KAPS EXAM RECALL MARCH-2023 by Nazia Rafique

1-Na Risinolate ------ Anionic SAA

but irritant to skin and mucus membranes used in cosmetic products like shampoo etc
(NOT USED IN PHARMA)
2- Dose of doxycycline prophylaxis in malaria
• Daily dose=100 mg starting 2 days before travel , one dose per day while there, and
for 4 weeks after leaving.
3- clearance = k . vd ( you have t1/2 and vd ) formula → CLT=Vd ×0.693/t1/2
4- low vd means: drugs increase in plasma than tissue
5-phynitoin ------- hepatic excretion
6- morphine --- no loading dose
7- lanolin calculation:

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 8- PCM dose : 15 mg/ kg ----- max 150 mg / kg
9- 1% chlorohexidine ----- result : 8.9

10- symptoms of mild dehydration in children: dizziness , lethargy

11- what is antibody not in plasma: Ig S
12-Calculation t1/2
Formula: t1/2=0.693/K
13- which ion does more affect on dehydration: Na
14-immunoassay can not measure = electrolytes

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 15-gonococcal antibiotic: azithromycin
16- endocarditis in children caused by :
Streptococcus viridans, Staphylococcus aureus, Streptococcus pneumoniae (less likely),
Coagulase-negative staphylococci: Coagulase-negative staphylococci, such as
Staphylococcus epidermidis, are opportunistic bacteria that can cause endocarditis,
particularly in children with indwelling medical devices or prosthetic valves.
Enterococcus spp.
17-diagnosis of Active T.B : Chest X-ray
For diagnosis of Latent T.B: Tuberculin Skin Test (TST): Also known as the Mantoux test
18- solubility of alcohol what change in structure : increase of R side chain DECREASE
SOLUBILITY, More OH = more solubility
19- antipsychotic mechanism : dopamine antagonist
20- formoterol LABA= long acting B2 Agonist
21- Asthma attack ---- no 5HT
22- Acute gout is used less often : MTX
First choice for acute gout

• Nsaids
• Colchicine
• Steroids like prednisolone
23- Butterfly Flushing: systemic lupus erythematosus (SLE)
24- Glyceryl trinitrate ------ reduces cardiac preload
25- FIRST enzyme increase in MI ---- Troponin then CPK ---LDH (Lactate dehydrogenase)
26- What medicine excreted unchanged: GENTAMYCIN, ACAMPROSATE, LITHIUM
(polar drugs excreted unchanged e.g antidote)
27-how to dose ibuprofen:
Adult dose: 200–400 mg three or four times daily. Maximum 2.4 g daily.
Pediatric dose: >3 months: 5–10 mg/kg (maximum 400 mg) three or four times daily.
Maximum 30 mg/kg (2.4 g) daily.
How ibuprofen is excreted from the body: HYDROXYLATION THEN GLUCORONIDATION
28- steven johns’ syndrome caused by: sulphonamide
29- Rivaroxaban which drug increase serum level -→ ketoconazole (cyp inhibitors)
30- angina and heart failure drugs: long-acting nitrates and bb(metoprolol)

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 31- antimicrobial depend on concentration: gentamycin (aminoglycosides &
daptomycin= conc. Dependent killing).
32- nausea and vomiting more with Cisplatin
33- Zollinger–Ellison syndrome: pancreas carcinoma (a condition in which a gastrin-
secreting tumor or hyperplasia of the islet cells in the pancreas causes overproduction
of gastric acid, resulting in recurrent peptic ulcers.
34-phenytoin dose in satatus epilepticus: 15- 20 mg
35- live vaccines: MMR – BCG for TB-TOPV– ROTA – ZOSTER – Yellow fever, Chicken
pox(varicella), oral typhoid(salmonella)
36- not use in immunocompromised patient : one of live vaccine (yellow fever)
37- statin cause myopathy : ( with colchicine and with gemfibrozil )
38- penicillinase and beta lactamase : amoxiclave
39- vancomycin skin infection :
Vancomycin flushing syndrome (VFS) was previously known as red man syndrome
(RMS) is an anaphylactoid reaction caused by the rapid infusion of the glycopeptide
antibiotic vancomycin
40- glaucoma doc : Betaxolol but in case of asthma, copd, bradycardia and CHF
=contraindicated
41-not required for rectal suppository absorption : patient hydration
42-cholchicine dose acute gout attack : 1mg colchicine then 500mcg 0r 0.5mg I hr
later….max 6mg per course(3days).
43- affected thyroid function : lithium , amiodarone
44- disease attack cholinergic receptors at NMJ : myasthenia gravis
45- eplerenone less side effect than spironolactone
46- drug that antagonize spironolactone (DIURETIC) treatment in acne : meloxicam
(NSAID)
The ‘triple whammy’ The risk of drug-induced renal impairment is cumulative, and is more likely
in patients with underperfused kidneys(e.g. congestive cardiac failure) or with pre-existing renal
disease (including agerelated renal decline). Renal function should be checked before an NSAID or
a COX-2 inhibitor is started in patientstaking ACE inhibitors or sartans. The risk is further increased
if the patient is also taking a diuretic. This combination can result in what is commonly referred to
as the ‘triple whammy’ effect.

47- Not S.E OF isotretinoin: hypoglycemia

48- benzoyl peroxide full effect in: 4-6 weeks
49 – aspirin antiplatelet action :

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 irreversibly inhibiting the enzyme cyclo-oxygenase (COX-1) which
is required to make the precursors of thromboxane within platelets.
This reduces thromboxane synthesis
50- vaginal nystatin self-treatment
51- imp in human : linoleic (omega 6 fatty acid) precursor of arachidonic acid
52 : drug not undergo liver metabolism : gabapentin, Pregabalin
53-linear first oder, non linear zero order
EXTRA NOTES:

Use in pregnancy and lactation

Pregnancy – for products containing two or more active ingredients, the categorisation
is based on the most restrictive component
• codeine – category A (but high doses in pregnancy may cause withdrawal or
respiratory depression in newborn)
• paracetamol – category A
• ibuprofen – category C
• aspirin – category C
• doxylamine – category A.
Lactation – consider safety of all ingredients:
• codeine – although only trace amounts excreted in breast milk, use not
recommended as risk of adverse effects in infants if mother is an ultrarapid
metaboliser.
• paracetamol – safe to use
• ibuprofen – may be used in recommended doses. Ibuprofen and diclofenac are the
NSAIDs of choice in breastfeeding mothers.
• aspirin – 75–150 mg may be used cautiously if necessary. Avoid higher doses in 3rd
trimester.
• doxylamine – small amounts excreted. May cause paradoxical excitement or
irritability in infant. Anticholinergic effects may inhibit lactation
Esters, amides and their cyclic derivatives, lactones and lactams, are the primary
functional groups that undergo hydrolysis.
Carboxylic acids are not normally reduced, but rather conjugated with either glucuronic
acid, glycine or glutamine

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 7/3/2023 RECALLS
1. One structure- phenylalkilamine to recognise only,
no amphetamine part.
*The basic amphetamine structure is composed of a
phenethylamine backbone with a methyl group
attached to the alpha carbon.

a. Indirect-acting sympathomimetic amines may have two, one, or no hydroxyl

groups. The fewer the hydroxyl groups, the higher the lipophilicity, and the greater
the absorption and the duration of activity after oral administration. Faster and
greater absorption also implies less intestinal destruction of the drug.

b. Alkyl substitution at the α-carbon (adjacent to the amino group) retards

destruction of phenol and phenyl compounds and increases lipophilic character,
contributing to prolonged activity.

c. N-substitution with bulky groups increases direct β-receptor activity, as with the
direct acting agents.
2. Cardiac glycoside has in its structure: a) OH groups b) phenol 3) steroid
Cardiac glycosides are naturally occurring steroids with a powerful stimulating action on
the cardiac muscle. These compounds are composed of an aglycone, which is either a
cardenolide or a bufadienolide, and a hydrophilic carbohydrate moiety linked at the C-3
position.

3. Concentration depending AB - gentamicine

4. Which one is selective MAO A – Meclobemide & selective MAO B - Selegiline
5. Which one you don't use in hypertension if pt has depression – methyldopa
6. Which drug cause haemolytic anaemia- methyldopa, quinidine, isoniazid, high dose
penicillin
7. What can affect levodopa passage through BB - high protein diet (de-carboxylation also
affect-use with carbidopa)-→ better to take empty stomach.

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8. What is responsible for catecholamines metabolism- COMT postsynaptically & by MAO
intraneuronally (present in mitochondria of neuron).
9. One dose only – sumatriptan (migraine)
This medicine is most effective if used as soon as possible after onset of the headache.
If there is no improvement with the first dose, do not take another dose.
Adult dose
• Oral: 50–100 mg. Maximum 300 mg in 24 hours.
• Intranasal: 10–20 mg into one nostril. Maximum 40 mg in 24 hours.
• SC: 6 mg. Maximum 12 mg in 24 hours
10. Your pt is taking Imipramine 25mg, What's most likely to occur as indication - excessive
urination
11. What's incorrect for camphor - water solubility
(other options make eutectic mixtures etc very straightforward)
. Eutectic mixtures: mixtures that melt at a lower temperature than any of
their ingredients.
substances that form eutectic mixtures: [Phenol- Camphor- menthol-Thymol-phenyl
Salicylate & phenacetin].

12. Pt gets IV Antibiotic and soon develops flushes, rush, erythema etc which Abx is most
likely to be- vancomycin
13. Which drug has active metabolite – codeine (metabolite=morphine)
14. Which drug doesn't have active metabolite - nifedipine
15. Which drug is prodrug – famciclovir (active metabolite=penciclovir)
16. What's not part of cell membrane- glucose
17. What's not measured with immunoassay technique=electrolytes
18. What are Golgi nucleus connected directly to - a) endoplasmic reticulum b) ribosome
c) mitochondria
19. The abundance of blood cells in blood volume – 45%
20. The possibility to get allergic reaction with
cephalosporines after same reaction when using penicillins -4% to 10%
21. Which enzyme is first elevated in MI - a) Ck-MB b) LDH c) Troponins d) liver
transaminase
22. Which drug is safely used iv - salbutamol
23. What is the percentage of chlorhexidine when used as preservatives in eyes
preparations -→ 0.01%

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MEMORIZE THESE VALUES
Chlorocresol___0.1%
Benzalkonium Chloride__0.5%
Chlorhexidine___0.01% Eye,
Chlorhexidine___0.1% Vaginal,
Chlorhexidine___0.2% Oral
Na Edetate__0.1%
Phenyl mercuric nitrate___0.002%
Cetrimide___0.005%

24. Formoterol onset of action: 2-3 min

25. Which is used in asthma prevention- corticosteroids
26. Where are transferase located in the cell? - a) golgi b) endoplasmatic ret c)
mitochondria
Glucuronyl tranferase --- ER
sulfonyl transferase --- Golgi
27. Which drug dose adjustment needed if stop smoking: clozapine, olanzapine
theophylline, aminophylline
Clozapine and olanzapine are examples of drugs that are mainly metabolised via CYP1A2,
and non-smokers might need a 50% lower starting dose of these drugs than smokers. If a
smoker on a stable clozapine regimen ceases smoking, the clozapine plasma level can
increase to up to 150% of the original stable level during the 2–4 weeks after smoking
cessation.
28. Which drug you advise to be taken with food - a) isotretinoin b) amoxicillin
29. What is usually the name for drug drug interaction when one drug induces the
metabolism of another – Pharmacokinetic Drug interaction
30. Which of the offered pairs is the example of metabolism inhibition - erythromycin and
verapamil
31 . What is not inhibitor of CYP 2D6 - ciprofloxacin
32. What is not SE of fentanyl- tachycardia
33. What is the SE of paroxetine - gynaecomastia and galactosaemica
34. What is the most common UTI MO in premenopausal women - E. Colli
35. Using buffer is very important when preparing- a) iv solutions b) nasal solutions

Non parental: Nasal

Parentals: 1st SC then IV.
Blood has capacity to resist change in PH, so that's why first you choose SC then IV. isotonicity
is critical factor for SC.
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36. What happens to cell if water administered iv? Cytolysis, or osmotic lysis, occurs when
a cell bursts due to an osmotic imbalance that has caused excess water to diffuse into the
cell.
37. What is the common SE of prazosin- orthostatic hypotension
38. What is t 1/2 very tricky - a) when peak of concentration reduces to its 50% b) when
50% of the drug is distributed c) when Cp reduces for 50% c) when drug achieves 59% of its
pharmacological effect
39. Which drug is least likely to cause hyperkalaemia - a) spironolactone b) ACEi c) ARBs d)
furosemid
40. Which drug is used as drug of choice in patient with severe HF and oedema - a)digoxin
b)furosemid
41 . Which drug is active against anaerobic bacteria- a) metronidazole b) nitrofurantoine
43. Bacteroides fragilis drug of choice: cefoxitin, cefotetan, ceftizoxime, tigecycline,
Metronidazole, clindamycin
44. If the pat has allergic reaction after dose of penicillin which drug should avoid in future -
a) cefepime b) doxycicline
c) another cefa of 2nd generation can't remember but it was obvious
45. Travellers diarrhoea DOC – norfloxacin and alternative: azithromycin or rifaximin for
uncomplicated E.coli
46. For drug to be released from its dosage form it needs to be - different solubility and
ionised/unionised
47. Which one is used in acute attack - a) salmeterol b) formoterol c) corticosteroid
48. What is correct about pethidine- a) cause more dependence than morphine b)
causes more respiratory depression faster than morphine c) contracts the sphincter of
oddi
49. Which drug is least likely used in neuropathic pain - a) amitriptyline b) gabapentin
c) pregabalin d) meloxicam
50. What do you advise your pt when give rifampicin - take on empty stomach
51. What is leucocytosis? increase in the number of white blood cells (leukocytes) in the
bloodstream.
52. What is monitored with clozapine: neutrophil count(WBC)
53. What is not CI in porphyria? – ketamine (can be used).
Because barbiturates enhance porphyrin synthesis, they are absolutely contraindicated in patients with a
history of acute intermittent porphyria, variegate porphyria, hereditary coproporphyria, or symptomatic
porphyria.

54. If M.O. is pencillinase resistant Staphylococcus which drug should we use - a)

amoxicillin + clavulanic b) dicloxacillin
55. PT gets verapamil prescription and it's already taking BB. What do you call doctor for-
---? concern about bradycardia from additive effect
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56. In asthma what not active - 5hydroxyltryptamin
57. The hydrophobic parts of proteins where are they located- a) on the surface b) buried
deep in the structure of protein
58. Which one is most likely DOC for UTI infection and gram+ve
a) nitrofurantoin b) metronidazole
59. Pt has got new drug for breast cancer and drug Least to cause alopecia and something
else. Which drug is it? - tamoxifen
60. Which drug NOT used in angina – quinapril
61. Which one is least likely to cause statin toxicity :a) simva + colchicine b) simva +
grapefruit juice c) simva + diclofenac d) simva + felodipine
62. What is true about T3 and T4 - T4 more potent
63. A 1 6 years old boy comes to emergency 6 hours after paracetamol poisoning. Which
one do you use - a) activated charcoal b) acetylcysteine
64. The MOA of formoterol - a) alpha agonist b) alpha antagonist c) beta agonist b) beta
antagonist
65. Blood flow Velocity is highest in – arteries and Lowest in Arteriole
66. TGN given sublingual which is advantage - To avoid first pass effect and buccal
absorption also Rapidly absorb from that site
67. MOA of nitrates- a) reduce preload in veins b) reduce preload in arteries c) reduce
afterload in veins d) reduce afterload in arteries

68. What is the base in chromatography – silica

(Stationary phase is silica or aluminium)

And mobile phase is depended upon drug polarity
Like if your drug is polar u have to choose the mobile phase combination like maximum polar
solvent and minimum non polar solvent
It differs for each drug and drug combination. It is used for qualitative and quantitative
analysis

69. Pt gets cephalosporin ttt and has reaction within 30 minutes. Which one is the one that
reacts – IgE (type 1 hypersensitivity-immediate or anaphylactic type)
74. Pt gets penicillin and has a reaction after 10 days, which one is responsible – T-
lymphocytes
Delayed-reaction allergy is caused by activated T cells and not by antibodies.
Whereas, in case of anaphylaxis:

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 allergen can react with basophils of the blood and mast cells in the tissues located
immediately outside the small blood vessels if the basophils and mast cells have been
sensitized by attachment of IgE reagins. Therefore, a widespread allergic reaction occurs
throughout the vascular system and closely associated tissues. This reaction is called
anaphylaxis. Histamine is released into the circulation and causes body-wide vasodilation, as
well as increased permeability of the capillaries

Initial immune response =B cells

Responsible for immunity =B cells

After 10 days or second exposure or cell mediated response =T cells .

IgE =immediate allergic rx

Test after anaphylaxis for= igE

Psoriatic lesions: T cells infiltration

Blisters on mouth with sulphonamides: lymphocytes (which is B cells )

Anaphylaxis reaction mainly after first exposure

Patient take drug for second time = hypersensitivity

* Anaphylaxis and hypersensitivity both after 1st and 2nd exposure but anaphylaxis mainly
first.
75. Which drug is least likely to be used in chronic kidney disease - a) erythropoietin b)
dabigatran c) ACEi d) ARBs
76. Pt has trichomoniasis DOC is – tinidazole 0r Metronidazole
77. Pt drinks a glass of alcohol and get nausea, vomiting etc, which drug is most likely the
reason - disulfiram
79. Difference between Isophane insulin and glargine duration of action: Glargine 36 hrs
Isophane 24 hrs
80. Labetalol MOA - a) blocks alpha receptors b) blocks beta receptors c) blocks alpha and
beta
81. Which drug will cause diabetes insipidus- Li
82. Propranolol is used in - a) migraine ttt b) asthma c) copd d) with verapamil
83. Which drug you use if pt has heart failure and diabetes: ACEI or ARBs
84. Which group is not important in human body - thiol

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85. Low bioavailability means - a) volume of distribution is low b) Vd is high c ) drug is
metabolised greatly in liver by first pass metabolism
86. Precursor of histamine: histidine
87. Mechanism of finasteride: inhibition of 5-alpha-reductase
88. Which group is not important in body: thiol
89. Degradation of procaine hydrochloride: a) oxidation, b) hydrolysis, c) reduction
90. A question about epoprostenol

Epoprostenol is a synthetic form of prostacyclinPGI2, which is a naturally occurring

prostaglandin. It is used as a medication to treat certain cardiovascular conditions,
particularly pulmonary arterial hypertension (PAH). Epoprostenol works as a vasodilator and
an inhibitor of platelet aggregation

91. - Which one is NOT a suggestion to a woman who is receiving rifampicin:

a) take B6 supplement, b) cause body fluids orange-red c) use another herbal

contraceptive(non-hormonal)

92. Which one is effective against Pneumocystis jiroviecii pneumonia: cotrimoxazole and
pentamidine

93- Live attenuated vaccine cannot be use in: immunocompromised person and during
pregnancy

94- Calculation of bioavailability, Hepatic clearance 72, blood flow 90: answer 20%

F=1-CLH/Q

F=1- 72/90

F=0.2 or 20%

95- Calculation about elemental Fe in FeSO4.H2O (question 47 Alaa)

96- Bond between DNA: H-Bond

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The complementary base pairs are:

Adenine (A) forms two hydrogen bonds with Thymine (T).

Cytosine (C) forms three hydrogen bonds with Guanine (G)

97- Bond between organophosphorus and acetylcholine esterase enzyme: covalent bond

Organophosphorus compounds, such as certain insecticides and nerve agents, are known as
acetylcholinesterase inhibitors. They irreversibly bind to the active site of the acetylcholinesterase enzyme,
preventing it from functioning properly. When an organophosphorus compound binds covalently to the
active site of acetylcholinesterase, the enzyme's activity is inhibited, leading to the accumulation of
acetylcholine at nerve synapses. The accumulation of acetylcholine overstimulates cholinergic receptors,
causing various physiological effects such as excessive nerve firing, muscle spasms, respiratory distress, and
potentially life-threatening symptoms in severe cases

98. Common microorganism in non-complicated UTI in women after menopause: E.coli

99. Bacteria cause meningitis in 2-10 years: Less than 2 years→H.Influenza,
Above 2 →Nisseria meningiditis
100. Main organ for metabolism: liver
101. Least place for drug absorption: ileum
Drugs given orally are well absorbed from the duodenum. The duodenum has a large surface area because of
the presence of villi and microvilli. In addition, because the duodenum is well perfused by the mesenteric blood
vessels, a concentration gradient is maintained between the lumen of the duodenum and the blood.
102. What is in reticulum endoplasmic: a) Golgi, b) lysozyme, c) Ribosome
103. Which isoenzyme induced by smoking: 1A2
104. Drug NOT use in HTN+ depression: methyldopa
105. Suggestion about GTN: store in amber glass and airtight Container
106. A patient takes levothyroxine how it is obvious he has good information about his
medicine: it is related to the thyroid problem.
107. Not to use in thyrotoxicosis: thyroxin, other option were medicines for
hyperthyroidism
108. Patient with thyroid problem, which has to be taken with caution: Amiodarone
109. Why fat-soluble vitamins may cause problem: they can accumulate in the body
110. Which vitamin with steroid structure: vitamin D
111. Which is correct about folic acid in pregnancy: has to be taken before contraception
and for 12 weeks in pregnancy
Adequate intake before conception and for the first 12 weeks of pregnancy is
recommended to reduce the risk of neural tube defects.
Prevention of folate deficiency before and during pregnancy:
°Diabetes, previous pregnancy with neural tube defect, close family history of neural tube
defects, or taking anti-epileptic medicine: 5 mg daily.
° All other women: 0.5 mg daily.

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112. A person drinks alcohol and suddenly showed flushing, vertigo, palpitation; which
medicine can be the reason: disulfiram
113. Which one does not have anti-cough effect: a) pholcodine, b) codeine, c) bromhexine
114. Difference between morphine and pethidine:
• Pethidine is less addictive than morphine.
• Pethidine is a synthetic opioid, meaning it is entirely man-made and not derived
from natural sources like morphine. Morphine is a naturally occurring opioid
alkaloid derived from the opium poppy plant (Papaver somniferum)

115. Which one antagonize warfarin effect: St. Johns wort(inducer CYP2C9)

116. Which is NOT correct about camphor: soluble in water

117. Pin worm treatment: mebendazole
118. Mechanism of anti-seizure INHIBIT Ca channel: ethosuximide
119. Blood pressure in pregnancy: labetalol
120. Risk of neural tube defects: valproic acid
121. Neuroleptic malignant syndrome with haloperidol: dopamine receptor block
122. Effect of penicillin on bacteria: inhibition of cell wall of bacteria
123. Which one is disaccharide: sucrose
124. Anaemia in renal failure: normocytic normochromic
Anemia in renal failure is typically classified as normocytic normochromic anemia. This
type of anemia refers to a condition where the red blood cells (RBCs) are of normal size
(normocytic) and contain normal amounts of hemoglobin (normochromic).
125. A person with type 2 diabetes and have BMI=30 which dose is appropriate? 500 mg
metformin OD, b) 1000 mg metformin BID
126. For gonococcal→ ceftriaxone or doxycycline or azithromycin
127. For non-gonococcal→ doxycycline or azithromycin
128. Release of drug delivery system (sustained release) depends on: PH.
129. Belladonna not used in: Glaucoma
130. Not used in clostridium difficile: clindamycin
131. All of the following are concentration dependent EXCEPT:
Gentamycin -ciprofloxacin- metronidazole-penicillin G
(Beta lactam is not conc dependent)
132. LEAST drug to ttt acute Gout: Allopurinol (for chronic use).
133. Vancomycin reduce dose in: renal insufficiency
134. Max dose of lisinopril:40mg
135. Total cholesterol: Levels below 200 mg/dL (5.2 mmol/L)
136. mannitol is C/I in congestive HF and pulmonary edema
137. Concentration dependent Abx: MAF: METRONIDAZOLE, AMINOGLYCOSIDE,
FLOUROQUINOLONES
138. Drug excreted unchanged: Gentamycin, Acamprosate, Li
139. Protein concentration in healthy individuals: 62-80g/L

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 The normal protein concentration in the blood of healthy individuals is typically in the
range of 62 to 80 grams per litre (g/L) or 6.2 to 8.0 grams per decilitre (g/dL).
This value represents the total protein concentration in the blood, which includes both
albumin and globulins.
140. GFR affected by: hydrostatic pressure
141. Herbal drug which affects ethinylestradiol: fenugreek
fenugreek may induce certain liver enzymes responsible for metabolizing
ethinylestradiol, which could lead to decreased levels of the hormone in the blood.
142. Cyclosporine immunosuppressant cause skin cancer and other malignancy
143. Probe drugs to measure cyp 450 enzymes:
3A4 Erythromycin
2D6 Dextromethorphan
2C9 NSAID(ibuprofen)
144. Furosemide and digoxin toxicity: Hypokalemia.
145. S.E of oral retinoid therapy: increase TG, anticholinergic, hepatitis, joint pain, muscle
pain.
146. Signs of hypoglycemia: headache, anxiety, tachycardia, confusion, vertigo,
diaphoresis, weakness/fatigue, termers, blurred vision

Potentially serious drug interactions: some examples

Angiotensin-converting enzyme inhibitors and potassium salts
Possible clinical consequence: Hyperkalaemia
Allopurinol and azathioprine
Possible clinical consequence: Azathioprine toxicity with bone marrow depression
Allopurinol and mercaptopurine
Possible clinical consequence: Mercaptopurine toxicity with bone marrow depression
Amiloride and angiotensin-converting enzyme inhibitors
Possible clinical consequence: Hyperkalaemia
Amiloride and potassium salt s
Possible clinical consequence: Hyperkalaemia
Amiloride and tacrolimus
Possible clinical consequence: Hyperkalaemia
Amiodarone and digoxin
Possible clinical consequence: Digoxin toxicity
Amiodarone and haloperidol
Possible clinical consequence: Prolonged QT interval
Amiodarone and phenothiazines
Possible clinical consequence: Prolonged QT interval
Amiodarone and sotalol
Possible clinical consequence: Bradycardia or torsade de pointes
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Carbamazepine and dextropropoxyphene
Possible clinical consequence: Carbamazepine toxicity
Cyclosporin and orlistat
Possible clinical consequence: Reduced cyclosporin levels
Cyclosporin and statins
Possible clinical consequence: Statin toxicity with myopathy
Fluoxetine and moclobemide
Possible clinical consequence: Serotonin toxicity
Fluoxetine and selegiline
Possible clinical consequence: Serotonin toxicity
Gemfibrozil and statins
Possible clinical consequence: Statin toxicity with myopathy
Imipramine and clonidine
Possible clinical consequence: Reduced effect of clonidine
Imipramine and moclobemide
Possible clinical consequence: Serotonin toxicity
Itraconazole and rivaroxaban
Possible clinical consequence: Bleeding
Itraconazole and simvastatin or atorvastatin
Possible clinical consequence: Statin toxicity with myopathy
Carbamazepine and dextropropoxyphene
Possible clinical consequence: Carbamazepine toxicity
Cyclosporin and orlistat
Possible clinical consequence: Reduced cyclosporin levels
Cyclosporin and statins
Possible clinical consequence: Statin toxicity with myopathy
Fluoxetine and moclobemide
Possible clinical consequence: Serotonin toxicity
Fluoxetine and selegiline
Possible clinical consequence: Serotonin toxicity
Gemfibrozil and statins
Possible clinical consequence: Statin toxicity with myopathy
Imipramine and clonidine
Possible clinical consequence: Reduced effect of clonidine
Imipramine and moclobemide
Possible clinical consequence: Serotonin toxicity
Itraconazole and rivaroxaban
Possible clinical consequence: Bleeding
Itraconazole and simvastatin or atorvastatin

Kaps recalls-2023 SOLVED by NAZIA RAFIQUE

Possible clinical consequence: Statin toxicity with myopathy
Itraconazole and tacrolimus or sirolimus
Possible clinical consequence: Tacrolimus or sirolimus toxicity
Lithium and angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker
Possible clinical consequence: Lithium toxicity
Lithium and frusemide
Possible clinical consequence: Lithium toxicity
Lithium and haloperidol
Possible clinical consequence: Neurotoxicity and extrapyramidal symptoms
Lithium and phenothiazines
Possible clinical consequence: Neurotoxicity and extrapyramidal symptoms
Lithium and thiazides
Possible clinical consequence: Lithium toxicity
Methotrexate and aspirin
Possible clinical consequence: Methotrexate toxicity
Methotrexate and non-steroidal anti-inflammatory drugs
Possible clinical consequence: Methotrexate toxicity
Sildenafil, tadalafil, vardenafil and nitrates
Possible clinical consequence: Severe hypotension
Spironolactone and angiotensin-converting enzyme inhibitors
Possible clinical consequence: Hyperkalaemia
Spironolactone and amiloride
Possible clinical consequence: Hyperkalaemia
Spironolactone and lithium
Possible clinical consequence: Lithium toxicity
Spironolactone and potassium salts
Possible clinical consequence: Hyperkalaemia
Spironolactone and tacrolimus
Possible clinical consequence: Hyperkalaemia
Tramadol and monoamine oxidase inhibitors
Possible clinical consequence: Serotonin toxicity
Triptans and ergot alkaloids
Possible clinical consequence: Vasoconstriction
Triptans and methysergide
Possible clinical consequence: Vasoconstriction
Triptans and monoamine oxidase inhibitors
Possible clinical consequence: Serotonin toxicity
Triptans and selective serotonin re-uptake inhibitors
Possible clinical consequence: Serotonin toxicity

Kaps recalls-2023 SOLVED by NAZIA RAFIQUE

Verapamil and beta-adrenoceptor blockers
Possible clinical consequence: Cardio depression
Verapamil and dabigatran
Possible clinical consequence: Bleeding
Warfarin/newer anticoagulant s (dabigatran, rivaroxaban) and antiplatelet medicines
Possible clinical consequence: Bleeding
Warfarin and miconazole (or other imidazoles)
Possible clinical consequence: Bleeding
Warfarin/newer anticoagulant s (dabigatran, rivaroxaban) and non-steroidal anti-
inflammatory drugs
Possible clinical consequence: Gastrointestinal bleeding

Kaps recalls-2023 SOLVED by NAZIA RAFIQUE