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REFERENCE GUIDE
FOR FOREIGN
PHARMACY
LICENSING EXAM
(Questions and Answers)
2014-2015
Manan H. Shroff
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This reference guide is not intended as a substitute for the advice of a physician. Students
or readers must consult their physician about any existing problem. Do not use any information
in this reference guide for any kind of self-treatment. Do not administer any dose of mentioned
drugs in this reference guide without consulting your physician. This is only a review guide for
preparation for the Foreign Pharmacy Licensing board exam.
The author of this reference guide is not responsible for any kind of misinterpreted, incorrect or
misleading information or any typographical errors in this guide. Any doubtful or questionable
answers should be checked in other available reference sources.
No part of this guide may be reproduced or transmitted in any form or by any means, electroni-
cally photocopyed, recorded or otherwise , without prior written permission of the publisher.
NAPLEX and FPGEE are federally registered trademarks owned by the National Associa-
tion of Boards of Pharmacy (NABP) and this reference guide is in no way authorized or spon-
sored by NABP.
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REFERENCE GUIDE
FOR FOREIGN
PHARMACY
LICENSING EXAM
(Questions and Answers)
2014-2015
Manan H. Shroff
4
PREFACE
Reference Guide For Foreign Pharmacy Licensing Exam Questions and Answers -
2014-2015 Edition is specifically written for students preparing for the FPGEE Exam.
It has approximately 1000 FPGEE TYPE questions with answers and complete explanations.
The FPGEE exam puts more emphasis on pharmacy management, statistics, immunology,
pharmacology, kinetics and biopharmaceutics, therefore an effort was made to include all of
these topics in a review guide. To prepare for pharmacology, I would highly recommend that you
take advantage of the Reference Guide For Pharmacy Licensing Exam-Theory.
Our preparation guide covers all the important topics you need to be familiar with to pass the
FPGEE. I would recommend that you to go through the FPGEE review guide sample
questions provided by the NABP (you will get one when your approval from the
FPGEE arrives) to evaluate the importance of our review materials.
Each answer is explained thoroughly to refresh your memory on specific topics. Please do
not go through only the questions and answers. Try to understand and learn the answer’s
explanations. It is the best way to get the most out of this review guide.
I hope my efforts will help you to pass your key exam. I wish you the very best of luck, and
any questions or comments are always welcome.
Good Luck,
Manan Shroff
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TABLE OF CONTENTS
SECTION-I
QUESTIONS 7
SECTION-II
ANSWERS 121
SECTION-III
TABLES 243
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5. Which of the following is the most a. The amount of drug systematically ab-
suitable route for administration of insulin ? sorbed.
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I. Creatinine a. Heteropolysacharide
II. Inulin b. Oligosaccharide
III. Albumin c. Homopolysacharide
d. Monosaccharide
a. I only
b. I and II only 19. Ribonucleic acid exists in all of the
c. II and III only following forms EXCEPT :
d. All
a. r RNA
14. The rapid degradation of a drug by b. m RNA
liver enzymes in a liver is defined as: c. q RNA
d. t RNA
a. Third pass effect of metabolism
b. First pass effect of metabolism 20. Which of the following structures is a
c. Rapid degradation host for Kreb’s cycle ?
d. Liver elimination
a. Mitochondria
b. Golgi bodies
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a. 1% C C
b. 3%
c. 5%
d. 10%
CH3 Cl
34. When the hypothetical value of a pa-
rameter is the same as the observed value of a FIGURE - I
parameter, the error should be considered:
a. Alfa-error
b. Beta-error
c. Gema-error
d. Infinitive
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CH3 H H O
N C
C C H
H. ................... O
F H a. Evaporation
b. Melting
FIGURE-3 c. Sublimation
d. Levigation
CH3 F
42. The characteristic of solid substances
C C to exhibit more than one crystalline or amor-
phous form is defined as:
CH3 F
a. Isomerism
b. Polymorphism
FIGURE-4
c. Zwitter ion
d. Coupling
a. Fig I
b. Fig II
43. Which of the following molecules rep-
resents CIS form ?
c. Fig III
d. Fig IV
H Cl
39. Which of the following molecules has
the highest boiling point? C C
a. H2O H Cl
b. H2S
c. H2Se FIGURE - I
d. HCN
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H H c. Diffusion coefficient.
H H a. Solvation
b. Hydration
C C c. Activation
d. Degradation
H H
48. What happens to the solubility of al-
FIGURE - 4 cohol as the molecular weight of alcohol in-
creases ?
a. Fig I
b. Fig II a. Reduces
c. Fig III b. Increases
d. Fig IV c. Remain unchanged
d. Insoluble in water
44. Which of the following drugs is an
angiotensin receptor antagonist ? 49. The degradation of Riboflavin by
light is classified as:
a. Lisinopril
b. Losartan a. Oxidation
c. Methyldopa b. Reduction
d. Captopril c. Photochemical degradation
d. Racemization
45. According to Fick’s law of diffusion,
which of the following is inversely propor- 50. The degradation of Penicillin G
tionate to the rate of diffusion ? Procaine is highest in:
a. The area of the solid. a. Solution
b. Suspension
b. The difference between the concentra- c. Elixir
tion of solute to concentration of d. Tablet
solute in stagnant layer.
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51 The rate of oxidation is influenced by all 55. To balance the following equation, how
of the following EXCEPT : many molecules of NH4Cl would be required?
III. Suspension of tragacanth follows the 57. Which of the following about floccu-
pseudoplastic’s flow. lated suspension is NOT true?
a. Lyophilic a CH3CONHC6H5
b. Lipophylitic b. CH3CHO
c. Lyophobic c. C H CH=N.C H
6 5 65
d. Radioactive colloids d. C H N=NC H
6 5 6 5
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60. The spontaneous isomerization of two Which of the following is an active moiety of the
stereoisomers in aqueous solution that causes above compound ?
specific rotation is known as:
a. Carboxylic acid
a. Zwitter ion rotation b. Imidazole
b. Micelle rotation c. Pyroline
c. Mutarotation d. Aniline
d. Steriorotation
65. Albumin is an example of a:
61. Which of the following is a polysac-
charide? a. Simple protein
b. Conjugated protein
a. Dextrose c. Derived protein
b. Dextran d. Hydrolysed protein
c. Lactose
d. Sucrose 66. NH
a. Sterols O
b. Phospholipids Fluorination of above compound will result
c. Glycolipids into a well known cancer drug known as:
d. Saponins
a. Methadone
63. Which of the following is NOT a hy- b. 5-fluorouracil
c. 6-mercaptopurine
drolyzed product of lecithins?
d. Procainamide
N CH CH NHCOOH
2 2 68. Which of the following is NOT classified
as a titrimetric method of analysis?
NH a. Direct titration
b. Gravimetric titration
c. Complexation reaction
d. Redox reaction
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69. Hemolytic anemia with abnormal he- 74. Which of the following is an anaerobic
moglobin is generally found in patients with : organism?
70. All of the following drugs may cause 75. Which of the following organisms is
hemolysis in a patient with G6PD deficiency responsible for causing most of the UTI ?
EXCEPT :
a. S. pharyngitis
a. Chloroquine b. E. coli
b. Sulfonamide c. N. gonorrhea
c. Dimercaptrol d. T. palladium
d. Penicillin
76. The accurate diagnostic test for a pa-
71. Which of the following drugs is use- tient with cystic fibrosis is :
ful in a Rh negative mother with a Rh posi-
tive infant ? a. Mantoux test
b. Sweat test
a. Rho gam c. Breath test
b. Octeroide acetate d. Sick test
c. Immunoglobulin
d. Pneu-immune 77. The allergic skin reaction character-
ized by wheel formation is known as:
72. Which of the following is NOT true
about PKU ? a. Eczema
b. Urticaria
a. It is a disease usually characterized by c. Impetigo
mental abnormalities. d. Erythema
b. A high concentration of phenylpyruvic-
acid is found in urine. 78. Which of the following about diabe-
c. It occurs due to excessive secretion tes insipidus is NOT true?
of Phenylalanine hydroxylase enzyme.
d. A guthrie test is normally performed a. It is a disease usually characterized by
to detect it. polyuria, polydypsia, and severe thirst.
b. The urine volume sometimes increases
73. The metabolite product of epinephrine 16 to 24 liters a day.
and norepinephrine is : c. It is thought to occur due to over-
activity of ADH.
a. Gama butyric acid d. A patient should be monitored for
b. Vanillymandelic acid dehydration.
c. Homovanillic acid
d. 5 Hydroxyindoleacetic acid
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79. In which kinetic reaction is the rate of re- 84. Which of the following drugs is indicated
action independent from concentration ? for reducing elevated blood concentration of
ammonia in blood ?
a. First order
b. Zero order a. Lactulose
c. Pseudo first order b. Diphenoxylate
d. Second order c. Sucralfate
d. Calcium polycarbophill
80. The initial degradation of a drug by
liver enzymes after oral administration of the 85. Patients with hemophilia have a defi-
drug is known as: ciency of :
81. Which of the following factors DOES 86. Sodium polystyrene sulfonate is found
NOT affect the protein binding of a drug ? to lower :
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I. Glucagon
103. Which of the following diuretics acts
II. I.V. Dextrose
through inhibition of carbonic anhydrase en-
III. Lidocaine
zyme?
a. I only
a. Furosemide
b. I and II only
b. Acetazolamide
c. II and III only
c. Spironolactone
d. I, II, and III only
d. Hydrochlorothiazide
104. Which of the following is a common ad- 108. Which of the following sulfonylurea
agents is indicated for the treatment of diabe-
verse effect of metolazone?
tes insipidus ?
a. Seizure
a. Glyburide
b. Electrolyte loss
b. Chlorpropamide
c. S.L.E.
c. Glipizide
d. Neuroleptic malignant syndrome
d. Tolbutamide
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109. The deficiency of vitamin A may cause 114. Which of the following is not classified as
an insect control chemical ?
a. Osteoporosis
b. Night blindness a. Insecticides
c. Scurvy b. Repellents
d. Anemia c. Attractants
d. Antiseptics
110. Which of the following can be used
for the treatment of Methotrexate overdose ? 115. Which of the following is NOT true
about Barium sulfate?
a. Mephyton
b. Leucovorin Ca+2 a. It is medicinally used in roentgeno-
c. Pyridoxine graphy for the examination of the
d. Niacin stomach and colon.
b. It is a clear solution.
111. Which of the following benzodiaz- c. The principle adverse effect is
epines can be safely administered to a geriat- constipation.
ric patient ? d. It needs to be mixed well with food or
strained through gauze before it is
a. Chlordiazepoxide administered to a patient.
b. Alprazolam
c. Oxazepam 116. The addition of Ascorbyl palmitate in
d. Prazepam the manufacturing process serves as a :
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387. Which of the following ratios is the best I. It indicates profitability as well as the
indicator of a pharmacy’s profitability ? efficiency of pharmacy.
a. Net profit to net sales II. It can be used for new and old phar-
b. Net profit to net worth macies.
c. Net profit to total asset
d. Net profit to inventory III. It increases with an increase in sales
of thepharmacy.
388. Which of the following ratios generally
indicates the efficiency of a pharmacy ? a. I only
b. I and II only
a. Net profit to total assets. c. II and III only
b. Inventory turnover rate d. I, II, and III only
c. Capitalization of net profit
d. Net profit to net sales 393. Manan Pharmacy’s net profit to total as-
sets ratio is found to be 15%. This will indicate
the pharmacy’s profitability is :
389. All of the following indicate the ratio
that measures the efficiency of a pharmacy
a. Good
EXCEPT:
b. Excellent
c. Outperform
a. Inventory turnover rate
d. Worst
b. Net sales to inventory
c. Acid test
d. Net sales to net working capital 394. Manan’s Pharmacy’s part of the finan-
cial balance sheet is as follows:
390. The acceptable ratio for net profit to
net sales would be: YEAR 2000 SALES
RX $600,000
a. Less than 1%
Merchandise $150,000
b. 1 to 2 %
Total $750,000
c. 2 to 3 %
Cost of goods sold $500,000
d. 5 to 7%
Beginning inventory $200,000
Ending inventory $220,000
391. What would be the acceptable ratio for
10 year old pharmacy’s net profit to net worth?
What would be the inventory turnover
rate for Manan’s Pharmacy?
a. 1%
b. 5%
a. 4.3
c. 15%
b. 2.38
d. 50%
c. 3.5
d. 6.0
392. Which of the following is true about net
profit to inventory ratio?
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395. The inventory turnover rate of the above 399. Which of the following classes of recalls
pharmacy would: should be considered a potential hazard to health
?
a. Meet the expectation
b. Below the expectation a. Class I
c. Exceed the expectation b. Class II
d. Cannot calculate c. Class III
d. Class IV
396. The net sales of the above pharmacy are
840,000. Find out the ratio of net sales to inven- 400. Which of the following categories indi-
tory of the above pharmacy. [assume inventory cates the use of a drug is restricted during preg-
of above pharmacy at time of calculation is nancy ?
$210,000]
a. A
a. 8 b. B
b. 4 c.X
c. 10 d. C
d. 12
401. Liquidity generally expresses a
397. Find out the net worth of Manan’s pharmacy’s ability to meet its:
Pharmacy?
a. Assets
Total current assets = $150,000 b. Current liability
Total fixed assets = $40,000 c. Inventory
Total liabilities = $75,000 d. Prepaid expenses
B FIXED ASSETS
410. Manancare Pharmacy wants to sell its pre-
Fixtures and equipment $ 30,000 scription files. The Manancare Pharmacy own-
Deposits $ 5000 ers asks $350,000 for the existing prescription
Total fixed assets $ 35,000 file.
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The average RX price $ 50 414. Find out the % markup of Vasotec pre-
scription if 30 tablets of Vasotec 5 mg retail price
Net profit % % 15 is $75 and the cost of the drug is $45.
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418. In a patient cost sharing plan, when a Year Students taking the exam.
patient has to pay a specified amount of the
cost of prescriptions and a third party will pay the 1981 350
remainding cost of prescriptions, it is known as: 1982 420
1983 530
a. Copayment 1984 600
b. Coinsurance 1985 620
c. Deductible 1986 635
d. Retrospective payment 1987 700
1988 850
419. A person who works for an insurance
company, provides the statistical data that in- Find out the mean of the above data:
dicates the risk associated with serving the popu-
lation, and determines the premiums to cover all a. 601
the estimated expenses is known as: b. 588
c. 720
a. Pharmacy manager d. 520
b. Actuary
c. Sponsor 423. What would be the median of the
d. Vendor above example?
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a. It is a genetic disorder resulting from 440. What would be the end product of gly-
the production of a variant hemoglo- colysis in the cell with mitochondria ?
bin.
a. Glucose
b. It is characterized with pain, lifelong b. Glycogen
hemolytic anemia and tissue hypoxia. c. Pyruvate
d. Lactate
c. The replacement of leucine at the sixth
position of the Beta-globulin chain for 441. Which of the following substance lev-
glutamate is generally responsible for els is found to be deficient in a patient with
causing it. G6PD deficiency?
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443. Which of the following should be classi- 448. Which of the following about steatorrhea
fied as a disaccharide? is NOT TRUE?
a. I only a. Prostaglandin
b. I and II only b. Spingomyelin
c. II and III only c. Thromboxane
d. I, II and III only d. Leukotriene
446. Which of the following substances should 450. The term cholelithiasis is generallyreferred
to as:
be classified as a polysaccharide?
a. Obstruction of the stomach by choles-
a. Glucose
terol stone.
b. Hyaluronic acid
c. Sucrose
b. Obstruction of the pancreas by choles-
d. Glycoprotein
terol stone.
447. Which of the following agents acts as c. Obstruction of the gall bladder by cho-
an emulsifying agent for metabolism of lipid lesterol stone.
in duodenum?
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a. I only a. Lysozymes
b. I and II only b. Plasmids
c. II and III only c. Mitochondria
d. I, II and III only d. Cytoplasm
453. Which of the following is considered pro- 458. Which of the following RNA types
tein deficient malnutrition? comprises 80% of the RNA in the cell?
a. I only a. I only
b. I and II only b. I and II only
c. II and III only c. II and III only
d. I, II and III only d. I, II and III only
454. Which of the following is NOT a water 459. Which of the following types of RNA
soluble vitamin? carries genetic information from DNA to cy-
tosol for protein synthesis ?
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ANSWERS
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1 (b) Benzyl alcohol is classified as a preserva- Multiple emulsions : Water in Oil in ware (W/O/
tive. Preservatives prevent the growth of micro- W), Oil in water in Oil (O/W/O). The w/o/w
organisms and prevent deterioration of pharma- emulsions are generally more preferable for prepa-
ceutical dosage forms. The ideal preservative must ration of various pharmaceutical dosage forms.
have the following characteristics: They are used to prolong the duration of action
of various drugs, to localize drug in the body and
It must be effective against a broad spectrum of to prepare cosmetics.
microorganisms. It must be stable for the lifetime
of the product. It must be nontoxic, soluble, pal- 3 (a) Egg yolk or egg white is useful as an emul-
atable in test and odor and compatible with other sifying agent. It lowers the interfacial tension be-
ingredients in the formulation. tween disperse phase and dispersion medium. It
can be classified as natural or synthetic.
Commonly used preservatives:
Commonly used emulsifying agents:
* phenol * benzoic acid
* benzyl alcohol * chlorobutanol * Acacia * Tragacanth
* thiomersal * benzalkonium * Gelatin * Methylcellulose
* cresol * cetylpyridinium * Pectin * Agar
* Spans * Tweens
2 (c) Cold cream is an example of W/O emul- * Sodium lauryl sulfate.
sion. It is a biphasic liquid dosage form, in which
disperse phase and the dispersion medium are 4 (c) The transfer of a drug from a high concen-
liquids. Emulsion is classified by five different cat- trated area to a low concentrated area is defined
egories: as “Diffusion”.
Water in Oil (W/O) : Oil is continuous phase and The addition of a levigating agent into a
water is a disperse phase, i.e. lotions and lini- solid to blend to make paste is defined as “Levi-
ments. gation” i.e. the addition of glycerine to the pow-
der of sulfa.
Oil in water (O/W) : Water is continuous phase
and oil is a dispersed phase i.e. most of the oral 5 (b) The most suitable route for administration
emulsions to unmask the oil taste of a medication. of insulin is subcutaneous, since it has been found
that absorption of insulin via this route is slow and
Microemulsion : Unlike emulsions, microemulsion therefore the chance of acute hypoglycemia is very
is a transparent with a small particle size. It is be- rare.
lieved to be thermodynamically unstable. The
particle size of microemulsion lies between 10 to 6 (b) Noyes Whitney equation helps to find out
200 nm. It is generally used for the solubilization the rate of dissolution of a drug. The rate of
of the drug in pharmaceutical dosage form. dissolution is a rate-limiting step in the drug’s
bioavailability.
Nanoparticles : As the name suggests, the par-
ticle size of this kind of emulsion is limited to dC = Dc S x (Cs - C)
nanograms. They are useful for the preparation dt h
of globulins and toxoids. Tetanus toxoid and hu-
man immunoglobulin G are examples of
nanoparticles emulsion.
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10 (c) Albumin is the major plasma protein in- 12 (a) The initial dose of a drug through I.V.
volved in binding of drugs. Drug binding inhibits bolus to achieve desirable plasma concentration
the clearance of the drug from the liver and kid- at once is defined as the Loading dose of drug.
ney. It limited the availability of free drugs to vari- The replacement of metabolic loss of a drug from
ous receptor sites. time to time to sustain the minimum effective con-
centration of drug (MEC) is defined as a mainte-
Profound increase in drug binding may nance dose.
reduce the effects of the drug or decrease in drug
binding may increase the toxic or adverse effects 13 (b) The creatinine (endogenous substance
of drugs. obtained from creatinine phosphate during muscle
metabolism) and Inulin (exogenous substance, a
Drugs having a high affinity for protein polysaccharide) are useful to measure the rate of
binding may displace a low affinity for protein glomerular filtration.
binding, such as oral sulfonylurea displaces the
coumadin from protein binding.
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The ideal characteristics of a drug to measure Polysaccharides : They consist of long chains of
glomerular filtration rate : monosaccharides i.e. starch and glycogen
* It must be nontoxic and non- 17 (c) Uracil. It is a pyrimidine base that only
reabsorable from the renal tubules. found on RNA.
* It must not affect the renal function. Nucleotides are the building blocks of the nucleic
acid. Purines and pyrimidines bases bind to ri-
* It should be actively secreted through bose to form nucleoside, which when binded to
renal tubules and should be easily mea- phosphoric acid forms the nucleotides.
sured in urine or plasma. DNA RNA
Purine bases
* It should not be metabolized by the
liver. Adenine
Guanine
Creatinine clearance is the most widely
acceptable test to measure the function of kid- Pyrimidine base
ney. Normal creatinine clearance lies between 80
to 120 cc/min. Creatinine clearance below 60 cc/ Cytosine
min indicates renal function impairment. Uracil
Thymine
14 (b) The rapid degradation of drugs by liver
enzymes is known as the First Pass Effect of me- 18 (a) Heparin is classified as a
tabolism. heteropolysaccharide. Polysaccharides are clas-
sified in two different categories :
15 (b) The normal creatinin clearance value lies
between 80 to 120 cc/min. I Homopolysaccharide
II Heteropolysaccharide
16 (b) Sucrose is an example of Oligosaccha-
ride. It consists of a short chain of monosaccha- Homopolysaccharide: Consist of only one type
ride. It consists of one molecule of glucose and of monomeric units i.e. starch, glycogen, cellu-
one molecule of fructose. Carbohydrates can be lose.
divided into three categories : Monosaccharide,
Oligosaccharide and Polysaccharide. Heteropolysaccharides: Consist of two or more
types of monomeric units, i.e. heparin and hy-
Monosaccharides : They are simple sugar such aluronic acid
as glucose or fructose.
19 (c) qRNA. Nucleic acids consist of long chains
Oligosaccharides : Consists of a small chain of of nucleotides. They can be subdivided into two
monosaccharides. i.e. sucrose, maltose and lac- different categories:
tose. They have to degraded into simple sugar in
order to be absorb from the intestine. Degrada- I DNA (Deoxyribose nucleic acid)
tion of sucrose gives one molecule of glucose and II RNA (Ribose nucleic acid)
fructose, degradation of maltose gives two mol-
ecules of glucose, and degradation of lactose gives RNA is subdivided into three categories:
each molecule of galactose and glucose.
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removal of various functional groups other than 27 (d) U test. Arm ratio test, Rider and gradu-
the process of hydrolysis. DNA isomerase cata- ated beam test and shift test are commonly em-
lyzes various isomerizations. ployed tests for checking sensitivity of class A
prescription balance. The minimum weighable
24 (b) Nucleotides are the building blocks of quantity for class A prescription balance is 120
nucleic acid. Nucleic acids consists of long chains mg.
of nucleotides.
28 (a) The ratio of the mass of an object mea-
25 (b) B lymphocytes and T lymphocytes are sured in a vacuum at a specific temperature to the
the primary cells of immune responses of the body. volume (in ml) of an object at the same tempera-
ture is defined as Absolute density.
26 (c) Immunoglobulins are protein of the anti-
bodies class. They can be subdivided into five Specific gravity : The ratio of the mass of a sub-
major categories. stance to the mass of an other substance an equal
volume taken as standard.
IgG: It is the major immunoglobulin found
in blood. It accounts for 75% of the serum immu- Relative density : The mass of 1 ml of a standard
noglobulin and 20% of plasma protein. It is the substance at a specified temperature, relative to
o
only immunoglobulin that can cross the placental water at 4 C.
barrier to provide protection to the fetus. It is the
only class of immunoglobulin whose Fc region Apparent density : The ratio of mass of an object
can be recognized by phagocytosis and NK cells. measured in air at specific temperature to the vol-
ume of the object in ml at the same temperature.
IgM: It is the first immunoglobulin pro-
duced by the body in response to antigen. It ac- 29 (c) The mean blood pressure of Mr. Ham
counts for 5 to 10% of total immunoglobulins. It can be calculated as follows:
is the first immunoglobulin that is formed by the
fetus, however it cannot cross the placenta due 80 + 82 + 81.5 + 90 + 85 + 83
to its large size. 6
= 83.58
IgA: It is the major immunoglobulin in
external body secretions such as saliva, tears and 30 (b) The deviation of data from its mean or
urine. It accounts for 10% of total immunoglobu- average is defined as standard deviation. The re-
lins. producibility of the series of measurements is
known as precision. Accuracy is defined as close-
IgE: This immunoglobulin plays an impor- ness of measurements to the true value.
tant role in combating helminth and allergy reac-
tions produced such as drugs, pollens or foods. 31 (a) The reproducibility of results of a num-
The level of this immunoglobulin is found to be ber of experiments is generally known as preci-
highly elevated in patients with allergy condition sion.
such as asthma and hay fever.
32 (b) The sum of the all probabilities (failure
IgD: It accounts for 1% of total immuno- and success) in binomial distribution is equal to 1,
globulins. It serves as an antigen receptor site in therefore if the probability of success is p = 0.6,
the early stages of immune response. the probability of failure (q) should be 0.4.
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34 (b) When the hypothetical value of a param- This type of attraction is known as dipole-dipole
eter is the same as the observed value of a pa- attraction and has a strength of 1 to 7 kcal/mole.
rameter, the error should be considered Beta er-
ror. Sometimes electrons are concentrated in one re-
gion of the atom or molecule, and this displace-
35 (a) The degree of freedom in a chi-square ment of electrons generally causes a nonpolar
test is defined as (R-1) x (C-1), therefore the molecule to become a polar molecule which re-
degree of freedom in 2 x 2 contingency table sults in an instantaneous dipole. Slowly, electrons
would be (2-1) x (2-1) = 1. in a neighboring atom or molecule may be dis-
placed to produce a dipole this is called process
36 (b) The “F” distribution is used to compare of induction. A newly formed dipole is known as
two variances. It is defined by the ratio of vari- an induced dipole or debey force. Debey force
ances, with n1 -1 in the numerator and n2-1 in has a strength of about 1 to 3 kcal/mole.
the denominator of the ratio. The “t” distribution
is useful for a comparison of two means. The attraction between two induced dipole
molecules is known as dipole-induced dipole
interaction, dispersion force or London force, This
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bond has a strength of about 0.5 to 1 kcal/mole. 44 (b) Cozaar (Losartan) is classified as angio-
Ion dipole or ion induced dipole bond; in a polar tensin II receptor antagonist. It blocks the bind-
substance, the positive end of one dipole tries to ing of angiotensin II to AT receptors. It is indi-
line up with the negative end of an other dipole. cated for the treatment of hypertension. The rec-
ommended dose of the drug is 50 mg per day
Hydrophobic bond: The association of with or without food. Hyperkalemia, diarrhea,
nonpolar groups in an aqueous solution such as hypotension, tachycardia and angioedema are
water, due to the tendency of aqueous solvents reported side effects of the drug.
to exclude nonpolar molecules.
45 (d) According to Fick’s law of diffusion, the
41 (c) The process of transforming a solid to a rate of diffusion is directly proportional to the area
vapor without intermediate change to the liquid is of the solid, the concentration difference between
defined as sublimation. The transform of solid to the concentration of solute in the stagnant layer at
a liquid is a defined as melting and the transfer of the surface of solid and its concentration on the
liquids to a vapor is defined as evaporation. farthest side of the stagnant layer and diffusion
coefficient. It is inversely proportional to the length
42 (b) The characteristic of solid substances to of stagnant layer.
exhibit more than one crystalline or amorphous
form is defined as polymorphism. The driving force behind the movement of the
solute molecules through the stagnant layer is the
43 (a) The arrangement of geometric isomers in difference in concentration of solute at C1 and its
which two ions (in our case Cl) can either be along concentration at C2.
the same edge of the square (cis) or on opposite
corners (trans). Rate of solution = D x A X (C - C )
1 2
L
Generally trans-isomers are more stable com- D = Diffusion coefficient
pared to cis-isomers. A = Surface area of solid
C1 = Concentration near to stagnant layer
C2 = Concentration of solute to other side
X Y of stagnant layer.
L = The length of the stagnant layer
C C
46 (c) Acetone is classified as a semipolar sol-
X Y vent. Water is classified as a polar and benzene is
classified as a non-polar solvent.
[CIS ISOMER]
47 (b) The process of degradation of ionic salt
into cations and anions in the presence of water is
known as hydration. If the solvent is other than
X Y water, the process is known as solvation.
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water and OH groups of alcohol decreases, The material that exhibits the plastic flow
therefore high molecular weight alcohols are is known as the Bingham body. Plastic flow has a
poorly soluble in water. yield value, which means that it does not start to
flow until shear stress exceeds the yield value,
49 (c) The degradation of Riboflavin by light is and therefore plastic flow curve does not pass
an example of photochemical degradation. Light through the origin but rather intersects the shear-
generally catalyzes oxidation and reduction of ing stress axis.
photoexcited species of such drugs. Riboflavin
and phenothiazine are examples of such drugs. Concentrated suspension with flocculated
particles generally follows the plastic flow. Plastic
50 (a) The degradation of Penicillin G Procaine flow has a yield value because of the presence of
is the highest in a solution, since the hydrolysis of van der walls force between flocculated particles,
Penicillin G procaine is catalyzed by hydrogen or and the need to break such force before it exists
hydroxide ions. in the flow.
51 (d) The rate of oxidation is influenced by tem- The third type of flow is described as
perature, radiation and the presence of a cata- Dilatant flow. It is also known as a “shear thick-
lyst. It is not affected by hydrolysis. Ephedrine, ening system” in which the viscosity of the system
ascorbic acid, phenothiazine and vitamin A are increases with increase in shear stress. It is gen-
examples of pharmaceutical products that oxidize erally observed more with suspension that con-
very easily. tains a high percentage of dispersed solid (about
50% or greater of small deflocculated particles).
52 (d) A large number of pharmaceutical prod-
ucts such as liquid dispersion of methyl cellulose, The system that follows conversion from
carboxymethylcellulose, tragacanth and sodium gel to sol upon applying shear stress and reforms
alginate follows pseudoplastic flow. The viscosity back to gel from sol upon resting is defined as
of the pseudoplastic flow decreases with an in- Thixotropy. The application of thixotropy is very
crease in rate of shear. It does not have the yield useful in the formulation of pharmaceutical prod-
value. ucts. For example, the well formulated thixotropy
suspension will not settle out readily and will be-
Normally, as shearing stress increases, the come fluid upon shaking.
disarranged particles of the solute try to get along
with the direction of flow. At certain levels with 53 (b) Microemulsion is the liquid dispersion of
each successive shearing stress, the greater rate water and oil that is made homogeneous and trans-
of shear can be achieved with minimum stress. In parent by the addition of surfactant and cosur-
addition, some of the solute molecules (entrapped factant. It is not a thermodynamically stable. The
between solvent molecules) may be released, droplet size of microemulsions lie between 10 to
which reduces apparent viscosity of the flow. 200 nm. They are intermediate in property be-
Pseudoplastic flow is known as a “shear thinning tween solution and emulsion.
system”.
54 (a) A system with considerable interaction
Generally, non-newtonian flow can be between the disperse phase and dispersion me-
classified in three classes of flow: plastic, pseudo- dium is known as Lyophilic dispersion or solvent
plastic, anddilatant. loving dispersion. If the dispersion medium is
water, the system is known as hydrophilic.
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Hydrophilic suspension is subdivided in to three 58 (d) The relation of the rate of sedimentation
categories: with various parameters can be expressed by
Stoke’s law.
I True solution, i.e. acacia and povidone
solution. V = 2r2 (P1 - P2) g
9n
II Gells or jellies, i.e. gels of
methylcellulose, gelatin and starch V = velocity of sedimentation in
cm/sec
III Particulate dispersions, i.e. suspension r = radius of the particles in cm
of bentonite P = density of disperse phase in
1 3
g/cm
Lipophilic or Oleophilic dispersions have a high P = density of dispersion medium
2 3
affinity for oily substances such as benzene, veg- in g/cm
etable oils, essential oils, and mineral oil etc. n = viscosity of dispersion me-
dium
55 (b) 2. g = gravity acceleration 980.7 cm/
2
sec
(NH4)2S + NICl2 = NIS + 2 NH4Cl
The rate of sedimentation is independent of the
56 (b) The random motion of solute particles in lipophilic nature of particles.
colloidal dispersion is known as Brownian mo-
tion. 59 (a) CH3CONHC6H5
57 (b) Flocculated suspensions have the follow- 60 (c) The spontaneous isomerization of two iso-
ing characteristics: mers in an aqueous solution causes specific rota-
tion which is known as mutarotation.
* The rate of sedimentation is high. A sedi-
ment generally forms rapidly compared to 61 (b) Dextran is an example of a polysaccha-
deflocculated particles. The sediment is loosely ride. Other polysaccharides include:
packed and can be easily redispersed with mini-
mum stress. Particles in sediment do not bind * Dextrin
tightly to each other. The suspension with floccu- * Inulin
lated particles has a clear supernatant region. * Starch
* Cotton
In contrast, the rate of sedimentation of * Soy polysaccharides
deflocculated suspension is slow, but once the
particles settle at the bottom of the container it is 62 (c) Lipids can be divided into five classes
very difficult to redisperse them. Sediment forms according to their chemical structure.
slowly and particles in sediment are tightly packed.
The supernatant remains the cloudy. Glycolipids : Also known as Cerebro-
sides. They are isolated from the brain. Upon hy-
In pharmacy practice suspension with drolysis, they yield fatty acid, galactose and sph-
flocculated particles is the most acceptable. ingosine. They are also known as galactolipids
due to the presence of galactose, such as
phrenosin, kerasin.
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Fixed oils and fats : They are esters of Metalloprotein Metals tyrosinase,
glycerol and fatty acids, such as olive oil. Fixed arginase,
oils such as lard, which are solid at room tem- xanthine
perature are known as fat. oxidase
63 (d) Sphingosine is not a hydrolysed product Derived proteins: They are formed from
of lecithin. Lecithins are phospholipids and are primary or conjugated proteins by the actions of
generally hydrolysed to fatty acid, phosphoric acid the acid, alkali, heat, water, enzyme or alcohol.
and nitrogenous compounds other than sphin- They generally differ in physical and chemical
gosine. properties from the protein they are derived from.
They subdivide into primary derived protein (De-
64 (b) Imidazole is an active moiety of the listed natured protein) or secondary derived protein.
compound.
66 (b) 5- Fluorouracil . It is classified as a cyto-
65 (a) Albumin is an example of simple protein. toxic substance. It is a pyrimidine antagonist. It is
indicated for the treatment of the rectum, stom-
Protein is generally classified in three different ach, colon, pancreas and breast cancers.
categories: Esophagopharyngitis, myocardial ischemia, an-
gina, photophobia and decreased vision are re-
I Simple protein ported side effects of the drug.
II Conjugated protein
III Derived protein 67 (a) L.leichmanni is the most widely used test
organism for microbial assay of vitamin B 12.
Simple protein : Naturally occurring pro- L.plantarum is generally used for microbial assay
teins, which upon hydrolysis yield only alpha- of Niacin and Calcium pantothenate.
amino acids such as albumins, globulins, prola-
mines, glutelins and albuminoids. 68 (b) Gravimetric analysis is not con-
sidered a titrimetric method of analysis. Titrimet-
Conjugated protein: Conjugated proteins ric methods of analysis generally include :
are further classified on the nature of prosthetic
groups. I Acid basetitrations
II Precipitation reactions
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Clostridium tetani Tetanus 76 (b) A sweat test helps to confirm cystic fi-
brosis. The sweat of patients with cystic fibrosis
Miscellaneous usually contains 3 to 5 times higher concentra-
tions of chloride ions than patients without the dis-
Organisms Disease ease.
Paramyxovirus Mumps
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* Type of proteins available for binding. 85 (b) A patient with hemophilia has a deficiency
of coagulation factor VIII, known as Antihemo-
* The protein binding affinity and capac- philic factor (AHF). The deficiency of this en-
ity of the drug. zyme will result in severe coagulation defect. It is
indicated for treatment of hemorrhage in patients
* The presence of competing substances with Hemophilia A or to prevent bleeding in vari-
for protein binding. ous surgical procedures.
* The disease condition that may alter
the amount of protein available for 86 (a) Sodium polystyrene sulfonate re-
binding. duces the elevated serum concentration of po-
tassium (hyperkalemia). It is an ion exchange resin
The lists of the conditions or diseases that may that replaces the potassium ions for sodium ions.
decrease albumin levels in plasma and thereby The recommended dose of the drug is 15 grams,
decrease the protein binding includes : one to four times a day. Constipation, anorexia,
and gastric irritation are reported side effects of
* Burns the drug.
* Pregnancy
* Cystic fibrosis 87 (b) Polycythemia and erythrocytosis
* Chronic liverdisease are conditions in which there is an increase in the
* Chronic renal failure number of erythrocytes found. In contrast, leu-
* Trauma kemia is a condition in which there is an increase
in the number of leukocytes. Thrombopenia is
The conditions that may increase albumin levels associated with a decrease in thrombocytes
in plasma and thereby increase the protein bind- counts.
ing includes:
88 (d) Doxazosin, Terazosin and Pra-
* Hypothyroidism zosin are specific alpha-1 blockers. They are in-
dicated for treatment of hypertension and BPH.
82 (d) In hypothyroidism, the plasma albumin The major side effects of these agents are first
level is found to be elevated. dose syncope and tachycardia.
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of this class are helpful in the treatment of cardio- mcg/kg administered slowly via I.V. infusion, over
genic shock. Inhibition of these receptors helps in ten minutes. Arrhythmia, tachycardia, hypoten-
controlling hypertension, therefore beta blockers sion, and thrombocytopenia are reported side
are indicated for treatment of hypertension i.e. effects of the drug.
propranolol and atenolol
95 (b) Procainamide is a class IA arrhythmic
Beta-2 receptors : Stimulation of these agent. Here is the classification of antiarrhythmic
receptors dilate vascular smooth muscles, there- agents:
fore most of the bronchodilators are good Beta-
2 stimulators. These include albuterol, and Class IA : Procainamide, quinidine,
salmeterol. disopyramide
91 (c) The most preferable route for the admin- 96 (b) Mevacor (Lovastatin) is a lipid lowering
istration of Sodium nitroprusside is intravenous drug that acts by inhibition of the HMG COA
because of the short half life of the drug. reductase enzymes. This enzyme is responsible
for the conversion of 3-hydroxy 3 mehtylglutaryl-
92 (b) Overdose of sodium nitroprusside gen- coenzyme A to mevalonate, the precursor for ste-
erally results in hypertension instead of hypoten- rols including cholesterol. The inhibition of
sion. The overdose of this agent results in cya- biosynthesis of cholesterol reduces the cholesterol
nide poisoning, which in turn stimulates the ca- in hepatic cells, which stimulates the synthesis of
rotid chemoreceptors, responsible for causing LDL receptors. These will all reduce the synthe-
hypertension and tachycardia. sis of cholesterol. It is indicated for the treatment
of hypercholesterolemia. Abdominal cramps,
93 (c) The use of Sodium nitroprusside should pain, diarrhea, constipation, dyspepsia, myalgia,
be strictly restricted in infants due to a lack of and arthralgia are reported side effects of the drug.
enzyme rhodanase that converts the cyanide into The recommended dose of the drug is 20 mg once
sodium thiocyanate. daily with an evening meal. The other agents in
the same class are:
94 (b) Primacor (Milrinone) is known as an in-
odilator since it has inotropic as well as vasodila- * Fluvastatin
tion properties. It is a selective inhibitor of cAMP * Atrovastatin
phosphodiesterase enzymes in cardiac and vas- * Pravastatin
cular muscles. It is indicated for the treatment of * Cerivastatin
CHF. The recommended dose of the drug is 50
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97 (a) Doxapram is indicated as the respiratory ing strech receptors in the respiratory passage and
stimulant agent in postanesthesia and in chronic reducing the cough reflexes. Dextromethorphan
obstructive pulmonary disease associated with and codeine act centrally by depressing the cough
acute hypercapnia. The respiratory stimulant to center in the medulla.
effect of this agent is attributed to its ability to Terbutaline is indicated as a bonchodilator
stimulate the respiratory center in the medulla via for asthma patients and as a uterine relaxant in
carotid chemoreceptors. premature labor.
Ipecac is widely used as an emetic in ac-
cidental poisoning. It is also used as an expecto- 99 (b) Terbutaline is indicated as uterine relaxant
rant. for women in labor.
Dopamine is formed by the decarboxy-
lation of 3,4-dihydroxyphenylalanine (DOPA). It 100 (b) Ipratropium is an atropine-like drug. It is
is a precursor to noradrenalin and is also itself a indicated for the treatment of asthma and chronic
neurotransmitter in CNS. It is indicated for treat- obstructive pulmonary disease. Dryness of mouth,
ment of cardiac shock. The vasodilation offered irritation in the throat, blurred vision and mild
by dopamine is very important in drawing the bradycardia have been reported with the drug.
blood in the kidney and small bowel during an Retrovir is indicated for treatment of HIV.
ischemic attack. The diuretic property of dopamine Anemia and neutropenia have been reported.
helps to preserve the renal tubules. The cardiac Retrovir induced anemia can be treated by the
stimulation improves the deteriorated cardiac use of Epogen.
function. Hypotension is a principal adverse ef- Carvedilol is a new beta blocker just re-
fect of the drug. cently introduced in the market. It is indicated for
Disopyramide is classified as a class IA treatment of CHF.
antiarrhythmic agent. It has profound anticholin- Latanoprost is a prostaglandin analog in-
ergic side effects with severe A.V. node suppres- dicated for treatment of glaucoma. It should be
sion properties. It should be carefully used in pa- refrigerated.
tients with congestive heart failure with glaucoma
and urinary hesistancy. The major adverse effects 101 (b) Cyclobenzaprine is indicated for treat-
reported are dry mouth, constipation, urinary re- ment of muscle spasm associated with acute,
tention and blurred vision. painful musculoskeletal conditions. It is ineffec-
tive in treating muscle spasm due to a central ner-
98 (b) Acetylcysteine is classified as an expec- vous system disease.
torant, an agents that loose as and liquefying the
mucous, soothes irritated mucosa and make Dantrolene sodium is indicated in con-
coughs more productive. It generally decreases trolling treatment of spasticity resulting from up-
the viscosity of bronchial secretions and facilities per motor neuron disorders such as spinal cord
the excretion of cough. It is also indicated as an injury, stroke, cerebral palsy or multiple sclero-
antidote to minimize hepatic toxicity in acute ac- sis. It is not indicated for skeletal spasm resulting
etaminophen overdose. Other expectorants in- from rheumatic disorders. The major adverse ef-
clude: guaifenesin, ipecac, potassium iodide and fect reported with Dantrolene is hepatotoxicity.
sodium iodide, terpin hydrate.
Dextromethorphan and benzonatate are Bromocriptine is indicated for treatment
classified as antitussive agents, the substances that of Parkinsons. It is a dopamine receptor agonist.
specifically inhibit or suppress the act of cough- The principal adverse effect associated with the
ing. Benzonatate acts peripherally by anesthetiz- use of Bromocriptine is lung toxicity.
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Amphetamine is indicated for treatment overdose. Glucagon and dextrose cause an in-
of Attention Deficit Hyperactivity Disorder. It is a crease in blood glucose concentration and helps
controlled II drug. Central system stimulation and in relieving hypoglycemia and insulin overdose
insomnia have been reported with use of Amphet- toxication.
amine.
108 (b) Diabinese (Chlorpropamide) is classi-
102 (c) Parlodel (Bromocriptine) is classified as fied as a sulfonylurea agent. It is indicated for the
an antiparkinsons drug. It is indicated for the treat- treatment of diabetes and as a secondary therapy
ment of Parkinsonism. It is a dopamine receptor to treat partial central diabetes insipidus. It has
agonist. The recommended dose of the drug is been successfully used as an antidiuretic to re-
2.5 mg to 5 mg twice daily with meals. Pulmo- duce polyuria in patients with this disorder. Hy-
nary dysfunction is the principal side effect of the poglycemia, severe diarrhea, and water retention
drug. are reported side effects of the drug. The recom-
mended dose of the drug is 200 mg to 500 mg
103 (b) Diamox (Acetazolamide) acts through per day for treatment of diabetes insipidus.
the inhibition of carbonic anhydrase enzymes. It Desmopressin is considered as primary therapy
is indicated for treatment of glaucoma, epilepsy for treatment of diabetes insipidus.
and edema. The recommended dose of the drug
is 250 mg to 1000 mg per day. Nausea, vomit- 109 (b)Adeficiency of vitaminAgenerally causes
ing, seizure, bone marrow depression, electro- night blindness. Below are vitamins and their
lytes loss, hemolytic anemia, and toxic epidermal deficiency induced diseases.
necrosis are reported side effects of the drug.
Vitamin Sources Diseases
104 (b) Zaroxolyn (Metolazone) is classified as
a thiazide diuretic. It increases the excretion of VitA carrots, milk night blindness
Na, Cl, and H2O. It is indicated for the treatment fish, liver, oil,
of edema associated with CHF, renal disease and eggs
nephrotic syndrome. The recommended dose of
the drug is 5 to 20 mg once daily. Electrolyte loss Vit B1 germinated beriberi
is a common complication of Metolazone therapy. (Thiamin) cereals
105 (d) ACE inhibitors therapy associated with Vit B2 milk, yeast, cheilitis
an increase in serum concentrations of potassium. (Riboflavin) eggs, meat,
Amiloride, Spironolactone and Triamterene are green veg.
potassium sparing diuretics and may cause hy-
perkalemia if used simultaneously with ACE Vit B12 milk, liver pernicious anemia
inhibitors. (Cyanocobalamin)
106 (d) All. Probenecid may competitively inhibit Nicotinic acid leafy veg., pellagra
the renal tubular secretion of penicillin, sulfony- (Niacin) wheat, nuts,
lurea, sulfonamide, naproxen, indomethacin, clofi- pulses
brate, aminosalicylic acid and pantothenic acid.
Folic acid green veg., macrocytic
107 (b) The I.V. dextrose and glucagon can curd, liver anemia
be administered for the treatment of insulin
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115 (b) It is a suspension form of Barium sulfate 119 (c) Spicy is not classified as a primary taste.
medically used in roentgenography for the exami- Sweet, sour, bitter and saline are primary tastes.
nation of the stomach and colon. The principal
adverse effect of Barium sulfate is constipation. It 120. (b) The initial plasma concentration of the
should be mixed well with food or strained through drug is 10 mcg/ml, therefore:
gauze before administered to the patient.
The solution form of Barium ion is highly Mcg/ml Hours
toxic, therefore it is recommended to indicate the
full name of the drug when prescribing. For ex- 10 mcg/ml 0
ample “Barium sulfate” instead of “Barium.” 5 mcg/ml 8 hours
2.5 mcg/ml 8 hours
116 (b) Ascorbyl palmitate is classified as an Total = 16 hours
antioxidant agent that prevents or inhibits the oxi-
dations in various pharmaceutical formulations and The half-life of the drug should be 8 hours.
therefore prevents the deterioration of various
formulations. These include butylated hydroxya- 121 (b) The sweet taste of a compound is
nisole, ehtylenediamine, potassium metabisulfite, attributed to the presence of polyhydroxy groups.
sodium bisulfite and sodium metabisulfite. The sweetness of a compound increases with an
increase in the number of hydroxy groups such as
A preservative is a substance that inhibits amino and amide groups that contain compounds.
the growth of microorganisms and prevents the The sour taste of a compound is attrib-
various formulations to get deteriorated from vari- uted to the presence of hydrogen ions and lipid
ous microbes such chlorobutanol, dehydroacetic solubility of compounds such as acid, tannins,
acid, potassium benzoate and potassium sorbate. phenol, lactones and alum.
The presence of cations and anions in the
Coloring agents may be defined as sub- same compound imparts the saltiness to the com-
stances used for the purpose of imparting color, pound, i.e. KBr, NH Cl and NaCl.
4
such as red ferric oxide, carbon black, titanium Free bases such as alkaloid and amides
dioxide and alizarin. (molecular weight greater than 300) may impart
a bitter taste to the compound, i.e. amphetamines.
Flavoring agents may be defined as com-
pounds used for the purpose of imparting fla- 122 (a) The alcohol content of low alcoholic elixir
vors. There are four basics or primary tastes- is 8 to 10%, and for high alcoholic elixir it is 73 to
sweet, bitter, sour and saline. Mannitol, lemon oil, 78%.
orange oil, peppermint oil, sucrose, vanilla and
wild cherry syrup are used for flavoring purposes. 123 (a) Erythema multiform (EM) is classified as
a dermatological reaction. It is characterized by
117 (b) Epinephrine hydrochloride solution can the presence of erythematosus macules and pap-
be stabilized by the addition of a small amount of ules peripherally, i.e. hands, feet, trunk, legs and
sodium bisulfite, which is an antioxidant. forearms.
118 (d) All mentioned choices (FD and C, D Toxic epidermal necrolysis (TEN) is gen-
and C, external D and C dyes) are classified as erally caused by drugs and group II staphylococci.
certified colors. It is also known as Lyell’s syndrome. It is charac-
terized by the presence of erythema all over the
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body. Drugs that may cause this are: penicillin, depend on the duration or dose of therapy and
phenylbutazone, allopurinol, chloramphenicol and cannot be prevented by withdrawing the drug.
sulfonamide.
Steven-johnson syndrome is a severe 128 (d) Drugs that may cause hemolysis in a pa-
variant form of erythema multiform (EM). It is tient with G6PD deficiency include: quinine, sul-
characterized by the presence of erythematosus fonamide, nitrofurantoin, primaquine, aspirin,
macules and papules peripherally, as well as on phenacetin, quinidine and isosorbide dinitrate.
the mucous membrane. The skin becomes hem-
orrhagic. The drugs that may cause this are sul- Immune hemolytic anemia is most com-
fonamide, penicillin, phenytoin, allopurinol, phe- monly found with methyldopa. Anemia usually
nobarbital and chlorpropamide. begins 18 weeks to 4 years after treatment .
Hirsutism or hypertrichosis is defined as Mefenamic acid, levodopa and streptomycin are
the presence of hair all over the body. It is a prin- also reported to cause immune hemolytic ane-
ciple adverse effect of Minoxidil. It is now used mia. Hemolytic anemia is induced by drugs, and
for the treatment of baldness. returns to normal rapidly with discontinuation of
therapy.
124 (b) N-acetylcysteine is found to be an
effective antidote for the treatment of acetami- Erythromycin does not produce
nophen overdose. The toxic metabolic product hemolytic anemia in patients with G6PD defi-
of acetaminophen damages the liver by binding ciency.
to the cells of the liver. The normal dose of ac-
etaminophen does not cause this since only a small 129 (b) Ringing or buzzing (tinnitus) in the ear is
amount of metabolites form, which may be easily associated with salicylate. It is dose related and
conjugated with glutathione in the liver. generally appears at a serum concentration of 20
mg/dl or higher. Salicylate induced hearing loss
125 (b) Chlorpromazine, erythromycin estolate, may return to normal within 3 days after discon-
chlorpropamide, trazodone, certain tricyclic anti- tinuation of the drug.
depressants, sulindac and methyldopa may pro-
duce cholestatic jaundice. The disease is usually Permanent hearing loss is reported with
characterized by the presence of fever, chills, aminoglycoside antibiotics. Neomycin is the most
nausea, vomiting, anorexia and myallgias. oto and nephro toxic among the aminoglycosides.
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study of a particular drug after the common ad- 385 (a) Deficiency of Iron normally
verse effects reported by number of patients is causes hypochromic anemia. Hyperchromic ane-
such a review. In this review method, there is no mia is normally reported with a deficiency of folic
scope to modify the patient’s therapy (since the acid and vitamin B12.
event has occurred).
386 (c) Ferrous fumarate contains a high
Prospective utilization review is generally amount of elementary iron (33%). Below is the
carried out before the patient receives the drug. list of iron salts and their iron contents.
Such as checking a patient’s profile before the
patient receives the drug. Ferrous sulfate 20%
Dried ferrous sulfate 30%
Concurrent utilization review is carried Ferrous gluconate 12%
out at the time when the patient is receiving the Ferrous fumarate 33%
drug.
387 (b) Net profit to net worth ratio is
378 (b) Nolvadex (Tamoxifen) is an es- the best indicator of a pharmacy’s profitability,
trogen receptor antagonist indicated for treatment because it compares the net profit to net invest-
of breast cancer. Pulmonary embolism, throm- ment in the pharmacy.
boembolic order, hepatic necrosis, nausea, vom-
iting, and diarrhea are reported side effects of the 388 (b) Inventory turnover rate generally
drug. The recommended dose of the drug is 10 describes the efficiency of a pharmacy. It is gen-
to 20 mg b.i.d. erally calculated by dividing the cost of the goods
sold by the average of beginning and ending in-
379 (b) Carrots are a good source of vi- ventory.
tamin-A.
389 (c) An acid test generally measures
380 (c) Bleeding from the gums, hemor- the liquidity of the pharmacy. It can be calculated
rhage and retarded healing are important signs of by dividing the sum of cash and accounts receiv-
scurvy. Defective bones and teeth are generally able by the current liabilities.
reported with osteomalacia and rickettsia due to
a deficiency of Vitamin D. 390 (d) The acceptable ratio of Net profit
to net sales generally lies between 5 to 7%.
381 (b) The deficiency of thiamine gen-
erally causes the disease Beri-Beri. The patient’s 391 (c) The acceptable Net profit to net
weight and appetite generally decreases and the worth ratio for a 10 year old pharmacy would be
patient gets easily tired. Neuritis may occur. 15%. The target value for this ratio would be 20%.
A 40% figure can be achieved in a new phar-
382 (c) The deficiency of Vitamin B12 macy.
generally causes pernicious anemia.
392 (d) All. This ratio is calculated by
383 (b) Green vegetables, liver, curd and dividing profit by inventory. It is a good indicator
pulses are good sources of folic acid. of profitability as well as efficiency. It can be used
for new and old pharmacies. It increases with an
384 (c) Abnormal destruction of RBC is increase in sales of a pharmacy.
generally classified as hemolytic anemia.
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393 (a) The normal target value for net 399 (a) Class I type of recalls should be
profit to total asset ratio is between 10 to 20%. considered a potential hazard to health. The prod-
Manan Pharmacy’s net profit to total asset ratio uct in question may cause temporary or medi-
is 15%, so it would be considered good. cally reversible adverse health consequences
should be classified as a class II type recall. The
394 (b) The inventory turnover rate can product in question is not likely to cause any ad-
be calculated by dividing cost of goods sold by verse health consequences should be classified
the average of beginning and ending inventory. as a class III type of recall.
The inventory turnover rate should be a minimum 402 (b) The acid test generally measures
of 4 with a target of 6 or higher. Manan a pharmacy’s liquidity.
Pharmacy’s turnover rate is below expectations.
403 (b) Accounts payable are generally
395 (b) not included in current assets. Cash, accounts
receivable and inventory are part of current as-
396 (b) The ratio of net sales to inven- sets.
tory can be calculated as :
404 (b) Fixtures and equipment would be
= 750,000 considered fixed assets of a pharmacy.
210,000
405 (d) Notes payable beyond 1 year are
= 4 considered Long-term liabilities of the pharmacy.
Accounts payable, accrued expenses and notes
397 (b) Net worth can be calculated by payable within 1 year are considered current li-
subtracting total liabilities from total assets. abilities of the pharmacy.
Net worth = Total assets - total liabilities 406 (b) Acid Test ratio can be calculated
= 190,000 - 75,000 by dividing the sum of cash and accounts receiv-
= 1,15,000 able by the current liabilities.
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407 (c) Net sales to inventory measures V = [ (80,000 x 0.4) x 50] 0.15
the efficiency of the pharmacy. = $ 240,000
408 (b) Below expectation. The owner of the Manan Care Pharmacy is ask-
ing $ 350,000 for an existing prescription file,
= Total liabilities therefore the asking price is too high.
Net worth
411 (a) E = Q where
= 105,000 x 100 P
165000
E = Coefficient of elasticity
= 63.63% Q = % of sales quantities change
P = % of price change
The target value for Total liabilities to net worth
ration would be 50% or less. In our example, the sales quantities of analgesic
balm has been changed from 60 to 80 (33%
409 (c) The investment of Manan Phar- change), and the price of balm has changed from
macy in a fixed asset meets requirements. The 3 to 2 (33%). Therefore elasticity of coefficient
target value for this ratio would be 20% or be- would be :
low.
= 33
= Fixed assets x 100 33
Net worth = 1
= 35000 x 100
165000 412 (a) When a relative change in rev-
enue is the same as relative change in price, it is
= 21% known as unitary elasticity.
410 (b) The price of a prescription file When the relative change in revenue is
can be calculated by the following equation: less than the relative change in price, it is known
as inelastic demand.
V = [ (F x R) P] N where
If the relative change in revenue is greater
V = Price of prescription file. than the relative change in price, it is said to be
elastic demand.
F = Total new prescription is dis-
pensed in past two years. 413 (b) $16.30
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Therefore the retail price of insulin would be Coinsurance: It is a part of a patient cost
sharing plan in which the patient pays a specified
= 9.00 percentage of all the losses incurred.
0.55
= $ 16.30 Deductible: A part of a patient cost shar-
ing plan in which the patient has to pay a fixed
Cost complements % + % mark up = 100% amount of the cost (normally $ 250) within a spe-
cific period of time (normally 1 year) before the
414 (c) 66% benefit is paid by third parties. i.e. Total health
care cost for Mr.X for year 1999 is $1500 and
The retail price of a drug is $75, therefore the his deductible is $250, then, the third party will
mark up on prescriptions would be $30 ($ 75 - $ only pay benefits after the patient pays $ 250 out
45). of his pocket.
For a $ 45 drug, $ 30 would be the mark up. Capitation: A form of prospective reim-
For a $100 drug ? bursement in which an institution will pay a fixed
30 x 100 / 45 = 66% make up amount of money to the service provider phar-
macy for each patient. In this type of payment,
415 (c) $16.30 the pharmacy will only make money when the cost
of medications dispensed to the patient is less than
the fixed cost provided by the institution.
MU/C = Known retail mark up
cost of complement 419 (b) A person who works for an in-
surance company and provides the statistical data
= 45/55 = 0.81 = 81% that indicates the risk associated with serving the
R = cost of drug x (100 + MU/C) population, and determines the premiums to cover
= 9 x (181%) all the estimated expenses, is known as an actu-
= 9 x 1.81 = $ 16.30 ary.
416 (c) $ 1200 420 (a) The maximum amount that will be
paid by a third party to a pharmacy when the
Rx rent = Total rent x space ratio drug is available from more than one source is
= 10,000 x 600/5000 defined as MAC, or maximum allowable cost
= $1200
Estimated acquisition cost (EAC): The
417 (b) The funding for Medicare pro- third party’s estimate of the prices paid by a phar-
grams is generally obtained from social security macist for a particular drug product.
tax and premiums paid by the participants.
Actual acquisition cost (AAC): The ac-
418 (a) Copayment: It is a patient cost tual price paid by a pharmacy after all trade, vol-
sharing plan in which the patient has to pay a ume and cash discounts.
specified amount ( normally $ 10 to $ 15) of the
cost of prescriptions and a third party will pay the Average wholesale price (AWP): The
remainder. published list price of a particular product.
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421 (b) If a patient pays a full predeter- 427 (b) Each trial in a Binomial experi-
mined amount to the provider at the beginning of ment comes out a success or failure. The repeated
each month is known as Prospective reimburse- trial are independent of previous experiments. The
ment. experiments generally consists of “n” repeated
422 (b) Mean = 588 trials. The probability of success remains constant
from trial to trial.
= 350+420+530+600+620+635+700+850 An example of this is tossing a quarter
8 for “n” times to get heads (tails would be consid-
= 588 ered a failure) each time.
423 (c) The median of a sample is the 428 (b) The mean of binomial distribution
middle value of an experiment. If the sample is can be calculated by :
even then calculate the average of the middle val-
ues, for example in our experiment the middle Mean = n x p
values are 600 and 620, therefore the median = 50 x 0.6
would be : = 3
426 (c) The Pearsonian coefficient can be 433 (b) Amino acids are joined by pep-
calculated by the following formula: tide bonds in proteins.
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436 (c) Sickle cell anemia is a genetic dis- 443 (b) Lactose is classified as a disac-
order resulting from the production of variant he- charides. It consists of glucose and galactose.
moglobin. It is characterized by pain, lifelong
hemolytic anemia and tissue hypoxia. The replace- 444 (b) The pairs of structure that are
ment of valine at the sixth position of the beta - mirror images of each other are known as enanti-
globulin chain for glutamate is responsible for this. omers.
The formation of HbS has extremely low solubil-
ity compared to HbA, and results in aggregation 445 (b) The principal storage of glyco-
of molecules to form or create sickle shaped red gen in the body is found in the skeletal muscles
blood cells. and liver.
437 (b) The enzyme with its cofactor is 446 (b) Hyaluronic acid, heparin and
known as Holoenzyme. Apoenzyme refers to the chondroitin are classified as polysaccharides.
protein portion of the holoenzyme. Nonprotein
+2 +2
cofactors (i.e. Zn , Fe ) required for the ac- 447 (b) Bile salts act as an emulsifying
tivities of certain enzymes are known as Coen- agent for metabolism of lipid in duodenum
zymes.
448 (b) Steatorrhea is a result of improper
438 (b) The process in which the release secretion of bile salts from the liver and pancre-
of energy from energy-rich molecules such as glu- atic juice from the pancreas. It normally causes a
cose and fatty acid occurs in mitochondria is com- loss of lipid, fatty acid and lipid soluble vitamins
monly referred to as Oxidative phosphorylation. in feces. The water soluble vitamins such as vita-
min C, thiamine and riboflavin have no effect on
439 (b) The breakdown of complex their absorption.
molecules such as protein, lipid and polysaccha-
ride into simple molecules such as carbon diox- 449 (b) Sphingomyelin is a building block
ide, water and ammonia is known as catabolic of membrane of nerve tissue.
reaction.
450 (c) An obstruction of the gall blad-
440 (c) Pyruvate is the end product of der by a cholesterol stone is defined as cholelithi-
glycolysis in cells that contain mitochondria. The asis.
cells that lack mitochondria produce lactate in-
stead of pyruvate as the end product of glycoly- 451 (b) Luteinizing hormone induces tes-
sis. tosterone synthesis in Leydig cells of the testis
and ovulation in females. It also stimulates syn-
441 (c) Glutathione in reduced form is thesis of estrogen and progesterone in the corpus
deficient in patients with G6PD deficiency. Cer- luteum. Follicle stimulating hormone (FSH) and
tain oxidant drugs such as sulfamethoxazole and testosterone stimulate spermatogenesis in the tes-
primaquine produce hemolytic anemia in patients tis.
with G6PD deficiency.
452 (d) All. BMR, thermic effect of food
442 (d) All. Oxidant drug, ingestion of and physical activity help in the calculation of en-
fava beans, and certain types of infections may ergy required by an individual.
cause hemolytic anemia in patients with G6PD
deficiency.
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453 (b) Kwashiorkor is a protein-defi- 460 (d) All. UAG, UGA and UAA are
cient malnutrition disorder. It is usually seen in known as Termination codons, Stop codons or
children. Skin lesions, edema, anorexia, Nonsense codons. When one of these codons
depigmented hair and a decrease in plasma albu- appears in an mRNA chain, it indicates that the
min concentration are common symptoms asso- peptide chain synthesis coded by the mRNA is
ciated with this disease. about to be complete.
454 (b) Vitamin D is not a water soluble Bright field microscopy is the mostly em-
vitamin. It plays an important role in increasing ployed microscopic method. It uses visible light.
the uptake of calcium by the intestine. Deficiency The microorganism generally appears colored on
of this vitamin causes osteoporosis, rickettsia and a light background.
hypocalcemia.
Phase contrast microscopy is used to
455 (a) Cabbage, spinach, cauliflower, observe the internal structure of unstained micro-
liver and egg yolk are principal sources of vitamin organisms. The specimen should be visualized in
K. The deficiency of this vitamin causes bleeding different degrees of brightness and darkness.
disorder.
Normarski microscopy is also useful for
456 (b) The end product of purine ca- the observation of finer details of internal struc-
tabolism is uric acid. The serum concentration of tures of unstained organisms. It produces three
uric acid plays an important role in precipitating dimensional images. It has better resolution than
gout. Certain mammals further oxidize uric acid Phase contrast microscopy.
into allantoin, and this further degrades (only in
animals) to urea or ammonia. Transmitting electron microscopy uses
electron beams instead of light rays. It is used to
457 (b) The small and circular extrach- study a thin section of cells for the details of inter-
romosomal DNA molecules in bacteria that carry nal structure, and is very expensive.
genetic information for future generations are
known as plasmids. Scanning electron microscopy also uses
electron beams instead of light rays, however it
458 (a) Ribosomal RNA comprises 80% produces three dimensional views of the surfaces
of total RNA. Transfer RNA comprises 15% of of specimens.
total RNA and Messenger RNA comprises 5%
of the total RNA. 462 (c) Acid fast stains generally stain the
mycobacterium species of bacteria, such as M.
459 (a) Messenger RNA (mRNA) car- leprare and M.tuberculosis.
ries genetic information from the DNA to cytosol
forprotein synthesis.
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463 (b) All living cells can be classified stance has the ability to produce mutagenicity and
as prokaryotic or eukaryotic. Most of the vice versa.
prokaryotic cells such as bacteria are unicellular
organisms. These cells lack a nucleus and other 467 (b) The synthesis of protein and lip-
membrane bound structures. ids in cells is generally carried out by endoplas-
mic reticulum.
Eukaryotic cells have a nucleus and mem-
brane bound structures. Most plants, animals and 468 (c) The growth of bacteria remains
fungi fall into this class. constant in the stationary phase, it dramatically
increases in the log phase and decreases in the
464 (c) Most bacteria are able to move decline phase.
through the long, thin, helical structure known as
flagella. Bacteria with only one flagella located at 469 (b) Moisture, pH, temperature, oxy-
one end are known as monotrichous, bacteria with gen, hydrostatics pressure, osmotic pressure and
two flagella located at each end are known as radiation are the physical factors needed for the
amphitrichous, bacteria with two or more flagella growth of the bacteria.
located at one or both ends are known as lo-
photrichous and bacteria with flagella all over the Carbon source, nitrogen source, vitamins,
body are known as peritrichous. trace elements, sulfur and phosphorus are nutri-
tional factors for the growth of bacteria.
465 (b) Bacteria that can move away
from (negative phototaxis) or move towards 470 (c) When the transfer of genetic in-
(positive phototaxis) the light are known as pho- formation from one cell to another cell is carried
totaxis. out by the plasmid, it is known as conjugation.
The movement of bacteria toward or
away from certain substances in their environment 471 (a) A Genome (a component of the
by an unknown mechanism is known as chemot- bacterio phage) carries the genetic informations
axis. necessary for replication of new phage particles.
The tail sheath of bacteriophage normally helps in
466 (a) An AMES test can be used to the transformation of genome from the head into
find out whether a substance has the capability the cytoplasm of the host cell. The plate and tail
to produce carcinogen. A cancer producing prop- fibers normally help the bacteriophage to attach
erty is usually associated with the mutagenic (ca- to the specific receptor site on the cell wall of the
pability of a substance to alter DNA) property of susceptible host bacterium.
a substance, so determining that a substance is
capable of producing mutagenicity is the first step 472 (c) The reduction of the numbers of
to identify carcinogenicity of the substance. pathogenic microorganisms, up to such an extent
they are not able to produce any kind of disease,
In an AMES test, the growth medium that is known as disinfection.
lacks histidine is inoculated with salmonella that
requires histidine to grow. A solution of substance Sterilization is defined as the complete re-
that needs to be tested should be placed on the moval of all microorganisms from the material or
plate. If colonies of salmonella (that means the an object.
substance has a mutagen ability to grow salmo-
nella without histidine) appear then the test sub-
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