‫‪Important Notes‬‬

‫صيــــــــــــــــــــــــــــــادلــــــــــة بتخدمــــــــك‬

‫‪SPLE 2023‬‬
1-First Order Kinetics First order kinetics is a concentration-dependent
process
(i.e. the higher the concentration, the faster the
clearance)

When a constant proportion of the drug is eliminated

per unit time.

2-Zero Order Kinetics Rate of Elimination is independent of the total

drug concentration in the plasma.
Examples of zero order elimination :
include ASPIRIN, PHENYTOIN and ETHANOL

3-DRUG CATEGORY Category A Adequate and well-controlled studies have failed to demonstrate a risk to the fetus
IN PREGNANCY in the first trimester of pregnancy (and there is no evidence of risk in later trimesters)

Category B Animal reproduction studies have failed to demonstrate a risk to the fetus and there
are no adequate and well-controlled studies in pregnant women.

Category C Animal reproduction studies have shown an adverse effect on the fetus and there
are no adequate and well-controlled studies in humans, but potential benefits may warrant use
of the drug in pregnant women despite potential risks

Category D There is positive evidence of human fetal risk based on adverse reaction data from
investigational or marketing experience or studies in humans, but potential benefits may warrant
use of the drug in pregnant women despite potential risks

Category X Studies in animals or humans have demonstrated fetal abnormalities and/or there i
s positive evidence of human fetal risk based on adverse reaction data from investigational or
marketing experience, and the risks involved in use of the drug in pregnant women clearly
outweigh potential benefit
4 Child- Pugh score
(For Severity Of Cirrhosis)

5-Pharmacological Therapy
For Stable COPD

6-Narenjo-Score

7-CHA2DS2-VASc
Used in Assess Atrial
Fibrillation
8-Phases Of Clinical Trials
9-USP General Chapters for
Compounding Establish
Procedures
1-Pharmacovigilance
‫اليقظة الدوائية‬
2-Prevalence
3-Incidence
4-Pharmacoepidemiology
5-Health Literacy
‫محو األمية الصحية‬
6-Biopharmaceutical
7-Orphan Drug
Pharmacovigilance In Which Phase? Phase IV
Post Marketing In Which Phase ? Phase IV
795 Pharmaceutical Compounding , Nonsterile Preparations
797 Pharmaceutical Compounding, Sterile Preparations
800 Hazardous Drugs, Handling in Healthcare Settings
825 Radiopharmaceuticals Preparation
Important Definitions
the science and activities relating to the detection, assessment,
understanding and prevention of adverse effects or any other drug-
related problem
refers to proportion of persons who have a condition at or during a
particular time period
refers to the proportion or rate of persons who develop a condition
during a particular time period
is the study of the utilization and effects of drugs in large numbers of people; it provides
an estimate of the probability of beneficial effects of a drug in a population and the
probability of adverse effects, present in Phase IV in clinical trial phases
the degree to which an individual has the capacity to obtain,
communicate, process, and understand basic health information and
services to make appropriate health decisions
study of the physical and chemical properties of drugs and their proper
dosage as related to the onset, duration, and intensity of drug action
intended for treatment, prevention or diagnosis of a rare disease
 Important Q*A in Drugs
Q A
1-Children with dry cough ttt?
2-Side Effects Amiodarone!
3-What reduce risk to developing DM !
4-What risk factor to develop DM!
5-Dose Warfarin ?
6-Which drug is banned in sport
competitions by international Olympics?
7-HbA1c normal range in pregnancy ?
8-In pregnancy what the trimester can be
use warfarin ?
9-Ibuprofen For Children!
10-Preventing Diabetic Foot Ulcer?
11-Larger lymphoid organ?
12-Lithium toxicity ttt !
13-Who the person has responsible about
Hazardous and High alert medication !
Dextromethorphan
4-to 6 years 15 mg (every 12 hr)
6 to 12 years 30mg (every 12 hr)
PULMONARY TOXICITY - THYROID ABNORMALITIES - BLUE-
GRAY SKIN DISCOLORATION
Physical activity 3 times per week
Family history
Initial dose: 2 to 5 mg orally once a day
Maintenance dose: 2 to 10 mg orally once a day
Target INR: (range: 2 to 3) and 3.5 in valve disease
Furosemide
lower than 6% * Diabetes > 6.5%
in normal case:
normal A1C level is below 5.7
prediabetic 5.7 to 6.4
diabetic 6.5 or more
Warfarin category D, avoided use in pregnancy and lactation
Not for children less than 6 months old and according to sfda
decongested and cough drug not given to child less than years
Proper Footwear ,Daily Foot Inspection , monitor blood sugar
level ,Weight Losses
Spleen
As antidote: Sodium bicarbonate - Polystyrene sulfonate
Gastric lavage useful if done early
Hemodialysis For severe toxicity
Pharmacist responsibility
14-What is shelf-life efficacy? Shelf life is the period of time, from the date of manufacture,
that a drug product is expected to remain within its approved
product specification while stored under defined conditions.

Shelf life is typically expressed in units of months, i.e. 24

months, 36 months, to a maximum of 60 month

15-Surfactant def! lower surface tension between 2 liquids or liquid + gas or

liquid and solid
16-Lubricant Def! substance that helps to reduce friction between surfaces in
mutual contact
17-What is refrigerator temp? Refrigerate: 2–8 ºc
Freeze: between -10 to -25 ºc
Room temperature: Between 15 - 25 ºc
Cool place: between 8 - 15 ºc

Cost-effectiveness , Drug formulary (Q,A)

Cost-effectiveness Definition method to compare treatment alternatives, or programs where cost is

measured in monetary terms
• Results are expressed as average cost-effectiveness ratios, or as the
incremental cost of using one alternative over another.
• Used to compare competing programs or treatment alternatives that differ
in therapeutic outcome.
➢ May be less expensive, and at least as effective as the comparator.
➢ May be more expensive while providing an additional benefit worth the
additional cost.
➢ May be less expensive and less effective when the extra benefit is not
worth the extra cost.
➢ is a list of prescription drugs that includes generics & trade names thus the
Drug formulary physicians & pharmacists can evaluate the ones of greatest value & can be
updated Regularly.
1-How can Separate look alike medication? Tall man letter
2-Pharmacist responsible for specific thing, monitoring planning, name of plan?
Strategy, business, operating
3-What Are the Five Rights Of Medication Administration?
The Right Patient, The Right Drug, The Right Dose, The Right Route And The Right Time.
4-What Is The Most High Risk When Happen Error?
Look Like Medication - High Alert Medication - Sound Like Medication
5-Which Of The Following Abbreviations Is A Dangerous Abbreviation?
Prn (As needed )
6-The Pharmacist Find Patient Don’t Take The Refill Medication For Last 3month ,What Drug Related
Problem ! No Adherance
7-Phase 1 of drug development?
Phase I. They are usually small trials, recruiting only a few patients. Phase 1 trials aim to find out how much
of the drug is safe to give
Confidentiality : when pharmacists keep patients secret
8-Another name of phase iv? Post marketing
9-What is GMP?
Good Manufacturing Practice (GMP) is a system for ensuring that products are consistently produced and
controlled according to quality standards. It is designed to minimize the risks involved in any pharmaceutical
production that cannot be eliminated through testing the final product
 Statistics Part

Mean
Definition The mean is the sum of the values, divided by the total number of values.
Equation X = x1 + x2+x3…X/n
Examples Example: The data show the number of patients in a sample of six hospitals who acquired an infection while
hospitalized. Find the mean. 110, 76, 29, 38, 105, 31
Solution: X = 110 + 76 + 29 + 38 + 105 + 31 / 6 = 64.83
Median
Definition The median of a data set is the value that lies in the middle of the data when the data set is ordered.
Equation If n is odd the equation = n + 1 / 2
If n is even the equation = n/2 , n+1/2
Examples The number of children with asthma during a specific year in seven local districts is shown. Find the median. 253,
125, 328, 417, 201, 70, 90
: ‫نرتب االعداد في البدايه‬
70, 90 , 125 , 201 , 253 , 328 , 417
201= ‫ ارقام وتعتبر عدد فردي فنستخدم المعادلة الفردية وناخذ العدد الي في النص‬7 ‫نالحظ انه عدد االرقام المتواجده هي‬
Median = 7 + 1/2 = 4
4 ‫ في السلسه هو‬201 ‫نالحظ انه مكان رقم‬
Example: Six customers purchased these numbers of magazines: 1, 7, 3, 2, 5, 8, Find the median.
Solution: 1, 2,3 , 5 , 7, 8
‫ ارقام موجوده‬6 ‫نالحظ انه مجموعهم عدد زوجي وهو‬
MD = 6/2 , 6+1/2 = (3,3) -------→ The median = 3
Mode.
Definition The value that occurs most often in a data set is called the mode. The mode of a data set is the data entry that
occurs with the greatest frequency
The following data represent the duration (in days) of US space shuttle voyages for the years 1992-1994. Find the
Examples
mode
8, 9, 9, 14, 8, 8, 8, 10, 7, 6, 9, 7, 8, 10, 14, 11, 8, 14, 11
Solution: Arrange the data in order
6, 7, 7, 8, 8, 8, 8, 8, 9, 9 9 10, 10, 11, 11, 14, 14, 14
Since 8-day voyages occurred 5times – a frequency larger than any other number the mode for the data set is 8.
Example:
Find the mode for the number of coal employees per county for 10 selected counties in southwestern
Pennsylvania.
110, 731, 1031, 84, 20, 118, 1162, 1977, 103, 752
Solution: Since each value occurs only once, there is no-mode.
Midrange
Definition The Midrange is defined as the sum of the lowest and highest values in the data set, divided by 2. The symbol MR is
used for the midrange
Equation MR = Lowest value + Higher value / 2
Examples Find the midrange of data for the NFL signing bonuses in previous Example. The bonuses in millions of dollars are
18, 14, 34, 11, 10, 12,
: Arrange the data in order : 10 , 11 , 12 , 14 , 18 , 34
MR = 34 +10 / 2 = 22
 P value
is the probability of obtaining results as extreme as the observed results of a statistical
hypothesis test, assuming that the null hypothesis is correct
<0.05 MEAN THAT IS SIGNIFICANT AND NULL HYPOTHESIS IS REJECTED
>0.05 MEAN THAT IS NOT SIGNIFICANT AND NULL HYPOTHESIS IS ACCEPTED
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………… are related to the ability to visualize the organization as a whole, recognizes
relationships among organizational parts, and understand how the organization fits into
the wider context of the industry, community and the world !
a) Human Relation Skills. b) Conceptual Skills. c) Technical Skills d) Clinical skills.

……….. is the ability to engage in a set of behaviors that are functionally related to one
another and that lead to a desired performance level in a given area !
a) Management. b) Leadership. c) Directing. d) Skill.

………….. is a process, composed of interrelated social and technical functions and activities
(including roles), occurring in a formal organizational setting for the purpose of
accomplishing predetermined objectives through the utilization of human and other
resources!

a) Management. b) Leadership. c) Directing. d) Decision Makin

……… monitor and survey the organization’s external environment to identify and assess
the affects of changes !

a) External relations. b) Environmental surveillance. c) Internal management. d) External

management.

…………….. are those in which executives engage for the general purpose of maintaining
contact with people or organizations that are associated with organization’s present or
future operations !

a) External relations. b) Environmental surveillance c) Internal management. d) External management.

……… is a technical management function that is a part of all other management functions !

A) Planning. b) Organizing. c) Decision Making. d) Controlling

…………….. is a social behavior in nature and focuses on initiating action in the organization
!

a) Planning. b) Organizing. c) Directing. d) Controlling

………………. is the acquiring and retaining human resources !

a) Planning. b) Organizing. c) Staffing. d) Controlling

………….. is technical and focuses on monitoring, adjusting and improving performance !

a) Planning. b) Organizing. c) Staffing. d) Controlling

…… is a technical function; it means establishing authority and responsibility relationships

and formal structure and reporting relationships !

a) Planning. b) Organizing. c) Staffing. d) Controlling

…………………………… measures the efficiency with which an organization uses its assets !

a) Turnover Ratio. b) Liquidity Ratio. c) Gross profit Margin. d) Net Profit margin

Which of the following represent throughout the fiscal year, the inflows and outflows of
cash are recorded in the statement of cash flows !

a) The Balance Sheet. b) The Statement of Cash Flows. c) The Statement of Cash retention. d)
The Income Statement.

which of the following Provides a snapshot of an organization’s assets, liabilities, and

shareholder equity at any particular point in time !

The Balance Sheet. b) The Statement of Cash Flows. c) The Statement of Cash retention. d) The Income
Statement

Joint Commission requires two identifiers as patient full name, date of birth
and or medical identification (ID) Number

The Best Insurance Company in Saudi Arabia Is Buba

 Herbal Medicine Uses SE Notes

1-Black cohosh 1-Contain high concentration of estrogen ‫ـــــــــ‬ ‫ـــــــــــــــــ‬

2-To treat Panful of menstruation
3-To treat Hot flashes caused by menopause

2-Cranberry To treat Recurrent UTI ‫ـــــــــ‬ ‫ـــــــــــــــــ‬

3-Saw palmetto To treat urinary symptoms of Benign Prostatic Hyperplasia ‫ـــــــــ‬ ‫ـــــــــــــــــ‬
BPH
4-Echinacea 1-Immunostimulants ‫ـــــــــ‬ ‫ـــــــــــــــــ‬
2-Supportive therapy for Respiratory tract infection
3-To treat Common cold and flu
4-To treat Ulcer
5-In case of hard to treat superficial wound

5-Fever few To treat Migraine headache ‫ـــــــــ‬ ‫ـــــــــــــــــ‬

6-Milk thistle 1-Active of ( Silymarin ) ‫ـــــــــ‬ ‫ـــــــــــــــــ‬

2-To treat Chronic inflammatory liver disease
3-To treat Cirrhosis

7-Fish oil Omega 3 – EPA – DHA: ‫ـــــــــ‬ ‫ـــــــــــــــــ‬

Prevent Cardiovascular disease
To treat ADHD

8-Chondroitin + To treat Osteoarthritis ‫ـــــــــ‬ ‫ـــــــــــــــــ‬

Glucosamine:

9-Melatonin To treat Sleep regulation in people work in different shifts. ‫ـــــــــ‬ ‫ـــــــــــــــــ‬

10-Eucalyptus oil Cough ‫ـــــــــ‬ ‫ـــــــــــــــــ‬

11-Curarine Muscle relaxant ‫ـــــــــ‬ ‫ـــــــــــــــــ‬

12- lavandula Induces sleep ‫ـــــــــ‬ ‫ـــــــــــــــــ‬

 Herbal Medicine Uses SE Notes
10-St. John's Wort To treat Anxiety and SE: Liver microsomal ‫ـــــــــــــــــ‬
Depressant enzyme inducer
SE: Decrease the
effect of any drug
take it with it
11-Kava Kava To treat Anxiety and Hepatotoxic Plant ‫ـــــــــــــــــ‬
Depressant

12-Garlic To teat High cholesterol SE: Bleeding in Monitor: INR – PT

and HTN overdose

13-Co-enzyme Q10 Antioxidant SE: Bleeding in Monitor: INR – PT

overdose

• Ginkgo biloba ‫ـــــــــــــــــ‬ Herbal Medicine + ‫ـــــــــــــــــ‬

• Garlic Dietary Supplement
• Co-enzyme Q10 NEED monitoring INR
and PT
14-Green Tea Contain Vitamin K ‫ـــــــــــــــــ‬ You have to
Antioxidant increase
concentration of
warfarin
15-Vitamin C-E + Beta Antioxidant ‫ـــــــــــــــــ‬ ‫ـــــــــــــــــ‬
carotene: Protect from free radicals

16-Valerian Restlessness and nervous ‫ـــــــــــــــــ‬ ‫ـــــــــــــــــ‬

disturbance

17-Ginger Dyspepsia and ‫ـــــــــــــــــ‬ ‫ـــــــــــــــــ‬

prophylaxis of symptoms
of travel sickness
18-Anise -Cannabis ‫ـــــــــــــــــ‬ POTENTIATE OR
Cranberry -Chamomile INCRESE EFFECT OF
Clove -Garlic-GINGER Warfarin

Ginko Bilobia
19-Co Enzyme Q –Green Tea INHIBIT EFFECT OF
Warfarin
ST. JOHN’S WORT VITAMIN E
 Qualitative Tests for Different Types of Phytochemicals;

Phytochemicals Test
Alkaloids Mayer’s test, Wagner’s test and Dragendroff’s test
Carbohydrates Molish’s test
Saponins Froth test
Cardio Glycoside Killer Killian test and Baljeet test

All About Statin

Statins need dose adjustment S = Simvastatin
SRP R = Rosuvastatin
P = Pravastatin
Statin not need adjustment A = Atrovastatin
AF
F = Fluvastatin
Statin that can be taken at F= Fluvastatin
morning/evening FAR A= Atrovastatin
R= Rosuvastatin
Statin that can be taken at evening S= Simvastatin
P= Pravastatin
SPFL
F= Fluvastatin
L= Lovastatin
Statin safe when taken with grape F= Fluvastatin
fruit juice P= Pitovastatin
FPRP R= Rosuvasatin
P= Pravastatin

Interaction statins with grapefruit ‫ ـــــــــــــــــــ‬Simvastatin

Active or Pro Drug Statins
*Lova* natural—> prodrug
LS
*Simva* semi-synthetic —> prodrug
 Important Notes in Cardiology
Q A
ST Interval between ventricular depolarization and repolarization
ST segment Relative Refractory of period and Ventricular repolarization
QT Ventricular action potential
QT prolongation Fluoroquinolones

RT Ventricular action potential

P value Significance of result or simple evidence

P wave Atrial depolarization

T wave Ventricular repolarization
PR Av conduction / Atrioventricular

QRS complex Ventricular depolarization and Absolute refractory period

AV node Delay action potential from atrial to ventricular

PR Interval sometimes referred to as the PQ interval
Stages of Kidney Disease

Enzymology

Organ Test

Diagnostic Enzymes for Liver Function Test Malate Dehydrogenase

D-lactate Dehydrogenase

Alcohol Dehydrogenase

Alkaline Phosphatase

Diagnostic Enzymes for Blood Lipid Metabolism Cholesterol Esterase

Cholesterol Oxidase

Cholesterol Dehydrogenase

Glucose-6-Phosphate Dehydrogenase, Hexokinase

Diagnostic Enzymes for Diabetes Diagnosis Glucose-6-phosphate Dehydrogenase

Diagnostic enzymes for Bone disease Alkaline phosphatase (BSAP),

Osteo-calcin

N-terminal Pro-peptide
 Recommended Treatment Regimens for Helicobacter pylori Infection
Regimen Drugs and doses Notes
Clarithromycin Triple PPI (standard or double dose) BID + Avoid if Clarithromycin resistance
amoxicillin 1000 mg BID or metronidazole 500 rate is known to be > 15% or in
triple mg TID + clarithromycin 500 mg BID for 14 days patients with prior macrolide
exposure

Bismuth PPI (standard dose) BID + Bismuth subsalicylate
300 mg QID or Bismuth subcitrate 120-300 mg
Quadruple QID + metronidazole 250 QID or 500 mg TID-
QID + tetracycline 500 mg QIDd + PPI BID x 10-
14 days
Initial treatment choice if
clarithromycin resistance rates
are high or patient has prior
macrolide exposure

Concomitant PPI (standard dose) BID + clarithromycin 500 Appears at least as effective as
mg BID + amoxicillin 1000 mg BID + clarithromycin triple therapy,
metronidazole or tinidazole 500 mg BID for 10- although not validated in North
14 days America

Sequential PPI (standard dose) BID + amoxicillin 1000 mg Efficacy subject to geographic
BID for 5–7 days; then PPI BID + clarithromycin variation of resistance rates;
500 mg BID + metronidazole or tinidazole 500 complexity of regimen makes it
mg BID for 5–7 days less desirable as first line therapy

Hybrid PPI (standard dose) BID + amoxicillin 1000 mg Regimen not studied in North
BID for 7 days; then PPI BID + amoxicillin 1 g BID America; complexity of regimen
+ clarithromycin 500 mg BID + metronidazole makes it less desirable as first line
or tinidazole 500 mg BID for 7 days therapy

Levofloxacin PPI (standard dose) BID + levofloxacin 500 mg Lack of North American data;
daily + amoxicillin 1000 mg BID for 10–14 days concerns for high levofloxacin
Triple resistance rates

Levofloxacin PPI (standard or double dose) BID + amoxicillin Lack of North American data; may
1000 mg BID for 5-7 days; then PPI BID + be more effective than
Sequential amoxicillin 1000 mg BID + levofloxacin 500 mg levofloxacin triple therapy
daily + metronidazole or tinidazole 500 mg BID
for 5-7 days

LOAD PPI (double dose) daily + levofloxacin 250 mg Lack of North American data; may
daily + metronidazole or tinidazole 500 mg BID be more effective than
+ doxycycline 100 mg daily levofloxacin triple therapy
 Important Q*A in Immunology
Q A
Longest half-life Ig ? lgG
Immunoglobulin found in Serum Predominantly? lgG
Strongest Ig? IgG
Ig on the blood? IgG
Ig have gamma globulin? IgG
Frist Ig antibody appear? IgM
New infection? lgM
Frist release in body? lgM
Immunoglobulins cells found in colostrum? IgA and IgM
Fastest Ig? IgM
Ig can’t across placenta? IgM
What’s the immunoglobulin in MALT? IgA
Ig in milk? IgA
Ig in serum, saliva and GIT? IgA
Hypersensitive lg fond in fat tissues? IgE
Ig in asthma? IgE
Angioedema type of hypersensitive? lgE
Peanut allergy symptom? lgE
Penicillin allergy? IgE
Passive immunity immune? IgA and IgG
 General Notes 1
Q A
Epilepsy or focal seizures and positive HALA- Levetiracetam
B(1502)
Major depression take medication for 6 week
Postpartum prophylaxis dose In women with High 3 month
risk of DVT

Osteoporosis ! Given weekly:Alendronate

Given monthly:Ibandronate
Given one in year:Zolendronic acid
Repackage Drug 6 month

INR monitoring as outpatient 2-5 days

Expiry of compound syrup containing water 14 days
Duration of aspirin treatment In CV 5 years
Amphotericin Hydroxylases
Aspirin metabolism Hydroxylation
Morphine to heroin: Esterification
Bond between amino acid Amide
Bond between carboxyl and amine Hydrogen bond
Amino acid for anorexia Leucine
Alkaloid cause skeletal muscle relaxant Theophylline

Skeletal muscle contraction Ephedrine

Positive symptoms Haloperidol
Antipsychotic cause uncomfortable sensation in leg Haloperidol
Mood stabilizer and mania Lithium
Safe in sulpha allergy Ethacrynic acid
 General Notes 2
Q A
Metabolic alkalosis : saline 9 Saline 9
Metabolic acidosis increase CO2
Metabolic acidosis decrease HCO3
Act on non-receptor mechanisms Deferoxamine
Mastitis Cephalexin
Enhance it’s absorption with ranitidine Naproxen
Cell have Y shape Attached to variable L and H side
Prophylaxis from breast cancer and prevent renal VIT D
Injury
Status asthmatics SABA alone or with oral corticosteroids like methyl
prednisone
Carrier of vit B12 Intrinsic factor(pernicious anemia
(Z) Standard score or standard deviation
Not use In gout: Diuretic
Increase lithium Concentration Thiazides diuretic
Meningitis empiric treatment Ceftriaxone
Affinity: How strong drug bind to receptor
Not in heterocyclic Fe
Least dominant of histamine NH3
Withdrawal symptoms Pentazocin
Dependence symptoms Methadone
Withdrawal symptoms of alcohol treated with Lorazepam
Gene mutation UGT1a1 Atazanavier
Breast cancer and elevated topoisomerase Irinotecan
Antibiotics bind with 30s Inhibit imitation of protein synthesis

Antibiotics bind with 50s Inhibit elongation of protein synthesis

Septic shock unresponsive to fluid Norepinephrine
Septic shock unresponsive to fluid with CKD Dopamine
Vasopressor without titration Vasopressin
Vasopressor with titration Norepinephrine
 General Notes 3
Q A
Acetyl coA to malonyl coA: Biotin(B7)
Methionine to cysteine: b6
Acetyl coA to citric acid b2
Codien to morphine De-alkylation and more analgesic
Morphine to Codeine. Methylation and more antitussive
Test for b12 Schilling
Crcl for child Schwartz
Crcl for Adult Cockcroft
Viral genome DNA(OR)RNA
Renal patients Increase half-life and decrease elimination
D glucose and D mannose Epi
D galactose and D mannose Dia
D glucose and l glucose Enan
Drug cause leukoencephalopathy Natalizumab
MOA of clonidine Alpha 2 adrenergic agonist
MOA of Bisoprolol. Beta 1 adrenergic blocker
MOA of Phentolamine Alpha 1,2 adrenergic blocker
gm of lipid = 9 calories
gm of protein= 4 calories
gm of carbohydrate = 4 calories
dextrose and amino 2*1
dextrose and amino and lipid 3*1
Cold Product CI <2y
Cough CI <6y

Curative and prevention Primary

Curative only 2ry,3ry
Trough Level of Gentamycin Before 3 or 4 dose Or 30 min after infusion

Bentonite Suspending Agent

Aspartame Sweeting Agent
 General Notes 4
Q A
Vitamin C Preservative
Gum Acacia Binding Agent
Purple glove syndrome Phenytoin
Purple toe syndrome Warfarin
Gray baby syndrome Chloramphenicol
Yellow nail syndrome Sodium Auro-thiomalate
High alert Red
Hazards Yellow
Control Yellow
LASA Blue
Narcotics Red
Expire Green
Parenteral Argatroban
Oral Dabigatran
High T cell indicator for Mononucleosis
Kissing disease
Heart Failure :
Stage 1 cold and Dry
Stage 2 : cold and Wet
(Z) Standard Score or Standard Deviation
Def: is a measure of how dispersed the data Is in relation to the
mean. Low standard deviation means data are clustered around the
mean, and high standard deviation Indicates data are more spread
out
Prescriber information's should be present in the prescription:
1-Name
2-License classification (Professional degree)
3-Address
4-Office telephone numbers
5-Signature
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Patients information:
Name
Age
Sex
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Prescription (Medication prescribed):
Quantities (amounts)
Strength of drug
Refill information.
-------------------------------------------------------------------------------------------------------------------
For Controlled Substance:
Date
Prescriber’s name & address
Patient’s name, age
Address
Diagnosis
No abbreviations
All doses (number of ampules, tablets should be written in words)
Prescriber’s signature
Prescription is dispensed once & is kept by pharmacist
-------------------------------------------------------------------------------------------------------------------
For chronic drugs:
Dispense the medications for chronic diseases every 90 days 3 months
Prescription Valid for 7 days (1 week).
Only Consultant physicians are allowed to Rx formulary drugs for unapproved Indication (Off-
Label)
Corrects serum phenytoin level for renal failure and/or hypoalbuminemia If clcr < 20 mL/min
then Corrected Phenytoin = Total Phenytoin Level / ( (0.1 x albumin) + 0.1)
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Oral dose of morphine and corresponding equivalent dose of transdermal fentanyl

----------------------------------------------------------------------------------------------------------------------

Size of Capsule
ISO stands for the International Organization for Standardization (ISO)
FS for Federal Standard.

----------------------------------------------------------------------------------------------------------------------

Glasgow Coma Scale

 T-Score
A T-score compares the patient’s measured BMD (bone mineral density)
to the average peak BMD of a healthy, young of the same sex

Interpreting T-SCORE Results

Normal ≥ -1
Osteopenia (low bone mass) -1 to – 2.4
Osteoporosis: ≤ - 2.5
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Stages of Chronic kidney diseases (CKD)

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Homogeneous system

Solution :
is a homogeneous system in which a solute is molecularly dispersed, or dissolved,
in a solvent

Heterogeneous system:
1-Suspension:
is a two-phase system that is composed of a solid material dispersed in an oily or
aqueous liquid.

2-Emulsion:is a heterogeneous system that consists of at least one immiscible liquid

that is dispersed in another in the form of droplets.
 Communication
Def :is the sharing of information, ideas, thoughts, and feelings.

Communication Barriers
1- Environmental Barriers:
Physical barrier .
Prescription counter, Raised floor, Inadequate lighting Noise and distraction.

2- Pharmacist Barriers:
Little training in interaction with patients leading to inappropriate nonverbal behaviors :
Nervous movement.
Crossed arms or legs.
leaning away from the patient.
Failure to maintain eye contact .
Lack of time.
Economic considerations.

Closer technique to improve patient interaction :

Control distractions as nervous habits
Open body posture
Uncross arms and legs
squarely (directly) face patient
Eye contact 50-75% of the time relax
3- Patient Barriers:
Functional barriers:
Low illiteracy
Hearing or visual impairment
Non-English speaking patients

4-Emotional barriers

Strong emotions interfering with the thought process as anger, sadness, worry, or embarrassment
or communication skills.
 Lipinski's Rule of Five

Determine if a chemical compound with a certain pharmacological or biological activity has

properties that would make it a likely orally active drug in humans.

The Rule describes molecular properties important for a drug's pharmacokinetics in the
human body, including their absorption, distribution, metabolism, and excretion "ADME"

Lipinski's Rule of Five states that, in general, an orally active drug has:

• Not more than 5 hydrogen Bond Donors

• Not more than 10 hydrogen Bond Acceptors

• A molecular weight under 500 g/mol

• A partition coefficient log P less than 5

 Child

1 In child with ADHD what is the appropriate choice?

Methylphenidate once daily

2 Methylphenidate indication
Attention deficit hyperactivity disorder (ADHD)

3 Neonates term
Suggested Age Groupings:
Premature Newborns: < 38 weeks’ gestational age
Term Newborns: > 38 weeks’ gestational age
Neonate: 0 – 30 days of age
Infant: 1 month – 2 years
Young Child: 2 – 6 years
Child: 6 – 12 years
Adolescent: 12 – 18 years

4 Which drug contraindicated in neonate?

Smx-tmp

5 Neonate doctor prescribe to him erythromycin eye ointment for ?

Chlamydia

6 Drug contraindication in children less than 12 year ?

At age
1- 28 days – ceftriaxone –
< 2 yeas – promethazine – fatal respiratory depression
< 12 yeas – codeine and tramadol – lethal overdose

7 Dose of dry cough syrup for child

Dextromethorphan
Cough suppressant
Adult: As dextromethorphan hydrobromide: As conventional preparation: 10-20 mg 4
hourly, or 30 mg 6-8 hourly. As extended-release preparation: 60 mg 12 hourly. Max: 120
mg daily. As loz: Suck not more than 12 loz daily.
Child: >12 years Same as adult dose.

8 Neonate with chalamedia infection what is the best antibiotics

Erythromycin

9 Drug contraindicated in neonates

Trimethoprim/sulfamethoxazol

10 Neonates water soluble ?

80%
11 Medication cause growth retardation
Glucocorticoids
Betamethasone
Cortisone
Dexamethasone
Hydrocortisone
Methylprednisolone
Prednisolone
Prednisone
Triamcinolone

12 Drug has role in RSV ( respiratory syncytial virus ) in newborn ?

Palivizumab for prevention and treatmen

13 Case children with fever 48hr, tugging ear diagnosis

otitis media

14 Most OTC for children

Antipyretic / 2-Analgesic

15 Which drug contraindicated in children

Doxycycline

16 Child has penicillin resistant which drug will be used

Cephalosporin

17 Child 4 years old has non-productive cough

Dextromethorphan

18 Child patient with ADHD, symptoms appear in house and in school

Methylphenidate

19 Ceftriaxone what cause on neonate

Ceftriaxone cause hyperalbunimia in neonate

20 gray baby syndrome caused by ?

Chloramphenicol

21 for otitis media in children use ?

high dose of amoxicillin

22 for a 4 year old child, the maximum daily dose of paracetamol is ?

1g

23 A Child with otitis media ?

high dose amoxicillin
 Herbal

1 Patient suffer from stress and want to improve endurance take?

Chamomile

2 Which glycosides of senna responsible for cathartic effect?

Anthraquinone

3 Which one is true about herbal supplement?

Need good manufacturing practice GMP

4 Extraction of active material from plant by adding solvent and heating?

Decoction

5 What herbs for mental disease?

Gingko biloba

6 plant source use for acute gouty

Colchicine

7 Cranberry used for

UTI infection

8 oil used in sunburn

Aloe

9 cyanide toxicity ?
cardiac toxicity

10 Senna is considered which type of laxative ?

It stimulates muscle movement in the intestines

11 Herbal for sedative ?

Valrein

12 case patient with sun burn ?

oleo vera

13 Glycoside in senna ?
Anthraquinone

14 Used in dark box

Clove Oil
-Enoxaparin prophylactic and treatment dose.
•Prophylaxis:
30mg SC twice daily or 40mg once
daily
•Treatment:
1mg/kg SC BID or 1.5mg/kg SC OD

-Alzheimers disease treatment dose:

• Donepezil : mild to moderate: 5-10mg once daily
moderate to severe: 10-23 mg once daily
• Rivastigmine : 1.5mg orally twice daily
• memantine : IR : 5 mg once daily
ER : 7 mg once daily

-Zolpidem
•Intermediate release ( max 10mg
•Extended release ( 12.5 mg

-Amoxicillin dose for children.

• 25 - 50 mg/kg/day

-Cortisone dose equivalents.

-PPI dose equivalents.

-Warfarin :
•Intial dose : 2-5 mg oral or IV for 2 day
•Maintenance dose : 2-10 mg oral or IV once a day

-Phenytoin :
•Oral 200-500 mg daily , •IV 10-15 mg/kg , •Infusion rate: 25-50mg/min

-Digoxin :
0.125 - 0.25 mg daily or every other day
 Peptic ulcer treatment doses for all regiments.

-osteoporosis
-Smoking cassation:
•Varenicline (Chantix):
0.5 mg/day PO for 3 days, then 0.5 mg BID for 4 days and then 1 mg BID for 11
weeks
•Bupropion SR (Zyban):
150 mg PO for 3 days and then 150 mg BID