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APEC REVISION
Dr. M
1/1/2014
Pharmacy Review
(Australia)
APEC Stage 1
Previous examination questions
1-Structure of Methyl Salicylate: Methyl 2-hydroxybenzoate
2-structure of diphenhydramine
3-Camphor is ketone.
2
12- Ascorbic acid acidifies urine.
I's.
16-Spironolactone is anti-aldosterone.
19- Vit. E is not proved to be essential for reproduction in man BUT Vit. A is
important.
23-pyuria=pus in urine.
3
24-Drug of Choice for E.coli: is co-trimoxazole.
4
40-Atropine selectively blocks muscarinic receptors.
47-Cartilage covers and protects bone from friction during normal joint
activity & osteofies to form bone.
5
55-Sulphonamide must have a non substituted aromatic amino gp essential
for anti bacterial activity.
Example:
6
68-Patient with mature onset diabetes can be treated with
tolbutamide & diet.
69-t1/2 = time required for conc. Of drug decrease by one half.
71- Gentamycine causes deafness due to its effect on 8th cranial nerve
(vestibular damage or auditory damage).
79- Tell a patient treated with Indapamide that the drug may cause k+
loss thus potassium supplement is required. (Orange juice &banana).
7
83- Al (OH)3 causes constipation.
84-
Absorption of A›B›C
87- Doses:
*Salbutamol: → 4-8mg or 10mg!!!
*Dithranol: → 0.1-1% (for ttt psoriasis)
*Chlorothiazide: → 125-500mg or up to 1 gm
8
95- Strong iodine solution contains 5% w/v, how many mg of iodine
are consumed daily; the usual dose is 0.3ml tid→45mg.
9
110- Erythropioesis= stimulation of Red blood cells formation from bone
marrow.
10
124-Amoxicillin is used in ttt of Otitis media.
126- Patient taking Metronidazole advice him to stop drinking alcohol (due to
disulfuram like Rx).
11
138-Myexoedema =↓in thyroid hormone secretion in adulthood.
142- woman taking combined pills for 21 days & 5 days rest but the bleeding
does not occur, you advice her to stop the pills as she may be pregnant.
149-weak acids &bases are more absorbed from the small intestine due to
large surface area.
12
150-Acidification of urine ↑excretion of alkaline drugs "like amphetamine" as
ionization ↑, thus absorption ↓.
156- Ca2+ is not given with digitalis because both ↑ contractility of the heart
"synergistic effect " which can lead to arrhythmia also Ca2+ replace K+ from
myocardial cells & ↑ digitalis toxicity.
157- Patient on probencid therapy, you advice him not to take aspirin.
13
162- This structure is steroid
Ethinyl Estradiol
14
173-Sulfamethoxazone+ Trimethoprim act in synergism because they block
sequential step in the same metabolic pathway.
174- Drug of choice in grand mal epilepsy is→ Na Valproate, while petit mal
is→ Ethosuximide & Status epileptics are → diazepam.
185-Gelatin is protein.
15
187-Oral drug with weak PH will be more absorbed from stomach.
189-Spironolactone SE is gynecomastia.
196- Phenolphthalein & Castor oil are used as intestinal irritants (stimulant
laxatives).
16
*Also quinine & quinidine → ↑digoxin→↑digoxin toxicity.
201-Cod Liver oil & fish oil contains vitamin A & Vit. D.
205-Eutectic mixture= when mixing some drugs or chemicals with each other,
they melt "liquefy" at a temperature lower than each of their melting point.
206-Phenylbutazone has the longest t1/2 75- 100 hrs & cause Aplastic anemia
& blood dyscariasis; it also displaces other drugs from plasma protein.
17
213-Preservatives in eye drops as bactericidal:
*benzalkonium chloride: 0.02%
*Chlorohexidine acetate: 0.01%
214- Carbamazepine → self inducer of its own metabolism, on long term use.
18
226-*Sorbitan monostearate (non ionic) → W/O emulsion.
*Na lauryl SO4→ O/W emulsion.
*Dioctyl sodium sulphosuccinate→ O/W emulsion.
228-Benzyl peroxide gel should not come in contact with eye or mucous
membrane.
235-Acetylcysteine is mucolytic.
19
237- 5-Carboxymethylcysteine is mucolytic & ↓mucous gland hyperplasia.
20
*Methyl dopa: 0.5-2gm
*Colchicine: 500mg
*Salbutamol 2-4 mg (bid)
*Prednisone: 5-60 mg
257- HCTZ interacts with: digoxin "Hypokalemia" & Lithium "↓Na with
Li→ toxicity".
261- A drug with pka 6.2 this drug will be 50% ionized in the small intestine.
21
262-The outer water proof layer of the skin is made up of Keratin.
275-Tetracycline is CI in pregnancy.
22
278-Paracetamol has no anti- inflammatory effect.
287-Axon is the part of the neuron that carries impulse away from! nerve cell.
288-The part of the ear which is responsible for balance is the Inner ear.
23
295-CH3-(CH2)16-COOH is stearic acid.
297-Doubling the drug conc. In the blood "that follow 1st order kinetics" will
not affect the half life.
24
305-Diastomers have 2 or more asymmetric atoms, they are non super
imposable and are not mirror image.
25
309-Common structure of sulfonamides:
314-Phenothiazines structure:
26
*Rapidly hydrolyzed in boiling H2O
*insoluble in H2O BUT: soluble in mineral acids "as it reacts with HCl →
soluble salt.
323-A specific drug with 1st order biological t1/2 of 4 hrs, this t1/2 value will be
independent on the initial concentration.
326- 2ry oxidation of alcohol gives ketone, while 1ry oxidation of alcohol gives
aldehyde.
27
327-SE of ketoconazole: GIT disturbances, headache, gynecomastia &
hepatotoxicity.
332-Caffeine & HCTZ have diuretic effect, but phenyl ephrine is not diuretic.
337-Structure of Warfarin:
28
Structure of Hydrocortisone:
344-………….
345-Phenol is metabolized by glucuronidation & sulfonation.
348-More than 50% of H2O & Na+ reabsorbed from proximal tubule by
passive transport (about 60% is reabsorbed).
29
351-UV light spectrum is 200-400nm (which most drugs show absorbance
within this range).
365- 2parents do not have congenital disease, but their son got congenital
disease .This means that both parents have recessive gene.
30
367-Glycerin syrup does not change the pH of the medium.
375-Structure of Quinidine:
31
379-Long residence of CO2 in body →↑pCO2 "hypoventilation in serum"→
↓[HCO3]→Lactic acidosis, but ↓Pco2 "hyperventilation" →respiratory
alkalosis. LOOK at Q715.
387-Thiazides SE → hyperglycemia.
389-Drug A has t1/2 24 hrs, if you give 2mg of it after 72 hrs, the conc will be
0.25mg.
32
392-Insulin zinc suspension has duration of action from 18-24hrs.
394- Al(OH)3 +Mg(OH)2 gel "antacid" is given hourly "dose every hr" in
duodenal ulcer.
397-Nitrazepam has t1/2 25-35 hrs "produce long day time sedation which
should be avoided in elderly" to avoid falls &fractures due to accumulation of
nitrazepam sedative effect.
399-Patient taking aspirin, advise him not to take probencid "or vice versa".
33
404-Corticosteroid in asthma→ ↓release of mediators & ↓ immune reaction
or immune edema.
408-Lidocaine or Lignocaine are not taken orally as it has substantial 1st pass
metabolism.
411- TCA & corticosteroids can cause HTN "hypertension" but not
Cimetidine.
34
417-SE of Clindamycin: diarrhea.
422-Rx Verapamil
Propranolol
Captopril
Slow K you expect that the patient has bradycardia.
429- Patient taking Theophylline, when he stops smoking the serum level of
Theophylline ↑↑ (as smoking (+) metabolism of Theophylline).
35
431-Polymorphs affect the solubility of the drug.
435-Isotonic solution is isoosmotic with blood "has the same osmotic pressure
of blood".
439-Structure of mepridine:
440-Structure of Methicillin:
441-Structure of sulphonamides:
36
442-Structure of sulfonylurea:
37
450-Oxidation of 2ry alcohol → ketone.
461-I2 in high doses only ↓ Iodide uptake by thyroid gland but carbimazole,
propylthiouracil & estrogen do not ↓ Iodide uptake by the thyroid.
38
464-Tricyclic antidepressant does not cause salivation, as it has
anticholinergic SE.
471-Damage of the posterior pituitary gland cause ↓↓ in the level (or (-)
release) of vasopressin & oxytocin.
472-Ferrous salts are the form (of iron) which is absorbed while ferric salts &
elemental iron are not absorbed well.
39
477-Structure of Cimetidine (Tagamat):
480-Tolbutamide & phenphormin both (↓) plasma glucagon level & are used
in ttt of NIDDM.
40
(50-100 mg).
Mode of Action: (+) NO effect on vascular smooth muscle→ ↑blood flow to
penis → ↑ erection (upon sexual arousal) through (-) phosphodiestrase type 5)
C.I with nitrates S.E: Headache Use: Erectile dysfunction.
493- SAA is added to tablets to act as binder & adhesive (e.g. gelatin, Acacia)
& improve dissolution & bioavailability.
495- CaCO3 is given to patient with terminal renal failure to ↑ Ca2+ in serum
& correct hypocalcaemia.
496-
41
497- Atenolol is the least lipid soluble B-blocker.
500- The diagnostic element in blood for AIDS patient is detecting antibody to
HIV (ELISA assay).
504- Na Valproate can be used to treat both grand mal and petit mal epilepsy.
42
5-Antibiotics "e.g. ciprofloxacin"
43
516-Discarded Chloramphenicol loses potency.
518- Androgens "nandrolone" are used for both decreased growth and
osteoporosis.
522- when giving furosemide dose check renal function and current
dose furosemide " as t1/2 is dependent on renal clearance".
527- Streptokinase:
*dose 1.5 million IV infused over 60 min
44
*not given within 6 months from the previous administration due to allergic
reaction "Ab-Ag reaction)
529- Boric acid is not used in the topical skin preparation for infants
because it cause boiled lobster rash
532- patient taking Loperamide advise him that it is not used for
infectious diarrhea as it cause stasis of M.O.
537- We mix 20% rose oil with cream on glass plate by slow agitation.
45
538- benzodiazepines+ drug (LME inducer) to overcome the problem add
Cimetidine “LME inhibitor”.
542- Some drugs show irrelevance between of activity and plasma conc.
Because they are quickly metabolized.
548- The receptor for cough suppression effect of codeine in the CNS “in the
brain stem” in medulla oblongata.
46
550-Captopril and all ACEIs are contraindicated in:
a) renal artery stenosis,
b) pregnancy.
554- after taking inhaler in asthma, the case may worsen due to:
a-improper way to use
b-down regulation of receptor” causing tachyphlaxis”
c-case become progressed.
557- Agents used to coat enteric coated tablets are shellac, cellulose
acetate phethalate.
47
560- Cromolyn Na is used for prophylaxis of asthma.
563- pKa= negative log of ionization constant” indicates the relative strength
of acid or base”.
573- Weak base drug is easily excreted by NH4 salts "Acidifying agents".
48
575- 50% of glomerular filtration returns back to blood from distal tubule.
49
588- Miosis= contraction of eye pupil.
593-Structure of Neostigmine:
50
Agranulocytosis=Leukemia=neutropenia.
600- Eye drops are sterilized by filtration with porosity 0.2 um diameter.
structure
51
612- Myasthenia gravis is autonomic disease of parasympathetic system.
52
hostile cervical mucus (increase viscosity). d- (-)
ovulation
53
Antiepileptic drugs: Disulfiram 1-Cortiocosteroids
1-carbamazpine 1-INH 2-Digitalsi
2-Valproic acid 2-Chloramphenicol 3-doxycyline
3-Clonazepam 3-Propoxyphene 4-estrogen
4-Phenobarbitol 4-coumarin 5-furosemide
5-Warfarin 6-contraceptives
7-oral anticoagulant
8-gaunedine
9-Rifampin
10-Theophylline
11-Vit D
12-Enteral Nutrition
640- alpha methyl dopa + HCTZ “diuretic” is used to decrease edema” fluid
accumulation” caused by alpha methyl dopa.
643- Loop diuretic mode of action “act at the ascending loop of Henle
decrease the co-transport of Na, K, Cl from the luminal filtrate → increase
54
excretion of H20, Na, K, Ca, Cl, decrease uric acid secretion and cause no
change in urinary pH.
55
658- Most potent respiratory stimulant is: increase Pco2 in blood
“respiratory acidosis”.
659- Oligurea=low urine excretion.
668- The human cells has 46 chromosomes while gonade cells has 23
chromosomes either 22+X or 22+y “sperm and ova”
670- Sulfasalazine is :
* poorly absorbed from GIT.
*used in treating ulcerative colitis and regional enteritis
673- Emergency case patient with hypotension, shock, the 1st choice
therapy is dopamine because it has:
a- +ve inotropic effect on the heart(B agonist action
b- release norepinephrine from its stores ( increase B.P)
c- + dopamine receptors within kidney increase renal blood flow
infusion is interrupted to decrease tachycardia as dopamine has very short t
½.
674- A good antacid should raise pH from normal value of 1-2 to pH of 3.5.
56
675- Gentamycin enhances SE” Ototoxicity” of Ethacrynic acid and also
aminoglycosides “Gentamycin” increase nephrotoxicity of loop diuretic.
*Aminoglycosides “streptomycin "enhance nephrotoxicity of Cephalothin,
cisplatin, Amphotericin b and methoxyflurane.
685- Disintegration of tablets ensures that the drug is available for dissolution
and absorption from GIT.
686- Na benzoate is used as preservative and is used in different pH this is
because of high wide ionization effect “it is effective only at pH5 or less”
687- Dusting powder is sterilized by dry heat at 120 Celsius for 60 min ”dry
heat sterilization”
688- The base used with hydrocortisone is simple ointment or “soft paraffin”
689- Polyvinylchloride (PVC) → type of plastic can be sterilized by
autoclaving.
690- The type of base used affects the local application of ointment.
57
691- Drugs sterilized by heating at 115 0C are: Lignocaine, adrenaline,
digoxin and atropine.
701- INH mode of action: inhibit synthesis of mycolic acids which are
essential component of mycobacterial cell wall.
58
706- P-amino salicylic acid:
effective orally, its SE: ulceration and blood dyscariasis
707- Drug of choice in leprosy is Dapson and other sulfones,
SE: methemoglobinemia and hemolytic anemia.
710- Dimercaprol “BAL: is an antidote for arsenic and all heavy metals
[ Lead, mercury, gold]
- a- metabolic acidosis)
a condition of low arterial pH, reduced plasma HCO3 concentration and
usually compensatory alveolar hyperventilation resulting in decreased PCO2
Ex: Lactic acidosis, Acetazolamide therapy.
B-Metabolic alkalosis:
a condition of increased arterial pH, increased plasma HC03 concentration
and usually compensatory alveolar hypoventilation resulting in increased
PC02
ex: vomiting and Thiazides, loop diuretics
c- Respiratory acidosis:
a condition of low arterial pH, hypoventilation ----> increased PC02 and
usually compensatory increase in HC03 concentration.
59
d-Respiratory alkalosis:
a condition of increased arterial pH, hyperventilation ---->decreased PC02
and usually compensatory decreased plasma HC03 concentration.
716- Typhus is characteristic of Rickettsial disease
a-epidemic typhus.
b-murine”endemic”typhus
c-rocky mountain spotted fever.
717- When a solution of soda lime is exposed to air C02 will react
with it forming CaCO3 and ppt. occurs.
718- Patient having depression and taking warfarin and thyroxin and
antidepressant which will change the thyroid function?
Both: a-lithium b-amiodarone.
719- Sterilization of soft contact lenses boiling with saline for 30 min.
720- *toxoid and vaccine active immunity*antisera, antitoxin-
passive immunity.
721- Glyceryl trinitrate:
a-advise the patient to take it in sitting position to avoid the first hypotension
effect
b-absorbed from skin, mucosal or buccal membrane.
c- taken sublingual
d- venous dilation “increase venous capacitance”
723- Tolnaftate cream is a topical ttt for athlete's foot tinea pedis.
60
hepatic 1st pass effect but aspirin and phenytoin not.
731- Rate of metabolism or elimination of drug which follows zero order
kinetic is constant.
746- Ethanol & KI syrup are neutral “doesn’t change the pH of the
medium” but sodium metabisulphite (acidic),
Na borate (Alk), KBr (Alk).
61
748- Hydralazine “arteriodilator” (decrease after load)
749- 10% of Na reabsorption occurs from distal tubule, but more than 50%
occurs from proximal convoluted tubule.
750- Alendronate cause problem if given to a patient sitting or lying down
because it cause oesophageal ulcer.
751- Patient taking haloperidol should not take alcohol & methyldopa
62
764- If we mix NaHCO3 to 5% Glucose Nothing will happen
765- Charcoal is decolorizing agent and adsorbent agent in toxicity
766- Agonist means high affinity to receptors with intrinsic activity, while
antagonist means high affinity with no intrinsic activity.
767- Silver sulfadiazine and Mafenide used topically for burns and
wounds, also phethalyl sulphathiazine is used locally to decrease intestinal
bacterial flora.
780- Warfarin can be used in different therapeutic forms, it has optical active
center.
63
783- When Hexyl resorcinol is exposed to air it is oxidized.
64
803- Vit E is soluble in fixed oil, ether, chloroform.
65