B5: panthothenic acid; paralytic ileus???
825 volatiles oils are rich in terpentines
826 1st choice in acute gout attack is colchicine
827 acetazolamide causes systemic acidosis and urinary alkalosis
828 slubilized vit A is a micellized dispersion of vit A an SAA
829 sinemet (carbidopa + levodopa in a ratio, 1:10) carbidopa dec the dose of L-dopa by
about 75% -- L-dopa 1g qid can be replaced by sinemet 25/250 qid
830 SE of ACEIs: 1st dose hypotension and syncope, agranulocytosis, chronic dry cough,
hyperkalemia, cholestatic jaundice -- C.I. of ACEIs: renal artery stenosis, pregnancy
831 when urinary pH inc= excretion of acids inc
832 sympathetic ganglia are located near the spinal cord
833 glycerine suppositories: 92% glycerine + Na stearate // 70% glycerine + 14% gelatine +
H2O
834 retinoic acid is used therapeutically to accelerate production of epithelial ceels in the skin
835 if a pt receiving heparin suffers from gum bleeding: should be advised to wait until action
of heparin subsides
836 TC, imidazoles, sucralfate should not be taken with food or antacids
35
837 Na stearate (soap) = anionic SAA
838 warfarin MOA: interfare with vitamin K dependant synth of active clotting factor II
(prothrombin), VII, IX, X, and the anticoagulant protein C, S (these agents prolong clotting time
in vitro only ), warfarin has optical isomers
839 dose of thyroid peparation in adult after surgical removal of the thyroid gland is 1.6
mcg/kg/day
840 hypertensive crisis caused by tyramine +MAOIs is treated with an alpha blocker like
phentolamine or phenoxybenzamine
841 pt on carpidopa and levodopa complain of dark urine discoloration of levodopa
metabolite
842 adrenalin 1% eye drop produce 1-2 hr duration
843 malathion is organophosphorus compound

844 acarbose #
845 hydroxyzine is an antianxiety antihistaminic
846 ADH inc tubular permeability thus inc water reabsorption
847 the only insulin that can be given intravenously is crystalline (regular) zinc insulin
848 mestranol : estrogen
849 duration of thiazide diuretics: HCTZ: t1/2= 15hrs --- chlorothiazide t1/2 =3hrs ---
chlorothalidone t1/2=50hrs
850 niacin=# lipolysis
851 salicylic acid + cholroform + H2NO3 = pptn of salicylic acid in the lower layer
852 acetazolamide is rarely used because of systemic acidosis and urine alkalinization
853 creaming in emulsion depends on difference between 2 phases
854 TPN fluids should be stored between 2-8 DC
855 insulin does NOT suppress syn of TG --- it stimulates its formation and storage
856 alpha methyl dopa antagonize TCA
857 theophyllin should be 10-20 mg/L
858 chlordiazepoxide is very effective in the ttt of alcohol withdrawal
859 antidepressants: amitryptilline, SSRT, NSRI, linezolide, tranylcypromine, phenelzine,
meclobemide, razodone, trazodone

36
860 azatidine SE = drowsiness
861 magaldrate gel is given q1hr in duodenal ulcer
862 dextromethorphan is a narcotic cough suppressant
863 early expected effect of amitriptylene is very sleepy sensation, very dry mouth, and no
progress in depression
864 solubility depend on isoelectric point??
865 botulism antiserum is passive immunity
866 HCl secretion receptors: M, H, gastrin … HCl is secreted from parietal cells

867 optically active means that the compound has assymetric C

868 ethyl stearate or ethyl palmitate are NOT surface active agents
869 radial artery is used to measure pulse rate --- brachial artery is used to measure blood
pressure
870 hypoparathyrodism is ttt by dihydrotachysterol
871 phenyl murcuric nitrate is nonirritant bacteriostatic
872 thyroxine metabolism: deiodinization, then conjugation, then excretion
873 gentamicin (aminoglycosides) is more effective in alk urine ---nitofurantoin and TC:
more effective in acidic urine
874 histamine: cardiac stimulation
875 estimation of glucose amount in solution can be done by: action of glucose peroxidase,
colorimetric method, titration BUT NOT by UV method
876 manifestation of hypoparathyrodism: hypocalcemia, hyperphosphatemia
877 linezolide : antibacterial, reversible nonselective MAOI, does NOT need dose adjustment
in renal failure also fosinopril does NOT need dose adjustment in renal failure
878 cetrimide is used to for O/W emulsion of chlorohexidine
879 metoclopramide is a prokinetic agent used as an antiemetic through: effect on CTZ, inc
rate of gastric emptying
880 aminoglycosides cause damage to 8th cranial nerve
881 acteyl cysteine is mucolytic used by inhalation
882 main source of blood flow resistence is arterioles
883 parathyroid gland affect Ca absorption

37
884 SE of L-dopa: diplopia, dark urine, o.hypotension
885 Sb (antimony) K tartarate is antiemetic anthelmentic
886 carboxymethylcysteine is mucolytic and dec mucous membrane hyperplasia
887 captopril SE: renal insufficiency, irritant dry cough
888 metabolism od drugs occurs in the subcellular organ in the endoplasmic reticulum,
ribosomes
889 pyrazinamide SE: arthralgia ( inc uric acid in blood) --- ethambutol SE: red-green
blindness
890 tamoxifen citrate is indicated primarily for estrogen-dependent neoplasm
891 proinsulin (86aa`) is insulin impurity most commonly used to compare the relative purity
of the various insulin products
892 probenecid # excretion of: sulfonamides, sulfonylureas, indomethacin, naproxen,
clofibrate, ASA, pantothenic acid, penicillins
893 a drug which is 20% absorbed from the oral dose is considered poorly absorbed in terms
of bioavailability
894 filgrastim is a protein
895 sympathomimetic long term use causes hypertension
896 BaSO4 is the least soluble compound

897 phenol is acidic

898 erythromycin is taken as enteric coated tablets as it is destroyed by HCl of the stomach
899 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 -- doses of 500-1000mg inc Fe absorption by
about 10% -- smaller doses are not recommended (neglecible inc in A)
900 ketoconazole needs acid medium to be activated thus it is C.I. with famotidine which dec
HCl
901 oprelvekin: inhance platelet production
902 folinic acid is antidote for methotrexate --- methotrexate is folic acid analogue used in
leukemia

903 caffeine has diuretic effect

904 TI= LD50/ED50
905 impetigo is a contagious disease caused by staph. Aureus - it does not cause endocarditis

38
906 metabolism of procainamide: N-acetyl procainamide
907 the ganglionic blockers are not as other antihypersensives because they do not selectively
block sempathetic ganglia but they also block parasympatheic ganglia causing unpleasant
anticholinergic side effects
908 homatropine is C.I. with glaucoma
909 most IV anesthetics are barbiturates except ketamine
910 cortisone eye drops should be stored at 2-8 DC
911 chronic use of APC tablets may result in analgesic neuropathy
912 cyclopenzaprine and amitrptyline have the same side effects
913 high cortisone intake may lead to moniliasis
914 amaranth is a coloring agent
915 purified water for injection is prepared by distillation
916 photosensitivity is SE of nalidixic acid and griseofulvin
917 HDL: scavenger of cholesterol protecting arteries
918 pt on dogoxin and HTCZ, most appropriate glucocorticoid is dexamethasone (no Na
content and no salt and water retention)
919 mineral oil is petrolatum derivative (aliphatic hydrocarbon) and immiscible in alcohol or
castor oil
920 cetrizine, terfenadine, astemizole:: # metabolism of ketoconazole, clarithromycin,
erythromycin
921 bendrofluazide is a thiazides
922 drop in plasma protein level causes edema
923 fick's law (diffusion) = dc/dt= D*S.A*(C1-C2)/L --- noyes witney:= dc/dt=dc*SA*(Cs-
C)/H
924 dimercaprol is sparingly soluble in H2O when when complexed with heavy metals form
stable non-toxic compound which is excreted from kidney
925 euthyroid=normal thyroid
926 pharmacist should suggest to pt that a supp. Made with carbowax and glycerinated gelatin
as base should be dipped in water before insertion
927 CaCO3 is given in renal failure to dec PO4 conc

39
928 lomotil (diphenoxylate + atropine) does NOT cause bronchospasm and atropine dec the
likelihood of opiate abuse

929 foscarnet (antiviral) : ttt of CMV (cytomegalo virus) SE: renal failure
930 constipation due to norphine is ttt by : inc fiber content in diet, stool softener (Na
docusate), stimulant laxative, if constipation persists use osmotic laxative (Mg citrate or
lactulose)
931 B-blocker and diuretics cause dylipidemia
932 tragacanth is used to increase viscosity
933 giardiasis ttt: metronidazole, quinacrine
934 drugs causing disulfuram like action: sulfonyl ureas (except: tolazamide, glimepride),
cefotetan, cefoperazone, cefamandole, moxolactam, metronidazole, INH, chloralhydrate,
nitrofurantoin

935 quinidine is optical isomer of quinine

936 important complications of corticosteroids are: dissemination of local infection, inc
susceptibility to infection, masking symptoms of an infection
937 aldosterone hormone is a mineralo corticoid acts on renal tubules causing salt and water
retention
938 cyclosporine: immunosuppressant
939 diseases and areas::: Adam's-Stoke's disease:heart, addison's disease: adrenal gland,
Bright's disease: kidney- Hodgkin disease: lymph nodes, myasthenia gravis: muscles, Goiter:
thyroid, acromegaly:pituitary gland, Klinefelter's syndrome:testis
940 guanthedine, methyldopa, clonidine cause bradycardia but hydralazine cause reflex
tachycardia
941 doses:: erythromycin:0.25-0.5g qid
942 ethopropazine is a phenothiazine derivative that has atropine like action so used in ttt of
parkinsonism
943 hydrocortisone is NOT suitable for ROSAISIA
944 ACEIs are C.I. is asthma, renal artery stenosis
945 maximum dose of phenytoin is 300 mg
946 CrCl=100-120cc/min

947 pemoline is used as stimulant drug in hyperkinesis with the advantage that can be taken
once daily

40
948 combined pills (estrogen, progesterone) inhibit pituitary gonadotropins so inhibit
ovulation

949 cystic fibrosis is hereditary related to parents

950 nitroglycerine dec preload while hydralazine dec afterload
951 halothane is inhalational NOT IV
952 sulfa is not liable to decomposition by heat
953 megaloblastic anemia ttt: leucovorin IM
954 function of lymph glands: filter out solids by phagocytosis

955 danazole is an androgen that inhibits gonadotropin release and so it's used fot ttt of
endometriosis
956 pt takeing warfarin should avoid phenylephrine as it is alpha agonis thus increase platelet
aggregation
957 penicillin has a B-lactam ring - erythromycin has a lactam ring
958 LD50 is not variable between species
959 polymorphs differ in solubility and melting point
960 ketoconazole can be administered orally
961 lorazepam is a BZD which is preferred to be used as anxiolytic drug for elderly pt with
history of cirrhosis
962 atropine is sol in acid forming atropine sulfate
963 tetany occur due to hypocalcemia
964 guanthedine interact with TCAs
965 NaHCO3 = systemic antacid
966 heart failure + lignocaine= inc lignocaine level due to low hepatic blood flow thus
decrease lignocaine clearance
967 when pt taking phenytoin has ataxia, he should reduce the dose
968 in asthma::: TLC, FRV, RV, WBC inc --- FEV dec
969 myathenia gravis: antibodies against nicotinic receptors on skeletal muscles plasma
membranes at NMJ act as a competitive antagonis to Ach binding
970 Cool tar cause photosensitization, carcinogenic in rectal, genital, groin
971 drugs excreted by active tubular secretion = penicillin

41
972 cortisone eye drop should be stored between 2-8 C
973 vitamin D is not decomposed by sunlight - but vitamin C does
974 penicillin is recommended on empty stomach but not diazepam
975 haloperidol is contraindicated with parkinsonism
976 photosensitivity is caused by: TC, nalidixic acid, piroxicam, chlorpromazine
977 erythromycin does NOT affect the bioavailability of ketoconazole
978 chloramphencol SE: aplastic anemia
979 aspirin, ibuprofen displace warfarin BUT acetaminophen DOESNOT
980 streptokinase: 1.5 million IU (IV inf) over 60 min
981 insulin lente: 24hrs --- insulin protamine Zn: 36 hrs
982 indomethacin frequent use: headache
983 IgG: major in serum, plasma, ONLY pass placenta -- IgM: 1st produced in response to
antigen -- IgA: major in body secretions -- IgE: allergy spicific -- IgD: (1%) antigen receptor
984 thioridazide is the phenothiazine with the least extrapyramidal SE
985 cystic fibrosis is heriditary not contagious characterized by secretion of viscous sticky
mucous from lungs and pancreas
986 -NHNH- present in MAOI structure 2006
987 tests::: acid fast: mycobacteria -- Rideal walker, phenol coefficient, chick martin:
disinfectants --- mantox, tuberculin, PPD : TB --- Schick's: diptheria --- Ames: carcinogenicity
988 prefixes:: cata: downward, dis: apart, infra: below, meso: middle, retro: backward, celi:
abdomen, cephal: head, col: large intestines, cor: heart, cost:rib
989 metabolism od drugs results in more polar compounds
990 salicylic acid is conjugated with glycine or glucuronic acid
991 more than 50% of water are reabsorbed from the proximal tubules by passive transport
992 vitamin A is solluble in fatty acids
993 safe laxative in pregnancy is methylcellulose

994 hypertrophy: an enlargement of overgrowth of an organ -- hyperplasia: abnormal inc in

cell number of a tissue -- hyperhidrosis: excessive sweating/perspiration -- hyperkinesia:
(excessive movement) -- hypersthesia: excessive sensitivity to stimulus
995 antithyroids = propylthiouracil , carbimazole

42
996 NaCl (neutral) does not change PH of the medium
997 thyroid hormone is responsible for: protein synthesis, inc activity of Na-K ATPase pump
to inc O2 consumption, stimulate secretion of growth hormone
998 muscle regidity is one of parkinsonism symptoms
999 minoxidil is assoc with reflex tachycardia, as hydralazine
1000 corticosteroids and estrogen caused HTN while ranitidine does NOT
1001 1% adrenaline gives short rapid mydriasis but chronically dec IOP by inc aqueous humor
outflow
1002 caffeine is of methylxanthines
1003 Coon's : inc of hyperaldosteronemia
1004 thiazide SE is gout induction
1005 glutithimidine is MAO inducer
1006 percentage of chlorbutol used as preservative in eye drops is 0.5%
1007 dipenoxylate is related to meperidine and activate opiate center in the GIT leading to
constipation
1008 TCA increase the action of MAOI - antidepressants : TCA , MAOI , alpha blockers -
tranyl cypromine is a MAOI - amphetamine , phenyl ephrine , ephedrine, tyramine + MAOI =
hypertensive crisis

1009 stearic acid + KOH = soap

1010 normal hypnotic dose of chloral hydrate= 3-2 gm
1011 mineral oil: antioxidant is added to prevent peroxide formation, mixture of hydrocarbons
obtained from petrolatum, immiscible with castor oil, immiscible with alcohol, specfic gravity is
more than 1
1012 hemoglobin quantity in 100 ml blood is 15g
1013 xerostomia: dryness of mouth
1014 succinylcholine should be taken with caution in pts taking phospholine
1015 silica: # moisture deterioration of drugs
1016 the metabolism of folic acid is altered in pts taking in anticonvulsant drugs
1017 morphine cause constipation
1018 chlorpropamide is given once daily

43
1019 most important worm in children is Oxyuris (pin worm) ttt by mebendazole (as ascaris
ttt)

1020 pseudoephedrine is used with caution with iproniazide

1021 sulfamethoxypyridine is long acting as it is highly bound to plasma protein
1022 oily antioxidants:: BHA:butylated hydroxy anisol , tocopherol, BTH: butylated hydroxy
tolwene, ascorpyl palmitate, propyl gallate
1023 Na/K acid phosphate : dec urine pH : inc methenamine activity
1024 slow acetylators develop rapid neuropathy with INH
1025 diflunisal : prodrug
1026 actazolamide increase K secretion , diuretic , carbonic anhydrase inhibitor , cause
systemic acidosis and urine alkalosis , ttt of systemic alkalosis
1027 alcohol, sildenafil: vasodilators thus C.I. with NTG
1028 2ry alcohol is oxidized to ketone - 1ry alcohol is oxidized to aldehyde
1029 tetracyclines side effects : renal damage , hepatic damage , tooth discolouration
1030 calamine lotion consists of ZnO and ferric oxide
1031 trazodon is TCA with least anticholinergic SE
1032 sulindac: NSAID
1033 pt allergic to penicillins sould not take carbapenems
1034 release of glucorticoids is under the control of : circulating cortisone level in blood,
hypothalamus which release corticotrophin releasing factor by feed back mechanism.
1035 high protein bound drugs: warfarin, clofibrate, salicylates, barbiturates, sulfonamides,
tolbutamides
1036 suxamethonium is short acting depolarizing skeletal muscle relaxant
1037 spironolactone
1038 normal CrCl: 80-120 cc/min
1039 phenol salts are conjugates or methylates - conjugated with glucuronic acid
1040 vitamin C is metabolized to oxalic acid
1041 cimetidine is C.I with theophylline, phenytoin, warfarin, carbamazepine

44
1042 physostigmine: short acting anticholinesterase used in the ttt of primary open angle
glaucoma and for emergency ttt of angle-closure glaucoma -- neostigmine is similar in action to
physostigmine
1043 griseofulvin is antifungal which is not used topically
1044 reduction in particle size do NOT show difference in Xray
1045 Na lauryl sulfate is incompatible with cetrimide BUT compatible with icthamol
1046 pyrogens: bacterial byproducts cause febrile reaction
1047 B-bloclers C.I. with asthmatic pts.
1048 thiopental is highly lipid soluble that is cross BBB
1049 hypoproteinemia cause edema
1050 didanosine: longest duration, least BMD
1051 migraine is due to celebral vasodilation
1052 SE of MAOI is tachycardia
1053 AlCl3 is locally applied antiprespirant because it precipitates proteins and dec excretion
1054 CHF inc creatine phosphokinase (CPK)
1055 metabolism of a drug results in a more polar compound
1056 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 action as PZI because XSS protamine will bind
to regular insulin and convert it to PZI
1057 timolol dec aqueous humor formation thus dec IOP BUT has NO effect on pupil size or
aqueous humor outflow
1058 carbamazepine is used for the ttt of trigeminal neuralgia
1059 digoxin soft gelatin capsules give greater bioavailability than tablets
1060 dihydroergotamine is not taken sublingually (IV) but ergotamine tartarate is taken
sublingually and orally
1061 Na lactate dec toxicity of quinidine
1062 tyrosine is precyrsor of thyroxin
1063 epson salt: MgSO4 -- gilbert salt: Na2SO4 -- russel salt: KH tartarate
1064 with levodopa we give domperidone to counteract dopaminergic GIT SE
1065 INH cause neuritis on prolonged use on slow acetylators

45
1066 procaine is so liable to destruction by heat
1067 advantage of usage of dopamine in cardiogenic shock is that it produce dose dependent in
in cardiac output and renal perfusion
1068 cimetidine # HME
1069 the cause of osteogenesis is genetic defect
1070 TCAs are contraindicated in glucoma and it cause sedation and anticholinergic side
effects
1071 inc partition coefficient: improve passive absorption of a drug
1072 tolbutamide is totally metabolized to inactive form
1073 trypsine and lipase inc in pancreatic disease
1074 meningitis: N.meningitidis -- H. influenza -- strept. Pneumonia, E-coli
1075 in asthma there is no increase in cAMP
1076 stomatitis is inflammation of the oral mucosa
1077 etarnecept: parentrally used for rhematoid arthritis NOT for osteoarthritis
1078 thiazides cause hypokalemia
1079 zolpidem: fast onset, short duration hypnotic
1080 antacid should be taken 1 hr before CPZ or 2 hrs after
1081 BMD leads to agranulocytosis
1082 olive oild + lime water= Ca oleate (emulsifier)
1083 trimethobenzamide : antiemetic # CTZ
1084 ketamine HCl (ketalar, ketaject): nonbarbiturate anesthetic, IM, IV, used for both
diagnostic and minor surgical anesthesia
1085 acidification of urine increases excretion of alkaline drugs like amphetamine as
ionization increases thus reabsorption decreases
1086 captopril is ACEI
1087 TCA is C.I. with guanthedine

1088 methotrexate + salicylate = bone marrow depression

1089 wool fat (anhydrous lanolin) -- lanolin contains more water than wool fat (anhydrous
lanolin)

46
1090 prodrug is an inactive form of the drug
1091 phospholine iodine is stored at 2-8 C
1092 pancreatitis is characterized by inc amylase level
1093 thermolabile sterilization technique using aseptic technique by 0.22 microne filter
1094 salbutamol, acute asthma -- Na chromoglycate: allergic asthma -- corticosteroids,
seasonal asthma
1095 carbamazepine is the drug of choice for the ttt of trigeminal neuralgia
1096 currently, all commertially available insulin no more than 25ppm proinsulin

1097 Vd of drug inc if amount of drug bound to plasma proteins dec

1098 SE of cyclobenzaprine is similar to amitriptyline --- cyclobenzaprine is a central skeletal
muscle relaxant structurally related to TCAs
1099 disulfuram # oxidation of ethanol to acetic acid
1100 staph. Aureus: bone infection -- clostridium difficile: pseudomembranous colitis -- E-
coli: UTIs, meningitis -- proteus mirabilis: UTI, Ps. Auroginosa -- treponema pallidum: syphilis
1101 uricosuric agents increase excretion of uric acid like probenecic, sulphipyrazone BUT
NOT allopurinol
1102 respiratory depression cause death in cocaine poisoning
1103 aminophylline is theophylline ethylenediamine
1104 NaHCO3 : ttt of lactic acidosis , ampoules sterilized by ultrafiltration , ttt of acidosis (
cardiac arrest )
1105 theophyllin is potentiated by erythromycin , O.C , cimetidime , ceprofloxacine , influenza
vaccine - inhibited by rifampin , carpamazepine , phenytoin
1106 pindolol: non selective B blocker with intrinsic sympathomimetic activity-- minoxidil:
vasodilator -- enalapril:ACEI -- guanabenz: centrally acting alpha2 agonist
1107 erythropoietin is a glucoprotein secreted by kidney to increase production of RBCs
1108 clarithromycin is active against : mycoplasma chlamydia, legionella, helicobacter pylori
1109 PH of skin is 5.5
1110 Na heparine is obtained from beef lung
1111 regular insulin=lispro insulin its duration of action is less than 12 hrs
1112 polydipsia=escessive thirst

47
1113 dose of chlorothiazide is 500 - 2000 mg / day
1114 thyroid hormone: dec vit K dependant clotting factors thus potentiate warfarin
1115 neostigmine does not cross BBB but physostigmine crosses BBB
1116 patients on propranolol and metoprolol having nightmares may shift to more hydrophyllic
B-blocker like atenolol or nadolol
1117 synergism between sulfamethoxazole and trimethoprim is because they block sequential
steps in folic acid synthesis pathway preventing DNA syn
1118 aminoglycosides are effective against pseudomonas infection BUT chloramphenicol is
not
1119 bradykinins increase vascular permeability to release PGI2 to relax smooth muscles

1120 piroxicam has a long t1/2: 36hrs

1121 benzalkonium chloride is a cationic germicidal SAA
1122 glyceryl trinitrate ( nitroglycerine ) is venules dilator - Na nitroprusside is arterular and
venular dilator - arterular dilators : daizoxide , minoxidil , hydralazine .
1123 vitamin E is called tocopherol used as antioxidant found in nut
1124 tophus is gout
1125 phenytoin is taken as a single daily dose or as 3 divided doses
1126 hypoglycemia: tachycardia, sweating --- hyperglycemia: acetone odor in breath, ketones
in urine
1127 endometriosis: menstrual like bleeding with pain and inflammation, ttt by danazole
(androgen)
1128 ringer soln: NaCl + KCl + CaCl2 + H2O
1129 measels vaccine is given to 1 y child
1130 the base used with hydrocortisone is simple ointment or soft parafin
1131 edta chelates Ca , Pb -- BAL :arsenic, gold, copper.
1132 high cortisone intake may lead to moniliasis
1133 polymorphs differ in: melting point, solubility, dissolution rate, desitym, stability BUT
NOT Ph
1134 thiopental sod is ultra short acting general anesthetic due to its high lipid solubility
1135 primary site of action of K-sparing diuretics is distal tubules

48
1136 lidocaine SE: malignant hyperthermia, CNS toxicity, tinnitus, blurred vision, parathesia,
tremor, dizziness, disturbed hearing

1137 phenol is metabolized as phenyl glucuronide

1138 plasma vol = 55ml/ kg body weight
1139 hemoglobin quantity in 100ml of blood is 15g
1140 introduction of halogen to acids inc acidity
1141 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
1142 chlorpromazine SE: agranulocytosis (Michael : not sure about that I think
agranulocytosis is more associated with carbamazepine rather than chlorpromazine)
1143 atropine is antidote for anticholinesterase amd selectively block muscarinic receptors
1144 comparing with hysrocortisone: prednisolone shows higher activity because it differs in
conformation at ring A
1145 creatinine clearance is used to assess the hepatic function with normal value 75-
120ml/min
1146 pyrogen causes fibrile reaction
1147 HCTZ interacts with digoxin and lithium --- HCTZ inc Na excretion so leads to Li
toxicity --- HCTZ inc K excretion so leads to digoxin toxicity
1148 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
1149 oliguria= dec urine excretion
1150 SE of ACEIs: angioedema ( swollen lips)
1151 sucralfate is not absorbed from the GIT
1152 increase partition coefficient of drug = increase passive absorption
1153 ampicillin and insulin are stored at 2-8 C but not freezed
1154 phenyl mercuric nitrate 0.002% is eye drop preservative
1155 mineral oils are not miscible with alcohol, chloroform, ether, benzene
1156 lice can infest man , dog
1157 IV inf: saline, Na nitroprusside, vancomycin, KCl
1158 essential amino acids must be supplied with diet
49
1159 cause osteogenesis is chromosomal --- cause of osteoporosis is estrogen deficiency
1160 promethazine is used with meperidine to relieve post-operative pain, inc its analgesic
effect
1161 ceftraixone, cefotaxime: cross BBB: ttt of meningitis
1162 chlorpromazine bioavailability is increased when taken parentrally IM
1163 CNS mediators: acetylcholine, serotonin, dopamine, noradrenaline BUT c-AMP is not
1164 avoid metronidazole with alcohol = disulfiram like reaction
1165 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
1166 warfarin is safe to be taken with allopurinol
1167 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
1168 gentamicin causes deafness due to auditory and vestibular damage
1169 bradykinins increase vascular permeability to release PG12 to relax smooth muscles
1170 moset suitable oral sulfisoxazole is acetyl sulfisoxazole
1171 suitable elderly dose is 1/3-1/2 of the adult dose
1172 bicyclic antidepressants; viloxine -- TCA: maprotiline, menserine
1173 folic acid with iron is used for folate deficiency in pregnant women
1174 pt on haloperidol should not take alpha methyl dopa or alcohol
1175 sibutramine: # reubtake of NE, S, D
1176 needle with smallest diameter carry the greatest number
1177 refractiometer depend on density
1178 ficks law of positive diffusion
1179 doxorubicin causes cardiac cumulative toxicity
1180 digitalis + furosemide + K -- we use K to decrease digitalis toxicity
1181 metronidazole is C.I. with alcohol
1182 low diameter of needle: high gauge number
1183 cyclophosphamide SE is hemorrhagic cystitis which is ttt with mesna

50
1184 tamoxifen is antiestrogen
1185 aspirin should not be taken with coumarin
1186 MOA::: sulfonamides # growth by competitive antagonism -- cephalosporines,
penicillins: # cell wall synth -- polymixin, nystatin, amphotricinB: # cell membrane function ---
macrolides, TC, chloramphenicol: # protein synthesis
1187 atropine (d,l hyoscyamine is more potent than d-hyoscyamine) (L isomer is 100 times
moe potent than D isomer
1188 grandmal epilepsy: Na valproate, phenobarbital, diphenyl hydantoin, primadone ---
petitmal epilepsy: ethosuximide. Chlorzepam. Trimethadione, Na valproate
1189 amiodarone cause occular, sight problems
1190 greatest drug concn gradient between blood and tissue will occur when drug is
administered by IV bolus

1191 drugs that cause iatrogenic HTN: TCA, O.C., clonidine withdrawal, corticisteroids
1192 nigh nitrite indicate bacteria in urine
1193 patients taking Li carbonate is advised not dec Na intake -- Li is C.I. with
naturetics/diuretics
1194 Na chromoglycate is used for seasonal allergy as mast cell stabilizer
1195 hypertensive pts should not use carbinoxolone
1196 verapamil is C.I. with: digoxin, Ca, disopyramide (48 hr spacing)
1197 after vomiting alkalosis occur due to HCl loss-- after diarrhea acidosis occur due to
HCO3 loss
1198 tubocurarine should not be taken in pts on gentamicin
1199 normal blood glucose level: fasting=100-110mg/dl or <6.1mmol/L -- random=70-
126mg/dl or3.9-6.9 mmol/L
1200 advantage of naloxone over nalorphine is lack of agonistic action
1201 pain of angina is due to ischemia of certain area of the myocardium
1202 SE of ketoconazole is gynecomastia and hepatotoxicity
1203 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
1204 clomiphen citrate is used clinically to ttt infertility --- tamoxifen citrate is used primarily
to ttt estrogen-dependet neoplasms

51
1205 lignocaine is long acting because it has amide structure BUT procaine is NOT
1206 folinic acid is antidote for MTX --- MTX is folic acid analogue used in leukemia
1207 dronabinol: antiemetic, appetite stimulant
1208 areas and diseases::: cushing syndrome: adrenal cortex, Stein-leventhal syndrome:ovary
1209 rifampine cause damage to contact lenses , urine discolouration
1210 fluphenazine deconate in given IM
1211 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
1212 soap is formed by reaction of inorganic base with organic acid
1213 calamine lotion = ZnO + ferric oxide
1214 ketoconazole: ttt of systemic candidiasis -- ranitidine: ttt of peptic ulcer (PU) -- Na
valproate: ttt of absence seizures -- theophylline: ttt of asthma
1215 zafirlukast # SRSA
1216 Na phenobarbital ( enzyme inducer ) affect OC
1217 nirtrazepam is NOT use in the ttt of insomnia in elders
1218 intermittent IV therapy is used to: avoid anticipated stability or comptability problems,
dec the potential of thrombophlebitis, better diffusion of some drugs into tissues
1219 hyperhydrosis: excessive hydration or sweat -- hypersthesia: excessive sensitivity of skin
--- lethargy: sleepness -- polyphagia: inc appetite -- pyuria: inc pus in urine
1220 adrenaline is given with local anesthetics to enhance their action by vasoconstriction
1221 how can you detect that a certain drug accumulates in tisse: when Vd is > 1L/Kg
1222 creatinine, inulin: measure GFR
1223 Na: the cation most prevalent in the extracellular fluid -- K: the cation prevalent in the
intracellular water
1224 causes of osteoporosis: hyper cortisone secretion, hypoparathyrodism, drop in estrogen
level
1225 salicylates cause: metabolic acidosis, alkaline diuresis, electrolyte imbalance, GIT
bleeding (ttt vit K+ fresh frozen plasma)
1226 large surface area of small intestine enhance absorption
1227 MTX is clinically used for psoriasis and RA and leukemia
52
1228 sotalol B-blocker antiarrythmic causes torsades de pointes
1229 penicillin should be administered on empty stomach
1230 sphingomyelin: building unit of nerve
1231 KI is used as enteric coated tablets to decrease irritation
1232 all the following drugs are used to treat open angle glaucoma carbachol, physostigmine,
neostigmine, demecarium
1233 mebendazole is anthelmentic
1234 sodium thiocyanate affect iodine uptake

1235 MAOIs in C.I. with guanithidine

1236 insulin lente actes for 24 hrs
1237 griseofulvin , nitrofurantoin are given after meals --- penicillins, tetracyclin, rifampin are
given before meals
1238 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
1239 symptoms of disulfuram reaction: throbbing headache, sweating, chest pain,
hyperventilation, weakness, vertigo, blurred vision, BUT NOT severe diarrhea
1240 parathyroid deformation affect absorption of Ca

1241 hypoglycemia: tachycardia, sweating --- hyperglycemia: acetone odor in breath, ketones
in urine
1242 anaphylactic reaction occurs after second exposure to antigen
1243 MAOI + cheese=cheese reaction=hypertensive crisis due to tyramine content which
increase norepinephrine concentration
1244 acrarbose #
1245 K is used with digitalis to avoid toxicity
1246 MTX is considered immunosuppressant
1247 hansen: leprosy
1248 ACEIs cause hyperkalemia so C.I. with spironolactone.. And can be taken with thiazide
diuretics
1249 epotein alpha : inc RBCs
1250 ethacrynic acis is used in pts with sulfa allergy
53
1251 indomethacin is contraindicated with HTN as it cause frontal headache - indomethacin
cause Na and H2O retention - epinephrine , nitrates cause throbbing headache

1252 measels vaccine is given to 1 year old child (12-15 month)

1253 agranulocytosis is caused by: chloramphenicol, carbamazepine, carbimazole, novalgin
(metimazole) sulphonamides, clozapine, ACEIs
1254 promethazine is antihistaminic, antimotion sickness
1255 psoriasis: silvery gray scales
1256 aluminium chloride is antiprespirant
1257 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 3,5cAMP
BUT by activation of adenylcyclase
1258 Li, amiodarone: interfer with thyroid gland function
1259 central vein is used for infusion of hypertonic solutions, postoperative hydration, poor
access to peripheral veins
1260 leflunomide (immunomodulator, antiinflammatory used in the ttt of rheumatoid arthritis)
: pregnancy category X
1261 amiodarone cause photosensitivity
1262 phenylbutazone is used for gout 7%
1263 TCA dec active reuptake of seretonin, norepinephrine
1264 vit C inc iron absorption
1265 thyroxine secretion from thyroid gland is regulated by iodine level in blood
1266 sulphonamides must have a nonsubstituted aromatic amine essential for antibacterial
activity (metabolized by acetylation)
1267 charcoal can not adsorb FeSO4, CN, boric acid, DDT
1268 INH is metabolized by acetylation
1269 allopurinol # xanthine oxidase
1270 amlodipine : least reflex tachycardia
1271 ascorbic acid is a lactone structure
1272 schilling's test: pernicious anemia
1273 gyrogen causes febrile reaction

54
1274 digitoxin metabolism: bound to serum albumin in liver -- digitoxin is best oral form and
used in renal impairment because it is excreted by liver

1275 vidarabin is used in the ttt of herpes simplex encephalitis

1276 HCTZ and hydralazine: most probably antihypertensive of choice in pt with severe
depression
1277 the bromsulphalein (BSP) excretion test is a measure of thyroid function
1278 antimony potassium tartarate is used as: antiemetic, anthelmentic
1279 remove Ca ions, add citrate salts to prevent blood clotting taken from volunteer
1280 quinine is an optical isomer to quinidine
1281 activity of phenol inc with increasing temperature
1282 Li and amiodarone both interfer with the function of the thyroid gland
1283 alprostadil is used in ductus arteriosus
1284 dose limiting SE of nicotinic acid: flushing of skin (itching) due to inc PG so give it with
aspirin
1285 theophylline is C.I. with cimetidine
1286 acetazolamide caused metabolic acidosis and urinary alkalosis
1287 indomethacin SE: Na and water retention, hyperkalemia, aplastic anemia
1288 chlorpromazine has longer duration when given IM
1289 body placed in hypertonic solution will dec in size
1290 oils, fats, powders are sterilized by heat at 160 DC for 2 hrs
1291 protamine Zn insulin has duration of action on 36 hrs
1292 serum creatinine clearance = 0.6-1.2 mg/ dL
1293 suxamethonium is a short-actine skeletal muscle relaxant ( depolarizing )
1294 digitalis is C.I. with Ca (displaces K: toxicity)
1295 thiopental = ultrashort acting barbiturate
1296 the part of ear responsible for balance is the inner ear
1297 gentamicin enhances nephrotoxicity of ethacrynic acid
1298 d-propoxyphene has 1/2 analgesic activity of codeine

55
1299 aromatic esters are: benzocaine, tetracaine, procaine -- aromatic amides are: lidocaine,
bupivacaine, mepivacaine

1300 M.O.A. of B agonist: inc c-AMP by activation of adenylcyclase

1301 refractiometer depend on difference in density between 2 substances
1302 a unit dose package: one that contains the exact dose of drug ordered for a given pt
1303 anions SAA are compatible with icthamol ans econazole nitrate
1304 e-coli: traveller's disease, treated by bismuth subsalicylate
1305 volatile oil is rich in terpentine

1306 bile conjugation ocurs in liver

1307 propranolol is used with hydralazine to control tachycardia caused by hydralazine
1308 hyperkalemia leads to :: bradycardia, paralysis, paresthesias --- hypokalemia leads to::
dry mouth, tachycardia, muscle cramps
1309 erythromycin + aminophylline= inc level of aminophylline so dec aminophylline dose by
25%
1310 allopurinol, alcohol, propranolol, cimetidine: inc theophylline
1311 pyuria=pus in urine
1312 normal adult dose of salbutamol is 1-10 mg
1313 sulindac is prodrug (sulphoxide is reduced to the active sulfide) more active by prodrug
1314 portagen is dietary product used in the ttt of steatorrhea
1315 phenothiazines SE is parkinson like
1316 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
1317 phenylbutazone has longest t1/2 (100 hrs), cause blood dyscrasias, also displace some
drugs from plasma proteins
1318 venoclysis is assoc with IV infusion
1319 antipseudomonal penicillins: carbenicillin, ticarcillin, mezlocillin, piperacillin
1320 radial walker test: disinfectant and germicidal action
1321 ttt of alzeheimer: tacrine (cholinesterase inhibitor), donepezil
1322 thiazide diuretics dec excretion of uric acid

56
1323 weak acids and bases are more absorbed from the small intestines due to large surface
area, most drugs are from the duodenum

1324 bacteriuria: greater than 100000 bacteria/ml

1325 smocking inc metabolism of theophylline
1326 1% adrenaline = short rapid mydriasis
1327 thiopental is highly lipid soluble thus cross the BBB
1328 thiazide diuretics enhance the action of amphetamine
1329 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

1330 Na polystyrene is a cation exchane resin used in excretion of K

1331 nitroglycerine mainly dec preload
1332 carbachol is used as a replacement when resistence or intolerence to pilocarpine occurs
1333 semithicone is antacid antifoaming agent
1334 pregnancy: X , D , C, B , A
1335 benzylperoxide (antiacne)= should not come in contact wirh eye or mucous membrane
1336 penicillin is excreted by tubular secretion from kidney but aminoglycosides by GF
1337 vitamin C is aromatic carboxylic acid
1338 atropine is sol in acids
1339 vincristin: only IV, little BMD
1340 metachlorpropamide is antiemetic
1341 sweat function: water excretion, Na excretion, temperature regulation
1342 lymph glands filter out solids by phagocytosis
1343 methotrexate is effective in the ttt of psoriasis
1344 fibrinolytic in MI is C.I. in duodenal ulcer pts
1345 dose of aspirin in rheumatic fever: 6g --- dose of atropine: 0.2-2 mg --- dose of
chlorothiazide: 0.5-2g
1346 fenoldopam ( D1 agonist) : ttt of HTN
1347 theophylline SE : NV, anxiety, tachycardia, tremors

57
1348 tranyl cypromine is MAOI antidepressant
1349 methylparaben is ester of parahydroxybenzoic acid
1350 Li: ttt of severe bipolar manic depression psychoses --- SE: D. insipidus
1351 long residence of CO2 in body= inc pCO2 (hypoventilation)= dec HCO3=lactic acidosis
1352 cisplatin SE: proximal renal tubular damage
1353 sod. Chromoglygate: mast cell stabilizer used for asthma prophylaxis
1354 nitofurantoin is useful against g+,-ve UTIs, more effective in acidic urine
1355 sloven used with HCTZ injection is propylene glycol
1356 spectinomycin is used for ttt of gonorrhea in pts with sensitivity to penicillin or with
resistent gonococci
1357 eutectic mixture: mixture of chemicals in which they melt (liquify) at a temperature lower
than their melting points (menthol + camphor + phenol)
1358 pt taking pargyline and have common cold should not take phenylephrine HCl
1359 drugs excreted by passive tubular reabsorption = aspirin, amphetamine
1360 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
1361 toxicity of thiazides is due to decreased blood volume
1362 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)
1363 cholestyramine interfers with GIT absorption of : chlorothiazide, warfarin, digoxin, TC,
phenylbutazone, phenobarbital
1364 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
1365 SR tablets are swallowed as a whole
1366 dolasetron C.I. with : hypokalemics, hypomagnesemics, antiarrythmics
1367 thiazide cause hypercalcemia(so good in osteoporosis on chronic use in elderly pts)
hyperlipidemia
1368 Bear's Lambert's law relate the absorption of light by solution to wave length
1369 decay of radioactive atom occurs at 1st order reaction

58
1370 dithranol 0.1% : for psoriasis ttt topically is better stabilized in ZnO pastes by addition of
2% salicylic acid

1371 ascorbic acid acidifies the urine

1372 drug induced neonatal jaundice is ttt with phenobarbital
1373 doxycyclin (vibramycin) : ttt of acne
1374 allopurinol is NOT taken with tea
1375 phenol + mentol + camphor = eutectic mixture
1376 dose of aspirin in rheumatoid arthiritis is 6 gm

1377 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
1378 t1/2 in 1st order kinetics is not affected by drug concentration
1379 use of vitamine E in deodorants is antioxidant
1380 inc P CO2 is the most potent respiratory stimulant
1381 osteoarthritis is a degenerative disease
1382 dysarthria: difficulty of speech
1383 HCTZ + prpranolol = dec edema
1384 drugs that may cause diabetes insipidus: Li, amphotricin B, demeclocyclin --- ttt by ADH
1385 suxamethonium is short acting depolarizing seletal muscle relaxant
1386 dose of digitalis is 0.125 - 0.25 mg daily
1387 charcoal is decolorizing agent and adsorbing agent in toxicity
1388 vitamin B12 contains cobalt
1389 morphine toxicity cause constipation NOT diarrhea
1390 acetohydroxiamide acid is used as adjunctive therapy for UTI
1391 ocusert pilo-20: pilocarpine 20mcg/hr -- ocusert pilo-40: 40mcg/hr -- each enough for 1
week

1392 anionic SAA is compatible with econazole nitrate and icthamol ex: Na lauryl sulphate
1393 vit B1 (thiamine) is heat labile
1394 MAOI SE is NOT tachycardia BUT it is the SE of TCA

59
1395 early morning symptoms of stffness, regidity: benztropin mesylate
1396 hypersensitivity::: I: IgE -- II: IgM, IgG : organ specific -- III: non organ specific -- IV:
T-cells
1397 risk factors of athersclerosis: smoking, family history, HTN, hyperlipidemia, BUT
rheumatic fever is NOT RELATED
1398 ritodrine: tocolytic, # oxytocic, relax uterine muscles
1399 tetanus toxoid booster dose every 10 years
1400 advantage of loperamide over lomotil as antidiarrheal is that loperamide dose not have
opiate like effects
1401 drug accumulation in tissue is related to Vd

1402 vtamin B6 is a detoxifying agent esp: alcohol and phenytoin

1403 advantage of peroxicam over other NSAIDs is that it is given once daily -- naproxen :
twice daily
1404 the highest count in plasma cells is erythrocytes
1405 labetalol is non selective adrenergic antagonist
1406 myopia: nearsightedness -- myalgia: pain in a muscle --myocardia pertains to the heart
muscle -- myoclonus is muscular twitching or conraction -- myositis iis inflammation of a
voluntary muscle
1407 grandmal epilepsy: Na valproate, phenobarbital, diphenyl hydantoin, primadone ---
petitmal epilepsy: ethosuximide, chlorzepam, trimethadion, Na valproate

1408 sterilization of parentrals , oils by dry heat at 170 C for 2 hrs

1409 lomotil should not be taken with clindamycin because toxic effects of clindamycin may
be enhanced
1410 propylthiouracil is better than carbimazole because it blocks peripheral conversion of T4
to T3 beside inhibition of T4,T3 synthesis
1411 reduction of particle size do not show difference of disintegration
1412 metabolized by acetylation: sulfonamides, INH, procainamide
1413 antacids: inc L-dopa absorption

1414 phenlphthalin, castor oil used as intestinal irritant (stimulant laxative)

1415 vitamin A is important for reproduction in man NOT vitamin E
1416 steven johnson syndrome: SE of sulfisoxazole

60
1417 blood makes 1/15 of body weight
1418 vit K: phytonadione: ttt of hemorrhage
1419 cetomacrogel is incompatible with tannic acid, NH4 salts, phenol
1420 soluble vit A is used in the form of veg. oil
1421 thiazides dec HTN by dec blood volume
1422 major respiratory volume is determined by vital capacity
1423 theophylline t1/2 dec in smokers
1424 SE of ACEIs is dry cough
1425 MO which is dangerous to eye is Pseudomonas aeruginosa
1426 rifampicin cause descoloration of lens, urine, sweat
1427 kwashiorkor: malnutrition
1428 Li is used in bipolar affective disorder
1429 aluminium hydroxide in C.I. with tetracyclines
1430 function of vagus:: regulate heart rate
1431 malathion is an organophosphorus compounds
1432 danazole ttt of endometriosis

1433 most volatile oil is menthol

1434 related to body muscles: myalgia, myocardia, myoclonus, myositis BUT NOT myopia
1435 stool softeners frequently anionic surfactant which is dioctyl Na sulfosuccinate =
docusate Na
1436 syphilis ttt: penicillin G, quinolone, chloramphenicol
1437 insulin secretion dec K level in blood
1438 non ionic cetomacrogel is compatible with: salicylic acid, camphor, KI BUT NOT with:
phenol

1439 safe diuretic with sulfonamide sensitivity is spironolactone, ethacrynic acid

1440 cyclophosphamide, methotrexate = total BMD
1441 nelfinavir (cross BBB) # protease
1442 phenobarbital is used to treat drug-induced neonatal jaundice

61
1443 alteplase is thrombolytic agent
1444 barbiturates:::: long acting: phenobarbital -- intermediate: amobarbital, butabarbital --
short: pentobarbital, secobarbital -- ultrashort: thiopental
1445 stability of emulsion depend on method of agitation
1446 gentamicin is active bactericidal against G-ve
1447 cholinergic crisis may be observed in M. gravis
1448 dicloxacillin=penicillinase resistant
1449 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
1450 systole= heart contraction
1451 long term androgen ttt= hepatic carcinoma, edema, testicular atrophy
1452 hypoprothrombinemia: dec ability of blood to clot -- to reverse hypoprothrombinemia:
adm. Fresh blood plasma
1453 the outer waterproof layer of skin in made of keratin
1454 exophthalmus is seen in Grave's disease hyperthyrodism
1455 conformation isomerism: it's orientation of molecules which result from rotation of atoms
about bonds, called rotamers
1456 K is nor present in dry fruits
1457 warfarin has optical isomers
1458 the glucocorticoid with highest potency is dexamethasone
1459 phenbarbitone is metabolized in liver by CYP450 then oxidation then conjugation
1460 TCA increase action of MAOIs
1461 B-lactamase is a plasmid mediated enzyme
1462 phenytoin SE is gingival hyperplasia, ataxia, hirsutism
1463 ischemia: deficiency of blood in a part of the body -- myocardial ischemia: deficiency in
blood supply to the heart muscle --- icterus: jaundice
1464 erythropoiesis is the stimulation of RBC formation from bone marrow
1465 haloperdoil, vit B6: are C.I. with parkinsonism
1466 retinol: reproductive -- retinal: visual -- retinoic: epithelial

62
1467 SE of MAOI is tachycardia
1468 Na metabisulfite is an antioxidant
1469 smallpox vaccine must be stored at 0 C (freezed)
1470 sulfa drugs are not liable to destruction by heat
1471 heparin is the anticoagulant of choice in pregnancy because it does not cross the placenta
1472 speed of blood is more in arteries than in arterioles
1473 cholestatic jaundice is a SE of: erythromycin estolate, chlorpromazine, chlorpropamide,
TCA, trazodone, sulindac, methyldopa

1474 hydralazine SE is a syndrome resembling SLE

1475 fat sol vitamins: ADEK
1476 aspirin should NOT be taken with coumarin
1477 phentolamine: diagnostic agent for pheochromocytoma
1478 nystatin # candida albicans -- griseofulvin # tinea capitis -- streptomycin # TB --
penicillin G# gonococci -- dapsone # leprosy
1479 cyclopentolate 1%, tropicamide 3hrs duration shorter than atropine (2 weeks)
1480 bile acids act by fat emulsification
1481 lefenalac is a dietary product used in pt with phenylketonuria
1482 tubocurarine should not be taken with gentamicin
1483 the antihypertensive effect of guanethidine is inhibited by amitriptyline
1484 metoclopramide is administered before aspirin to inc gastric emptying and inc aspirin
absorption
1485 quinidine inc levels of:: digoxin, warfarin, nifedipine, haloperidol, procainamide
1486 patient taking aspirin should avoid probenecid
1487 vitamin H: biotin: ttt of skin disorders
1488 antidepressants : TCA , MAOI , alpha blockers
1489 Zollinger-Ellison syndrome: marked hypergastrinemia, gastric hypersecretion, peptic
ulceration caused by a gastrin producing tumor of pancreas or duodenum wall
1490 glutamic acid (+ glutamic acid decarboxylase + vitamin B6) = GABA ---- deficiency of
vitamine B6 : dec GABA, inc glutamic acid

63
1491 tocainide (antiarrythmic) SE: pulmonary fibrosis, blood dyscrasias
1492 lyophopic colloids:: inorganic particles: Au, Ag. Small electrolyte concn: pptn,, inc concn
of particles: constant viscosity
1493 if a pt has hypersensitivity the the diagnostic lab test can be done is complete blood
picture and differential WBCs
1494 acetazolamide causes urine alkalinization
1495 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
1496 haloperidol is NOT used in parkinsonism
1497 propylthiouracil is the best antithyroid
1498 chlorpromazine causes extrapyramidal effects
1499 FSH, LH reach highest levels during ovulation
1500 warfarin, dicumarol both have coumarine structure thus have anticoagulant activity
1501 ticarcillin is preferred than carbenicillin because it is given in smaller doses
1502 65% sucrose: # microbial growth
1503 loteprednol : ttt of allergic conjunctivitis
1504 normal blood sugar concn in fasting adult is 100mg/dl
1505 jacksonian epilepsy is associated with focal convulsions
1506 benzyl penicillin is used in pneumonia
1507 children 3-10 y have low acidity skin thus may have skin infection
1508 KOH + organic acid = soap
1509 thiazide dec glucose tolerance leading to hyperglycemia
1510 phenazopyridine is effective as urinary analgesic
1511 drugs used for psoriasis: MTX, cool tar 2%, salicylic acid
1512 pentamidine: ttt of PCP in HIV

1513 aldosterone is a mineralocorticoid

1514 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

64
1515 coadministration of kaolin with lincomycin cause impairment of lincomycin absorption
1516 RX containing: kaolin + aluminium + chalk= astringent
1517 qunine sulfate relieve night cramps
1518 outer layer of skin (stratum corneum) is made up of keratin
1519 -NH-NH- is present in MAOI structure phenelzine
1520 cyclic AMP is a 2ry messenger NOT a mediator in CNS
1521 SAA is added to tablets to act as a binder and adhesive and improve dissolution and
bioavailability

1522 erythromycin interacts with oral anticoagulants and inc levels of carbamazepine, digoxin,
theophylline
1523 MAOIs are : psychotropics, antidepressants, antileptics -- SE: hallucinations, tremors,
hyperthermia, anticholinergic SE., dry mouth, constipation, failure of ejaculation
1524 in antemenetic effect chlorpromazine is greater than promethazine which is greater than
fluperazine
1525 sulfonylurea mechanism of action:: stimulate insulin secretion
1526 sulfonamide must have a non substitute amino group essential for antibacterial activity
1527 piroxicam: ttt of morning stiffness
1528 streptococcus viridans: subacute bacterial endocarditis, ttt ampicillin + aminoglycoside --
- streptococcus pyrogens: throat, scarlet fever, rheumatic fever --- streptococcus fecalis
(enterococci F.): nosocomial hospital infection
1529 pt with angina and have hypertensive crisis should take Na niroprusside by slow IV
infusion instead of diazoxide because of its cardiostimulating effects
1530 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
1531 erythromycin structure is a macrocyclic lactone ring attached to a sugar moiety
1532 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
1533 ketoconazole, FeSO4 should not be taken with antacids

1534 insulin purity: content of proinsulin

1535 acid stable (oral) penicillins: ampicillin, amoxicillin, penicillin V, penicillin G Na and K
salts

65
1536 flurazepam is the benzodiazepin which has the least hypnotic effect and cause hangover
sedation as SE

1537 penicillamine is a chelating agent used in rheumatoid arthritis

1538 pentazocin: strong analgesic pain killer
1539 glucose cannot be detected or measured by the UV light because it shows no absorbance
in this range: 200-400 nm wavelength
1540 horizontal laminar flow is better than vertical laminar flow --- tests for it: DOP, smoke
test, microbial test
1541 dantrolene: centrally acting skeletal muscle relaxant -- SE: seizures --- baclofen,
orphenadrine, cyclobenzaprine: peripherally acting skeletal muscle relaxants
1542 propranolol incsease hypoglycemic action of insulin also masks the signs of
hypoglycemia

1543 universal antidote: charcoal + MgO + tannic acid

1544 parkinsonism: inc in Ach, dec in dopamine, assoc with muscle regidity
1545 advantages of timolol over pilocarpine is: longer duration of activity, no effect on visual
acuity or accommodation, little or no effect on pupil size
1546 indomethacin cause frontal headache
1547 loop diuretics cause dose related ototoxicity, alkalosis, hypokalemia
1548 chlorthalidone: 12.5-50mg with the longest activity, t1/2=40-65hrs
1549 acetyl + CoA + ATP = acetyl CoA + ADP ------ acetyl CoA + choline + cholinesterase =
acetlycholine
1550 ethylaminobenzoic acid (benzocaine): local, topical anesthetic, benzoic acid derivative,
rapidly hydrolized in boiling water, insoluble in water but soluble in mineral acids
1551 WBCs (leukocytes): basophils, eosinophils, monocytes, lymphocytes BUT NOT
reticulocytes (unmature RBCs)
1552 theophylline + ethylene diamine = aminophylline
1553 ph.ph with mineral oil is used as intestinal irritant
1554 acne vulgaris is made by bacterial inflammation

1555 fansidar (antimalarial) : sulfadoxime 400+ pyrimethamine 80 --- cotrimoxazole:

sulfasoxazole+ trimethoprime -- otitis media: erythromycin + sulfasoxazol
1556 anxiolytic drug with least sedative action: buspirone

66
1557 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
1558 1st choice for ttt of emergency hypotensive shock is dopamine
1559 oral drug absorption rate is affected by its dissolution not disintegration rate
1560 amitriptylline: ttt of depression with anxiety
1561 chlorpromazine inc 1 and 1/2 when given IM
1562 droperidol is used as adjunct to anesthetics
1563 PH is equal to pka at half neutralization point
1564 K used as SR ( wax matrix ) as it is very irritant to GIT
1565 propoxyphen has poor oral availability due to: poor release from dosage form,
metabolism in liver and gut wall, chemical degradation in dosage form
1566 generic= drug having same ingredient as the brand drug
1567 anionic surfactant like Na lauryl sulfate is compatible with icthamol
1568 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
1569 an ointment base is made of hydrocarbons

1570 blood volume=5-6 L

1571 oleic acid is monounsaturated fatty acid --- linoleic acid is polyunsaturated fatty acid
1572 antidotes:: B-blockers: epinephrine + glucagone (heart stimulant)-- CaCBs: IV Ca +
glucagone (heart stimulant)-- glucagone can only be given SC or IM but not IV
1573 methadone is a narcotic agonist
1574 propylthiouracil is preferred over carbimazole as antithyroid
1575 diethylether is used to prevent peroxide which is a toxic compound
1576 dug of choice for ttt of status epilepticus is diazepam
1577 nalidixic acid + phenothiazines = phototoxic reaction
1578 aminocaproic acid is used as antifibrinolytic agent , ttt of hemmorrhage due to
fibrinolytics
1579 hypoparathyrodism ttt : calcitriol, vitaminD --- hyperparathyrodism ttt: calcitonin,
vitaminD analogue
67
1580 examples of drugs that don't need dose adjustment in renal failure : linezolide, fosinopril,
digitoxin

1581 preservatives in eye drops as bacteriocidal: e.g. benzalkonium chloride 0.02%,

chlorohexidine 0.01
1582 piroxicam is used for morning stiffness
1583 exophthalmus is protrusion of the eye associated with hyperthyrodism, hyperplasia of
thyroid gland
1584 nystatine: ttt of moniliasis (candida albicans)
1585 muscle fatigue is due to lactic acid accumulation
1586 P450 inducers: phenobarbital, fifampin, alcohol, troglitazone, OC, phenytoin,
carbamazepine, prednisone
1587 dolasetron, ondansetron, granisetron : antiemetics
1588 vit B6: pyridoxine: used with INH to dec peripheral neuritis, inc extracellular metabolism
od levodopa, ttt of sideroblastic anemia, used with cyclizin for ttt of vomiting induced in
pregnancy
1589 Na normal level in blood=135-146 mmol/L -- K normql level in blood=3.5-5.5 mmol/L
1590 ethyl palmitate/ ethyl stearate are not SAA
1591 warfarin is active due to a specific sterioisomer
1592
1593 pka= -log of ionization constant which indiactes relative strength of acid or base
1594 TI= LD50/ED50
1595 initial plasma concentration after IV dose is affected by dose or clearance
1596 sterilization of contact lens by soaking in saline or preservative
1597 mebendazole is anthelmentic
1598 in HTN we do NOT use atropine
1599 acetycysteine is ineffective in ttt of paracetamol toxicity if taken after 12 hrs
1600 1gm protein= 4kcals -- 1gm carbohydrate= 4kcal -- 1gm fat= 9kcal
1601 mononucleasis + ampicillin therapy = rash
1602 benztropine is given with phenothiazines as benztropine is anticholinergic thus dec
extrapyramidal SE of phenothiazines

68
1603 reverse transcriptase inhibition: efavirenz, didanosine, zidovudine, stavudine, nevirapine,
abacavir, zalcitabin

1604 fick's law (diffusion) = dc/dt=D*S.A*(C1-C2)/L --- noyes whitney's law=

dc/dt=dc*S.A*(Cs-C)/h
1605 ephedrine is optically active , diastereoisomer
1606 steady plasma level depend on infusion rate
1607 sulfisoxazole causes kernicterus in neonates
1608 prazocin is not used as initial antihypertensive ttt
1609 sulfonamides SE: rash, fever, blood dyscrasias
1610 norethindrone is used in endometriosis -- danazole is used in endometriosis
1611 1,2 bezodiol formed by hydration of phenol
1612 children 3-10 years old have low acidity skin thus may have skin infection
1613 T-cells, B-cells : 1ry response # antigen
1614 SE:: hydralazine: SLE -- prazosin: 1st dose syncope -- guanethidine: orthostatic
hypotention, drug-induced inhibition of ejaculation
1615 cyanosis = bitter almond breath
1616 receptors of cough occur in medulla in the brain stem
1617 HgCl2: very water soluble --- BaSO4 is the least soluble
1618 pheny Hg nitrate 0.002% is eye drop preservative bacteriostatic
1619 corticosteroids in asthma inhibit release of mediators, dec immune reaction
1620 myxedema is decreased secretion of thyroid hormone in adulthood
1621 clotrimazole, nystatin: ttt of candidiasis
1622 racemic mexture is optically inactive because it contains equal amounts of D and L
stereoisomers
1623 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
1624 thiazide + methyldopa = to relieve salt and water retention
1625 diflunisal is not metabolized into salicylic acid within the body
1626 isoniazide causes peripheral neuritis due to INH-induced pyridoxine deficiency

69
1627 E coli is the most common MO in complicate UTI
1628 salbutamol is used before inhalation of betamethasone by 10 min
1629 haloperidol + alphamethyldopa = life-threatening reaction
1630 adrenalin is given with local anesthetic to prolong their duration
1631 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
1632 phenobarbitone Na + chloramphenicol= pptn of barbituric acid
1633 B-agonists (adrenaline- like )= stimulate adenyl cyclase so inc cAMP so inc Ca entry to
myocardial cells = positive inotropic action

1634 more than 50% of water is reabsorbed in the proximal tubules --- K reabsorption in the
ascending limb of distal tubules
1635 BaSO4 is the least sol compound
1636 dioctyl Na sulfosuccinate = docusate Na (anionic)
1637 L-isomer of adrenaline is 20 times more active than D-isomer --- L isomer of atropine is
100 times more potent than D isomer
1638 quinolone SE: CNS stimulation
1639 the ester group in atropine is liable to destruction

1640 haloperidol is C.I. with methyldopa or guanthedine

1641 mechanism of GABA: inhibitory neurotransmitter acting on:: GABA A inc Cl
conductance -- GABA B presynaptic: dec Ca conductance, postsynaptic: inc K conductance
1642 SE of phenytoin: nystagmus, gingival hyperplasia, morbiliform rash (measles like), SLE,
ataxia, hirsutism, steven johnson syndrome
1643 SE of spironolactone: hyperkalemia, gynecomastia, postmenoposal bleeding
1644 overdose of Na.nitroprusside= CN poisoning
1645 hight concentration of drug in plasma = higher bioavailability
1646 hidrophilic depend on osmolarity -- hydrophobic depend on partition coefficient
1647 mephenisin carbamate is antidote for strychnine
1648 procaine HCl is thermolabile

70
1649 antidotes:: iron:desferroxamine -- lead: calcium EDTA, dimercaprol --Li:
decontamination, ipecac, bowel irrigation, Na polystyrene sulfonate -- opiates:naloxone,
naltroxone -- organophosphates: atropine, pralidoxime
1650 triamterene is a K-sparing diuretic
1651 microcystic anemia: MCV is less than 80 but normal range is 90
1652 toxic effects of clindamycin may be inc when used with lomotil
1653 sterile H2O for injection is prepared by distillation then autoclaving ???
1654 hypoglycemia may be induced after stopping of hyperalimentation (consists of amino
acids, glucose, electrolytes or vitamins)
1655 alkaline phospahate inc in liver disease

1656 atherosclerosis: inc in LDL

1657 H.M.E inducers: phenobarbitone, glutethimidine, EtOH, carbamazepine --- H.M.G
inhibitors: phenylbutazone, benzodiazepines, INH, dicumarol, chloramphenicol, estrogen
1658 erythrocytes are the highest count in plasma cells
1659 antacids dec A of: cimetidine, ranitidine, INH, digoxin, phenthiazines, iron, sucralfate,
anticholinergics, TC, quinolones
1660 photosensitizers: thiazides, phenothiazines, fluoroquinolone, amiodarone, TC
1661 T-cells mature in thymus gland

1662 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
1663 salbutamol dose is 2-8 mg daily --atropine dose: 0.25-2 mg -- chlorothiazide: 0.5-1 gm
1664 compounds containing aldehyde and keto groups , barbiturates , caffeine
1665 estrogen secretion is controlled by FSH
1666 antioxidants: ascorbyl palmitate, butylated hydroxy anisole (BHA), ethylene diamine, K
metabisulfite, Na metabisulfite, Na bisulfite
1667 Aspirin is C.I. with probenecid
1668 rose oil + cetrimide 20 % is stabilized by agitation
1669 phospholine iodine is stored at 2-8 DC
1670 doxorubicin cause cardiac toxicity
1671 atenolol is the least lipid soluble B blocker
71
1672 TXA2 cause platelet agregation
1673 cyclosporine: cyclic polypeptide immunosuppressant - nephrotoxicity in 25-30% of pts,
synergism with other nephrotoxic drugs may occur, HTN, hirsutism, gum hyperplasia
1674 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
1675 ampicillin SE: diarrhea
1676 clomid is 50 mg for 5 days
1677 the onset of TCA requires 3-4 weeks
1678 megaloplastic anemia is due to foilc acid deficiency

1679 function of vagus: regulation of heart rate

1680 phenobarbitone is a metabolite of primadone
1681 methimazole in pregnants: agranulocytosis
1682 sertraline is SSRI, also fluoxetine
1683 isotonicity is critical in S.C.
1684 if both parents have recessive genes it is enough to produce disease in children even if the
parents have no disease
1685 HTN pt taking amitriptylene develops depression due to its anticholinergic effects should
shift to trazodone (only inhibits reuptake of serotonin not NE)
1686 vit B6 is used in alcohol toxicity as it decreases alcohol levels
1687 chloramphenicol is indicated primarily for typhoid fever
1688 sorbitane monostearate (nonionic) w/o emulsion--- Na lauryl sulfate = O/W --- dioctyl Na
sulphosuccinate = O/W
1689 Al in Rx is used as astringent
1690 cholrpromazine side effect is photosensitivity
1691 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
1692 plastic which is not affected with autoclaving is PVC
1693 all of the following are clinical manifestations of parkinsonism: tremor, bradykinesia,
disturbance of posture, and regidity BUT NOT mental deterioration
1694 in urine PH inc, excretion of salicylic acid inc
72
1695 CaCO3 is given to pt with terminal renal failure to in Ca in serum, correct hypocalcemia
1696 tetracyclin is contraindicated in pregnancy
1697 ticarcillin is preferred to carbenicillin for pts with CHF , renal failure or HTN because it
is used in smalled doses than carbenicillin
1698 sympathetic ganglia are located near spinal cord
1699 flurazepam: longest duration benzodiazepine (BZD)
1700 drugs excreted by glumerular fileration: TC, aminoglycosides, digoxin, ethambutol,
MTX,
1701 all ACEIs are prodrugs except captopril and prinivil (lisinopril)
1702 use of siver sulfadiazine, mafenide is topically for burns and wounds
1703 pheochromocytoma ttt : mixture of alpha and beta blockers
1704 dicobalt edetate is antidote for CN --- Ca edetate is antidote for Pb (lead)
1705 clinical investigation of a new drug consists of 4 phases: first phase include
administration of drug by selected clinicians to healthy volunteers
1706 allopurinol # metabolism of 6-MP NOT 6-TG
1707 terbutaline is a beta2 agonist used in acute attacks of asthma
1708 nitrogycerin inc c-GMP = vasodilation
1709 skin contraceptive implants: levonorgestrel
1710 1ry alcohol oxidation gives aldehyde --- 2ry alcohol oxidation gives ketone
1711 K reabsorption is from the ascending limb of distal tubules
1712 non ionic cetomacrogen 1000 is compatible with: salicylic acid, camphor, KI NOT with
phenol
1713 GABA is inhibitiry neurotransmitter in brain
1714 dose of colchicine is 500mcg orally
1715 early signs of theophylline overdose: tachycardia
1716 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..
1717 demeclocyclin cause D. insipidus and ttt is by ADH
1718 paracetamol has NO antiinflammtory effects

73
1719 NaHCO3 is contraindicated with HTN
1720 pts arrived in hospital with hypertensive crisis will be ttt with diazoxide
1721 male hemoglobin: 14-17 g/dl --- female hemoglobin: 12-15 g/dl
1722 emulsion is liquid in liquid dispersion system
1723 adrenaline injection strength is 1:1000 mg/L
1724 sulfamethoxypyridine is long acting due to plasma protein binding
1725 stearyl alcohol, cetyl alcohol are used as stabilizers
1726 penicillin is recommended on empty stomach BUT NOT diazepam
1727 atropine C.I. with glucoma
1728 gelatin is a protein
1729 atropine blocks muscarinic receptors of acetylcholine
1730 chenodiol is used in dissolving cholesterol gallstones, hepatotoxicity is the most serious
SE, diarrhea is the most common SE
1731 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%) -
1732 glucagon inc glucose level by inc hepatic gluconeogenesis, glycogenolysis
1733 major determinant of myocardial O2 consumption in cardiac output
1734 chlorpromazine: relieve pre-surgical apprehension
1735 insulin needle , boil with H2O for 30 minutes
1736 NaHCO3 is given after shock to neutralize lactic acid, egulate respiration due to CO2
accumulation, replace plasma
1737 purulent boils in the ear are usually caused by staph.
1738 PH of blood=7.4
1739 pyrivinuim 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
1740 SE of thiazide is hyperglycemia
1741 phenytoin: dec theophylline --- interferone: inc theophylline 100%
1742 nilutamide (ntiandrogen): delay dark adaptation

74
1743 pseudoephedrine should be taken with caution with iproniazine
1744 mestranol is estrogen not progesterone
1745 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
1746 drugs caising parkinsonism: haloperidol, phenothiazines, reserpine, heavy metal
poisoning, methyldopa
1747 TB: mantox test, tuberculin test
1748 Na.nitroprusside: CN toxicity, protect from light, slow IV infusion
1749 pregnancy X: Li, vitamin A, isotretinoin, TC, ACEIs, warfarin, alcohol, finasteride,
misoprostol, metronidazole, phenytoin

1750 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
1751 drugs causing SLE: hydralazine, procainamide, quinidine, TC, methyldopa,
penicillamine, phenytoin, phenothiazines, sulfonamides, INH, nitrofurantoin, ethosuximide
1752 hydroxychloroquine is antimalarial used in SLE and rheumatoid arthritis, C.I in favism
1753 insulin lente:24hrs --- insulin protamine Zn=36hrs
1754 advantage of naloxone over nalorphine is that it lacks agonistic action
1755 HNO3 conc= 0.002% --- phenyl Hg acetate=0.002%
1756 more than 80% of water and Na are reabsorbed from the proximal tubules
1757 INH=isonicotinic acid hydrazine is the most potent anti-TB
1758 NSAIDs # PG synthesis
1759 amylase, trypsin are secreted from pancreas
1760 morepinephrine acts on postganglionic sympathetic receptors on the effector organs
mainly or presynaptic receptors on the nerve endings
1761 narrow angle glaucoma is C.I with atrpine or other anticholinergics
1762 congenital adrenal hyperplasia: deficiency of 21-alpha-hydroxylase
1763 Na nitroprusside, KCl: slow IV infusion -- diazoxide: rapid bolus IV
1764 ttt of choice for herpes simplex of eye lid and conjunctiva is idoxuridine, BUT in skin:
acyclovir
1765 indometahcin frequent use:: headache
75
1766 liver cirrhosis is progressive fibrosis, scarring of liver

1767 no of RBCs in blood of healthy person=5*10 ⁶/ml

1768 inotropic action of B stimulants of cardiac muscle is increased ny in Ca entry

1769 tolnaftate is ineffective against candida
1770 acetyl cystein is administered by inhalation
1771 fluxacillin syrup must be refrigirated
1772 lente insulin : 70% crystalline (ultralente) + 30% amorphous (semilente)
1773 OTC# lice: pyrethrins, piperonyl butoxide, petrolatum distillate --- RX: cretamiton
1774 edema occur with nephritis
1775 endorphines, enkephalines are classified as peptides
1776 if a drug has a small Vd then it does not accumulate in various tissues and organs
1777 competitive inhibitors cause less enzyme inhibition that non competitive inhibitors
1778 aspirin inhibit platelet aggregation
1779 methotrexate: intrathecal --- thiopental: IV, intrathecal
1780 therapeutic index: LD50/ED50
1781 phenytoin , theophylline have narrow therapeutic index
1782 procaine is not used topiclly
1783 phenol + menthol + camphor = melt giving eutectic mixture
1784 edrophonium is used in the diagnosis of myasthenia gravis

1785 barbiturate metabolism: oxidation the conjugation with sulfate

1786 L-dopa is a dopamine precursor used in the ttt or parkinsonism; C.I. with B6: dec
antiparkinsonism action, MAOI: hypertensive crisis, anticholinergics: synergism
1787 Na phenobarbitone + chloamphenicol = pptn of barbituric acid
1788 nospital infections=nosocomial
1789 SE of nalidixic acif: photosensitivity, visual disturbances (as amiodarone)
1790 in aspirin toxicity we use NaHCO3 to increase excretion
1791 miconazole: antifungal -- glyburide: hypoglycemic
1792 chlorpromazine has long t1/2 when given IM
76
1793 oral drug with weak PH is more absorbed from stomach
1794 stomatitis: inflammation of the oral mucosa -- blepharitis: inflammation of the eyelid --
gastritis: inflammation of the stomach wall -- glossitis: inflammation of the tongue
1795 aspirin may induce asthma, may interact with sulfonylureas but NOT interact with
MAOIs
1796 duration of action of Lente insulin is 24 hours
1797 dipivefrin is a prodrug of adenalin
1798 xerostomia= dryness of mouth
1799 penicillin allergic pts should shift to erythromycin not cephalosporins
1800 warfarin can be used in different therapeutic forms because it has optically active centers
1801 thyroxine secretion from thyroid gland is regulated by iodine level in blood
1802 loop/ thiazide diuretics are contraindicated with gout
1803 safe diuretic with sulfonamide sensitivity: ethacrynic acid, spironolactone
1804 ttt of alcohol withdrawal syndrome: chlordiazepoxide, chlorazepate, diazepam, oxazepam
1805 penicillinase resistant penicillins : methicillin, nafcillin, cloxacillin, dicloxacillin,
fluoxacillin, oxacillin
1806 cystic fibrosis is hereditary related to parents
1807 colististiken : cofactor liberated from d. mucosa after ingestion of meat ot fat
1808 ciprofloxacin: enzyme inhibitor: inc theophylline toxicity
1809 propranolol does not cause tremors or tachycardia -- B-agonists cause tremors
1810 amoxicillin + calvulenic acid = cholestatic jaundice and hepatotoxicity
1811 metabolized by acetylation: INH, hydralazine, sulfonamide, procainamide
1812 increase QT interval elevation: cisapride, ketoconazole (azoles), phenothiazine,
quinolones
1813 cholestatic jaundice: erythromycin estolate, ACEIs, (amoxicillin + clavulenic acid),
phenothiazines
1814 cisapride + ketoconazole = prolong QT
1815 terfenadine , astimazole + ketoconazole = life treatening arrythmia
1816 ketoconazole interact with warfrin

77
1817 griseofulvin is LME inducer so interact with OC
1818 the most specific laboratory investigation for MI cardiac troponin
1819 salbutamol + terbutaline = not logic combination for asthma
1820 L-dop SE: hypotension
1821 glyceryl nitrate is absorbed from the skin
1822 loop diuretic inc the prostaglandind
1823 piroxicam is used for morning stiffness because of long t1/2
1824 indomethacin dec antihypertensive effect og B-blockers
1825 fluoxetin does not cause hepatotoxicity
1826 mechanism od digoxin is bound to Na/K ATPase pump
1827 cetrizine does not cause nausea
1828 fentanyl used in chronic bone metastasis
1829 there is no digoxin loading dose
1830 logest acting opioid= methadone
1831 least addicting = nicotine
1832 olanzapine (least extrapyramidal ???) SE agranulocytosis

1833 bipolar depression can be ttt by: Li, carbamazepine, SSRI, Na valporate BUT NOT
haloperidol
1834 hypoglycemia does NOT cause acetone mouth which is caused by hyperglycemia
1835 immunity is related to thymus gland
1836 pyrazinamide: arthrlgia + hyperuricemia
1837 griseofulvin is taken after food
1838 citrate in oral rehydration is to compete alkalosis
1839 hemodialysis for polar drugs
1840 procarbazine is MAOI requires dietary percautions
1841 atropine cause hemodynamic alteration as it cause initial bradycardia
1842 half normal saline is hypotonic
1843 cimetidine inc dose at bedtime
78
1844 carpamazepine dose not cause vomiting
1845 moxifloxacin is quinolone
1846 diabetics have highest risk of erectile dysfunction
1847 COMT does not metabolize isoprenaline
1848 slow IV of adrenaline: inc cardiac output, not diastolic bl pressure
1849 ribosomes are attached to the endoplasmic reticulum (rough endoplasmic reticulum)
1850 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

1851 conscious anesthesia: fentanyl + midazolam

1852 cyclophosphamide: alkylating agent BUT cytarabine is NOT
1853 drug effective against giardiasis: tinidazole
1854 drug used in anaerobic infections: metronidazole
1855 glucose is completely reabsorbed after GF
1856 metformin : biguanide
1857 1,25 dihydroxy cholcalciferol aid in Ca absorption
1858 uric acid is a derivative of purine
1859 correct order: Blood-ureter-bladder-urethra
1860 the UV range used in spectrophotometry is 200-400 nm
1861 haloperidol should not be taken with alcohol and alpha methyl dopa
1862 antihypertensive effect of alpha methyl dopa is due to its central alpha agonistic effect,
where it's metabolized to alpah methyl norepinephrine (active)
1863 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
1864 the amount of glomerular filterate reabsorbed: 85-99%
1865 the substance secreted in the stomach and present in the intestine is: mucous NOT pepsin

1866 angina pectoris is due to ischemia of the heart muscle NOT due to MI
1867 Addison's disease is hypofunction of the adrenal cortex BUT cushing syndrome is
hyperfunction of the adrenal cortex

79
1868 atropine is C.I in narrow angle glaucoma
1869 cholic acid aids in fat absorption
1870 selegline is selective MAOI b, used in parkinsonism
1871 order of impulse: SA node - AV node - bundle of His - Purkinge
1872 when a soln, is separated from its solvent by a semipermeable membrane, solvent will
pass through the membrane
1873 amiodarone K-sparing diuretic MOA: direct Na channel blocker - rapid onset of action
1874 conformation is rotation about a single bond

1875 trimethoprim cause photosensitivity

1876 cyproheptadine is antihistaminic / anti 5HT
1877 impetigo: bacterial infection
1878 symptoms of hypoglycemia: sweating, tachycardia
1879 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??
1880 cocaine toxicity is : respiratory failure
1881 alkaline phosphate level is raised in liver damage
1882 arterial HTN needs immediate medical attention (responsible for angina)
1883 amylase level is raised in pancreatitis
1884 nitrates are given sublingually because (to avoid) 1st pass effect NOT destroyed by
gastric acid
1885 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
1886 para amino benzoic acid=PABA--- ethyl amino benzoic acid=benzocaine
1887 procaine hydrolysis gives PABA
1888 bradykinin are peptides: arterial vasodilators, constrict brochi and intestines, cause pain
and inflammation and allergy
1889 B-blockers are C.I. in asthma
1890 indomethacin: used in chronic arthritis pain ttt

80
1891 adrenaline drops has SHORT ACTING mydriatic effect NOT homatropine
1892 cycloplegic for kids atropine drops
1893 hyoscine is a muscarinic antagonist
1894 aspirin antiplatelet action is due to inhibition of TXA2
1895 urine alkanlinizer is not given when the pt is on erythromycin
1896 diuresis is a symptom of hyperglycemia
1897 anabolism is: biosynthetic (build up), fat storage, polymerization of amino acids
1898 azadatine: antihistamine that causes drowsiness
1899 phenelzine: MAOI, not taken with tyramine
1900 amitriptyline (TCA) used in the ttt of deep visceral pain, post operative neuralgia
1901 phenytoin: has narrow therapeutic index, need TDM (therapeutic drug monitoring)
1902 when drug has first pass effect at in the liver that means: it has less systemic effect
1903 lignocaine has longer duration of action because it has amide group that resists hydrolysis
1904 in CHF pt we should adjust the dose of lignocaine because of decreased blood perfusion
of liver so decreased metabolism of lignocaine
1905 piroxicam: drug that is usually given to relief the morning stiffness pain
1906 streptokinase is contraindicated ib pt with peptic ulcer
1907 allopurinol: has no effect on warfain plasma protein binding, can be given safely with
warfarine -- also chlopheniramine can be given safely with warfarin
1908 corticosteroids: inc susceptibility to infection
1909 butylated hydroxy tolween (BHT): oily antioxidant -- like it: butylated hydroxy anisol
(BHA) , ascorbyl palmitate..
1910 tobramycin make hearing loss
1911 drug which is used in methicillin resistant staph: vancomycin
1912 temazepam: it is metabolized outside the liver (OTL) to active oxazepam
1913 diazepam is different from temazepam in that diazepam has longer duration of action
than temazepam
1914 astimazole: 2nd generation antihistamine, does not cause drowsiness -- astimazole,
terfenadine + ketoconazole=life threatening arrhythmia

81
1915 cetrimide give O/W emulsion
1916 codeine is partially metabolized to morphine (demethylation) -- 15-20mg is effective as
antitussive
1917 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)
1918 the best way to prescribe GTN is: (transdermal) absorbed through the skin
1919 chlorothiazide is C.I. with amitriptylline (TCA)
1920 anionic surfactant is compatible with icthamol
1921 nalidixic acid can cause phototoxic reaction

1922 ibuprofen is less toxic than naproxen

1923 common SE of chloramphenicol is aplastic anemia
1924 indomethain can cause salt and water retention with HTN pt leading to frontal headache
1925 ergot alkaloids are are used in migrain and also used as oxytocics
1926 SE of amitriptyline are: constipation, dry mouth, blurred vision, drowsiness
1927 clindamycin is very sol in H2O -- not in ( alc, alc+propylene glycol)
1928 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)
1929 mestranol is estrogen
1930 titanium dioxide: sunscreen agent
1931 indapamide is C.I with alcohol
1932 structure of benzaldhyde is metabolized byoxidation
1933 structure of estrogen is a steroid
1934 CH3COOH + ROH=CH3COOR +H2O (OH from acid, H from alcohol)
1935 oleic acid exists in cis form : 2 groups fixed around a double bond on the same side
1936 malathion: irreversible choliesterase
1937 paraldhyde is a polymer of acetaldhyde -- paraldhyde is oxidized to acetic acid
1938 benzene ring structure: easily determined by UV

82
1939 discarding of outdated tetracycline is important because: it changes to a more toxic form
1940 estrification: OH group from acid is replaced by RO from alcohol
1941 lactulose is synthetic disaccharide
1942 the most essential group in sulindac is: sulfide
1943 the structure of sulfonylureas can be substituted at R1 and R2 positions -- 2nd generation
have larger substitutions on R1
1944 labitolol is alpha and beta blocker
1945 valproic acid is used for grandmal and petitmal epilepsy

1946 cyclophosphamide SE: hemorrhagic cystitis

1947 cystic fibrosis is a genetic disease: both parents must have the genes for it
1948 alpha receptors: constriction of arterioles
1949 IV infusion of aminophylline is given in: acute asthma case
1950 thiazides can be related to hyperuricemia
1951 ttt of shingles: acyclovir
1952 what is the most cause of HTN: unknown mechanisms
1953 cromolyn Na is given in: prevention of execise induced asthma -- unstable orally
1954 verapamil: has the most Ca channel blocking activity
1955 medroxyprogesterone: a progesterone NOT a corticosteroid
1956 hypothyroid in adults is called: myxedema
1957 normal hematocrit value: 35-45%
1958 lift side heart failure leads to dyspnea
1959 naloxone: pure opiate antagonist
1960 trypsinogen is produced by pancreas
1961 systemic anaerobic infection is ttt by metronidazole
1962 restriction endonuclease enzyme: cut DNA
1963 TXA2 could be inhibited by indomethacin
1964 digitalis does not treat ventricular arrythmia
1965 hydrocotisone : ttt of rosacea NOT isotretinoin
83
1966 clostridium difficile: causes enteroclitis
1967 proteins are present in blood more than urine
1968 triamterin: K sparing diuretic
1969 cells of distal convoluted tubules are sensitive to aldosterone
1970 the respiratory volume: the respiratory air and expiratory air
1971 the epidermis is made of keratin
1972 indapamide: thiazide diuretic
1973 lipid solubility order of B-blockers: atenolol, metoprolol, propranolol
1974 hydrophylic B-blockers: atenolol, nadolol, esmolol -- lipophylic B-blockers: propranolol,
metoprolol, timolol, betaxolol
1975 conc of 6ppm= 0.00006%
1976 trituration: grinding
1977 dose of chloroquine in malaria: 500mg once weekly
1978 dose of mesoprostol for ttt of ulcers: 800 mg daily (2-4 divided doses)
1979 cellulose acetate phthalate: used in enteric coated tablets
1980 freezing point depression: coligative property
1981 in a lipid soluble drug: dissolution is the rate limiting step
1982 absorption occurs in the ileum
1983 rifampicine cause red urine
1984 given the half life of a drug is 1 year, after 3 years 12.5% are left
1985 knowledge of Vd allowes us to: determine amount of drug in body based on plasma
concn.
1986 the emulsifying agent in olive-lime water emulsion is : Ca oleate
1987 0.1% clorohexidine HCl, the emulgent is cetrimide

1988 most common SE of ketoconazole are: GIT disturbance and headache

1989 ranitidine would NOT produce iatrogenic (drug-induced) HTN
1990 cimitidine SE: gynecomastia
1991 bendrofluazide SE: photosensitivity

84
1992 thyroxin interactions: inhance effect of anticoagulants, antagonizes insulin and inc
requirements of hypoglycemics, cholestyramine dec thyroxin absorption

1993 pheny Hg nitrate use: sporocidal

1994 clarithromycin: macrolide antibiotic
1995 dose of viagra 50mg 1hr before intercourse (range is 25-100 once daily)
1996 dose of thyroxine=50-150 mcg daily
1997 cimetidine interaction:: inc effect of every thing (‫)اﻟﺤﯿﺎة‬- dec the effect of ketoconazole
and phenothiazines -- antacids dec cimetidine effect
1998 laws for calculation of child doses:: Young's rule (year+12) , Clark's rule, Frid's rule
1999 sterilization of water for injection: by distillation, reverse osmosis
2000 nitrates: dec preload -- hydralazine, diazoxide: dec afterload -- Na nitroprusside: dec
preload + afterload
2001 metamucil: psyllium husk, inc dietary intake of fibers, used as laxative, dose is 7g tid,
must drinh enough water with the tablet
2002 codeine, indomethacin = should not be taken in HTN dye to salt and water retention
2003 lignocaine is given IV to avoid oral first pass effect
2004 streptokinase is given IV, never IM to avoid hematoma
2005 acetazolamide causes hyperchloremic acidosis and urinary alkalosis
2006 side effects of codeine: nausea, vomiting, constipation, repiratory depression
2007 SE of antidepressents: antimuscarinic effects, constipation, posural hypotension,
drowsiness, but venlafaxine cause HTN
2008 drugs that prevent the uptake of iodine: prechlorates, thiocyanates, iodine in high doses
2009 propylthiouracil, carbimazole:: ttt of hyperthyrodism
2010 some antineoplastic agents:: alkylating agents: nitrogen mustard, chlorambucil,
cyclophosphamide -- antimetabolites: MTX, 6-MP, 5-FU
2011 methyldopa interactions: inc the effect of all antihypertensive agents
2012 theophyllin dec Li
2013 psoriatic arthritis: inflammation of skin, joints, eye, heart, lung, kidney, systemic
rheumatic autoimmune, ttt: NSAIDs, MTX, corticosteroids, antimalarial??
2014 phenothiazines:: chlorpromazine, thioridazine, fluphenazine, trifluperazine, perphenazine

85
2015 anatomy of small intestines: duodenum, ileum, jejunum
2016 worms that are present in humans but not in animals:: ascaris, anclystoma, oxyrious --
worms in men and animals:: faschiola, hetrophes (fish), ?? -- in animals only: ??
2017 rifampicin is taken before meals, it is taken with INH to dec bacterial resistance
2018 tetracyclin SE: discolorization of teeth
2019 expired tetracycline: fanconi-like syndrome
2020 types of respiratory volumes: tidal vol, minimum vol, max vol.
2021 tobramycin structure is similar to gentamicin

2022 ergometrin is NOT taken sublingually

2023 drugs that canNOT be given IV bolus:: prazocin, nitroprusside, KCl
2024 boric acid is NOT used in neonates
2025 pencillins lose their activity by hydrolysis NOT oxidation, reduction
2026 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
2027 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
2028 Li SE: diabetes insipidus, hypothyrodism?, convulsions
2029 pts on Li therapy should not restrict Na intake
2030 pts with sulfa allergy could take safely:: etahcrynic acid or spironolactone as diuretic,
sulfamethizol (bec of short t1/2)
2031 drugs that could be given in acute asthma: salbutamol, albuterol, terbutaline
2032 in dipolar mood disturbance: Li, carbamazepine, Na valproate
2033 SE of B-blockers: cold extremities, bronchospasm, inc hypoglycemic effect of insulin,
dec HDL, up-regulation of receptors on long use, nightmares
2034 erythromycin inc the effect of aminophylline
2035 site of action of spironolactone: DCT (distal convoluted tubules)
2036 psoriasis does not cause endocarditis
2037 if a pt taking metoprolol but cannot sllep your advice is: shift to atenolol, tahe diazepam
2038 chiral C atom= asymmetric C atom

86
2039 end result of protein is uric acid
2040 kidney dysfunction: unc (BUN) blood urea nitogen
2041 ttt of opiate withdrawal: methadone??
2042 ttt of constipation due to codeine is by stimulant laxative NOT enema or bulk
2043 tes-tapes: measure glucose in blood or urine
2044 deficience in posterior pituitary hormones will cause diabetes insipidus
2045 MOA of warfarin: inhibit vit K epoxide reductase ??
2046 terbutaline is a B2 agonist
2047 volatile oils are terpines
2048 doxipen: TCA
2049 phenazopyridine (pyridium): urinary tract analgesic, causes red urine
2050 loperamide: antidiarrheal, if given to a pt with ulcerative colitic it will produce intestinal
perforation
2051 phenytoin SE: gingival hyperplasia, osteomalacia, hirsutism, ataxia
2052 infectious mononucleosis: is assossiated with high insidence of rash after ampicillin
injection ???
2053 deficiency in intrinsic factor:: pernicious anemia
2054 heparin is administered SC
2055 GTN tab:0.6mg, spray 400-600mcg/spray
2056 chlorhexidine in eyedrop: 0.2%
2057 if oral coated tablet is used:: disintegration will be the rate limiting step
2058 clomipramine is used in occlusive depression disorder
2059 in loading dose: Vd and desired amount of drug is important
2060 antihypertensive NOT C.I. with amitriptyline: HCTZ ??? -- chlorothiazide is
contraindicated with amitriptyline
2061 mantox test:: old tuberculin
2062 with MAOI can take red meat BUT NOT wine, beer, cheese, chicken liver
2063 nystatine can be taken topically NOT ketoconazol, griseofulvin ??

87
2064 chlorpromazine has lonf duration of action when given IM
2065 vigabatrine is enzyme inducer that inc clearance of phenytoin, carbamazepine,
phenobarbital
2066 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 ??
2067 polysorbate is known as wetting agent
2068 some phototoxic drugs: amiodarone, sulphonamides, TC, thiazides, phenothiazines,
nalidixic acid
2069 gold - naproxen - penicillamine - ibuprofen,, of all listed: ibuprofen has the least SE
2070 common SE of chloramphenicol: aplastic anemia, gray baby syndrome
2071 SE of amitriptyline: dry mouth, constipation, blurred vision
2072 insulin lente same as monotard same as insulin Zn suspension = 18-28 hrs
2073 phenytoin can be used once daily and three times daily
2074 aminoglycosides can be given once daily
2075 for sustained release K= use inner wax matrix
2076 myxedema (dec thyroxin in adults) can be caused by: Li or amiodarone
2077 sulfacetamide eye drop is not destryed by heat in the autoclave
2078 drugs thae can be destroyed by heat in the autoclave: procain, penicillin, insulin, Ab?,
phenylephrine, heparin?
2079 phenyl Hg nitrate: preservative in eye drops, sporocidal
2080 celecoxib contains sulfa group, salfasalazine contains sulfa group, BUT trimethoprim
does NOT contain a sulfa group
2081 sulfasalazine is used in rheumatoid arthritis and for ulcerative colitis (Crohn disease
2082 bethanechol is similar in action to acetylcholine
2083 CaCl2 will not be active when given orally
2084 in cardiogenic shock we give NaHCO3 to treat ventilation acidosis
2085 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
2086 ethyl palmitate is not SAA
88
2087 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.
2088 thyrotoxicosis is ttt by : PTU (propylthiouracil) and carbimazole
2089 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
2090 methicillin is used in the ttt of staph, G+ve, used in upper respiratory infection?? -- only
parentral not oral because of insatbility
2091 cyproheptadine is antihistaminic drug with serotonin antagonist and Ca channel blocking
property
2092 tolbutamide and fenformin have increased risk of cardiovascular disease ??
2093 disease related to destruction of myeline sheath is multiple sclerosis (MS) ??

2094 ferric iron is the iron form least absorbed from intestine
2095 thyroxin release can be controlled by TSH (thyroid stimulating hormone)
2096 in 10 year old child, which one should be used long term? Answer: prednisolone tab. Not
predisone inhaler or theophylline (can be used)
2097 postmenoposal vaginal infection is by: E-coli
2098 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,
2099 (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
2100 methyl paraben is an ester of benzoic acid and parahydroxy benzoic acid -- prevent yeast
and mould growth
2101 heparin delay thrombin formation??
2102 on asthma c-AMP is decreased
2103 in emergency room the preferred first line therapy of asthma is B agonist
2104 zinc deficiency causes: growth retardation, hair loss, nausea, loss of appetite
2105 droperidol is used as an adjuvant to anesthesia

2106 lomotil (diphenoxylate + atropine) does not cause bronchospasm

2107 steady state depend on the half life of the drug??

89
2108 phenytoin should be taken with food to dec gastric irritation
2109 cimetidine causes gynecomastia in elderly patients
2110 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
2111 niclosamide is used in the ttt of tapeworm
2112 grandmal epilepsy: generalized tonic clonic seizure
2113 aseptic pencil is used in minor cuts
2114 hypothyrodism due to Li therapy is a rare case
2115 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.
2116 Senokot is a selective neuromuscular stimulant of the colon, restoring normal rythmic
motility
2117 propranolol shows first pass metabolism that when given orally it has little systemic
effect
2118 NSAID with longest duration of action: piroxicam
2119 dextrose is used in parentral solution for transfusion
2120 tetracyclin should not be given to neonates because it leads to discoloration of teeth
2121 TXA2 induce platelet aggregation
2122 GTN: venodilator: dec blood return to the heart: dec preload
2123 camphor is not freely dissolved in water, it is insoluble in water, soluble in alcohol
2124 fluorinated corticosteroid is C.I. in rosacea (chronis vasodilation on nose and cheeks
causing redness)
2125 the major determinant of myocardial oxygen deman is cardiac output
2126 if pt's symptoms are dyspnea, sweating: diagnosis is heart failure
2127 EDTA is used as Ca salt because it binds to body Ca causing Ca loss
2128 prmethazine is a potent antiemetic
2129 chromoglycate: inhibit the release of mediator and cause bronchial relaxation
2130 atropine is antidote for anticholinesterase

90
2131 storage of cisplatin: store from 15-25 C, do not refrigirate, protect from light, discard
unused portion

2132 which drug is given in alternate day and causes osteoporosis ?: predisolone
2133 pencillin # transpeptidase enzyme ??
2134 if a fixed dose of drug is eliminated by first order kinetics at fixed dose interval, time to
reach plataeo level will depend on t1/2
2135 cholinergic crisis causes parkinsonism??
2136 critical interaction between cimetidine and ranitidine???
2137 propranolol is not recommended with verapamil
2138 alprostadil is for patent ductus arteriosus in neonates ??
2139 hydroxyzine: anxiolytic with high antihistaminic action
2140 carbachol is a cholinergic agent
2141 indapamide is contraindicated in pts taking alcohol ??
2142 vitamin E is used as antioxidant (oily)
2143 pregnant woman cannot use TC
2144 fluphenazine deconate is mainly given IM
2145 cetostearyl, and cholestrol : stabilizers
2146 haloperidol in C.I. with parkinsonism
2147 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
2148 botulinum antitoxin: passive immunity -- typhoid vaccine: active immunity
2149 sterilization of oils, fats, powders: dry heat at 160 C for 2 hrs
2150 salbutamol can lower blood pressure
2151 ascorbic acid: rapidly absorbed from GIT, it is utilized at increased rate during infection,
protects against scurvy, reversibly oxidized to oxalic acid ??
2152 estrogen: breakthrough bleeding
2153 latanoprost: for open angle glaucomaif the phenytoin dose in inadequate (fit occur) what
is the dose increment? 30 mg/day

91
2154 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
2155 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
2156 polycythemia 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
2157 (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
2158 (continue polycythemia vera) drugs used include: busulfan (myleran),, radio active
phosphorus 32P.
2159 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
2160 (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
2161 (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
2162 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
2163 (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

2164 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:
2165 (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
2166 anticoagulant of choice for use in pregnant pt near the time of delivery: heparin, it is a
high molecular weight mucopolysaccharide that does not cross the placenta- prothrombin time in
mother should be closely monitored to dec the risk of fetal hemorrhag

92
2167 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
2168 (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.
2169 (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
2170 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.
2171 (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
2172 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
2173 (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,
2174 (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
2175 (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,
2176 (cont. Schilling test) which results in poor absorption of the radioactive B12, most of the
radioactivity in those pts will be detected in the feces
2177 a dopamine agonist used to treat hyperprolactinemia: bromocriptine, it is an ergot
alkaloid derivative that acts on the anterior pituitary to supress prolactin secretion.
2178 (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.
2179 bromocriptine: dopamine agonist -- chlorpromazine: dopamine antagonist

93
2180 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,
2181 (cont. regular insulin) the drug is often used in conjunction with subcutaneously
administered longer acting preparations
2182 protamine Zn insulin, logest duration, 24-36 hrs -- regular insulin, shortest duration, 6-8
hrs.
2183 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
2184 (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
2185 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)
2186 (cont. Tes-Tape) the glucose oxidase test for the presence of glucose in the urine is
apparently not affected by cephalosporins
2187 (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:
2188 (cont. Tes-Tape) 1% with Clinitest and 0.25% with Tes-Tape. Conclusion: a false
positive result with clinitest
2189 (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.
2190 (cont. Tes-Tape) it is well documented in the literature that cephalosporin antibiotics may
cause false positive readings with Cu reduction tests.
2191 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
2192 (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
2193 benzodiazepines preferred as anxiolytic drugs for an elderly pt with a history of cirrhosis:
lorazepam, oxazepam (NOT: chlordiazepoxide, diazepam, chlorazepate, prazepam)

94
2194 (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)
2195 (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
2196 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
2197 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.
2198 (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.
2199 200mg FeSO4.2H2O=325mg FeSO4.7H2O=65mg elemental iron.
2200 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
2201 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.
2202 (cont. BCG vaccine) MOA is the activation of macrophages to make them more effective
killer cells in conjunction with lymphoid cells.
2203 (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.
2204 prednisone, 6-MP, chlorambucil Rho (D) immunoglobulin:: useful immunosuppressants
in cancer chemotherapy
2205 DOC for ttt of trigeminal neuralgia (tic douloureux) is: carbamazepine.
2206 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.
2207 (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.
2208 (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

95
2209 four clinical features of parkinsonism: tremor, disturbances of posture, bradykinesia,
rIgidity BUT NOT mental deterioration

2210 (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
2211 (cont. parkinsonism) tremor is a rhythmical alternating contraction of a given muscle
group and its antagonist
2212 (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
2213 (continue parkinsonism) or festination (an involuntary increase or hastening in gait,
generally in a stooped position
2214 (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.
2215 (cont. parkinsonism) rigidity is an increased muscle tone that is resistent to passive
movement of an extremity.
2216 digoxin is cheifly excreted unchanged by kidney
2217 the emulsifying agent of Ca(OH)2 and olive oil (oleic acid) is Ca oleate
2218 the emulsifying agent with chlorhexidine is cetrimide
2219 the usual dose of chlorhexidine is 0.02, 0.05%
2220 mantoux test is with tuberculin PPD NOT diphtheria antitoxin
2221 polymorphic drugs are different in all except PH in soln.
2222 cimetidine is associated with gynecomastia and mental cofusion in the elderly
2223 sensitization to the sunlight may be produced in a pt being ttt with bendrofluazide
2224 pt suffering from gout and taking probenecid should be warned not to take aspirin
2225 normal thyroid level is called euthyroid
2226 SE of GTN is throbbing headache
2227 SE of Ca channel blocker is constipation and edema
2228 buspirone is antianxiety agent, it has very few sedative, muscle relaxant and
anticonvulsant effect

96
2229 interaction of digoxin and K: hypokalemia or drugs that cause hypokalemia may lead to
cardiac arrhythmia - hyperkalemia reduces therapeutic effect of digoxin

2230 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
2231 allopurinol inhibits xanthine oxidase, the enzyme which converts hypoxanthine to
xanthine, and xanthine to uric acid
2232 anaphylactic reaction occurs after second exposure to the antigen
2233 antihypertensive that causes angina is: hydralazine (the steal phenomenon)
2234 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
2235 niclosamide is used for ttt of tapeworm
2236 phenytoin, diazepam, valproic, phenobarbital all are used in grandmal except
ethosuxamide which is DOC for petitmal epilepsy
2237 for grand mal benzodiazepines (diazepam) to stop seizures then phenytoin DOC to
maintain
2238 phenytoin is not used in absence seizures
2239 warfarin toxicity: skin necrosis and purple discoloration of the toes, hemorrhage, ttt by vit
K
2240 100 mg of thyroxin is equivaent to 25mg of triiodothyronine
2241 bradykinine cause potent vasodilation

2242 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,
2243 (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
2244 the most common SE of digoxin is GIT disturbances
2245 nystatine is used in ttt of GIT bacterial flora ???
2246 the drug to be available in the plasma should be in soln form

97
2247 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
2248 (cont. tobramycin) but damage may be continued even after the drug has been
discontinued. Dizzines, vertigo, tinnitus and hearing loss have been reported
2249 medication used in methicillin resistant staph: vancomycin
2250 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 ???
2251 glutamic acid by decarboxilation is converted to GABA
2252 dicofenac is phenylacetic acid derivative, sulindac, indomethacin
2253 indomethacin is similar in structure to sulindac

2254 xanthine, uric acid, and adenines are purines # 6-MP

2255 substitution od cephalosporines at C7: increase stability to B lactamase
2256 ascorbic acid is a lactone structure
2257 32P is radioactive
2258 lactic acid= 2-hydroxypropanoic acid
2259 lomotil should not be given to pts taking oral clindamycin or lincomycin because toxic
effects of clindamycin or lincomycin will be enhanced.
2260 (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
2261 (cont. clindamycin, lincomycin vs. lomotil) although many antibiotics have been
implicated, there've been a disproportionate no of reports specifically involving clindamycin and
lincomycin
2262 (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
2263 (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.
2264 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.

98
2265 (cont. loperamide) it inhibits peristaltic activity by direct effect on musculature of the
intestinal wall. It appears to be devoid of opium-like effects.

2266 (cont. loperamide) even after chronic administration of loperamide, the injection of
narcotic antagonist naloxone does not produce pupillary dilatation
2267 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.
2268 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
2269 (cont. cyclobenzaprine) because they are so chemically alike in chemical structure,
cyclobenzaprine & amitriptyline have essentially the same SE and toxicity.
2270 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,
2271 (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
2272 perindopril 24mg: dose not appropriate to adults
2273 starting HCTZ dose in mild HTN: 50mg
2274 theophylline is not used as antiarrythmic
2275 sulfasalazine metabolized to 5-aminosalicylic acid
2276 synovitis and ulcerative colitis are related inflammatory disease?? Diclofenac and
hydrocortisone are used
2277 TPN is stored 2-8 C for not more than 24 hrs
2278 ketoconazol SE: GIT, headache,?? Gynecomastia ??
2279 pt on erythromycin and warfarin for 5 days:: dec warfarin to half for 5 days
2280 salicylic acid excretion is increased by alkaline urine and forced diuresis
2281 thiazide cause hypokalemia and hypochloremia and systemic alkalosis
2282 trimethoprin is not C.I. is sulfa allergy but captopril is..
2283 a potential advantage of pemoline over other stimulant drugs for uses in hyperkinesis
(minimal brain dysfunction) is that pemoline can be given once daily

99
2284 (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
2285 (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,
2286 (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
2287 (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
2288 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
2289 (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,
2290 (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.
2291 (cont. phenobarbital vs. n.jaundice) complete failure of this ttt can probably be attributed
to discontinuing of the drug prematurely
2292 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
2293 (cont. warfarin interactions) but drugs like: phenylbutazone, indomethacin, aspirin,
tolbutamide have high affinity for plasma protein binding, so cause therapeutic problems with
warfarin
2294 pt taking pargyline when prescribing cold remedies to him avoid: phenylephrine HCl,
BUT NOT: chlopheniramine maleate, aspirin, caffeine, acetaminophen.
2295 (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
2296 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.

100
2297 (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.
2298 steatorrhea is excessive loss of fats in feces
2299 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
2300 (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.
2301 1L D5W gives 170-200 kcals
2302 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.
2303 (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.
2304 (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.
2305 (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
2306 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.
2307 (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
2308 (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,
2309 (cont. PKU) since aspartam (methyl N-1-alpha-aspartyl-L-phenylalanine) is metabolized
to phenylalanine and aspartic acid and methanol
2310 (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..

101
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.
2314 erythromycin: would be a good alternative to penicillin V in a pregnant pt allergic to
penicillins. NOT: demeclocyclin, TC, trimethoprim.
2315 (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.
2316 (cont.) deposition of TC in the teeth of fetuses has been associated with enamel defects
and staining of teeth. Trimethoprim is teratogenic.
2317 sulfonamide best suited for the topical prophylactic ttt of burns: mafenide (sulfamylon
cr), silver sulfadiazine. NOT: sulfacetamide, sulfameter, phthalylsulfathiazole,
sulfamethoxypyridazine.
2318 (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.
2319 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.
2320 (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;
2321 (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.
2322 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.
2323 citrate is in oral rehydration, used to compat alkalosis and to improve salty taste of the
solution
2324 hemodyalisis is used for polar drugs
2325 atropine cause hemodynamic alterations as it causes initial tachycardia
2326 procarbazine is MAOI
2327 loading dose depend on Vd and plasma concn.

102
2328 half normal saline is hypotonic
2329 t1/2=0.7Vd/Cl
2330 cimetidine in elderly cause: mental confusion, gynecomastia-- cimetidine large dose is
taken at bedtime
2331 Al(OH)3=constipation
2332 non-linear pharmacokinetics:: t1/2 inc as dose inc???
2333 base of supp must not melt below 30 C
2334 coal tar is mixed with polysorbate 80 to assist its dispersion

2335 cetrizine does NOT cause nausea

2336 clorpromethazine does NOT cause vomiting
2337 L-dopa does NOT cause HTN
2338 xanthine, uric acid, adenine all are purines
2339 immunoassay is used for all (antidody, enzyme, drug level, receptor distribution)
EXCEPT electrolytes
2340 temazepam (BDZ) common metabolism is glucuronidation and alpha-N- delakylation
2341 degradation of penicillin is by hydrolysis
2342 substitution of cephalosporines at C7 inc B-lactamase stability
2343 methylcellulose + p-hydroxybenzoic acid is estrification reaction
2344 glucose an fructose are monosaccharides
2345 carbohydrates and fats are alike because they release energy to the cell ‫ﺣﺎﺟﺔ ﺣﻠﻮة ﺑﺼﺮاﺣﺔ‬
2346 sumatriptam mimic the serotonin action - C.I. in: CHF, angina, MAOIs
2347 insulin inc entering of glucose, fat and amino acids
2348 electroencephalogram monitor deep in the brain ?
2349 in epilepsy GABA transmission is low ???

2350 moxifloxacin is quinolone

2351 diabetes has higher risk of erectile dysfunction
2352 the aortic and pulmonary valves prevent the backflow of blood to the ventricles
2353 adrenaline is metabolized by MAO

103
2354 COMT does NOT metabolize isoprenaline
2355 slow IV infusion of adrenaline: inc cardiac output NOT diastolic blood pressure
2356 appropriate stimulation of sympathetic nerve: contraction of vascular smooth muscles
2357 pilocarpine in open angle glaucoma cause constriction of the pupil and produce dimming
vision of night
2358 storage of fats, formation of scar tissue, polymerization of aminoacids are called
anabolism
2359 RBCs formation is controlled by erythropoietine
2360 tranexamic acid, aminocaproic acid and aprotinin are all antifibrinolytic
2361 mestranol is estrogen not progesterone
2362 TCA affect neural amine reuptake mechanism
2363 pethidine, opioid, not used as antitussive
2364 iodine uptake by the thyroid gland is inhibited by high iodine dose
2365 B-estradiol has steroid structure
2366 FSH is controlled by the blood estrogen level
2367 estradiol is secreted from the ovarian follicle
2368 gout occurs more in men than in women
2369 rheumatoid arthritis management: NSAIDs to maintain mobility, DMARD used after
NSAIDs -- DMARD: disease modifying antirheumatic drug
2370 lamivudine is reverse transcriptase inhibitor used in HIV
2371 aspirin asthma sensitivity is due to decreased prostaglandin synth and increased
leukotriene synthesis
2372 inner ear is responsible for equilibrium
2373 carbachol is cholinergic agonist
2374 restriction endonuclease: cut double DNA of virus
2375 SE of vancomycin: ototoxicity

2376 sertraline is hepatotoxic

2377 Na chromoglycate does NOT cause direct bronchodilation
2378 -NHNH- is present in MOAI structure (phenelzine)??

104
2379 penicillin # transpeptidase enzyme so # bactreial cell wall synthesis
2380 sulindac is a prodrug: sulfoxide is reduced to the active sulfuide
2381 red meat in NOT C.I. with MAOIs
2382 tyrosine is a precursor of thyroxine
2383 thiopental Na is ultrashort acting phenobarbital due to its high lipid solubility
2384 vit D is NOT used in hyperthyrodism
2385 vit E is not proved to be essential for reproduction in man but vit A is important
2386 toxicity of thiazide is due to decreased blood volume
2387 drug of choice for E-coli is co-trimoxazole
2388 ventricular fibrillation is the most common complication of myocardial infarction
2389 sulfonamides SE: blood dyscrasias, rash, fever, steven-johnson syndrome
2390 sweat is used for: water excretion, Na excretion, temperature equlation (the most
important)
2391 in nephritis there is edema
2392 ketoconazole can be administered orally
2393 nitrazepam is not used for the ttt of insomnia in elderly pts but we can use oxazepam,
lorazepam
2394 edrophonium is used in diagnosis of myathenia gravis
2395 promethazine is a potent antiemetic
2396 osteoarthritis is a degenerative disease
2397 corticosteroids action in asthma:: dec inflammatory response and dec airway
hyperresponsiveness
2398 polymorphs differ in: melting points, solubility, dissolution rate, density, stability, BUT
NOT PH
2399 dec plasma protein level leads to edema
2400 ethylpalmitate is not SAA

2401 cortisone eye drop should be stored from 2-8 C

2402 norethindrone is used in endometriosis but medroxyprogesterone is better ?
2403 hypokalemia inc digoxin toxicity

105
2404 hydralazine cause anginal attack due to coronary steal phenomenon
2405 bulk-forming laxatives: psyllium, methylcellulose, bran, polycarbophil
2406 dithranol dose: 0.1-1% (psoriasis)
2407 aspirin does NOT interact with MAOI
2408 organophosphorus compounds act by irreversible inhibition of cholinesterase
2409 diphtheria vaccine and tetanus toxoid give active immunity
2410 chloral hydrate dose: 0.3-2 gm
2411 codeine dose: 30-60mg max: 200mg
2412 chlorbutol (preservative in eye drops)= 0.5%
2413 ergotamine tartarate and nitroglycerine can be used sublingually
2414 ergot alkaloids are used and migraine and prevent post0partum hemorrhage by increasing
uterine contraction
2415 bile conjugation occurs in liver
2416 corticosteroids functions include all the following: intermediate in metabolism, salt and
water retention, muscle development, hemopoesis
2417 phenytoin dose: 50-400 mg max? increment: 30mg once
2418 penicillinase-resistant penicillins: methicillin, nafcillin, cloxacillin, dicloxacillin
2419 antipseudomonal penicillins: carbenicillin, ticarcillin, mezlocillin, piperacillin
2420 acid-stable (oral) penicillins: ampicillin, amoxicillin, penicillin V
(phenoxymethylpenicillin), penicillin G Na and K salts
2421 drug of choice in H. influenza is ampicillin
2422 amoxicillin is used in the ttt of otitis media
2423 during ovulation FSH and LH reach highest peak
2424 corpus leuteum secretes mainly progesterone
2425 selective B1 blockers: atenolol, metoprolol, bisoprolol
2426 cimetidine is C.I. with: theophylline, phenytoin, warfarine, carbamazepine
2427 Na level in blood: 135-146 mmol/L - K level in blood: 3.3-5.5 mmol/L
2428 loop diuretics: furosemide, bumetanide, ethacrynic acid

106
2429 gentamicin is most effective against pseudomonas aerogenosa and against G- bacteria in
general

2430 phenol, NH4Cl,= acidic -- NaHCO3, amphetamine, acetazolamide = basic

2431 thiazides dec glucose tolerance
2432 drugs excreted by GF: ethambutol, aminoglycosides, MTX, digoxin, procainamide --
drugs excreted by passive tubular secretion: aspirin, amphetamine -- drugs excreted by active
tubular secretion: penicillin
2433 cod liver oil contains vit A and vit D
2434 phenylbutazone has ling t1/2 (75-100 hrs) and cause aplastic anemia and blood
dyscrasias, it also displace other drugs from plasma proteins
2435 in HTN we don't use atropine because it dec heart rate
2436 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
2437 carbamazepine self-induces its own metabolism on long-term use
2438 azathioprine + allopurinol:: increased levels of both drugs -- 6-MP + allopurinol::
increased levels of both drugs
2439 hypertensive crisis caused by tyramine+MAOIs is ttt by alpha blocker like phentolamine
2440 diphenoxylate is related to mepiridine, it stimulates opiate center in GIT causing
constipation
2441 initial plasma concn after IV administration depends on dose and clearance
2442 theophylline SE: nausea, vomiting, anxiety, tachycardia
2443 MAOIs are C.I. with guanthidine
2444 haloperidol is C.I with guanthidine and alpha methyldopa
2445 theophylline is C.I. with cimetidine
2446 TCA is C.I. with guanithidine
2447 metronidazole is C.I. with alcohol
2448 B-blockers are C.I. with verapamil
2449 bromohexine: depolymerization of mucous
2450 5-carboxymethylcysteine=acetylcysteine is mucolytic, ttt of mucous gland hyperplasia
2451 stearyl alc, cetyl alc, cholesterol are stabilizers
107
2452 don't take NaHCO3 (antacid) in HTN
2453 8.4% ib alcohol shock to neutralize lactic acidosis ???
2454 parathion and malathion are organophosphorus compounds and act as irreversible
anticholinesterases
2455 hydroxyzine has the greatest anthistaminic action (of all anxiolytic drugs)
2456 penicillamine is a chelating agent and used in rheumatoid arthritis and wilson's disease
2457 mestranol is estrogen not progesterone
2458 prednisone dose: 5-60 mg

2459 thyroid storm= sudden onset thyrotoxicosis

2460 favism is due to G-6-PD deficiency
2461 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.
2462 (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,
2463 (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
2464 antimony potassium tartarate (tartar emetic) is emetic and anthelmentic: tartar emetic is
intravenously administered anthelmentic agent which is employed against: schistosoma
japonicum/mansoni/haematobium

2465 (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
2466 nylidrin 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
2467 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.
2468 (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.

108
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 levels.
2472 (cont. case2) if large IM dose of chlordiazepoxide are given repeatedly over a short
period of time, it's quite likely that the pt will demonstrate symptoms of overdose several hours
later when large amount of the drug are absorbed from the multiple injns
2473 (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.
2477 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
2478 (cont. dobutamine) that mediate vasodilation. Consequently dobutamine produces
inotropic effects with consequently little effect on preload, afterload or heart rate.
2479 (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,

109
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.

2483 (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 20% of the insulin is added to an IV in bound to
the flask and tubing.
2487 (cont. case5) proportionally greater binding occurs with lower doses of insulin. If the
same IV set is used for subsequent infusions, the binding sites on the set may be saturated with
insulin. This would be observed clinically as some improvement in
2488 (cont. case5) control of blood glucose since subsequent binding would be to the IV bottle
alone. Furthermore, even if the insulin dose is adjusted for binding by the flask, hyperglycemia
may occur after the admn set is changed
2489 (cont. case5) this of course does not mean that insulin should not be administered by IV
infusion, but that the absorption of insulin by IV bottles and tubing should be considered in
accounting for unusual changes in blood glucose levels,
2490 (cont. case5) and in determining insulin doses, espicially when low doses are
contemplated.
2491 (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 refrigerate the vial in use. Insulin
vials stored in pharmacies are required to be refrigerated because it's possible to be in stoke for a
long time.

110
2496 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
2497 (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.
2498 (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.
2499 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
2500 (cont. proinsulin and insulin purity) such as glucagone, somatostatin, pancreatic
polypeptide. Currently, all comercially available insulins contain no more than 25ppm of
proinsulin
2501 (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.
2502 Iletin II contains <,=10ppm proinsulin and is available as a single species product (either
prk or beef)
2503 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
2504 (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
nonselective B-blockers atenolol does not delay recovery of glucose to normal levels
2508 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

111
2509 hypoglycemia: complication most likely to occur after sudden discontinuation of
parentral hyperalimentation (composed of amino acids or protein hydrolysates, glucose,
electrolytes and vitamines
2510 (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.
2511 (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.
2512 (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.
2513 (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
2514 (cont. TPN) hyperosmotic nonketotic hyperglycemic causes include too rapid infusion
rate, dextrose soln that are too concentrated and malfunction of pancreatic secretion of insulin
2515 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
2516 (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
2517 (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
2518 erythromycin interact with: oral anticoagulants, carbamazepine, digoxin, theophylline
2519 acne vulgaris is caused by bacterial infection: propionibacterium acne
2520 impetigo is contagious and caused by: staph. Aureus
2521 tombramycin and streptomycin resemble each other, both are aminoglycosides
2522 suxamethonium is succinylcholine ??
2523 nitroglycerine inc venous pool of blood
2524 prolonged use of spironolactone causes gynecomastia
2525 E-coli is the most common MO in uncomplicated UTI
2526 paracetamol has no antiinflammatory effect
2527 thirst is controlled by hypothalamus

112
2528 waste product of protein is urea
2529 amiodarone cause occular and sight problems
2530 the main sourse of peripheral resistance=arterioles
2531 metoprolol is B1 antagonist
2532 exertion of muscle (muscle fatigue) is due to lactic acid accumulation
2533 CH3-(CH2)16-COOH is stearic acid
2534 mineral oil is mon miscible in alcohol
2535 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
2536 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
2537 in contrast to spironolactone neither amiloride nor amiodarone inhibit aldosterone..
Metolazone, HCTZ, chlorthalidone are thiazide diuretics
2538 (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
2542 (cont. case8) in this case, since there are no symptoms or ECG changes, the rectal admn
of Na polystyrene sulfonate (enemas containing 50g in 70% sorbitol soln) is the most appropriate
option
2543 (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

113
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 peripheral resistance rapidly
with minimal effect on myocardial oxygen consumption. Nitroprusside dilates both venous
(capacitance) & arterial (resistance) vessels,
2548 (cont. case9) thus dec both preload and afterload on the heart. Nitroprusside is preferred
over trimethaphan because tolerance rapidly develops to trimethaphan hypotensive effect.
Propranolol is not effective in hypertensive emergencies.
2549 (cont. case9) hydralazine & menoxidil are both likely to cause cardiac stimulation
2550 (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 reuptake of serotonin rather than of norepinephrine, you would
now recommend also trazodone
2554 (cont. case10) NOT: imipramine, nortriptyline, trimipramine, maprotiline.. Trazodone is
the only listed agent that primarily # the reuptake of serotonin.. Imipramine, nortriptyline,
trimipramine # reuptake of both serotonin and norepinephrine.
2555 (cont. case10) maprotiline selectively # reuptake of norepinephrine with no effect on
serotonin
2556 (glucocorticoids) hydrocortisone (cortisol):: relative potency: 1, equivalent dose: 20mg,
Na-retaining potency: 2
2557 (cont. glucocorticoids) cortisone:: relative potency: 0.8, equivalent dose: 25mg, Na-
retaining potency: 2
2558 (cont. glucocorticoids) prednisolone & prednisone:: relative potyency: 4, equivalent dose:
5mg, Na-retaining potency: 1
2559 (cont. glucocorticoids) methylprednisolone:: relative potency: 5, equivalent dose: 4mg,
Na-retaining potency: 0

114
2560 (cont. glucocorticoids) betamethasone:: relative potency: 25, equivalent dose: 0.6mg, Na-
retaining potency: 0

2561 (cont. glucocorticoids) dexamethasone:: relative potency: 30, equivalent dose: 0.75mg,
Na-retaining potency: 0
2562 (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.
2565 (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 after admn. SR products are expected to peak 4hrs after
admn.
2569 (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.
2573 (cont. case13) when compared to those other agents, ephedrine has a shorter duration of
action, a lower peak effect & more adverse effects, ephedrine also adde little to the
bronchodilation produced by therapeutic doses og theophylline

115
2574 (cont. case13) theophylline+ephedrine: such a combination is likely to produce a
SYNERGISTIC TOXICITY.

2575 "(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 300mgX0.92=276mg/day of phenytoin acid. And
phenytoins suspension contains 125mg/5ml
2579 (cont. case14) so 5ml/125mg=Xml/276mg.. X=11.04ml -- the person measuring the dose
should use accurate measuring device and be sure to shake the container thoroughly before
measuring each dose.
2580 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.
2581 (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)
2582 (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.
2583 (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

2584 (cont. hypnotics) and fluorazepam often cause morning after effects
2585 cata: downward -- catabolism indicates any destructive process by which complex
substances are converted by living cells into more simple compounds
2586 dis: apart -- disarticulation is amputation or separation of a joint
2587 meso: middle -- mesobronchitis indicates inflammation of the middle coat of the bronchi
2588 retro: backward -- retrograde means retrace of a former course
2589 celi: abdomen -- celiotomy is incision into the abdominal cavity

116
2590 cephal: head -- cephalalgia: headache
2591 col: large intestine -- coloproctitis: inflamation of colon and rectum
2592 cor: heart -- the precordium: the region over the heart
2593 cost: rib -- intercostal: located between two ribs
2594 intra-articular: in the joint -- intrasynovial: in the joint fluid -- intrathecal: in the spinal
fluid
2595 Klinefelter's syndrome is a series of symptoms related to diminished development of the
seminiferous tubules of the testes
2596 acromegaly is a disease caused by the presence of a pituitary tumor which results in the
production of xss growth hormone

2597 Stein-Leventhal syndrome is a collection of symptoms related to the hypersecretion of

andregens by the ovarian stroma
2598 Cushing's syndrome is a series of clinical symptoms related to the excessive secretion of
cortisol by the drenal cortex
2599 Adam- Stoke's disease or syndrome disease is caused by heart block. It is characterised
by sudden attacks of unconsciouness, sometimes with convulsions
2600 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
2601 Bright's disease is a term used to describe kidney disease characterized by proteinurea
and glomerulonephritis
2602 Hodgkins disease affects lymphoidal tissue. There is a progressive enlargement of lymph
nodes, spleen and other lymphoid tissue
2603 Myasthenia gravis is characterised by fatigue and exhaustion of muscles. Although
progressive paralysis of muscles occurs, there are no sensory effects or atrophy.
2604 Raynaud's disease: pallor or cyanosis of the fingersor toes
2605 Graves disease: enlragement of the thyroid gland, exophthalmus, acceleration of pulse
rate, sweating, nervousness, psychatric disturbances, emaciation and increased metabolic rate
2606 herpse simplex: watery blisters on skin and mucous membranes, espicially the lips.
2607 Meniere's disease: deafness, tinnitus and dizziness, this is a nonsuppurative disease of the
labyrinth

117
2608 diagnistic agents:: azoresin: detection of achlorhydria -- congo red: detection of
amyloidosis -- Evans blue: determination of blood volume -- phenolsulfonphthaline:
determination of kidney function
2609 sulfobromophthaline: test for liver function
2610 (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.
2611 (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
2612 (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
2613 (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.
2614 (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

2615 (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.
2616 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
2617 indocin (indomethacin) take with milk, meals or antacids or immediately after food to
reduce gastric irritation
2618 Colace: do not take with mineral oil -- Colace is a surfactant and may increase the
absorption of mineral oil if given concurrently
2619 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.
2620 dulcolax tablets: should be taken whole and not broken or chewed - because they are
enteric-coated to prevent gastric irritation
2621 achromycin V: don't take with milk or antacids -- milk and antacids reduce the absorption
of tetracycline by forming insoluble complexes.
2622 coumadin: do not use aspirin without knowledge of your physician or pharmacist.

118
2623 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
2624 (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
2625 butazolidin: take with milk, antacids or meals to decrease gastric irritation
2626 phenformin: was indicated for obese diabetics whose hyperglycemia is due to ineffective
insulin action
2627 acetohexamide: reported to have significant uricosuric properties, metabolized to
compounds having equal or greater hypoglycemic activity.
2628 tolazamide: more slowly absorbed than other compounds(tolbutamide, acetohexamide,
chlorpropamide, phenformin)
2629 tolbutamide: totally metabolized to an inactive form

2630 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
2631 reference sources:: facts and comparison, handbook of ninprescription drugs, physician's
desk reference, united states dispensatory, united states pharmacopea.
2632 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.
2633 (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
2634 (cont. Facts and Comparisons) of similar products based upon cost per ml, per tablet, or
other common dosage base
2635 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.
2636 (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
2637 (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
2638 (cont. Handbook of Nonprescription Drugs) is listed in the section discussing sleep aids.
119
2639 Physician's Desk Reference:: list products manufactured by Paul B. Elder Co. - Possible
identification of a capsule having a distinctive color combination

2640 (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
2641 (cont. PDR) that section is subdivided by individual manufaturers.
2642 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
2643 (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
2644 (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
2645 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
2646 (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..
2647 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.

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