Exam june 2019

1- Dose of colchicines is 500 mcg orally with ibuprofen

once or twice daily
if acute gout
1 mg initially then 500mcg every 6hours until pain relief or toxicity ex N,V,D
max dose 6 mg per course , don’t repeat the course within 3 days

2- Side effects of colchicines : muscle weakness, numbness pale and grey lips
and tongue, vomiting, vomiting, diarrhea, fever flu like symptoms, unusual
bleeding, hair loss, bone marrow suppression

3- Dose of phenytoin
epilepsy oral
4-5 mg/kg increased by 30 mg daily once every 2 weeks according to response
usual range 200-500 mg once daily or in 3 divided doses
status epilepticus IV
15-20 mg/kg
dose equivalence
100mg phenytoin sodium contains approximately 92 mg phenytoin Phenytoin
capsules and injection are available as phenytoin sodium , while the tablets and
oral liquid contain phenytoin

4- Dose of paracetamol for children is 15mg/kg given 4 -6 times daily

for child 20 kg it will be 300 mg

5- HLB number in o/w emulsifying agent is 8-18

6- Bleomycin side effects: pulmonary toxicity

pain and swelling at the injection site
lung changes ( cough or breathing problems) pulmonary toxicity
poor blood flow in fingers and toes and feel cold
scleroderma collagen laid down in skin affecting joints, tendons
sore mouth and ulcers
loss of appetite
increased risk of getting chest infection due to drop in white blood cells
nail and skin changes skin rash darker skin
hair loss
feeling or being sick
tiredness and weakness
less common SE headache rash allergy blood clots
Rare SE: low BP difficult in urine changes in liver diarrhea

7- Metronidazole interactions: alcohol, warfarin, cimetidine, phenytoin and

phenobarbitone, disulfuram, 2C9 & 3A4 inhibitor
8- Disulfuram like reaction drugs with ethanol
beta lactams
cephalosporins
chloramphenicol
isoniazid
ketoconazole, griseofulvin
metronidazole
nitrofurantoin
sulfonamides
chlorpropamide
glipizide, glyburide
tolbutamide, tolazamide

9- flucloxacillin structure

10- epoprostenol is a prostaglandin member of

the eicosanoid family of lipid molecules. It
inhibits platelet activation and is also an
effective vasodilator.

11- The ultra violet range is 200-400 nm

12- Ion exchange chromatography is a chromatography process that separates
ions and polar molecules based on their affinity to the ion exchanger. It works on
almost any kind of charged molecule—including large proteins, small
nucleotides, and amino acids (separate charged copmouds - large bio
molecules)
Ion exchange chromatography is also useful in metal purification. It can be
used to purify actanides, such as plutonium, and remove it from spent nuclear
reactor fuel rods. It can also be used to scavenge uranium and remove it from
water or other environmental samples.
An ion exchanger contain positive group and cation exchanger contain negative
group
ion-exchange chromatography is a chromatography process that separates ions
and polar molecules based on their affinity to the ion exchanger. It works on
almost any kind of charged molecule—including large proteins, small
nucleotides, and amino acids

13- There are five immunoglobulin classes (isotypes) of antibody molecules found in
serum: IgG, IgM, IgA, IgE and IgD (GAMDE) the igE is the least one

14- B blockers reduce symptoms of hyperthyroidism (such as tremor and

palpitations, heat tolerance, anexity which are caused by excess thyroid
hormone acting on the cardiac and nervous system)

15- Propylthiouracil inhibits iodine and peroxidase from their normal interactions
with thyroglobulin to form T4 and T3
16- Omeprazole : cyp450 inhibitor (CYP2C19)

17- Ciprofloxacin: cyp450 inhibitor (CYP1A2)

18- azathioprine + allopurinol:: increased levels of both drugs

Combining low-dose azathioprine with allopurinol bypasses side effects,
improves efficacy, and may be appropriate as first-line therapy reducing
thiopurine-induced hepatotoxicity
The coadministration of allopurinol and azathioprine (especially if doses are not
reduced) can therefore result in life-threatening reductions in WBCs
Allopurinol and azathioprine should not be co-prescribed unless the
combination cannot be avoided. Allopurinol interferes with the metabolism of
azathioprine, increasing plasma levels of 6-mercaptopurine which may result
in potentially fatal blood dyscrasias and bone marrow toxicity

19- daunorubicin side effects include nausea, vomiting, constipation, diarrhea, and
loss of appetite, may cause urine to turn a reddish color, cardiotoxicity

20- side effects of antitumor

reduce bone marrow density
low blood count could cause anemia
tiredness
mouth soreness
nausea, vomiting
loss of appetite
constipation or diarrhea
hair loss
skin changes
nerve pain
gonadal suppression

21- The beta-blockers with low lipid solubility-i.e. atenolol, nadolol and sotalol-are
not metabolised, and their dose must be reduced in renal failure

22- Paracetamol toxicity antidote is N-acetylcysteine

23- Tricyclic Cause serotonin syndrome if combined together which cause muscle
rigidity, sweating, confusion, diarrhea, high HR, high BP , dilated pupil

24- Propranolol inhibit the peripheral conversion of T4 to the more biologically active
hormone, T3.
25- Cigarette smoking accelerates the metabolism of certain drugs, particularly those
primarily metabolized by P450 1A2 (CYP1A2) and, to a lesser extent, CYP2E1

26- Methylparaben is the methyl ester of p-hydroxybenzoic acid

27- Enantiomers have identical physical and chemical properties except for the
rotation of plane polarized light while diastereomers have different physical and
chemical properties

28- Enantiomers can have one or more stereocenters while diastereomers usually
have two stereocenters

29- optical enantiomers: due to one assymmetric carbon atom, consider mirror
image
diastereomers: due to 2 or more assymetric C atom and not mirror image

30- Tertacyclin is not take with antacids

31- Na lauryl sulfate (soap) is an anionic SAA so its

incompatible to cationic SAA (cetrimide) and compatible with econazole nitrate
and icthamol

32- Acute hypocalcemia secondary to hyperphosphatemia

33- Allopurinol block xanthine oxidase so -Decrease conversion of hypoxanthine to

xanthine and xanthine to uric acid so decrease production of uric acid

34- Treatment of cystic fibrosis: dornase alpha, N-acetylcysteine, pancreatin,

Mannitol .corticosteroids and antibiotics

35- Salbutamol used in iv bolus not doxorubicin , not vancomycin

36- Hiv material transfer from RNA to DNA

37- Fluoxetine don’t need withdrawal

38- Cyclosporine mode of action is inhibition of the production of cytokines

involved in the regulation of T-cell activation. In particular, cyclosporine inhibits
the transcription of interleukin 2.

39- nicotinic acid ttt of pellagra, agranulocytosis, dermatitis, hyperlipidemia

40- metabolism of drugs occurs in the subcellular organ in the endoplasmic
reticulum,ribosomes

41- proteins donot pass through nephron

42- the amount of glomerular filterate reabsorbed: 85-99%

43- amount of sodium water reabsorption in loop of henle approximately 200

mOsm/kg

44- tubular secretion by approximately 10 to 20 percent of urinary creatinine

45- Q fever is an infection caused by the bacterium Coxiella burnetii. Q fever is

usually a mild disease with flu-like symptoms. ... This more deadly form of Q
fever can damage your heart, liver, brain and lungs

46- Many different types of bacteria can cause bacterial meningitis. In newborns,
the most common causes are group B strep, E. coli, and less commonly,
Listeria monocytogenes. In older kids, Streptococcus pneumoniae
(pneumococcus) and Neisseria meningitidis (meningococcus) are often the
causes

47- interaction between diltiazem and cyclosporin in kidney transplant recipients.

... Lowering the doses of diltiazem should result in fewer adverse effects and
may allow its use in situations where it was hitherto contraindicated

48- indomethacin is similar in structure to sulindac

49- Diphenoxylate structure is similar to pethidine

50- Amoxicillin is more absorbable and active than ampicillin because it has para
hydroxyl gp (oH)

51- alkaloids has pka>7

52- Remifentanil: used for intraoperative analgesic

53- Flucloxacillin is stable against hydrolysis by a variety of beta-lactamases

54- Benzylpenicillin: is acid sensitive antibiotic

55- Serotonin origin from tryptophan

56- Histamine origin is from histidine

57- Dextran is used as plasma expander

58- Acacia is not soluble in alcohol

59- Methadone is longest duration of action

60- Polysorbate 80 is a nonionic surfactant and emulsifier often used in foods and
cosmetics

61- Urea is used as humectant

62- Norfloxacin is only used in oral dosage form

63- NSAID all have antipyretic action

64- Acetazolamide cause hypokalemia

65- theophylline cause hypercalcemia

66- doubling the drug conc. in the blood (that follow 1st order kinetics) = will not
affect the half life

67- Amiodarone casuse pulmonary fibrosis

68- Verapamil used in angina and hypertension,

69- Verapamil most –ve inotropic

70- diltiazem or verapamil is contraindicated in patients with ventricular

tachycardia

71- ca gluconate increases digoxin toxicity

72- captopril is drug of choice in treatment of hypertension in diabetic patients

73- Dronabinol is delta-9-tetrahydrocannabinol

74- Break through pain of morphine is 1/6 from daily dose

75- Mefloquine is used for malaria prophylaxis

76- Action of beta blocker not appropriate in angina that it increases diastolic
ventricular volume
77- Ascorbic acid used with methnamin to acidfy urine increase formaldehyde which
has antibacterial activity

78- Cyclosporine and pridnesolone used in ttt or RA

79- captopril is ACEI

80- 5 half life will decrease dose to 1/32

81- to prepare a buffer system of PH 4 use lactic acid, pka=3.86

82- Boric acid pka 9.24 is weakest acid

83- Epinephrine for anaphylactic shock

84- cyp450 metabolise phenytoin and losartan is 2c9

85- Paroxetine is metabolized by cytochrome P450 (CYP) 2D6

86- Alpha-methyldopa causes the production of such antibodies in about 15% of

patients receiving the drug, with 0.5%–1% developing hemolytic anemia

87- hemolytic anemia with:: aspirin, dapsone, primaquine, quinine, dimercaprol,

sulfonamides, chloramphenicol, nirofurantoin, nalidixic acid

88- SSRIs Sertraline antidepressant Taking your medication with food may reduce
the risk of nausea

89- pralidoxine is used for ttt of organophosphorus poisoning by activate choline

estera enzyme

90- Zollinger-Ellison syndrome is a rare condition in which one or more tumors

form in pancreas or the upper part of your small intestine (duodenum)

91- Cross sensitivity between penicillin and cephalosporin 3% - 5%

92- clotting factors synsthesed by vitamin K is 2 , 7 , 9 , 10

93- calcitrol is the active metabolite of vit D

94- Tropicamide is mydriatis agent short acting

95- Healthy person blood is high in protein and low in urine

96- Blockage Canal of Schlemm, in the canal itself, or in the aqueous veins. ...
Glaucoma caused by this type of obstruction is called acute or narrow-angle
 glaucoma.

97- (dapsone and rifampicin) treat paucibacillary leprosy

98- tyramine increase norepinephrine concentration

99- local anesthetic work by block Na channel

100- most Anticonvulsants and antiepileptic drugs act by block sodium

channels

101- Thyroid hormones are derivatives of the the amino acid tyrosine

102- prepare clindamycin 100ml topical solution Dissolve in water then add
alcohol and propylene glycol (not sure)

103- Doxorubicin causes cardiac cumulative toxicity

104- heparin induced thrombocytopenia

105- Ciprofloxacin increases serum levels of theophylline

106- Elevated creatinine level signifies impaired renal failure or kidney disease

107- St John's wort decrease warfarin

108- erythromycin (CYP3A4 inhibitor)

109- lisinopril dose is htn 5-20 or max 40

110- Benzoyl peroxide is an antimicrobial, which means it helps reduce the

amount of acne

111- creatinine in the blood can vary from lab to lab, between men and
women, and by age

112- Imipramine-Maximum dose: 300 mg/day

113- Amphotericin B is an antifungal medication used aspergillosis,

114- Valproate exposure in pregnancy has also been associated with a risk of
spina bifida

115- Lamivudine mechanism is as a Nucleoside Reverse Transcriptase

Inhibitor in treatment of HIV

116- prolactin release from the pituitary which promotes continued milk
production and is necessary for normal milk production during breastfeeding
117- amino acid bind to RNA is tRNA

118- Cushing syndrome symptoms: weight gain, fatty deposits,purple stretch

mark, thining skin

119- Medroxyprogesterone acetate is hormonal medication not

glucocorticoids

120-

121- Pacemaker is SA node which is in right atrium

122- inner ear is responsible for equilibrium

123- The last part of the small intestine is ileum (duodenum,> jejunum,> and
ileum)

124- dinoprostone, is a naturally occurring prostaglandin which is used as a

medication. As a medication it is used in labor induction, bleeding after delivery,
termination of pregnancy, and in newborn babies to keep the ductus arteriosus
open

125- Venlafaxine antidepressant acts via inhibiting serotonin and

noradrenaline reuptake. So cause Hypertension

126- Haloperidol cause elevation in Hyperprolactinemia which is high prolactin

level leading to galactorrhea

127- Higher-than-normal levels of ALP in your blood may indicate a problem

with your liver or gallbladder

128- MAO-B inhibitors; Selegiline

129- erythropoietin is a glucoprotein secreted by kidney to increase production

of RBCs from bone marrow

130- Paget's disease TTT is calcitonin and bisphosphonates

131- Common symptoms of digoxin toxicity is in GIT

132- Levodopa –carbidopa SE :N, V, dizziness, blurred vision, loss appetite

133- Bromhexine not used as antitussive

134- Bond between alcohol and water hydrogen bond

135- For instance, certain antibiotics, like beta-lactams (penicillins,
cephalosporins, carbapenems, monobactams), clindamycin, macrolides
(erythromycin, clarithromycin), oxazolidinones (linezolid), can be effective
because of the extensive amount of time the antibiotic binds to the
microorganism

136- rancidity is the oxidation of double bonds in fatty acids

137- Saponification is a process that involves conversion of fat or oil into soap
and alcohol by the action of heat in the presence of aqueous alkali

138- Conjugation is phase 2 metabolism

139- Treatment is recommended for Severe Asymptomatic Hypertension

140- Chest pain is not symptoms of heart failure

141- Blood from lung come to heart through left atrium

142- Metformin 500 mg initial therapy whatever the bmi

143- bipolar depression can be ttt by: Li, carbamazepine, SSRI, Na valporate
BUT NOT haloperidol

144- GTN cause vasodilation

145- very important reaction which utilizes folate is the synthesis of

deoxythymidylate (dTMP),

146- otitis media , TTT : amoxicillin , tmp-smz (erythromycin+ sulfasoxazol)

147- The two atrioventricular (AV) valves, the mitral valve (bicuspid valve),
and the tricuspid valve, which are between the upper chambers (atria) and the
lower chambers (ventricles

148- roxithromycin is effective in doses of 150 ... The maximum duration of

therapy is 4 weeks

149- Cerfutoxime not good for pneumonia

150- Cipro act on gram –ve bacteria

151- Methionine absorption from the gastrointestinal tract is highly

152- Short acting benzodiazepens midazolam

153- Shingles is a viral infection that causes a painful rash

154- Drugs should be stored at Tightly stoppered container

Procedure for Preparation of ointment

1. Melt the stearyl alcohol and white petrolatum on a hot plate.
2. Heat this mixture to 70°C.
3. Dissolve remaining ingredients in water and heat the solution to
70° C.
4. Add the oleaginous phase slowly to the aqueous phase, stirring
constantly.
5. Remove from heat and stir the mixture until it congeals