PHARMACOLOGY OSPE (2nd Term)

compiled by Arnab Mazumdar Avi (26 th/16)

• Identify the supplied sample. Write about its doses regimen and adverse effects.

# This is a blister containing Tablet Rifampicin, Isoniazid, Pyrazinamide and Ethambutol.

Doses regimen:
• 6 months regimen • 12 months regimen
• 9 months regimen • 24 months regimen

Adverse effects:
Rifampicin – Pyrazinamide –
• Orange coloration of body fluids. • Gout / Hyperuricemia.
• Flu like symptoms. • Hypersensitivity.

Isoniazid – Ethambutol –
• In slow acetylators – Peripheral • Retro bulbar or retro optic neuritis (red
neuropathy. green color blindness).
• In rapid acetylators – Hepatotoxicity. • Hypersensitivity.

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 • Identify the supplied sample. Justify the use of the combination.

# This is a strip containing Tablet Levodopa & Carbidopa.

Justification of the combination:

When levodopa is given, only 3-5% enters into the CNS because the remaining 95% is metabolized to
dopamine by dopa decarboxylase which can’t cross BBB.
On the other hand, Carbidopa itself can’t cross BBB but it inhibits dopa decarboxylase enzyme.
So, when levodopa & Carbidopa is given together, levodopa will not be metabolized to dopamine. More
levodopa can enter into CNS unaltered and more therapeutic effect will be achieved.

• Write down the safety drugs when a pregnant women suffering

from respiratory tract infection.

Safe drug for RTI in pregnancy:

1) Amoxicillin
2) Erythromycin
3) Ceftriaxone
4) Cefixime
5) Flucloxacillin

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 a) Identify the supplied sample.
b) Write about its clinical use and
c) Contraindication

a) This is a blister containing Tablet Levofloxacin / Ciprofloxacin.

b) Clinical use:
• Bacterial diarrhea ( Shigella, Salmonella, toxigenic E.coli, Campylobacter)
• Enteric fever
• UTI
• RTI
• Anthrax

c) Contraindication:
• Pregnancy
• Lactating mother
• Children below 18 years

a) Identify the supplied sample.

b) Write down its composition.
c) Clinical uses.

a) This is a packet containing Oral Rehydration Saline

b) Composition:
• NaCl – 1.30 gram • Trisodium citrate dihydrate – 1.45 gram
• KCl – 0.75 gram • Anhydrous glucose – 6.75 gram

c) Clinical uses:
• To correct dehydration in acute watery diarrhea.

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 • Write down the safety drugs when a pregnant women
suffering from Enteric fever.

Safe drug for enteric fever in pregnancy:

1) Amoxicillin
2) Cefuroxime
3) Ceftriaxone
4) Cefixime
5) Cefaclor

a) Identify the supplied sample.

b) Write down its 5 indications.
c) Write down its 3 adverse effects.

a) This is a blister containing Capsule Tetracycline.

b) 5 indications:
• Rocky mountain spotted fever
• Q fever
• Typhus fever
• Syphilis
• PUD caused by H.pylori

c) 3 adverse effects:
• Teratogenicity
• Bone & teeth deposition
• Nephrotoxicity

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 a) Identify the supplied sample.
b) What are the extra malarial uses of this drug?
c) Mention its 5 important adverse effects.

a) This is a blister containing Tablet Quinine.

b) Extra malarial uses of quinine:
• Pyrexia of unknown origin
• Nocturnal leg cramp
• Cardiac arrhythmia
c) 5 important adverse effects:
• Hypotension
• Hypoglycemia
• Hypersensitivity
• GIT upset – nausea, vomiting, diarrhea, abdominal cramp.
• CNS disturbances – Cinchonism (ataxia, tinnitus, blurring of vision, headache, dizziness)

a) Identify the supplied sample.

b) Name some other drugs of this group.
c) Tell 5 indications & 3 adverse effects of this drug.

a) This is a blister containing Tablet Metronidazole.

b) Other drugs of this group:

• Tinidazole
• Ornidazole
• Secnidazole

c) 5 indications: 3 adverse effects:

• Amoebiasis • Dry mouth
• Giardiasis • Metallic taste
• Trichomoniasis • GIT upset
• H.pylori infection in PUD
• Dental infections

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 a) Identify the supplied sample.
b) Name some Second generation
Anti-Histamines.
c) What is ‘Triple Response’?

a) This is a blister containing Tablet Fexofenadine / Cetirizine.

b) Some 2nd generation antihistamines:

• Rupatadine
• Fexofenadine
• Loratadine
• Astemizole
• Cetirizine
• Bilastine

c) Triple response:
It is the skin response due to intradermal injection of histamine which is characterized by –
• Redness due to vasodilation
• Edema due to increased vascular permeability
• Flare due to axon reflex

Comments about following drug interaction –

a) Amoxicillin + Clavulanic acid

b) Tetracycline + Antacid
c) Digoxin + Spironolactone
d) Warfarin + Cimetidine
e) Oral contraceptive + Carbamazepine

a) Amoxicillin + Clavulanic acid = Potentiate the antibiotic effect of amoxicillin

b) Tetracycline + Antacid = Decreased absorption of tetracycline
c) Digoxin + Spironolactone = Digoxin toxicity
d) Warfarin + Cimetidine = Increased bleeding tendency
e) Oral contraceptive + Carbamazepine = Contraceptive failure

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 Comments about following drug interaction –

a) Penicillin + Probenecid
b) Tetracycline + Iron preparations
c) Frusemide + Spironolactone
d) Warfarin + Metronidazole
e) Oral contraceptive + Rifampicin

a) Penicillin + Probenecid = Increased bioavailability of both drugs

b) Tetracycline + Iron preparations = Decreased bioavailability of both drugs
c) Frusemide + Spironolactone = Balance potassium level / Prevent hypokalemia
d) Warfarin + Metronidazole = Increased bleeding tendency
e) Oral contraceptive + Rifampicin = Contraceptive failure

• Steps of inhaler administration.

Parts:
1) Cap
2) Mouth piece
3) Body
4) Canister

Procedure:
1. Shake the inhaler well.
2. Patient should be in standing position or sitting up straight.
3. Exhale and breathe out completely.
4. Open the cap.
5. Place the mouth piece in mouth.
6. Press the canister and start to breathe in slowly for 3-5 seconds.
7. Hold the breath for 10 seconds.
8. Take the mouthpiece out and release the breath.
9. Repeat the procedure if it is advised by the physician and close the cap.
10. After 1 minute, gargle with warm water for 10 seconds to prevent Oropharyngeal candidiasis.

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