Practice questions and answers

Objective:

This page enlists some practice questions and answer relevant to pharmaceutical sciences, pharmacology and drugs and provide the opportunity to practice..

Disclaimer

Most of the practice questions in this page are collected from Google and Google AI Overview. These are for informational purposes only. For medical advice or diagnosis, consult a professional. AI responses may include mistakes. 

The *OPRA™ exam* evaluates candidates across several content modules, ensuring readiness for pharmacy practice in Australia. Here are the details of the key modules and their respective weightages:

### Content Modules

1. *Biomedical Sciences (20%)*:

   - Covers foundational topics like anatomy, physiology, and biochemistry.

   - Focuses on understanding the biological basis of diseases and treatment mechanisms.

2. *Medicinal Chemistry and Biopharmaceutics (10%)*:

   - Includes drug design, synthesis, and mechanisms of action.

   - Biopharmaceutics explores the relationship between drug properties and its absorption, distribution, metabolism, and excretion.

3. *Pharmacokinetics and Pharmacodynamics (10%)*:

   - Pharmacokinetics: Studies how the body processes drugs.

   - Pharmacodynamics: Examines how drugs affect the body, including their mechanisms and interactions.

4. *Pharmacology and Toxicology (15%)*:

   - Focuses on drug actions, therapeutic uses, side effects, and toxic effects.

   - Covers adverse drug reactions and safety considerations.

5. *Therapeutics and Patient Care (45%)*:

   - The largest module, emphasizing clinical application of knowledge.

   - Includes disease management, evidence-based prescribing, and patient counseling.

### Exam Format

- *120 multiple-choice questions* randomized across these modules.

- Focus on application-based and clinical scenarios.

### Comparison to KAPS

- The OPRA™ exam consolidates content previously split across two papers in KAPS.

- Increased emphasis on *therapeutics* and real-world application. 

For further resources, including exam guides and sample papers, visit the  website.

The *Overseas Pharmacist Readiness Assessment (OPRA™)* exam is a new initiative by the Australian Pharmacy Council (APC) to replace the *Knowledge Assessment of Pharmaceutical Sciences (KAPS)* exam. It will officially commence in *March 2025, with the final KAPS exam session being conducted in **November 2024*. Here are the key details:

### Key Features

1. *Exam Structure*:

   - Single paper with 120 multiple-choice questions.

   - Duration: *2.5 hours*.

   - Covers five content areas:

     - Biomedical Sciences (20%).

     - Medicinal Chemistry and Biopharmaceutics (10%).

     - Pharmacokinetics and Pharmacodynamics (10%).

     - Pharmacology and Toxicology (15%).

     - Therapeutics and Patient Care (45%).

2. *Format and Focus*:

   - Designed to align with current Australian pharmacy practices.

   - Emphasis on *therapeutics* and the *application of knowledge*.

   - Incorporates modern psychometric methodologies for scoring.

3. *Changes from KAPS*:

   - Shorter exam duration (reduced from two papers and four hours).

   - Reduced cost.

   - No changes to difficulty, eligibility, or number of attempts allowed.

4. *Delivery*:

   - Administered at *Pearson VUE test centers* in a closed-book format.

5. *Registration*:

   - Opens on *January 9, 2025*, for the March 2025 session.

   - ID and security requirements are mandatory.

6. *Preparation Resources*:

   - Updated exam guides and sample papers are available on the APC website.

The OPRA™ exam retains the comprehensive assessment framework of the KAPS exam while adapting to the evolving needs of pharmacy practice in Australia. It evaluates candidates' readiness to commence their pharmacy internship effectively.

What will be the OPRAs Passing Criterion 

Hi there! Many of you were asking me the passing criteria of OPRA exam. So here is your answer

1. *How Scoring Works*: 

   - The *OPRA™ exam* uses a fair system where your performance is compared to a standard (the "passing score"), not to other candidates. 

   - This passing score is decided by experts and reflects the minimum ability needed to qualify as an intern pharmacist.

2. *Overall Performance Matters*:

   - To pass, your *total performance* across the exam must meet the passing score for your specific version of the exam. 

   - You don't need to score a certain percentage; it’s about showing you meet the required ability level.

3. *Types of Questions*:

   - Out of the *120 questions, 90% (108 questions) are **scored* and count towards your result.  

   - The other *10% (12 questions)* are *unscored*, meaning they don’t count but are included to test future exam questions.  

4. *Unscored Questions*:

   - These unscored questions can appear in any topic area and are spread throughout the exam.  

   - You won’t know which questions are scored and which are not.

5. *Fairness*:

   - Experts (psychometricians) ensure the exam is reliable and valid, so every version of the test is fair for everyone. 

In short: Focus on doing your best on the whole exam, as your overall performance determines whether you pass!

Hi students!

OPRA Syllabus Completion Plan ✅

Step 1: Start with Pharmacology (16 lectures).

👉 No need to study Lippincott. Focus only on the lecture content.

Step 2: Alongside, cover Medicinal Chemistry:

Isomerism

Single & double structure questions

SAR (Structure–Activity Relationship)

Solubility concepts

Step 3: Move on to PK/PD and Biopharmaceutics:

PK/PD principles

pH/pKa relationship

Complete Biopharmaceutics module

📌 By this point, your Biomedical, Medicinal, and PK/PD modules will be fully covered.

Step 4: Finally, focus on Calculations and Recalls for reinforcement and practice.

Special focus on therapeutics topics like

(1) counselling

(2) Anti dotes

(3) Drug routes ; enteral and parenteral

(4) drug interactions 

Etc

## *Anticoagulants (Warfarin)*  

- *Warfarin + Aspirin (ASA):* Increased bleeding risk  

- *Warfarin + Simvastatin:* Increased bleeding risk  

- *Warfarin + Clarithromycin:* Increased warfarin effect  

- *Warfarin + Metronidazole:* Increased INR  

- *Warfarin + Itraconazole:* Increased bleeding risk  

- *Warfarin + Tramadol:* Increased bleeding risk  

- *Warfarin + Phenytoin:* Decreased warfarin effect  

- *Warfarin + Spironolactone:* No significant interaction  

- *Warfarin + Ketoconazole:* Increased bleeding risk  

- *Warfarin + Allopurinol:* No significant interaction  

---

## *Statins & Lipid-Lowering Agents*  

- *Cholestyramine + Rifampicin:* No direct interaction, but cholestyramine reduces absorption of many drugs. Administer other medications at least 1 hour before or 4–6 hours after cholestyramine.  

- *Simvastatin + Fibrates:* Increased risk of myopathy  

- *Simvastatin + Colchicine:* Increased risk of myopathy  

- *Simvastatin + Diltiazem:* Pharmacokinetic interaction, increased myopathy risk  

- *Statin + Cholestyramine:* Decreased statin absorption, reducing statin efficacy  

---

## *Combined Oral Contraceptives (COCs)*  

- *COC + Rifampicin:* Risk of contraceptive failure  

- *Topiramate + COC:* Risk of contraceptive failure  

---

## *Antibiotics & Enzyme Inhibitors*  

- *Clarithromycin + Rivaroxaban:* Increased rivaroxaban levels, increased bleeding risk  

- *Ciprofloxacin + Theophylline:* Increased theophylline levels  

- *Ciprofloxacin + Calcium:* Chelation, leading to decreased ciprofloxacin absorption  

- *Cephalexin + Probenecid:* Increased cephalexin levels  

- *Probenecid + Methotrexate:* Increased methotrexate toxicity  

---

## *Psychotropics & CNS Drugs*  

- *Lithium + Amiodarone:* Risk of thyroid disturbances  

- *St. John’s Wort + Fluoxetine:* Increased risk of serotonin syndrome  

- *St. John’s Wort + Methadone:* Decreased methadone levels  

- *St. John’s Wort + Digoxin, Tacrolimus, Statins (except Rosuvastatin):* Decreased drug levels  

- *St. John’s Wort + SSRIs:* Increased risk of serotonin syndrome  

- *Aspirin + Citalopram:* No significant interaction  

---

## *Cardiovascular Drugs*  

- *Beta-Blockers + NSAIDs:* Reduced antihypertensive effect  

- *Levodopa + Bromocriptine:* Pharmacodynamic interaction  

- *Simvastatin + Felodipine:* No significant interaction  

---

## *Gastrointestinal & Absorption Interactions*  

- *Famotidine + Itraconazole:* Decreased itraconazole absorption  

- *Alendronate + Calcium:* Chelation, reducing absorption  

- *Alendronate + Potassium:* No chelation  

---

## *Miscellaneous Interactions*  

- *Alcohol + Disulfiram:* Disulfiram-like reaction (severe nausea, vomiting, flushing)  

- *Alcohol + Griseofulvin:* Disulfiram-like reaction  

- *Theophylline + Smoking:* Decreased theophylline levels  

- *Theophylline + Clarithromycin:* Increased theophylline levels

*November Drug Interactions (DI):*  

---

## *Anticoagulants (Warfarin)*  

- *Warfarin + Phenytoin:* Initial increase in warfarin effect, but decreased warfarin levels in the long term  

- *Warfarin + Spironolactone:* No significant interaction  

- *Fluoxetine + Warfarin:* Increased warfarin effect  

- *Warfarin + Metronidazole:* Increased INR  

- *Aspirin + Warfarin:* Increased risk of bleeding  

---

## *Statins & Lipid-Lowering Agents*  

- *Diltiazem + Simvastatin:* Increased myopathy risk (Pharmacokinetic interaction)  

- *Simvastatin + Felodipine:* No significant interaction  

- *Simvastatin + Colchicine:* Increased risk of myopathy  

- *Cholestyramine + Statins:* Decreased statin effects  

---

## *Combined Oral Contraceptives (COCs)*  

- *Topiramate + COC:* Increased risk of contraceptive failure  

---

## *Antibiotics & Enzyme Interactions*  

- *Cephalexin + Probenecid:* Increased cephalexin levels  

- *Clarithromycin + Rivaroxaban:* Increased rivaroxaban levels, leading to a higher bleeding risk  

- *Ciprofloxacin + Theophylline:* Increased theophylline levels  

- *Ciprofloxacin + Calcium:* Chelation, leading to decreased ciprofloxacin absorption  

- *Probenecid + Methotrexate:* Increased methotrexate toxicity  

- *Methotrexate + Hydroxychloroquine (HCQ):* Increased risk of hepatotoxicity  

---

## *Psychotropics & CNS Drugs*  

- *Lithium + Amiodarone:* Risk of thyroid disturbances  

- *St. John’s Wort + Methadone:* Decreased methadone levels (least affected drug)  

- *St. John’s Wort + Fluoxetine:* Increased fluoxetine levels  

- *St. John’s Wort + Rifampicin:* No significant interaction  

- *St. John’s Wort + Tacrolimus, Methadone, Digoxin, Statins (except Rosuvastatin):* Decreased drug levels  

- *St. John’s Wort + SSRIs:* Increased risk of serotonin syndrome  

---

## *Cardiovascular Drugs*  

- *Levodopa + Bromocriptine:* Pharmacodynamic interaction  

---

## *Gastrointestinal & Absorption Interactions*  

- *Famotidine + Itraconazole:* Decreased itraconazole absorption  

---

## *Miscellaneous Interactions*  

- *Alcohol + Disulfiram:* Disulfiram-like reaction (severe nausea, vomiting, flushing)  

- *Theophylline + Smoking:* Decreased theophylline levels  

- *Theophylline + Clarithromycin:* Increased theophylline levels  

- *Not exacerbating asthma:* St. John’s Wort

1. Which hormone regulates blood glucose by increasing its uptake into cells?

A) Glucagon

B) Insulin

C) Cortisol

D) Growth Hormone

Answer: B) Insulin

2. The primary hormone responsible for increasing blood glucose levels is:

A) Insulin

B) Glucagon

C) Thyroxine

D) Aldosterone

Answer: B) Glucagon

3. Which of the following insulins is long-acting?

A) Lispro

B) Aspart

C) Glargine

D) Regular insulin

Answer: C) Glargine

4. Metformin primarily works by:

A) Stimulating insulin secretion

B) Reducing hepatic glucose production

C) Increasing pancreatic β-cell function

D) Blocking glucose absorption in the intestines

Answer: B) Reducing hepatic glucose production

5. A major side effect of sulfonylureas is:

A) Hyperglycemia

B) Hypoglycemia

C) Hypertension

D) Osteoporosis

Answer: B) Hypoglycemia

6. The main risk associated with thiazolidinediones (e.g., pioglitazone) is:

A) Liver toxicity

B) Fluid retention and heart failure

C) Hypoglycemia

D) Increased insulin resistance

Answer: B) Fluid retention and heart failure

7. Which oral antidiabetic class is most associated with weight loss?

A) Sulfonylureas

B) DPP-4 inhibitors

C) GLP-1 receptor agonists

D) Thiazolidinediones

Answer: C) GLP-1 receptor agonists

8. Which of the following is an example of a DPP-4 inhibitor?

A) Sitagliptin

B) Canagliflozin

C) Exenatide

D) Pioglitazone

Answer: A) Sitagliptin

9. Which drug class works by inhibiting glucose reabsorption in the kidneys?

A) Sulfonylureas

B) DPP-4 inhibitors

C) SGLT2 inhibitors

D) Biguanides

Answer: C) SGLT2 inhibitors

10. The most common side effect of SGLT2 inhibitors is:

A) Pancreatitis

B) Urinary tract infections

C) Weight gain

D) Hyperglycemia

Answer: B) Urinary tract infections

11. Which hormone is deficient in Addison’s disease?

A) Insulin

B) Cortisol

C) Aldosterone

D) Both B and C

Answer: D) Both B and C

12. The treatment for Addison’s disease includes:

A) Insulin therapy

B) Hydrocortisone

C) Methimazole

D) Metformin

Answer: B) Hydrocortisone

13. Hyperthyroidism is most commonly caused by:

A) Hashimoto’s thyroiditis

B) Graves’ disease

C) Iodine deficiency

D) Pituitary adenoma

Answer: B) Graves’ disease

14. Which drug is used in the treatment of hyperthyroidism?

A) Levothyroxine

B) Methimazole

C) Fludrocortisone

D) Hydrocortisone

Answer: B) Methimazole

15. The preferred treatment for hypothyroidism is:

A) Liothyronine

B) Levothyroxine

C) Propylthiouracil

D) Carbimazole

Answer: B) Levothyroxine

16. Which of the following conditions is associated with hyperprolactinemia?

A) Cushing’s syndrome

B) Acromegaly

C) Prolactinoma

D) Diabetes mellitus

Answer: C) Prolactinoma

17. Which drug is used to treat hyperprolactinemia?

A) Metformin

B) Cabergoline

C) Levothyroxine

D) Hydrocortisone

Answer: B) Cabergoline

18. What is the mechanism of action of bisphosphonates?

A) Stimulate bone formation

B) Inhibit osteoclast activity

C) Increase calcium absorption

D) Decrease calcium excretion

Answer: B) Inhibit osteoclast activity

19. Which hormone is responsible for stimulating ovulation?

A) FSH

B) LH

C) Estrogen

D) Progesterone

Answer: B) LH

20. The primary function of progesterone is to:

A) Stimulate follicle development

B) Maintain pregnancy

C) Increase ovulation

D) Promote bone resorption

Answer: B) Maintain pregnancy

Respiratory System (Questions 41–60)

41. The primary mechanism of action of β2 agonists in asthma is:

A) Bronchoconstriction

B) Bronchodilation

C) Inhibition of histamine release

D) Increased mucus production

Answer: B) Bronchodilation

42. Which of the following is a short-acting β2 agonist (SABA)?

A) Salmeterol

B) Formoterol

C) Albuterol (Salbutamol)

D) Tiotropium

Answer: C) Albuterol (Salbutamol)

43. Which class of drugs is first-line therapy for persistent asthma?

A) Leukotriene receptor antagonists

B) Inhaled corticosteroids

C) Antihistamines

D) Beta-blockers

Answer: B) Inhaled corticosteroids

44. Which of the following is an inhaled corticosteroid?

A) Salbutamol

B) Montelukast

C) Fluticasone

D) Ipratropium

Answer: C) Fluticasone

45. Montelukast belongs to which drug class?

A) Beta-agonists

B) Leukotriene receptor antagonists

C) Inhaled corticosteroids

D) Anticholinergics

Answer: B) Leukotriene receptor antagonists

46. Which drug class is most effective for COPD management?

A) Beta-agonists

B) Anticholinergics

C) Corticosteroids

D) Mast cell stabilizers

Answer: B) Anticholinergics

47. Which of the following is a long-acting muscarinic antagonist (LAMA)?

A) Salmeterol

B) Ipratropium

C) Tiotropium

D) Albuterol

Answer: C) Tiotropium

48. Theophylline acts by:

A) Blocking β2 receptors

B) Inhibiting phosphodiesterase

C) Blocking histamine release

D) Increasing mucus secretion

Answer: B) Inhibiting phosphodiesterase

49. A major side effect of theophylline is:

A) Hypertension

B) Tachycardia

C) Hypoglycemia

D) Hyperkalemia

Answer: B) Tachycardia

50. Which drug is used as a mast cell stabilizer in asthma?

A) Salmeterol

B) Cromolyn sodium

C) Theophylline

D) Montelukast

Answer: B) Cromolyn sodium

51. Which hormone is responsible for sodium and water retention?

A) Cortisol

B) Aldosterone

C) Insulin

D) Glucagon

Answer: B) Aldosterone

52. Which of the following is a common side effect of levothyroxine overdose?

A) Bradycardia

B) Hyperthyroidism symptoms (tachycardia, weight loss)

C) Hypoglycemia

D) Fluid retention

Answer: B) Hyperthyroidism symptoms (tachycardia, weight loss)

53. Which of the following is NOT a function of growth hormone?

A) Stimulating protein synthesis

B) Increasing glucose uptake by cells

C) Promoting lipolysis

D) Increasing bone growth

Answer: B) Increasing glucose uptake by cells

54. Which of the following drugs is used to treat acromegaly?

A) Somatropin

B) Octreotide

C) Levothyroxine

D) Metformin

Answer: B) Octreotide

55. Which of the following is an androgen receptor antagonist used in prostate cancer treatment?

A) Finasteride

B) Flutamide

C) Testosterone

D) Leuprolide

Answer: B) Flutamide

Respiratory System (Questions 56–60)

56. Which of the following medications is a long-acting beta agonist (LABA)?

A) Albuterol

B) Salmeterol

C) Montelukast

D) Tiotropium

Answer: B) Salmeterol

57. What is the mechanism of action of ipratropium in COPD?

A) Beta-agonist

B) Muscarinic receptor antagonist

C) Phosphodiesterase inhibitor

D) Leukotriene receptor antagonist

Answer: B) Muscarinic receptor antagonist

58. Which of the following is a major side effect of corticosteroids in chronic asthma therapy?

A) Hypertension

B) Oral candidiasis

C) Hyperkalemia

D) Dry cough

Answer: B) Oral candidiasis

59. What is the primary action of leukotriene receptor antagonists like montelukast?

A) Bronchodilation

B) Inhibition of leukotriene-mediated inflammation

C) Blocking acetylcholine receptors

D) Increasing mucus clearance

Answer: B) Inhibition of leukotriene-mediated inflammation

60. Which of the following drugs is a methylxanthine used in asthma treatment?

A) Montelukast

B) Theophylline

C) Cromolyn sodium

D) Beclomethasone

Answer: B) Theophylline

61. Which hormone stimulates milk production in lactating women?

A) Oxytocin

B) Prolactin

C) Estrogen

D) Progesterone

Answer: B) Prolactin

62. The function of oxytocin is to:

A) Stimulate follicle development

B) Induce labor and milk ejection

C) Maintain pregnancy

D) Inhibit uterine contractions

Answer: B) Induce labor and milk ejection

63. Which of the following hormones is responsible for regulating calcium homeostasis?

A) Insulin

B) Cortisol

C) Parathyroid hormone (PTH)

D) Aldosterone

Answer: C) Parathyroid hormone (PTH)

64. Which of the following is a common side effect of glucocorticoids?

A) Hypoglycemia

B) Osteoporosis

C) Hyperkalemia

D) Hypotension

Answer: B) Osteoporosis

65. What is the main therapeutic use of desmopressin (DDAVP)?

A) Hypothyroidism

B) Diabetes insipidus

C) Addison’s disease

D) Acromegaly

Answer: B) Diabetes insipidus

Respiratory System (Questions 66–70)

66. Which of the following medications is used for the acute management of an asthma attack?

A) Salmeterol

B) Montelukast

C) Albuterol (Salbutamol)

D) Tiotropium

Answer: C) Albuterol (Salbutamol)

67. The primary mechanism of action of inhaled corticosteroids in asthma is:

A) Bronchodilation

B) Inhibition of inflammatory mediators

C) Blocking histamine release

D) Increasing mucus production

Answer: B) Inhibition of inflammatory mediators

68. Which drug is an antitussive used to suppress dry cough?

A) Guaifenesin

B) Dextromethorphan

C) Salbutamol

D) Bromhexine

Answer: B) Dextromethorphan

69. Which of the following is a first-line treatment for allergic rhinitis?

A) Antihistamines

B) Beta-blockers

C) Leukotriene inhibitors

D) Theophylline

Answer: A) Antihistamines

70. Which of the following drugs is most likely to cause oral candidiasis as a side effect?

A) Albuterol

B) Montelukast

C) Inhaled corticosteroids (e.g., Fluticasone)

D) Ipratropium

Answer: C) Inhaled corticosteroids (e.g., Fluticasone)

Drug of choice

The drug of choice for myasthenia gravis (MG) is typically pyridostigmine for symptomatic relief, but the overall treatment depends on the severity and type of the disease. For more severe or widespread symptoms, long-term immunosuppressants like prednisolone or azathioprine are often added, and treatments like IVIg or plasma exchange may be used for MG crises. 

The drug of choice for Parkinson's disease is levodopa, specifically in combination with carbidopa to increase its effectiveness and reduce side effects like nausea. While levodopa is the most effective medication, the initial choice can also depend on a patient's age and disease severity. For younger patients, a dopamine agonist might be recommended first to delay the onset of movement problems. 

There is no single "drug of choice" for Alzheimer's, as treatment depends on the stage of the disease and individual patient needs. For mild to moderate Alzheimer's, cholinesterase inhibitors like donepezil, galantamine, and rivastigmine are most commonly prescribed. For moderate to severe Alzheimer's, memantine is often used, and sometimes combined with donepezil. Newer amyloid-clearing antibodies are available for early-stage disease but are not yet covered by all public health schemes. Azhar Mama Done his Gala Rivercruise

Cardiovascular system (CVS)

Which drug reduces mortality in heart failure with reduced ejection fraction?

A) ACE inhibitors

B) Beta-blockers

C) Spironolactone

D) All of the above

In heart failure with reduced ejection fraction, all of ABC are used. So, the correct answer is D. In heart failure with angina, Beta blocker is the first drug of choice, second drug of choice is ACE Inhibitors which also prevents end organ damage. Then the choice could be  Spironolactone.

Angiotensin converting enzyme inhibitors-

A inhibit the conversion of angiotensin I to angiotensin II

B should never be used with potassium sparing diuretics

C may decrease lithium levels

D all have similar half-lives

E may cause cough and in some instances angioedema

A&E

NSAIDS

2. Which drug does not interact with NSAIDs?
A. Methotrixate

B. Warferin
C. Antihypertensive drugs

D. Dyphenhydramine

Dyphenhydramine is an antihistamine compound used for the symptomatic relief of allergies.

9. Among NSAIDS aspirin is unique because it: 

A. Irreversibly inhibits its target enzyme

B. Prevents episodes of gouty arthritis with long-term use

C. Reduces fever

D. Reduces the risk of colon cancer

E. Selectively inhibits the COX-2 enzymes spectrophotometry

Aspirin acetylates both COX-1 and COX-2 enzymes, preventing them from synthesizing prostaglandins. 

Aspirin does not selectively inhibit COX-2 enzymes; it is a non-selective inhibitor that targets both COX-1 and COX-2 enzymes. It irreversibly inhibits both isoforms, but it is more effective at inhibiting COX-1 than COX-2. Spectrophotometry can be used to measure the activity of both enzymes, which is how their inhibition by various compounds, including aspirin, is quantified in experiments.

Findings suggest that the use of low-dose aspirin on two consecutive days is associated with an increased risk of recurrent gout attacks.

Antimicrobial

3. A patient's urine culture is positive for vancomycin resistant enterococcus faecium. He is treated with Linezolid 600 mg iv q12h. After 2 days on his new antibiotic, he has developed a major drug interaction. His home medications are fluconazole, citalopram, furosemide, metoprolol, aspirin, and lisinopril. Which of the following is the major sign/symptom of this drug interaction?

A. Thrombocytopenia

B. Serotonin syndrome

C. Torsades de pointe

D. Hypertensive crisis

E. Jaundice

Torsades de pointes is a rare, life-threatening heart rhythm disorder (a type of ventricular tachycardia) where the heart's lower chambers beat extremely fast and irregularly, causing them to "twist" on an electrocardiogram. This is caused by a prolonged QT interval, which can be congenital or acquired through factors like certain medications, electrolyte imbalances (low potassium or magnesium), or other heart conditions. Symptoms include fainting and a risk of sudden cardiac death, and treatment involves identifying and correcting the underlying cause, often with magnesium and pacing.  

Thrombocytopenia is a medical condition characterized by a low level of platelets in the blood, which can lead to excessive bleeding and easy bruising. It can be caused by the bone marrow not producing enough platelets, the destruction of platelets, or them being trapped in the spleen. Causes include certain medications, chemotherapy, infections, and other diseases, and treatment depends entirely on the underlying cause.  

A hypertensive crisis is a sudden and severe spike in blood pressure, to 180/120 mmHg or higher, which is a medical emergency that can lead to life-threatening complications like stroke or heart attack without treatment. It is classified into two types: a hypertensive urgency, with high blood pressure but no new organ damage, and a hypertensive emergency, where there are signs of organ damage such as chest pain, shortness of breath, vision changes, or difficulty speaking. Immediate medical attention is crucial for both, especially if organ damage is suspected.

Ketoconazole should not be given to a patient being treated with astemizole because :

A) Ketoconazole induces the metabolism of astemizole

B) Dangerous ventricular arrhythmias can occur

C) Astemizole inhibits the metabolism of ketoconazole

D) Astemizole antagonizes the antifungal action of ketoconazole

E) Ketoconazole is ok to be given with astemizole

F) none of the above

Explanation: Combined use of astemizole and ketoconazole resulting in torsade de pointes, a serious ventricular arrhythmia which is usually associated with a long QT interval.

A patient is treated for vancomycin-resistant Enterococcus faecium with linezolid 600 mg twice a day. Which one of the

following acid accumulation is MOST likely to occur with linezolid therapy?

A. Acetoacetic acid

B. β-Hydroxybutyric acid

C. Lactic acid

D. Pyroglutamic acid

E. None of the above

Many case reports have documented that patients treated with linezolid can develop severe high anion gap. metabolic acidosis due to lactic acid production. Although it is unclear, mitochondrial toxicity has been suggested as the underlying mechanism for lactic acid production. Thus, option lactic acid is correct.

4. Which of the following medications is MOST extensively cleared unchanged by the renal route?

A. Digoxin

B. Phenytoin

C. Naproxen

D. Paracetamol

Which of the following choices would not be appropriate in treating nausea and vomiting associated with motion sickness? 

A. Metoclopramide

B. Hyoscine hydrobromide

C. Prochloperazine

D. Promethazine

E. A and C

F. C and D

Scopolamine, also known as hyoscine, or Devil's Breath, is a medication used to treat motion sickness and postoperative nausea and vomiting.

Promethazine is a synthetic antihistamine drug derived from phenothiazine, used chiefly to treat the symptoms of allergies and motion sickness. 

Prochlorperazine is used to treat nervous, emotional, and mental conditions (eg, schizophrenia) and non-psychotic anxiety. It is also used to control severe nausea and vomiting. This medicine should not be used to treat behavioral problems in older adult patients who have dementia.

Urinary tract

10. A 55-year-old male with kidney stones has been placed on a diuretic to decrease calcium excretion. However, after a few weeks, he develops an attack of gout. Which diuretic was he taking?

A. Furosemide

B. Hydrochlorothiazide

C. Spironolactone

D. Triamterene

Thiazide, thiazide-like, and loop diuretics are the main classes of diuretics that increase uric acid levels. Examples include hydrochlorothiazide (HCTZ), furosemide, and bumetanide. These medications can increase serum uric acid levels by increasing reabsorption and decreasing secretion in the kidneys. Potassium-sparing diuretics, such as spironolactone, are less likely to cause this effect. 

Urinary tract

Corticosteroids are effective in the treatment of acute asthma because they

A cause acute bronchodilation

B reduce mucosal oedema

C suppress precipitating infections

D prevent mediator release from mast cells

E reduce prostaglandin formation by inhibiting cyclo-oxygenase activity

Immunology

Q. Which of the following is NOT a component of the innate immune system?

A. Natural killer (NK) cells

B. Complement proteins

C. Skin barrier

D. Memory B lymphocytes [Ans]

Explanation: 

Innate immunity (fast, non-specific):

- Barriers: Skin, mucosa

- Cells: Neutrophils (WBC), macrophages, NK cells, dendritic cells

- Proteins: cytokines

Adaptive immunity (long-term, slow, specific, memory):

- B cells: Produce antibodies

- T cells: Helper T cells (activate B cells), Cytotoxic T cells (kill infected cells)

- Memory cells: Long-term immunity

Excipient

13. Pyrantel pamoate is used for treatment of: 

A. Athletes foot

B. Nickel poisoning

C. Nematode infestations

D. Toxoplasmosis

Pyrantel, an antiworm medication, is used to treat roundworm, hookworm, pinworm, and other worm infections. This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information

Which of the following is not true about liquid Paraffin? 

A. Sparingly soluble in alchohol

B. Is made of unsaturated hydrocarbons

C. Not soluble in water

D. Soluble in chloroform

Liquid paraffin is insoluble in water and sparingly soluble in ethanol but is soluble in organic solvents like ether, benzene, chloroform, and carbon disulfide. It is also miscible with other hydrocarbons and most oils, except for castor oil. 

liquid paraffin is made of saturated hydrocarbons, which are a mixture of liquid alkanes derived from petroleum. These molecules consist of carbon and hydrogen atoms linked by single bonds, meaning all carbon atoms are bonded to the maximum number of hydrogen atoms. This structure makes liquid paraffin stable, colorless, and odorless, and it is used in products like cosmetics and pharmaceuticals.   

Which ONE of the following suppository bases is immiscible with body fluids?

A. Gelatin

B. Polyethylene glycol

C. Glycerinated gelatin

D. Cocoa butter

E. Macrogol base

The suppository base that is immiscible with body fluids is

cocoa butter (theobroma oil), which is a fatty base. While it melts quickly at body temperature, its immiscibility can impact the release of certain drugs. 

Virology

11. Cold sores are typically caused by:

A. HSV-1

B. HSV-2

C. Varicella zoster

D. HIV

E. None of the above

Cold sores are caused by the herpes simplex virus, typically type 1 (HSV-1). After a person is first infected, the virus remains dormant in the body and can be reactivated later by triggers like stress, illness, sun exposure, or hormonal changes. The virus is spread through direct contact, such as kissing or sharing items, and can even be transmitted when no sores are visible.

Varicella zoster virus, also known as human herpesvirus 3, is one of nine known herpes viruses that can infect humans. It causes chickenpox, commonly affecting children and young adults, and shingles in adults but rarely in children.

Metabolism

Clozapine is metabolized in the body by: 

А. СҮРЗА4

B. CYP2D6

C. CYP1A2

D. CYP2C9

Clozapine is a psychiatric medication and was the first atypical antipsychotic to be discovered. Clozapine is metabolized in the body primarily by the cytochrome P450 (CYP) enzyme system in the liver, with key enzymes including CYP1A2 and CYP3A4. These enzymes convert clozapine into metabolites, most notably norclozapine (N-desmethylclozapine) and clozapine-N-oxide. CYP1A2 is the primary enzyme responsible for creating the active metabolite, norclozapine. CYP3A4 is also a significant contributor, producing clozapine-N-oxide.

8. Which of the following is most appropriate regarding biotransformation reaction?

A. Can occur in the kidney

B. Only occurs in the liver

C. Biotransformation reaction is same in all mammalian species

D. None of the above

Gynocologiacl system

14. Estradiol undergoes which of the following phase 2 metabolism reaction:

A. Glucronidation + Amino acid conjugation

B. Glucronidation + Sulfation

C. Acetylation

D. Glutathione conjugation

Estradiol undergoes several phase 2 metabolism reactions, most notably glucuronidation and sulfation. It can also undergo methylation. These conjugation reactions make the molecule more water-soluble to facilitate its excretion from the body. 

Medicinal Chemistry

12. Conformation of organic molecules is most commonly determined by which of the following analytical methods? 

A. Nuclear magnetic resonance

B. Optical rotation

C. pk determinations

D. Biological assay

E. Mass spectrophotometry

Nuclear Magnetic Resonance (NMR) spectroscopy is the most commonly used method to determine the conformation of organic molecules. 

Explanation: NMR allows chemists to identify different conformers within a molecule by observing the slight differences in their chemical environments, which lead to distinct NMR signals for each conformer. This is particularly useful for studying rotational isomers around single bonds. 

15. Lactulose is a disaccharide composed of: 

A. Glucose + Fructose

B. Glucose + Glucose

C. Galactose + Fructose

D. Glucose + Galactose

E. Cellulose derivative

Lactulose is a synthetic sugar with laxative properties. It is a disaccharide consisting of glucose and fructose units.

Glucose + glucose equals maltose, also known as "malt sugar," which is a disaccharide (a sugar made of two units). This happens when two molecules of the simple sugar glucose bond together.

Glucose and fructose combine to form sucrose, which is commonly known as table sugar. This combination is also found in other sweeteners like high-fructose corn syrup (HFCS) and is the basis for many manufactured syrups

Galactose and fructose combine to form a synthetic disaccharide called galactofructose (or sometimes lactulose, though this is also the name for a different synthetic sugar). While other disaccharides like sucrose (glucose + fructose) and lactose (glucose + galactose) occur naturally, galactofructose is a man-made sweetener with prebiotic and laxative effects

Glucose and galactose combine to form lactose, a disaccharide commonly known as milk sugar. This process involves a condensation reaction, where a glycosidic bond forms between the two monosaccharides and a water molecule is released. Lactose is naturally found in milk.

16. Drug A is full agonist for a specific receptor system; drug B is a competitive antagonist for the same receptor system. If increasing doses of drug B are co-administered with drug A, drug B will: 

A. Increase the apparent Emax of drug

B. Reduce the apparent Emax of drug A.

C. Increase the apparent EC50 of drug

D. Reduce the apparent EC50 of drug A.

Emax is the maximal effect of a drug on a parameter being measured. For example, this could be a measure of platelet inhibition as an ex-vivo test or the maximum lowering of blood pressure. EC50 is the drug concentration at a steady state that produces half of the maximum effect.

17. All of the following adverse drug events are reported for pioglitazone (a thiazolidinedione), except: 

A. Exacerbation of CHF

B. Resumption of ovulation

C. Edema

D. Upper respiratory infection

E. Megaloblastic anemia

Pioglitazone is used with proper diet and exercise to treat high blood sugar levels caused by type 2 diabetes. It may be used alone or with other medicines such as insulin, metformin, or sulfonylurea agents. Pioglitazone works by helping your body use insulin better.

Pioglitazone can cause the resumption of ovulation in women with insulin resistance, particularly those with

Polycystic Ovary Syndrome (PCOS), by improving insulin sensitivity. This can lead to a risk of pregnancy, so patients should be aware and use contraception if they do not wish to become pregnant. 

Pioglitazone can cause edema, which is a common side effect that is often related to dose and can be more frequent when combined with other diabetes medications. Fluid retention from pioglitazone can manifest as peripheral edema (swelling in the legs, feet, and hands), but it can also progress to more serious conditions like pulmonary edema or worsening heart failure in some patients. It is important to use pioglitazone with caution, especially in patients with a history of heart failure, and to monitor for signs of fluid retention

No, pioglitazone does not directly cause megaloblastic anemia, but it is associated with a small decrease in hemoglobin and can increase the risk of anemia, possibly due to effects on bone marrow. Metformin, a common co-treatment, can cause megaloblastic anemia, and patients are advised to have regular blood panels to monitor for this

18. Which type of anemia is seen in patients with rheumatoid arthritis, that is unrelated to drug therapy? 

A. Microcytic, Hypochromic

B. Normochromic, normocytic

C. Normochromic, Macrocytic

D. Hypochromic, Macrocytic

The type of anemia seen in patients with rheumatoid arthritis (RA) that is unrelated to drug therapy is anemia of chronic disease (ACD), also called anemia of inflammation. This condition is caused by the chronic inflammation from RA, which interferes with the body's ability to use iron to produce red blood cells. 

19. What condition usually increases the rate of drug dissolution for a tablet? 

A. Increase in the particle size of the drug

B. Decrease in the surface area of the drug

C. Use of the ionized, or salt, form of the drug

D. Use of the free acid or free base form of the drug

E. Use of sugar coating around the tablet

20. Which patient is at potential risk for Digoxin toxicity? 

A. Patient with a calcium of 8.9

B. Patient taking furosemide 20mg IV twice a day

C. Patient with a potassium level of 3.8

D. Patient presenting with painful muscle spasms and positive Trousseau's sign

Pharmacokinetics/Dynamics

1. What is the main site of drug absorption in the body?

A) Stomach

B) Small intestine

C) Large intestine

D) Esophagus

Answer: B) Small intestine

2. Which of the following is NOT a phase I metabolic reaction?

A) Oxidation

B) Reduction

C) Hydrolysis

D) Glucuronidation

Answer: D) Glucuronidation

3. Which enzyme system is responsible for the metabolism of most drugs?

A) CYP450

B) MAO

C) COMT

D) Cholinesterase

Answer: A) CYP450

4. What is the primary function of Phase II metabolism?

A) Increasing drug solubility

B) Activating prodrugs

C) Enhancing drug absorption

D) Decreasing renal excretion

Answer: A) Increasing drug solubility

5. A drug that follows zero-order kinetics is eliminated:

A) At a constant percentage per unit time

B) At a constant amount per unit time

C) Proportional to its plasma concentration

D) Independent of its dose

Answer: B) At a constant amount per unit time

6. Which route of administration bypasses the first-pass metabolism?

A) Oral

B) Sublingual

C) Rectal

D) Intravenous

Answer: D) Intravenous

7. The volume of distribution (Vd) is highest for:

A) Hydrophilic drugs

B) Highly protein-bound drugs

C) Lipophilic drugs

D) Large molecular weight drugs

Answer: C) Lipophilic drug

To make the following solution isosmotic with blood serum how much Anhydrous Dextrose required ?

NaCl 2.5g, Water for Injections 1 litre,  FD1%(NaCl) = 0.576°C, FD1 (Anhydrous Dextrose) = 0.101°C

a) 101.1 mg

b) 74.4 mg

c) 74.4 g

d) 37.2 mg

e) 37.2 g

Converted to % 0.25 per 100ml

What is Rasch Methodology

This methodology will be implemented in your upcoming exam

The Rasch methodology follows an adaptive testing approach where question difficulty adjusts based on the test-taker's performance.  

- The test starts with an easy question.  

- If answered correctly, the next question increases in difficulty.  

- If the correct answer is given again, the difficulty continues to rise.  

- However, if a question is answered incorrectly, the next question becomes easier.  

This dynamic system ensures that the test accurately measures ability by continuously adjusting to the test-taker’s performance.

With a solid foundation of knowledge and the right study materials, nothing will seem too difficult. Mastery comes from strong command over concepts, allowing you to tackle any challenge with confidence.

Isosmotic Solution Calculation

Step 1: Calculate the sodium chloride equivalent of the given NaCl

The sodium chloride equivalent (E-value) is the amount of NaCl that has the same osmotic effect as 1 gram of the substance. The E-value for a substance can be calculated using the following formula:

E=17×LisoMwcap E equals the fraction with numerator 17 cross cap L sub i s o end-sub and denominator cap M sub w end-fraction

𝐸=17×𝐿𝑖𝑠𝑜𝑀𝑤

where

Lisocap L sub i s o end-sub

𝐿𝑖𝑠𝑜

is the freezing point depression constant and

Mwcap M sub w

𝑀𝑤

is the molecular weight.

A simpler method is to use the given freezing point depression values (FD1%) for a 1% solution.

Given:

FD1%(NaCl) =

0.576∘C0.576 raised to the composed with power cap C

0.576∘𝐶

FD1%(Anhydrous Dextrose) =

0.101∘C0.101 raised to the composed with power cap C

0.101∘𝐶

The amount of NaCl equivalent to 2.5 g of NaCl is simply 2.5 g.

Step 2: Calculate the amount of Anhydrous Dextrose needed to make the solution isosmotic

To make the solution isosmotic with blood serum, the total freezing point depression of the solution must be

0.52∘C0.52 raised to the composed with power cap C

0.52∘𝐶

. The freezing point depression from the NaCl is calculated as follows:

Freezing point depression from NaCl = (grams of NaCl / 100 mL)

×cross

×

FD1%(NaCl)

The given solution contains 2.5 g of NaCl in 1 litre (1000 mL), which is equivalent to 0.25 g of NaCl in 100 mL.

Freezing point depression from NaCl =

(0.25 g/100 mL)×0.576∘C=0.144∘Copen paren 0.25 g / 100 mL close paren cross 0.576 raised to the composed with power cap C equals 0.144 raised to the composed with power cap C

(0.25 g/100 mL)×0.576∘𝐶=0.144∘𝐶

The remaining freezing point depression must be provided by the Anhydrous Dextrose.

Required freezing point depression from Anhydrous Dextrose = Total required freezing point depression - Freezing point depression from NaCl

Required freezing point depression from Anhydrous Dextrose =

0.52∘C−0.144∘C=0.376∘C0.52 raised to the composed with power cap C minus 0.144 raised to the composed with power cap C equals 0.376 raised to the composed with power cap C

0.52∘𝐶−0.144∘𝐶=0.376∘𝐶

Now, we can calculate the amount of Anhydrous Dextrose needed.

Amount of Anhydrous Dextrose (g/100 mL) = (Required freezing point depression from Anhydrous Dextrose) / FD1%(Anhydrous Dextrose)

Amount of Anhydrous Dextrose (g/100 mL) =

0.376∘C/0.101∘C=3.72277 g/100 mL0.376 raised to the composed with power cap C / 0.101 raised to the composed with power cap C equals 3.72277 g/100 mL

0.376∘𝐶/0.101∘𝐶=3.72277 g/100 mL

This is the amount of Anhydrous Dextrose required for 100 mL of solution. The problem specifies 1 litre (1000 mL) of solution.

Total amount of Anhydrous Dextrose required =

3.72277 g/100 mL×10=37.2277 g3.72277 g/100 mL cross 10 equals 37.2277 g

3.72277 g/100 mL×10=37.2277 g

Answer:

The amount of Anhydrous Dextrose required is approximately 37.2 g, which corresponds to option (d) or (e).

A patient has diabetes, had a mild heart attack on metformin 1g bid, candersartan 8mg daily, glyburide 7.5mg bid .since last year her A1C was not controlled and started increasing upto 9-11% what can you add on?

a. acarbose

b. TZD

c. )increase metformin dose

d. increase glyburide dose

e. add meglitinide

Answer D.  Glyburide is an oral medication used to treat high blood sugar in adults with type 2 diabetes. It is a type of sulfonylurea drug that helps the body produce more insulin and use it more effectively

Adrenaline Enhance local anaesthetic's action by vasoconstriction. True or false

True

A 36-year-old man has schizophrenia and a history of mild tardive dyskinesia. His psychiatrist recently switched his medication to olanzapine taken at bedtime. The patient smokes approximately a pack of cigarettes daily, weighs 70 kg (154 lb) at a height of 5 feet 10 inches (178 cm), and does not drink alcohol. Which of the following would be the most common adverse side effect of olanzapine in this patient? A) Gastrointestinal complications B) Orthostatic hypotension C) Sedation D) Tardive dyskinesia E) Weight gain

Weight gain is major side effect of olanzapine

A 34-year-old woman, who was hospitalized 6 months ago and diagnosed with bipolar disorder, mixed type, arrives for a followup appointment. She feels that she is stable on her medication but has noticed an increased appetite with significant weight gain, as well as hair loss, since her discharge. Her physical examination and laboratory tests, including a thyroid panel, are unremarkable. Her physician concludes that her medication is the cause of her problems. Which of the following medications is this patient most likely taking?

A. Clonazepam 

B. Divalproex 

C. Gabapentin 

D. Lithium 

E. Olanzapine

Answer: The patient is most likely taking olanzapine because it is an atypical antipsychotic known to cause metabolic side effects, including  increased appetite, significant weight gain, and hair loss, which are all symptoms the patient is experiencing. While other mood stabilizers can cause weight gain, olanzapine is strongly associated with these specific side effects, particularly in combination with other medications, and is commonly used to treat bipolar disorder. 

Which antibiotic is associated with Gallbladder Pseudolithiasis? 

a. Vancomycin 

b. Ciprofloxacin 

c. Tetracycline 

d. Ceftriaxone

Answer: Ceftriaxone is one of the most commonly used 3rd generation parenteral cephalosporins because it has wide spectrum of anti-microbial activity, a long plasma half-life that allows once-daily administration and it can even penetrate the blood brain barrier. Ceftriaxone could have potential complications and these are biliary sludge or biliary lithiasis, and even urinary tract precipitation, but these complication may be reversible upon discontinuation of ceftriaxone. Pseudolithiasis ("pseudo-" meaning false, and "-lithiasis" meaning the presence of stones) is a condition caused by precipitation of a calcium-ceftriaxone salt, leading to symptoms that mimic gallstones, which is often reversed after discontinuing the antibiotic ceftriaxone. Risk factors include high-dose or long-term ceftriaxone therapy, prolonged fasting, total parenteral nutrition (TPN), and renal impairment  [https://doi.org/10.4174/jkss.2011.81.6.423].

Ques - 62-year-old man with ischemic heart disease is newly diagnosed with hypothyroidism (TSH 12.0 mIU/L, low T4). He experiences mild fatigue and cold intolerance.

Which of the following is the best initial dose of levothyroxine?

A. 100 mcg daily

B. 25 mcg daily

C. 75 mcg daily

D. 150 mcg daily

25 mcg

When comparing chlorthalidone to hydrochlorothiazide at equipotent doses, it is expected that a patient receiving chlorthalidone will experience:

a. cardiovascular risk reduction that is independent of improved blood pressure control.

b. decreased risk of electrolyte disturbances, like hypokalemia and hyponatremia.

c. decreased incidence of glycemic and lipid disturbances.

d. increased risk of dermatologic reactions, like rash and photosensitivity.

e. improved blood pressure control

Statins are a class of prescription medications used to lower cholesterol levels in the blood and reduce the risk of heart attack and stroke. They work by helping the liver remove cholesterol and reducing the amount the liver produces. FDA-approved statins include atorvastatin, rosuvastatin, simvastatin, pravastatin, fluvastatin, lovastatin and pitavastatin. Clinicians have long used statin medications to treat hypercholesterolemia, hyperlipoproteinemia, and hypertriglyceridemia as an adjunct to diet and exercise. The preferred statins for patients taking warfarin (Safe with warfarin): Atorvastatin, Pravastatin.

Statins cause: Myopathy, Rhabdomyolysis, Hepatotoxicity and sleep disturbances (as insomnia, nightmares).

Mnemonic for statins:

Sachin [Tendulkar] atoned [(corrected) he] loves seam bowling [and celebrates with] roasted, fluffy parata and pitha.

Statins: atorvastatin, lovastatin, simvastatin, rosuvastatin, fluvastatin, pravastatin and pitavastatin.

Bengali mnemonic for statins:

(Someone's) সতীনে এত রসুন (আর) সিম দিয়ে পরটা (বানায় যে পরটা) ফুলে লোভনীয় পিঠা হয়ে যায়. 

Statins: atorvastatin, rosuvastatin,  simvastatin, pravastatin, fluvastatin, lovastatin and pitavastatin.

528. Omeprazole with (Ketoconazole or Itraconazole): omeprazole decreases stomach acidity leading to decreasing level of Ketoconazole or itraconazole.

529. Omeprazole with Fluconazole: fluconazole (strong 2019 inhibitor) will increase level of omeprazole.

530. Saquinavir with Grapefruit: increased level of oral saquinavir because (Grapefruit 3A4 inhibitor).

531. Grapefruit (3A4 inhibitor) has NO significant effect on: Warfarin, phenytoin, digoxin.

532. Elasticity of skin is due to: Collagen.

Phenytoin

In case of seizure treatment, avoid antacids with phenytoin as they can reduce the effects of phenytoin.

533. latrogenic Hypertension (drugs-induced Hypertension) as: NSAIDS, Corticosteroids, oral contraceptives, TCAS.

534. Enzyme of succinylcholine (Suxamethonium) metabolism is: Pseudocholinesterase.

535. Methadone (3A4 metabolism) with St. john wort: decreased methadone level.

536. Antioxidants for Sickle cell anemia: Hydroxyurea, Pentoxifylline

537. Pentoxifylline: improves RBCs deformability (known as a hemorheological effect), reduces blood viscosity and decreases platelet aggregation and blood clot formation.

538. Effective drug for treatment of Polycythemia in patients fail to Hydroxyurea: Busulfan.

539. Best option in case of hypersensitivity to a drug: Stop the drug.

540. In Asthma: Decreased cAMP.

541. Methylxanthines as Theophylline: Inhibit phosphodiesterase enzyme leading to increase CAMP and skeletal muscles (Bronchi) dilation, so used as Bronchodilators.

542. Effect of CCBs (Verapamil, Diltiazem, Amlodipine) in treatment of Angina:

Potent coronary vasodilating (Arterio-dilators): decrease afterload and increase coronary blood flow. Cardio-depressant effect: decrease heart rate and decrease contractility leading to decreased oxygen demand.

543. Effect of B-Blockers in Angina: decrease Heart rate, decrease cardiac output, decrease oxygen consumption.

544. Na nitroprusside infusion is the drug of choice in management of Hypertensive crisis due to: Rapid onset of action 2-3 minutes.

545. Fenoldopam: selective D1 agonist, used intravenously for treatment of hypertensive crisis. Useful in patients with chronic kidney disease.

546. Opioid with Least effect on heart (least cardiotoxicity): Fentanyl.

547. Fentanyl patch in renal impairment: 5 usual doses.

548. Immunoglobulin can cross placenta from mother to fetus: Ig G.

549. Immunoglobulin from mother to baby via colostrum: Ig A.

550. Dose for Breakthrough pain: 1/6 usual dose,

551. Dapsone and Rifampicin are used to treat: Leprosy.

552. Dapsone dose: 50-100 mg once daily.

553. Drugs cause Metallic taste: Metronidazole, Clarithromycin, Clindamycin, Methimazole, Metformin, Captopril, Lithium and Bismuth.

554. Dopamine as levodopa (dopamine agonist) actions:

Psychosis (Mesolimbic/Miso cortical).

Emesis (CTZ).

Treatment of Parkinsonism (substantia nigra)

Treatment of Hyperprolactinemia (pituitary gland).

a1 Eye mydriasis (so contraindicated in Glaucoma due to increase IOP)

B1 increases contractility (Heart), increase HR (Tachycardia)

Vasodilatation (Hypotension) dopaminergic receptors in BVs.

555. Opioid antitussives (Cough suppressants): Morphine, Codeine, Pholcodine, L-Propoxyphene.

556. Non-opioid antitussives (Cough suppressant): Dextromethorphan, Benzonatate, Noscapine.

557. Treatment of ACEIs dry cough: Dextromethorphan, Codeine, Pholcodine, Noscapine.

558. Marasmus: Low-Calorie intake (Energy deficiency).

559. Kwashiorkor: Low-Protein intake.

560. Primary immune response: Production of 8 cells and Ig M antibody.

561. Diltiazem with Aripiprazole: increase Aripiprazole level (3A4 inhibition).

562. Cisplatin causes kidney injury because: Glomerular endothelial cells more sensitive to Platinum drugs leading to glomerulonephritis.

563. Centrally-acting muscle relaxants: Diazepam, Baciofen, Cyclobenzaprine.

564. Baclofen: centrally acting skeletal muscle relaxant, GABA agonist, increases GABA inhibitory effect. Can be injected into spinal cord to treat severe spasticity. Common side effect (Nephrotoxicity) so, needs dose adjustment in renal failure.

565. Dantrolene (Peripheral muscle relaxant):

Drug of choice in Malignant Hyperthermia triggered by General anesthetics.

Management of Neuroleptic malignant syndrome and muscle spasticity.

566. Phenylephrine: selective al agonist used as Decongestant and in Priapism.

567. Time to begin Iron Supply to Pregnant woman: 2nd Trimester.

568. Cromolyn sodium (Na cromoglycate): Mast-cell stabilizer used to prevent allergy-induced asthma attacks.

569. Least drug amount excreted in: Milk.

570. Thiopental shorter duration of action due to: High lipid solubility.

571. Absorption of Levodopa affected by: Antacids or Protein diet.

572. Shingles (herpes zoster):

Viral infection characterized by painful skin rash with blisters.

Acyclovir most effective shingles if initiated within 48-72 hours after first appearance will reduce pain and progression of rash.

Shingles causes nerve damage (post-herpetic neuralgia).

573. Nicotine: Agonist in low dose and Antagonist in high dose.

574. Diuretics of choice in pulmonary edema: Loop diuretics.

575. Remission-inducing drugs in RA that suppress disease activity as: Antimalarials, Gold compounds, penicillamine.

576. Drug for Remission maintaining in RA: Methotrexate.

577. Glucocorticoids as Prednisolone, Methylprednisolone used in RA to: Avoid relapse (prevent Recurrent RA).

578. Chlorpropamide: Long-acting 2nd generation sulfonylurea, duration of action (60-70 hours), onset of action 1 hour and t$ 35 hours.

579. Cardiotoxic sulphonyluria as: Tolbutamide.

580. Sulfonamides: increase the hypoglycemic effect of sulphonylureas.

581. NSAIDs: increase the hypoglycemic effect of sulphonylureas.

582. To reduce risk of hemorrhagic cystitis with cyclophosphamide:

Drinking water (2-3 L).

MESNA.

583. First-line antibiotic for diabetic foot: Co-Amoxiclav (Augmentin).

584. ACEIs decrease Aldosterone by: inhibiting conversion of Ag 1 to Ag II.

585. Least seizures within carbapenems: Meropenem, Ertapenem.

586. Hypertrophy in CHF is common in: Left side (left ventricular Hypertrophy).

587. Aminoglycosides, Tetracyclines, Digoxin, Methotrexate: Excreted via glomerular filtration.

588. Reserpine unopposed parasympathetic activity due to NE depletion:

Causes Nasal congestion, nausea, vomiting, stomach cramps, diarrhea and bradycardia (due to increased cholinergic activity).

Cross BBB and causes CNS side effects as depression, dizziness, nightmares, parkinsonism, hyperprolactinemia.

589. Guanethidine: decreases NE release, decrease sympathetic activity. Causes Hypotension and erectile dysfunction and diarrhea, but it doesn't cross 888

590. Flumazenil (GABA antagonist): Antidote for Benzodiazepines overdose. Contraindicated in Epilepsy.

591. Tetracyclic antidepressants (TeCAs)

Mianserin

Causes Blood dyscrasias.

Mirtazapine

Increases Serotonin, NE

neurotransmission.

blocks a2 and 5HT-2 receptor

Selective H1 blocker.

Potent SHT-3 blocker can be used as antiemetic alternative to ondansetron.

Serious side effects including Mania and increased Suicidal thoughts.

Amoxapine

Potent Serotonin, NE reuptake inhibitor.

D2 and 5HT-2 Blocker

Maprotiline

Selective NE reuptake inhibitor

As Desipramine

592. Scopolamine (Hyoscine): used for motion sickness. As Atropine but it causes More CNS side effects as Amnesia (memory loss).

593. Insulin glargine to give the long action: Precipitates at injection site and released slowly.

594. Insulin detemir to give the long action: Highly bound to plasma proteins primarily albumin.

595. Warfarin onset of action: 1-3 days (24-72 hours).

596. Warfarin duration of action: 2-5 days.

597. Warfarin t%: 20-60 hours.

598. Lomotil (Diphenoxylate/ Atropine) toxicity:

Atropine side effects: Tachycardia, restlessness, urinary retention, blurred vision, constipation.

Diphenoxylate causes: drowsiness, vomiting, respiratory depression, and coma.

599. Quinolones considered as 2nd line treatment for: TB (Tuberculosis).

600. Hypokalemia and Hyperkalemia-induced c

Drugs cause Hypokalemia

Thiazides, loop diuretics

Acetazolamide, Brinzolamide

Caffeine, Theophylline,

Aminophylline, Theobromine

Salbutamol (albuterol)

Amphotericin B, Foscarnet.

Ondansetron, Dolasetron

Laxative abuse, insulin, Cortisones,

Aspirin.

Drugs cause Hyperkalemia

ACEIs, ARB5

Spironolactone, Eplerenone, Amiloride

Triamterene

B-Blockers

NSAIDS

Succinylcholine

Heparin.

601. Treatment of hypertension in presence of depression (drugs with low-depression risk):

Enalapril, Ramipril (ACEIs)

Verapamil, Amlodipine (CCBs)

Propranolol, Atenolol, Bisoprolol, Carvedilol (B-Blockers).

602. Antihypertensive taken with TCA: Thiazides.

603. Treatment of hypertension in Asthma: CCBs (B-Blockers and ACEIs are contraindicated in Asthma)

604. To decrease toxic effects of Methotrexate: Leucovorin (folinic acid).

605. Treatment of Neutropenia: Filgrastim (GCSF).

606. Treatment of Thrombocytopenia: Oprelvekin (IL-11)

607. Cytotoxic drug induces more nausea and vomiting: Cisplatin.

608. Least chemotherapeutic causes BMD: Vinca alkaloids (Vincristine).

609. Calcitonin (Hypocalcemic hormone) used for treatment of: Hypercalcemia and Hyperparathyroidism.

610. Alteplase (Tissue-plasminogen activator): Fibrinolytic converts plasminogen to plasmin which causes fibrin lysis.

611. Streptokinase: Fibrinolytic, produced from B-hemolytic streptococci, forms an active one to one complex with plasminogen.

612. Streptokinase contraindicated in peptic ulcer due to: Risk of Bleeding.

613. Drugs to treat bleeding

If from heparin give: Protamine sulfate

If from warfarin give: Vitamin K.

Aminocaproic acid, Tranexamic acid: inhibit plasminogen activation.

Aprotinin: competitive inhibitor, blocks plasmin receptor.

614. Paracetamol toxicity is due to lack of: Glutathione or sulfur element.

615. First choice in morning sickness in pregnancy (nausea and vomiting): Doxylamine + Pyridoxine 86

616. Drug can be used for nausea in 3rd trimester of pregnancy: Metoclopramide

617. Drug for Acute Metastatic pain: Fentanyl.

618. Drug for Chronic Metastatic pain: Indomethacin.

619. ACEI+ NSAID+ diuretic (As: Perindopril+ piroxicam+ furosemide): Renal failure.

620. Antidepressant in pregnancy: Fluoxetine (SSRI).

621. Pralidoxime used for treatment of organophosphorus poisoning by: Activation of Ach-esterase enzyme (Replenish AChE).

622. Antidote for Theophylline toxicity: Esmolol (B-Blocker).

623. If you are allergic to Aspirin: Don't take ibuprofen because of cross-sensitivity between Aspirin and ibuprofen (Take paracetamol).

624. Least anti-inflammatory effect: Paracetamol (NO effect on COX1, COX2).

625. Between TCAs and Aromatic Antiepileptics as carbamazepine or phenytoin: cross-sensitivity.

626. CCBs especially Nifedipine contraindicated in GERD because: Cause impaired esophageal motility.

627. Misoprostol used with piroxicam to: Avoid peptic ulcer.

628. Somatic nerve: NO ganglia.

629. Drug for treatment of Alzheimer disease: Donepezil.

630. Celiac disease: small intestine disease (inability to absorb gluten).

631. Sjogren's syndrome: Salivary gland disease, dry mouth and dry eyes.

632. Bell's palsy: paralysis of the facial 7th cranial nerve, often due to HSV-1.

633. Kernicterus: Bilirubin-induced brain damage.

634. Adam's stroke syndrome: heart disease, sudden syncope.

635. Klinefelter syndrome: Small poorly functioning testis leads to infertility.

636. Tetany from: Hypocalcemia.

637. Conn's syndrome: Hyperaldosteronism may be due to over-activity of adrenal glands, excessive aldosterone leads into increased Na, H2O retention and Hypertension. Treatment by K-sparing diuretics as Spironolactone.

638. Vitamin B6 (Pyridoxine) deficiency associated with: Microcytic, Normocytic or Sideroblastic anemia.

639. Antidote for Valproic acid toxicity: Levocarnitine (L-Carnitine) for management of hyper-ammonemia and hepatotoxicity.

640. Antidote for magnesium: CaCL 10% or Ca Gluconate 10%.

641. Antidote for thallium: Prussian blue.

642. Maximum dose of Repaglinide: 16 mg.

643. Methoxyflurane (inhalation anesthetic) + Tetracyclines: Increased Nephrotoxicity.

644. Halothane + succinylcholine: Malignant Hyperthermia.

645. Astemizole: Long-acting 2nd generation antihistaminic causes dangerous QT prolongation.

646. Atropine dose: 0.5 to 2 mg.

647. Rifampin causes: Body fluids discoloration.

648. Nitroglycerin (GTN) mechanism: by Glutathione enzyme gives nitric oxide (NO) which ↑ cGMP leading to Ca influx in Blood Vessels. (Coronary Vasodilatation), treat angina.

649. Carbimazole (antithyroid drug) causes: Agranulocytosis.

650. Corticosteroids are secreted from: Adrenal cortex.

651. Using St. john wort with theophylline causing: Decrease in theophylline level (St. john wort is 1A2 inducer).

652. Transdermal opioids as: Fentanyl patch and Buprenorphine patch, while (Oxycodone NOT used transdermal).

653. Morphine metabolites: 60% converted to M3G (Morphine 3 Glucuronide) and 6-10% converted to the active M6G (Morphine 6 Glucuronide).

654. Diabetic retinopathy is characterized by: Microaneurysms and vitreous hemorrhage.

655. Blackheads (open comedo) result from: block of hair follicles.

656. Adrenaline used in local anesthetic solutions for injections to: Reduce local blood flow; reduce diffusion and absorption leading to prolong the action.

657. Drugs used for bipolar disorders: lithium, haloperidol, carbamazepine, sodium valproate, lamotrigine and quetiapine.

658. Disease which characterized by selective destruction of myelin sheath surrounding nerve axons: Multiple Sclerosis.

Activate V

659. Benzodiazepines are NOT indicated for: Depression.

660. Dapsone dose: 50-100 mg once daily.

661. Filgrastim (human G-CSF) is: Protein.

662. The heart natural pacemaker is: The Sino-atrial node (SA node).

663. Omeprazole is: Selective and irreversible proton pump (H/K) inhibitor.

664. Penicillin mechanism: inhibits trans-peptidase enzyme, inhibits cell wall synthesis.

665. Allopurinol mechanism: non-competitively inhibits xanthine oxidase enzyme, inhibits uric acid synthesis.

666. Terminal part of small intestine: ileum.

667. Allergic reaction (anaphylaxis) antibody: Ig E.

668. Insulin secretion: Decreases Potassium (K) level.

669. Most common side effect of GTN (Nitrates) is: Headache.

670. Metabolic acidosis occurs with: Diarrhea. (Diarrhea causes loss of too much NaHCO3 from the body).

671. Insulin glargine acts via: Tissue uptake of glucose.

672. Patients with diabetes have higher risk for: Erectile Dysfunction.

673. Nosocomial infection: Acquired in a medical facility (hospital-acquired infection)

674. Atropine (anticholinergic) causes: Mydriasis, constipation, urinary retention, ejaculation, tachycardia

675. Rickets develops from a deficiency of: Vitamin D.

Activate

676. Ataxia means: Poor muscle coordination.

677. Longest duration of action opioid analgesic: Fentanyl patch, Methadone.

678. Digoxin (cardiac glycoside): Blocks Na/K ATPase pump, increases Na and Ca inside and thus increases contractility.

679. Signs of hypoglycemia: feeling tired, sweating, confusion, disorientation, tingling lips, palpitations (tachycardia-warning sign).

680. Alpha hemolytic streptococci treated by: Penicillins, especially amoxicillin.

681. Simvastatin is effective in lowering: Both LDL cholesterol and TG.

682. Flecainide may cause: Exacerbation of arrhythmia.

683. Short-acting insulin (less than 12 hours): Regular/Neutral insulin.

684. Intermediate-acting insulin: Protamine zinc insulin (Isophane insulin) NPH

685. Long-acting insulin: Detemir and Glargine.

686. Fast-rapid acting insulin: Lispro, Aspart, Glulisine.

687. The anthracyclines antineoplastic drugs as doxorubicin associated with: Cardiotoxicity, tissue necrosis, nausea and vomiting.

688. When determining furosemide dose: Consider both the renal function and the current furosemide dose.

689. Salicylates (as aspirin): Stimulate the respiratory center in medulla (respiration) leading to hyperventilation and respiratory alkalosis, and compensated renal excretion of bicarbonate leading to compensated metabolic acidosis.

690. Ranitidine is safer alternative to cimetidine in: Elderly patients.

KAPS Master Dr/Hamdi

691. Factors determining therapeutic approach of cancer (TNM staging system):

Tumor size

Lymph node involvement

Metastasis

Age.

692. Factors considered in choosing a chemotherapy regimen:

Efficacy

Synergism

Route of administration

Emetic potential.

693. Renal transplant patient taking immunosuppressant: increased risk of skin cancer and other organs cancer.

694. Chest pain is NOT characteristic for: CHF.

695. Clotting factors synthesized by Vitamin K: II, VII, IX and X

696. Cross-sensitivity between penicillin and cephalosporin: 1:10

697. Moderate Physical exercise: Doesn't increase risk of seizures.

698. Proteins are: NOT filtered through glomerulus.

699. TCAs if used with each other: Serotonin syndrome.

700. Chronic kidney disease anemia is: Normocytic Normochromic anemia.

701. HIV genetic material transfers from: RNA to DNA.

702. Salbutamol can be used as: I.V bolus for severe asthma.

703. Nifedipine causes: Ankle edema.

704. First choice for diabetic patient: Metformin 500.

705. Sarcolemma surrounds: Striated muscle fiber cells.

706. Alkaline phosphatase (ALP) test for: liver function and bones.

707. Emulsifier for (w/0) lime water (CaOH2) and Olive oil (oleic oil): Ca-Oleate.

708. Lime water (CaOH2) in air: CaCO3 Precipitate.

709. Aminophylline on exposure to air develops: Theophylline Crystals.

710. Cholesterol causes: Hardness of arteries (Atherosclerosis).

711. Vitamin E (Tocopherol): Antioxidant prevents LDL oxidation, useful in Atherosclerosis.

712. Vitamin E (Tocopherol) can dissolve in: Fixed oil, Ether, Chloroform (lipid-soluble).

713. Transdermal therapeutic systems affected by: Humidity.

714. Least soluble salts: Ba-Sulfate.

715. Fats are: Esters of glycerol and fatty acids.

716. Flucloxacillin solution and Total Parenteral Nutrition storage: 2-8° C (Refrigerator).

717. Cisplatin storage: At room temperature, don't refrigerate, away from light and discard the unused portion.

718. Nitroglycerin storage: at room temperature, away from light, kept in their original bottle.

Tablets should be kept in small, amber, tightly capped glass bottles.

Last update 2023:

It is very important to store NTG pills properly since they are sensitive to light, moisture, and heat.

Most pills should be stored in a dark, tightly capped bottle in the refrigerator; you should carry a small number with you at all times.

719. Nitrates expiration: 8 weeks after opening.

Last update 2023:

An unopened nitroglycerin bottle is good for one year.

Pills that are in an opened bottle should be thrown away after three (3) months.

720. Source of proteins in parenteral nutrition is: Amino acids.

721. Source of carbohydrates in TPN solutions: Dextrose.

722. The most prone to DOSE-DUMPING: Modified release.

The Food and Drug Administration (FDA) in 2005 warned of the possibility that the presence of alcohol in the medium, interacts with the modified-release oral formulations, accelerating the release of the drug. This phenomenon, known as “Dose Dumping”, is the consequence of tablet rupture or erosion, and accumulation in the body. Single unit non disintegrating dosage forms are liable to a higher risk of dose-dumping [https://doi.org/10.1016/j.jconrel.2011.04.002 ].

723. Urea: Humectant.

724. Gelatin: Protein.

725. Starch: Disintegrant.

726. Glycerin: Hygroscopic (moisturizer).

727. Tragacanth: Natural gum.

Terpenes: Volatile unsaturated hydrocarbons. 728.

729. Talc used with volatile oils as: Dispersing agent and absorbs moisture.

730. Sodium metabisulfite: Antioxidant and food preservative.

731. Sodium metabisulfite in adrenaline injection: Antioxidant.

732. ALUM: Clarifying agent (for purification using flocculation process).

733. Aluminum oxide (Al2O3): Abrasive.

734. Aluminum hydroxide (AIOH3): Antacid.

735. Aluminum chloride (AICI3): Antiperspirant.

736. Aluminum acetate: Astringent.

737. Bismuth subgallate: Astringent.

738. Tablet Enteric-coating agent: Cellulose Acetate Phthalate (CAP).

739. Preservatives in eye drops include: Benzalkonium Chloride and Chlorhexidine.

740. Benzalkonium chloride: Bactericidal, preservative in eye drops.

741. Phenyl mercuric nitrate (0.002%): Sporicidal preservative in Eye drops.

742. Ethylene oxide, H2O2, Formaldehyde: Sporicidal. Dr/Hamdi

743. Nonoxynol: Surfactant spermicide used for contraception in spermicidal creams, jellies, foams, gel, and lubricants

744. Ethylene oxide (CH2CH2O):

Colorless, inflammable gas

Surface disinfectant, used in hospitals, medical equipment industry.

Direct alkylating agent used for gas sterilization.

Sporicidal, bactericidal, viricidal.

Boiling proteins with Ethylene oxide: Alkylation.

745. Essential trace element in Vitamin B12: Cobalt.

746. Aspirin solubility: Slightly soluble in water. Soluble in Ethanol, Ethyl ether and Chloroform.

747. Saponification (soap formation): glyceryl-esters + alkali solution (KOH) OR organic acid + inorganic base.

748. UV range: 200-400 nm.

749. DNA damage wavelength: 280-320nm.

750. Emulsion particle size: 0.1-1 micro

751. Suspension particle size: 0.5-5 micro

752. Cetrimide: Cationic surfactant, used for O/W emulsions.

753. Enantiomers: Optical isomers, identical physicochemical properties (differ in chemical reactions).

754. Petrolatum (Mineral oil): insoluble in water, alcohol, ethyl alcohol, glycerin.

755. Petrolatum (Mineral oil): soluble in benzene, ether, chloroform.

756. Saturated fatty acids: Palmitic acid, Stearic acid.

757. Monounsaturated fatty acid: Oleic acid (olive oil) Omega 9.

758. Oleic acid (monounsaturated omega 9) is: Anionic surfactant (soluble in aqueous base to give soaps).

759. Polyunsaturated fatty acid: Linolenic acid (Essential Omega 3), linoleic acid (precursor of Arachidonic acid Essential Omega 6)

760. Salicylic acid shaken with chloroform and dilute aqueous nitric acid: will be present mainly in the lower layer.

761. Atropine instability due to: Ester hydrolysis to tropic acid.

762. Sodium Phenobarbitone solubility is greatest in: Aqueous buffer PH 10.

763. Hexyl resorcinol on exposure to light air undergoes: Phenolic Oxidation.

764. Interaction between methylcellulose (ether) and PHBA (acid): Complexation.

765. Interaction between Alendronate and calcium/antacids: Complexation.

766. Interaction between glycerol (alcohol) and fatty acid (acid): Esterification.

767. Oxidation of 1ry alcohol gives: Aldehyde.

768. Oxidation of aldehyde gives: Carboxylic acid.

769. Oxidation of 2nd alcohol gives: Ketone.

770. Phenol:

Aromatic alcohol, slightly acidic, deliquescent crystalline solid.

Soluble in NaOH, Hcl.

Undergoes photo-oxidation, (doesn't undergo dehydration).

771. Quinine, atropine, morphine, ephedrine, nicotine: Alkaloids.

772. Occlusive dressings as Petrolatum gauze used clinically with topical corticosteroids to: Enhance

dermal penetration of steroid.

773. Non-official non-pharmacopeial testing for tablets: Hardness.

774. Drugs in form of suspension or oily solutions given: Intramuscularly (IM).

775. Hydroxy propyl methylcellulose in ophthalmic preparations: Increase contact time with cornea.

776. Base for Hydrocortisone acetate topical cream: Cetomacrogol.

777. Cetomacrogol 1000: PEG hexadecyl ether produced by ethoxylation of cetyl alcohol, non-ionic surfactant for O/W emulsions.

778. Poly ethylene glycol PEG: Water soluble ointment base and O/W emulsion base.

779. Na-acetate hydrocortisone structure, the sodium part to: increase solubility.

780. Physical sunscreens (Zn Oxide, Titanium dioxide): More effective than the chemical sunscreens (Benzophenone, Octinoxte).

781. Essential for sulfonamide activity: non-substituted aromatic amine.

782. Dimercaprol (BAL): Chelating agent, antidote for heavy metals poisoning, competes with thiols groups of enzymes for binding metal ion forming a chelate which is non-toxic, highly soluble and easily excreted in urine.

783. Conformational isomerism: non-identical spatial arrangement of atoms resulting in rotation about one or more single bonds. Also called Conformers or Rotamers. They have the same melting points and boiling points. Example: Acetylcholine.

784. Fats yield: the largest amount of joules/gram (9 calories per gram).

785. Penicillins differ chemically in: the nature of Acyl side chain.

786. Nuclear magnetic resonance (NMR): determination of organic molecules conformation (structure).

787. Polymerase chain reaction (PCR): identify virus types, mutations, bacterial strains or presence of expressed RNA.

788. The isomer is Cis when: The groups attached to carbons of the double bond are on the same side of the molecule.

789. The isomer is Trans when: The groups attached to carbons of the double bond are on opposite sides.

790. Alkaloids: insoluble in water, and soluble in organic solvents as benzene, chloroform, ether.

791. Alkaloids salts: dissolve in water. We can make quinine sulfate soluble in water: by addition of small amount of sulphoric acid which converts it to the more soluble bisulphate.

792. Amide: RCONH2

793. Ester: RC-O-O-R

794. Ether: R-O-R

795. Lidocaine, Procainamide remain stable long period because they are: Amides

796. Atropine ester hydrolysis to: Tropic acid.

797. Procaine ester hydrolysis to: PABA.

798. Drugs affected by moist heat: Penicillin G, Procaine, Nystatin, Thiamin (vitamin B1), Streptomycin.

799. Quinolones and sulfonamides are: Heat-stable.

800. Ciprofloxacin and Kanamycin are: Not destroyed by Autoclave.

801. Antibiotics can autoclave for 15 minutes: Ciprofloxacin, Kanamycin.

802. Sodium lauryl sulfate: Anionic surfactant, incompatible with cetrimide, but compatible with ichthammol and econazole nitrate, high HLB value, used in o/w emulsions.

803. Hyoscyamine: Levo-atropine (levo isomer of atropine).

804. Hemodialysis: for polar drugs.

805. Hemodialysis NOT effective in: Digoxin toxicity.

806. Acidic drug in acidic media: non-polar, unionized, lipophilic, more absorbed.

807. Weak acid more absorbed in: stomach.

808. Basic drug more absorbed in: intestine.

809. Fatty suppository base as cocoa butter: Melts rapidly at body temperature. To maximize the bioavailability, it is better to incorporate the hydrophilic drug or the ionized form of drug (salt form) to be easily escaped to the aqueous body fluids.

810. Methyl or Propyl paraben in soft gelatin capsule: Antifungal preservative prevents fungi growth.

811. Stearyl alcohol, cetyl alcohol, cholesterol in emulsions: Stabilizers.

812. Micronized particles have: increased solubility, dissolution rate and bioavailability.

813. If drug in oral dosage form is insoluble in water: particle size and crystal structure are important factors in bioavailability.

814. Surfactants are used in some tablets: to decrease the interfacial tension between solid particles and

dissolution media to increase dissolution rate.

815. Sublingual administration: drug diffuses into blood through tissues under the tongue (NO first-pass effect).

816. Substance for sublingual administration should be:

High lipid soluble

Non-ionic (unionized)

Small molecular weight.

817. lidocaine (Lignocaine) not used orally due to: Extensive rapid hepatic metabolism to inactive compounds (first pass metabolism).

818. Topical lidocaine (Lignocaine) absorbed from: Mucus membranes.

819. Nitroglycerin sublingual due to: 1st pass hepatic metabolism.

820. Promethazine absolute bioavailability 25% due to: First pass metabolism.

821. Ergotamine tartrate: can be used sublingually. (Treatment of migraine).

822. Chlorocresol 0.1% in creams: Antimicrobial preservative.

823. Mineral oil (liquid paraffin): A distillate of petroleum

Lubricant laxative: oral or enema for constipation.

Good levigating agent for hydrophobic ointment as white petrolatum.

824. Petrolatum (petroleum jelly):

OTC moisturizer (Vaseline)

Oleaginous ointment base.

Occlusive dressing with topical corticosteroids to enhance dermal penetration.

825. Benzoyl peroxide: Bleaching agent (bleaches hair fabrics), when used for treatment of acne, should avoid contact with hair or fabrics. Dose started from 2.5-5% once or twice daily.

Go to Se

826. Docusate sodium (Colace): surfactant, Emollient laxative, stool softener used for treatment of constipation and can be used in pregnancy (psyllium also can be used).

827. Docusate sodium (Colace) shouldn't be taken at the same time with Mineral oil because: Colace will increase amount of mineral oil absorbed in the body.

828. Mineral oil causes vitamin deficiency because: it is NOT absorbed from intestine and carries fat-soluble vitamins out of digestive system preventing their absorption.

829. Mineral oil: impairs Vitamin K absorption.

830. Methylparaben is: Methyl ester of Para hydroxy benzoic acid (PHBA).

831. Inulin: used to measure Glomerular Filtration Rate (GFR).

832. R-isomer and Dextroisomer rotate plane of polarized light to: Right.

833. S-isomer and Levoisomer rotate plane of polarized light to: Left.

834. Preparation of Topical Clindamycin for Acne:

dissolve clindamycin in water, then

Add alcohol and propylene glycol.

835. Preparation of Mandl's throat paint for sore throat:

Dissolve KI in water

Add iodine to form KІЗ

Dissolve Peppermint oil in alcohol 90%v/v

Add alcoholic solution to iodine solution

Volume is made up with glycerin.

836. Composition of Calamine lotion:

Calamine, ZNO

Ferric oxide (Fe2O3) gives calamine the pink color.

Bentonite and Calcium Hydroxide (CaOH2).

Glycerin and water.

837. CaCl2 and Ca gluconate:

Not given as oral supplements.

Used as injection for treatment of Hypocalcemia or Hypermagnesemia.

838. Use of oral Nystatin suspension: place one half of the dose in each side of your mouth, hold or switch around in your mouth, then gargle and swallow.

839. Polysorbate 80 (tween 80): Non-ionic surfactant used for o/w emulsions.

Polysorbate 80 (tween 80) is a non-ionic surfactant.

It is used for oil-in-water (o/w) emulsions.

840. Acacia: insoluble in Alcohol.

841. HLB 1-3: Anti-foaming.

The Hydrophilic-Lipophilic Balance (HLB) value of 1-3 indicates that the substance is highly lipophilic (oil-loving) and minimally hydrophilic (water-loving). This property makes it effective at reducing foaming by destabilizing the foam's liquid film.

842. HLB 4-6: W/O emulsifier.

A substance with an HLB value of 4-6 is more lipophilic than hydrophilic. It is used as a water-in-oil (W/O) emulsifier, meaning it helps to stabilize a mixture where water droplets are dispersed within an oil phase.

843. HLB 7-9: Wetting agent.

A wetting agent with an HLB value of 7-9 has a balanced hydrophilic and lipophilic nature. It reduces the surface tension of a liquid, allowing it to spread more easily over a solid surface. 

844. HLB 8-18: O/W emulsifier.

An HLB value of 8-18 indicates that the substance is more hydrophilic than lipophilic. This type of substance is used as an oil-in-water (O/W) emulsifier, which stabilizes a mixture where oil droplets are dispersed within a water phase. 

845. HLB 13-15: Detergent

A detergent with an HLB value of 13-15 is highly hydrophilic. It is effective at removing dirt and oil by surrounding the oil molecules and allowing them to be washed away by water.

846. HLB 15-18: Solubilizing agent

A solubilizing agent with an HLB value of 15-18 is very hydrophilic. It is used to help dissolve substances that are not normally soluble in a particular solvent, such as dissolving an oil in water.

847. Spans (sorbitan esters): Wetting agents, Antifoaming, W/O Emulsifiers

Spans are a group of surfactants (sorbitan esters) that have low HLB values, typically in the range of 1.8 to 8.6. Due to their lipophilic nature, they are used as wetting agents, antifoaming agents, and water-in-oil (W/O) emulsifiers.

848. Tweens (polysorbate): Detergent, Solubilizing agent, O/W Emulsions

Tweens are a group of surfactants (polysorbates) that have high HLB values, typically in the range of 9.6 to 16.7. Their hydrophilic nature makes them effective as detergents, solubilizing agents, and oil-in-water (O/W) emulsifiers.

848. Tweens (polysorbate): Detergent, Solubilizing agent, O/W Emulsions.

849. Diphenoxylate structure related to: Meperidine (Pethidine).

850. Vitamin K structure related to: Quinolones (Polycyclic aromatic Ketone).

851. Vitamin D structure related to: Steroids.

852. Sumatriptan structure related to: Serotonin.

853. Amphetamine derived from: Phenyl ethylamine.

854. Sulindac structure related to: Indomethacin.

855. Sulindac (prodrug): indene acetic-acid derivative contains methyl sulfoxide group (CH3-S=O) reduced

to sulfide group (S-CH3) which is the functional group.

856. Xanthine: Purine base (Pyrimidine + Imidazole)

857. Theophylline: 1,3 dimethylxanthine.

858. Caffeine: 1,3,7 trimethyl xanthine

859. Theophylline to caffeine: Methylation

860. Pteridine ring: Pyrimidine + Pyrazine

861. Pteridine ring found in: Methotrexate and folic acid structures.

862. Opioids classification

Phenanthrenes: Morphine, Hydro morphine, Codeine, Heroin, Oxycodone

Phenylheptylamine: Methadone, Propoxyphene

Phenylpiperidines: Fentanyl, Merperidine (pethidine), Diphenoxylate, Loperamide

863. The weakest acid: Boric acid.

864. Boric acid emulsion type: O/W emulsion.

865. Normal GFR: > 90

866. Highly potent topical corticosteroid: Clobetasol propionate 0.05%.

867. Most potent ophthalmic steroid: Prednisolone acetate 1%.

868. Acetyl choline (Ach): Quasi-ring structure, and example of conformational isomerism.

869. Atropine: Condensed Pyrrolidine and Piperidine (Tropane structure).

870. Nicotine structure: Pyridine ring and Methyl pyrrolidine.

871. Clonidine: Imidazoline derivative.

872. Antihistamines (Histamine H1 Antagonists) classification

Alkylamine: Chlorpheniramine, Triprolidine

Ethanolamine: Diphenhydramine Dimenhydrinate Doxylamine Clemastine

Ethylene-diamine: Antazoline

Phenothiazine: Trimeprazine Promethazine, Mequitazine

Piperazine: Cyclizine, Cetirizine, Hydroxyzine

Piperidine: Azatadine, Loratadine, Fexofenadine, Astimezole, Cyproheptadine

873. Chlorpheniramine, dexchlorpheniramine: Alkylamine derivatives

874. Tranylcypromine: Rigid Cyclopropane ring.

875. Phenelzine: Hydrazine group, primary amine.

876. Moclobemide structure contains: Morpholine ring.

877. Dapsone: Diphenyl sulfone.

878. Conversion of primidone to phenobarbital by 2C9,2C19: Oxidation.

879. 4-aminosalicylic acid used for: Tuberculosis

880. 5-aminosalicylic acid (mesalamine-masalazine): IBD, Crohn's disease, Ulcerative colitis.

881. Trimethoprim: Amino-pyrimidine Antibiotic.

882. Clopidogrel, Prasugrel, Ticlopidine: Thienopyridine derivatives.

883. Pioglitazone, Rosiglitazone: Thiazolidinediones.

884. Ethenyl group (Vinyl group): CH2=CH-

885. Ethinyl group (Ethynyl group): -C =CH

886. Metronidazole: doesn't contain sulfur atom.

887. The only ACEI that contains Sulfur atom: Captopril

888. All ACEIs are pro-drugs except: Captopril (short acting), Lisinopril (long acting).

889. Chloroacetic acid: 100 times more acidity than acetic acid.

890. To prepare buffer PH 4 use: Lactic acid.

891. To prepare buffer PH 9 use: Boric acid.

892. Colloidal Silver: Silver particles in a liquid, used as Antibacterial.

893. Ion Exchange Chromatography: Technique used to separate molecules according to their charge. Can be used to purify charged molecules as proteins and nucleotides.

894. Amount of Glomerular filtrate reabsorbed: 85-99%

895. Proximal tubular secretion of creatinine: 10-20%, so creatinine clearance overestimates actual GFRate by 10-20%.

896. Alkaloids PKa: > 7 Alkaloids are basic

897. When PKa increased: lonization and acidity decreased, Partition Coefficient increased.

898. When PKa decreased: lonization and acidity increased, Partition Coefficient decreased.

899. Buffer has Maximum capacity when: PH = PKa (50% ionized and 50% unionized) (Ratio between acid or base and its salt equals 1).

900. Dronabinol: Delta-9-tetrahydrocannabinol.

901. Elevated serum creatinine indicates: Kidney dysfunction

902. Creatinine measure: differ from Lab to Lab, Age to Age, Man to Woman.

903. The bond between Alcohol and water is: Hydrogen bond.

904. Clindamycin class: Lincosamides.

905. Linezolid class: Oxazolidinones.

906. Density of Sulfuric acid: 1.84 g/ml.

907. Clindamycin phosphate topical solution 1% used for: ACNE.

908. Lugol's solution: solution of KI with lodine in water, used for treatment of lodine deficiency, and in

Thyrotoxicosis until surgery can be carried out.

909. Metoclopramide is: highly soluble in water.

910. Digoxin: very low aqueous solubility.

911. Phenytoin is: Insoluble in water.

912. Phenytoin: should not be mixed with any other solution.

913. Diazepam: don't mix or dilute with other solutions of drugs in syringe or in infusion flask.

914. Spectrophotometry: measures how much a chemical substance absorbs light by measuring light intensity as a beam of light passes through sample solution.

915. Absorption of light depends mainly on: Molar concentration of solution and the light path length.

916. Erythromycin structure: 14-Membered lactone ring.

917. Erythromycin is resistant to B-lactamases due to presence of: Large-lactone ring and sugar moiety.

918. Amino acid structure: zwitter ion +NH COO- (Amphoteric).

919. Azo compounds metabolized by: Reduction.

920. AZO compounds metabolism Hydrazo→ 1ry amine.

921. Sodium ricinolate: irritant to skin and mucus membranes, causes hypersensitivity, NOT used as surfactant.

922. An acid NOT used for extraction: Alginic acid.

923. Histamine: Imidazole-ethylamine.

924. Cimetidine is: Guanidine analogue of Histamine.

925. The bond between two hydrogen atoms in H2O: Covalent bond.

The bond angle between two hydrogen atoms in H2O is 109

927. Bond in complexes: Covalent bond.

928. Giant living organism in salt water solution: Shrink.

929. Greatest drug absorption from: small intestine.

930. Vitamin C (Ascorbic acid): Sugar-acid contains unsaturated Lactone ring (Furan). Acidity due to Enolic-OH group.

931. Decarboxylation of 4-aminosalicylic acid (para-ASA) in aqueous solution gives: Meta Amino-phenol.

932. IM, SC injection absorption rate increased with: increased lipid solubility.

933. Conversion of codeine to morphine: O-dealkylation.

934. Conversion of phenacetin to paracetamol: O-dealkylation.

935. Drug Metabolic processes phase 1: Oxidation, Reduction, and Hydrolysis.

936. Most common metabolic process: Oxidation.

937. Drug Degradation processes: Hydrolysis, Oxidation, and Photolysis.

938. Most common drug degradation process in GIT: Hydrolysis.

939. Hydrolysis degradation process for: Esters, Amides, Lactams.

940. Drug undergoes Photolysis degradation: Na. Nitroprusside in water.

941. Phenylbutazone: Pyrazolidine derivative.

942. Isotonic solution more appropriate for: Nasal spray.

943. Isotonic NaCL 0.9% contains: 150 mmol/L Na+.

944. Phosphate buffer saline for: Nasal preparations.

945. Preparation by a pharmacist because an appropriate drug is not readily available: Extemporaneous preparation.

946. Parenteral emulsifier: Egg Lecithin (Egg yolk).

947. Heroin: Diacetyl morphine (3 times more potent than morphine).

948. Powders, oils, fats are sterilized by: dry-heat sterilization (Hot oven 160 for 2 hours).

949. Mask bitter taste by: Sugar coating, Film coating.

950. Linear pharmacokinetics: Concentration-dependent. (follow 1st order kinetics)

951. Non-linear pharmacokinetics: Concentration-independent. (Combination of zero order and 1st order)

952. Highest percentage in blood: Erythrocytes (RBCs).

953. NADPH: important role for cytochrome, it supplies cytochrome by electrons by NADPH-cytochrome reductase.

954. Most abundant cytochrome is: Cytochrome 3A4 (50% of lipophilic drugs metabolism).

955. Citrate in Oral Rehydration solution (ORS) for treatment of: Acidosis.

956. Ibuprofen (phenyl propionic acid derivative): weak acid has very low solubility in H2O or at acidic pH.

957. Ibuprofen + NaHCO3: Salt formation (Higher solubility).

958. Sodium salicylate: Higher water solubility.

959. Polysorbate (Tween) in Cortisone formulations acts as: Stabilizer.

960. Cisplatin: Diamine-dichloro-platinum.

961. Immunoassay: procedure for detecting specific substance (Analyte) as proteins, antibodies or antigens. (Not for electrolytes).

962. Isoenzymes assay indicators of: Tissue Necrosis.

963. Examples of substances with amphoteric properties: Amino-acids, Tetracyclines, Quinolones, Amphotericin B, Methotrexate, Enalapril, Pioglitazone.

964. For maximum activity of antihistaminic (H1 blocker):

Terminal tertiary nitrogen.

More than one aryl or hetero-aryl group.

965. CCBs are: Optically active.

966. Nifedipine, Amlodipine: Dihydropyridines (DHPs) CCBs

967. Verapamil: Phenylalkylamine.

968. Diltiazem: Benzothiazepine.

969. More Oxygen atoms and less Hydrogen: High water solubility.

970. Diuretics safe in sulfa allergy (don't contain sulfonamide group): Spironolactone, Eplerenone, Amiloride, Triamterene, Ethacrynic acid.

971. Ethacrynic acid: non-sulfonamide loop diuretic (Phenoxy acetic acid derivative).

972. Temperature affecting: Chemical reaction.

973. Atom size, bond length, electrophilicity affecting: chemical bond.

974. Calcium Edetate: Chelating agent used for lead poisoning but not used in children.

975. Lubricant laxatives as: Mineral oil, Mg Stearate.

976. Saline osmotic Laxative as: Mg sulfate, Mg citrate.

977. Methyl stearate: fatty acid methyl ester used as non-ionic surfactant.

978. Oral Isotretinoin: 13-Cis Retinoic acid.

979. Vitamin A: Trans-Retinol.

980. Excluded in raw materials extraction: Crushing (Not method of extraction).

981. Main mechanisms of coprecipitation: inclusion, occlusion, adsorption. (NOT exclusion).

982. CrCL < 50 ml/min: Mild renal impairment.

983. CrCl 25 ml/min: Moderate renal impairment

984. CrCL < 10 ml/min: Severe renal impairment.

985. Captopril, erythromycin, azithromycin, levothyroxine, Methotrexate: on empty stomach for maximum bioavailability.

986. Clarithromycin OR Paroxetine taken with food: to avoid GIT upset.

987. Sertraline (SSRI): Taken anytime, best taken with food to avoid Nausea.

988. Misoprostol best taken with food: To avoid loose stools and diarrhea.

989. Protein's primary structure: Linear sequence of amino acids starts with amino and ends with carboxyl (Geometric arrangement).

990. Hypromellose (HPMC)

Binder in modified release formulations, increasing duration of action.

Lubricant in eye drops (artificial tears), increases viscosity and prolongs contact time with cornea, protecting the cornea from dryness and damage.

991. Iron to be absorbed from intestine must be in the: Ferrous state (Fe+2)

992. Lactulose, sodium benzoate, sodium phenyl acetate: decrease ammonia in hepatic encephalopathy.

993. Sodium benzoate: Preservative, most commonly used in Acidic foods.

994. Sodium polystyrene sulphonate: Cationic-exchange resin, for treatment of Hyperkalemia.

995. Cholestyramine: Anion exchange resin, for Hyperlipidemia (bile acid sequestrant).

996. Sodium cellulose phosphate: lon-exchange resin, for Hypercalcemia and Hypercalciuria.

997. Cis and trans isomers are: Diastereomers.

998. The more stable isomer: Trans.

999. The more reactive isomer: Cis.

1000. Low Mean corpuscular volume (MCV) is due to: Iron-deficiency.

1001. ΝΕ, ΕΡ, 5HT substrates for: MAO A and COMT

1002. Dopamine substrate for: MAO B and COMT

1003. Ephedrine and Amphetamine: Not substrates for COMT.amdi

1004. Sugar spoonful or carbohydrate food with Amoxicillin will: Increase Amoxicillin absorption and bioavailability.

1005. Phenobarbitone, methadone, camphor, caffeine, prednisolone all have: Ketone in structure.

1006. HIV binds to CD4 on the surface of: T-helper cells (Helper T lymphocytes).

1007. Ceftriaxone, Cefepime, Ceftazidime, Cefazolin: Only Parenterally.

1008. Sodium phosphate load (phosphate enema) contraindicated in: renal impairment patients.

1009. Emulsion stability depends on: Agitation speed and viscosity.

1010. Cocaine local anesthetic: Topical and Lozenges.

1011. Lidocaine, Procaine: Topical and IV.

1012. Antifungal agents:

Topical

Clotrimazole

Gentian violet

Tolnaftate

Systemic

Griseofulvin

Fluconazole

Systemic and topical

Amphotericin B

Nystatin

Ketoconazole

Terbinafine

1013. Phosphate enema + lisinopril: Kidney damage (Nephrotoxicity).

1014. Test for Endocrine therapy patients: Estrogen-receptor assay.

1015. Determination of Calcium ca+2 in water is done by Titration using: EDETA (Edeta + calcium ions form a more stable strong complex).

1016. Urine alkalinization to increase excretion of weak acids drugs is called: lon-Trapping.

1017. Uracil, Thymine, Cytosine: Pyrimidines.

1018. Uracil Methylation gives: Thymine.

1019. Uracil Amination gives: Cytosine.

1020. Purine: Pyrimidine + Imidazole.

1021. Purine Amination gives: Adenine.

1022. Adenine, Guanine, Xanthine, Allopurinol, Thioguanine, Uric acid are: Purines

1023. Iron + Tetracycline: decreased absorption and decreased tetracycline bioavailability.

1024. The antibacterial activity of penicillin lies within: B-lactam ring.

1023. Iron + Tetracycline: decreased absorption and decreased tetracycline bioavailability.

1024. The antibacterial activity of penicillin lies within: B-lactam ring.

1025. Long-acting insulin (glargine, detemir): can't be mixed.

1026. KCL IV: Slow infusion.

KAPS Master Dr/Hamdi

1027. KCL extended release for hypokalemia contraindicated in: Peptic ulcer.

1028. Increased PH on salicylic acid: increased ionization and decreased Partition Coefficient.

1029. Colligative properties:

Vapor pressure depression (Raoult's law).

Freezing point depression.

Boiling point elevation.

Osmotic pressure (Van't Hoff equation).

1030. The total density of mast cells in COPD patients: Reduced.

1031. Plasma volume expander: High Molecular weight Dextran.

1032. Dextran is used to treat: Hypovolemia (decreased volume of circulating blood plasma).

1033. Changes in colligative properties depend only on: Total number of solute particles (Not on the identity of solute particles).

1034. To render the solution isotonic: Decrease the freezing point. (Freezing depression method).

1035. Shear thickening (dilatancy): increase force will increase viscosity and decrease flow. For suspensions of small flocculated particles with high solid content.

1036. Shear thinning (Pseudoplastic): increase force will increase flow. For polymer solutions.

1037. Thixotropy: decreasing the viscosity (Gel to solution transformation), time-dependent pseudoplastic behavior as Ketchup, Pseudo-plastic fluid.

1038. Anti-thixotropy/ Negative thixotropy (Rheopecty): increasing viscosity (solution to gel transformation), time-dependent viscosity as printer ink or gypsum paste.

1039. Syneresis: gel contraction and spreading out of fluids as Yoghurt.

1040. Rate-limiting step for uncoated, immediate release tablets: Dissolution.

1041. Rate-limiting step for Enteric coated controlled release: Disintegration.

1042. To prevent peroxide formation for many peroxide-forming solvents as Diethyl ether, we add: Mineral oil or Butylated hydroxyl toluene (BHT).

1043. Butylated hydroxyl toluene (BHT): Antioxidant.

1044. Addition of mineral oil to diethyl ether will: prevent peroxide formation.

1045. Calcium salts in blood sample: Increase Clotting.

1046. Calcium ions: Clotting factor IV.

1047. Citrate in blood sample: decrease Clotting (chelates ionized calcium).

1048. Vitamin D supplement is useful for treatment of: Hyperparathyroidism and Hypothyroidism.

1046. Calcium ions: Clotting factor IV.

1047. Citrate in blood sample: decrease Clotting (chelates ionized calcium).

1048. Vitamin D supplement is useful for treatment of: Hyperparathyroidism and Hypothyroidism.

1049. Initial plasma concentration after IV bolus depends on: Dose and Vd.

1050. Concentration of chronic treatment taken every day depends on: Half-life t½

1051. Loading dose depends on: Steady state plasma concentration (Cpss) and Volume of distribution (Vd).

1052. NaCl Equivalents used to: Estimate the amount of NaCl needed to make the solution isotonic.

1053. NaCl Equivalent (Equivalent value) means: the amount of NaCl that equivalent to 1 g of specified substance.

1054. The solution reaches Equilibrium when: the concentration of the solute is the same throughout the system (solution).

1055. Cholesterol esters present in: All plasma lipoproteins.

1056. Sodium chloride 0.9% is: a good wound cleansing agent with NO antiseptic properties.

1057. Zinc deficiency causes: delayed wound healing.

1058. Average nitrogen content (amino-nitrogen) in proteins: 16%.

1059. All insecticides carbamates are: N-methyl carbamates.

1060. Dextrose in blood bag to: generate ATP to prevent RBCs hemolysis.

1061. Emulsion cracking: Irreversible destruction (Also called emulsion coalescence).

1062. Emulsion creaming: reversible process (return by shaking).

1063. Hydrogel: for dry wound healing

Cross-linked hydrophilic polymer.

Allows transporting bioactive molecules.

Absorbs and retains wound excludes.

Promotes fibroblast proliferation and keratinocyte migration.

1064. Precursor of NAD: Vitamin B3 (Niacin).

1065. Precursor of FAD: Vitamin B2 (Riboflavin).

1066. Ammonia (NH3) converted to Carbamate (NH2COOH) by:

Replacing one H by COOH.

1067. Carbamate is: Amino-carboxylic acid.

1068. Moist heat and dry heat sterilization methods:

Moist heat

Lower temperature, shorter time

Hot water < 100 pasteurization

Boiling water 100

Autoclave > 100 (121 for 15 minutes)

Coagulating and Denaturation of microbial enzymes and proteins.

Killing of resistant spores requires exposure to moist heat at 121°C for 10-30 minutes.

Applications as: Surgical dressings.

Dry heat

Higher temperature, longer time

Hot air

oven 160, IR conveyer, IR vacuum oven.

Oxidation of microbial proteins.

Killing of resistant spores requires a temperature of about 160°C for 60 minutes.

Applications as: powders, oils, fats, metals, paraffin gauze dressing, glassware.

1069. Moist heat is more effective than dry heat because: Its ability to kill wide range of microorganisms.

by coagulation and denaturation of their proteins.

1070. Boiling at 100 for 30 minutes: kills spores, however some can withstand.

1071. At 121 for 15 minutes: spores destroyed.

1072. Oxidation of Ascorbic acid (vitamin C) to Oxalic acid is: Irreversible process.

1073. In Asthma: Decreased CAMP.

1074. Hematocrit value: percentage of RBCs to blood volume, for a healthy adult (Normal 45%-50%).

1075. Blood is made up of about: 55% Blood Plasma and 45% blood Cells.

1076. Blood centrifugation is done for: Hematocrit and ESR.

1077. Chitosan:

Cationic surfactant, hydrophilic colloid suspending agent.

Wound healing dressing

Antihypertensive, antihyperlipidemic

Used for Obesity.

1078. Methylcellulose (MC): Neutral (non-ionic) hydrophilic colloid.

1079. Acacia, Tragacanth: Anionic hydrophilic colloid.

1080. Bentonite, Veegum: Anionic silicates (Clays).

1081. Switching from warfarin to Apixaban: Stop warfarin and start Apixaban when INR < 2.

1082. Liquorice:

Demulcent

Laxative

Antidiabetic effect.

Treatment of adrenal insufficiency.

1083. Epinephrine parenteral concentration: 1:1000 (1mg/ml).

1084. Adrenaline (Epinephrine) Auto Injector:

It is designed for easy use by the lay person and has to be considered as first aid.

Delivers a single dose 0.3 ml injection equal to 0.3 mg adrenaline when activated. Usual adrenaline adult dose for allergic emergencies is 0.3 mg.

For pediatric use, the appropriate dosage may be 0.15 mg or 0.30 mg depending upon the body weight of the patient (0.01 mg/kg body weight).

Inject into the anterolateral aspect of the thigh, through clothing if necessary.

1085. HgCl2 (Mercuric chloride): soluble in water, highly toxic to humans.

1086. Hg2Cl2 (Mercury chloride, Calomel): insoluble in water.

1087. Drugs follow Zero-order (Concentration-Independent) Kinetics as: Phenytoin, Warfarin, Heparin, Theophylline, Tolbutamide, Ethanol, and Aspirin.

1088. Counseling for using Metered dose inhalers (MDI): Deep slow inhalation.

1089. Counseling for using Dry-powder inhaler (DPI): Quickly and deeply.

1090. Pyruvate is reduced by lactate dehydrogenase during anaerobic respiration into: Lactate.

1091. Lactic acid of commerce is usually: Racemic mixture (Optically inactive).

1092. Vidarabine (synthetic purine-nucleoside analogue): Antiviral used for HSV-1, HSV-2 and VZV

1093. Laminar flow

Vertical laminar flow

Protective for people

(Safe handling of chemotherapeutics).

No good for products

Horizontal laminar flow

Less protective for people

The preferred for products

1094. Promethazine structure differs in: Only 2 (two) carbons separating the amino moiety providing

strong anticholinergic activity.

1095. Carbohydrate catabolism: Glycolysis.

1096. Glucose synthesis from non-carbohydrates: Gluconeogenesis.

1097. Isoelectric point: the pH at which the molecule carries NO charge.

1098. Proteins solubility depends on: Isoelectric point.

1099. At isoelectric point, proteins have: its lowest solubility (net zero charge).

1100. PH > isoelectric point: enhanced proteins solubility (net negative charge).

1101. Paracetamol catabolism: Glucuronidation by 1A2, the OH group replaced by O-Glucuronide forming ether group.

1102. Miscibility: (Polar and polar liquids) or (non-polar and non-polar liquids).

1103. Gentamycin when injected intravenously (IV Push): should be injected directly into vein over no les than three minutes.

1104. Theophylline dose depends on: Age, body weight and smoking.

1105. Endospores: Highly resistant to unfavorable environmental conditions.

1106. Nicotinic acid undergoes: Oxidation.

1107. Vanishing cream and Hydrophilic ointment: O/W emulsion bases.

1108. Cold cream and Hydrous lanolin: W/O emulsions bases.

1109. Methenamine, Nitrofurantoin, Tetracyclines more effective in: Acidic urine.

1110. Removal of para-OH group of catecholamine structure gives: Only a1 activity (Phenylephrine).

1111. Ergocalciferol (Vitamin D2): from food.

1112. Cholecalciferol (Vitamin D3): made by skin when exposed to sunlight (Cod liver oil).

1113. Calcidiol (25 hydroxycholecalciferol): synthesized in liver, available as oral medication.

1114. Calcitriol (1.25 dihydroxycholecalciferol): Active Vitamin D, synthesized in kidney.

1115. Intravenous intermittent infusion (piggyback medication): Infusion of a volume of fluid over a set period of time at prescribed intervals and then stopped until the next dose is required. Advantages:

Avoid anticipated stability problems.

Decreases thrombophlebitis potential.

Better diffusion of drugs into tissues.

1116. Active metabolite of Atracurium: Laudanosine.

1116. Active metabolite of Atracurium: Laudanosine.

1117. Fick's law: Passive diffusion

1118. Stock's law: Sedimentation rate.

1119. Rault's law: Vapor pressure. TCAPS

1120. Van't Hoff equation: Osmotic pressure.

1121. ELISA assay: Diagnostic test for AIDS patients.

1122. Van den Bergh test: Specific test for conjugated Bilirubin.

1123. 1,4 dihydropyridine calcium channel blocker CCB: Nifedipine.

1124. Terminal part of small intestine: ileum.

1125. Daily urine output: 1500 ml.

1126. Erythropoietin effective therapy determined by: elevated Reticulocytes count (immature RBCs).

1127. The three main Omega 3 fatty acids:

Alpha-linolenic acid (ALA) "Essential"

Eicosapentaenoic acid (EPA)

Docosahexaenoic acid (DHA).

1128. Drugs contain a Sulphur atom as: Meloxicam, Gliclazide, Indapamide, captopril and Furosemide.

1129. Instability of atropine occurs due to: Ester hydrolysis.

1130. Organ plays a major role in immune system development (T-cell maturation): Thymus.

1131. Glucose, Fructose and Galactose are: Monosaccharaides.

1132. Maltose, sucrose and lactose are: Disaccharides.

1133. Filgrastim is: a colony-stimulating factor, which stimulates Granulocytes.

1134. Use of protamine sulfate for heparin toxicity is: Chemical antagonism.

1135. Prevention of absorption of a toxicant by ipecac or charcoal is: Dispositional antagonism.

1136. Two drugs at the same organ or tissue through independent receptors resulting in opposite effects: Physiologic or functional antagonism.

1137. Features of simple competitive (reversible) antagonism curve:

[Image]

a) Agonist curves have the same form (same slope).

b) Maximal response of an agonist is not reduced.

c) Increasing antagonist concentrations shift the agonist log concentration-effect to the right.

1138. The efficacy of a drug (effectiveness) is related to: its maximal agonist effect.

1139. The potency of a drug (power) related to: its concentration-response.

1140. The smaller the gauge number: the larger needle diameter.

1141. Partial or complete separation of the top or bottom crown from the main body of tablet: Capping.

1142. Separation of a tablet into two or more distinct layers: Lamination

1143. Removal of the surface material of a tablet by a punch: Picking

1144. Adhesion of tablet material to a die wall: Sticking

1145. Unequal color distribution in tablet: Mottling

1146. Greatest absorption of amoxicillin due to: Para hydroxyl group.

1147. Phenylalanine → Tyrosine dopa dopamine → NE→ ΕΡ.

1148. Least weigh gain antidepressants:

Fluoxetine acute therapy: decreased appetite and weight loss.

Bupropion: decreased appetite and weight loss.

1149. Least constipation antidepressant: Paroxetine "diarrhea"

1150. Least withdrawal symptoms antidepressants: Fluoxetine.

1151. Shortest MAOI wash-out period: Moclobemide (wears off completely after 24 hours).

1152. Highest Extra Pyramidal Symptoms antipsychotics: Haloperidol, Fluphenazine.

1153. Least EPS antipsychotics: Clozapine, Olanzapine (Highest anticholinergic activity).

1154. Highest Gynecomastia (Galactorrhea): Risperidone, Haloperidol, Fluphenazine.

1155. Least Gynecomastia (Galactorrhea): Clozapine, Olanzapine, Ziprasidone, Aripiprazole.

1156. Least weight gain Antipsychotics: Ziprasidone, Aripiprazole.

1157. Least ATP-producing pathway: Pentose phosphate pathway.

1158. Highest ATP-producing pathway: Electron transport chain (Oxidativephosphorylation).

1159. Higher GIT risk NSAIDs: Ketorolac, Piroxicam, Indomethacin.

1160. Least GIT risk NSAIDs: Ibuprofen, Diclofenac.

1161. Higher cardiotoxicity risk NSAIDs: Cox 2 inhibitors (Celecoxib), Diclofenac.

1162. Least cardiotoxicity risk NSAIDs: Naproxen.

1163. Least cardiotoxicity risk Antiepileptics: Valproic acid.

1164. Least cardiotoxicity risk opioids: Fentanyl

1165. Least depression risk antihypertensives: Enalapril, Ramipril, Verapamil, Amlodipine.

1166. Highest nausea, vomiting risk chemotherapeutics: Cisplatin.

1167. Least BMD risk chemotherapeutics: Vinca alkaloids (Vincristine).

1168. Na nitroprusside onset: 2-3 minutes.

1169. Chlorpropamide onset: 1 hour, t½: 35 hours, action duration: 60-70 hours.

1170. Dexamphetamine onset: 20-60 minutes, duration 3-7 hours.

1171. Fluoxetine t½: 2-4 days.

1172. Aspirin t½: 20-30 minutes.

1173. Amiodarone t½: 60 days

1174. PTU t½: 1.5 hours, Methimazole and Carbimazole t½: 6 hours.

1175. Amlodipine t½: 30-50 hours.

1176. Dapsone t½: 30 hours.

1177. NSAIDs t½ < 6 hours (short-acting): Ibuprofen, Ketoprofen, Diclofenac, Indomethacin.

1178. NSAIDS T½ >6 hours (long-acting): Piroxicam 50, Meloxicam 20, Naproxen 15, Celecoxib 12.

1179. Tropicamide: 4-6 hours mydriasis

1180. Cyclopentolate: 1 day mydriasis.

1181. Cyclosporine solution: Can be mixed with milk or orange juice.

1182. Apixaban: Can be crushed or mixed with water or orange juice.

1183. Cyproheptadine: Can be crushed.

1184. Omeprazole and Alendronate: Can't be crushed.

1185. Diazoxide: Artery vasodilator and Oral hyperglycemic medication (inhibits insulin secretion).

1186. 5HT-3 receptor type: Ligand ion channel receptor.

1187. Antacid optimum effect: when taken 1-3 hours after meal.

1188. Meropenem can be used for: Bacterial meningitis.

1189. Hydroxyurea enhances secretion of: Vasopressin (ADH).

1190. Drug can be used for ankylosing spondylitis: Certolizumab.

1191. Drug can be used for plaque psoriasis: Etanercept.

1192. Hippuric acid (methenamine) is better used with: Vitamin C (ascorbic acid).

1193. Vancomycin poorly absorbed orally, only for: pseudomembranous colitis.

1194. Vancomycin parenterally for: MRSA (Methicillin-resistant Staphylococcus Aureus).

1195. The greatest negative inotropic effect of CCBs is: verapamil.

1196. Initial drug for DM type 2 is: metformin.

1197. Symptoms

Serotonin syndrome

hyperthermia, sweating Muscle rigidity "stiffness", convulsions Headache, confusion Diarrhea, tachycardia.

Treated by Benzodiazepines and Cyproheptadine.

Neuroleptic malignant syndrome

High fever, sweating Muscle rigidity "stiffness", convulsions Stupor, confusion Tachycardia.

STOP drug and give Bromocriptine, Dantrolene.

Extrapyramidal symptoms

Motor restlessness Dystonia "sustained contraction" Tardive dyskinesia Parkinson's-like symptoms

Anticholinergic minimizes EPS Profenamine, Tetrabenazine

1198. a- dornase used as a mucolytic for treatment of: cystic fibrosis.

1199. Main thyroid hormones that regulate body metabolic rate are: T3 and T4.

1200. Drug used to treat child colic is: Simethicone drops.

1200. Drug used to treat child colic is: Simethicone drops.

1201. Drug suitable for hypertensive patient with chesty cough is: Guaifenesin.

1202. Aminoglycosides and vancomycin cause: Nephrotoxicity and ototoxicity.

1203. Colchicine: used for prophylaxis and treatment of acute gout.

1204. Addison's disease related to: adrenal insufficiency (hypocortisolism).

1205. Artery carries Deoxygenated blood is: pulmonary artery.

1206. The heart natural pacemaker is: the Sinoatrial node (SA node).

1207. Antihistamines in cold medicines: H1 blocker (histamine antagonist).

1208. Penicillin mechanism: inhibits trans-peptidase enzyme, inhibits cell wall synthesis.

1209. Doxorubicin causes: Cardiotoxicity.

1210. Bottles of Flucloxacillin liquid should be stored in: a refrigerator (2 to 8°C).

1211. Antioxidants: interact with the free radicals and inhibit LDL oxidation.

1212. Hypertension counseling: Getting blood pressure checked regularly is important because high blood pressure often asymptomatic.

1213. Fat-soluble vitamins are more likely to cause toxicity because: they are stored in adipose tissue, liver and skeletal muscles.

1214. Calcium salt that can't be used as antacid: Ca metabisulfite.

1215. Another name for Isopropyl alcohol (CH3CHOHCH3): 2-propanol.

1216. Phenobarbitone (Phenobarbital) is metabolized in liver by: the microsomal mixed function oxidases.

1217. Volatile oils contain: Terpenes (volatile unsaturated hydrocarbons).

1218. Barbiturates are Acidic.

1219. Possible side effect of levodopa: Dyskinesia.

1220. Using St. john wort with Tacrolimus causing: decrease in tacrolimus level because St. john wort is P. glycoprotein inducer.

1221. Enables drug to be detected by UV analysis: Aromatic ring

1222. Majority of hypertension: unknown causes.

1223. Oxytocin and vasopressin are secreted from: Posterior pituitary gland.

1224. Type 1 allergic reaction is an indication of: hypersensitivity to a given protein.

1225. Signs of left-sided heart failure: shortness of breath and Paroxysmal nocturnal dyspnea.

1226. Estradiol (natural form of estrogen) is secreted by: Ovarian follicle.

1227. Distal convoluted tubule cells are sensitive to: Aldosterone.

1228. The main role of collecting tubule (duct): Water reabsorption by ADH.

1229. The composition of sweat is altered in patients with: Cystic fibrosis.

1230. Muscle fatigue is thought to be: consequence of Lactic acid accumulation.

1231. Prevent backflow of blood to heart valves: Aortic and pulmonary valves.

1232. Single daily doses of simvastatin are best taken at: Bedtime.

1233. Anticonvulsants NOT used in pregnancy as: Phenytoin (category D), Valproic (category X).

1233. Anticonvulsants NOT used in pregnancy as: Phenytoin (category D), Valproic (category X).

1234. Side effect of hydrochlorothiazide: Rash.

1235. The RNA which binds to amino acids: tRNA.

1236. T½ in zero-kinetic is: Concentration dependent (Note the reaction rate in zero order is concentration independent).

1237. Zero-order kinetics:

A constant amount of drug is lost per unit time (concentration-independent)

The half-life is not constant, but depends on the concentration. The higher the concentration, the longer the t½.

1238. After chronic oral dose, plateau is depending on: t½ (half-life).

1239.5 t½ will decrease dose to: 1/32.

1240. Bromhexine is Mucolytic: Not used as antitussive.

1241. Severe asymptomatic hypertension: Treatment is recommended.

1242. Highest negative inotropic effect CCBs: Verapamil.

1243. Alendronate: improves fasting plasma glucose and insulin sensitivity.

1244. Vitamins which are more likely to be toxic: Fat-soluble vitamins.

1245. Acarbose maximum daily dose: 600 mg.

1246. Common side effect of antineoplastic drugs: BMD.

1247. Pyrantel pamoate is: Anthelmintic (can be used for treatment of threadworm).

Pyrantel is a medication used to treat a number of parasitic worm infections. This includes ascariasis, hookworm infections, enterobiasis (pinworm infection), trichostrongyliasis, and trichinellosis. It is taken by mouth.

1248. Molarity definition: The moles of a solute per liters of a solution.

1249. Alendronate similar to: Pyrophosphate.

1250. First choice in barbiturates toxicity: oxygen support (support respiration).

1251. Insulin release in response to: high blood glucose level.

1252. Dipyridamole is: Antiplatelets.

1253. Perindopril is: ACEI (NOT antianginal).

1254. Reduction in renal perfusion may be due to: increase afferent tone (afferent vasoconstriction).

1255. NSAIDs: increase reabsorption of lithium (decrease excretion).

1256. Celecoxib: substituted pyrazole moiety.

1257. NSAIDs affect: Renal clearance.

1258. Most drug absorption in: Upper small intestine.

1259. NOT biotransformation method: Esterification.

1260. Impetigo pathogens: Staphylococcus aureus and Streptococcus pyogenes.

1261. Morphine: NO loading dose.

1262. Fastest blood flow (higher velocity): Arteries.

1263. Severe side effect of Docusate: chronic flatulence.

Docusate is a medication utilized for managing and treating constipation. Belonging to the stool softener class of drugs, it reduces the surface tension of the oil and water interface within the stool, facilitating the passage of water and lipids into the stool mass.

1264. When low sodium intake is required, sodium chloride is replaced by: KCL

1265. Left AV valve closed in: atrial filling and ventricular ejection.

1266. Left AV valve opened in: ventricle filling.

1267. Resorcinol is: NOT a surfactant

1268. In asthma: increase airways passages resistance.

1269. Paracetamol dose in 20 kg child: 300 mg.

1270. Ferrous gluconate elemental iron: approximately 12%.

1271. Ferrous sulfate elemental iron: approximately 20%.

1272. Ferrous fumarate elemental iron: approximately 33%.

1273. Dexamethasone in chemotherapy for: Nausea and vomiting.

1274. Handling chemotherapy: NO Crushing of tablets.

1275. Methotrexate inhibits: dihydrofolate reductase.

1276. Levothyroxine and liothyronine are similar in: increase dose during pregnancy.

1277. Digoxin half-life is approximately: 36 hours.

1278. Antidepressant that can be used to treat chronic neuropathic pain: Amitriptyline.

1279. Medications should be used with caution in treating hypertension associated with renal artery

stenosis: ACEIS, ARBs.

1280. Oxymetazoline mechanism: direct-acting alpha (a)-adrenergic agonist sympathomimetic (nasal decongestant).

1281. Long acting tetracyclines: Doxycycline, Minocycline.

1282. Precursor of tyrosine: phenyl-alanine.

1283. Precursor of thyroxine: tyrosine.

1284. Most preventer medication for asthma is: inhaled corticosteroid (ICS) commonly called preventers.

1285. Sucralfate is: protective barrier.

1286. Retroviruses mechanism: use reverse transcriptase to transform their single-stranded RNA into double-stranded DNA.

1287. Basal long-acting insulin best taken: at bedtime.

1288. Insulin multiple injections: short acting or rapid acting at each meal with intermediate or long acting at bedtime.

1289. Initial dose of insulin: 0.3 to 0.4 units/kg once to twice daily (if needed).

1290. Procainamide metabolism: Hydrolysis and Acetylation.

1291. Cholinergic crisis associated with overmedication in patient with: Myasthenia gravis.

1292. Nitroglycerin IV administration:

Not for direct intravenous injection (for intravenous infusion only).

Concentrated potent drug which must be diluted prior to its infusion.

Should not be mixed with other drugs.

Discard the unused portion.

1293. Best practice for antiepileptic therapy:

Monotherapy is the ideal in epilepsy treatment because of reduced side effects, absence of drug interactions, better compliance, lower cost and, in many cases, improved seizure control compared to poly-therapy.

Using higher loading dose followed by lower maintenance doses.

1294. 4 chiral carbon give: 16 stereoisomers, 14 diastereomers.

1295. Clopidogrel is: Prodrug.

1296. Shelf-life of eye drops after opening: 28 days.

1297. Antiviral can be used in pregnancy: Acyclovir.

1298. The chief nitrogenous end product resulting from the metabolic breakdown of proteins: Urea.

1299. Dichloromethane is: Homotopic.

1300. Mechanism of action of local anesthetics: inhibit nerve transmission by binding voltage-gated sodium channels.

1301. NOT used in aspirin toxicity: calcium edetate.

1302. Diabetic ketoacidosis: Without enough insulin, your body can't use sugar properly for energy. This prompts the release of hormones that break down fat as fuel, which produces acids known as ketones. Excess ketones build up in the blood and eventually "spill over" into the urine.

DKA is most common among people with type 1 diabetes.

1303. Leukocytosis is: increased levels of leukocytes (WBCs) in the blood.

1304. Advantages of Moclobemide over Phenelzine:

Moclobemide is regarded as a generally safe antidepressant and due to its favorable side effect profile, it can be considered a first-line therapeutic antidepressant.

Reversible selective MAO-A inhibitor.

Fewer drug and food interactions.

1305. Pilocarpine causes: Miosis.

1306. The primary structure of a peptide or a protein is: The linear sequence of its amino acids.

1307. Treatment of fluoride overdose: calcium salts.

1308. Dopamine decrease and Ach increase may lead to: Hyperreflexia as in Parkinsonism.

1309. Advantage of T4 over T3: longer duration.

1310. Soft tissue nodules are seen in: Rheumatoid arthritis.

1311. More drug absorption from small intestine than stomach due to: large surface area.

1312. Cisplatin structure: Chloride ions are adjacent to each other.

1313. Codeine: NOT used in breastfeeding.

1312. Cisplatin structure: Chloride ions are adjacent to each other.

1313. Codeine: NOT used in breastfeeding.

1314. Tramadol: may be used in breastfeeding (The excretion of tramadol into milk is low and even lower amounts of the active metabolite, O-desmethyltramadol, are excreted. With usual maternal dosage, the amount excreted into breastmilk is much less than the dose that has been given to newborn infants for analgesia).

1315. Dose limiting factor for chemotherapy: Myelosuppression.

1316. Enoxaparin requires dose adjustment in: Renal impairment.

1317. Magnesium hydroxide as an antacid: Chemical action (neutralization).

1318. Magnesium hydroxide as a laxative: Physical action (osmosis).

1319. The first-line therapy of penicillinase-producing staphylococci: Penicillinase-resistant penicillin as oxacillin, cloxacillin, dicloxacillin, methicillin or flucloxacillin.

1320. Drugs NOT used in glaucoma: Antimuscarinic drugs as Atropine and Tropicamide.

1321. Dronabinol is: an isomer of tetrahydrocannabinol (THC).

1322. Annual vaccine recommended for 65 years old patient: Flu-vaccine.

1323. The initial course of PPI treatment should be for: 4 to 8 weeks, following by a review.

1324. Enantiomers: NOT a subtype of diastereomers.

1325. Co-administration of Colchicine with Statins: Increase myotoxic effect, causing myopathy and varying degrees of rhabdomyolysis.

1326. A good combination for parkinsonism: Levodopa + Apomorphine.

1327. Drug needs gastric absorption for activity: Methionine.

1328. A protein inside skin cells, makes up the skin cells and, along with other proteins, sticks together to form this layer: Keratin.

1329. Most protective layer of skin: Epidermis.

1330. Ion exchange chromatography (IEX): Separates molecules by their surface charge.

1331. Maximum dose of imipramine: 300 mg/day.

1332. Potassium carbonate (K2CO3) forms the potassium salt of: Ibuprofen.

1333. 10mg Sc Morphine = 100mcg Sc Fentanyl.

1334. Drugs can be used for treatment of Community acquired pneumonia (CAP): Amoxicillin, Doxycycline Clarithromycin, Roxithromycin.

1335. Drug requires Loading dose: Amiodarone.

1336. Trimethoprim: inhibits the subsequent conversion of dihydrofolic acid to tetrahydrofolic acid by inhibiting dihydrofolic acid reductase (inhibits folic acid synthesis).

1337. Increase risk of tendonitis: Quinolones.

1338. Should be avoided with colchicine: Grapefruit (Grapefruit and grapefruit juice may increase the effects of colchicine by increasing the amount of this medicine in your body).

1339. Doxorubicin has an accumulative effect on: Heart.

1340. 4-Aminosalicylic acid (ASA) metabolism in acidic media: Decarboxylation.

1341. Time to reach steady state concentration depend on: t½.

1341. Time to reach steady state concentration depend on: t %.

1342. Accumulates in tissues that are actively exercised: Lactate.

1343. NOT a side effect of TCA: Diarrhea.

1344. Aminoglycosides main side effect: Nephrotoxicity

1345. Peptide vaccines are: an attractive alternative strategy that relies on usage of short peptide fragments to engineer the induction of highly targeted immune responses, consequently avoiding allergenic and/or reactogenic sequences.

Peptide-based synthetic vaccines, also called epitope vaccines can be utilized as therapeutical cancer vaccines.

1346. An effective Acne treatment, used in combination with spironolactone: Birth control pills.

1347. Signs of Hypoglycemia: Looking pale Shakiness Sweating Headache Hunger or nausea. An irregular or fast heartbeat. Fatigue. Irritability or anxiety, palpitations.

1348. Morphine excreted via: Kidneys (renally cleared).

1349. Drug used for treatment of vertigo associated with migraine: Prochlorperazine.

1350. Deficiency of lodine in adults: Myxoedema.

1351. Oxidation of double bonds in fatty acids: Rancidity.

1352. Bacterial byproduct causes febrile reaction: Pyrogen.

1353. Order of impulse: SA node (pacemaker) → AV node → Bundle of HIS→ Purkinje fibers.

1354. Tocolytics as: Nifedipine.

1355. Side effect of isotretinoin: Hyperlipidemia.

1356. Amylase level used for diagnosis of: Acute pancreatitis.

1357. Drugs metabolized via acetylation as: Sulfonamides.

1358. Metformin dose reduction in: Renal impairment.

1359. Vancomycin dose reduction in: Renal impairment.

1360. Vaccine should generally not be given to people who are immunocompromised: yellow fever.

1361. Drug for treatment of hyperlipidemia in patient who can't tolerate statins: Ezetimibe.

1362. Not a side effect of nitrates: Breathlessness.

1363. Paraldehyde is oxidized to: Acetic acid.

1364. Antibiotics for Cellulitis: Flucloxacillin (first choice), Cephalexin or Clindamycin.

1365. Antibiotics for Mastitis: Flucloxacillin (first choice), Cephalexin or Clindamycin.

1366. Antibiotics for Paronychia: Flucloxacillin (first choice), Cephalexin or Clindamycin.

1367. Peripheral neuropathy occurs at a higher rate in: Poor (low) Acetylators.

1368. Patient on hydrochlorothiazide and atenolol, which medication least to take: Verapamil.

1369. Brinzolamide: reduces the production of aqueous humor.

1370. The most common bacterial infection of the throat: Strep throat.

1371. A potent ultra short-acting synthetic opioid given to patients during surgery: Remifentanil.

1372. Proteins normally high in: Blood (NOT urine).

1373. Drug used for bacterial vaginosis: Clindamycin.

1374. No cell wall in: Mycoplasma.

1375. Pregnant woman used ranitidine for gastric acidity but not effective, may recommend: Omeprazole.

1375. Pregnant woman used ranitidine for gastric acidity but not effective, may recommend: Omeprazole.

1376. Isotretinoin: (13-Cis retinoic acid) Oral treatment for Acne, increases cell turnover rate and reduce sebum production, vitamin A derivative, and causes teratogenicity so contraindicated in pregnancy and increased risk of Hyperlipidemia.

Isotretinoin important points:

For women, ensure effective contraception during treatment, and for 1 month after stopping.

Contraindicated in women planning to conceive or who are using inadequate contraception. It is recommended that two effective methods of contraception be used (eg a COC and a barrier method).

Contraindicated in hypervitaminosis A and hyperlipidemia.

Avoid taking vitamin A supplements.

Avoid combination with tetracyclines "may increase risk of benign intracranial hypertension".

Contraindicated in severe hepatic impairment.

Contraindicated in pregnancy or breastfeeding.

Absorbed best if taken with food.

often causes dry lips, mouth and eyes. Use white soft paraffin, eg Vaseline", to treat dry lips;

use lubricating eye drops to treat eye irritation.

Protect skin from sunlight with protective clothing or a broad-spectrum sunscreen.

Avoid using topical anti-acne preparations as local irritation may increase.

Using together with benzoyl peroxide topical may increase skin irritation.

Most common side effects: dryness of skin, lips and mucous membranes.

1. Which enzyme metabolizes norepinephrine?

a) COMT

b) MAO

c) P450

d) CYP3A4

Answer: b) MAO

2. Which is a selective MAO-B inhibitor?

a) Selegiline

b) Moclobemide

c) Tranylcypromine

d) Phenelzine

Answer: a) Selegiline

3. Mechanism of action of Finasteride:

a) Inhibits 5-alpha reductase

b) Blocks DHT receptors

c) Inhibits PDE-5

d) Inhibits HMG-CoA reductase

Answer: a) Inhibits 5-alpha reductase

4. Mechanism of action of Mebendazole?

a) Inhibits glucose uptake in parasites

b) Inhibits protein synthesis

c) Disrupts cell membrane

d) Inhibits DNA synthesis

Answer: a) Inhibits glucose uptake in parasites

5. Ondansetron acts by blocking:

a) 5-HT1 receptors

b) 5-HT2 receptors

c) 5-HT3 receptors

d) Dopamine D2 receptors

Answer: c) 5-HT3 receptors

6. Which is a non-selective COX inhibitor?

a) Celecoxib

b) Ibuprofen

c) Meloxicam

d) Etoricoxib

Answer: b) Ibuprofen

7. Which antibiotic inhibits bacterial cell wall synthesis?

a) Gentamicin

b) Cefoxitin

c) Erythromycin

d) Ciprofloxacin

Answer: b) Cefoxitin

8. Which drug is a selective beta-2 agonist?

a) Propranolol

b) Terbutaline

c) Carvedilol

d) Metoprolol

Answer: b) Terbutaline

9. Atropine acts as a:

a) Muscarinic receptor agonist

b) Nicotinic receptor antagonist

c) Muscarinic receptor antagonist

d) Alpha-1 receptor blocker

Answer: c) Muscarinic receptor antagonist

10. Which medication is a CYP3A4 inhibitor?

a) Rifampin

b) Ketoconazole

c) Phenytoin

d) St. John’s Wort

Answer: b) Ketoconazole

Pharmacokinetics & Drug Interactions

11. Warfarin’s effect is antagonized by:

a) Vitamin K

b) Heparin

c) Aspirin

d) Clopidogrel

Answer: a) Vitamin K

12. What increases warfarin toxicity?

a) St. John’s Wort

b) Rifampin

c) Metronidazole

d) Phenytoin

Answer: c) Metronidazole

13. Which drug is most affected by CYP3A4 inhibitors?

a) Simvastatin

b) Atenolol

c) Metformin

d) Levothyroxine

Answer: a) Simvastatin

14. Which drug should be avoided in pregnancy?

a) Amoxicillin

b) Warfarin

c) Paracetamol

d) Metformin

Answer: b) Warfarin

15. Which drug requires renal dose adjustment?

a) Amiodarone

b) Acyclovir

c) Warfarin

d) Losartan

Answer: b) Acyclovir

16. Which drug causes bradykinin-induced cough?

a) Amlodipine

b) ACE inhibitors

c) ARBs

d) Beta-blockers

Answer: b) ACE inhibitors

17. Which beta-blocker is cardioselective?

a) Propranolol

b) Atenolol

c) Carvedilol

d) Labetalol

Answer: b) Atenolol

18. Which drug is used in hypertensive crisis?

a) Diazoxide

b) Amlodipine

c) Atenolol

d) Ramipril

Answer: a) Diazoxide

19. Which diabetes drug causes dehydration?

a) Empagliflozin

b) Metformin

c) Sitagliptin

d) Insulin

Answer: a) Empagliflozin

20. Which drug is used to treat thyrotoxicosis?

a) Levothyroxine

b) Methimazole

c) Liothyronine

d) Amiodarone

Answer: b) Methimazole

Pharmacology & Mechanism of Action

1. Which enzyme metabolizes norepinephrine?

a) COMT

b) MAO

c) P450

d) CYP3A4

Answer: b) MAO

2. Which is a selective MAO-B inhibitor?

a) Selegiline

b) Moclobemide

c) Tranylcypromine

d) Phenelzine

Answer: a) Selegiline

3. Mechanism of action of Finasteride:

a) Inhibits 5-alpha reductase

b) Blocks DHT receptors

c) Inhibits PDE-5

d) Inhibits HMG-CoA reductase

Answer: a) Inhibits 5-alpha reductase

4. Mechanism of action of Mebendazole?

a) Inhibits glucose uptake in parasites

b) Inhibits protein synthesis

c) Disrupts cell membrane

d) Inhibits DNA synthesis

Answer: a) Inhibits glucose uptake in parasites

5. Ondansetron acts by blocking:

a) 5-HT1 receptors

b) 5-HT2 receptors

c) 5-HT3 receptors

d) Dopamine D2 receptors

Answer: c) 5-HT3 receptors

6. Which is a non-selective COX inhibitor?

a) Celecoxib

b) Ibuprofen

c) Meloxicam

d) Etoricoxib

Answer: b) Ibuprofen

7. Which antibiotic inhibits bacterial cell wall synthesis?

a) Gentamicin

b) Cefoxitin

c) Erythromycin

d) Ciprofloxacin

Answer: b) Cefoxitin

8. Which drug is a selective beta-2 agonist?

a) Propranolol

b) Terbutaline

c) Carvedilol

d) Metoprolol

Answer: b) Terbutaline

9. Atropine acts as a:

a) Muscarinic receptor agonist

b) Nicotinic receptor antagonist

c) Muscarinic receptor antagonist

d) Alpha-1 receptor blocker

Answer: c) Muscarinic receptor antagonist

10. Which medication is a CYP3A4 inhibitor?

a) Rifampin

b) Ketoconazole

c) Phenytoin

d) St. John’s Wort

Answer: b) Ketoconazole

---

Pharmacokinetics & Drug Interactions

11. Warfarin’s effect is antagonized by:

a) Vitamin K

b) Heparin

c) Aspirin

d) Clopidogrel

Answer: a) Vitamin K

12. What increases warfarin toxicity?

a) St. John’s Wort

b) Rifampin

c) Metronidazole

d) Phenytoin

Answer: c) Metronidazole

13. Which drug is most affected by CYP3A4 inhibitors?

a) Simvastatin

b) Atenolol

c) Metformin

d) Levothyroxine

Answer: a) Simvastatin

14. Which drug should be avoided in pregnancy?

a) Amoxicillin

b) Warfarin

c) Paracetamol

d) Metformin

Answer: b) Warfarin

15. Which drug requires renal dose adjustment?

a) Amiodarone

b) Acyclovir

c) Warfarin

d) Losartan

Answer: b) Acyclovir

16. Which drug causes bradykinin-induced cough?

a) Amlodipine

b) ACE inhibitors

c) ARBs

d) Beta-blockers

Answer: b) ACE inhibitors

17. Which beta-blocker is cardioselective?

a) Propranolol

b) Atenolol

c) Carvedilol

d) Labetalol

Answer: b) Atenolol

18. Which drug is used in hypertensive crisis?

a) Diazoxide

b) Amlodipine

c) Atenolol

d) Ramipril

Answer: a) Diazoxide

19. Which diabetes drug causes dehydration?

a) Empagliflozin

b) Metformin

c) Sitagliptin

d) Insulin

Answer: a) Empagliflozin

20. Which drug is used to treat thyrotoxicosis?

a) Levothyroxine

b) Methimazole

c) Liothyronine

d) Amiodarone

Answer: b) Methimazole

---

Antibiotics & Infections

21. DOC for Pneumocystis Jirovecii Pneumonia:

a) Amoxicillin

b) Trimethoprim-sulfamethoxazole (TMP-SMX)

c) Vancomycin

d) Ciprofloxacin

Answer: b) TMP-SMX

22. Which antibiotic is effective against Legionella?

a) Azithromycin

b) Amoxicillin

c) Cephalexin

d) Metronidazole

Answer: a) Azithromycin

23. Which antibiotic is used for cystitis?

a) Cephalexin

b) Amoxicillin

c) Vancomycin

d) Rifampin

Answer: a) Cephalexin

24. Which antibiotic is a beta-lactamase inhibitor?

a) Clavulanic acid

b) Metronidazole

c) Vancomycin

d) Daptomycin

Answer: a) Clavulanic acid

25. Which is a broad-spectrum penicillin?

a) Amoxicillin

b) Penicillin G

c) Vancomycin

d) Erythromycin

Answer: a) Amoxicillin

26. Which antibiotic is used in Enterococcus faecalis infection?

a) Imipenem

b) Cefoxitin

c) Gentamicin

d) Azithromycin

Answer: a) Imipenem

27. Which antibiotic causes ototoxicity at high doses?

a) Amoxicillin

b) Erythromycin

c) Vancomycin

d) Doxycycline

Answer: b) Erythromycin

28. Which antibiotic should be avoided in penicillin-allergic patients?

a) Cefepime

b) Azithromycin

c) Ciprofloxacin

d) Vancomycin

Answer: a) Cefepime

29. Which drug treats chlamydia?

a) Metronidazole

b) Azithromycin

c) Amoxicillin

d) Cephalexin

Answer: b) Azithromycin

30. Which drug is used in Mycoplasma pneumonia?

a) Doxycycline

b) Amoxicillin

c) Cephalexin

d) Metronidazole

Answer: a) Doxycycline

---

Cardiology & Endocrinology

31. Which drug is used for postural hypotension?

a) Midodrine

b) Prazosin

c) Terazosin

d) Clonidine

Answer: a) Midodrine

32. Which medication is used in hypertensive crisis?

a) Diazoxide

b) Ramipril

c) Atenolol

d) Losartan

Answer: a) Diazoxide

33. Which drug increases bradykinin levels?

a) Losartan

b) Amlodipine

c) ACE inhibitors

d) Beta-blockers

Answer: c) ACE inhibitors

34. Which beta-blocker has the least effect on blood glucose?

a) Atenolol

b) Propranolol

c) Carvedilol

d) Metoprolol

Answer: c) Carvedilol

35. Which drug should be avoided in patients with diabetes and hypertension?

a) Thiazide diuretics

b) Beta-blockers

c) ACE inhibitors

d) Calcium channel blockers

Answer: b) Beta-blockers

36. Which drug is the first-line treatment for thyrotoxicosis?

a) Levothyroxine

b) Methimazole

c) Liothyronine

d) Amiodarone

Answer: b) Methimazole

37. Which drug is used in diabetic nephropathy?

a) Metformin

b) ACE inhibitors

c) Insulin

d) Sitagliptin

Answer: b) ACE inhibitors

38. Which drug causes hyperkalemia?

a) Furosemide

b) Spironolactone

c) Hydrochlorothiazide

d) Mannitol

Answer: b) Spironolactone

39. Which diabetes drug causes genital infections?

a) Metformin

b) Empagliflozin

c) Sitagliptin

d) Insulin

Answer: b) Empagliflozin

40. Which drug causes lactic acidosis as a side effect?

a) Insulin

b) Metformin

c) Empagliflozin

d) Sitagliptin

Answer: b) Metformin

41. Which drug causes QT prolongation?

a) Amiodarone

b) Metformin

c) Lisinopril

d) Amlodipine

Answer: a) Amiodarone

42. Which medication causes serotonin syndrome when combined with SSRIs?

a) Tramadol

b) Ibuprofen

c) Warfarin

d) Losartan

Answer: a) Tramadol

43. Which drug causes gingival hyperplasia?

a) Phenytoin

b) Atenolol

c) Metformin

d) Digoxin

Answer: a) Phenytoin

44. Which drug is most associated with hypothyroidism?

a) Lithium

b) Metformin

c) Furosemide

d) Prednisolone

Answer: a) Lithium

45. Which beta-blocker is non-selective?

a) Atenolol

b) Propranolol

c) Metoprolol

d) Bisoprolol

Answer: b) Propranolol

46. Which drug is used to reverse opioid overdose?

a) Naloxone

b) Flumazenil

c) Atropine

d) Physostigmine

Answer: a) Naloxone

47. Which drug is used for benzodiazepine overdose?

a) Flumazenil

b) Naloxone

c) Physostigmine

d) Atropine

Answer: a) Flumazenil

48. Which drug causes nephrotoxicity and ototoxicity?

a) Gentamicin

b) Amoxicillin

c) Ceftriaxone

d) Clindamycin

Answer: a) Gentamicin

49. Which drug class does Montelukast belong to?

a) Leukotriene receptor antagonist

b) Beta-2 agonist

c) Antihistamine

d) Mast cell stabilizer

Answer: a) Leukotriene receptor antagonist

50. Which drug is used as an antidote for acetaminophen overdose?

a) N-acetylcysteine

b) Vitamin K

c) Flumazenil

d) Naloxone

Answer: a) N-acetylcysteine

---

Antibiotics & Antimicrobials

51. Which antibiotic is contraindicated in pregnancy?

a) Doxycycline

b) Amoxicillin

c) Cefalexin

d) Erythromycin

Answer: a) Doxycycline

52. Which antibiotic is effective against MRSA?

a) Vancomycin

b) Amoxicillin

c) Cephalexin

d) Gentamicin

Answer: a) Vancomycin

53. Which antifungal is used for oral candidiasis?

a) Nystatin

b) Fluconazole

c) Amphotericin B

d) Itraconazole

Answer: a) Nystatin

54. Which antiviral is used for herpes simplex?

a) Acyclovir

b) Oseltamivir

c) Zidovudine

d) Efavirenz

Answer: a) Acyclovir

55. Which antibiotic is a macrolide?

a) Azithromycin

b) Ceftriaxone

c) Amoxicillin

d) Ciprofloxacin

Answer: a) Azithromycin

56. Which antibiotic interacts with warfarin, increasing bleeding risk?

a) Metronidazole

b) Ciprofloxacin

c) Rifampin

d) Clindamycin

Answer: a) Metronidazole

57. Which antibiotic is used for otitis media?

a) Amoxicillin

b) Azithromycin

c) Vancomycin

d) Clindamycin

Answer: a) Amoxicillin

58. Which drug is used to treat tuberculosis?

a) Rifampin

b) Amoxicillin

c) Azithromycin

d) Vancomycin

Answer: a) Rifampin

59. Which drug is used for anaerobic infections?

a) Metronidazole

b) Azithromycin

c) Amoxicillin

d) Ceftriaxone

Answer: a) Metronidazole

60. Which antibiotic is a fluoroquinolone?

a) Ciprofloxacin

b) Amoxicillin

c) Doxycycline

d) Clarithromycin

Answer: a) Ciprofloxacin

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Other Important Drugs & Conditions

61. Which drug is used to treat bipolar disorder?

a) Lithium

b) Diazepam

c) Fluoxetine

d) Haloperidol

Answer: a) Lithium

62. Which drug is an atypical antipsychotic?

a) Olanzapine

b) Haloperidol

c) Diazepam

d) Lithium

Answer: a) Olanzapine

63. Which drug causes agranulocytosis?

a) Clozapine

b) Haloperidol

c) Risperidone

d) Aripiprazole

Answer: a) Clozapine

64. Which drug is used for rheumatoid arthritis?

a) Methotrexate

b) Metformin

c) Amlodipine

d) Diazepam

Answer: a) Methotrexate

65. Which drug is used in migraine prophylaxis?

a) Propranolol

b) Paracetamol

c) Ibuprofen

d) Aspirin

Answer: a) Propranolol

66. Which drug is a proton pump inhibitor?

a) Omeprazole

b) Ranitidine

c) Metoclopramide

d) Sucralfate

Answer: a) Omeprazole

67. Which drug treats motion sickness?

a) Scopolamine

b) Ondansetron

c) Diphenhydramine

d) Ranitidine

Answer: a) Scopolamine

68. Which drug is a loop diuretic?

a) Furosemide

b) Spironolactone

c) Hydrochlorothiazide

d) Acetazolamide

Answer: a) Furosemide

69. Which drug is an H1 antihistamine?

a) Diphenhydramine

b) Ranitidine

c) Omeprazole

d) Sucralfate

Answer: a) Diphenhydramine

70. Which drug is a reversible acetylcholinesterase inhibitor?

a) Neostigmine

b) Atropine

c) Pralidoxime

d) Scopolamine

Answer: a) Neostigmine