1 Pharmacy Practice Therapeutics OTC Drugs Q&A Content Ver1

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Canadian Pharmacy Review
Pharmacy Prep
Pharmacy Practice/
Therapeutics and OTC Drugs
Review and Guide
Misbah Biabani, Ph.D
Director
Toronto Institute of Pharmaceutical Sciences (TIPS) Inc.
Toronto, ON M2N K7
Pharmacy Prep
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Copyright 2000-2008 Tips Inc
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2000-2008 TIPS. All rights reserved.
Foreword by
Misbah Biabani, Ph.D
Coordinator, Pharmacy Prep
Toronto Institute of Pharmaceutical Sciences (TIPS) Inc
5460 Yonge St. Suites 209 and 303
Toronto ON M2N 6K7, Canada
Content
Part IV: Pharmacy Practice/ Therapeutics and OTC Drugs

49-Prescription processing and Medication dispensing
50-Pharmaceutical Care and Drug Related Problems
51-Safety of medications in special populations
52-Identification and prevention of drug toxicity
53-Professional Pharmacy communication skills
54-Therapeutic Drug Monitoring
55-Safe and effective use of medications/ Strategies to Prevent Medication errors
56-Adverse Drug Reactions and Management
57-Drug Interactions
58-Pharmaceutical Preparation Storage Conditions
59-OTC and Prescription Drugs for Dermatological Disorders
60-OTC and Prescription Drugs for Ophthalmic, Ear and Mouth Disorders
61-OTC Drugs antihistamine, decongestants, antitussives, Expectorants
62-OTC Drugs for Nausea, Vomiting, Constipation, Diarrhea, Hemmorrhoids
63-OTC Drugs for Headache, Sports Injuries, Pressure Ulcers, Low Back Pain
64-Asthma and Chronic Obstructive Pulmonary Disease (COPD)
65-Smoking cessation
66-Insomnia
67-Eating disorders
68-GERD, Ulcers, Inflammatory bowel disease (IBD) and Irritable bowel syndrome (IBS)
69-Diabetes Mellitus Type I and Type 2
70-Thyroid Disorders
71-Contraception
72-Reproductive, Gynaecologic and Genitourinary Disorders
73-Rheumatoid arthritis, osteoarthritis and Gout arthritis
74-Osteoporosis
75-Hypertension
76-Coronary Artery Diseases
77-Congestive Heart Failure
78-Cardiac Arrhythmias
79-Peripheral vascular diseases
80-Anxiety Disorder
81-Depression
82-Psychosis and schizophrenia
83-Dementia
84-Seizures and epilepsy
85-Parkinsons Disease
86-Anti-microbial agents
87-Anticancer drugs and chemotherapy
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PHARMACY PREP
PRESCRIPTION PROCESSING AND DISPENSING
1-What is prescription?
A-A written direction by the doctor to pharmacist
B-A written order by the doctor to patient
C-A written order by the doctor to public
D-A written order by the pharmacist
E-A sales invoice from the pharmacy
Ans-A
2-What is not present on prescription label?
A-Prescriber initial
B-Drug name
C-Pharmacist name
D-Patient name
E-Drug strength
Ans-C
3-What is correct about after meals
A-bc
B-ac
C-pc
D-hs
E-qd
Ans4- The Latin abbreviation for: Take one tablet four time daily after meals and at
bedtime is:
a) QID ac & pc
b) QID pc & hs
c) BID pc & hs
d) OD ac & pc
e) QID ac & hs
Ans5-What is the prescription:
A-A written order by a doctor to pharmacist
B-A written order by a doctor to pharmacist and patient
C-A written order by a doctor to patient
D-A written order by a doctor to patient dispensed by the pharmacy.
E-All of the above
Ans6-What is po means?
Copyright 2000-2008 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This
manual is being used during review sessions conducted by PharmacyPrep.
A-Take through mouth
B-Take crush & chew tablets
C-Take under and on tongue
Ans-A
7-What is FP?
A- for oral
B- for pain
C- for family physician
D- for pneumonia
Ans-B
8-A patient presents to a pharmacy with a new Rx for 60 tablets levothyroxin 0.15 mg to
be taken OD. On checking the patients history the pharmacist notices that the patient
filled a similar Rx for 180 tablets levothyroxin 0.15 mg with the same directions 4 weeks
ago. What course of action should be the pharmacist follow?
A-Fill the prescription
B-Check with the doctor before dispensing
C-Talk to the patient about this
D-Give only 1-month supply
E-Refuse to fill the prescription
Ans-C
9-Nitroglycerin 0.4mg #100: i SL prn CP. MR q5min x 2, your label directions?
A-Dissolve under the tongue one tablet as needed for chest pain. May repeat every 5
minutes if pain persists, to a maximum of 2 additional doses.
B-Take nitroglycerin 0.4mg SL as needed and may repeat every 5 minutes if pain persist,
to maximum of 2 doses
C- Take nitroglycerin 0.4mg SL as needed and may repeat every 5 minutes if pain persist,
to minimum of 2 doses
D-Give nitroglycerin 0.4mg SL as needed and may repeat every 5 minutes if pain persist,
to maximum of 2 doses
Ans-A
10. How many 4 mg tab are needed? Weight of the child = 44 lb
Rx
Ondansetron HCl
0.15mg/kg/tsp
cherry syrup
qs 60 ml
A- 4 tabs
B- 6 tabs
C- 9 tabs
D- 12 tabs
E- 10 tabs
Ans-C
wt = 44 / 2.2 = 20 kg
the dose = 0.15 x 20x = 3 mg/tsp
but 60 ml/5ml = 12 doses
Total dose = 3 x 12 = 36 mg
Tab needed = 36/4 = 9 tabs
11. If miss one pill of oral contraceptive, what do you recommend?
A-Take two pill next day
B-Take no pill next day
C-Take three pill next day
D-Take two pill next 2 days
Ans-A
Tips: If miss one pill take two pills next day.
12. 1 po q4-6h prn pain means:
A.Take 1 tablet every 4 to 6 hours as needed for pain.
B.Take 4-6 tablets every 1 hour as needed for pain.
C.Take 1 tablet every 4 to 6 hours with milk
D.Take 1 tablet every 4 to 6 hours with juice
E.Take 1 tablet every 4 to 6 hours every other day
Ans-A
13-A prescription sign as indicates 1 gtt ou qid x 10. It can be interpreted as:
a. 1 drop to right eye four times a day for 10 days
b. Apply 1 tube to affected area four times a day for 10 days
c. 1 drop to both eyes four times a day for 10 days
d. 1 drop to left eye four times a day for 10 days
Ans: C
14-What is ac means:
A-After meals
B-Before meals
C-With meals
D-Take empty stomach
E-Take at bedtime
Ans-B
15. Prednisolone each tablet containing 5 mg. Start 35 mg and then taper by 5 mg every
day. How tablets are needed?
A-20 tab
B-56 tab
C-14 tab
D-28 tab
E-8 tab
Ans-D
Tips: 7+6+5+4+3+2+1+0 = 28 tablets
PHARMACY PREP
PHARMACEUTICAL CARE AND DRUG RELATED PROBLEMS
1. What is the most important focus of pharmaceutical care?
a) The pharmacist
b) The patient
c) The prescription
d) The patient chart
e) Pharmacist salary
Ans: B
2. A 60-year-old patient with congestive heart failure who has been stabilized for 3
months on digoxin, furosemide, and potassium chloride is gradually placed on the
following additional medicines. Which of these drugs is most likely to cause a problem if
added to patient treatment?
A. Quinidine
B. Temazepam (restoril)
C. Meperidine hci (demerol)
D. Aspirin
E. Nitroglycerin
Ans-A
Tips: Although digoxin and quinidine may be used together, it is well documented that
administering quinidine to a patient previously stabilized on digoxin will cause serum
digoxin levels to rise an average 2- to 2.5- fold. The mechanism of this interaction may
involve both a displacement of digoxin from tissue-binding sites and a reduction in renal
clearance of digoxin. Even though the significance of this interaction remains
controversial, many clinicians suggest reducing the dose of digoxin by 50% when adding
quinidine. In any case, the patient should be monitored carefully for signs of digoxin
toxicity.
3. What is NOT a requirement of pharmaceutical care?
A- Prevention of disease
B- Cure of disease
C- Decrease of symptoms
D- Slowing of disease progression
E- Dispensing the cheaper drug
Ans-B
4. Which of the following does not included in drug related problems?
A-Adverse effects of drugs
B-Improper storage conditions
C-Receiving too little drug
D-Receiving inappropriate drug for condition
E-Dispensing the cheaper drug
Ans-E
5. What is NOT a requirement of pharmaceutical Care?

A- Prevention of disease
B- Cure of disease
C- Decrease of symptoms
D- Slowing of disease progression
E- Dispensing the cheaper drug
6-Which of the following does not included in Drug related problems?
A-Adverse effects of drugs
B-Improper storage conditions
C-Receiving too little drug
D-Receiving inappropriate drug for condition
E-Dispensing the cheaper drug
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Safety of Medication in special populations
PHARMACY PREP
SAFETY OF MEDICATION IN SPECIAL POPULATIONS
1. Correct statement/s regarding the general considerations in drug therapy in pediatric
patients may include
I.
II.
III.
Drug therapy monitoring is essential

Pharmacokinetic parameters in children changes as they mature from birth to
adolescence
Neonates are relatively chlorhydric
a) I only
b) III only
c) I & II only
d) II & III only
e) All of the above
Ans: C
Tips: High hydrochloric acid levels chlorhydric. Low hydrochloric acid levels
Achlorhydric. Relatively neonates are achlorhydric and Relatively elderly are chlorhydric
2. Volume of distribution in neonates is affected by many age-dependent factors
including
I.
II.
III.
The degree of protein binding

The sizes of various body compartments
The presence of various endogenous substances
a) I only
b) III only
c) I & II only
d) II & III only
e) All of the above
Ans: E
3. Correct statements regarding age-related physiologic changes affecting drug therapy
may include
I.
Decreased gastric motility may affect the rate and extent of absorption
II.
Increased body fat/ lean muscle mass ratio increases Vd of fat soluble drugs
III.
Decreased total body water decreases Vd of water soluble drugs
a) I only
b) III only
c) I & II only
d) II & III only
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Safety of Medication in special populations
4- All of the following are TRUE about prescribing medication for elderly patients
EXCEPT that
a) Lower doses may be used in elderly
b) Absorption of drugs may be decreased
c) Efficiency of drug elimination is likely to be increased in old age
d) Elderly patients are particularly susceptible to adverse drug reactions
e) None of the above
Ans-C
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PHARMACY PREP
MEDICATION OVERDOSAGE AND PREVENTION STRATEGIES
1- An adult patient who ingested 30 acetaminophen tablets (325 mg/tab) 6 hours ago
should be treated with/by
A. EDTA infusion
B. Ipecac syrup
C. Activated charcoal
D. N-acetylcysteine
E- Probenecid
Ans-D
2. Glutathione conjugation are catalyzation is extremely important in preventing toxicity
from variety of drugs, toxic products are excreted as:
A-S-adenosyl transferase
B-Glutamic acid
C-Marcapturic acid
D-Mercaptopurines
E-Sulfadryl groups
Ans-C
3-A 33-year-old male receiving Acetaminophen 300 mg + codeine 30 mg + caffeine 15
mg (Tylenol # 3) for pain relief, which of the following laxative is appropriate choice for
constipation associated with codeine;
A-Sennakot
B-Bulk laxatives
C-Lactulose
D-Psyllium
E-Glycerine
Ans-A
Tips: Stimulants laxative are the drug of choice for the treatment of constipation
associated with opioids use.
4-A patient brings the prescription of amitriptyline 300 mg 6 months supply. Patient
medical history includes, major depression and in the past has 2 unsuccessful attempts to
suicide. What is the appropriate, a pharmacist should do?
A-Dispense 6 months supply of amitriptyline and caution about overdose symptoms.
B-Dispense in part fills and ask patient pick up in parts every 15 days
C-Refuse the prescription and ask patient to see other doctor
D-Refer patient to other physician for mental assessment.
Ans-B
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PHARMACY PREP
PHARMACY COMMUNICATION SKILLS
1-Which of the following is
the most effective communication skills:
I-Verbal skills
II-Nonverbal listening skills
III-Verbal skills only
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans-C
2-A pharmacist is required to give knowledge of drugs and supply the patient with
enough pieces of information to overcome the patient ignorance. This is done by:
a) Written information only
b) Verbal information only
c) Verbal and written information
d) Magazines and folders information
e) Video information
Ans-C
3-The most effective communication skills include?
A-written
B-Verbal and written
C-verbal and non-verbal
D-verbal only
E-Listening
Ans-B
4-All of the following communication distractions, except:
A-Telephone
B-Language
C-Cell phone
D-Music
E-Television
Ans-B
Tips: language can communication barrier
5-A 90-year-old senior patient cannot hear, how to counsel?
A-Speak louder
B-Counsel in quite area of pharmacy
C-Give recorded tape of counseling
D-speak closer to customer
E-Dont speak to customer
Ans-B
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Therapeutic Drug Monitoring
PHARMACY PREP
THERAPEUTIC DRUG MONITORING
1-Which antipsychotic drugs monitored for WBC?
A-Olanzapine
B-Clozapine
C-Risperidone
D-Haloperidol
E-Quetiapine
Ans: B
2-Patient taking acetaminophen, what liver enzyme may be elevated?
A-ALT
B-AST
C-LFT
D-ALP
E-LDH
Ans-A
3-Patient taking atorvastatin, what liver enzymes are elevated?
A-ALT and AST
B-LDH and ALT
C-LDH only
D-ALT only
E-AST only
Ans-A
4-Patient using warfarin should be monitored for?
A-PT
B-INR
C-aPTT
D-A and B
E-All of the above
Ans-D
5-Hypothyroidism patient should be monitored
A-Decrease TSH
B-Elevated TSH
C-elevated T3
D-Free T3
E-TBG
Ans-B
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Therapeutic Drug Monitoring
6-A 50-year-old male a regular customer of your pharmacy, his current medications
include: Hydrochlorthiazide, Furosemide 50 mg, and Digoxin 0.125 mcg
Which of the following he should be monitored?
I-Monitor K levels
II-Serum creatinin
III-Blood pressure
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
Ans-C
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Strategies to Prevent errors and safe dispensing
PHARMACY PREP
ERROR PREVENTION STRATEGIES AND SAFE DISPENSING
1-Angry person walks in your pharmacy and complains that you have dispensed wrong
medications? What is appropriate first step in resolving this problem?
A-Apologise patient for dispensing error
B-Calm down patient
C-Acknowledge his anger, ask and verify what is error
D-Ignore and let him vent his anger
E-Acknowledge his anger and refer to doctor
Ans-C
2-Busy pharmacies a long line up in 15 customers, a person came he is insisting and fighting
with pharmacist, do dispense him first?
A-ignore that customer
B-dispense him first
C-dont dispense
D-just talk to him and explain there are other before you.
E-Call police
Ans-D
Copyright 2000-2008 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is
being used during review sessions conducted by PharmacyPrep.
12
Adverse Drug Reactions
PHARMACY PREP
ADVERSE DRUG REACTIONS
1-Nitroglycerine patch comes off during shower, what is suitable action?
A-refer to the physician
B-put another patch
C-reapply the same patch
D-use glue and reapply the same patch
E-None of the above
Ans-C
2-All of the drug cause orthostatic hypotension, except:
A-propranolol
B-prazocin
C-captopril
D-doxazocin
E-enalapril
Ans-A
3-Neuroleptic malignant syndrome side effects is not associated with?
A-haloperidol
B-Levodopa
C-clozapine
D-Chlorpromazine
E-Risperidon
Ans-B
4-Which of the following drugs give severe rebound hypertension?
A-prazocin
B-propranolol
C-clonidine
D-captopril
E-enalapril
Ans-c
5-Which of the following drug should not be taken if it is not effective with first dose?
A-Nitroglycerine spray
B-Nitroglycerine SL
C-Beta blockers
D-Nifedipine
E-Sumatriptan
Ans-E
6-Drugs that gives bronchospasm?
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13
Adverse Drug Reactions
A-Albuterol
B-acebutalol
C-Salmeterol
D-Formeterol
E-Ipratropium
Ans-B
7-Drugs that alter TSH levels?
A-Lithium
B-Amiodarone
C-Levothyroxin
D-L-thyroxin
E-All of the above
Ans-E
8-All of the following drugs can cause weight gain except?
A-Fluoxetine
B-Paroxetine
C-Resperidone
D-Qutiapine
E-topiramate
Ans-E
9-Which of the following drugs priapism side effects, patient should report to doctor?
A-Trazodone
B-Seldanafil
C-fluoxetine
D-Alprostadil
E-All of the above
Ans-B
10-All of the following drugs can give pulmonary fibrosis, except?
A-Bromcriptine
B-Cisapride
C-Amiodarone
D-Ropinarole
E-Methotrexate
Ans-D
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Drug Interactions
PHARMACY PREP
DRUG & DRUG INTERACTIONS
1-A 55 year old male patient receiving warfarin for deep vein thrombosis, he get the
prescription of carbamazepine; which of the following drug interaction possible:
I-Carbamazepine decrease metabolism of warfarin
II-Carbamazepine is has not interaction with warfarin
III-Carbamazepine increase metabolism of warfarin
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans-B
Tips: Carbamazepine is an inducer of CYP 2C9, and the same enzyme is substrate of
warfarin. Therefore Carbamazepine increase metabolism of warfarin
2-A 20 year old female patient currently on fluoxetine for depressive disorder, she get the
prescription of Tylenol # 3 for sever headache. Which of the following drug interaction
are possible:
A-Fluoxetine metabolism increases
B-Codeine metabolism increases
C-Fluoxetine metabolism decrease
D-Codeine metabolism decrease
E-No change and there is no drug interactions
Ans-D
Tips: Fluoxetine inhibits CYP 2D6 and this same enzyme is a substrate for codeine and
therefore decrease codeine metabolism
3-A 40-year old female is regular customer of your pharmacy, her current medical history
include lovastatin. She brings prescription for her recent condition, Which of the
following medication is safe for her medical profile:
A-Erythromycin
B-Ketoconazole
C-Grapefruit juice
D-Niacin
E-Hydrochlorothiazide
4- Enzyme complex not working as a drug-metabolizing enzyme may include:
a) Cytocrome P-450
b) Cytocrome P450 3A4
c) Alcohol Dehidrogenase
d) UDP Glucoronyl Transferase
e) Cytocrome oxidase.
Ans-C
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Drug Interactions
5-What is incorrect about tetracycline antibiotics:

I-Take with water and milk
II-Take with food
III- Must take empty stomach
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans-C
6-Tetracyclin binds with?
A-monvalent ions
B-bi valent ions
C-tri valent ions
D-b and C only
E-all of the above
Ans-D
7-Ciprofloxacin should be taken with:
A-avoid taking with full glass of milk
B-take with or after food
C-take empty stomach
D-take with or without food
E-A and D
Ans-E
8-A patient using calcium supplements 500 mg bid. Now gets the prescription of
ciprofloxacin 500 mg bid for 3 days.
What is appropriate method of administration?
A-Take ca supplements and ciprofloxacin together morning and evening.
B-take calcium supplements before 2 hour and after 4 hours of ciprofloxacin.
C-Stop taking calcium supplements for 3 days and continue ciprofloxacin
D-stop taking ciprofloxacin and continue calcium supplement daily
E-Call the doctor, change to tetracyclin
Ans-C
9-Which of the following statement is incorrect about alcohol and drug interactions?
A-Alcohol and Metronidazole can give disulfiram reactions
B-Alcohol and metformin can give lactic acidosis
C-alcohol and chlorpropamide an antidiabetic drug can give lactic acidosis
D-alcohol and benzodiazepine can give sedation
Ans-C
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Drug Interactions
11-All of the following agent can cause urine discoloration, EXCEPT;

A-Metronidazole
B-Rifampin
C-Sulfasalazine
D-pyrivinium pamoate
E-tetracycline
Ans-E
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Pharmaceutical Storage Conditions
PHARMACY PREP
PHARMACEUTICAL STORAGE CONDITIONS
1- You received a new drug in your pharmacy and the manufacture instructions tell you to keep
this drug in a cool place. Which temperature should you keep this drug?
a) <0C
b) 2 to 8C
c) 8 to 15C
d) 15 to 30C
e) >30C
Ans-C
2-All of the following antibiotics suspensions are stored at room temperature, EXCEPT
A-Metronidazole
B-Clarithromycin
C-Azithromycin
D-Clindamycin
E-Clotrimoxazole
Ans-A
3-Insulin can be stored at?
A-room temperature
B-Refrigerator
C-Freezer
D-Deep freezer
E-Cool temperature
Ans-B
4-All vaccines should be stored in?
A-Room temperature
B-Refrigerator
C-Freezer
D-Deep freezer
E-Cool temperature
Ans-B
18
OTC medications dermatological conditions
PHARMACY PREP
OTC DRUGS FOR DERMATOLOGICAL CONDITIONS
1-Incorrect statement about poison iv treatment?
A-Hydrocortisone 0.5%
B-calamine lotion
C-antihistamine
D-Polysporin
E-Oatmeal cream
Ans-D
2-Incorrect statement about psoriasis treatment?
A-Hydrocortisone 1%
B-coal tar
C-Tazarotene
D-Polysporin
E-UVA + coal tar
Ans-D
Burns
3-What is incorrect about burns?
A-1st degree is superficial burns, that may cause by sunburn
B-2nd degree is superficial and partial thickness burns that may cause by hot water, oil spills
and splashes
C-3rd degree is the severe burns that can give lathery skin.
D-If it burn put burn part in cold water
E-It it burn put burn part in warm water
Ans-E
4-Incorrect statement about sunburn?
A-peak time of sunburn is 10:00 am to 4:00pm
B-High altitude has low sunburn
C-cloud do not protect sunburn
D-beach area may have more sunburn
E-Apply sunscreen before get into sun
Ans-B
5-What is incorrect about sunburn treatment?
A-Use cool baths or wet compresses with tap water or saline
B-Take plenty of fluids
C-Topical vitamin E applied two minutes after UV exposure may decrease erythema and
edema
D-Acetaminophen can relieve pain
E-Avoid NSAIDs for sunburn pain
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Ans-E
Head lice
6-What is incorrect about head lice treatment?
A-Permethrin 1% cream rinse applies to hair and scalp (1/2 to 1 bottle) and leave it on for 10
min then rinse.
B-Permethrin may repeat after 7 days if live head lice is observed.
C-May temporarily exacerbate itching and pruritus in head.
D-May gives burning/stinging, tingling numbness in scalp
E-If it gives itching and pruritus refer to doctor
Ans- E
What is incorrect about headlice?
A-All family members need not to treated if one family has headlice
B-headlice can fly and transmit to other family member
C-Long hair or short hair both can have headlice
D-Hygiene is a not criteria for headlice
E-Nits can hatch headlice in 7 to 10 days
Ans7-Contact dermatitis and itching:
I-oatmeal cream
II-calamine lotion or zinc oxide
III-local anesthetics (procaine)
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans-C
Tips: Astringents calamine lotion, aluminum acetate, zinc oxide
8-Complicated diaper rash (diaper rash more than 3 days):
I-barrier bases (zinc oxide, petrolatum)
II-Antifungal agents (nystatin)
III-Anti-inflammatory agents (0.5% hydrocortisone)
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans-E
20
What is incorrect in treatment of diaper rash?

A-Keep diaper area dry
B-Swab diaper area with alcohol
C-Apply petrolatum on diaper area
D-apply 0.5% hydrocortisone
Ans-B
What does sun protection factor (SPF) 15 mean?
A-if it takes 10 minutes to get sunburn, in SPF 15, it would take 15x10min
B-If it takes 10 minutes to get sunburn in SPF 15, it would take 15x100min
C- If it takes 10 minutes to get sunburn in SPF 15, it would take 150x100min
D- If it takes 10 minutes to get sunburn in SPF 15, it would take 150x1000min
E-If it takes 10 minutes to get sunburn in SPF 15, it would take 1500x100min
Ans-A
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PHARMACY PREP
OTC AND PRESCRIPTION DRUGS FOR OPHTHALMIC, EAR AND MOUTH
DISORDERS
1-What is an optimal range of pH for ophthalmic products
A-2-3
B-4-5
C-5-6
D-6-8
E-8-10
Ans-D
2-Opthalmic agents contraindicated in glaucoma patients include, which of the following
substances:
A-antioxidants
B-decongestants
C-emollients
D-antipruritics
E-All of the above
Ans-B
3-Which of the following lenses can be worn continuously for 6 days:
a-soft lenses
B-Extended wear soft lenses
C-Frequent replacement soft lenses
D-None of the above
Ans-B
4-Image formed by lens received by:
A-iris
B-retina
C-sclera
D-conjunctiva
E-pupil
Ans-B
What is correct statement about treatment in eruption cysts in infants
A-In general cysts rupture spontaneously
B-Use teeters to rupture cysts
C-manually cysts can be removed
D-None of the above
Ans-A
23
Which of the following treatment is used to treat cold sores?

I-Antihistamine
II-Zinc oxide (ZnO)
III-Benzocaine 7.5% gel
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans-D
35. What is treatment of cold sores in chicken pox?
I-Calamine lotion
II-Oatmeal bath (micellar colloidal bath)
III-Oral antihistamine
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans-C
Tips: Calamine lotion (ZnO+FeO) and oatmeal bath and oral antihistamine can be helpful
in treatment of cold sores.
Which of the following is the incorrect action of sympathomimetic?
I- Increase of IOP
II- Increase the drainage of H2O humor from the eye
III- Decrease the H2O humor in the eye
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans-D
Sympathomimetic increase outflow of aqueous humor thus decrease IOP.
Tips: Sympathetic agonist (sympathomimetics) increases IOP. Open angle glaucoma
(OAG) is due to increase in IOP and increase in H2O humor of eye or could be due
decrease in drainage of H2O humor in the eye. For the treatment of OAG sympathetic
blockers such as Timolol are effectively used to decrease IOP and H2O humor.
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PharmacyPrep.Com
OTC Antihistmines, decongestants and antitussives
PHARMACY PREP
OTC ANTIHISTAMINE, DECONGESTANTS AND ANTITUSSIVES
Which of the following is NOT an environmental measure to prevent allergic rhinitis:
A-Avoidance of window or attic fans
B-Avoid outdoor activities during pollen season
C-Shower or bath following outdoor activity to avoid contamination of bedding
D-Use air conditioning
E-Open windows over night
Ans-E
Sympathomimetics decongestant acts as?
A-Vasoconstrictor
B-Vasodilator
C-Congestion
D-Anti-inflammatory actions
E-None of the above
Ans-A
Sympathomimetics decongestant can cause, all of the following complications, except?
A-caution in open angle glaucoma
B-caution in hypertension
C-caution in diabetics
D-Can cause rebound congestion in prolong use
E-Can cause vasodilatation
Ans-E
All of the allergens or factors can trigger asthma except?
A-Molds
B-Warm air
C-Emotional stress
D-Pets
E-Coackroaches
Ans- B
Opioids may be used as all the following agents, EXCEPT:
a) Antitussive
b) Analgesic
c) Antidiarrheal
d) Anti-inflammatory
e) Pre-anesthetic
Ans -D
7-Alpha 1 agonist, phenylephrine has all of the following side effect EXCEPT:
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OTC Antihistmines, decongestants and antitussives
A-vasoconstriction
B-Headache
C-orthostatic hypotension
D-Arrhythmias
E-Mydriasis
Ans-C
Comments: Hypertension is common side effect phenylephrine.
8- Fexofenadine HCI (Allegra 12 Hour and Allegra 24 Hour) is classified as:
A-Histamine H2-Receptor Antagonist
B- Histamine H1-Receptor Antagonist
C-Proton Pump inhibitor (PPI)
D-Serotonin reuptake inhibitor (SSRI)
E-5-HT1 Receptor Agonist
Ans-B
26
PharmacyPrep.Com OTC drugs for Nausea, vomiting, diarrhea, constipation hemorrhoids and
helmenths
PHARMACY PREP
OTC DRUGS FOR NAUSEA, VOMITING, CONSTIPATION, DIARRHEA,
HEMORRHOIDS AND HELMENTHS
1. What suggestions and advice should be given to the patient with pinworm infection?
I.
Treatment of pin worms should be taken for all members of the family
II.
Must not share under garments
III.
Must not share dishes
a) I only
b) III only
c) I and II only
d) II and III only
e) All of the above
Ans: E
Comments: spreads by oral-fecal infestation.
2-Metamucil (psyllium) is a bulk-forming laxative agent. Patients using should get the
following instructions:
I- Avoid Metamucil (psyllium) in pregnancy
III- It should mix the dose with a glass of cool water or other fluid and drink it down quickly.
II-This should be followed with more fluids.
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans-D
Tips: pysllium is safe to use in pregnancy
3- Antacids are normally used to equilibrate the stomach pH and protect the stomach from the
effect of acids. Which of the following antacids has a cathartic side effect?
a) Calcium carbonate
b) Dihydroxyaluminum sodium carbonate
c) Magnesium hydroxide
d) Calcium sulfate
e) Aluminum silicate
Ans-C
4- Which antihelmenthic drug is used to treat pin worm?
A-Pyremethamine
B-Pyridoxin
C-Streptomycin
D-Pyrivenium pamoate
E-Metronidazole
27
PharmacyPrep.Com OTC drugs for Nausea, vomiting, diarrhea, constipation hemorrhoids and
helmenths
Ans-D
5- Lactulose is an osmotic laxative agent that may be used to treat:
I- Constipation
II- Portal-systemic encephalopathy
III- Renal tubular necrosis
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
Ans-C
Tips: Portal systemic encephalopathy Osmotic laxative decrease blood ammonia levels
and as result this effect on mental status in encephalopathy patients.
28
PharmacyPrep.Com OTC drugs for headache, sports injuries, pressure ulcers, and back pain
PHARMACY PREP
OTC DRUGS FOR HEADACHE, SPORTS INJURIES, PRESSURE ULCERS, AND LOW
BACK PAIN
1. Correct statement/s about ASA may include
I.
Low dose are used in heart problem
II.
Less potent than naproxen as an analgesic
III.
More potent than acetaminophen as analgesic
a) I only
b) III only
c) I and II only
d) II and III only
e) All of the above
Ans: C
2-What is antidote of acetyl salicylic acid (ASA)?
A-N-acetylcysteine
B-Flumezanil
C-Nalexone
D-Naltrexone
E-None of the above
Ans-E
3-Anti-inflammatory action of ASA is due to?
A-Irreversible inhibition of platelet aggregation
B-Prevention of prostaglandin synthesis
C-Inhibition of COX-I receptors
D-Inhibition of Cox-1 and Cox-II receptors
E-Inhibition of Cox-II receptors
Ans-B
4- A 50 year old female currently she is on atorvastatin, and atenolol and Tylenol # 1 for
arthritic pains. She visit pharmacy complaining of diarrhea, which of the following medication
may associated to her problem:
A-Atenolol
B-Codeine in Tylenol
C-Tylenol
D-Atorvastatin
E-All of the above
Ans-D
5. Dyspnea means
a) Painful muscle spasms
b) Pain in the heart
being used during review sessions conducted by PharmacyPrep
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PharmacyPrep.Com OTC drugs for headache, sports injuries, pressure ulcers, and back pain
c) Pain in extremities
d) Painful breathing
e) Painful menstruation
Ans: D
6. Over dosage of acetaminophen in patients would affect
I.
Liver functions
II.
Prothrombin time
III.
Renal functions
a) I only
b) III only
c) I & II only
d) II & III only
e) All of the above
Ans: C
7-Which of the following is not a side effect of an opioids analgesic for example morphine:
a) C.V depression
b) Constipation
c) Sedation
d) CNS depression
e) Dilatation of eye pupil
Ans-E
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Respiratory Complications
PHARMACY PREP.
RESPIRATORY COMPLICATIONS
1- Patient has a relevant increase in his asthma symptoms due to environmental allergies.
He is currently having salbutamol and fluticasone inhalers. What would you advise as an
adjunct medication to treat his symptoms?
a) Oral corticosteroids
b) Higher dose of corticosteroid inhalers
c) Salmeterol
d) Sodium cromoglycate
e) Anticholinergic agents
2- Treatment of smoke withdrawal symptoms may include which of the following?
I- Nicorette
II- Nicoderm
III- Zyban
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
3- Which of the following vitamins is depleted in the blood by smoke?
a) Vitamin C
b) Vitamin B
c) Vitamin C
d) Vitamin D
e) Vitamin A
4- Condition characterized by a reversible form of airflow obstruction is known as:
a) Aneurism
b) Emphysema
c) Embolism
d) Cirrhose
e) Jaundice
5- Advantages of nasal route over oral route absorption of drugs may include:
I- Nasal route has a higher surface area
II- Nasal route has more blood vessels
III- Nasal route has a higher onset of absorption
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
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6- Which is not a drug used for smoke cessation?

a) Nicotine polacrilex
b) Transdermal nicotine patches
c) Nicotine sublingual tablets
d) Bupropion
e) Buspirone
7- Example of leukotriene antagonist drug include:
a) Salbutamol
b) Ipratropium
c) Zafirlukast
d) Montelukast
e) C and D are right
8- Which reaction can ozone cause in the lungs?
a) Oxidation
b) Hydration
c) Reduction
d) Complexation
e) Hydrolysis
9- Correct statements regarding glossitis include which of the following?
I- Inflammation of the tongue
II- Characterized by presence of pinkish-red central lesions on the dorsal surface of the
tongue
III- It can be a chronic condition of the tongue seen in pernicious anemia.
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
10- Intal-Sodium cromoglycate is characterized by which of the following statements?
I- Non-steroidal drug with anti-inflammatory proprieties
II- They can be used in prophylaxis of asthma and allergic rhinitis
III Used in asthma only
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
11- Drug of choice in the treatment of chronic obstructive pulmonary disease may
include:
a) Salbutamol
b) Ipratropium
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c) Salmereol
d) Sodium cromoglycate
e) Fluticasone
12- Chronic progressive lower airway destruction causing reduced pulmonary inspiration
and expiratory capacity is known as:
a) Asthma
b) Bronchitis
c) GERD
d) COPD
e) CHF
13- Asthma is a condition of respiratory tract that may be aggravated by:
a) Allergens
b) Cold weather
c) Execise
d) Emotion stress
e) All are correct
14- Which of the following is considered as the best treatment of asthma?
a) 2-agonists
b) -Blockers
c) -agonists
d) Anticholinergic drugs
e) Cholinergic drugs
15- Which of the following agents or combinations may be appropriated to treat severe
intermittent asthma?
a) High doses of inhaled corticosteroid
b) Long acting 2-agonists
c) Short acting 2-agonists
d) Oral corticosteroids
e) Combination of all the above medication
16- Examples of drug(s) that may precipitate asthma include all of the following,
EXCEPT:
a) Aspirin
b) -Blockers
c) Ipratropium
d) NSAIDs
e) Cholinergic drugs
17- All of the following are pathophysiologic characteristics of asthma, EXCEPT:
a) Airway obstruction and inflammation
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b) Destructive changes in the alveolar walls

c) Thickened smooth muscle of airway
d) Mucosal edema
e) Narrowed lumen of airway
18- The MOST well known characteristic symptom of asthma include:
a) Wheezing
b) Mucosal edema
c) Cough
d) Chest tightness
e) Tachycardia
19- Drug considered as the drug of choice in a specific asthma emergency treatment
include:
a) Salmeterol
b) Adrenaline
c) Albuterol
d) Cortisone
e) Zafirlukst
20- Salbutamol is short acting 2-agonists that may be used in the treatment of which of
the following asthma type?
a) Mild asthma
b) Emergency asthma
c) Severe intermittent asthma
d) Moderate asthma
e) All kind of asthma
21- All are correct concerning the action of corticosteroids in asthma status, EXCEPT:
a) Suppress the inflammatory response
b) Decrease production of inflammatory mediators
c) Decrease airway responsiveness to inflammation
d) Relieve brochocontriction
e) Increase -agonist receptors response
22- All are examples of corticosteroids inhalers used in asthma, EXCEPT:
a) Beclometasone
b) Sodium cromoglycate
c) Flunisolide
d) Fluticasone
e) Budesonide
23- All are examples of drugs used in the treatment of bronchoconstriction, EXCEPT:
a) 2-agonists
b) Anticholinergic
c) Methyl xanthenes
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d) Xanthine oxidase inhibitors

e) Leukotriene modifiers
24- Best drug used in the prevention of exercise-induced asthma may include:
a) Long acting 2-agonists
b) Short acting 2-agonists
c) Anticholinergics
d) Leukotriene modifiers
e) Corticoids
25- All are 2-agonists used as brochodilators in the treatment of bronchospasm,
EXCEPT:
a) Albuterol
b) Salmeterol
c) Terbutaline
d) Pindolol
e) Levalbuterol
26- Example of methyl xanthine used in the treatment of respiratory complications
include:
a) Theophyllin
b) Terbutaline
c) Ipratropium
d) Zafirlukast
e) Salmeterol
27- Agents considered as precursor of leukotriene include:
a) Tyrosine
b) Cyanide
c) Arachidonic acid
d) Prostaglandins
e) Histamine
28- Indication of leukotrienes modifiers in the treatment of asthma includes which of the
following?
I- Acute treatment
II- Prophylaxis
III- Chronic treatment
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
29- Drug known as the new relative cromolyn like drug include:
a) Cromolyn sodium
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b) Cromoglycanate sodium
c) Cromolyin disodium
d) Disodium cromoglycanate
e) Nedocromil sodium
30-Leukotriene antagonist is referred as steroid sparing agents, thus it is indicated to:
A-Reduce corticosteroid doses
B-To avoid increase of corticosteroid dose
C-Do not used together with corticosteroids
D-It increases toxicities of steroids
CORRECT ANSWERS
RESPIRATORY COMPLICATIONS
1- D
Comments: Sodium cromoglycanate would be the best choice because it is a safe antiinflammatory inhaler for children and very useful in treating environmental allergy and
asthma prophylaxis.
2- C
Comments: Nicoret and nicoderm are nicotine replacement therapy for smoking
cessation, therefore their use avoid the smoke withdrawal effect.
3- A
Comments: Smokers have more tendencies to vitamin C depletetion rather than other
vitamins
4- B
Comments: Aneurysm is an abnormal dilatation of a blood vessel while embolism is an
obstruction of airway by a mass transported in the circulation. Cirrhoses and jaundice are
liver related complications.
5- D
Comments: Although nasal route has a smaller surface area than intestine drugs
administrated by nasal route will have faster onset of action due to large quantity of blood
vessels in the nasal route.
6- C
Comments: Buspirone is an atypical anxiolitic agent used to treat anxiety disorders.
7- E
Comments: Zafirlukast and montelukast are classics leukotriene antagonists used in the
oral treatment of asthma
8- A
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Comments: Ozone is a gas that may cause irritation and toxicity of pulmonary system.
The main reaction of ozone in the body is oxidation.
9- E
Comments: Glossitis is an inflammatory disease of tongue of unknown etiology
characterized by multiple annular areas of desquamation of the filiform papillae on the
dorsal surface of the tongue. Usually presenting pinkish-red central lesions, normally
seen in pernicious anemia.
10- C
Comments: Sodium cromoglycanate is an anti-inflammatory, nonsteroid inhaler, mast
cell stabilizer used in asthma prophylaxis and as antiallergic agent.
11- B
Comments: Ipratropium is a cholinergic antagonist used as the drug of choice in the
treatment of COPD-Chronic Obstructive Pulmonary Disease by blocking the
brochoconstriction caused by activation of the parasympathetic nervous system.
12- D
Comments: COPD-Chronic Obstructive Pulmonary Disease
13- E
Comments: Asthma is a chronic inflammatory disorder of the airway that may be induced
by allergens, occupational exposure, exercise, emotion, weather, drugs and so on.
14- A
Comments: Inhalated short-acting -agonists are the most effective drugs available for all
the kinds of asthma treatment.
15- E
Comments: Severe intermittent asthma treatment is best done by short and long-acting agonists plus inhaled and oral corticosteroids.
16- C
Comments: Ipratropium is an anticholinergic drug that be used in adjunct treatment of
asthma.
17- B
Comments: Destructive changes in the alveolar walls are characteristics of a respiratory
complication called Emphysema
18- A
Comments: Mainly symptoms of asthma are: Wheezing, shortness of breathing, chest
tightness, cough, tachycardia, tachypnea and pulses paradoxus.
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19- C
Comments: Albuterol is the fastest acting -agonist used in the treatment of
bronchocostriction emergencies-asthma.
20- E
Comments: Salbutamol is a fast acting -agonist and considered the drug of choice in all
kind of asthma.
21- D
Comments: The use of corticosteroids in asthma suppresses the inflammatory response
and decreases the airway hyperesponsiveness by decreasing the production of
inflammatory mediators and mucus production.
22- B
Comments: Sodium cromoglycanate is an anti-inflammatory, antiallergenic and mast cell
stabilizer drug.
23- B
Comments: Xanthine oxidase inhibitor is mainly used in the treatment of gout.
24- B
Comments: Salbutamol, a fast acting -agonist, is the most effective drug in the
prevention of exercise-induced asthma.
25- D
Comments: Pindolol is a -blocker used mainly in the treatment of hypertension.
26- A
Comments: Ipratropium is an anticholinergic drug used in COPD as the drug of choice.
27- C
Comments: Cysteinyl leukotrienes are products of arachidonic acid metabolism.
Leukotriene modifiers drugs inhibit leukotriene synthesis by inhibiting 5-lipoxygenase
that catalyzes the conversion of arachidonic acid to leukotriene.
28- D
Comments: Leukotriene modifiers are approved for oral prophylaxis and chronic
treatment of asthma.
29- E
Comments: Nedocromil sodium is the new relative cromolyn like drug acting in a very
similar way as sodium cromoglycanate does.
30-A
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BIBLIOGRAPHIC REFERENCE
1- COMPREHENSIVE PHARMACY REVIEW Lippincott William & Wilkins

Fourth edition
2- CPS-COMPENDIUM OF PHARMACEUTICALS AND SPECIALITIES - Canadian
Pharmacist Association 2001 edition.
3- MEDICAL DICTIONARY Dorlands illustrated 27th edition.
4- PHARMACY PREP Lectures series & study guide for Evaluating ExaminationTIPS - 2003/2004
5- THERAPUTIC CHOICES Canadian Pharmacist Association -Third edition
6- USP DI Drug Information for the Health Care Professional15th edition Volume I.
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Smoking Cessation
PHARMACY PREP
SMOKING CESSATION
1-What is incorrect statement about smoking cessation?
A-Person using nicotine replacement therapy, should stop smoking same time as start NRT
B-Person using bupropion can set quit date in 1 to 2 week of after start of treatment
C-A person using nicotine patches can smoke but reduce number of cigarettes
D-A person with hypertension, body weight less than 45 Kg should start with low dose of NRT
i.e step 2 patch
E-Patches can be applied on while taking shower
Ans-C
2-Nicotine patches are stored in?
A-Refrigerator
B-Room temperature
C-Cold temperature
D-Freezer
E-Any temperature
Ans3-What is incorrect about nicotine patches?
A-Stored in room temperature
B-Avoid sun light exposure
C-Hygroscopic, thus open from pack when you ready use
D-Does not need to protect from light
E-Can be applied on arms and thighs
Ans-D
4-What is incorrect about bupropione?
A-Reduce the seizure threshold
B- avoid in bulimia nervosa
C-avoid in anorexia nervosa
D-Avoid in sexual dysfunction
E-It has low weight gain side effects
Ans-D
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Insomnia
PHARMACY PREP
INSOMNIA
1-What is incorrect recommendations for persons complaining insomnia?
A-make a regular sleep schedule for 7 days/wk
B-Over the counter Diphenhydramine for 3 days may be helpful
C-It is essential to exercise before bedtime
D-Avoid heavy meals before bedtime
E-Avoid long day nap can give good sleep in night
Ans-C
2-What is incorrect about zopiclone?
A-A non benzodiazepine act on benzodiazepine receptor
B-Associated with sever hangover effect
C-It indicated for short time insomnia
D-It is short acting
E-It has low dependency
Ans-B
3-All of the following are long acting benzodiazepines except?
A-Diazepam
B-Clonazepam
C-Flurazepam
D-Temazepam
E-Chlorozepate
Ans-D
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PharmacyPrep.Com
Eating disorders and weight loss treatments
PHARMACY PREP
EATING DISORDER AND WEIGHT LOSS TREATMENTS
1-Which of the following antidepressant should be avoided in bulimia an anorexia nervosa?
A-Venlafaxine
B-Fluoxetine
C-Buprapione
D-Mirtazepine
E-Paroxetine
Ans-C
2-What is normal body mass index (BMI)
A- 18.5 to 24.9
B- 25.0 to 29.9
C- >30
D- <30
E- All of the above
Ans-A
Tips: BMI = weight/height2 = kg/m2
3-What is overweight body mass index (BMI)
A. 18.5 to 24.9
B. 25.0 to 29.9
C. >30
D. <30
E. All of the above
Ans-B
4-What is obese body mass index (BMI)
A. 18.5 to 24.9
B. 25.0 to 29.9
C. >30
D. <30
E. All of the above
Ans-C
5-All of the following drugs are used to treat weight loss except?
A-Meridia
B-Orlistat
C-Buprapion
D-Topiramate
E-Mirtazepine
Ans-E
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PHARMACY PREP
GASTROINTESTINAL SYSTEM
1- Correct statements regarding the characteristics of hernias may include:
I-It is a protrusion of a loop of an organ or tissue normally through the GI area
II-Hernia hiatus is a herniation of stomach through the esophageal hiatus of diaphragm
III-Strangulated hernia is an incarcerated hernia that is so tightly constricted as to
compromise the blood supply of the contents of the hernia sac.
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
2- Misoprostol is used as mucosal protectants of GI and may be classified as:
a) PGE1 analog
b) H2 inhibitor
c) Protom-pump inhibitor
d) NSAID
e) Antimuscarinic
3- Drugs are mainly metabolized in the GIT by many different reactions. The most
common drug reaction in the GIT may include:
a) Oxidation
b) Reduction
c) Hydrolysis
d) Dealkylation
e) Ionization
4- ASA-Acetyl salicylic acid is one of the most used worldwide analgesics. Which of the
following reactions metabolizes it in the gastrointestinal tract and liver?
a) Oxidation
b) Hydrolysis
c) Reduction
d) Dealkylation
e) Deamination
5- Accumulation of fluids in the peritoneal cavity is normally known as:
a) Pannus
b) Starvation
c) Edema
d) Ascitis
e) Cholecystitis
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6- Examples of the used of Karaya gum in ostomy patients may include:
a) Decrease odor from colostomy
b) Act as germicidal agent
c) Liquidify the stomal effluent
d) Protect skin from stomal effluent
e) Soften the stomal effluent
7- All of the following are examples of gastric acid stimulators, EXCEPT:
a) Gastrin
b) Acetylcholine
c) Somatotropin
d) G-Cell
e) None of the above
8- Gastroesophageal reflux (GERD) is mainly characterized by:
a) Diaphragm wall inflammation
b) Diaphragm perforation
c) Reflux of the stomach content into the esophagus
d) Hyperacidity of stomach
e) All are correct
9- One of the most common conditions associated with acute hemorrhagic gastritis may
include:
a) Chronic alcoholism
b) H. Pyloric bacterial infection
c) Carcinoma of stomach
d) Carcinoma of colon
e) Travelers diarrhea
10- Antacids are normally used to equilibrate the stomach pH and protect the stomach
from the effect of acids. Which of the following antacids has a cathartic side effect?
a) Calcium carbonate
b) Dihydroxyaluminum sodium carbonate
c) Magnesium hydroxide
d) Calcium sulfate
e) Aluminum silicate
11- Elongated proliferations in the small intestine are called:
I- Villi
II- Fontanelle
III- Hernias
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
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12- Metoclopramide is a parasympathetic agent that may have which of the following
characteristics?
I- Cholinomimetic agent that stimulates motility of the stomach
II- Used in treatment of diabetes gastro paralysis and GERD
III- Used centrally as antiemetic during cancer chemotherapy
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
13- All of the following are correct statements regarding bile, EXCEPT:
a) It is secreted by the liver
b) It is poured into the small intestine via the bile ducts
c) It is constituted of bile acids, cholesterol, phospholipid, bilirrubin and electrolytes
d) Bile is acid due to its bicarbonate content
e) It is also responsible for the alkalinization of intestinal content
14- Proton Pump Inhibitors are irreversible direct inhibitors of K pump. Correct
statements regarding these drugs may include:
I- Used in gastric and duodenal ulcers
II- Omeprazol and lansoprazol are examples of proton pump inhibitors
III- They decrease stomach acid secretion
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
15- Zollinger-Ellison disease is a grave stomach disease. Drug of choice in the treatment
of Zollinger-Ellison diseases may include:
a) Ranitidine
b) Famotidine
c) Loratidine
d) Omeprazol
e) Antacids
16- Correct statements regarding the administration of antacids may include:
I- Taken 1hr before meals
II- Taken 3hrs after meals
III- Taken 2hrs before bedtime
a) I only
b) III only
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c) I and II only
d) II and III only
e) All are correct
17- All of the following enzymes are found in saliva, EXCEPT:
a) Amylase
b) Ptyalin
c) Gastrin
d) Lysoenzyme
e) All are correct
18- Which of the following is/are examples of salivary glands?
I- Parotid
II- Submandibular
III- Sublingual
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
19- The digestive process is done in many different steps. The first step of digestion may
be taken in:
a) Mouth
b) Esophagus
c) Stomach
d) Small intestine
e) Large intestine
20- Wrong statement regarding stomach secretions may include:
a) Mucus is present in stomach as lubricant and protect surface from acid
b) Acids breakdown food, kill bacterias and convert pepsin to pepsinogen
c) Pepsinogen is also called chief cell
d) Gastrin is the one that inhibit acid secretion
e) The intrinsic factor in stomach is secreted from parietal cell
21- The small intestine is classified in three parts, the anatomical order division of small
intestine is known as:
a) Jejunum, duodenum and ileum
b) Ileum, jejunum and duodenum
c) Duodenun, jejunun and ileum
d) Duodenun, ileum and jejunun
e) Jejunun, ileum and duodenun
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22- Conditions that may be the main cause of duodenal ulcers include:
a) High motility of stomach
b) Bacterial migration
c) Squirting of acid stomach content into the duodenal wall
d) Reflux of stomach content into the esophagus
e) Hyperacidity of stomach
23- The pancreas is constituted of endocrine and exocrine glands. What is the function of
endocrine gland of pancreas?
a) Production of enzymes
b) Production of insulin
c) Production of proteins
d) Production of glycogen
e) Production of bile
24- Colon is the last part of the digestive system and may be anatomical divided in:
a) Ascending colon
b) Transverse colon
c) Descending colon
d) Sigmoid colon and rectum
e) All are correct
25- H2 is involved in gastric acid and pepsin secretion. All of the following are examples
of H2 inhibitors, EXCEPT:
a) Ranitidine
b) Nizatidine
c) Cimetidine
d) Omeprazole
e) Famotidine
26- H2 inhibitors are used in the treatment of gastric hyper secretion and GI ulcers. One
of the most potent H2 inhibitors may include:
a) Famotidine
b) Cimetidine
c) Ranitidine
d) Nizatidine
e) Promethazine
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27- Example(s) of conditions that may be treated with H2 inhibitors may include:
a) Gastric hypersecretion
b) Duodenal ulcers
c) Zollinger-Ellison syndrome
d) Pain associated with GERD
e) All are correct
28- Proton pump inhibitors used in gastrointestinal complications are irreversible
inhibitors of:
a) Na pump
b) Na/K pump
c) K pump
d) Cl pump
e) Mg/K pump
29- Most common side effect during treatment with proton pump inhibitors may include:
I- Headache
II- Diarrhea
III- GIT pain
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
30- Ulcers are complications of gastrointestinal tract. The risk of having ulcers is bigger
in people having which of the following conditions:
a) Smokers
b) Alcoholics
c) NSAID long-term treatment
d) Corticosteroids long-term treatment
e) All are correct
31- Examples of effective treatment of ulcers may include:
I- Antacids
II- H2 inibitors
III- Proton pump inhibitors
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
32- Sulcrafate is used in gastrointestinal complications and may act as:
a) Antacid
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b) H2 inibitor
c) Mucosal protectant
d) Antisecretory prostaglandin analog
e) Proton pump inhibitor
33- Antacids are commonly used to neutralize gastric acid pH. Example of best antacids
constitution may include which of the following combinations?
a) Magnesium hydroxide only
b) Aluminum hydroxide only
c) Calcium carbonate only
d) Magnesium and aluminum hydroxide
e) Calcium and aluminum hydroxide
34- Antacids neutralize the gastrointestinal acid pH by which of the following mechanism
of action?
a) Reduce the concentration and total load of acid in the gastric content by increasing
gastric pH.
b) Inhibit (H+,K+)-ATPase enzyme system at the secretory surface of the gastric parietal
cell
c) Inhibit H2 neurotransmitters
d) Inhibit gastrin secretion
e) Inhibit the conversion of pepsin to pepsinogen
35- Diarrhea is a common side affect seen with which of the following antacids?
a) Aluminun containing antacid
b) Magnesium containing antacid
c) Calcium containing antacid
d) Magnesium and aluminum containing antacid
e) Calcium and aluminum containing antacid
36- Constipation and/or diarrhea may be side effects of antacids therapy. Which of the
following antacids may have constipation as side effect?
a) Aluminun containing antacid
b) Magnesium containing antacid
c) Calcium and magnesium containing antacid
d) Magnesium and aluminum containing antacid
e) Calcium and aluminum containing antacid
37- Correct statements regarding the advantages of taken antacids mixtures of aluminum
and magnesium may include:
I- Provides more sustained action
II- Permit a lower dose of each compound
III- The constipation effect of aluminum may counter the diarrhea caused by magnesium
a) I only
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b) III only
c) I and II only
d) II and III only
e) All are correct
38- Laxative is normally contra-indicated during pregnancy. The only agent with laxative
effects that may be used during pregnancy include:
a) Senna
b) Magnesium hydroxide
c) Psyllium
d) Docusate sodium
e) Bisacodyl
39- Examples of stimulant laxative may include all of the following, EXCEPT:
a) Senna
b) Cascara
c) Bisacodyl
d) Lactulose
e) Castor oil
40- Common or regular diarrhea may best be treated by the administration of:
I- Loperamide
II- Aluminum hydroxide
III- Bismuth subsalicylate
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
41- Antidiarrheal agent that appears to be bactericidal to H. pylori being useful in the
treatment of duodenal ulcers and gastric ulcers associated with H. pylori:
a) Bismuth subsalicylate
b) Loperamide
c) Docusate sodium
d) Psyllium
e) Milk of magnesium
42- Drug(s) used for the short-term treatment of gastro esophageal reflux and peptic ulcer
diseases may include which of the following?
I- H2 receptors antagonists
II- Proton pump inhibitors
III- Corticosteroids
a) I only
b) III only
c) I and II only
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d) II and III only
e) All are correct
43- One of the most frequent side effect seen with SULCRAFATE therapy may include:
a) Diarrhea
b) Constipation
c) Edema
d) Cramps
e) Vomiting
44- Metoclopramide can act as effective agent in the management of many different
conditions. Some characteristics of metoclopramide include:
I- It increases the rate of gastric emptying
II- It has both peripheral and central effect
III- It can induce Parkinsons disease
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
45- Drug of choice in treating NSAIDs-induced ulceration may include:
a) Ranitidine
b) Omeprazole
c) Misoprostol
d) Sulcrafate
e) Aluminium hydroxide
46- A 5-Aminosalicylate active metabolite drug used in the treatment of Crohns disease:
a) Lansoprazole
b) Famotidine
c) Misoprostol
d) Sulfasalazine
e) Omeprazole
47- Active metabolite of sulfasalazine may include:
a) Acid salicylic acid
b) Salicilyc acid
c) Salicylates
d) Aminosalicylate
e) 5-Aminosalicylate
48- Sulfasalazine, a 5-Aminosalicylate active metabolite drug suffer its metabolism
mainly where?
a) Colon
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b) Stomach
c) Small intestine
d) Duodenum
e) Esophagus
49- Lipase inhibitor used to treat obesity may include:
a) Diethylpropiom
b) Orlistat
c) Benzphetamine
d) Mazindol
e) Phenylpropanolamine
50- Which of the following drugs are available in a transdermal form for the prevention
of motion sickness?
a) Metoclopramide
b) Granisetron
c) Ondasetron
d) Scopolamine
e) Diphenhydramine
51- Sinvastatin used in hypercholesteramia is characterized by which of the following
mechanism of action?
a) Inhibiting xanthine oxidase
b) Inhibiting HMG-CoA reductase
c) Inhibit acetylcholinesterase
d) Acting as a bile sequestrant
e) Interfering with fat absorption from GI
52- Lactulose is an osmotic laxative agent that may be used to treat:
I- Constipation
II- Portal-systemic encephalopathy
III- Renal tubular necrosis
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
53- The primary function of simethicone used in antacid products is to act as:
a) Suspending agent
b) Adsorbent
c) Buffer
d) Antiflatulant
e) Flavoring agent
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All of the following diseases cause the GI bleeding, except:
A-Gastritis
B-Peptic ulcer
C-NSAIDs
D-GI cancer
E-Pancreatitis
Ans-E
GASTROINTESTINAL SYSTEM
CORRECT ANSWERS
1- E
Comments: Hernias is a protrusion of a loop of an organ or tissue normally through the
GI area. Hernia hiatus is a herniation of stomach through the esophageal hiatus of
diaphragm. Strangulated hernia is an incarcerated hernia that is so tightly constricted as to
compromise the blood supply of the contents of the hernia sac.
2- A
Comments: Misoprostol is a prostaglandin analogue that increases bicarbonate and
mucin release and reduces acid secretion.
3- C
Comments: The most common drug reaction in the GIT is hydrolysis because most of
the drugs have an ester and/or amide group attached to their molecular formula and/or
react with water contests in GIT.
4- B
Comments: Salicylate compounds are largely hydrolyzed in the GIT, liver and blood to
salicylate, which is further metabolized primarily in the liver.
5- D
Comments: Ascitis is an effusion and accumulation of serous fluid in the abdominal
cavity; called also abdominal or peritoneal dropsy.
6- D
Comments: Karaya gum is used as skin adhesives and protective skin barriers in the
fitting and care of ostomy, colostomy appliances and in other conditions involving an
artificial stoma
7- C
Comments: Somatotropin is a hormone growth with no effect on gastric acid secretion.
8- C
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Comments: Gastro-esophageal Reflux disease is a chronic, pathologic, potentially lifethreatening disease manifested by reflux of the stomach and duodenal contents into the
esophagus, which is principally characterized by heartburn and regurgitation
9- A
Comments: Acute hemorrhagic gastritis is an erosive inflammation of the stomach with
bleeding normally seen with chronic alcoholism.
10- C
Comments: Magnesium salts used in antacids cause diarrhea. It also may cause systemic
effect as hypermagnesemia.
11- A
Comments: Villi and microvilli are found in the small intestine and are formed of
capillaries that works in the absorption of digestive food to rich the venous and capillaries
drainage of the gut.
12- E
Comments: Metoclopramide can be classified as dopaminergic blocking agent,
gastrointestinal emptying adjunct, peristaltic stimulant and antiemetic agent. It can be
used in cancer chemotherapy avoiding nausea and vomiting as well in diabetes
gastroparesis.
13- D
Comments: Bile is a fluid secreted from the liver and poured into the small intestine via
the bile ducts. It constituted of conjugated bile acids, cholesterol, phospholipid, bilirubin
diglucuronide and electrolytes. Bile is also responsible for the alkalinization in the
intestinal content due to its bicarbonate content.
14- E
Comments: Proton-pump inhibitors are the ultimate mediator of gastric acid secretion
inhibition; they are specific inhibitors of H+, K+ ATPase enzyme system at the secretory
surface of the gastric parietal cells. The most widely used proton-pump inhibitors are
omeprazole and lansoprazole.
15- D
Comments: Omeprazole is a proton-pump inhibitor is the drug of choice in treating
Zollinger-Ellison disease and reflux disease.
16- E
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Comments: Antacids should be taken 1 hour before meals, 3 hours after meals and at
bedtime
17- C
Comments: Gastrin, also known as G-cell is present in the stomach and stimulates acid
secretion.
18- E
Comments: Salivary glands are composed of 3 pairs of glands: Parotid, submandibular
and sublingual gland.
19- A
Comments: The first step of digestion is done in the mouth by the salivary enzymes,
amylase, ptyalin and lysozyme.
20- D
Comments: Gastrin is responsible for the stimulation of gastric acid secretion
21- C
Comments: The small intestine is anatomically divided in Duodenum, Jejunum and
ileum.
22- C
Comments: Duodenal ulcers also known as peptic ulcers are mainly characterized by
squirting of acid stomach into the duodenal wall.
23- B
Comments: The pancreas has two different glands. 1-Exocrine, responsible for the
production of enzymes which go to the duodenum via the pancreatic duct and 2Endocrine gland, responsible for the production of insulin, the blood sugar regulator.
24- E
Comments: The colon is anatomically divided into: Ascending colon, transverse colon,
descending colon, sigmoid colon and rectum.
25- D
Comments: Omeprazole is a proton-pump inhibitor.
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26- A
Comments: Famotidine is the most potent H2 blocker. It reduces the gastric acid in 94%
up to 10 hours.
27- E
Comments: H2 blockers can be used to treat gastric hypersecretion, duodenal ulcers,
Zollinger-Ellison disease and reduce pain associated with gastroesophageal reflux
disease.
28- C
Comments: Proton-pump inhibitors are irreversible direct inhibitor of potassium pump.
29- E
Comments: The most frequent side effect seen in the treatment with proton-pump
inhibitors are: Abdominal pain or colic, diarrhea or constipation, unusual tiredness,
muscle pain, headaches, dizziness and skin rashes
30- E
Comments: Long-term treatment with NSAIDs and corticosteroids definitely increase the
risk of ulcers disease because these drugs cause many different GI side effects as pain,
cramps, acidity of stomach and other GI motility effects. Ulcers are also increased in
alcoholism and in smokers due to irritation and destruction of gastric mucosa. Other
agents that may increase the incidence of ulcers are coffee, orange juice, fatty and spice
food and emotional stress.
31- E
Comments: The basic pharmacological choices in the treatment of ulcers include H2antagonists, proton-pump inhibitors, misoprostol and sulcrafate. Ulcers associated with
H. pylori can be treated by triple therapy with omeprazole, clarithromycin and
amoxacillin.
32- C
Comments: Sulcrafate acts as protective coating of the gastric mucosa, it is particularly
used in ulcerated areas.
33- D
Comments: The mixtures of aluminum and magnesium are the most widely used
combination of antacids, because they compensate the side effects of each other.
34- A
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Comments: Antacids act neutralizing gastric acid, which increases the pH of refluxed
gastric contents and lower esophageal sphincter pressure.
35- B
Comments: Diarrhea is the most common side effect seen with the administration of
magnesium hydroxide antacid. Aluminum and calcium carbonate cause constipation.
36- A
Comments: Constipation is the most common side effect seen with the administration of
aluminum containing antacid. Magnesium is an antacid with cathartic side effect.
37- E
Comments: Magnesium and aluminum mixtures are commonly used together because
they provide more even sustained action than used as single agent and permit lower dose
of each compound. The constipation effect of aluminum may counter the diarrhea caused
by magnesium.
38- C
Comments: Therapeutically safe in pregnancy, psyllium is a bulk-forming agent used as
laxative, it contains plant matter that absorbs water and softens the stool.
39- D
Comments: Lactulose is an osmotic laxative.
40- E
Comments: Diarrhea caused by infections, toxins and drugs are mostly treated with
specific agents, however the regular diarrhea normally caused for stress or stomach
indisposition is best treated with loperamide, bismuth subsalicylate or aluminum
hydroxide.
41- A
Comments: Duodenal and gastric ulcers are often caused by H. pylori. The treatment
objective is eradication of the bacterium with combination of antibiotics and h2antagonists, however bismuth subsalicylate is also used because it appears to be
bactericidal to H. pylori in high doses concentration.
42- C
Comments: Corticosteroids are neither used in the treatment of GERD nor in the
treatment of peptic ulcers. They normally induce or make worsen the ulcer condition.
43- B
Comments: Sulcrafate is used as protective coating of the gastro intestinal mucosa and
have constipation as its main side effect.
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44- E
Comments: Metoclopramide can be used as gastrointestinal emptying adjunct, peristaltic
stimulant, antiemetic agent and dopaminergic blocking agent, which may induce
Parkinsons disease due to the blockage of dopamine.
45- C
Comments: Misoprostol is a prostaglandin analogue that increases bicarbonate and
mucin release and reduces acid secretion. It is used to treat NSAID-induced ulceration.
46- D
Comments: Sulfasalazine is an 5-Aminosalicylate (5-ASA) active metabolite agent used
as the drug of choice in the treatment of crohns disease.
47- E
Comments: The pharmacologic action of sulfasalazine is seen through its active
metabolite 5-Aminosalicylate (5-ASA).
48- A
Comments: Sulfasalazine is metabolized in the colon by resident bacterias into 5-ASA
and sulfapyridine. Sulfapyridine is absorbed while the 5-ASA remains in the colon.
49- B
Comments: Orlistat is a lipase inhibitor being used to treat obesity, it binds to pancreatic
and gastric lipase and inactivate the enzyme reducing the dietary absorption of fat by
about 30%.
50- D
Comments: Scopolamine is the only available transdermal drug used to treat motion
sickness.
51- B
Comments: Sinvastatin is a statin (HMG-CoA reductase inhibitor) used as
antihyperlipidemic agent.
52- C
Comments: Lactulose is an osmotic laxative that can be used to treat constipation and
portal systemic encephalophaty as well.
53- D
Comments: Simethicone is mainly used in antacids preparations as antiflatulant agent
(anti-gas).
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Fourth edition
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Diabetes Mellitus
PHARMACY PREP
DIABETES
1. What is/are not symptoms of hypoglycemia
A-sweating
B-hunger
C-polyuria
D-fainting
E-fatigue
Ans: C
Comments; sweating, hunger, dizziness, fainting, fatigue are symptoms of hypoglycemia
Polyurea, polydipsea, neuropathic pains, and blurred vision are symptoms
hyperglycemia.
2-Which of the following antidiabetic drug may be taken regardless of meals:
A-Metformin
B-Chlorpropamide
C-Glyburide
D-Roziglitazone
E-Acarbose
Ans-D
Tips: Rosiglitazone can be taken with or without meals, where as metformin.
Chlorpropamide, glyburide taken with food, and acarbose is taken with first bite of meals.
3-Which of the following drug associated hypoglycemia treated with glucose rather than
sucrose:
I-Metformin
II-Insulin
III-Acarbose
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
AnsTips: Acarbose impair the digestion of sucrose. Hypoglycemia in-patient taking acarbose
should be treated with glucose rather than sucrose.
4-A 17-year-old type 1 diabetic patient is currently on diabetic medications. All of the
following antidiabetic drugs are not used in type I diabetes EXCEPT:
A-Chlorpropamide
B-Glyburide
C-Repaglinide
D-Nateglinide
E-Pioglitazone
Ans-E
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Diabetes Mellitus
5-Which of the following antidiabetic drug is gender selective:

A-Metformin
B-Chlorpropamide
C-Glyburide
D-Roziglitazone
E-All of the above
Ans-D
Tips: increase risk of pregnancy if inadequate contraception is used. Resume ovulation in
previously anovulatory women
6- Diabetic patient with hypercholesterolemia has high cholesterol, high LDL, normal
TG. What would be the drug of choice?
a) Lovastatin
b) Colestipol
c) Gemfibrozil
d) Niacin
e) Metformin
Ans: A
7-Which of the following antidiabetic drug effect on lipid levels (increase HDL, LDL and
decrease TG).
A-Metformin
B-chlorpropamide
C-Pioglitazone
D-Repaglinide
E-Insulin
Ans-C
8-Which of the following is the intestinal lipase inhibitor:
A-Acarbose
B-Metformin
C-Pioglitazone
D-Orlistat
E-Repaglinide
Ans-D
Tips: Orlistat (xenical) act as intestinal lipase inhibitor and prevents absorption of fat
soluble vitamins ADEK.
9-Chlorpropamide is not used with ethanol because
A-It can induce hypoglycemia
B-Hypoglycemia occur
C-Alcohol intolerance occur
D-Disulfuram like reaction
E-All of the above
Ans-D
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PHARMACY PREP
THYROID DISORDERS
1-Select incorrect combinations in the following pairs:
A-Antithyroid drugsthionamides (PTU, methimazole)
B-Antithyroid drugslugols solution
C-Lugols solution5%I +10% KI
D-HypothyroidismThyroxine (T4) and liothyrosine (T3)
E-HypothyroidismGraves disease
F-HypothyroidismHoshimoto thyroiditis
Ans-E
Tips: Graves disease is hyperthyroidism
2-All of the following are the symptoms of hypothyroidism EXCEPT:
A-weight gain
B-Fatigue
C-Impaired memory
D-Constipation
E-Heat intolerance
Ans-E
3-Conversion of T4 to T3 is catalyzed by:
A-tetraiodinase enzyme
B-Deiodinase enzyme
C-triiodinase enzyme
D-Hydrogenase enzyme
E-Iodinase enzyme
Ans-B
4-Which of the following laboratory monitoring indicated hypothyroidism:
I-Elevated TSH levels
II-No change in TSH levels
III- Decreased TSH levels
a) I only
b) III only
c) I and II only
d) II and III only
e) I, II, and III
Ans-A
5-All of the following are the symptoms of hyperthyroidism, EXCEPT:
A-weight gain
B-heat intolerance
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C-palpitation
D-diarrhea
E-anxiety
Ans-A
Tips: in hyperthyroidism, there is weight loss
6-Which of the following condition is hyperthyroidism
I-Hoshimoto thyroiditis
II-Myxedema
III-Graves disease
a) I only
b) III only
c) I and II only
d) II and III only
e) I, II, and III
Ans-B
7-Lugol solution contain:
A-Iodine
B-KI 10%+Iodine 5%
C-KI
D-Radioactive iodine
E-Sodium iodide
Ans-B
8-A patient using lugol solution should be counseled:
I-Lugol solution may cause stains
II-Use topical only
III-Used in hypothyroidism patients
a) I only
b) III only
c) I and II only
d) II and III only
e) I, II, and III
Ans-A
Tips: Lugol solution is used as oral drops, Lugol solution is indicated in hyperthyroidism
patients.
9-Drug of choice in pregnancy for hyperthyroidism
A-Lugol solution
B-Propylthiouracil
C-Methimazole
D-Levothyroxine
E-Liothyronine
Ans-B
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10-Patient receiving levothyroxine (L-T4) (synthroid) should monitor levels of:
A-INR
B-T4
C-TSH
D-PT
E-fT3
Ans-C
11- A woman with Graves disease. Doctor prescribed methimazole. All of the
following statements are true, EXCEPT:
a) This drug inhibits thyroid hormone
b) Onset of action is after 2 weeks synthesis
c) Do not stop the drug if there is a rash
d) Call the doctor if there are symptoms of infection
Ans: C
12- Instructions for Synthroid tablet.:
I.
Should not be taken with Iron and soya
II.
Should not be taken within 4 hours of Ibuprofen
III.
Should not be crushed
a) I only
b) III only
c) I and II only
d) II and III only
e) I, II, and III
Ans: A
Synthroid should not be taken with aluminum hydroxide, cholestyramine resins,
colestipid, ferrous sulfate, sod. Polystyrene sulfonate, soybean flour (infant formula) due
to decreased absorption of levothyroxin from GI tract.
May be given to children by crushing the tab. and suspending them in a small amount of
water, breast milk or non-soybean based formula. Do not store the suspension for any
period of time.
Food and formula containing large amount of soybean, fibre, or iron should not be used
for administration of levothyroxin.
13- Symptoms of overdose of levotyroxin all, EXCEPT:
a) Cold tolerance
b) Tachycardia
c) Diarrhea
d) Weight loss
Ans: A
14-What is the most common side effects of propylthiouracil?
A-weight loss
B-weight gain
C-agranulocytosis
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D-platelet aggregation
E-diarrhea
Ans-C
15-Hypothyroidism symptoms except?
A-diarrhea
B-weight gain
C-bradycardia
D-hair loss
E-puffy face
Ans-A
16-Hypoglycemia symptoms, except?
A-palpitation
B-tremor or shaking
C-fails to think
D-sweating
E-polyphagea
Ans-E
17-What is effect of cotrimoxazole on wafarin
A-decrease INR by inhibiting GI flora
B-Increase INR by inhibiting GI flora
C-does not alter INR
D-Increase the risk of thromboembolism
Ans-B
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Diabetes Mellitus
59
PHARMACY PEP
CONTRACEPTION
1-Contraceptive methods that protect STDs such as, gonorrhea, syphilis, chlamydia, and
AIDS?
A-Oral contraceptive
B-Condoms
C-Contraceptive sponges
D-Vaginal cream
E-Plan B
Ans-B
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PHARMACY PREP
GENITOURINARY CONDITIONS
1-Toxic shock syndrome is caused by:
A-E. coli
B-S. aureus
C-Chlamydia
D-Gonnorhea
E-Non gonococcal
Ans-B
2-Toxic shock syndrome may have risk with the use of:
I-Tampons use
II-Diaphragm contraceptive
III-Condoms as contraceptive
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans-C
3-Finastride is alpha reductase inhibitor, indicated in:
I-Benign prostate hyperplasia (BPH)
II-Alopecia
III-Increase sexual function
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
Ans-C
4-All of the following are the BPH symptoms, EXCEPT:
A-nocturia
B-frequent urination
C-Jet urination
D-urinary retention
E-post void dripping
Ans-C
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5-Correct statement about Pre Menstrual Symptoms (PMS) include:
I-All women have PMS
II-Luteal phase of cycle have PMS
III-vitamins, and estrogens deficiency may cause PMS
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
Ans-D
9. Urinary incontinence is NOT aggravated by:

I.
Furosemide
II.
TCA
III.
Doxylamine
a) I only
b) III only
c) I and II only
d) II and III only
e) All of the above
Ans: D
Tips: Doxylamine succinate belongs to the ethanolamine class of antihistamines gives
anticholinergic side effects such as urinary retention, and induce sedation. Furosemide is
a diuretics increase urinary frequency.
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PHARMACY PREP.
BONES AND JOINT COMPLICATIONS
1- Osteoporosis is a disease characterized by loss of bone mass and may be aggravated
by:
I-Corticosteroids
II-Menopausa
III-Graves disease
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
2- A patients with allergy to Sulphonamides (i.e.: Sulphametoxazole) can take all of the
following medications, EXCEPT:
a) Penicillin
b) Lidocaine
c) Celecoxib
d) Clindamycin
e) Tetracycline
3- All of the following are examples of Disease Modifying Antirheumatic Agents
(DMARD), EXCEPT
a) Methothrexate
b) Sulfasalazine
c) Organic Gold Compounds
d) Sulfinpyrazone
e) Penicillamine
4- Calcitonin is mainly classified as hormone liberated by thyroid gland. Which stimulate
the release of calcitonin?
a) Hypercalcemia
b) Hypocalcemia
c) Hypophosphatemia
d) Hyperphosphatemia
e) High concentration of Vit. D
5- Which of the following statements is/are right regarding calcitonin
I- It secretion is normally stimulated during feeding, particularly of high calcium meals.
II- Prevents hypercalcemia by inhibiting the transport of Ca into extra cellular fluid and
by increasing the renal clearance of calcium
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III- It is a vitamin D derivative
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
6- The level of which drug should be adjusted during treatment with allopurinol
I- Mercapturic acid
II- Theophillin
III- Anticoagulants
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
7- Uricosuric agents are used in gout treatment by inhibiting the uric acid re-absorption
in the proximal tubules, the best example of a uricosuric agent is:
a) Allopurinol
b) Sulphinpyrazone
c) Indomethacin
d) Penicillamine
e) Methotrexate
8- An oral chelating agent used in the treatment of rheumatoid arthritis is:
a) Allopurinol
b) Sulphinpyrazone
c) Indomethacin
d) Penicillamine
e) Methotrexate
9- In the treatment of rheumatoid arthritis the salicylates:
a) Stop and often reverse the progressive joint involvement
b) Specifically reverse the cause of the disease
c) Provide only analgesic effect
d) Are effective because they are uricosuric agents
e) Are more effective when given with allopurinol
10- Importance of Vitamin D in osteoporosis:
I- Increase the absorption of calcium from the small intestine
II- The best vitamin D analog to treat osteoporosis is calcitriol
III- Antacids containing aluminum and magnesium may interfere with proper activity of
vitamin D.
a) I only
b) III only
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c) I and II only
d) II and III only
e) All are correct
11- Drug that inhibits xanthine oxidase and affect the metabolism of 6-mercaptopurine:
a) Sulfinpyrazone
b) Allopurinol
c) Penicillamine
d) Purinethol
e) Celecoxib
12- Pannus is an inflammatory exudates characterized by:
I- Synovial cell proliferation inside of a joint
II- Normally occurs in patients with rheumatoid arthritis
III- An immunologic complication
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
13- Intra-articular means:
a) In the joint space
b) In the tissues space
c) In the spinal fluid
d) In the spinal column
e) In the dermis
14- Colchicines, a widely used drug in gout treatment, can give false results of:
a) Glucose
b) Uric acids
c) Urates
d) Ketones
e) RBCs
15- Colchicine is used as anti-inflammatory agent in the acute treatment of:
a) Osteoporosis
b) Rheumatoid arthritis
c) Osteomyelites
d) Gout
e) Pressure atrophy
16- The use of indomethacin in gout treatment:
a) Inhibit the acute gout arthritis inflammation by inhibition of prostaglandin formation
b) Inhibits tubulin synthesis
c) Accelerate renal excretion of uric acid
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d) Inhibit uric acid synthesis
e) Inhibit the reabsorption of uric acid by the kidney
17- Allopurinol, a xanthine oxidase inhibitor, is a derivative of:
a) Uric acid
b) Purine
c) Pyridine
d) Pteridine
e) Urate salts
18- Goals of gout treatment may include:
I- Reduce inflammation during acute attacks
II- Accelerate renal excretion of uric acid
III- Reduce the conversion of purine to uric acid
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
19- Characteristics of GOUT, a group of disorders of purine and pyrimidine metabolism
may include:
I- Hereditary metabolite disease marked by inflammation of the joints
II- The joint inflammation is caused by precipitation of uric acid crystals
III- It is a type osteoporosis
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
20- Allopurinol, xanthine oxidase inhibitor, used in gout treatment may produce all the
following side effects, EXCEPT:
a) Increase in protrombin time
b) Hypersensitivity rashes
c) GIT intolerance
d) Peripheral neuritis
e) Necrotizing vasculitis
21- Use of estrogen in osteoporosis:
I- Estrogen enhance calcium retention and retard bone loss
II- Estrogen is useful in treat osteoporosis associated to menopause
III- Estrogen is not effective at increasing bone mass that has already been lost.
a) I only
b) III only
c) I and II only
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d) II and III only
e) All are correct
22- Osteoporosis is mainly characterized by:
a) Loss of joint movements
b) Loss of bone mass
c) Imbalance of uric acid
d) Hormonal imbalance
e) All are correct
23- Antimalarial drug used in the treatment of rheumatoid arthritis as Disease-Modifying
Antirheumatic Drug (DMARD)
a) Chloroquine
b) Quinine
c) Sulfasalazine
d) Hydroxycloroquine
e) Primaquine
24- Which is the correct start dose of methothrexate in the treatment of rheumatoid
arthritis?
a) 7.5 mg once a week
b) 15 mg once a week
c) 7.5 mg daily
d) 15 mg daily
e) 25 mg once a week
25- Correct administration of Penicillamine in the treatment of rheumatois arthritis
include:
a) With meals
b) In emptying stomach
c) With plenty of water
d) With orange juice
e) Before bedtime
26- Which of the following agents is the best choice of treatment for an asthma patient
with rheumatoid arthritis who is considered to have aspirin sensitivity?
a) Ibuprofen
b) Acetaminophen
c) Gold therapy
d) Azathioprine
e) Cyclophosphamide
27- Diflunisal is most likely to be prescribed for the treatment of:
a) Wilsons disease
b) Rheumatoid arthritis
c) Cysteinuria
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d) Psoriasis
e) Hansens disease
28-What calcium supplement has the most elemental calcium?
A-Calcium citrate
B-natural calcium
C-Calcium carbonate
D-milk
E-Calcium gluconate
Ans-C
29-The type of calcium supplement produced from oysters shells is?
A-Calcium citrate
B-natural calcium
C-Calcium carbonate
D-dairy calcium
E-Calcium gluconate
Ans-C
30-What is calcium supplement daily dose in adults?
A-1 g
B- 500 mg
C-800 mg
D-100 mg
E- 2 g
Ans-A
31-What is incorrect about alendronate?
A-Take first thing in the morning empty stomach with 1 full glass of water
B-Contraindicated renal diseases
C-70 mg/wk dose have equivalent effect as daily 10 mg dose
D-Monitor hypercalcemia before initiating treatment
E-Do not lie down for 30 min after oral dose
Ans-D
32-A patient using alendronate 70 mg/wk and calcium supplement, what is incorrect?
A-Avoid calcium supplement while using alendronate
B-It is important to take calcium supplement while using bisphosphonates
C-separate alendronate and calcium supplement at least 2 hour before and 4 after.
D-It is also essential to vitamin D supplements
E-It is recommended to take daily 800 mg IU vitamin D
Ans-A
CORRECT ANSWERS
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1- E
Comments: Osteoporosis is a disease characterized by the loss of bone mass. Substances
or conditions that alter the metabolism of bones may predispose or aggravated
osteoporosis. Example: Corticosteroids, menopause and Graves disease.
2- C
Comments: There is a cross-sensitivity drug interaction between sulphonamides and
celecoxib
3- D
Comments: Sulphynpyrazone is an uricosuric acid agent used in the treatment of gout.
4- A
Comments: Calcitonin is a hormone elaborated by the thyroid gland in response to
hypercalcemia.
5- C
Comments: Calcitonin is not a vitamin D derivative. It is a hormone elaborated by the
thyroid gland in response to hypercalcemia, lowering plasma calcium and phosphate
levels.
6- E
Comments: Allopurinol may inhibit enzymatic metabolism of anticoagulants, leading to
potentiation of the anticoagulant effect. Mercapturic acid dosage should be reduced with
concomitant use with allopurinol because it induced inhibition of xanthine oxidase
decreasing metabolism of mercapturic acid and potentiating therapeutic and toxic effects.
Allopurinol decrease theophyllin clearance resulting in increased serum theophyllin
concentrations
7- B
Comments: Allopurinol and indomethacin are used in gout treatment however not as
uricosuric agent but as xanthine oxidase inhibitor and NSAID respectively. Methotrexate
is used to treat rheumatoid arthritis as DMRA agent.
8- D
Comments: Allopurinol and sulphynphyrazone are only used in gout treatment.
Indomethacin can be used in rheumatoid arthritis however as NSAID and Methotrexate is
used as DMRA agent.
9- C
Comments: Salicylates in the treatment of rheumatoid arthritis provides only analgesic
effect by reducing prostaglandin synthesis.
10- E
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Comments: Osteoporosis is characterized by the loss of bone mass. Vitamin D
supplements have been used in the treatment of osteoporosis because vitamin D increases
the absorption of calcium that is essential to reduce bone loss. Antacids interact with
vitamin D in many ways, magnesium containing antacids may lead to hypermagnesemia
and aluminum containing antacids have its levels increased leading to aluminum bone
toxicity when currently used with vitamin D.
11- B
Comments: Allopurinol inhibit xanthine oxidase enzyme therefore the conversion of 6mercaptopurine to uric acid inhibiting the uric acid synthesis-formation
12- C
Comments: Pannus is an inflammatory exudates overlying the lining layer of synovial
cells on the inside of a joint, usually occurring in patients with rheumatoid arthritis or
related articular rheumatisms, and sometimes resulting in fibrous ankylosis of the joints.
13- A
Comments: Intra-articular is normally referred to a kind of injection given within a joint.
14- E
Comments: Colchicine may cause false-positive test results of red blood cells-RBC and
hemoglobin in urine. It may also cause decrease in platelet count.
15- D
Comments: Cochicine is only used in gout treatment. It has no effect on uric acid
therefore it is used just in the acute treatment of gout by inhibiting the migration of
leukocytes, phagocytes and leukotrienes B4 to the affected joint.
16- A
Comments: Indomethacin is a potent NSAID that inhibits the acute gout arthritis
inflammation by inhibition of prostaglandin formation and inhibition of crystals
phagocytes by macrophages.
17- B
Comments: Allopurinol is a purine derivative working as xanthine oxidase enzyme
inhibitor responsible for the conversion of 6-mercaptopurine to uric acid.
18- E
Comments: The gout disease is normally controlled by three different mechanisms: 1Control the inflammatory response by inhibition of leukocytes, macrophages and
leukotrienes migration to the affected joint. 2- Increase the renal clearance of uric acid by
inhibiting the reabsorption of uric acid by the kidney and 3- Reduce the conversion of 6mercaptopurine to uric acid by inhibition of the enzyme xanthine oxidase.
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19- C
Comments: Gout is a group of disorders of purine and pyrimidine metabolism. It is
manifested by hyperuricemia, recurrent characteristic arthritis induced by deposit of
crystals in and around the joint of the extremities, which may lead to destruction and
severe crippling of joints.
20- A
Comments: Main side effects of allopurinol therapy include: Steven-Johnsons
hypersensitivity rashes reactions, gastro-intestinal intolerance, peripheral neuritis and
necrotizing vasculitis.
21- E
Comments: Estrogen is widely used to prevent bone loss after menopause. Estrogen can
enhance calcium retention and retard bone loss but does not increase bone mass that has
already been lost.
22- B
Comments: Osteoporosis is mainly characterized by the loss of bone mass. It is the most
common of the metabolic bone diseases and is an important cause of morbidity in elderly.
23- D
Comments: Cloroquine and primaquine are normally used together only in the treatment
and prevention of malaria. Quinine and hydroxycloroquine are antimalarial agents and
alternatively used in prophylaxis and treatment of muscle cramps leg and rheumatoid
arthritis respectively.
25- B
Comments:
In the treatment of rheumatoid arthritis penicillamine should be
administrated in an empty stomach. Improvement of the condition may take up to 2 to 3
months of therapy
26- C
Comments: Gold therapy would be the best choice for this particular patient because the
other drugs may have cross-sensitivity with aspirin and/or induce brochospasm.
27- B
Comments: Diflunisal is a NSAID used for both acute and chronic anti-inflammatory
treatment of rheumatoid arthritis.
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Fourth edition
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Osteoporosis
PHARMACY PREP
OSTEOPOROSIS
1- Osteoporosis caused by the deficiency of the following:
I. Inadequate intake of vitamin D
II. Inadequate intake of calcium
III. Estrogen deficiency
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
Ans-E
2- Importance of Vitamin D in osteoporosis:
I- Increase the absorption of calcium from the small intestine
II- The best vitamin D analog to treat osteoporosis is calcitriol
III- Antacids containing aluminum and magnesium may interfere with proper activity of
vitamin D.
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
Ans- E
Tips: Osteoporosis is characterized by the loss of bone mass. Vitamin D supplements have
been used in the treatment of osteoporosis because vitamin D increases the absorption of
calcium that is essential to reduce bone loss. Antacids interact with vitamin D in many ways,
magnesium containing antacids may lead to hypermagnesemia and aluminum containing
antacids have its levels increased leading to aluminum bone toxicity when currently used with
vitamin D.
3. All of the following are side effect of a systemic corticosteroids prednisone: EXCEPT:
A-Weight gain
B-Glucose intolerance
C-Osteoporosis
D-Cataract
E-Resistant to infection
Ans-E
Tips: Corticosteroids increase the risk of infections.
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Hypertension
PHARMACY PREP
HYPERTENSION
1-A 45-year-old male diabetic patient blood pressure is 145/85, what action considered
appropriate?
A-Refer to emergency
B-Refer to physician
C-Uncontrolled diabetes
D-uncontrolled hypertension
E-It is normal blood pressure in 40 year of age patient
Ans-B
Tips: diabetics with hypertension and renal disease with hypertension should be treated for
hypertension at blood pressure over 130/85
2. Bradycardia associated with which of the following drug?
A-Nifedipine
B-Amlodipine
C-Verapamil
D-Nitroglycerine
E-All of the above
Ans-C
Tips: Dihydropyridine type of calcium channel blockers have reflex tachycardia, where as nondihydropyridine type of calcium channel blockers such as verapamil and diltiazem have
bradycardia.
3-A 57-year-old patient is regular customer of your pharmacy. His current medication include
hydrochlorothiazide. He complains the following side effects. Which of the following is not
due to his medication:
A-Gout
B-Erectile dysfunction
C-Hyperglycemia
D-Hypokalemia
E-Hypocalcemia
Ans-E
4-A hypertensive patient used sildenafil 20 hours before, which of the following is
contraindicated in this patient:
A-Nitroglycerine transdermal
B-Isosorbide dinitrate
C-iv nitroglycerine
D-Nitroglycerine sublingual
E-All of the above
Ans-E
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Hypertension
5-When spironolactone is used in-patient with cardiac heart failure, it works through which of
the following mechanism?
A-Aldosterone antagonist
B-Negative inotropic effect
C-Angiotensin II Inhibitors
D-Positive inotropic drugs
E-Positive chronotropic effect
Ans-A
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Coronary Artery Diseases
PHARMACY PREP
CORONARY ARTERY DISEASES
1-Which of the following anticholesterol medication may increase his blood sugar levels:
A-Atorvastatin
B-Niacin
C-Simvastatin
D-Fluvastatin
E-All of the above
Ans-B
2-Purple toe syndrome side effect is produced by:
A-Amiodarone
B-Raynaud phenomenon
C-Warfarin
D-Rifampin
E-Verapamil
Ans-C
3. Which medication CAN NOT BE used for prinzmetal angina (vasospastic angina)?
A. Amlodipine
B. Metoprolol
C. Acetyl salicylic acid
D. Verapamil
E. Diltiazem
Ans-B
Tips:
TC page 275, avoid beta blockers in prinzmetal angina, beta blockers cause vasoconstriction
(vasospasm)
4 Which effect of nitroglycerin is most likely responsible for its therapeutic action in angina
pectoris?
a. Dilation of coronary artery
b. Relaxation of peripheral vascular smooth muscle
c. Decrease myocardial after-load
d. A and B
e. A and C
Ans:
5.
a)
b)
c)
d)
e)
Nitroglycerin dilates the coronary arteries in angina pectoris by

Decreasing the heart rate reflexly
Increasing the metabolic work of the myocardium
Direct action on smooth muscle in the vessel walls
Increasing the effective refractory period in the atrium
Blocking beta-adrenergic receptors
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Coronary Artery Diseases
Ans-C
6.Which one of the following conditions is not associated with verapamil?
A. Inhibition of calcium ion influx
B. Negative inotropic effect
C. Coronary vasodilation effect
D. Peripheral vasodilation effect
E. None of the above
Ans: e
Tips: Verapamil act as coronary vasodilator by inhibiting calcium ion influx in coronary
smooth muscles, and it does negative inotropic effects.
7. Which one of the following factors is most directly attributed to angina attacks?
A. Stress
B. Heavy smoking
C. Myocardial ischemia
D. Obesity
Ans: c
8-Administration of which of the following drugs is most likely to PROLONG clotting time?
A. Morphine
B. Vitamin K
C. A barbiturate
D. Acetaminophen
E. Acetylsalicyclic acid
Ans-E
9. Which of the following drugs acts by inhibiting renal reabsorption of sodium?
a) Urea
b) Chlorothiazide
c) Theophylline
d) Digitalis glycosides
e) Procainamide
Ans-B
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Arrhythmias
PHARMACY PREP
ARRHYTHMIAS
1-Which of the following are the most common cardiovascular side effect of beta blockers:
A-Arrhythmias
B-Bradycardia
C-Sexual impairment
D-Bronchoconstriction
E-Drowsiness
Ans-B
Ans-B
Tips: Beta blocker side effects:
CVS Bradycardia, AV blockade, CHF
CNS sedation and sleep alterations
Other impotence, exacerbation of asthma,
2-Beta blockers are indicated in hypertension, because it act by:
A- cardiac output and renin secretion
B- heart rate and contractility as result O2 consumption
C- AV conduction velocity
D-Decrease mortality
E - cardiac output and renin secretion
Ans-A
Tips: Beta blockers indications:
Hypertension cardiac output and renin secretion
Angina heart rate and contractility as result O2 consumption
Supraventricular Tachycardia (SVT) AV conduction velocity
MIDecrease mortality
3-All of the following are neuromuscular blockers EXCEPT:
A-Succinylcholine
B-Pancuronium
C-Atracurium
D-Nicotine
E-Mivcurium
Ans-D
Tips: Nicotine is ganglionic blockers
Absolute refractory period?
A-Phase I to Phase 3
Relative refractory period
A-Phase 3
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Congestive Heart Failure (CHF)
PHARMACY PREP
CONGESTIVE HEART FAILURE
1. Symptoms of digitalis toxicity include all of the following EXCEPT
a) extrasystoles
b) nausea and vomiting
c) yellow-green vision
d) A-V conduction block
e) Decreased P-R interval
Ans-E
2. Which of the following drugs is MOST useful in treating or preventing angina pectoris?
a) Digitalis
b) Quinidine
c) Propranolol
d) Procainamide
e) Pentobarbital
Ans-C
2. Which of the following ions augments the inotropic effect of a digitalis?
a) Sodium
b) Lithium
c) Calcium
d) Chloride
e) Magnesium
Ans-C
3. Which of the following diuretics is appropriate for a patient for a patient who is suffering
from congestive heart failure and tends to show digitalis toxicity?
a) Furosemide
b) Triamterene
c) Ethacrynic acid
d) chlorthiazide
e) Hydrocholorothiazide
Ans-B
4-About digoxin, which of the following statement are true:
I-+ve chronotropic effects
II-+ve inotropic effects
III-Vagomimetic effects
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
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Congestive Heart Failure (CHF)
Ans-D
Tips: Digoxin blocks Na+/K+ ATpase, thus it causes +ve inotropic effect by increase free
calcium ions, where as it decreases heart rate, which is -ve chronotropic effect. It para
sympathetic action cause vegomimetic effects.
5. In the treatment of congestive heart failure, digitalis glycosides generally DECREASE all of
the following EXCEPT
a) Edema
b) Urine flow
c) Heart size
d) Heart rate
e) Residual diastolic volume
Ans-B
Tips: digoxin is indicated to treat CHF, its effects such as ve chronotropic effects decrease
heart rate, it also decrease edema, heart size, however, it increases urine flow.
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Peripheral Vascular Diseases
PHARMACY PREP
PERIPHERAL VASCULAR DISEASES
1. Which of the following monitoring parameter is essential for patient who currently taking
Low molecular weight heparin (LMWH):
A-International Normalized Ratio (INR)
B-Prothrombin time
C-Heparin assay
D-Sensitive TSH
E-None of the above monitoring needed
Ans-E
Tips: INR and PT is monitored for warfarin, aPTT for heparin, where as for LMWH these tests
are not effective
2. Which of the following are the monitoring parameters of warfarin therapy?
I
Total blood count (CBC)
II
PT (prothrombin time)
III
INR (international normalization ratio)
a. I only
b. III only
c. I and II
d. II and III
e. I, II and III
Ans D
3-Which of the following drugs increase INR?
A-Clotrimazole
B-Clindamycin
C-Azithromycin
D-Penicillins
Ans-A
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Anxiety Disorders
PHARMACYPREP
ANXIETY DISORDERS
1.Ms X is a 32-year old woman, who comes into your pharmacy to seek help on finding a
good lotion for her hands. You noticed that her hands are extremely chapped and raw. In
order to make the best product suggestion to her, you ask her more questions to determine the
cause. After some discussion, she admits to you that she washes her hands repeatedly
throughout the day, sometimes for 20 minutes at a time. When asked why, she says she feels
she must.
Which of the following terms most likely describes her repeated washing?
a. An obsession
b. A compulsion
c. An addiction
d. A phobia
Ans:
Tips: Obsession = repetitive imagination and compulsion = repetitive behavior
2-What is the drug of choice for generalized anxiety disorder (GAD)?
A-Haloperidol
B-Paroxetine
C-Amitriptyline
D-Phenytoin
E-Benzodiazepine
Ans-B
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Depression
PHARMACY PREP
DEPRESSION
1-All of the following are SSRIs except:
A-Fluvoxamine
B-Fluoxetine
C-Sertraline
D-Venlafaxine
E-Trazodone
Ans-D
Tips: venlafaxine is dual action antidepressant that is SNDRI.
Nefazadone withdrawn
2-Which of the following drug can stopped without tapering
A-Fluoxetine
B-Fluvoxamine
C-Sertraline
D-Citalopram
E-Paroxetine
Ans-A
Tips: Fluoxetine has long half-life, therefore it does not require tapering where as other SSRI
have short half-life require tapering.
3-All of the following drugs require waiting period for 2 weeks, before begin other
antidepressants, Except;
A-Fluvoxamine
B-Sertraline
C-Citalopram
D-Fluoxetine
E-Venlafaxine
Ans-A
Tips: Fluoxetine has long half life require 5 weeks washout period
4-Which of the following most appropriate dose range of lithium in treatment of acute mania.
I-0.6 0.8 mEq/L
II-0.2-0.8 mEq/L
III-0.8-1.5mEq/L
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans: B
Tips: acute maniac treatment lithium serum levels should be 0.8 mEq/L to 1.5 mEq/L
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Depression
5. Factors that increase lithium concentrations are all EXCEPT

A-Dehydration
B-Sodium loss
C-Caffeine
D-Fluoxetine
E-ACE inhibitors
Ans-D?
Tips: Lithium concentration may be increased by dehydration, sodium loss by diuretics and
ACE inhibitors, where as SSRI may cause serotonergic syndrome. Thereby drug that increase
Li concentration and SSRI require precaution when combined together.
6-Which of the following is a SSRI:
A-Bupropion
B-citalopram
C-Venlafaxine
D-Nortriptyline
E-Mirtazapine
Ans-B
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Antipsychotics
PHARMACY PREP
ANTIPSYCHOTICS
1-What antipsychotics should be monitored for WBC?
A-Olanzapine
B-Risperidone
C-quetiapine
D-clozapine
E-Haloperidol
Ans-D
2-What antipsychotics that is used to treat +ve and ve schizophrenia symptoms
A-clozapine
B-Haloperidol
C-chlorpromazine
D-Flufenazine
E-Domperidone
Ans-A
3-What is antipsychotic are used for hallucinations and delusions.
A-clozapine
B-haloperidol
C-risperidone
D-olanzapine
E-quetiapine
Ans-B
Tips: Hallucinations and delusions are positive schizophrenia symptoms thus drug of choice is
haloperidol.
4-The most potent D2 inhibitor antipscyhotics is?
a-clozapine
b-haloperidol
c-risperidone
D-olanzapine
Ans-B
5-The most common Extrapyramidal symptoms associated with?
a-clozapine
b-haloperidol
c-risperidone
D-olanzapine
Ans-B
6-Antipsychotic side effects, except
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Antipsychotics
A-EPS
B-Galactorrhea
C-Hyperprolactenemia
D-orthostatic hypotension
E-schizophrenia
7-Antipsychotics that preferred in Parkinsons patients?
A-quetiapine
B-clozapine
C-haloperidol
D-carbamazepine
Ans-A
8-A senior of 82 year age in senior home, violent and fighting and hitting spouse what is drug
of choice?
A-Clozapine
B-qutiapine
C-Risperidone
D-Haloperidol
Ans-B
9-Drugs that give Neuroleptic syndrome, except
A-phenothiazine
B-haloperidol
C-Flufenazine
D-chlorpromazine
E-Bromocriptin
Ans-E
10-All of the following drug can give serotonin syndrome except?
A-Sebritamine (Meridia)
B-fluoxetine
C-Venlafaxine
D-Phenelzine
E-Risperidol
Ans-E
11-All of the following are the symptoms of Irritable bowel syndrome (IBS), except?
A-constipation
B-diarrhea
C-stomach upset
D-GI bleeding
E-flatulence
Ans-D
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Antipsychotics
12-All drugs have withdrawal syndrome except?

A-lorazepam
B-alcohol
C-nicotine
D-morphine
E-omeprazole
Ans-E
13. Second generation antipsychotic drug are mainly indicated for:
A-Positive schizophrenia symptoms
B-Negative schizophrenia symptoms
C-Positive and negative symptoms
D-Depression and schizophrenia
E-Seizures and depression
Ans-B
Tips: the second generation antipsychotics i.e. olanzapine, risperidone, clozapine and
quetiapine are mainly indicated for the treatment of negative schizophrenia symptoms where as
1st generation antipsychotics i.e haloperidol, chlorpromazine, phenothiazines are mainly
indicated for the treatment of positive schizophrenia symptoms. Clozapine is indicated for +ve
and ve symptoms.
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Dementia
PHARMACY PREP
DEMENTIA
1. All of the following are symptoms of Alzheimers disease, EXCEPT:
A. Slurred speech
B. Reduced cognitive functions
C. Fatigue
D. Reduced sexual function
Ans: D
2. Risk factors of Alzheimers disease
A. Female gender
B. Smoking
C. Use of alcohol
D. Obesity
E. Diabetes
Ans: A
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Seizure and antiepileptic drugs
PHARMACY PREP
SEIZURE & ANTIEPILEPTICS
1-Phenytoin is indicated the treatment of all of the following types of seizure EXCEPT:
A-Grand mal
B-Complex partial
C-Simple partial
D-Tonic clonic
E-Absence seizure (petit mal)
Ans-E
Tips: Grand mal Valproic acid, Complex partial Carbamazepine, Simple partial
Carbamazepine, Tonic-clonic Valproic acid, Absence seizure Ethosuximide, and Status
epilepticus Diazepam
2-Which of the following drug is NOT used in absence seizure patient?
A-Phenytoin
B-Valproic acid
C-Diazepam
D-Ethosuximide
E-All of the above
Ans-A
3-Which of the following drug least likely to effect on oral contraceptives:
A-Tetracycline
B-Phenytoin
C-Carbamazepine
D-Gabapentin
E-Phenobarbital
Ans-D
4-Which of the following is the drug of choice in status epilepticus?
A-phenytoin iv
B-Carbamazepine iv
C-Diazepam iv
D-Infliximab
E-Valproic acid
Ans-C
5-Which of the following anticonvulsive drug treatment most likely cause kidney stone
formation.
A-Carbamazepine
B-Phenytoin
C-Tiagabine
D-Topiramate
E-Phenobarbital
Ans-D
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Seizure and antiepileptic drugs
Tips: topiramate is a derivative of fructose. Indicated as anti seizure drugpartial seizure, tonic
clonic seizures. Has high kidney stone formation side effect. Fibrates also causes gall bladder
stone formation
6-The most common side effects of anti seizure drugs:
I-Appetite and body weight changes
II-GI symptoms
III-Head ache and dizziness
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans-E
Comments: valproic acid and valproate increase appetite and may results in weight gain,
carbamazepine may cause dizziness and confusion.
7-Which of the following antiepileptic drugs has weight loss side effects:
A-Valproic acid
B-valproate
C-Phenytoin
D-Topiramate
E-Carbamazepine
Ans-D
8-A 25 year old female patient taking gabapentin for neuropathic pain, which of the following
statement is/are true:
I-She should avoid taking oral contraceptive because, this drug decrease effectiveness of
gabapentin
II-Gabapentin chemical structure is not similar to GABA
III-Gabapentin chemical structure contains GABA structure.
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans-B
9-Which of the antiseizure drug has weight loss side effects.
A-Topiramate
B-Carbamazepine
C-Phenytoin
D-Valproic acid
E-Gabapentin
Ans-A
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Parkinsons Disease
PHARMACY PREP
PARKINSONS DISEASE
1-Involuntary movements typically involves mouth, face, limbs and trunk is characterized as:
A-Trigeminal neuralgia
B-Tardive dyskinesia
C-Neuroleptic malignant syndrome
D-Extrapyramidal symptoms
E-Akathisia
Ans-B
Tips: dyskinesia = slow movement, tardive dyskinesia = involuntary movement of mouth, face,
limbs and trunk. Akinesia = difficulty in movement.
2-Which of the following antiviral drug indicated in Parkinson disease treatment:
A-Pergolide
B-Amantadine
C-Rimantadine
D-Selegiline
E-Entacapone
Ans-B
3-Which of the following Catecholamine Methyl Transferase (COMT) inhibitor has fatal liver
toxicity:
A-selegiline
B-Tolcapone
C-Entacapone
D-Pergolide
E-Amantadine
Ans-B
4-A 60-year-old adult who has been treated with haloperidol for 3 weeks. He presents with
muscle stiffness, tremors. This is the most likely what kind of side effect:
A-Acute dystonia
B-Akathisia
C-Tardive dyskinesia
D-Parkinsonism disease
E-Pseudoparkinsonism
Ans-E
Comments: Pseudoparkinsonism (TRAP) may be side effects of antipsychotics.
Pseudoparkinsonism may disappear after discontinuation of medication.
5-Which of the following is NOT used in treatment of Extrapyramidal side effects (EPS)?
A-Benztropine
B-Diphenhydramine
C-Trihexyphenidyl
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Parkinsons Disease
D-Donepezil
E-All of the above
Ans-D
Comments: anticholinergic agents such as benztropine, diphenhydramine, and trihexyphenidyl
are use in treatment of EPS. Donepezil is acetylcholinesterase inhibitor is not indicated in EPS
treatment.
6-Selegiline is:
A-COMT inhibitor
B-MAO-B selective inhibitor
C-Non-selective MAO inhibitor
D-Levodopa preparations
E-MAO-A selective inhibitor
Ans-B
Comments: MAO-B selective inhibitors
Tips: treatment for Parkinsons disease is:
BALSAC = Bromocriptine, Amantadine, Levodopa, Selegiline, Antimuscarinic (benztropine),
and COMT inhibitors
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Antimicrobial agents
PHARMACY PREP
ANTI-INFECTIVE AGENTS ANTIBIOTICS
1- Cephalosporin mechanism of action may include:
a) Inhibit protein synthesis
b) Inhibit cell wall synthesis
c) Inhibit synthesis of essential metabolites
d) Alter the function of cell membrane permeability
e) Inhibit translation of genetic information
2- The bacteriostatic effect of sulphametoxazole may be increased by:
a) Penicillin
b) Sulbactam
c) Clavulanic acid
d) Tarzobactam
e) Trimetroprim
3-Correct statements regarding Penicillin V may include which of the following?
I--lactamase sensitive antibiotic acid stable
II- Has a short half-life because is rapidly excreted by glomerular filtration
III- Probenecid increase penicillins activity
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
4- The only antibiotic available as chew able tablet include:
a) Penicillin
b) Amoxacillin
c) Ampicillin
d) Erytromycin
e) Claritromycin
5- Correct statements regarding Erythromycin ESTOLATE may include:
I- Primarily effective against gram-positive bacteria and also have activity against some
gram-negative bacteria
II- It is a macrolid antibiotic very useful as alternative to penicillin for those that have
allergy to penicillin antibiotics
III- Regular erythromycin is better absorbed from GIT that erythromycin estolate
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
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6- Penicillin should be administrated 1 hour before meals or 2 to 3 hours after meals in

order to:
I- Improve the bioavailability
II- Maximize the dissolution rate
III- Avoid interaction with calcium ions
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
7-Drugs used in the treatment of meningitis are all of the following, EXCEPT:
a) Penicillins
b) Cephalosporins
c) Gentamycin
d) Streptomycin
e) Sulfonamides
8- Examples of antibiotic that is an acid stable penicillinase resistant include:
a) Amoxacillin
b) Oxacillin
c) Ampicillin
d) Carbenicillin
e) Penicillin V
9- All of the following penicillins are acid labile penicillins, EXCEPT:
a) Penicillin V
b) Penicillin G
c) Methicillin
d) Nafcillin
e) Carbenicillin
10-Which of the following are/is correct regarding tetracycline?
I- Inhibit protein synthesis
II- May be used in dental works
III- Cannot be taken for children less than 8 years old
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
11- Which of the following describes the mechanism of action of sulphametoxazole?
b) Inhibit cell growth by competitive antagonism with folic acid synthesis
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d) Alter the function of cell membrane permeability

12- Mechanism of inhibit protein synthesis is characteristic of all the following
antibiotics, EXCEPT:
a) Aminoglycosides
b) Tetracycline
c) Cephalexin
d) Chlorafenicol
e) Clindamycin
13- Which of the following agents may interfere with the regular effect of penicillins?
a) Antacids
b) Food
c) Probenecid
d) Aminoglycosides
e) All of the above
14- Which of the following drugs cannot be taken orally?
a) INH
b) PABA
c) ASA
d) Streptomycin
e) Oxacillin
15- Example of drug used in prophylaxis of malaria include:
a) Cloroquine
b) Quinine
c) Primaquin
d) Quinin
e) Quinidine
16- Which of the following is NOT an anti-fungal drug?
a) Amphotericin B
b) Metronidazole
c) Grisofulvin
d) Nystatin
e) Clotrimazole
17- Examples of drugs that may inhibit DNA gyrase may include:
a) Gentamycin
b) Ceftriaxone
c) Norfloxacine
d) Erythromycin
e) Penicillin
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18- Which of the following agents may best treat Meningococcal encephalitis?
a) Sulfametoxazole
b) Erythromycin
c) Cephalexin
d) Tetracycline
e) Penicillin
19- Correct statements regarding aminoglycosides may include:
I- Has a half-life of 32hours
II- The effect continue remain after all drug is eliminated
III- The relation plasma concentration and half-life is not clear
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
20- Which of the following statement is/are correct regarding Gray Babies syndrome?
I- Occurs in premature and new born infants when choraphenicol is administrated during
the first few days of life
II- Due to inability of the infant to metabolize the drug because of glucoronyl transferase
deficiency
III- Glucoronyl transferase is required to detoxify cloraphenicol
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
21- Correct statements regarding Pellagra include:
I- Caused due to deficiency of niacin
II- Caused by failure in converting tryptophan to niacin
III- Characterized by dermatitis, diarrhea and dementia
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
22- Gonorrhea, a sexually transmitted disease may be treated by which of the following
agents?
I- Cefixime
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II- Ceftriaxone
III- Ciprofloxacin
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
23- Nosocomial infections may be best treated by which of the following agents?
I- Cephalosporin 3rd generation
II- Macrolides antibiotics
III- Penicillins
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
24- Viral encephalitis, a CNS infection, may be best be treated by which of the following
agents?
a) Benzyl penicillin
b) Ceftriaxone
c) Acyclovir
d) Streptomycin
e) Vancomycin
25- Example of drug(s) used to treat pneumonia include:
I- Ampicilin combined with aminoglycosides
II-Chlaritromycin
III- Levofloxacin
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
26- Otite extern, an ear infection may be best is best treated by:
a) Ciprofloxacin eardrop
b) Gentamicin eardrop
c) Prednisone eardrop
d) Levobunolol eardrop
e) Saline solution
27- Otite media is an ear infection normally caused by S. pneumoniae and may be the
best treated by:
a) Amoxacillin
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b) Penicillin V
c) Ampicilin
d) Amoxacillin clavulanate
e) Oxacillin
28- First line treatment for Urinary Tract Infection (UTI) may include:
a) Sulphametoxazole + Trimetroprine
b) Amoxacillin clavulanated
c) Penicillin
d) Erythromycin
e) All are very effective in treating UTI
29- Which of the following agents would be used in the treatment of infections caused by
Helicobacter pylori as combination therapy?
a) Penicillin, amoxacillin, ampicillin and metronidazole
b) Chlaritromycin, amoxacillin, omeprazole and metronidazole
c) Chlaritromycin, azithromycin and lansoprazole
d) Ceftriaxone and metronidazole only
e) Combinations of antibiotic should not be used due to resistance.
30- Treatment of large intestine infection mainly caused by food intoxication may
include:
I- Lots of fluids
II- Ciprofloxacin
III- Metronidazole
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
31- Colitis associated with antibiotic use can best be treated by:
a) Cephalosporins
b) Macrolides
c) Aminoglycosides
d) Vancomycin
e) Penicillin
32- Antibiotics that often cause colitis-acute inflammation of colon as side effect include:
I- Broad-spectrum penicillins
II- Cephalosporins
III- Clindamycin
a) I only
b) III only
c) I and II only
d) II and III only
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e) All are correct

33- Drug used together with chloroquine in the treatment of malaria with the purpose to
kill persistants parasites in the liver of a person infected with Plasmodium vivax is:
a) Quinine
b) Pyrimethamine
c) Sulfadoxine
d) Primaquine
e) Quinidine
34- Patient is resistant to chloroquine and need to be treated for malaria. Which of the
following drugs or combination should be more appropriate for this patient?
a) Atovaquone only
b) Chloroquine and primaquine
c) Quinine and doxacycline
d) Mefloquine
e) C and D are correct
35- Correct statements regarding antibiotics may include:
a) Drugs derivated from synthetic substances that can kill or inhibit bacterial growth
b) Drugs derivated from natural and synthetic source that can kill or inhibit bacteria
growth
c) Drug with ability only to kill bacteria
d) Drug with ability only to inhibit bacterial growth
e) All are wrong regarding antibiotics
36- Drugs derivated from synthetic substances that can kill bacteria is normally called:
a) Bacteriostatic antibiotic
b) Bactericidal antibiotic
c) Bactericidal antimicrobial
d) Bacteriostatic antimicrobial
e) Bacteriostatic bactericidal antimicrobial
37- Antiviral drugs act in many different ways, they can be classified in:
a) RNA inhibitors only
b) DNA inhibitors only
c) RNA and DNA inhibitors
d) Protease inhibitors
e) All are correct
38- Examples of very narrow spectrum penicillins include all of the following, EXCEPT:
a) Amoxacillin
b) Nafcillin
c) Metcillin
d) Oxacillin
e) All are very narrow spectrum penicillins
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39- Examples of extended spectrum penicillin may include:

a) Amoxacillin
b) Ampicillin
c) Cloxacillin
d) Carbenicillin
e) Dicloxacillin
40- Resistance is the major problem with penicillins due to ability of bacteria to
breakdown the lactam ring of penicillin and inactivates the drug. To overcome these
problem penicillins can be administrated together with -lactamase inhibitors.
Examples of -lactamase inhibitors is/are:
I- Clavulanic acid
II- Sulbactam
III- Tazobactam
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
41- Correct statements regarding CEPHALOSPORINS include:
I- Bactericidal antimicrobial
II- Derivated from natural source: Cephalosporium acremonium
III- Broad-spectrum agent
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
42- Example of fourth generation cephalosporin include:
a) Ceftriaxone
b) Cefipime
c) Cefixime
d) Cefotaxime
e) Cefoxitin
43- Correct statement regarding the mechanism of action of Vancomycin may include:
a) Inhibit release of tRNA bound to peptyl site after peptide bond formation
b) Inhibit peptide bound formation between acylaminoacids bound to the peptyl and
acceptor site
c) Inhibit stage II of cell wall synthesis preventing polymerization of the linear
peptideoglycan
d) Inhibit DNA gyrase in the bacteria
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e) Bind to ergosterol from pores resulting in linkage of cellular contents

44- Which of the following is one of the most common side effects of vancomycin?
a) Ototoxicity
b) Dissulfiran like side effect
c) Diarrhea
d) Weight gain
e) Hallucinations
45- All of the following are narrow spectrum protein synthesis inhibitors, EXCEPT:
a) Erythromycin
b) Azithromycin
c) Chlarithromycin
d) Tetracycline
e) Clindamycin
46- Which of the following is NOT a side effect of tetracycline?
a) Alteration in gut flora
b) Dissulfiran like reactions
c) Teeth permanent discoloration
d) Fanconi like syndrome
e) Hyperchloremic metabolic acidosis
47- Which of the following agents can be classified as macrolide antibiotics?
I- Azithromycin
II- Chlarithromycin
III- Erythromycin
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
48- Wrong statement regarding MACROLIDES ANTIBIOTICS include:
a) Used in both gram-positive and gram-negative infections
b) Used as an alternative to penicillin when patient has allergy to penicillins
c) Inhibit cell wall synthesis of microorganisms
d) Increase gastric motility causing cramps and diarrhea as major side effect
e) Very safe for children
49- All of the following are examples of aminoglycosides drugs, EXCEPT:
a) Nystatin
b) Gentamicin
c) Amikacin
d) Streptomycin
e) Garamycin
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50- Which of the following is an anti-infective agent with lowest therapeutic index?
a) Macrolide
b) Cephalosporins
c) Clorafenicol
d) Aminoglycosides
e) Antifungal agents
51- Fluoroquinolone are anti-infective agents analogs of:
a) PABA
b) Folic acid
c) Vitamin K
d) Cyanide
e) Nalidixic acid
52- Which of the following best classify metronidazole?
a) Antiprotozoa
b) Antibiotic
c) Antifungal
d) Antiviral
e) Antimicrobial
53- Example of drug(s) used in treatment of tuberculosis include:
I- Isoniazide
II- Rifampin
III- Ethambutol
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
54- Drug of choice in the treatment of percutaneous blood infection-schistosomyasis may
include:
a) Niclosamide
b) Prazinquatel
c) Mebendazole
d) Dapsone
e) Thiabendazole
55- All are examples of antihelmintic drugs, EXCEPT:
a) Niclosamide
b) Prazinquatel
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c) Mebendazole
d) Dapsone
e) Thiabendazole
56- Which of the following is considered a polyene antifungal agent?
a) Miconazole
b) Clotrimazole
c) Amphotericin
d) Itraconazole
e) Ketoconazole
57- Wrong statement regarding antifungal agents includes which of the following?
a) Polyene antifungal act binding to ergosterol from pores resulting in linkage of cellular
contents
b) Azoles antifungal act blocking the synthesis of ergosterol.
c) Polyene antifungal has the widest spectrum compared to any other agent
d) Side effects of antifungals include fever, chills, anorexia, headaches and muscle pain
e) Side effects of antifungals cannot be treat for Tylenol due to high drug interaction.
58- Which of the following statement is RIGHT regarding influenza treatment?
I- Type A influenza is best treated by amantadine and rimantadine
II- Type B influenza is best treated by oseltamivir and zenamivir
III- Influenza should not be treated with antiviral agents
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
59- All of the following are examples of quinolone antimicrobial agents, EXCEPT
a) Cephalexine
b) Ofloxacine
c) Norfloxacine
d) Ciprofloxacine
e) Levofloxacine
60- Which of the following conditions is quinolone antimicrobial drugs mainly used?
a) Respiratory tract infections
b) Urinary tract infections
c) Gastrointestinal tract infections
d) Endocarditis
e) Cerebral infections
61- Which of the following statements best describes the action of the antitubercular
agent ISONIAZID?
a) Inhibit cell wall synthesis of mycobacterium
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b) Inhibit the DNA duplication of mycobacterium

c) Inhibit arachydonic acids that feed mycobacterium
d) Inhibit mycolic acids that are unique for mycobacterium
e) Inhibit protein synthesis of mycobacterium
62- Which of the following complications is considered the gravest side effect associated
with isoniazid treatment?
a) Cardiac dysfunction
b) Mental dysfunction
c) Hepatitis
d) Renal complications
e) Discoloration of skin
63- The side effects of isoniazid are potentialized by deficiency of which vitamin?
a) Thiamine
b) Pyridoxine
c) Folic acid
d) Niacin
e) Cyanocobalamin
64- All of the following are examples of amino penicillin, EXCEPT:
a) Ampicillin
b) Cloxacillin
c) Amoxacillin
d) Bicampicilin
e) All are correct
65- Which of the following is an antiviral drug used in the treatment of AIDS-HIV?
I- Acyclovir
II- Zidovudine
III- Stavudine
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
66- Bacterial resistance to an antibiotic may occurs due to:
I- Mutation
II- Adaptation
III- Gene transfer
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
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67- The effectiveness of VANCOMYCIN is seen ONLY in:

a) Virus
b) Gram-negative bacterias
c) Gram-positive bacterias
d) Both gram-positive and negative bacterias
e) Plasmodium
68- Protein synthesis inhibitors may bind to:
a) 30s ribosomal subunit only
b) 50s ribosomal subunit only
c) 70s ribosomal subunit only
d) 30s and 50s and 70s ribosomal subunits
e) 30s and 70s ribosomal subunits
69- Broad-spectrum antibiotic that may cause severe impairment of bone marrow include
which of the following agents?
a) Tetracycline
b) Aminoglycosides
c) Vancomycin
d) Clorafenicol
e) Clindamycin
70- Which of the following agent is classified as lincosamide antibiotic?
a) Tetracycline
b) Aminoglycosides
c) Vancomycin
d) Clorafenicol
e) Clindamycin
CORRECT ANSWERS
ANTI-INFECTIVE AGENTS
1- B
Comments: Cephalosporin is antibiotics that act by inhibition of bacterias cell wall
synthesis.
2- E
Comments: Trimetropin is used together with sulphametoxazole to avoid resistance and
to increase the action of sulphametoxazole.
3- E
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Comments: Penicillin V is an acid-stable beta-lactamase sensitive antibiotic often used

together with probenecid, a beta-lactamase inhibitor, to avoid resistance of bacterias.
4- B
Comments: Amoxacillin is the only antibiotic available as chewable tablets.
5- C
Comments: Erythromycin estolate is a salt type of erythromycin; a macrolide antibiotic
that is better absorbed from GIT that erythromycin base.
6- A
Comments: Penicillins should be administrated in an empty stomach in order to improve
its bioavailability.
7- D
Comments: Streptomycin is not used in the treatment of meningitis. The main treatment
of bacterial meningitis may include penicillins, cephalosporins and vancomycin while
viral meningitis is mainly treated by acyclovir IV.
8- B
Comments: Oxacillin and cloxacillin are examples of acid-stable penicillanase resistant.
9- B
Comments: Penicillin V is an acid-stable penicillanase sensitive.
10- E
Comments: Tetracycline is broad-spectrum protein synthesis inhibitors that must be
avoided in children less than 8 years old due to its irreversible side effects as deposition
of the drug in teeth and bones causing permanent discoloration of teeth and bad
structural-formation in childrens teeth.
11- B
Comments: Sulphametoxazole act competing with PABA for incorporation into the
pathway leading to the synthesis of folic acid. Results in inhibition of folic acid synthesis
that is required for synthesis of purines and pyrimidines.
12- C
Comments: Cephalexin is a first generation cephalosporin that acts by inhibition of
bacterial cell wall synthesis.
13- E
Comments: Antacids and food interfere with the regular effect of penicillin by decreasing
the bioavailability of penicillin while probenecid and streptomycin increase the
bioavailability and effectiveness of penicillin when used currently.
14- D
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Comments: Streptomycin is only available in injectable form because it is not properly

absorbed by GIT.
15- A
Comments: Cloroquine is the main drug in prophylaxis and treatment of malaria.
16- B
Comments: Metronidazole is antiprotozoa drug acting by breakage of cell DNA.
17- C
Comments: Norfloxacine is a quinolone synthetic bactericidal antibiotic that acts by
inhibition of DNA gyrase in the bacteria.
18- E
Comments: Meningococcal encephalitis is a type of septic meningitis that normally is
best treated by penicillins, having Ceftriaxone and vancomycin as alternative treatment.
19- D
Comments: Aminoglycosides are inhibitors of protein synthesis characterized for having
a very small therapeutic window and for having the relation plasma concentration and
half-life not clear, therefore its therapeutic use should be closely monitored to avoid
serious side effect.
20- E
Comments: Gray Babies syndrome occurs in premature and new born infants when
choraphenicol is administrated during the first few days of life. It happens due to inability
of the infant to metabolize the drug because of glucoronyl transferase deficiency that is
essential to detoxify cloraphenicol.
21- E
Comments: Pellagra is a disease characterized by niacin deficiency and/or failure of body
to convert tryptophan to niacin. It is mainly characterized by dermatitis, diarrhea and
dementia.
22- E
Comments: Cefixime 400mg orally as single dose, ceftriaxone 125mg IM as single dose
and ciprofloxacin 500mg orally as single dose are the recommended regimens for the
treatment of uncomplicated gonorrhea.
23- A
Comments: Nosocomial infections are normally hospital developed secondary diseases
and may be best treated by third generation cephalosporin or ciprofloxacin.
24- C
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Comments: Viral encephalitis is mainly caused by HSV-1 and 2 viruses and may be
treated by acyclovir IV.
25- E
Comments: The treatment of pneumonia is based on the agent causative. Bacteria
pneumonia is mainly treated by the currently used of amoxacillin with aminoglycosides
or clarithromycin or levofloxacin.
26- B
Comments: Otite externa also known as swimmers ear is mainly caused by
pseudomonas, staphylococcus or enterobacterias and may be treated by garamycin or
gentamycin eardrops.
27- D
Comments: Otite media may be caused by caused by S. pneumoniae, H. influenza and M.
cataharlis, and may be treated by amoxacillin clavulanated.
28- A
Comments: First line treatment of UTI associated with E.coli infected agent is mainly
treated by sulphametoxazole and trimetroprim.
29- B
Comments: Helicobacter pylori is a GI infection associated with peptic ulcer and gastric
cancer that may be treated by the triple therapy that involves amoxacillin,
clarithromycin and omeprazole with or without metronidazole.
30- E
Comments: Treatment of large intestine infection mainly caused by food intoxication
include ciprofloxacin and metronidazole as therapeutic agents and increase the volume of
intake fluids as a non-pharmacologic help.
31- D
Comments: Vancomycin is the drug of choice in the treatment of pseudomembranous
colitis associated with antibiotic use.
32- E
Comments: Antibiotics that often cause colitis-acute inflammation of colon as side effect
include broad-spectrum penicillins, cephalosporins and clindamycin.
33- D
Comments: Primaquine is normally used together with Cloroquine in the treatment of
malaria with the purpose to kill persistants parasites in the liver of a person infected with
Plasmodium vivax.
34- E
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Comments: Treatment of malaria in those patients resistant to Cloroquine is normally

done by the currently use of quinine and doxacycline.
35- B
Comments: Antibiotics are drugs derivated from natural sources that can kill or inhibit
bacteria growth.
36- C
Comments: Bactericidal drugs have the capacity to completely kill the bacteria and
antimicrobial are drugs derivated from synthetic substances that can kill or inhibit
bacterial growth.
37- E
Comments: Antiviral drugs are classified as RNA inhibitor, DNA inhibitors, RNA and
DNA inhibitors, and protease inhibitors.
38- A
Comments: Amoxacillin is a wide spectrum penicillin antibiotic.
39- D
Comments: Carbenicillin is extended spectrum penicillin often given IV for serious
infections.
40- E
Comments: All, clavulanic acid, sulbactam and tazobactam are beta-lactamase inhibitors
used together with penicillins sensitive.
41- D
Comments: Cephalosporins are bactericidal antibiotics derivated from cephalosporium
acremonium. They are broad-spectrum agents and are resistant to many types of betalactamase. They may be classified by first, second, third and fourth generation.
42- B
Comments: Cefipime is a fourth generation cephalosporin antibiotic.
43- C
Comments: Vancomycin is a bactericidal agent that acts inhibiting stage II of cell wall
synthesis preventing polymerization of the linear peptideoglycan.
44- A
Comments: Side effects of vancomycin may include ototoxicity, phlebitis, chills and
fever.
45- D
Comments: Tetracyclines are broad-spectrum inhibitors of protein synthesis.
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46- B
Comments: Dissulfiran side effects are characterized by skin rashes, headache, acne,
drowsiness, tiredness, impotence and metallic or garlic taste in the mouth therefore is not
a side effect of tetracyclines.
47- E
Comments: Azithromycin, clarithromycin and erythromycin are examples of macrolides
antibiotics.
48- C
Comments: Macrolide antibiotics are protein synthesis inhibitors and have no effect on
cell wall synthesis inhibition.
49- A
Comments: Nystatin is a polyene antifungal drug.
50- D
Comments: Aminoglycosides are protein synthesis inhibitor agents characterized by its
low therapeutic index.
51- E
Comments: Fluoroquinolones are quinolones analog of nalidixic acid.
52- A
Comments: Metronidazole is an antiprotozoa agent that acts by breakage of cell DNA.
53- E
Comments: Isoniazide is the single most important drug used in TB. Rifampin is
normally used in combination with Isoniazide. Ethambutol is only used in TB treatment
given in combination with isoniazide.
54- B
Comments: Prazinquatel is an antihelmintic drug used in the treatment of schistosomiase.
55- D
Comments: Dapsone is an antimycobacterium drug of choice in the treatment of leprosy.
56- C
Comments: Amphotericin is the polyene antifungal prototype.
57- E
Comments: Tylenol and ibuprofen are considered the best drugs in the treatment of side
effects caused by antifungal drugs.
58- C
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Comments: Influenza is a viral disease and must be treated by antiviral agents.

59- C
Comments: Cephalexine is a first generation cephalosporin.
60- B
Comments: The most common use of quinolone is in the treatment of urinary tract
infections.
61- D
Comments: Isoniazide act by inhibiting mycolic acids that are unique for mycobacterium
62- C
Comments: Hepatitis may be a grave side effect associated with isoniazide therapy.
63- B
Comments: Isoniazide is a structural congener of pyridoxine-Vitamin B6, therefore
deficiency of pyridoxine potentate the effects of isoniazide.
64- B
Comments: Aminopenicillins are penicillins with amine group on its molecular structure.
Cloxacillin does not have an amine group on its molecular structure
65- D
Comments: Acyclovir is not used in HIV treatment.
66- E
Comments: Bacterial resistance to an antibiotic may occurs by mutation, adaptation
and/or gene transfer.
67- C
Comments: Vancomycin is a narrow spectrum bactericidal agent with activity only
against gram-positive bacterias.
68- D
Comments: Protein synthesis inhibitors bind to
50s(Choraphenicol) and 70s (macrolide) ribosomal subunits
30s
(aminoglycosides),
69- D
Comments: Choraphenicol is a broad-spectrum antibiotic that may cause hematological
disorders as side effect including severe impairment of bone marrow.
70- E
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Comments: Clindamycin is a lincosamide antibiotic that acts by inhibition of bacterial of

protein synthesis.
Fourth edition
1- Ciprofloxacin mechanism of action may include:

b) Inhibit cell wall synthesis
d) Inhibit DNA gyrase
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PharmacyPrep.Com
Anticancer drugs and chemotherapy
PHARMACY PREP
ANTICANCER DRUGS AND CHEMOTHERAPY
1. Stomatitis is characterized by all of the following signs and symptoms EXCEPT
A. headache
B. erythema
C. bleeding
D. ulcerations
E. dryness of mouth
Ans- A
Tips: Stomatitis, or mucositis, is an inflammation of the mucous membranes, particularly the
oral mucosa. Although the symptoms generally are limited to the mouth and throat, stomatitis
may affect any part of the gastrointestinal tract, potentially causing diarrhea and anal fissures.
2-All of the following chemotherapy agents are vesicants EXCEPT
A. doxorubicin
B. mechlorethamine
C. vincristine
D. methotrexate
E. idarubicin
Ans-D
Tips: Vesicant chemotherapy agents may cause local necrosis of extravasated outside the vein.
Doxorubicin, idarubicin, mechlorethamine, and vincristine are all classified as vesicants.
Hemorrhagic cystitis results from irritation of the lining of the bladder by acrolein, a metabolite
of ifosfamide and cyclophosphamide. Acrolein can be inactivated by?
A-Mesna
B-Doxarazoxane
C-Chlropropamide
D-Erythropoeitins
E-None of the above
Ans-A
Tips: Mesna may be used to inactivate the acrolein, thus preventing hemorrhagic cystitis.
Copyright 2000-2008 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being
used during review sessions conducted by PharmacyPrep.

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Canadian Pharmacy Review

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Canadian Pharmacy Review

Part IV: Pharmacy Practice/ Therapeutics and OTC Drugs

Canadian Pharmacy Review

Copyright 2000-2008 Tips Inc

5. What is NOT a requirement of pharmaceutical Care?

Safety of Medication in special populations

Drug therapy monitoring is essential

The degree of protein binding

Safety of Medication in special populations

Therapeutic Drug Monitoring

Therapeutic Drug Monitoring

Strategies to Prevent errors and safe dispensing

Adverse Drug Reactions

Adverse Drug Reactions

Copyright 2000-2008 Tips Inc

5-What is incorrect about tetracycline antibiotics:

11-All of the following agent can cause urine discoloration, EXCEPT;

Pharmaceutical Storage Conditions

OTC medications dermatological conditions

OTC medications dermatological conditions

OTC medications dermatological conditions

What is incorrect in treatment of diaper rash?

Which of the following treatment is used to treat cold sores?

OTC Antihistmines, decongestants and antitussives

OTC Antihistmines, decongestants and antitussives

6- Which is not a drug used for smoke cessation?

b) Destructive changes in the alveolar walls

d) Xanthine oxidase inhibitors

1- COMPREHENSIVE PHARMACY REVIEW Lippincott William & Wilkins

Eating disorders and weight loss treatments

5-Which of the following antidiabetic drug is gender selective:

9. Urinary incontinence is NOT aggravated by:

Coronary Artery Diseases

Nitroglycerin dilates the coronary arteries in angina pectoris by

Coronary Artery Diseases

Congestive Heart Failure (CHF)

Congestive Heart Failure (CHF)

Peripheral Vascular Diseases

5. Factors that increase lithium concentrations are all EXCEPT

12-All drugs have withdrawal syndrome except?

Seizure and antiepileptic drugs

Seizure and antiepileptic drugs

6- Penicillin should be administrated 1 hour before meals or 2 to 3 hours after meals in

d) Alter the function of cell membrane permeability

e) All are correct

39- Examples of extended spectrum penicillin may include:

e) Bind to ergosterol from pores resulting in linkage of cellular contents

b) Inhibit the DNA duplication of mycobacterium

67- The effectiveness of VANCOMYCIN is seen ONLY in:

Comments: Penicillin V is an acid-stable beta-lactamase sensitive antibiotic often used

Comments: Streptomycin is only available in injectable form because it is not properly

Comments: Treatment of malaria in those patients resistant to Cloroquine is normally

Comments: Influenza is a viral disease and must be treated by antiviral agents.

Comments: Clindamycin is a lincosamide antibiotic that acts by inhibition of bacterial of

1- Ciprofloxacin mechanism of action may include:

Anticancer drugs and chemotherapy

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1 Pharmacy Practice Therapeutics OTC Drugs Q&A Content Ver1

1 Pharmacy Practice Therapeutics OTC Drugs Q&A Content Ver1