800 Questions :)

APEC REVISION

Dr. M
1/1/2014
 Pharmacy Review
(Australia)
APEC Stage 1
Previous examination questions
1-Structure of Methyl Salicylate: Methyl 2-hydroxybenzoate

2-structure of diphenhydramine

3-Camphor is ketone.

4- -NH-NH- is present in MAOI's structure (phenelzine).

5-penicillin (-) bacterial wall synthesis by (-) of Transpeptidase.

6-Amylase level increase in pancreatic disease (pancreatitis).

7-Insulin does not reduce synthesis of triglycerides.

8-Structure of Barbituric acid:

9-On discarding stored tetracycline, it changes into more toxic form

(Fanconi like Rx).
10-Sulindac is a prodrug (Sulphoxide is reduced to the active sulphide)
(more active than the prodrug).

11-Euthyroid=person with normal thyroid function.

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12- Ascorbic acid acidifies urine.

13-Red meat is not contraindicated immunity

I's.

14-Tyramine does not reduce blood pressure.

15-Thiopental sodium is ultra short acting general anesthetic (due to its

high lipid solubility.

16-Spironolactone is anti-aldosterone.

17-Ascorbic acid is:

-rapidly absorbed from GIT.

-Utilized at increased rate during common cold & infection.
-protects against scurvy.
- Reversibly oxidized to oxalic acid.
18-Vitamin D is not used in hyperthyroidism

19- Vit. E is not proved to be essential for reproduction in man BUT Vit. A is
important.

20-Tyrosine is precursor of thyroxin.

21-Cis means 2 gps are on the same side.

22-Oral prednisolone or corticosteroid is not given to a patient 11

years old with chronic asthma, he can be given:
*inhaled prednisolone.
*Long acting Theophylline.

23-pyuria=pus in urine.

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24-Drug of Choice for E.coli: is co-trimoxazole.

25-Metabolism of drug occurs at the sub cellular organ in endoplasmic

reticulum (smooth) & ribosome.

26-Ventricular fibrillation is the most common complication of MI.

27- Sulphonamides SE are blood dyscariasis, rash &fever.

28-Sweat is used for (function):

water excretions, Na+ excretion & temp. regulation.

29-In Nephritis: there is edema.

30- Phenytoin SE is gingival hyperplasia, ataxia & hirsutism.

31-Peripheral neuropathy (neuritis) SE of Isoniazide is due to:

INH induced pyridoxine deficiency.

32-Ketoconazole can be administered orally.

33-Nitrazepam is not used in ttt of insomnia in elderly patients.

34-Edrophonium is used in diagnosis of Myasthenia gravis.

35-Promethazine is a potent antiemetic.

36-Osteoarthritis is a degenerative disease.

37-Ortho position= 1 &2 positions on benzene.

38-Corticosteroid action in asthma is reducing the inflammatory

response & reducing airway hyper responsiveness.

39-Atropine is an antidote for anticholinestrase.

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40-Atropine selectively blocks muscarinic receptors.

41-Nitroglycerine mainly reduces preload.

42-One drug with 2 polymorph will differ in:

melting point, solubility, dissolution rate, density, stability EXCEPT pH.

43-c AMP is not CNS mediator but it is 2nd messenger.

44-Dyspnea=breathing with difficulty.

45-Noradrenaline acts on postganglionic sympathetic receptor on the

effector organ mainly or presynaptic receptors on the nerve endings.

46-Cotrimoxazole is a bactericidal by reducing of Folic acid synthesis.

47-Cartilage covers and protects bone from friction during normal joint
activity & osteofies to form bone.

48-Ethyl palmitate is not a surface active agent.

49-Cortisone eye drops should be stored betn 2-8 0C.

50-An ointment base is made of hydrocortisone.

51- A drug 60 mg t1/2 is 1 year, after 3 years the amount remaining is

7.5 gm.

52- Drug with low Vd (volume of distribution) →less accumulation in

tissues (or no accumulation at all).

53-Phenyl mercuric nitrate 0.002% is eye drop preservative, bacteriostatic.

54- Insulin lente=70% ultralente (crystalline), 30% semilente (amorphous).

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55-Sulphonamide must have a non substituted aromatic amino gp essential
for anti bacterial activity.

Example:

56- Haloperidol is not used in Parkinsonism (as it ↑ EPS).

57- Acetazolamide causes alkaline urinary PH.

58- Heparin anticoagulant activity is monitored by:

Activated Partial Thromboplastin Time (APTT).

59- A body placed in hypertonic solution will ↓ in size (crenation occurs).

60-We use occlusive dressing or plaster with corticosteroid to:

enhance absorption of it.

61- Botulism antiserum induces passive immunity.

62-Oil, fats &powders are sterilized by dry heat at 16 0c for 2 hrs.

63-Ophthalmic preparation is sterilized by filtration using 0.22 μm

microbial filter or heating with bactericidal.

64-Lignocaine has long duration of action because it is amide which is

resistant to hydrolysis.

65-Clindamycin to prepare a solution: dissolve in H2O.

66- Essential amino acids= must be supplied with diet.

67-Norethistrone is used in endometriosis (But megestrol &

medroxyprogestrone are better).

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68-Patient with mature onset diabetes can be treated with
tolbutamide & diet.
69-t1/2 = time required for conc. Of drug decrease by one half.

70- Protamine zinc insulin has duration of action of about

36hrs (11/2 day) & ultra lente.

71- Gentamycine causes deafness due to its effect on 8th cranial nerve
(vestibular damage or auditory damage).

72- Hypokalemia ↑ digoxin toxicity.

73- Fluphenazine deaconate is given IM.

74- Corticosteroid & estrogen causes hypertension except ranitidine.

75-Patient on propranolol or metoprolol has nightmares → shift to

more hydrophilic B blocker like atenolol or nadolol.

76- Morphine toxicity causes constipation but not diarrhea!!!!

77- Cimetidine ↓ metabolism of other drugs.

78-To prepare a buffer system at PH 4, we use lactic acid of pka 3.86.

79- Tell a patient treated with Indapamide that the drug may cause k+
loss thus potassium supplement is required. (Orange juice &banana).

80- Prazocin cause 1st dose hypotension.

81-Style pencil is used in minor cuts.

82- Na lauryl SO4 (-ve) is incompatible with cetrimide (+ve).

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83- Al (OH)3 causes constipation.
84-

Absorption of A›B›C

85- Hydralazine (antihypertensive & VD) can precipitate anginal attack

due to coronary steal phenomena.

86- Bulk forming laxative (psyllium, methyl cellulose, bran

&polycarbophil) are used safely in pregnancy, stool softener (Docusate Na)
can be used safely.

87- Doses:
*Salbutamol: → 4-8mg or 10mg!!!
*Dithranol: → 0.1-1% (for ttt psoriasis)
*Chlorothiazide: → 125-500mg or up to 1 gm

88- Patient on phenytoin still has fits we give him dose of 30 mg

phenytoin (taken once).

89- Na metabisulphite is antioxidant or reducing agent.

90- Aspirin: *may induce asthma.

* interact with sulphonylurea (↑), but not interact with MAOI's.

91-Hypersensetivity & idiosyncrasy is not dose dependent adverse effect.

92-Naloxone is used to block respiratory depression effect caused by

Opiates.

93-In asthma, there is no ↑ in cAMP and ↑ in catecholamines.

94-Nalidixic acid & amiodarone cause photosensitivity.

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95- Strong iodine solution contains 5% w/v, how many mg of iodine
are consumed daily; the usual dose is 0.3ml tid→45mg.

96-Cystic fibrosis recessive gene may be present in both mother &father.

97-Main measure of respiratory volume is vital capacity.

98- Allopurinol → (-) xanthine oxidase→ (-) uric acid formation.

99- Anaphylactic reaction occurs after 2nd exposure to antigen.

100- Chloropromazine has longer t1/2 when given IM.

101-Prenicious anaemia is deficiency of Vit B12.

102- Atropine (d-l hyoscyamine mixture) is more active than d-

hyoscyamine (L isomer is 100 x more potent than D isomer).

103- The ester gp in atropine is liable to destruction.

104- Str. Of phenyl alkyl amine:

105- Procaine is liable to destruction upon sterilization by heat.

106- Clomiphen is antiestrogen (not estrogenic compound).

107-Trypsin is secreted from pancreas.

108- Organophosphorous compounds act by irreversible ↓ of cholinesterase.

109- Timolol (B-blocker) →↓↓ I.O.P by ↓ of aqueous humor formation, in

glaucoma, but has no effect both on pupil size "not mitotic" & on the aq.
Humor outflow.

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110- Erythropioesis= stimulation of Red blood cells formation from bone
marrow.

111-Thiazide ↓ HTN by ↓ blood volume.

112-Diphtheria vaccine or tetanus toxoid gives active immunity.

113- Glyceryl trinitrate dose is: 0.3-1.2 mg

Atropine dose is: 0.2-2mg
Chloral hydrate dose is: 0.3-2g.
Chlorbutal "preservative": 0.5% [in eye drops].
114- Ergotamine tartarate & nitroglycerine can be used sublingually.
115-Ergot alkaloids are used in migraine & prevention of postpartum
hemorrhage by ↑ of uterine contraction.
116- Bile conjugation occurs in liver.

117-Corticosteroid function includes the following:

*Intermediate in metabolism. *Salt & water regulation
*Muscle development. *Haematopoesis.

118-Phenytoin dose 50mg-400mg "max", 2nd dose is 30 mg.

119-When Salbutamol is used with Betamethasone inhaler, Salbutamol is

used before inhaled corticosteroid by 10 mins.

120-Penicillinase resistant penicillins are: Methicillin - Nafcillin- Cloxacillin-

Dicloxacillin- Floxacillin- Oxacillin.

121-Antipseudomonal penicillins are: Carbenicillin- Ticarcillin- Mezlocillin-

Piperacillin.
122-Acid stable (oral) penicillins are: "PAPA": Ampicillin- Amoxicillin-
Penicillin V "Phenoxy methyl penicillin" & Penicillin G

123-Drug of choice in H. influenza is Ampicillin*.

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124-Amoxicillin is used in ttt of Otitis media.

125-MAOI's +cheese → HTN crisis due to tyramine content which ↑ NE conc.

126- Patient taking Metronidazole advice him to stop drinking alcohol (due to
disulfuram like Rx).

127-Mebendazole is used as antihelmentic.

128-Cholestyramine is used as anionic exchange resin (bile acid binder) in

hyperlipidemia.

129-Lomotil® (diphenoxylate +atropine) don't cause Bronchospasam &

atropine ↓ likehood of abuse of the opiate.

130-NaHCO3 (IV) is used to neutralize acidosis of lactic acid (in cardiac

arrest).

131-Stoke's Law: (in suspension/ also applied to rate of creaming):

Sedimentation rate (v) = N.B sed. Rate is directly prop with (p1-p2)
d = particle diameter g=acceleration due to viscosity
ᶯ= viscosity of dispersion medium (p1-p2) =difference betn density of!
Particle (p1) & density of! Dispersion medium (p2).

132-Na nitroprusside is given by slow IV infusion in emergency lowering of

blood pressure as it offers rapid onset &short duration.

133-Alkaline phosphatase (↑) in liver disease.

134-Vit B12 contains cobalt.

135-During ovulation FSH &LH reach highest peak.

136-Corpus luteum "yellow body"→secrets mainly progesterone.

137-Estrogen secretion is controlled by FSH.

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138-Myexoedema =↓in thyroid hormone secretion in adulthood.

139-Exophthalamus = "protrusion of! eye ball" associated with hyperthyroidism

& hyperplasia of thyroid gland.

140-Half life= half the radioactive material to decay.

*Shelf life t90= 10% of the radioactive material to decay.

141- Suxamethonium is depolarizing short acting skeletal musclerelaxant.

142- woman taking combined pills for 21 days & 5 days rest but the bleeding
does not occur, you advice her to stop the pills as she may be pregnant.

143-BaSO4 is the least soluble compound.

144-Narrow angle glaucoma acute attacks are treated with

parasympathomimetics.

145- % of RBCs compared with blood volume (45%) →Hematocrit value.

146-Labetalol is  receptor antagonist.

147-Selective  receptor antagonists (cardioselective) are atenolol,

metoprolol, bisoprolol, esmolol, Acebutolol……

148-Uricosuric "↑ excretion of uric acid in urine" are: probencid,

sulphinpyrazone BUT not Allopurinol.

149-weak acids &bases are more absorbed from the small intestine due to
large surface area.

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150-Acidification of urine ↑excretion of alkaline drugs "like amphetamine" as
ionization ↑, thus absorption ↓.

151-Calamine lotion: ZnO + Ferric oxide.

152- Lithium causes nephrogenic diabetes insipidus.

153-Atropine + parlidoxime are used to treat Organophosphorous poisoning.

154-Possible number of stereoisomers for compounds having 4 asymmetric

Carbon atoms is 16 →2'no of asymmetric C atoms"→24= 16.

155-Kcl therapy is given by slow IV infusion "not given by IV injection".

156- Ca2+ is not given with digitalis because both ↑ contractility of the heart
"synergistic effect " which can lead to arrhythmia also Ca2+ replace K+ from
myocardial cells & ↑ digitalis toxicity.

157- Patient on probencid therapy, you advice him not to take aspirin.

158-patient on Kanamycin antibiotic+ FeSO4 therapy can't hear due to

damage of 8th cranial nerve &effect on auditory nerve function.

159-Patient infected with infectious mononucleosis experience rash after

Ampicillin therapy.

160-Muscle rigidity is one of Parkinsonism's symptoms.

161-Sorbitan monostearate (w/o) is non ionic surfactant.

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162- This structure is steroid

Ethinyl Estradiol

163-This structure is prednisone:

164-Warfarin is active due to specific stereoisomer.

165-Pain of angina is due to ischemia of certain area in myocardium.

166-MAOI's is CI with Guanethidine.

167-Cimetidine (H2 Antagonist) dose is: 400-2000 mg

* Cimetidine is CI with Theophylline, Phenytoin, Warfarin, and
Carbamazepine.

168-Refractionmeter principle depends on difference in density between 2

substances.

169-Na+ Level (normal) in blood: 135-146 mmol/L

K+ Level (normal) in blood: 3.5-5.5 mmol/L

170-Folinic acid (Leucoverin) is antidote for Methotrexate.

171-Methotrexate is antineoplastic (folic acid analogue) & used in acute

leukemia.

172-Propranolol is used in combination with Hydralazine to control reflex

tachycardia induced by Hydralazine.

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173-Sulfamethoxazone+ Trimethoprim act in synergism because they block
sequential step in the same metabolic pathway.

174- Drug of choice in grand mal epilepsy is→ Na Valproate, while petit mal
is→ Ethosuximide & Status epileptics are → diazepam.

175-MAOI's SE is not tachycardia but it is SE OF TCA.

176-Pyrogens are bacterial byproducts which causes febrile reactions.

177-Na cromoglycate stabilizes mast cells thus used in asthma.

178-Furosemide, Bumetanide & Ethacrynic acid (Loop diuretics) → act by ↑

Na+ excretion.

179-In Rx Kaolin, Alum, Chalk →Astringent.

180-Quinine is CI with Digoxin as it ↑Digoxin plasma level "↓Digoxin

clearance".

181-Gentamycin is most active # Pseudomonas Aerigonosa & G-ve bacteria in

general.

182-Parathormon & 1, 25 dihydroxycholecalciferol (Vit D) affect the

absorption of Ca2+.

183- Griseofulvin is prepared in microcrystalline form to enhance its stability

& absorption.

184- 1% adrenaline "epinephrine" gives short rapid mydriasis but

chronically ↓IOP by ↑ aqueous outflow.

185-Gelatin is protein.

186-Thyrotoxicosis is caused by excessive thyroid excretion.

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187-Oral drug with weak PH will be more absorbed from stomach.

188-Dissolution rate affect absorption of oral drugs.

189-Spironolactone SE is gynecomastia.

190-Phenol & NH4Cl →acidic, But NaHCO3, Amphetamine &Acetazolamide

are basic.

191-Thiazides cause → (↓) glucose tolerance.

192-Aspirin should not be taken with Coumarin.

193- Aspirin→ (↓↓) platelet aggregation.

194-Ampicillin is stored in refrigerator at cold temp 2-8 0c But not freezed.

195-Insulin is stored at 2-8 0c.

196- Phenolphthalein & Castor oil are used as intestinal irritants (stimulant
laxatives).

197-Chloramphenicol SE is aplastic anaemia.

198--blocker is CI in asthmatic patients.

199-Azatidine (sedating antihistamine) SE is drowsiness.

200-Heart Failure+ Lignocaine cause ↑ Lignocaine level due to↓↓ hepatic

blood flow, thus clearance ↓ & dose is required to↓↓.
N.B

*Drugs excreted by glomerular filtration:

Ethambutol, aminoglycosides, Methotrexate, digoxin& procainamide.

*Drugs excreted by passive tubular secretions are: Aspirin &Amphetamine.

*Drugs excreted by active tubular secretions are: Penicillin.

*Probencid→ ↓active tubular secretion →↑ blood level.

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*Also quinine & quinidine → ↑digoxin→↑digoxin toxicity.

201-Cod Liver oil & fish oil contains vitamin A & Vit. D.

202-Suspension is not suitable for IV injection.

203-Penicillin allergic patients do not shift to Cephalosporins due to cross

allergy but shift to Erythromycin.

204-On long term use of sympathomimetic blocker, hypotension can occur.

205-Eutectic mixture= when mixing some drugs or chemicals with each other,
they melt "liquefy" at a temperature lower than each of their melting point.

206-Phenylbutazone has the longest t1/2 75- 100 hrs & cause Aplastic anemia
& blood dyscariasis; it also displaces other drugs from plasma protein.

207-Al (OH) 3 is CI with tetracycline.

208-Cetomacrogel "emulsion wax" → O/W emulsion.

Na lauryl SO4 + cetocteryl alc "anionic" →O/W
Cetrimide + Cetocteryl alc. "cationic" →O/W
Cetomacrogel 1000 + cetocteryl alc "non ionic"→O/W

209-Tricyclic antidepressant causes many SE like sedation & anticholinergic

SE.

210- Patients taking phenazopyridazine (Azo dye used as urinary analgesic)

should be advised that urine color will be changed.

211- In HTN we don't use Atropine.

212-Guanethidine, Methyldopa, Clonidine cause bradycardia but

Hydralazine causes reflex tachycardia.

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213-Preservatives in eye drops as bactericidal:
*benzalkonium chloride: 0.02%
*Chlorohexidine acetate: 0.01%

Eye dps sterilized either by autoclave (98-100oc for 30 min) or filtration

(0.22μm porosity).

214- Carbamazepine → self inducer of its own metabolism, on long term use.

215- Azathioprine (→metabolism→6-mercaptopurine) + Allopurinol →↑

level of both drugs metabolism.

216-Hypertensive crisis occurred by" tyramine +MAOI's" is treated by 

blocker "Phentolamine".

217-Patient using lithium carbonate advise him not to ↓ normal Na intake

"Not restrict salt in diet".

218-Lithium is CI with naturetics "diuretics".

219-Anionic surfactant (Na lauryl SO4) is compatible with Iscthamol.

220-Olive oil +Lime water→ Ca oleate "emulsifier"

221-Bioavailability= amount of drug available in blood "systemic

circulation".

222-Glucocorticoid function acts as intermediate in metabolism.

223-Metabolism of Drugs results in more polar compounds.

224-Prostaglandins gp related to fatty acids.

225-Diphenoxylate related to mepridine, it (+) opiate action in GIT→

constipation.

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226-*Sorbitan monostearate (non ionic) → W/O emulsion.
*Na lauryl SO4→ O/W emulsion.
*Dioctyl sodium sulphosuccinate→ O/W emulsion.

227-Prostaglandin synthesis ↓↓↓ by NSAIDs.

228-Benzyl peroxide gel should not come in contact with eye or mucous
membrane.

229-Initial plasma conc. After IV dose is affected by dose or clearance.

230-SE: * Atropine → dry mouth, blurred vision, constipation, &tachycardia

"it can cause initial bradycardia".
* Theophylline : N, V, tachycardia, tremor.

231- Ranitidine dose: 150 mg twice daily, it's H2-blocker→↓gastric acid

secretion.

232-Contraindications:*MAOI's CI with Guanethidine.

*Haloperidol CI with Guanethidine &  methyl dopa
*Theophylline is CI with Cimetidine.
*Metronidazole CI with alcohol.
*TCA is CI with Guanethidine.
*B-blocker CI with verapamil (Ca2+ Ch. Blocker).

233-Doses:*Aspirin in rheumatoid arthritis →6 gm

*HCTZ →12.5-200mg.
*Hydralazine →50-200mg.

234-Oxytocin is used to (+) uterine contraction.

235-Acetylcysteine is mucolytic.

236-Bromohexine "by depolarization of mucopolysaccarides"→↓viscosity of

bronchial secretion acts as mucolytic.

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237- 5-Carboxymethylcysteine is mucolytic & ↓mucous gland hyperplasia.

238-Stearyl alc, cetyl alc &cholesterol are stabilizers.

239- Do not take NaHCO3 with HTN as it ↑Na →↑blood pressure.

240-Needle with smallest diameter carries the largest gauge number

"pressure".

241-8.4% NaHCO3 in alc. Shock to neutralize lactic acid (acidosis).

242-Parathion &Malathion are Organophosphorous compounds which act as

irreversible anticholinestrases.

243-Thioridazine is phenothiazine derivative with the least extrapyramidal

SE because it is piperidine derivative.

244-Hydroxizine has the greatest antihistaminic action of the anxiolytic

agents.

245-Penicillamine is chelating agent & used in rheumatoid arthritis

(DMARDs).

246-Mestranol is estrogen not progestin.

247-Parasympathomimetics cause miosis &blurred vision.

248-Bundle of His is present in the heart.

249-Vit C is aromatic carboxylic acid , added to blood samples to prevent

coagulation.

250- Doses:* Carbamazepine: 0.2-1.2gm

*Aspirin:"antigout"> 5 gm, "antiplatelet" 50-325mg

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 *Methyl dopa: 0.5-2gm
*Colchicine: 500mg
*Salbutamol 2-4 mg (bid)
*Prednisone: 5-60 mg

251- Graves disease= form of hyperthyroidism.

252-Thyroid Storm = sudden onset of thyrotoxicosis.

253-Beer Lambert's law: relationship between light absorption by solute&

wave length.

254- Dose of chlorocresol is 0.05%.

255- Heparin is the anticoagulant of choice during pregnancy, ↓↓ conversion

of prothrombin to thrombin, taken IV for treatment & SC for prophylaxis.

256- Antidote for heparin is Protamine SO4.

257- HCTZ interacts with: digoxin "Hypokalemia" & Lithium "↓Na with
Li→ toxicity".

258-Hydroxychloroquine is antimalarial used in SLE & rheumatoid arthritis,

also it is CI with Favism "due to G-6-phosphdehydrogenase deficiency".

259- Digoxin absorption ↓↓ by Kaolin, neomycin & cholestyramine.

260-Erythromycin interacts with: * oral anticoagulant

*Carbamazepine "↓metabolism"→↑ toxicity.
*"digoxin"→↑ serum level"
* Theophylline →↑ serum level.

261- A drug with pka 6.2 this drug will be 50% ionized in the small intestine.

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262-The outer water proof layer of the skin is made up of Keratin.

263-Acne vulgaris is caused by bacterial inflammation "propionibacterium

acne.

264- Impetigo is contagious skin infection caused by staph. aureus.

265-Propranolol SE as: cold extremities.

266- Tobramycin & streptomycin resemble each other →"both are

aminoglycosides".

267- Suxamethonium is succinylcholine.

268- Respiratory depression is the cause of death in cocaine poisoning.

269-Ethyl stearate or ethyl palmitate is not surface active agent.

270-Nitroglycerin eases the pain of angina bec. it causes venous dilation (↑

venous capacitance pool of the blood).

271-prolonged use of spironolactone causes gynecomastia.

272-E. coli is most common M.O in uncomplicated urinary tract infection.

273-Patient taking -blocker should not take verapamil.

274- Vit E is called Tocopherol, antioxidant & found in Nuts.

275-Tetracycline is CI in pregnancy.

276- Hydrocortisone is not suitable for Rosacea.

277- Tetracyclines may cause hepatic & renal damage.

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278-Paracetamol has no anti- inflammatory effect.

279- To improve passive absorption of drug→↑↑ partition coefficient.

280-Thirst is controlled by hypothalamus.

281- Waste product of protein is urea.

282- Amiodarone causes ocular & sight problems.

283-Trimethoprim (-) folic acid synthesis "by competing with PABA".

284-Propylthiouracil is preferred over carbimazole in treating

hyperthyroidism because in addition to (-) of T3 & T4 synthesis,
propylthiouracil blocks peripheral conversion of T4 toT3.

285-Chlorpropramide (antidiabetic) is given once daily.

286- Sarcolema is found in striated muscle cells.

287-Axon is the part of the neuron that carries impulse away from! nerve cell.

288-The part of the ear which is responsible for balance is the Inner ear.

289- The main source of resistance to blood flow is arterioles.

291-Anticholinestrase act by virtue of structure similarity to Acetylcholine.

292- Metoprolol is  antagonist.

293- Excretion of muscle (muscle fatigue) is due to accumulation of lactic acid

294-Penicillins have similar M.O.A as Cephaloxin.

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295-CH3-(CH2)16-COOH is stearic acid.

296-We can monitor renal function by plasma creatinine.

297-Doubling the drug conc. In the blood "that follow 1st order kinetics" will
not affect the half life.

298-Benzalkonium Chloride "cationic germicidal surfactant is inactivated by:

Soap.

299-Upon exposure to air, aminophylline soln. may develop crystals of

Theophylline.

300- Reagent strips impregnated with glucose oxidase, peroxidase &

orthotoluidine are dipped in urine as a test for presence of glucose the Rx is→
glucose is oxidized to gluconic & H2O, in presence of peroxidase converts
orthotoluidine into blue substance.

301-Acetazolamide "carbonic anhydrase inhibitor" is rarely drug of choice

for diuretic therapy because it causes systemic acidosis & alkaline! urine.

302-Mineral oil is not miscible with alcohol.

303-Conformational isomerism "known as Rotamers or Conformers" are non

super imposable orientation of a molecule which results from the rotation of
atoms about single bonds.

304-Both described as optical enantiomers "have one asymmetric carbon"

they are non super imposable mirror images.

24
305-Diastomers have 2 or more asymmetric atoms, they are non super
imposable and are not mirror image.

308-Digoxin when given as a soft capsule, in comparison to tablet provides

greater bioavailability.

25
309-Common structure of sulfonamides:

310-Niclosamide is used in ttt of tape worm infection.

311- Methyl paraben is ester of p- hydroxybenzoic acid

312-this structure is dimethyl Sulphoxide (DMSO):

313-Soap is formed by reaction between inorganic base + organic acid.

314-Phenothiazines structure:

*antiemetic, antipsychotic, anticholinergic BUT not antimalarial.

315-Ethyl amino benzoic acid "Benzocaine":

*Local & topical anesthetic

*Benzoic acid derivative.

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*Rapidly hydrolyzed in boiling H2O
*insoluble in H2O BUT: soluble in mineral acids "as it reacts with HCl →
soluble salt.

316- Patient on Sucralfate "cytoprotective on peptic ulcer disease" should be

advised not to take the drug with food or antacid.

317-Terbutaline is 2 agonist "bronchodilator" in asthma (acute attack).

318-Cholinergic= neuron which transmit impulse by releasing acetylcholine.

319-Captopril is ACE inhibitor, Dose 25-50 mg, 3 times daily ,causes

hyperkalemia &dry cough.

320-Floxacillin syrup must be refrigerated "2-80C.

321-Insulin administration is SC.

322-Vd of drug will be greater for drug which is concentrated in tissues

rather than in plasma.

323-A specific drug with 1st order biological t1/2 of 4 hrs, this t1/2 value will be
independent on the initial concentration.

324-Corticosteroid therapy complications include: dissemination of local

infection, masking symptoms of infection & ↑ susceptibility to infecrion.

325-Mestranol is steroid structure "estrogen"

326- 2ry oxidation of alcohol gives ketone, while 1ry oxidation of alcohol gives
aldehyde.

27
327-SE of ketoconazole: GIT disturbances, headache, gynecomastia &
hepatotoxicity.

328-Fixed dose drug eliminated by 1st order kinetic, administered at regular

interval, the time required to achieve steady plasma conc. Depends on
elimination t1/2 of drug.

329- 1, 25- dihydroxycholecalciferol (Vit D) enhance Ca2+ absorption.

330-Antibodies against the nicotinic acetylcholine receptors on skeletal

muscle plasma membrane at NMJ act as competitive antagonist of Ach
binding → called Myasthenia gravis.

331-Naproxen structure: t1/2= 13hrs, taken once daily.

332-Caffeine & HCTZ have diuretic effect, but phenyl ephrine is not diuretic.

333-HCTZ can be given with propranolol to↓↓ edema.

334-Phenylephrine is not H1 antagonist (antihistaminic) but cyclizine,

diphenhydramine promethazine & Chlorpheniramine are antihistamines.

335-Injection of large amount of purified H2O in RBCs → swelling & burst.

336-Vit B12 is the drug of choice in pernicious anemia.

337-Structure of Warfarin:

338-Structure of succinic acid:

28
Structure of Hydrocortisone:

339- agonist in asthma act by (+) 2 receptor thus (+) adenylyl

cyclase→↑cAMP → bronchodilation.

340-Cephalosporins (↓↓) cell wall synthesis by (↓↓) of transpeptidase step

"like penicillin".

341-Major determinant of myocardial O2 consumption is Cardiac output.

342-Danazol is used in endometriosis.

343-Danazol is androgen which (-) gonadotropin release.

344-………….
345-Phenol is metabolized by glucuronidation & sulfonation.

346-Activity Of phenol (↑) by (↑) temperature.

347-If salicylic acid is added to chloroform, then HNO3 acid is added →

salicylic acid will precipitate in the lower layer.

348-More than 50% of H2O & Na+ reabsorbed from proximal tubule by
passive transport (about 60% is reabsorbed).

349-K+ reabsorption occurs in proximal tubule but K+ secretion occurs in the

distal tubule.

350-Glucose cannot be measured by using UV light.

29
351-UV light spectrum is 200-400nm (which most drugs show absorbance
within this range).

352-Nalidixic acid absorption ↓ by food or antacid.

353-Spironolactone SE →menstrual irregularities.

354-Theophylline is CI with Cimetidine as Cimetidine ↑Theophylline toxicity.

355-Monounsaturated organic acid → oleic acid {CH3(CH2)7 –

CH=CH(CH2)7COOH}

356-Polyunsaturated organic acid → linoleic acid.

357-Volatile oils are rich in terpentines.

358-Mineral oil is petroleum derivative "aliphatic hydrocarbon"& it is

immiscible with alcohol or castor oil.

359-Neutral compounds absorbed from lipid biological membrane depends

on partition coefficient.

360- Cystic fibrosis is hereditary not contagious, (it is widespread exocrine

dysfunction causing pulmonary & pancreatic disease)

361-Rate of creaming in emulsion depends on viscosity.

362-Tardive dyskinesia is irreversible SE of phenothiazines.

363-Penicillin should be administered on empty stomach.

364-Tetracycline gives different absorption & dissolution patterns because it

is amphoteric"form salt with acid or base &capable of forming internal salt"

365- 2parents do not have congenital disease, but their son got congenital
disease .This means that both parents have recessive gene.

366-Local anesthetic not administered topically is→ procaine.

30
367-Glycerin syrup does not change the pH of the medium.

368-MAOIs is psychotropic, antidepressant & psycoanaleptic, SE:

hallucination, tremor, hyperthermia or hyperpyrexia &anticholinergic SE
"dry mouth, constipation, failure of ejaculation…..etc".

369-Allopurinol is not taken with tea.

370-L-propoxyphene is antitussive; D- Propoxyphene is analgesic "not anti-

inflammatory".

371-Inflammation of synovial fluid or synovial membrane is called synovitis,

But inflammation of joint is called arthritis.

372-Arthritis is accompanied by inflammation in synovial fluid.

373-Loop diuretic & thiazide are CI in gout as they cause Hyperuricemia(as

most diuretics except spironolactone)

374-Structure of Ethacrynic acid:

375-Structure of Quinidine:

376-Prednisolone is more active than hydrocortisone because it differs in the

conformation at ring A.

377-Adsorption is a physical phenomenon.

378-Mechanism of action of agonist "adrenaline like" ↑ adenylyl cyclase→

↑cAMP→↑ Ca2+ entry to myocardial cells →↑ +ve inotropic action.

31
379-Long residence of CO2 in body →↑pCO2 "hypoventilation in serum"→
↓[HCO3]→Lactic acidosis, but ↓Pco2 "hyperventilation" →respiratory
alkalosis. LOOK at Q715.

380-Chloral hydrate, cephalosporins, sulphonylurea & Metronidazole →

↑↑Alcohol disulfiram like reaction.

381-Ionization constant of H2O at 250C is 1x10-14.

382-Stool softener frequently contain anionic SAA "Dioctyl Na

sulphosuccinate= Docusate Na"

383-Cholinergic crisis may occur in Myasthenia gravis.

384-Measles vaccination is given at age of one year old.

385- Tetanus vaccine should be given to a patient with superficial infected

"minor wound if the previous vaccination was taken from more than 10
years.

386-Warfarin is safe to be taken with Allopurinol.

387-Thiazides SE → hyperglycemia.

388-Tachycardia is uncommon effect which is unlikely to occur with

blocker.

389-Drug A has t1/2 24 hrs, if you give 2mg of it after 72 hrs, the conc will be
0.25mg.

390-Emulsion is liquid in liquid dispersion system.

391-phosphodine I2 (E.D) is stored at 2-80C.

32
392-Insulin zinc suspension has duration of action from 18-24hrs.

393-Minocin ®"minocycline" adverse effects are GIT disturbances "N, V, D"

& Vestibular toxicity "dizziness" (its main use is in oral ttt of acne vulgaris).

394- Al(OH)3 +Mg(OH)2 gel "antacid" is given hourly "dose every hr" in
duodenal ulcer.

395-Bioequivalent drugs= both products are pharmaceutical

equivalent & its rate &extent of systemic absorption do not show a
statistically significant difference when administered in the same dose of the
active ingredient in the same chemical form , in a similar dosage form, by the
same route of administration, & under the same condition.

396-Sterilization of contact lens→ soaking in a saline or preservative solution.

397-Nitrazepam has t1/2 25-35 hrs "produce long day time sedation which
should be avoided in elderly" to avoid falls &fractures due to accumulation of
nitrazepam sedative effect.

398-Tetracycline should not be taken in pregnancy.

399-Patient taking aspirin, advise him not to take probencid "or vice versa".

400- Biphosphonates,Ca2+,calcitonin,Vit D, Na Fluoride, progesterone,

androgens & calcitriol→ all these can be used in the management of
osteoporosis.

401-Polysorbates"Tweens" are used as detergents & solubilizing agents,

Sorbitan "Spans" are used as wetting agents (W/O emulsifying agent).

402- Blood volume =5-6 liters.

403-Adrenaline 1% eye drops produce 1-2 hrs duration of action.

33
404-Corticosteroid in asthma→ ↓release of mediators & ↓ immune reaction
or immune edema.

405-Rifampicin may cause orange coloring of contact lenses (damage soft

contact lenses).

406-Ketoconazole should not be taken with antacids, H2 blockers, proton

pump inhibitors, cisapride, amphotercin B or food, But with astemizole &
terfinadine → life threatening arrhythmia (prolong QT).

407-Vit E is insoluble thus it is better formulated as emulsion in heavy

mineral oil.

408-Lidocaine or Lignocaine are not taken orally as it has substantial 1st pass
metabolism.

409-Phenytoin & Theophylline have narrow therapeutic index.

410-TCA can cause sedation, anticholinergic SE & CI in glaucoma.

411- TCA & corticosteroids can cause HTN "hypertension" but not
Cimetidine.

412-Belladonna alkaloids (Atropine) are not recommended in glaucoma.

413-Buffer solution is used to resist pH changes.

414-Phenyl group in phenyl mercuric nitrate leads to less solubility than

other inorganic salts.

415- -blockers used in glaucoma:

Timolol, levobunolol, Carteolol, metapranolol, Betaxolol.

416-Al (OH)3 is abrasive, removes comedone.

34
417-SE of Clindamycin: diarrhea.

418-Rifampicin colourifies the urine red (orange red).

419-Digoxin toxicity →↑ with Cimetidine.

420-Drug its oral dose show bioavailability of 20 % of its IV dose thus in

terms of bioavailability it is poorly absorbed from the stomach.

421-In pancreatic disease→ lipase & trypsin ↑↑.

422-Rx Verapamil
Propranolol
Captopril
Slow K you expect that the patient has bradycardia.

423-Theophylline + Ethylene diamine produce Aminophylline.

424-Ergot alkaloid in (+) of uterine contraction also oxytocin & ergometrine.

425-- lactam ring is found in amoxicillin.

426-Agranulocytosis (↓ in polymorphonuclear leukocytes) caused by as a

result of Bone marrow depression.

427-Generic = drug having same ingredient as the brand or original drug.

428- Nystatin is used for treatment of Candida.

429- Patient taking Theophylline, when he stops smoking the serum level of
Theophylline ↑↑ (as smoking (+) metabolism of Theophylline).

430-Reduction of particle size does not show difference of X-ray.

35
431-Polymorphs affect the solubility of the drug.

432-If pH increases (alkaline)→ excretion of acids increases (eg salicylic acid).

433-Gentamycin is bactericidal used for pseudomonas aeruginosa infection.

434-Clonidine has no significant effect as prophylactic in ttt of migraine but

propranolol may.

435-Isotonic solution is isoosmotic with blood "has the same osmotic pressure
of blood".

436-Phenytoin dose 50-400 mg "max" & chloral hydrate is 0.5-2gm.

437-TCA is avoided with adrenergic blocker "terazocin, prazocin,

doxazocin" as both ↑ hypotension due to -adrenergic blockade.

438-*Naluphine & buprenophine are mixed agonist-antagonist.

*Naltrexone, naloxone & nalmefene are pure antagonists
*butorphanol & levallorphan are morphinan derived antagonists

439-Structure of mepridine:

440-Structure of Methicillin:

441-Structure of sulphonamides:

36
442-Structure of sulfonylurea:

443-Structure of dimethyl Sulphoxide (DMSO):

446-Niclosamide is used for Tapeworm infection.

447-Benzylpenicillin is used in the treatment of pneumonia.

448-Sulphonamides are metabolized in humans by Acetylation.

449-Amoxycillin is more absorbable than Ampicillin because it has Para

hydroxyl gp (OH).

37
450-Oxidation of 2ry alcohol → ketone.

451-Cocaine overdose→ Respiratory failure.

452-Lactic acid "optically active"→oxidation→ pyruvic acid

"isomer/optically inactive".

453-100 ml distilled H2O is injected IV what will happen to RBCs? →

Swelling & rupture occurs.

454-↓↓ of GABA level occurs in Huntington's chorea.

455-Diflunisal is not metabolized to Salicylate in body.

456-Quinine is optical isomer of Quinidine.

457- Overdose of paracetamol is treated by glutathione and/or N-acetyl

cysteine.

458-Cyproheptadine is NOT used in ttt of Epilepsy.

459-Alprostadil "prostaglandin, PGE analog" is used for temporary

maintenance of a patent ductus arteriosus in a waiting corrective surgery for
congenital heart defect & in treating impotence due to erectile dysfunction.

460-Nystatin, Amphotercin B are used in treatment of fungal infection eg

Aspragellus by Nystatin not ampho. B, but Candida albicans by both.

461-I2 in high doses only ↓ Iodide uptake by thyroid gland but carbimazole,
propylthiouracil & estrogen do not ↓ Iodide uptake by the thyroid.

462-Psoriasis is treated by Methotrexate & is characterized by shiny scales,

also calcipotriol is used in the topical ttt of psoriasis, salicylic acid is used as
keratolytic, also coal tar is used in ttt of psoriasis.

463- Allopurinol is not uricosuric agent.

38
464-Tricyclic antidepressant does not cause salivation, as it has
anticholinergic SE.

465-Plasma % of blood = 55%, it is about 5% of total body weight & =

3500ml of total body volume.

466-Heparin mode of action: (-) conversion of fibrinogen to fibrin & catalyzes

the (-) thrombin by antithrombin III (HEPARIN COFACTOR).

467-ACE inhibitor mode of action: blocking the conversion of angiotensin I to

the potent vasoconstrictor angiotensin II, the reduced angiotensin II →
↓Aldosterone conc. →↓Na retention.

468-Glucocorticoid used in inflammation as it ↓ synthesis of prostaglandin.

469- Corticotrophin secretion is stimulated by corticotrophin releasing

hormone "from the anterior pituitary" from the hypothalamus.

470-Phenylephrine is not diuretic but caffeine "methyl xanthines" has

diuretic effect.

471-Damage of the posterior pituitary gland cause ↓↓ in the level (or (-)
release) of vasopressin & oxytocin.

472-Ferrous salts are the form (of iron) which is absorbed while ferric salts &
elemental iron are not absorbed well.

473-Clonidine is not drug of choice in chronic treatment of HTN (SE:

sedation).

474--methyldopa mode of action is ↑ presynaptic 2-inhibitory response →

↓sympathetic output & ↓ peripheral resistance.

475-Vit D is not decomposed by sunlight.

476-↑↑Level of thyroid hormone (as in hyperthyroidism) signals the pituitary
to stop releasing TSH (-ve feedback).

39
477-Structure of Cimetidine (Tagamat):

478-Estrogen is secreted from ovarian follicle.

479-In hyperkalemia, don't use spironolactone.

480-Tolbutamide & phenphormin both (↓) plasma glucagon level & are used
in ttt of NIDDM.

481-Cartilage may change to bone in Ossification.

482-Urea is the waste product of protein (outcome of protein metabolism).

483-Sudden death in MI is due to ventricular fibrillation.

484- M.O.A of Nitroglycerin: directly relaxes vascular smooth muscle (by

N.O) = nitric oxide.

485- Impetigo prognosis:

Impetigo is a superficial vesiculopustular skin infection caused by staph
aureus.
Prognosis untreated→ cellulitis, lymphangitis or furunculosis. BUT not cause
endocarditis.
If treated→ prompt recovery.

486-Shingles= Herpes Zoster: is infection with varicella- Zoster virus

primarily involving the dorsal root ganglia & characterized by vesicular
eruption & neuralgic pain in the dermatome of the affected root ganglia.

487- Dose of Sildenafil (Viagra®) is 100 mg

40
(50-100 mg).
Mode of Action: (+) NO effect on vascular smooth muscle→ ↑blood flow to
penis → ↑ erection (upon sexual arousal) through (-) phosphodiestrase type 5)
C.I with nitrates S.E: Headache Use: Erectile dysfunction.

488- Racemic mixture is optically inactive (which contains equal amount of D

& L stereoisomers).

489- Dose of Erythromycin base = 0.25-0.5 g every 6 hrs

490- Clarithromycin is active against Mycoplasma, Chlamydia & Legionella

(organisms).

491- Structure of Amoxacillin:

492-Structure of Phenobarbitone or Phenobarbital:

493- SAA is added to tablets to act as binder & adhesive (e.g. gelatin, Acacia)
& improve dissolution & bioavailability.

494- Dose of Thyroid preparation in Adult after Surgical removal of thyroid

gland is 1.6 g/ kg/day.

495- CaCO3 is given to patient with terminal renal failure to ↑ Ca2+ in serum
& correct hypocalcaemia.

496-

41
497- Atenolol is the least lipid soluble B-blocker.

498- Lithium is used in Bipolar Affective disorder.

499- Constipation due to morphine agonist is treated by :

a) Increasing fiber content in diet.
b) Stool softener (Docusate Na 100 mg Bid or tid)
c) Stimulant laxative (Senna)
*If constipation persist use Osmotic laxative (Magnesium citrate or
Lactulose)

500- The diagnostic element in blood for AIDS patient is detecting antibody to
HIV (ELISA assay).

501- Glucose is not detected by (UV method)

502- Chlorohexidine is compatible with cetrimide

503- KOH+ organic acid→ soap

504- Na Valproate can be used to treat both grand mal and petit mal epilepsy.

505- Cystic fibrosis is an inherited" autosomal recessive" disease of the

exocrine glands primarily affecting the GI, respiratory system and usually
characterized by COPD, exocrine pancreatic insufficiency and abnormally
high sweat electrolytes. Pseudomonas infection is the dominant infection.
Treatment:
1-Pancreatic enzyme replacement
2-Diet therapy
3-Oral corticosteroid
4-Ibuprofen

42
5-Antibiotics "e.g. ciprofloxacin"

506-Addison disease is due to adrenocortical insufficiency.

507- Cholecalciferol "Vit D3" is secosteroid produced in the skin from

7-dehydrocholestrol by UV radiation, its main function is to increase calcium
absorption from intestine, increase bone formation and mineralization.

508- Thyroid hormone is responsible for:

a-protein synthesis
b-increase activity of Na, K ATPase pump to increase oxygen consumption.
c- increase secretion of growth hormone

509- Zollinger Ellison syndrome characterized by marked by

hypergastrinemia, gastric hypersecretion and peptic ulceration caused by
gastrin producing tumor of the pancreas or duodenal wall.

510- Structure of Zwitter ion" of amino acids" »»» R-CH-COO-

NH3+

511- Microcytic anemia:

is measured by MCV "Mean Corpuscular Hb" < 80 fl
but normal range 90 ± 10fl.

512- Patient taking phenytoin experience ataxia, what to do??

Decrease dose of phenytoin.

513-Ileum is the last part of the small intestine.

514- Insulin lent act for 24 hr.

515- Highest calories per gram given by fat.

1g of protein=4 Kcal.
1g of carbohydrate=4 kcal.
1g of fat=9 kcal.

43
516-Discarded Chloramphenicol loses potency.

517- Septrin mode of action: (-) purine and DNA synthesis.

PABA Dihydrofolic acid THF purines DNA.

518- Androgens "nandrolone" are used for both decreased growth and
osteoporosis.

519-Erythromycin does not affect bioavailability of ketoconazole.

520-Furosemide causes metabolic alkalosis "systemic alkalosis"

Acetazolamide systemic acidosis + urinary alkalosis
ascorbic acid  urinary acidosis.

521- Amiodarone causes:

a-pulmonary fibrosis
b-yellow deposits on cornea
c-skin deposits and change in color
d-CNS effects
e-Thyroid dysfunction " hypo and hyper"
f- Photosensitivity

522- when giving furosemide dose  check renal function and current
dose furosemide " as t1/2 is dependent on renal clearance".

523-Rifampin cause harmless orange color in urine.

524- Contact lens is sterilized by heating with saline for 5 min.

525- Warfarin mode of action is interference with Vit K dependent hepatic

synthesis of the active clotting factors II, VII, IX, X and the anticoagulant
protein C & S, these agents prolong clotting time in vivo only.

526- Warfarin has optical isomers (Racemic Mixture).

527- Streptokinase:
*dose 1.5 million IV infused over 60 min

44
*not given within 6 months from the previous administration due to allergic
reaction "Ab-Ag reaction)

528-Chloramphenicol mode of action: (-) bacterial protein synthesis

[(-) peptidyl transferase step].

S.E:*GIT disturbance *BM depression *Aplastic anemia *Gray baby

syndrome.

529- Boric acid is not used in the topical skin preparation for infants
because it cause boiled lobster rash

530- structure of cisplatin:

531- (++) of Vagus nerve  bradycardia.

532- patient taking Loperamide advise him that it is not used for
infectious diarrhea as it cause stasis of M.O.

533- Amphoteric drugs don't change pH.

534- Dihydroergotamine is not taken sublingually but ergotamine tartarate

is taken sublingually.

535-Clonidine S.E:*Dry mouth, sedation, withdrawal life threatening

hypertensive crisis " tachycardia, headache, sweating" but not cause nasal
stiffness.

536-Tophus is characteristic of Gout.

537- We mix 20% rose oil with cream on glass plate by slow agitation.

45
538- benzodiazepines+ drug (LME inducer) to overcome the problem add
Cimetidine “LME inhibitor”.

539- Methyldopa passes B.B.B

540- Sulphonamides are contraindicated in infants because it displaces

bilirubin from plasma protein causing Kernicterus.

541- Anaphylaxis has manifestations: (treated by epinephrine).

*agitation, coughing, sneezing, urticaria, edema, difficult breathing, and
bronchospasm.
* Shock, CVS collapse.

542- Some drugs show irrelevance between of activity and plasma conc.
Because they are quickly metabolized.

543 Mode of action of aspirin as antiplatelet is irreversible

acetylation of cyclo-oxygenase enzyme causing decrease of thromboxane A2
synthesis - decrease platelet aggregation, dose 75-325 mg/day “for 1ry
prophylaxis from MI”.

544- Piroxicam has long t ½ taken once daily.

545-acetaminophen is given for chronic pain in the elderly patient.

546- Diet with fibers  decrease constipation -diarrhea.
547- Drugs causing gynecomastia: Cimetidine , digoxin, Isoniazide,
methyl dopa, estrogen, spironolactone, and testosterone.

548- The receptor for cough suppression effect of codeine in the CNS “in the
brain stem” in medulla oblongata.

549- COX II inhibitor”celecoxib” can be used as NSAID in patient with

peptic ulcer (which is not active).
N.B [Rofecoxib “vioxx” is withdrawn from market due to its relation with MI
occurrence”.

46
550-Captopril and all ACEIs are contraindicated in:
a) renal artery stenosis,
b) pregnancy.

551- Echothiophate iodide is cholinesterase inhibitor “indirect acting

miotics", increase aqueous humor outflow & cause accommodation thus used
in glaucoma treatment.

552- Tetanus vaccine should be given as booster dose, 10 years.

553- Management of acute asthma attack:

a- O2 therapy
b-bronchodilators”B2 agonist” or IV aminophylline.
c- Systemic corticosteroids “1st oral if no response”
d- epinephrine SC.
thus we can say that IV aminophylline is taken in acute asthma.

554- after taking inhaler in asthma, the case may worsen due to:
a-improper way to use
b-down regulation of receptor” causing tachyphlaxis”
c-case become progressed.

555- Sucralfate should not be taken with food or antacid.

556- Ciprofloxacin + Theophylline - increase toxicity of Theophylline
thus we need to decrease dose of Theophylline.

557- Agents used to coat enteric coated tablets are shellac, cellulose
acetate phethalate.

558- Which is optically active?

Levofloxacin, Carvedilol, are optically active and ephedrine also.

559- KCL is given in enteric coated tablets to protect gastric mucosa” to

prevent irritation of gastric mucosa”
a-to prevent destruction of the drug by gastric juice.
b-to prevent irritation of the stomach lining by drug.
c- To allow absorption of drug in the intestine not in the stomach.

47
560- Cromolyn Na is used for prophylaxis of asthma.

561- Sterile water for injection is prepared by distillation then autoclaving.

562- Vit B1Thiamine,

B2Riboflavin,
B3 Niacin,
B6pyridoxine,
B12Cyanocobalamine.

563- pKa= negative log of ionization constant” indicates the relative strength
of acid or base”.

564- Creatinine clearance is used to assess the renal function,

normal value 75-120 ml/min.

565 Zinc helps in wound healing.

567- Anticoagulants, NSAIDS, ASA (acetylsalicylic acid) are

contraindicated in peptic ulcer.
568- Glucose and fructose are monosaccharide.

569- B Lactams are metabolized by hydrolysis.

570- Hepatotoxicity of INH is due to its conversion by phase II is due to

its conversion by phase II reaction into more toxic metabolite.

571-Distal tubule is sensitive to thiazide derivatives, and spironolactone

act on the late distal convoluted tubule.

572-patient on digoxin should not take laxative to prevent hypokalemia

which increase digitalis toxicity.

573- Weak base drug is easily excreted by NH4 salts "Acidifying agents".

574- Number of RBCs in blood of healthy person= 5 x 106l.

48
575- 50% of glomerular filtration returns back to blood from distal tubule.

576- 180 liter of fluid is filtered in glomerular filtration.

577- Conjugation with bilirubin occurs in liver.

578- Dose of Aspirin in rheumatoid arthritis is 3-6 gm

579- Drug dose 4mg, t ½ is 1.6, when does it reach 1 gm??

4 after 1.6 hr 2 1.6 hr 1

after 3.2 hr.

580- One of the critical drug interactions is:

*Cimetidine with warfarin
* Cimetidine with Theophylline.

581- *Metabolism of:

methyl alcohol ---oxidation----> formaldehyde ----[O]---> formic acid.
*Metabolism of:
ethyl alcohol -----oxidation----> acetaldehyde ----[O]---------> acetic acid.

582- We use simple ointment with hydrocortisone.

583-Methadone is morphine agonist not narcotic antagonist.

584- Urine retention is least likely to occur in diabetic patient???

585- Majority of HTN is essential hypertension.

586- Carbenoxolone “derivative of glycerhyzic acid, extracted from

liqourice” used in treatment of gastric and duodenal ulcer, S.E aldosterone
like effect→ HTN, Fluid retention.

587- Not used to treat HTN caused by Na and H2O retention is

Guanethidine or Minoxidil.

49
588- Miosis= contraction of eye pupil.

589- Dextromethorphan is 1st choice cough suppressant.

590- Hydralazine cause nasal congestion.

591- Reserpine cause nasal stuffiness.

592- Destruction or removal of posterior pituitary cause

deficiency of ADH” vasopressin and oxytocin”.

593-Structure of Neostigmine:

594 Example of MAOI is Tranylcypromine, phenelzine, Moclobemide.

595- Deterioration of this structure:

occurs by oxidation of aldehydic group to carboxylic”

596- Sulphonamides are antimicrobial “AB” but are not antiviral.

597- Inotropic action of B-stimulant of cardiac muscle is by

increasing Calcium influx entry to the myocardial cell.

598- Neuron structure: Myelinated fatty acid structured sheath around

nerve.

599-Agranulocytosis is accompanied with necrotic lesions of

mouth and throat.

50
Agranulocytosis=Leukemia=neutropenia.

600- Eye drops are sterilized by filtration with porosity 0.2 um diameter.

601- Paraldehyde is acetaldehyde polymer, its

structure

602-stratum corneum is outer layer of skin.

603-Griesovalvin and phenothiazine cause photosensitivity.

604- Inflammation of synovial fluid and membrane found in

rheumatoid arthritis.

605- Moniliasis or candidiasis “yeast infection of skin” caused by overuse

of: *cortisone *antibacterial *immunosuppressive therapy *pregnancy
*Diabetes

606- Nystatin treats Moniliasis “Candida Albicans”

607- Erythromycin structure is macrocyclic lactone ring attached to sugar

moiety.

608-all are hormones and mediators except cAMP:

( Adrenaline- Insulin- Serotonin-CAMP).

609-Carbachol is cholinergic agonist drug, Probucol is antihyperlipidemic

drug.
610-phenotthiazine not used in epilepsy.

611- Ranitidine preferred than Cimetidine because Cimetidine is hepatic

microsomal inhibitor and there are many drug interaction with Cimetidine.

51
612- Myasthenia gravis is autonomic disease of parasympathetic system.

613- d-propoxyphene has (½) analgesic activity of codeine.

614- Sulpha drugs are not liable to decompose by heat.

615- 1st choice in acute gout attacks is Colchicine or
NSAID`Indomethacin`

616- Cystic Fibrosis is inherited disease not contagious.

617- Thiazides are used to relieve Na & H20 retention “edema”

618- Adrenaline mechanism in glycogenolysis lead to increased glucose

release into the circulation “through its effect on B-receptor”.

619-Nalidixic acid S.E is visual disturbance.

620-Aminocaproic acid is antifibrinolytic agent.

621- The complex formed between BAL “Dimercaprol” which is

sparingly soluble in H20 and heavy metals from stable nontoxic, soluble in
H2O compound which is extracted through kidney.

622- Linoleic CH3 (CH2) 4CH=CHCH 2CH= CH (CH2)7COOH is

polyunsaturated fatty acid.

623- Optical activity is due to asymmetric C atoms.

624- Additional instruction for penicillin preparation “except

Amoxacillin)  take 2 hr before food and preferred to be taken on empty
stomach.

625- Adrenaline is used with local anesthetic to:

prolong its action “by vasoconstriction”

626- Combined pills (estrogen + progesterone) act by:

a- (-) implantation
b-fasten transfer of fertilized ovum c-produce

52
 hostile cervical mucus (increase viscosity). d- (-)
ovulation

627- NaCl (neutral) does not change pH of the medium.

628- Sulfa methoxypyridine is long acting as it is highly bound to plasma

proteins.

629- Diuretics which are used safely in sulpha or sulphonamide

allergic patients are:
*Ethacrynic acid
*spironolactone

630- CN “cyanide toxicity” is due to its binding to Cytochrome oxidase

enzyme or complexing of Cytochrome iron.

631-cetomacrogol “non ionic SAA” is incompatible with tannic acid, NH4

salts & phenol.

632- Erythromycin is contraindicated with Theophylline as it decrease

hepatic metabolism of Theophylline.

633- Phenytoin drug interaction:

a- Decrease b- Increase c-drugs impaired by

phenytoin level by phenytoin level by phenytoin
increasing decreasing
metabolism. metabolism.

53
Antiepileptic drugs: Disulfiram 1-Cortiocosteroids
1-carbamazpine 1-INH 2-Digitalsi
2-Valproic acid 2-Chloramphenicol 3-doxycyline
3-Clonazepam 3-Propoxyphene 4-estrogen
4-Phenobarbitol 4-coumarin 5-furosemide
5-Warfarin 6-contraceptives
7-oral anticoagulant
8-gaunedine
9-Rifampin
10-Theophylline
11-Vit D
12-Enteral Nutrition

634- Chlorohexidine “disinfectant” is cationic thus to prepare O/W

emulsion we can use cetrimide “which is also cationic” because it is
compatible with Chlorhexidine.

635- Polypropylene syringes can withstand autoclaving while other

plastics used for syringe are gas sterilized.

636-Solvent used with hydrocortisone (I.V injection) is:

propylene glycol.

637-Phenobarbitione Na+ Chloramphenicol→ ppt of barbituric acid.

638-Atropine is soluble in acids, forming atropine SO4.

639-Plasma volume=55 ml/Kg body wt.

640- alpha methyl dopa + HCTZ “diuretic” is used to decrease edema” fluid
accumulation” caused by alpha methyl dopa.

641-life threatening interaction:

*Haloperidol + amiodarone → increase ventricular arrhythmia
another common interaction:
*Haloperidol+ alpha methyl dopa → increase hypotension, EPS

642- Tranexamic acid and Aminocaproic acid antifibrinolytic

used in overdose of streptokinase and altepase which are fibrinolytic agents.

643- Loop diuretic mode of action “act at the ascending loop of Henle
decrease the co-transport of Na, K, Cl from the luminal filtrate → increase

54
excretion of H20, Na, K, Ca, Cl, decrease uric acid secretion and cause no
change in urinary pH.

644- Radial Walker test used to estimate disinfectant activity.

645- Antihelmentic of Choice:

#Tapeworm--Niclosamide
#ThreadwormThiobendazole
#Pinworm & Roundworm-Pyrantel Pamoate
#Whipworm & Hookworm-Mebendazole.

646- Uses of Vit D are in: Rickets and Osteomalacia.

647- Sulphonylureas mode of action: stimulate B cells of pancreas to

release insulin. S.E: Hypoglycemia

648-Chloropromazine I.M gives better bioavailability

649- Causes of Osteoporosis:

a- long term use of steroids
b- hyperparathyroidism
c-postmenopausal due to decrease in estrogen level

650- Emulsifier used with salicylic acid preparation is wool alcohol.

651- On long term use of sympathomimetics-HTN can occur.

e.g. Nasal decongestant “phenyl propanolamine”

652- Guanethidine cause diarrhea because the parasympathetic tone

predominant as Guanethidine blocks the sympathetic outflow.

653- Safest sulfa to allergic patient is Sulfamethizole (t ½ is short & 90%

is protein bound)

654- Tobramycin is not used with TB.

655- Procainamide is metabolized to N-acetyl procainamide.

656- Chlorthalidone is the longest acting diuretic of t ½= 40-65hr, dose=2.5-
50mg or up to 100mg.
657- Metabolic acidosis is due to [HC03] loss.

55
658- Most potent respiratory stimulant is: increase Pco2 in blood
“respiratory acidosis”.
659- Oligurea=low urine excretion.

660- Vasomotor and respiratory centers are located in medulla.

661- The sympathetic ganglia located near the spinal cord.

662- Haemoglobin quantity in 100 ml blood= 15gm.

663- Function of Vagus is: regulation of heart rate.

664- Pacemaker of the heart is SA node which is located in the right
atrium.

665- Cirrhosis = progressive fibrosis and scarring of the liver.

666- Xerostomia=dryness of the mouth

667- Bilirubin is end product of haemoglobin decomposition

668- The human cells has 46 chromosomes while gonade cells has 23
chromosomes either 22+X or 22+y “sperm and ova”

669- Blood makes 1/15 of body wt.

670- Sulfasalazine is :
* poorly absorbed from GIT.
*used in treating ulcerative colitis and regional enteritis

671- Chenodiol is used to dissolve cholesterol gall bladder stones.

672- Cyclosporine is immunosuppressant.

673- Emergency case patient with hypotension, shock, the 1st choice
therapy is dopamine because it has:
a- +ve inotropic effect on the heart(B agonist action
b- release norepinephrine from its stores ( increase B.P)
c- + dopamine receptors within kidney increase renal blood flow
infusion is interrupted to decrease tachycardia as dopamine has very short t
½.

674- A good antacid should raise pH from normal value of 1-2 to pH of 3.5.

56
675- Gentamycin enhances SE” Ototoxicity” of Ethacrynic acid and also
aminoglycosides “Gentamycin” increase nephrotoxicity of loop diuretic.
*Aminoglycosides “streptomycin "enhance nephrotoxicity of Cephalothin,
cisplatin, Amphotericin b and methoxyflurane.

676- Lymph gland principal function is filter out solids by phagocytosis.

677- Phenol, menthol and camphor if mixed together will melt and give
eutectic mixture.

678 strong analgesic pain killer→ pentazocine.

679- Normal blood glucose level:

*fasting <110 mg/dl or <6.1 mmol/l
*random 70-126 mg/dl or 3.6-6.9 mmol/l
680-Nalorphine is partial agonist antagonist “narcotic” can cause ppt of
withdrawal symptoms.

681- If t ½ decreases to half and dose doubled, what will happen?

Nothing will happen “to the t ½.”

682- W/O emulsion prepared by using W/O emulsifier.

683- In zero order kinetics the rate is independent on drug conc.

684- Cyanide poisoning cannot be treated with milk or ipecac, but

hospitalization or using cyanide antidote kit which includes:
a- Amyl nitrite + Na nitrite. b- Na thiosulphate. c- oxygen
d-NaHCO3”for acidosis” e-if no response→ hyperbaric O2.

685- Disintegration of tablets ensures that the drug is available for dissolution
and absorption from GIT.
686- Na benzoate is used as preservative and is used in different pH this is
because of high wide ionization effect “it is effective only at pH5 or less”
687- Dusting powder is sterilized by dry heat at 120 Celsius for 60 min ”dry
heat sterilization”

688- The base used with hydrocortisone is simple ointment or “soft paraffin”
689- Polyvinylchloride (PVC) → type of plastic can be sterilized by
autoclaving.

690- The type of base used affects the local application of ointment.

57
691- Drugs sterilized by heating at 115 0C are: Lignocaine, adrenaline,
digoxin and atropine.

692- pH= pka occur at half neutralization point.

693- Another name for EtOH= ethanol.

694- Person susceptible to atherosclerosis, which of the following is

unlikely to be dangerous?? Rheumatoid arthritis.

695- Ethanol or acetaminophen or tetracycline or penicillin→ should

be given on empty stomach as their Bioavailability is delayed or reduced by
food.
696- Drug following 1st order kinetics, if conc. doubled Bioavailability
will increase too much.

697-Atropine toxicitytachycardia, dry mouth, mydriasis, hot flushed skin,

agitation and delirium.

698- Senna is not used in pregnancy “as Senna is stimulant laxative”

699- Estrogens:
*Natural  Estradiol, Estrone, and Estriol.
*SyntheticSteroidal: Ethinyl estradiol, Mestranal,Quiestrol.
 Non steroidal: diethylstilbestrol, chlorotrianisene.
Progesterones:
- Hydroxyprogesterone- Medroxyprogesterone- Megestrol – Norethindrone-
Desogestrel L-Norgestrel

700- INH + Rifampicin + Ethambutol drug of choice in TB.

701- INH mode of action: inhibit synthesis of mycolic acids which are
essential component of mycobacterial cell wall.

702- Rifampicin is used in prophylaxis of meningococcal carrier

703- Probencid may increase blood levels of Rifampin.

704- Ethambutol SE optic neuritis

705- PAS” Para amino salicylic acid” has the same metabolic pathway as
folate so coadminstration  decrease blood levels of folate

58
706- P-amino salicylic acid:
effective orally, its SE: ulceration and blood dyscariasis
707- Drug of choice in leprosy is Dapson and other sulfones,
SE: methemoglobinemia and hemolytic anemia.

708- Benzathine penicillin is not used in gonorrhea because of the

emergence of penicillin resistant gonorrhea causing bacteria.
709- Serotonin is considered mediator in the CNS

710- Dimercaprol “BAL: is an antidote for arsenic and all heavy metals
[ Lead, mercury, gold]

711- 6-thioguanine decrease too much guanine synthesis, it decreases

nucleotides----> cytotoxicity.

712- Major side effect of alkylating agents:

*Bone marrow depression
*nausea and vomiting
*Alopecia.

713- Dactinomycin is cytotoxic antibiotic

714- Breast carcinoma treated by:
a-Tamoxifen “estrogen receptor antagonist” in Er+ cancer in all women
b- Anastrozole and Letrozole “Aromatase inhibitor” Er +ve for
postmenopausal women.
C-Aminoglutethimide"aromatase inhibitor”

715- Is the accurate form of question no 379

- a- metabolic acidosis)
a condition of low arterial pH, reduced plasma HCO3 concentration and
usually compensatory alveolar hyperventilation resulting in decreased PCO2
Ex: Lactic acidosis, Acetazolamide therapy.
B-Metabolic alkalosis:
a condition of increased arterial pH, increased plasma HC03 concentration
and usually compensatory alveolar hypoventilation resulting in increased
PC02
ex: vomiting and Thiazides, loop diuretics
c- Respiratory acidosis:
a condition of low arterial pH, hypoventilation ----> increased PC02 and
usually compensatory increase in HC03 concentration.

59
d-Respiratory alkalosis:
a condition of increased arterial pH, hyperventilation ---->decreased PC02
and usually compensatory decreased plasma HC03 concentration.
716- Typhus is characteristic of Rickettsial disease
a-epidemic typhus.
b-murine”endemic”typhus
c-rocky mountain spotted fever.
717- When a solution of soda lime is exposed to air C02 will react
with it forming CaCO3 and ppt. occurs.

718- Patient having depression and taking warfarin and thyroxin and
antidepressant which will change the thyroid function?
Both: a-lithium b-amiodarone.

719- Sterilization of soft contact lenses boiling with saline for 30 min.
720- *toxoid and vaccine active immunity*antisera, antitoxin-
passive immunity.
721- Glyceryl trinitrate:
a-advise the patient to take it in sitting position to avoid the first hypotension
effect
b-absorbed from skin, mucosal or buccal membrane.
c- taken sublingual
d- venous dilation “increase venous capacitance”

722- Grand mal epilepsy= generalized tonic clonic seizures

Petit mal epilepsy= absence seizures

723- Tolnaftate cream is a topical ttt for athlete's foot tinea pedis.

724- Patient receiving phenytoin may develop morbiliform rash which is

measles like.

725- Nonoxynol is SAA with spermicidal action “contraceptive”.

726- Patient on Carbidopa and Levodopa complain of dark wine urine

discoloration “of Levodopa metabolite”
727- Amyl nitrate is the only antianginal taken by inhalation.
728-Regular insulin is the only insulin taken by IV.

729- Ascorbic acid is prescribed with Methenamine to produce acidic

urine which facilitates its conversion to formaldehyde “active ingredient”
730- Propranolol, Oxyphenbutazone, Nortriptyline, Reserpine exhibit

60
hepatic 1st pass effect but aspirin and phenytoin not.
731- Rate of metabolism or elimination of drug which follows zero order
kinetic is constant.

732- Allopurinol doesn’t bind to plasma protein.

733- Endorphins and enkephalines are classified as peptides.
734- Conjugation of salicylic acid is with * glycine *glucouronic acid

735- Indomethacin causes frontal headache.

736- Benzyl penicillin, streptomycin and Nystatin are thermolabile.

737- Small pox vaccine must be given at 0C “must be frozen”

738- Tropicamide causes mydriasis for 3-4 hrs

Atropine cause mydriasis for 7 days while Cyclopentolate cause mydriasis
for 1 day.
739- Action of ADH “vasopressin” -increase tubular permeability and
increase water reabsorption.

740- Dextrose is added to blood to reduce hemolysis “hypertonicity”

741- Microorganism is resistant to chloramphenicol Chlamydia +

pseudomonas

742- Ferrous sulfate+ antacid absorption of iron is decreased thus not

used together. Dose of Ferrous sulfate (200-300 mg 3 times/day), also
ketoconazole is not used with antacid.

743- Phenoformin and Metformin “Biguanide” can be used with

sulfonylurea.

744- Acetazolamide is carbonic anhydrase inhibitor.

745- Barbiturate metabolismoxidation then conjugation with sulphate.
Penicillin metabolism hydrolysis of B-lactam- phenolic acid.

746- Ethanol & KI syrup are neutral “doesn’t change the pH of the
medium” but sodium metabisulphite (acidic),
Na borate (Alk), KBr (Alk).

747-Paracetamol is analgesic, antipyretic not anti-Inflammatory.

61
748- Hydralazine “arteriodilator” (decrease after load)

749- 10% of Na reabsorption occurs from distal tubule, but more than 50%
occurs from proximal convoluted tubule.
750- Alendronate cause problem if given to a patient sitting or lying down
because it cause oesophageal ulcer.

751- Patient taking haloperidol should not take alcohol & methyldopa

752- Chloropromazine does not cause vomiting.

753- Anionic SAA is compatible with: Econazole & Ichthammol.

745- Insulin secretion decrease K level in blood

755- PTH (Para Thyroid Hormone) is regulated by Ca level in blood Ca

increase in blood (PTH secretion decrease ( calcium deposition in bone increase
&vice versa

756- Baclofen & Dantrolene are used to treat muscle spasticity.

757- Indomethacin administered immediately after food.

758- Aloe protect from UV thus used as sunscreen oil.

759- Amaranth is coloring agent.

760- + Vit D3 (Calciferol) does not occur

naturally, but Vit D3 (Cholecalciferol) occurs naturally in cod liver oil of
fish.

761- Podophyllium is used to treat warts “genital warts”

762- Procaine HCl is thermolabile, Vit E is antioxidant.

763- Cetromacrogol is non ionic emulsifying agent.

62
764- If we mix NaHCO3 to 5% Glucose Nothing will happen
765- Charcoal is decolorizing agent and adsorbent agent in toxicity

766- Agonist means high affinity to receptors with intrinsic activity, while
antagonist means high affinity with no intrinsic activity.

767- Silver sulfadiazine and Mafenide used topically for burns and
wounds, also phethalyl sulphathiazine is used locally to decrease intestinal
bacterial flora.

768- Lignocaine, Cocaine and Amethocaine used topically but procaine

locally only.
769- Iproniazide is MAOI is not used “contraindicated” with
sympathomimetic amine (pseudoephedrine).

770- Ephedrine and Neostigmine facilitate neuromuscular transmission

“used to treat myasthenia gravis”

771- Ribosomes composed of ribonucleic acid.

772- HgCl2 is very H2O soluble “all Hg salts are H2O soluble”
773- Thiamine B1 is heat labile factor in B-complex Vit.
774- Tolbutamide displaces Coumarin from plasma proteins.

775- Keratin is albuminoid.

776- Amorphous form is more soluble than crystalline.

777- The increase N2 waste in blood is: uremia

778- Dipiverfin HCl is a prodrug of epinephrine used in treatment of

glaucoma.

779- L-isomer of adrenaline is 20 times more active than D.

780- Warfarin can be used in different therapeutic forms, it has optical active
center.

781- Duration of action of lente insulin (12-24 hr).

782- Metronidazole treats anaerobic bacteria.

63
783- When Hexyl resorcinol is exposed to air  it is oxidized.

784- Trazadone is the antidepressant (TCA) with the least

anticholinergic and CV side effects.

785- Phenol -----hydration---->1, 2 Benzodiol

786- Orthopnea  dyspnea on lying position, relieved on standing.

787- Metabolism of PAS & INH occurs by acetylation.

788- Thyroxin metabolism isde-iodinationconjugationexcretion

789- Lanolin contains more H20 than wool fat.

790- % of body water at birth= 80 %.

791- Levarterenol is L-norepinephrine

792- Mephenium Carbamate is antidote for strychnine.

793- Main content of urine is urea.

794- Sulphonylureas  CV risk

795- Multiple sclerosis is a disease leading to destruction to myelin sheath.

796- Rheumatoid arthritis is more common in women than men.

797- Procyclidine causes atropine like symptoms “anti- muscarinic”

798- Respiration of the cell occurs in mitochondria while metabolic

occurs in microsomes (ribosomes attached to endoplasmic reticulum).

799- Haemophellia is hereditary deficiency of clotting factor.

800- Solubility depends on Isoelectric point.

801- Steady state achieved at 4-5 t ½.

802- Acacia soluble in water.

64
803- Vit E is soluble in fixed oil, ether, chloroform.

804-Coal tar is used with Polysorbate 80 to assist its dispersion.

805- Rose oil +cetrimide 20% is stabilized by agitation.

806- Imipramine is metabolized by demethylation.

807- LD 50 is not variable between species.

808- Tetany occurs due to hypocalcaemia.

809- Difference between competitive and non competitive
(-) extent of enzyme “which is less with competitive”.

65