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Pharmacy Prep

Pharmaceutical Sciences Review and Guide

Misbah Biabani, Ph.D

Director Toronto Institute of Pharmaceutical Sciences (TIPS) Inc.

Toronto, ON M2N K7

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Content

Part II: Pharmaceutical Sciences 19-Pharmacy Calculations

20-Pharmacokinetics

21-Rates and Orders of reactions

22-Pharmacodynamics

23-Basics of Medicinal Chemistry

24-Medicinal chemistry and Pharmacology of Drugs that act on autonomic nervous system

25-Medicinal chemistry and Pharmacology of Histamines, Serotonin, Prostaglandin and Non-

Steroidal anti-inflammatory Drugs

26-Medicinal chemistry and pharmacology of cardiovascular drugs

27-Medicinal chemistry and pharmacology of psychiatric & neurological diseases

28-Medicinal chemistry and pharmacology Endocrine drugs

29-Drug Metabolism

30-Biopharmaceutics

31-Pharmaceutics

32-Pharmaceutical Additives

33-Rheology

34-Pharmaceutical Dosage Forms

35-Drug delivery Systems

36-Sterile Preparations

37-Extemporaneous Pharmaceutical Preparations

38-Pharmaceutical Analysis

www.Pharmacyprep.com Pharmacy Calculations

PHARMACY PREP.

GENERAL CALCULATIONS 1- Given a Rx and the signature is: Start 40mg and decrease 5mg everyday until finish. How many days the patient will take to finish this Rx. a) 8 days b) 7 days c) 6 days d) 5 days e) 4 days 2- you have a stock solution of 1:750 and would like to prepare 60mls of 1:10.000, how much you need to use of the stock solution? a) 2.4mls b) 4.6mls c) 1.3mls d) 46mls e) 0.46mls 3-How many tablets each containing 25µg, will provide the equivalent of 0.5 mg of sodium Liothyronine? A-10 tablets B-15 tablets C-20 tablets D-25 tablets E-30 tablets 4-How much drug should be added to 30 ml of water to make 10% w/w solution ? A-10g B-90g C-3.3g D-6.6g E-9.9g 5-Syrup is an 85% w/v solution of sucrose in water .it has a density of 1.313g/ml .how many milliliters of water should be used to make 125 ml of syrup? A-106.2g B-164.1g C-57.8g D-125g E-1.33g

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6- Dissociation factor (i) plays an important role in determining the contribution of a substance towards isotonicity. If it is assumed that HCl undergoes 80% dissociation, what will be its dissociation factor? a) 2.3 b) 3.2 c) 6.1 d) 3.6 e) 1.6 7- Calcium gluconate injection contains 0.1g of Ca2(C6H11O7)/ ml. If the NaCl equivalent of calcium gluconate is 0.16, the injection is: a) Hypotonic b) Iso-osmotic c) Isotonic d) Hypertonic e) Opisthonic 8- Assuming you have alcohol 95% and need to prepare 60mls of alcohol 12%. How much of alcohol 95% should be used to make this new concentration of alcohol? a) 4.32mls b) 7.57mls c) 8.64mls d) 6mls e) 6.57mls 9- You are giving ZnCl2 0.7%, phenilephrine 0.1% and boric acid 1.1% with E values 0.16, 0.32 and 0.5 respectively. This solution will be: a) Isotonic b) Hypertonic c) Hypotonic d) Iso-osmotic e) Isotonicity cannot be finding. 10- You receive a Rx with the following signature: Start with double dose of 5mls, than take 2.5mls BID for 7 days. How many mls of amoxicillin suspension should be dispensed to this patient: a) 30mls b) 35mls c) 40mls d) 45mls e) 50mls 11- Rx; Prednisone 5mg Start 40mg and decrease 5mg everyday until finish. How many tablets should be dispensed? a) 30 tablets


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b) 35 tablets c) 36 tablets d) 40 tablets e) 12 tablets 12- An inhaler contains 120 doses. How many days the patient will take to finish the entire inhaler with this signature: “Use 2 inhalers in each nostril every morning and at bedtime” a) 7 days b) 10 days c) 20 days d) 15 days e) 30 days 14- What is the sensitivity of a balance that can weight 120mg of a substance and has a permissible error of 5%? a) 6mg b) 16mg c) 66mg d) 26mg e) 1.6mg

CORRECT ANSWERS

1- A 40mg / 5mg tablets = 8 days of treatment 2- B 1:750 = 0.13% C1 . V1 = C2 . V2 V= 4.6ml 1:10.000 = 0.01% 0.13 x V1 = 0.01 x 60 0.13V = 0.6 3-C

0.5 mg=500 µg ∴Number of tablets = 500 / 25=20 tablets

4-C

The mass of the final solution in this case in unknown, we only have the mass of solvent (water ) as 30 ml will weight 30 grams . So know we need a solution which contains 10 grams (10%) of drug in 100 grams of the solution (solvent + drug ) In this case the solvent will represent 100 –10 = 90% So if 90% 30 grams, how much is 10%? The weight of the drug is = 10* 30/90 = 3.33

5-C

Density of solution =mass / volume


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1.313 = weight of solution / 125 therefore the weight of the solution will be 164.125 g now we have 85 grams of sucrose in 100 ml of solution Therefore for 125 ml of solution we need: (125 *85)/100=106.25 grams the weight of water in this solution =164.125 –106.25 = 57.875

6- E Dissociation factor of HCl = H(1) + Cl(1) = 2 2----------100% X-----------80% → 1.6 7- D 8- B C1 x V1 = C2 x V2 → 95 x V1 = 12 x 60 → V1 = 7.57mls 9- C 0.7 x 0.16 + 0.1 x 0.32 + 1.1 x 0.5 = 0.00112 + 0.00032 + 0.0055 100 100 100 = 0.00694 NaCl = 0.9 = 0.009 > 0.00694 = Hypotonic 100 10- C 5mls-start dose + (5mls/day x 7days) = 5 + 35 = 40mls 11- C 40mg = 8 tablets decrease one tablet every day until finish. 12- D “Two inhalers in each nostril every morning and at bedtime” 2 x 2 nostril x 2 (morning+night) = 8 doses daily 120 doses ÷ 8 doses daily = 15 days supply 13- C SR = Weight x Error → 15 = weight x 5 = 300mg 100 14- A SR = Weight x Error → SR = 120mg x 5 = 6mg 100

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 – Dorland’s illustrated – 27th edition. 4- PHARMACY PREP – Lectures series & study guide for Evaluating Examination-TIPS - 2003/2004


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5- THERAPUTIC CHOICES – Canadian Pharmacist Association -Third edition 6- USP DI – Drug Information for the Health Care Professional–15th edition – Volume I.


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EE review Book and Guide

Chapter Calculations Answers

In dosing the drug gentamicin in pediatric patients, for every 1 mg/kg of gentamicin administered, serum drug concentrations are expected to increase by 2.5 µg/ml. What would be the expected serum drug concentration following an administration of a 2.5 mg/kg dose of gentamicin? A-5 µg/ml B-6.25 µg/ml C-10 µg/ml D-2.5 µg/ml Ans: B _1 mg/kg__ = 2.5 mg/kg 2.5 µg / ml X X = 6.25 µg /ml

An elixir is to contain 250 mg of an alkaloid in each teaspoonful dose. How many grams of the alkaloid will be required to prepare 5 litres of the elixir? A-0.25g B-5g C-250g D-2.5g Ans: C = __Xg___ 0.25 g 5000 ml 5 ml

X= 250 g

A pediatric product contains 100mg of erythromycin ethylsuccinate in each dropperful (2.5ml) of the product. How many kilograms of erythromycin ethylsuccinate would be required to prepare 5000 pint-size bottles? A-74.6 kg B-84.6 kg C-99.5 kg D-94.6 kg Ans: D 1 pint = 473 ml 473 ml x 5000 = 2, 365,000 ml

0.0001 kg = ____ X_____ X = 94.6 kg 2.5 ml 2, 365,000 ml

A physician places a patient on a daily dose of 48 units of U 80 insulin (80units/mL). How many ml should the patient inject each day?


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A-0.4 ml B-0.5 ml C-0.6 ml D-0.25 ml Ans: C U- 80 insulin 80 U = 48 units 1ml X X= 0.6 ml

A 20-ml vial of biologic solution is labeled “2.0 megaunits.” How many units of drug are present in every ml of solution? A2000 B1000 C100,000 D10,000 Ans: 1Megaunit = 1000KU 1KU = 1000 units 2.0 M units x 1000 KU_ x 1000 units = 1000,000 units 1M units 1KU X= 2 x 1000 x 1000 = 100,000 units 20

A prescription calls for 10 units of a drug to be taken 3 times a day. How much will the patient have taken after 7 days? A-21.0 units B-0.21 units C-2.10 units D-210 units Ans:D 10 units x 3 x 7 = 210 units

A physician orders Meprobamate 0.2 g. How much is to be administered if the dose on hand is 400 mg. in each tablet? A-do not dispense B-give 2 tablets C-give 1 tablet D-give ½ tablet Ans:


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200 mg = _1_ tab 400mg 2

The usual initial dose of chlorambucil is 150 µg per kg of body weight once a day. How many milligrams should be administered to a person weighing 154 lbs.? A-10.5 mg B-18 mg C-15 mg D-8 mg Ans:A 154 lbs x_1 kg__ = 70 kg 2.2 lbs

150 µg_ = _ X_ 1 kg 70 kg X = 10, 500 µg = 10.5 mg

An initial heparin dose of not less than 150 units/kg of body weight has been recommended of open-heart surgery. How many ml of an injection containing 5000 heparin units per milliliter should be administered to a 300-pound patient? A-5.1 µl B-4.1 µl C-5.1 ml D-4-.1 ml Ans: D 300 lbs x _1kg_ = 136.36 kg 150 units = _ X___ = 20, 454.54 units 1 kg 136.36 kg _5000 u_ = 20454.54 u 1 ml X X= 4.1 ml

The pediatric dose of cefadroxil is 30 mg/kg/day. If a child is given a daily dose of 2 teaspoonful of a suspension containing 125 mg of cefadroxil per 5 ml, what is the weight in lb. of the child? A-19.5 lbs. B-18.8 lbs. C-18.3 lbs. D-18.1 lbs. Ans: C _125 mg_ x 2 = 250 mg 5 ml 5 ml


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_250 mg_ = _30mg_ X 1 kg X = 8.33 kg 8.33 kg x 2.2 lbs = 18.33 lbs 1 kg If the loading dose of Kanamycin is 7 mg/kg of body weight, how many grams should be administered to a patient weighing 130 lbs.? A-0.492 g B-0.414 g C-414 g D-0.485 g Ans: B 130 lbs x _1kg_ = 59.09 kg 2.2 lbs 7 mg = _ X__ 1 kg 59.90 kg X= 413.63 mg = 0.414 g

The adult dose of a liquid medication is 0.1 ml/kg of body weight as single dose. How many teaspoonfuls should be given to a patient weighing 220 lbs.? A-2 tsp. B-2.5 tsp. C-2 tbsp. D-2.5 tbsp. Ans:A 220 lbs x _1 kg_ = 100 kg

lbs 0.1 mL = _X_ 1 kg 100 kg X = 10 ml = 2 tsp

If a prescription order requires 25 g of concentrated HCI (density 1.18 g/ml), what volume should the pharmacist measure? A-29.50 ml B-0.0212 ml C-23.0 ml D-21.2 ml Ans: D W= 25 g D= 1.17 g/ml V= _M_ = _25_ = 21.2 ml D 1.18


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If the dose of a drug is 0.5 mg/kg body weight/day, how many mg will a 35 lb infant receive per 24 hours? A-7.9 mg B-7.1 mg C-7.2 mg D-7.4 mg Ans: A 35 lbs x _1 kg_ = 15.9 kg 2.2 lbs

0.5 mg = __X__ 1 kg 15.9 kg

X = 7.9 mg

What is the weight of 60 ml of oil whose density is 0.9624 g/ml? A-5.770 g B-57.7 g C-6.0 g D-0.577 g Ans: B

V = 60 ml D = 0.9624 g/ml D = _M_ V M = D x V

= 0.9624 x 60

= 57.7

A prescription calls for 0.3 g of phosphoric acid with a specific gravity of 1.71. How many millilitres should be used in compounding the prescription? A-0.5 B-0.7 C-0.18 D-0.3 Ans:C

D = _M_ = _g_ V ml V = _M_ = _ 0.3 g_ D 1.71 g/ml X = 0.18 ml


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How many ml of 0.9% (w/v) NaCl solution should be prepared from 250 ml of 25% (w/v) solution? A-3750 B-2500 C-6944.4 D-9 Ans: Q1C1 = Q2C2 (X)(0.9)= 250(25) X = 6944.4 ml

A patient is determined to have 0.8 mg of glucose in each millilitre of blood. Express the concentration of glucose in the blood as mg%. A-800 mg% B-0.8 mg% C-8 mg% D-80 mg% Ans: D mg% __X mg__

0.8 mg = __X__ 1 ml 100 ml X = 80 mg %

How many mL of a 1:400 (w/v) stock solution should be used to make 4 liters of a 1:2000 (w/v) solution? A-1000mL B-200 mL C-800 mL D-1600mL Ans: C _1 g_ = __X__ = 2 g 2000ml 4000mL XmL = 400mL 2g 1g = 800 mL

C1V1 = C2V2

1g x 2000mL = C2 x 4000mL

If a patient is determined to have 100 mg % of blood glucose, what is the equivalent

concentration in terms of mg/dL?

A-1 mg/dL


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B-10 mg/dL C-40 mg/dL D-100 mg/dL Ans:D _mg_ = __mg__

dL 100 mL =100 mg /dL

Strong Iodine Solution USP contains 5% w/v iodine. How many mg of iodine are consumed daily if the usual dose is 0.3 mL t.i.d.? A-15 mg B-90 mg C-22.5 mg D-45 mg Ans: D _5_ = _X_

0.9 X = 0.045 g x 1000

= 45 mg

Express in percentage the fluoride concentration in drinking given in 0.6 ppm. A-0.06% B-0.00006% C-0.0006% D-0.006% E-0.06% Ans: B ___0.6g____ = _X_

1,000,000 100

X = 0.00006%

How many grams of dextrose are required to prepare 4 litres of a 5% solution? A-0.2 g B-200 g C-2 g D-20 g Ans-B x = 5 g

4000 mL 100 mL

Change to percent the number 1/300. A-3%


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B-33% C-3.3% D-1/3% Ans:D _1_ = _X_

300 100 _1/3_ = 0.33% = 1/3% 100

A Pharmacy tech adds 75 mL of strong iodine solution USP (5.0% w/v) to 1 litre of sterile water for irrigation. What is the % w/v of iodine present? A-0.35% B-0.375% C-0.53% D-0.60% Ans:A Q1C1 = Q2C2

75(5) = (1075)X

X = 0.35%

How many grams of potassium citrate are needed to prepare 1 litre of 10%? A-1000 g B-50 g C-100 g D-10 g Ans:C _X_ = _10_ 1000 100

X = 100

How many grams of a drug are required to make 120 mL of a 25% solution? A-30 g B-10 g C-12.0 g D-120 g Ans: A _X_ = _25_ 120 100 X = 30

Calcium hydroxide topical solution contains 170 mg of calcium hydroxide per 100 mL at 15º C. Express this concentration as ratio strength. A-1: 688 B-1: 888 C-1: 588


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D-1: 788 Ans: 170 mg → 0.17 g = 1_

100 ml 100 ml X

X = 588 ≈ 1:588

How many mg of isofluorophate are contained in 15 g of a 1: 10,000 ophthalmic solution of isoflurophate in peanut oil? A-1.7 mg B-1.9 mg C-1.8 mg D-1.5 mg Ans:D ___1 g__ = _ X_ 10,000 mg 15 g

X = 1.5 mg

Express 0.2 % in a ratio strength. A-1:5000 B-1:50 C-1:500 D-1:5 Ans:C _0.2_ = _1_ 100 x 0.2 X = 100 X = 500

How much of a substance is needed to prepare 1L of a 1: 10,000 solution? A-0.1 g B-10 g C-0.01 g D-1.0 g Ans: A _ 1_ = _ X _ 10,000 1000

X = 0.1 g

A cupric chloride injection (0.4 mg Cu/mL) is used as an additive to IV solution for TPN. What is the final ration strength of copper in the TPN solution if 2.5 mL of the injection is added to enough of the IV solution to prepare 500 mL? A-1: 500


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B-1:5000 C-1: 500,000 D-1: 50,000 Ans: C _0.4 mg__ = X___ 0.001 g = _1_ 1 ml 2.5 ml 500 ml X X = 1 mg ≈0.001 g X = 500,000

1: 500,000

How many milliliters of a 23.5% (w/v) concentrate of Sodium Chloride solution should be used in preparing 650 mL of a stock solution such that 30 mL diluted to liter will yield a 1: 5000 solution? A-0.2 mL B-4.33 mL C-18.44 mL D-11.75 mL Ans: C _ 1_ = __X_ X = 0.2 g 1000 0.2 g_ = _ X _ X = 4.33 g 30 ml 650 ml 23.5 = 4.33 g X = 18.44 ml 100 X

You have a stock solution of 50% Sodium citrate and you were asked to prepare 300 mL of a 10% solution. How many mL is needed? A-20 B-15 C-30 D-60 Ans: D Q1C1 = Q2C2

X (50) = 300(10) X = 60

How many milliliters of 1:16 solution of sodium hypochlorite should be used in preparing 5,000 mL of a 5% solution of sodium hypochlorite for irrigation? A-800 ml B-2500 ml C-4000 ml D-300 ml


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Ans: C Q1C1 = Q2C2

(X) 6.25% = (5000)(5%)

X = 5% x 5000mL

6.25% X = 4000 ml

Prepare 1000 ml of KMnO4 1:12,000 compresses out of KMnO4 1: 8,000. A-Add 333.3 mL water to 1000 mL KMnO4 1: 8,000 B-Add 666.6 mL water to 333.3 mL KMnO4 1: 8,000 C-Add 333.3 mL KMnO4 1: 8,000 and enough water to make final volume 1000 mL D-Add 333.3 mL water to 666.6 mL KMnO4 1: 8,000 Ans-D C1V1 = C2V2 0.0125.x = 0.0083 . 1000 x =

How many millilitres of 24% (w/v) concentrate of saline solution should be used in preparing 600 mL of a solution such that 10mL diluted to a litre will yield a 0.09% solution? A-300 ml B-150 ml C-50.0 ml D-225 ml Ans-D _ 0.09_ = __X_ X = 0.9 g 100 1000 0.9 g_ = _ X _ X = 54 g 10 ml 600 ml 24 = 54_ X = 225 ml 100 X

The only source of Sodium Chloride is in the form of tablets, each containing 5.0 g. How many tablets should be used in preparing 3000 litres of a solution of such strength that 20 mL diluted to 100 mL with water will yield a 0.9% (w/v) solution? A-60,000 tablets B-27,000 tablets C-12,000 tablets


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D-9,000 tablets Ans-B

_ 0.9_ = __X_ X = 0.9 g 100 100 0.9 g_ = _ X _ X = 135,000 g 20 ml 3,000,000 ml 135,000 g = 27, 000 tabs 5 g

How many grams of 10% (w/w) ammonia solution can be made from 1800 g of 28% (w/w) strong ammonia solution? A-6428.57 g B-5040 g C-50,400 g D-642.86 g Ans: B Q1C1 = Q2C2

(10) X = (1800)(28)

X = 5040 g

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PHARMACY PREP.

PHARMACOKINETIC CALCULATIONS

1- A dose of 240mg was given to a patient, his total body clearance is 3.5L/min and the drug excreted unchanged in the urine is 80mg. What is his non-renal clearance? a) 240mls b) 2.4L c) 3.3L d) 1.16L e) 1160mls 2- A dose was given, after 2 hours, the plasma concentration was 64 mg, t1/2=0.7hrs. After 7 hours from the initial dose, what is the drug's concentration? a) 0.0mg b) 1mg c) 2mg d) 3mg e) 4mg 3- What is the absolute bioavailability of tablet A? TABLET A-----------------50mg---------------AUC 40 IV PUSH -------------------10mg---------------AUC 50 a) 80% b) 0.16% c) 16% d) 8% e) 25% 4- If the rate of infusion of the drug is 500mg q8hours and clearance is 7.3L/hr. Find steady state concentration a) 85.6mg/L b) 856mg/L c) 8.56g/L d) 8.56mg/L e) 5.86mg/L 5- A drug was found to have zero order kinetic: 100 mg ⇒ after 6 days ⇒ 99 mg. How long it will take to eliminate the entire drug from the body? a) 100 days b) 200 days


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c) 300 days d) 600 days e) 900 days 6- Ampicilin in 5% dextrose degrades by first order kinetic, at rate constant of 0.026 h. What is the shelf life of ampicilin? a) 4hr b) 8hr c) 2hr d) 16hr e) 12hr 7- Approximately 50% of cloxacillin is excreted unchanged in the urine. If the normal dosage schedule for cloxacillin is 125mg q6h, a patient with renal function 20% of normal should receive: a) 25mg q6h b) 31.25mg q6h c) 62.5mg q6h d) 75mg q6h e) 125mg q12h 8- Drug which dose is 1500 mg is given every 24 hours. The renal clearance of this drug is 1.2 mg/dL. Calculate the clearance in ml/min. a) 88.6 ml/min b) 76.8 ml/min c) 86.8 ml/min d) 66.8 ml/min e) 43.6 ml/min 9- If a drug is 50% metabolized. What is the percentage of blood concentration after 4hrs? a) 50% b) 25% c) 12.5% d) 6.25% e) 3.12% 10- A new antifungal was given at a dose of 5mg/Kg by a single intravenous bolus injection to a 32 years old female who weighted 75Kg. The antifungal has an elimination half-life of 2 hours and apparent volume of distribution of 0.28L/Kg. What is the initial plasma drug concentration in this patient? a) 36mg/L b) 1.8mg/L c) 17.9mg/L d) 1.79mg/L e) 19mg/L


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11- Following the anterior information, calculate the predicted plasma concentration at 8 hours after the dose: a) 15mg/L b) 111mg/L c) 11.1mg/L d) 1.11mg/L e) 2.64mg/L 12-Following the same anterior information, calculate how much drug remains in the patient body, 8 hours after the administrated dose: a) 23mg b) 112mg c) 100mg d) 15.3mg e) 84.4mg 13- Following the anterior information, how long after the dose is exactly 75% eliminated from the patient body? a) 2 hours b) 4 hours c) 6 hours d) 8 hours e) 10 hours Let us assume the following characteristics of the drug in a 70kg man. -Therapeutic effective plasma concentration: 2.0mg/L -Biologic half-life: 80minutes -Apparent volume of distribution: 0.70Kg/L 14- What is the recommended rate of infusion for this drug? a) 85mg/min b) 58mg/min c) 0.85mg/min d) 8.5mg/min e) 0.085mg/min 15- What is the total body clearance for this patient? a) 33L/min b) 43mls/min c) 43L/min d) 0.43L/min e) 0.43mls/min 16- Still following the information of the anterior questions, calculate the corresponding loading dose:


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a) 98mg b) 160mg c) 48mg d) 24mg e) 100mg

CORRECT ANSWERS 1- B 240mg-------100% of dose 3.5L------100% Total Clearance 80mg-------- X X-------- 33% Renal Clearance X=33% X=1.16L of Renal Clearance CLhepatic=CLt-CLr CLh=3.5-1.16= 2.4L or

240 mg ---------------- 3.5L/min 80 mg------------------?

CLhepatic=CLt-CLr CLh=3.5-1.16= 2.4L 2- A Dose --------After 2 hours-------64mg 64mg-----after t1/2 of 0.7hr-----32mg 32mg-----after t1/2 of 0.7hr-----16mg 16mg-----after t1/2 of 0.7hr-----8mg 8mg-----after t1/2 of 0.7hr-------4mg 4mg-----after t1/2 of 0.7hr-------2mg 2mg-----after t1/2 of 0.7hr-------1mg 1mg-----after t1/2 of 0.7hr-------0.5mg TOTAL: 6.9 hr---Approximately---0.5mg = 0mg 3- C We need to multiply the IV dose by 5 to find the same dosage so: IV Push---------------50mg---------------AUC 250 Bioaval = AUC Tablet A = 40 = 0.16 X 100 = 16% AUC IV Push 250 4- D Css = Rate of infusion = 500/8 = 8.56mg/L Clearance 7.3 5- D 1mg--------6days X= 600 days 100mg----- X 6- A T90% = 0.105 = 0.105 = 4hours K 0.026h


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7- D Patient has normal non-renal function (liver), so patient should receive 62.5mg dose and patient has 20% renal function, i.e 12.5 mg. so total dose is 62.5+12.5mg=75 mg. or Patient has 20% of normal renal function, so 50-20=30% 50%-----------125mg q6h 30%-----------X X = 75mg q6h [dose/frequency for ri] / [dose/frequency for normal] 8- C 1.2mg/dL--------100ml(dL) 125.000mls--------1.440min (60min x 24hrs) 1500mg---------X X---------------1min X = 125.000mls X = 86.8ml/min 9- D Drug concentration = 100% t1/2 (decrease the drug by half) = 50% 2t1/2 = 25% → 3t1/2 = 12.5% → 4t1/2 = 6.25% 10- C Cp = Do Cp = 5mg/L = 17.8mg/L Vd 0.28L/kg 11- D Cp initial = 17.9mg/L and elimination t1/2 is 2hours Cp = 17.9 after 2 hours = 8.95 Cp = 8.95 after 2 hours = 4.47 Cp = 4.47 after 2 hours = 2.23 Cp = 2.23 after 2 hours = 1.11 IN 8 HOURS 12- A D = 375mg after t/1/2 of 2 hours = 187.5mg after t1/2 of 2 hours = 93.75..Continue the same as the anterior question!!! After 8 hours you will have 23mg 13- B Initial dose = 375mg and elimination t1/2 is 2hours Cp = 375mg after 2 hours = 187.5 → 50% Cp = 187.5mg after 2 hours = 93.75 → 25% 4 hours → 75% 14- C R = K x Vd x Css → R = 0.0087 x 49 x 2 = 0.85mg/min K = 0.693/80min = 0.0087 Vd = 0.70 x 70Kg = 49L 15- D CLT = K x Vd → ClT = 0.0087 x 49 = 0.43L/min


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16- A LD = Vd x Css → LD = 49 x 2 = 98mg

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 – Dorland’s illustrated – 27th edition. 4- PHARMACY PREP – Lectures series & study guide for Evaluating Examination-TIPS - 2003/2004 5- THERAPUTIC CHOICES – Canadian Pharmacist Association -Third edition 6- USP DI – Drug Information for the Health Care Professional–15th edition – Volume I.


PHARMACY PREP.

RATES AND ORDERS OF REACTIONS 1-Plot of log of concentration against time produces a straight line with a: A-Slope of –K/2.303 B-Slope of –K/t1/2 C-Slope of –Ko D-slope of K/2.303 E-slope of K/0.693 Ans-A 2-AUC of drug can be determined by a graph using the following rule I-Trapezoidal rule II-Fick’s first law III-Rule of nine A-I only B-III only C-I and II only D-II and III only E-All of the above Ans-A 3-Determine the F value for a capsule AUC 20 mg/dL/hour with 100 mg dose when i.v of same drug AUC is 25 mg/dL/hour with 100 mg dose. A-20% B-60% C-40% D-80% E-100% Ans-D AUC po x 100 = 80% AUC iv 4-Determine the F value for a capsule AUC 20 mg/dL/hour with 50 mg dose when i.v of same drug AUC is 25 mg/dL/hour with 100 mg dose. A-20% B-60% C-40% D-80% E-160% Ans-E AUC po x 100 AUC iv AUC po = 20 x 2 = 40 mg = 1.6 x 100 = 160% 25 mg


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5-Two drugs to be pharmaceutical equivalent, the drugs must: I-contain same exipient II-Contain it salts III-Same therapeutic moiety A-I only B-III only C-I and II only D-II and III only E-All of the above Ans:D 6-The time it takes to infused drug to reach plasma steady state concentration (Css) depends on: I-Elimination half-life of drug. II-Fraction of free excreted in urine III-Plasma concentration curve A-I only B-III only C-I and II only D-II and III only E-All of the above Ans-A 7-A 40 year old patient who weighs 70 kg, needs intravenous infusion of amoxicillin. The desired Css of drug is 15mg/dL. The physician ordered antibiotic infused for 10 hours. Amoxicillin has t1/2 = 1 hour and Vd = 9L. What rate of iv is recommended for this patient? (no loading dose was given); A-135 mg/hr B-936 mg/hr C-1000 mg/hr D-333 mg/hr E-400 mg/hr Ans- Tips: Css = R___

K x Vd R = Rate of infusion K = first order elimination constant Vd = volume of distribution R = Css x k x Vd R = 15 0.693 x 9000 = 100 1 hour = 935.54 mg/hr


PHARMACY PREP

PHARMACODYNAMICS 1. Lethal dose LD50 is classified as: I-Dose causes 50% of toxic response in tests II-Dose causes 50% of effect response in tests III-Dose cause 50% of death response in tests A-I only B-III only C-I and II only D-II and III only E-All of the above Ans-B 2. The km value of an enzyme is numerically equal to a) Half the maximum velocity expressed in moles/liter b) Velocity of a reaction divided by substrate concentration c) Substrate concentration in moles/litre necessary to achieve half the maximum velocity

of a reaction d) Maximum velocity divided by half the substrate concentration in moles necessary to

achieve maximum velocity e) Substrate concentration divided by velocity of a reaction Ans-C


26

Pharmacyprep.com Medicinal Chemistry


27

PHARMACY PREP.

MEDICAL CHEMESTRY

1.Which of the following drug structure can form epimers A.β-lactam antibiotics B.Quinolones C.Tetracycline D.Sulfanilaminde E.Erythromycin Ans-C Comments: tetracycline epimerizes to epitetracyclin, which is more stable than tetracyclins 2- Pyrrolidine and piperidine are important heterocyclic compounds in the structure of drugs. Which of the following drugs has these heterocyclic rings on its structure? A) Folic acid B) Clonidine C) Tetrodotoxin D) Imipramim E) Atropine 2- E Comments: - Pyrrolidine is a five membered and piperidine six membered, important heterocyclic compounds in the structure of drugs. Atropine is an antimuscarinic agent having pyrrolidine and piperidine heterocyclic rings on its molecular structure. 3- Allylic is a common group in the molecular structure of drugs. Which of the following groups is commonly called a vinyl group? A) H2C=CH B) H3C−O− C) H2C=CH−CH2− D) H3C−C− E) HC≡C− 3- C Comments: Vinyl group is the univalent group CH2=CH-CH2 4- Diastereoisomers that have the opposite configuration at only one of two or more tetrahedral stereogenic centres present in the respective molecular entities are epimers. Interconversion of epimers are epimerization. Which of the following class of antibiotics known to have epimerization properties a) B-lactams b) Quinolones c) Vancomycin d) Tetracyclines e) Cephalosporins



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4- D Comments: Tetracycline is an important group of anti-infective agents that suffer in vivo an important metabolism reaction. The transfer of tetracycline to epi-tetracycline is called epimerization. Epimerization is the reaction responsible for the transfer of tetracycline to epi-tetracycline 5- Oxidation of alkyl group results into alcohol, aldehyde and finally carboxylic acids. What type of alkyl group that mostly undergoes oxidation to an acid is known as: a) Terminal alkyl group of aliphatic structure b) Terminal Aromatic alkyl group of structure c) Benzylic alkyl group attached to aromatic ring structure d) Heterocyclic ring structure carbons e) Cyclic ring structure carbons 5- C Comments: 5- Alkyl group attached to aromatic rings would undergo faster oxidation because of resonance effect of aromatic ring. 6- Amines are one of the most common group present in the molecular structure of drugs. Primary amines are mainly metabolized by phase II metabolism: a) Deamination b) Dealkylation c) Acetylation d) Hydrolysis e) Oxidation 6- C Comments: Acetylation is a phase II metabolism reaction characterized by the gain of an acyl group, and the main reaction that undergoes primary amines. 7- Compound considered an constitutional isomer of hexane include: a) Cyclohexane b) Cyclopentane c) 1-methyl-pentane d) 1-methyl-cyclohexane e) None of the above 7- C Comments: Isomers are compounds that have the same molecular formula but different chemical structure, hexane and 1-methyl-pentane are examples of isomerism. 8- Structure Activity Relationship (SAR) studies of cholinergic drugs indicate that: I- Maximum activity is achieved when the quaternary nitrogen is three carbons removed from the ester group II- Structures which display a quasi-ring conformation exhibit antimuscarinic activity III- One methyl group of the trimethylammonium group can be replaced by an ethyl group with only slight loss of activity. a) I only b) III only c) I and II only



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d) II and III only e) All are correct 8- D Comments: Parasympathetic cholinergic drugs have their effect based on nature of their structural molecule. To be effective, cholinergic drugs most display a quasi-ring conformation. One methyl group of the trimethylammonium group can be replaced by an ethyl group with only slight loss of activity 9- Molecular structures (drugs) having carboxylic acid, amide, alcohol and/or thio group are mainly metabolized by: a) Oxidation b) Hydrolysis c) Conjugation d) Estherification e) Deamination 9- C Comments: Conjugations are phase II metabolism reactions characterized by an incorporation of endogenous substrate on the molecular structure of drugs normally coming from phase I metabolism reaction. Carboxylic acids are one of the most common groups present in the molecular structure of drugs mainly metabolized by conjugation. 10- For an antihistaminic drug be effective, it must have which of the following molecular characteristics on its structure? I- A terminal tertiary nitrogen II- More than one aryl or heteroaryl group III- Presence of C−C−C between C−O a) I only b) III only c) I and II only d) II and III only e) All are correct 10- C Comments: In order for an antihistaminic drug be effective, they must have a terminal tertiary nitrogen and more than one aryl or heretoaryl group on their molecular structure. 11- Arrange the following groups from the most reactive to the least reactive:

COOH CH4 OCH3 COO¯ a) COO¯→COOH→OCH3→CH4 b) COOH→CH4 →COO¯→OCH3 c) OCH3 →COOH→COO¯→CH4 d) CH4→OCH3→COO¯→COOH e) COOH→OCH3→CH4 →COO¯ 11- A



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Comments: Molecules may be classified as more or less reactive depending in the presence of hydrogen and oxygen. Less hydrogen molecules and more oxygen molecules increase the reactivity of the compound or substance. 12- Conformational isomerism are stereo isomers produced by; I- rotation around single bond II- typically rapidly interconverting at room temperature III- They can be enantiomers a) I only b) III only c) I and II only d) II and III only e) All are correct 12- C Comments: Isomerism are compounds that have the same molecular formula but different chemical structures, and may be classified in many different ways depending of structure. One example is conformational isomerism that is characterized by: The relationship between isomers that differ only by rotations around single bond. The molecules must be stereoisomers. Conformational isomerisms are stereoisomers produced by rotation around single bond, typically rapidly interconverting at room temperature. They are normally classified as enantiomers and diastereomers. 13- Geometrical isomerism may be classified in CIS and TRAS depending the spatial position of the molecule around a bond with restricted rotation, which of the following is an example of geometrical isomerism? a) Butene b) 1-Butene c) 2-Butene d) 3-Butyne e) 1-Butane 13- C Comments: Geometric isomers may be classified as CIS and TRANS depending the spatial position of the molecule around a bond with restricted rotation. 2-Butene is an example of molecule having geometric isomerism. 14- Cylcohexane may form chair and boat conformations. At each carbon has equatorial and axial conformations. For compounds 1,4-dimethyl-cyclohexane what is the conformation of the 2-methyl groups in is: a) Equatorial-equatorial b) Conformational-conformational c) Equatorial-spatial d) Geometric-geometric e) Spatial-spatial 14- A



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Comments: Equatorial-equatorial is a structural formation of a molecule occurring at the same distance from each extremity of an axis. 15- Strength of acids and base may depends on several electronic factors of molecule, Which of the following electronic factors makes cloroacetic acid is stronger than acetic acid due to: a) Higher ionization effect b) Higher molecular weight c) Higher disintegration rate d) Electron withdrawal effect e) All are right 15- D Comments: Higher the electron withdrawing effect higher the acidity. The halogens F, Cl, Br, I has higher electron withdrawing effect. The cloroacetic acid is stronger than acetic acid due to higher molecular weight. 16- Pyridine is a mono heterocyclic compound very important in the activity of many different drugs. The molecular structure 1,4-dihydropyridine is found in: a) Verapamil b) Digoxin c) Clonidine d) Nifedipine e) Diltiazen Ans-D Comments: Nifedipine is calcium channel blocker that has 1,4-dihydropyridine on its structure responsible for its mechanism of action. It is also contain nitro fuctional group 17- Quinolone structure may be found in which of the following substances? a) Vitamin K b) Thiamine c) Cyanocobalamin d) Folic acid e) Vitamin A 17- A Comments: Vitamin K has a quinolone on its molecular structure. 19- Steroid structures are common in hormones, such estrogen, progesterone, testosterones. Steroid contain how many cyclohexane and cyclopentane respectively in it skeleton. a) 2 and 3 b) 3 and 2 c) 4 and 1 d) 3 and 1 e) 1 and 3 19- D



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Comments: Most of the steroid compounds have three cyclohexanes and one cyclopentane ring on their molecular structure. 20- Phase I metabolism reaction also known as functionalization metabolism, during this phase drug will metabolized to obtain functional groups such as hydroxyl group or carboxyl group and these group in phase II are best metabolized by which of following conjugation reaction: a) Acetylation b) Glucuronidation c) Reduction d) Hydrolysis e) Methylation 20- B Comments: Glucuronidation is the main reaction of phase II metabolism reactions, and are responsible mainly for the metabolism of drugs having hydroxyl, carboxyl and amide group on their molecular structure. Conjugation reactions are the most common reactions of phase II drug metabolism. 21- Which of the following is the strongest acid? a) Acetic acid b) Hydrochloric acid c) Perchloric acid d) Benzylic acid e) Carboxylic acid 21- C Comments: Perchloric acid is one of the strongest acids due to its molecular structure. 22- The most common reactions in stomach is hydrolysis. Which of the following functional group is more susceptible to hydrolysis? a) R-COO-R b) R-O-R c) R-NHCH3 d) R-COOH e) R-CH=O 22- A Comments: Amides and esters are the only groups undergoing hydrolysis. 23- The Bronsted-Lowry theory describe acid is a proton (hydrogen ion) donor. Phenol is an acid. The acidic properties of phenol is due to: a) Stable Cation resonance b) Weak dissociation c) Common ion effect d) Stable anion resonance e) Fast dissociation is lipophilic solutions 23- D Comments: Phenol is a weak acid due to stable anion resonance



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25- Wrong statement regarding optical isomerism include: a) To be optimal isomer molecule should contain minimum one chiral or stereogenic center b) Diastereomers are non superimposable mirror image c) Optical isomer rotate plane polarized light d) Enantiomers are non-superimposable mirror images e) Has one or more chiral center 25- Ans: B Comments: Diastereomers must have more than one stereogenic center and are not mirror image, they have superimposed image. 26- R-COOH is an acid while R-OH is not due to: a) Presence of dipole b) Presence of stable anionic resonance c) Presence of stable cationic resonance d) Presence of stable non-ionic resonance e) Complexation 26- Ans:B Comments: R-COOH is an acid while R-OH is not due to presence of stable anionic resonance, an indication of the extent of activity of free radicals in an organic reaction. Factors that influence stability of conjugate bases (anions) are size, electronegativity, resonance. The factors to consider: Two of the factors which influence the ionization of an acid are, the strength of the bond being broken, the stability of the ions being formed.

o Acetic acid: pKa=4.76 o Phenol: pKa=10.00 o Ethanol pKa=16.00

27- The pH value is calculated mathematically as the: a) Log of the hydroxyl ion (OH ¯) concentration b) Negative log of the OH ¯ concentration c) Log of the hydrogen ion (H+) concentration d) Negative log of the H+ concentration e) Ratio of H+/OH ¯ concentration 27- Ans: D Comments: pH is the measure of the acidity or basicity of a solution that is calculated mathematically as the negative log of the H+ concentration 28- This reaction is known as: NH4+ + OH ¯ → H2O + NB3 a) First order reaction b) Ionization reaction c) Neutralization reaction d) Equilibrium reaction



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e) Protonated reaction 28- C Comments: NH4+ + OH ¯ → H2O + NB3 is an example of neutralization reaction. 29- Correct statements regarding bioisosters may include: I- Molecules containing one different group or atom but electronically equivalent II- May act as antagonist to a normal metabolite III- Molecules that differs only in the length of the side chain a) I only b) III only c) I and II only d) II and III only e) All are correct 29-Ans: C Comments: Bioisosters are functional group or atoms that impact similar physical and chemical properties on biological activity of molecule. 30-Which of the following is the molecular structure of isotretinoin, used in oral treatment of acne? a) 13-CIS Retinoic acid b) 13-TRANS Retinoic acid c) 13-CIS-TRANS Retinoic acid d) Retinoic acid e) None of the above 30- A Comments: The molecular structure of isotretinoin, used in oral treatment of acne is 13-CIS Retinoic acids. The TRANS molecular structure is only used in topical preparations. 31- Morphine is the prototype of opioid analgesics. The analgesic activity of morphine is dependent of which molecular structure? a) Phenolic hydroxyl group b) p-phenyl-N-alkylpiperidine c) Methyl substitution d) Piperidine e) Phenolic amino group 31- B Comments: The analgesic activity of morphine is dependent of p-phenyl-N-alkylpiperidine 32- Imidazoline is a molecular structure that contain a heterocyclic ring and belongs the molecular structure of: a) Prazosin b) Nifedipine c) Atropine d) Clonidine



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e) Allopurinol 32- D Comments: Clonidine is an antihypertensive drug that depends of its imidazoline molecular structure to be effective. 33-Which of the following cardiovascular medications chemically classified as glycoside? A-Digoxin B-Warfarin C-Nitrates D-Nitrites E-Cholestyramine Ans-A

CORRECT ANWERS MEDICAL CHEMESTRY

1-C Comments: tetracycline epimerizes to epitetracyclin, which is more stable than tetracyclins 2- E Comments: Atropine is an antimuscarinic agent having pyrrolidine and piperidine heterocyclic rings on its molecular structure. 3- A Comments: Vinyl group is the univalent group CH2:CH. 4- E Comments: Epimerization is the reaction responsible for the transfer of tetracycline to epi-tetracycline 5- A Comments: 5- Terminal alkyl group easily undergoes oxidation to an acid. 6- C Comments: Acetylation is a phase II metabolism reaction characterized by the gain of an acyl group, and the main reaction that undergoes primary amines. 7- C Comments: Isomers are compounds that have the same molecular formula but different chemical structure, hexane and 1-methyl-pentane are examples of isomerism. 8- D Comments: Parasympathetic cholinergic drugs have their effect based on nature of their structural molecule. To be effective, cholinergic drugs most display a quasi-ring



36

conformation. One methyl group of the trimethylammonium group can be replaced by an ethyl group with only slight loss of activity 9- C Comments: Conjugations are phase II metabolism reactions characterized by an incorporation of endogenous substrate on the molecular structure of drugs normally coming from phase I metabolism reaction. Molecular structures (drugs) having carboxylic acid, amide, alcohol and/or thio group are mainly metabolized by a conjugation. 10- C Comments: In order for an antihistaminic drug be effective, they must have a terminal tertiary nitrogen and more than one aryl or heretoaryl group on their molecular structure. 11- A Comments: Molecules may be classified as more or less reactive depending in the presence of hydrogen and oxygen. Less hydrogen molecules and more oxygen molecules increase the reactivity of the compound or substance. 12- C Comments: Conformational isomerisms are stereoisomers produced by rotation around single bond, typically rapidly interconverting at room temperature. They are normally classified as enantiomers and diastereomers. 13- C Comments: Geometric isomers may be classified as CIS and TRANS depending the spatial position of the molecule around a bond with restricted rotation. 2-Butene is an example of molecule having geometric isomerism. 14- A Comments: Equatorial-equatorial is a structural formation of a molecule occurring at the same distance from each extremity of an axis. 15- B Comments: Choracetic acid is stronger than acetic acid due to higher molecular weight 16- D Comments: Nifedipine is calcium channel blocker that has 1,4-dihydropyridine on its structure responsible for its mechanism of action. 17- A Comments: Vitamin K has a quinolone on its molecular structure. 18- E Comments: As much higher is the pKa of the drug stronger will be the acid.



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19- D Comments: Most of the steroid compounds have three cyclohexanes and one cyclopentane ring on their molecular structure. 20- B Comments: Glucuronidation is the main reaction of phase II metabolism reactions, and are responsible mainly for the metabolism of drugs having hydroxyl, carboxyl and amide group on their molecular structure. 21- C Comments: Chloracetic acid is one of the strongest acids due to its molecular structure. 22- A Comments: Amides and esters are the only groups undergoing hydrolysis. 23- D Comments: Phenol is a weak acid due to stable anion resonance 24- E Comments: Molecules may be classified as more or less water-soluble depending in the presence of hydrogen and oxygen. Less hydrogen molecules and more oxygen molecules increase the water solubility of the compound or substance. 25- B Comments: Diastereomers must have more than one stereogenic center and are not mirror image, they have superimposed image. 26- B Comments: R-COOH is an acid while R-OH is not due to presence of stable anionic resonance, an indication of the extent of activity of free radicals in an organic reaction. 27- D Comments: pH is the measure of the acidity or basicity of a solution that is calculated mathematically as the negative log of the H+ concentration 28- C Comments: NH4+ + OH ¯ → H2O + NB3 is an example of neutralization reaction. 29- C Comments: Bioisosters are functional group or atoms that impact similar physical and chemical properties on biological activity of molecule. 30- A



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Comments: The molecular structure of isotretinoin, used in oral treatment of acne is 13-CIS Retinoic acids. The TRANS molecular structure is only used in topical preparations. 31- B Comments: The analgesic activity of morphine is dependent of p-phenyl-N-alkylpiperidine 32- D Comments: Clonidine is an antihypertensive drug that depends of its imidazoline molecular structure to be effective. 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 – Dorland’s illustrated – 27th edition. 4- PHARMACY PREP – Lectures series & study guide for Evaluating Examination-TIPS - 2003/2004 5- THERAPUTIC CHOICES – Canadian Pharmacist Association -Third edition 6- USP DI – Drug Information for the Health Care Professional–15th edition – Volume I

PharmacyPREP.Com Medicinal Chemistry of autonomic nervous system

NERVOUS SYSTEM

1- Which of the following cytochrome is mainly the benzodiazepinic action? a) 1A2 b) 3A4 c) 2D6 d) 2C9 e) 3C2 2- When the use of MAO antidepressant is associated with some medications cause a serotonergic syndrome, an example of class of medication that normally cause this syndrome a) Tricycle antidepressants b) Birth control pills c) ß-Blockers d) Digitalis e) H1 inhibitors 3.Scabies preferred treatment in pregnancy, lactation and children less than two months old; I.Permethrin 5% II.Lindane III.Precipitated sulfur 6% in petrolatum A.I only B.III only C.I and II only D.II and III only E.All of the above 4- Which of the following is not a side effect of an opioid analgesic for example morphine: a) C.V depression b) Constipation c) Sedation d) CNS depression e) Dilatation of eye pupil 5- Example of peptide neurotransmitter that binds to opioids receptors include: a) Acetylcholine b) Norepinephrine c) Epinephrine d) Enkephalins e) GABA


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6- Alzheimer is a progressive disease characterized by relentless and loss of mental function due to lack of: a) Thiamine d) Dopamine c) Acetylcholine d) Norepinephrine e) Serotonin 7.Topical yeast preparations may be necessary in a diaper dermatitis that has been ongoing for more than three days since it is likely colonized with Canadida and may need preventative anti yeast therapy. What are the topical anti yeast preparation causes stains: I.miconozole 1% II.Clotrimazole 2% III.Nystatin A.I only B.III only C.I and II only D.II and III only E.All of the above 8- CNS depressant that cause retinal damage (ocular damage) include: a) Ethanol b) Alcohol c) Methanol d) Propylalcohol e) Isopropylalcohol 9- Thiopental is used in anesthesia due to high distribution in body tissues and fast onset of action, we can classify thiopental as: a) General anesthetic b) Local anesthetic c) Opiate d) Barbiturate e) Benzodiazepinic 10- Which of the following agents may be used as thiopental antagonist? a) Flumazenil b) Naloxone c) Naltrexone d) Atropine e) Aminophilin 11- Which of the following is not classified as SSRI’s antidepressant? a) Fluoxetine b) Phenelzine c) Paroxetine


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d) Citalopram e) Sertraline 12- The effect of inhalation anesthesia may be determined by: I- Concentration of the drug in the alveolar airway II- MAC-Minimum Alveolar Concentration III- Inhalation anesthesia in not used in children a) I only b) III only c) I and II only d) II and III only e) All are correct 13- Sumatriptan is widely used in migraine treatment acting on: a) 5HT1D/1B agonist b) 5HT1D/1B antagonist c) 5HT2 agonist d) Enkephalin e) Dopamine 14- Benztropine is used in treatment of extra pyramidal syndrome acting as: a) Cholinergic b) Anticholinergic c) Dopaminergic d) Dopamine antagonist e) Serotoninergic 15- Correct statements regarding chlorpromazine may include: I- A phenothiazine anti-psychotic drug II- Long-term treatment produces tardive dyskinesia III- Contra indicated in Parkinson’s disease because decrease dopamine. a) I only b) III only c) I and II only d) II and III only e) All are correct 16- Benzodiazepinics as antianxiety agent action: I- Enhance GABA transmission II- Act on GABA-A III- Binds with BZ1 and BZ2 receptors a) I only b) III only c) I and II only d) II and III only e) All are correct


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17- Agent classified as short acting antidepressant may include: a) Lorazepan b) Amitriptiline c) Fluoxetine d) Trazodone e) Citalopram 18- Toxin that inhibit sodium sensitivity channels may include: a) Tetrodotoxin b) Bungarotoxin c) Botulism toxin d) Edrophonium e) None of the above 19- Drug considered as the drug of choice in the treatment of status epileptics include: a) Oral diazepam b) Diazepam IV c) Carbamazepine IV d) Oral phenytoin e) Clorazepate IV 20- Examples of drug(s) used in petit mal epilepsy treatment may include: I- Valproic acid II- Gabapentin III- Diazepam a) I only b) III only c) I and II only d) II and III only e) All are correct 21- Dopamine deficiency in the nigrostriatal pathway cause: a) Alzheimer’s disease b) Parkinson’s disease c) Schizophrenia d) Serotoninergic syndrome e) Seizures 22- Characteristics regarding Parkinson’s disease may include which of the following? I- Primary: Loss of substantia nigra neurons II- Secondary: Loss or interference in the action of dopamine in the basal gland III- Secondary Parkinson may be the results of long-term treatment with anti-psychotic drugs a) I only b) III only


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c) I and II only d) II and III only e) All are correct 23- Parkinson’s disease may be treated with all of the following agents, EXCEPT: a) Amantadine b) Selegiline c) Pergolide d) Levodopa e) Donezepil 24- The action of acetylcholine in the motor endplates and in the celiac ganglia is described as: a) Nicotinic stimulation b) Muscarinic stimulation c) Dopaminic stimulation d) Adrenergic stimulation e) Serotonine stimulation 25- Correct statements regarding schizophrenia may include: I- Characterized by long term-standing paranoid delusion II- Treated by anti-psychotic medication III- Onset of age incidence is normally in later 20’s early 30’s. a) I only b) III only c) I and II only d) II and III only e) All are correct 26- Which of the following factors would be important in determining the concentration of drug that would be reached in the cerebrospinal fluid for treatment of meningitis I- Oil/Water partition coefficient II- Plasma binding protein III- pKa of the drug a) I only b) III only c) I and II only d) II and III only e) All are correct 27- Select the drug whose major metabolites have therapeutically significant pharmacological activity a) Oxazepan b) Nitrazepan c) Diazepan d) Triazolan


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e) Clonazepan 28.Leukotriene modifiers, zafirleukast indicated in long term care or mild asthma symptoms over 15 years of age patient; zafirleukast administration with meals: I.Decreases bioavailability II.Take atleast 1 hour before and 2 hours after meals III.Increases bioavailbility a) I only b) III only c) I and II only d) II and III only e) All are correct 29- Drug commonly used with local anesthetic to decrease the absorption and increase the time of action of anesthesia include: a) Epinephrine b) Adrenaline SC c) Isoproterenol d) Aminophiline e) Salmeterol 30- The mechanism of antipsychotic effect of phenothiazines is thought to: a) Improvement of cholinergic transmission b) Blockage of catecholamines re-uptake c) Blockage of dopamine receptors d) Blockage of enkephalinergic neurons e) Prolactin release 31- Correct statements regarding codeine may include: I- Used as antitussive especially in children not less than 2 years old II- Opiod analgesic III- Cause extreme addiction and drug dependency a) I only b) III only c) I and II only d) II and III only e) All are correct 32- Pilocarpine normally used in the treatment of glaucoma may cause which of the following effects? I- Mydriasis effect II- Cholinergic drug III- Miosis effect a) I only b) III only c) I and II only


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d) II and III only e) All are correct 33- Correct statements regarding carbidopa + levodopa include: I- Used as drug of choice in Alzheimer’s disease II- Carbidopa inhibit dopa-decaboxylase enzyme allowing levodopa reach the brain without suffer alterations III- Levodopa is a pro-drug that can cross blood brain barrier a) I only b) III only c) I and II only d) II and III only e) All are correct 34- Mechanism of action of levodopa may include: a) Inhibit the dopamine re-uptake b) The small amount that reaches the brain is decarboxylated to dopamine c) Inhibit dopa-decarboxylase enzyme increasing the levels of dopamine d) Inhibit the action of dopamine e) Improve the balance between cholinergic and dopaminergic activity resulting in an increased level of acetylcholine 35- Tardive dyskinesia is mainly characterized by an involuntary movement of mouth and tongue that can be a side effect of long term treatment with: a) Phenothiazine b) Chlorpromazine c) Dopamine antagonist drugs d) Antispychotic drugs e) All are correct 36- Competitive non-depolarizing neuromuscular blocker may include: a) Pancuronium b) Succinylcholine c) Nicotine d) Bungarotoxin e) Tetradotoxin 37- Correct statements regarding succinylcholine may include which of the following? I- Non-competitive depolarizing neuromuscular blocker II- Used in general anesthesia providing skeletal relaxation III- It is a sympathetic agent a) I only b) III only c) I and II only d) II and III only e) All are correct


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38- Examples of drug(s) that may cause secondary-Parkinson’s disease include: a) Haloperidol b) Phenothiazines c) Chlorpromazine d) Clozapine e) All can cause secondary Parkinson’s disease 39- Opioids may be used as all the following agents, EXCEPT: a) Antitussive b) Analgesic c) Antidiarrhea d) Anti-inflammatory e) Pre-anesthetic 40- Which of the following is the strongest morphine analog opioid agent? a) Methadone b) Heroin c) Codeine d) Hydrocodone e) Oxycodone 41- Which of the following opioids can be used as antidiarrheal agent? a) Diphenoxylate b) Butorphanol c) Propoxyphene d) Pentazocine e) Methadone 42- Morphine may be used in adjunct treatment of which of the following conditions? a) Increase intracranial pressure b) High blood pressure c) Emphysema d) Asthma e) Pulmonary edema secondary to left ventricular failure 43- Anticholinergic drugs may be used to treat which of the following conditions? I- Parkinson’s disease II- Spasms and ulcers III- Organophosphates overdose a) I only b) III only c) I and II only d) II and III only e) All are correct 44- Example of antianxiety drug with great antihistaminic effect may include:


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a) Diazepan b) Hydroxazine c) Memprobamate d) Chlorodiazepoxide e) Oxazepan 45- For a sympathomimetics drug to be effective it should: I- Fits in receptor II- Bind to plasma proteins III- Compete at the site where the neurotransmitter is released a) I only b) III only c) I and II only d) II and III only e) All are correct 46- Damage of the auxiliary nerve is thought to produce: a) Paralysis of the 5th finger b) Impaired sensation c) Numbness of extremities d) Inability to bend the elbow e) Paralysis of hand 47- A hypertensive patient suffering from depression can be taking all of the following, EXCEPT: a) Clonidine b) Methyldopa c) Reserpine d) Guanithidine e) Hydralazine 48- Drug considered as the drug of choice in the treatment of bipolar-maniac depression may include: a) Carbamazepine b) Lithium c) Phenytoin d) Diazepam e) Valproic acid 49- Which of the following vitamins accelerate the metabolism of phenytoin? a) Vitamin A b) Vitamin B c) Vitamin C d) Folic acid e) Vitamin E


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50- Drugs classified as long acting benzodiazepinic include: a) Diazepam b) Lorazepan c) Triazolan d) Alprazolan e) Temazepan 51- Drugs classified as intermediate acting benzodiazepinic include: a) Triazolan b) Midazolan c) Diazepan d) Lorazepan e) Oxazepan 52- All the following are examples of long acting benzodiazepinic, EXCEPT: a) Clonazepan b) Diazepam c) Chlorazepate d) Flurazepan e) Temazepan 53- Chemical mediator that is released from the end nerve of sympathetic system: I- Adrenaline II- Noradrenaline III- Acetylcholine a) I only b) III only c) I and II only d) II and III only e) All are correct 54- Chemical mediator that is released from the end nerve of parasympathetic system: I- Adrenaline II- Noradrenaline III- Acetylcholine a) I only b) III only c) I and II only d) II and III only e) All are correct 55- One of the major inhibitory neurotransmitter in the brain and mediates include: a) GABA b) Serotonin c) Acetylcholine d) Enkephalin


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e) Epinephrine 56- Which of the following may stimulates adrenaline release from adrenal medulla? a) Acetylcholine in very low doses b) Nicotine in very low doses c) Bilirrubine d) Noradrenaline e) None of the above 57- Tolerance of narcotics is normally characterized by which of the following statements? I- Decrease duration of analgesia II- Decrease sensitivity to receptors III- The dose should be first adjusted instead to change for a stronger narcotic. a) I only b) III only c) I and II only d) II and III only e) All are correct 58- All are examples of amides local anesthetics, EXCEPT: a) Mepivacaine b) Bupivacaine c) Lidocaine d) Procaine e) Prilocaine 59- Which of the following anesthetics metabolites is characterized by its PABA structure? a) Amides local anesthetics b) Ester type local anesthetics c) All local anesthetics d) All general anesthetics e) Lidocaine 60- The CNS – Central Nervous System is mainly constituted of: I- Brain II- Spinal cord III- Thoracic Lumbar a) I only b) III only c) I and II only d) II and III only e) All are correct 61- All the following group of drugs have direct action on CNS, EXCEPT:


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a) Cardiotonics b) Analgesics c) Anesthetics d) Antidepressives e) Antipsychotics 62- All of the following are important neurotransmitters, EXCEPT: a) Acetylcholine b) Dopamine c) Norepinephrine d) Muscarinic-M1 e) Serotonin 63- Catecholamines neurotransmitter may include: I- Dopamine II- Norepinephrine III- Epinephrine a) I only b) III only c) I and II only d) II and III only e) All are correct 64- Agents well known as precursor of dopamine include: a) Epinephrine b) Tyrosine c) Tyramine d) Norepinephrine e) Thiamine 65- Reaction that converts norepinephrine to epinephrine is normally called: a) Chatecholinization b) Methylation c) Oxidation d) Deamination e) Glutathione conjugation 66- Neurotransmitter with an indole group in its structure include: a) Serotonin b) Acetylcholine c) Histamine d) Dopamine e) PABA 67- Example of amino acid neurotransmitter may include: a) Tyrosine


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b) Thiamine c) Histamine d) Glycine e) Glutamate 68- Examples of cholinergic neuroreceptors may include: I- Muscarinic receptors II- Nicotinic receptors III- Serotoninergic receptors a) I only b) III only c) I and II only d) II and III only e) All are correct 69- The major dopaminergic receptor that controls the extrapyramidal system include: a) D1 b) D2 c) D3 d) D4 e) D5 70- Which of the following is an example of pure narcotic antagonist? a) Pentazocine b) Butorphanol c) Naltrexone d) Naloxone e) C and D are pure narcotic antagonists 71- Example of opioid used in the treatment of alcoholism include: a) Morphine b) Naloxone c) Hydrocodone d) Naltrexone e) Codein 72- Opioid widely used during labor due to its less liability to induce neonate respiratory depression include: a) Meperidine b) Morphine c) Methadone d) Fenthanyl e) Oxycodone 73- Intense pruritus and vasodilatation are side effects of classic opioids due to stimulation and release of: a) Adrenaline


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b) Histamine c) Serotonin d) Mu receptors e) Histadine 74- Examples of neurotransmitters used by barbiturates drugs include: I- Benzodiazepinics neurotransmitters II- GABA III- Glycine neurotransmitters a) I only b) III only c) I and II only d) II and III only e) All are correct 75- Primidone is a prodrug that when biotransformed become: a) Carbamazepine b) Risperidone c) Phenobarbital d) Lorazepan e) Phenytoin 76- MAO-Monoamine Oxidase inhibitor increases the bioavailability of biogenic amines and are mainly used to treat depression. A classic example of MAO is: a) Doxepine b) Reserpine c) Venlafaxine d) Desipramine e) Phenelzine 77- Example of less sedating TCAs-Tricyclic Antidepressants include: a) Desipramine b) Clomipramine c) Amitriptiline d) Imipramine e) Nortriptiline 78- Tricyclic antidepressant with effect in serotonin system used to treat maniac compulsive disorders include: a) Lithium b) Phenelzine c) Clomipramine d) Desipramine e) Nortriptiline 79- Which of the following is a wrong statement regarding lithium?


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a) Most effective psychiatric medication used to treat bipolar depression b) Interfere with trans membrane Na exchange c) Takes 2 to 3 weeks to start to show pharmacological effect d) Weight gain and weight loss is a side effect of lithium therapy e) Blood levels less than 1.5mEq/L cause over dose symptoms. 80- Antipsychotic drugs are effective in treating all of the following conditions, EXCEPT: a) Bizarre behavior b) Dellutions and hallucinations c) Schizophrenia d) Parkinson’s disease e) Alzheimer’s disease 81- Mechanism that best describe the action of general anesthetics include: a) Reversible block nerve impulse conduction b) Reversible loss of sensation at their administration site c) Binds to specific membrane Na ion, restricting Na permeability in response to partial depolarization d) Inhibit sensory, autonomic reflex and skeletal muscles inducing analgesia, amnesia and loss of consciousness e) Do not produce loss of consciousness 82-Mechanism of action of local anesthetics may include: a) Reversible block nerve impulse conduction b) Reversible loss of sensation at their administration site c) Binds to specific membrane Na ion, restricting Na permeability in response to partial depolarization d) Do not produce loss of consciousness e) All are correct 83- Example of general anesthetic with malignant hyperthermia as side effect include: a) Isoflurane b) Halothane c) Sevoflurane d) Nitrous oxide e) Fentanyl 84- Volatile liquid general anesthetic that is more recommended to be used in children include: a) Halothane b) Sevoflurane c) Isoflurane d) Enflurane e) Nitrous oxide


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85- Endorphins may be classified as which of the following? a) Endogenous neurotransmitter b) A new class of topical anti-inflammatory agents c) Neuromuscular blocking agents d) Biogenic amines believed to cause schizophrenia e) Endogenous opioid peptides 86- Example of MAO-B inhibitor used to treat Parkinson’s disease include: a) Hydralazines b) Phenelzine c) Selegeline d) Clomipramine e) Levodopa 87- Characteristics of agonist drugs may include which of the following statements? a) Bind to a receptor site and produces 100% of biological response b) Bind to a receptor site but do not produces 100% of the biological response c) Bind to a receptor site and produces 100% biological response only when given in high doses d) Bind to receptor site and block the biological response e) Bind to the receptor site and block the biological response in 50% 88- Drug dosages that can kills 50% of the experimental animals receiving the drug is called: a) Effective dose b) Minimum dose effect c) Lethal dose d) Maximum dose effect e) Therapeutic index 89. Inhaled carticosteroids indicated in asthma long term prevention symptoms, suppression, control of inflammation: space/holding chamber devices and mouth washing after inhalation. I.Decreases local side effects II.Decrease systemic absorption III.Increases systemic absorption a) I only b) III only c) I and II only d) II and III only e) All are correct 90- The action of acetylcholine released from parasympathetic fibers in visceras are mediated by which receptor? a) Muscarinic b) Nicotinic


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c) Adrenergic d) Dopaminic e) Serotonergic 91- Which of the following neurotransmitter is used by all preganglionic fibers of the autonomic nervous system? a) Dopamine b) Acetylcholine c) Epinephrine d) Norepinephrine e) GABA 92- The major neurotransmitter for sympathetic postganglionic fibers is known as: a) Dopamine b) Acetylcholine c) Epinephrine d) Norepinephrine e) GABA 93- Stimulation of blood vessels by α1-receptors may causes: a) Dilation b) Constriction c) Increase in blood flow d) Vasodilatation e) All are wrong 94- The peripheral nervous system is anatomically divided in: I- Somatic Nervous System II- Autonomic Nervous System III-Spinal cord a) I only b) III only c) I and II only d) II and III only e) All are correct 95- Part of nervous system responsible for body homeostasis: a) Central Nervous System b) Somatic Nervous System c) Spinal cord d) Autonomic nervous system e) Brain 96- Acetylcholine is an ester neurotransmitter synthesized from:


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a) Gluthamine b) Tyrosine c) Acetyl CoA d) Dopa e) Cathecolamines 97- Nicotinic receptors are mainly found in: I- Motor end plate II- Adrenal medulla III-Autonomic ganglia a) I only b) III only c) I and II only d) II and III only e) All are correct 98- Prototype of muscarinic antagonist class of drugs: a) Atropine b) Scopolamine c) Ipratropium d) Benztropine e) Oxybutynin 99- Botulism toxins are used in the treatment of prolonged muscle spasm where a small amount of the toxin is injected directly into a muscle fiber, causing the muscle to relax. What is the action of botulism toxins in acetylcholine? a) It blocks the release of acetylcholine b) It increase the release of acetylcholine c) It inhibit the nicotinic receptors d) It stabilizes the serum acetylcholine e) It increase the action of acetylcholine 100- Malignant hyperthermia can be a side effect of general anesthetics and may be treated by: a) Aminophillin b) Terbutaline c) Dantrolene d) Pancuronium e) Dobutamine 101- Which of the following antianxiety agents causes the least sedation? a) Diazepan b) Buspirone c) Chlordiazepoxide d) Oxazepan e) Chlorazepate


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102-What is drug of choice in Petit-mal seizure? A-Diazepam B-Phenytoin C-Carbamazepine D-Valproic acid and ethosuximide E-Gabapentin Ans-D 103-Valproic acid is used in treatment of a- Petit-mal b- Grand-mal c- Fabrile seizure in children d- All of the above e- A and C only Ans-D

104-Anticonvulsive agent that cause kidney stones? A-Topiramate

105-Phenytoin causes elevation of blood glucose levels by? A-Increasing insulin degradation B-Decreasing insulin release C-Increasing glucose absorption D-increasing glycogen release Ans-B

106-Side effects of phenytoin are? A-Gingival hyperplacia B-Steven Jhonson syndrome C-Hirsutism D-All of the above E-A and C Ans-D

107-Epilepsy cause due to deficiency of? A-Sodium ion B-GABA C-Serotonin D-Dopamine E-Acetyl choline Ans-B

108-Early symptoms of epilepsy are? A-Part of brain is involved B-Sensory seizure or focal motor seizure


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C-Patient is conscious D-All of the above Ans-D

109-Which one of the following CNS receptors is directly coupled to an ion channels, and this do not involve secondary messenger system? A-Alpha (NE) B-D2 (DA) C-Ach (N) D-5HT (serotonin) E- None of the above Ans-C Tips; Ach receptors, in the CNS are present on less than 5% of the neuronal population.

110-All of the following are antimuscarinic drugs that are used in treatment of antipsychotic induced parkinsonism, Except: A-Benzotropin B-Trihexphenidyl C-Bromocriptine D-Diphenhydramine E-Procyclidine

111-What type of local anesthetic is the most effective? A-The most hydrophilic B-The most lipophilic C-The least hydrophilic D-The least lipophilic Ans-B

112-Metabolism of local anesthetic takes place in? A-Skin B-Tissue C-Liver D-Gut E-Local area Ans-C

CORRECT ANSWERS NERVOUS SYSTEM

1- B Comments: Generally benzodiazepinics binds to the most abundant cytochrome P-450 in the body: 3A4. 2- A


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Comments: - Serotoninergic syndrome is characterized by agitation, neuromuscular rigidity, hypotension, coma and death. It mainly happens with the concomitant use of MAO antidepressant with other medication that also have interference in the serotonin neuroreceptors an example of drugs that may cause this syndrome is clomipramine, meperidine and Selective serotonin re-uptake inhibitors antidepressives. 3- B Comments: Scabies preferred treatment in pregnancy, lactation and children less than two months old is Precipitated sulfur 6% in petrolatum. Pemethrin 5% is currently preferred treatment for adults and children older than two months. Lindane 1% has convulsions as side effect. Ref: Patient Selfcare, P.613 1st edition, CPhA, Canada 4- E Comments: Morphine causes a miosis side effect therefore diminishes eye pupil. 5- D Comments: Enkephalins are pentapeptides that bind to opioid receptors. They act as neurotransmitter or neuromodulators at many locations in the brain and spinal cord and play a part in pain perception, movement, mood, behaviour and neuroendocrine regulation. 6- C Comments: Comments: Alzheimer’s is a progressive disease characterized by a imbalance of acetylcholine and dopamine, low levels of acetylcholine and high levels of dopamine. 7- B Comments: Nystatin known to cause staining 8- C Comments: Methanol when is metabolized form formaldehyde that is a very toxic substance causing retinal damage. 9- D Comments: Thiopental is a barbiturate mainly used as adjunct in general anesthesia. 10- E Comments: Aminophillin is considered the thiopental antagonist drug. 11- B Comments: Phenelzine is a MAO-Monoamino Oxidase inhibitor antidepressant. 12- C


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Comments: Inhalation anesthesia is the most used method of general anesthesia for children 13- A Comments: Sumatriptan activate serotonin receptors-5HT1B/1D agonists. It is used in the abortive treatment of migraine. 14- B Comments: Benztropine is a parasympathetic anti-cholinergic agent used specifically in the treatment of extra pyramidal syndrome-Parkinson’s disease. 15- E Comments: Chlorpromazine is a phenothiazine anti-psychotic drug completely contra indicated in Parkinson’s disease because decrease dopamine levels and may cause tardive diskinesia, abnormal movements of tongue and mouth, as side effect of its long-term therapy. 16- C Comments: Benzodiazepinics bind to GABA-A and enhance its transmission. 17- D Comments: Trazodone is the shortest acting antidepressant agent. 18- A Comments: Tetradotoxin is a toxin that inhibits sodium sensitivity channels. 19- B Comments: Diazepan IV is the most appropriate drug in treating status epileptics due to its fastest onset of action. 20- A Comments: Valproic acid is the drug of choice in the treatment of petit-mal epilepsy. Phenobarbital and clonazepan are also used. 21- B Comments: Parkinson’s disease is mainly caused by hypofunction of nigrostriatal pathway resulting in decrease of dopamine levels and increase of acetylcholine levels. 22- E Comments: Parkinson’s disease is characterized by a decrease in dopamine levels causing tremors and muscular rigidity among other symptoms. It can be classified as primary, when occurs loss of substantia nigra neurons and secondary, when occurs loss or


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interference in the action of dopamine in the basal gland, normally due to drug induction as per example long-term treatment with anti-psychotic drugs. 23- E Comments: Donezepil is used in the treatment of Alzheimer’s disease and it is completely contra-indicated in Parkinson’s because of decrease in dopamine levels. 24- A Comments: Nicotinic receptors are found at the motor end plate, in all autonomic ganglia and in the adrenal medulla. 25- E Comments: Schizophrenia is a mental disorder characterized by disturbances in form and content of thought, delusions, hallucinations, mood disorder, loss of sense of self and relationship to the external world and behavior. Antipsychotic drugs mainly treat it. 26- E Comments: Oil/Water partition coefficient is one of the most important considerations when choosing a drug for treatment of meningitis because completely water-soluble drugs cannot cross blood brain barrier. As much the drug is bound to plasma protein less drug will reach the site of action. PKa of the drug is other very important factor to be considered when determining the concentration of drug that would reach the cerebrospinal fluid 27- C Comments: Diazepan metabolites have therapeutically significant pharmacological activity. 28- C Comments: Zafirleukast with meals deccreases bioavailability. 29- A Comments: Epinephrine is a vasoconstrictor used in adjunct with local anesthesia to increase the duration of action of local anesthetic agents. 30- C Comments: Antispychotic drugs are used to reduce the intensity and frequency of psychotic symptoms. They act primarily by blocking dopamine receptors. 31- C Comments: Codeine is not a strong opioid analgesic. It is classified as moderate. Although it may cause addiction as most of all opioids, codeine is not well known as a drug that causes extremely dependency or strong drug dependency. 32- D


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Comments: Pilocarpine is a parasympathetic cholinergic agent that causes miosis. 33- D Comments: Carbidopa + Levodopa is the drug of choice in the treatment of Parkinson’s disease, levodopa when used alone loss part of its action due suffer decarboxylation from dopa-decarboxylase enzyme, thus carbidopa is used in combination to inhibit dopa-decarboxylase enzyme allowing levodopa reach the brain without suffer alterations 34- B Comments: Levodopa is a prodrug that cross blood brain barrier however it loss most of its action in the way to reach the brain crossing blood brain barrier just a small amount of the drug that is decarboxylated to dopamine. 35- E Comments: Tardive dyskinesia is mainly characterized by an involuntary movement of mouth and tongue that can be a side effect of long-term treatment with phenothiazines, dopamine antagonist drugs and other antispychotic drugs. 36- A Comments: Pancuronium is a nicotinic antagonist neuromuscular junction blocker acting as competitive non-depolarizing agent. : 37- C Comments: Succinylcholine is a nicotinic antagonist neuromuscular junction blocker acting as non-competitive depolarizing agent. It is mainly used as adjunct in general anesthesia providing skeletal relaxation. 38- E Comments: Secondary Parkinson’s disease can be induced by most of antipsychotic drugs due to decrease in dopamine levels by the blockage of dopamine neurotransmitters. 39- D Comments: Opioids have no action as anti-inflammatory agents. 40- B Comments: Heroin is the strongest morphine analog. 41- A Comments: Diphenoxylate, well known as lomotil, and loperamide are opioids used in the treatment of diarrhea. 42- E Comments: Morphine also may be used in adjunct treatment of pulmonary edema secondary to left ventricular failure.


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43- E Comments: Anticholinergic drugs as benztropine can be used to treat Parkinson’s disease. Scopolamine another anticholinergic drug is used to treat spasms and ulcers and atropine, the anticholinergic prototype can be used to treat organophosphates overdose, so all are correct answers. 44- B Comments: Hydroxazine is an antianxiety drug with great antihistaminic effect 45- A Comments: One of the most important considerations in the effectiveness of a drug is fit it into receptor to produce the biological or pharmacological response. 46- D Comments: Damage of the auxiliary nerve will lead to inability to bend the elbow. 47- C Comments: Reserpine is used in the treatment of hypertension and should be avoid in patients suffering depression because it acts depleting tissues and central nervous system stores of catecholamines and serotonin. 48- B Comments: Lithium is the most effective psychiatric medication used to treat bipolar depression disorder 49- D Comments: Phenytoin deplete the body of folate stores, supplementation with folic acid may result in lowered serum phenytoin concentration and possible loss of seizure control, therefore, an increase in phenytoin dosage is necessary in patients who receives folate supplementation. 50- A Comments: Diazepan is one of the longest acting benzodiazepinic with duration of action up to 48 hours. 51- D Comments: Intermediate acting benzodiazepinics include: Alprazolan, bromazepan, lorazepan and temazepan. 52- E Comments: Temazepan is an intermediate acting benzodiazepinic. 53- C


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Comments: Noradrenaline and adrenaline are chemical mediator that are released from the end nerve of sympathetic system 54- B Comments: Acetylcholine is the only chemical mediator that is released from the end nerve of parasympathetic system 55- B Comments: GABA is a neurotransmitter permeable to Cl ions and the major inhibitor of Central Nervous System. 56- B Comments: Nicotine in low doses stimulates the release of adrenaline from adrenal medulla. 57- E Comments: Tolerance of narcotics results in a decrease of sensitivity to receptors and therefore decreases in the duration of analgesia. 58- D Comments: Procaine is an ester local anesthetic. 59- B Comments: Ester local anesthetics have similar structure with GABA neurotransmitter. 60- C Comments: Thoracic lumbar is part of peripheral nervous system. 61- A Comments: Cardiotonics interfere with autonomic-peripheric nervous system. 62- D Comments: Muscarinic-M1 is a cholinergic neuroreceptor, not neurotransmitter. 63- E Comments: Dopamine, epinephrine and norepinephrine are catecholamines neurotransmitters due the presence of a catecholamine group on their molecular structure. 64- B Comments: Tyrosine is the precursor of dopamine.


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65- B Comments: Norepinephrine is converted to epinephrine through mediation of phenyl-ethanol-amine-methyl transferase enzyme by a reaction called methylation. 66- A Comments: Serotonin is 5HT-5-Hydroxyl-Tryptamine permeable to Na and K ions with an indole group on its molecular structure. 67- D Comments: Glycine is the only amino acid neurotransmitter. 68- C Comments: Cholinergic neuroreceptors include only muscarinic and nicotinic receptors. 69- B Comments: D2 dopamine neuroreceptor is the one responsible for the control of extra-pyramidal syndrome. 70- E Comments: Pentazocine and buthorphanol are mixed agonist and antagonist agents therefore cannot be considered pure as naltrexone and naloxone. 71- D Comments: Naltrexone is given orally in the treatment of alcoholism. 72- A Comments: Meperidine is the opioid analgesic of choice administrated during labor due to its less liability to induce neonate respiratory depression. 73- B Comments: Classic opioid can prompt the release of histamine causing intense pruritus and vasodilatation. The best example for these symptoms is morphine. 74- D Comments: Barbiturates use glycine and GABA neurotransmitters. Benzodiazepinic neurotransmitters are the use exclusive of benzodiazepinic drugs. 75- C Comments: Primidone is a barbiturate prodrug that when biotransformed in the body become Phenobarbital, the longest acting barbiturate. 76- E Comments: Phenelzine is a hydralazine monoamine oxidase inhibitor used to treat depression. 77- A


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Comments: Desipramine is the least sedating tricyclic antidepressant while amitriptiline is the most sedating one. 78- C Comments: Clomipramine enhance the action of biogenic amines by inhibiting their re-uptake. It also exert action on serotonin system, therefore it may be used to treat maniac compulsive disorders. 79- E Comments: Main side effects of lithium therapy include: Loss of appetite, nausea, mild diarrhea, dizziness, tremors, excessive urination, thirst and diabetes insipidus. 80- D Comments: Antipsychotic drugs act by blocking dopamine receptors; therefore they cannot be used to treat Parkinson’s disease that is already characterized by decrease in dopamine levels. 81- D Comments: General anesthetics induce a combined state of analgesia, amnesia, loss of consciousness, inhibition of sensory and autonomic reflex and skeletal muscle relaxant. 82- E Comments: Local anesthetics reversible block nerve impulse conduction producing reversible loss of sensation only at administration site, therefore they do not produce loss of consciousness. 83- B Comments: Halothane is a volatile liquid used in inhaled anesthesia and may cause malignant hyperthermia. 84- A Comments: Halothane is the most recommended general anesthetic in the anesthesia induction of children. 85- E Comments: Endorphin are opioids endogenous neurotransmitters. 86- C Comments: Selegeline is the only MAO-B used in the treatment of Parkinson’s disease. It blocks the central catabolism of dopamine; it is indicated in the early stage of Parkinson’s and in adjunct of levodopa treatment. 87- A Comments: An agonist drug is a compound that binds to a receptor and produces the biological response.


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88- C Comments: The lethal dose is the dose that kills 50% of the animals that receive it. The lethal dose is mainly compared with the effective dose to determine the therapeutic window of a drug. Effective methodology in determining both the range of effective drug concentration and the safety of the drug. 89- C Comments: Decrease local side effect, and systemic absorption 90- A Comments: All of the parasympathetic postganglionic fibers release acetylcholine. At the target organ acetylcholine interacts with muscarinic receptors. 91- B Comments: All preganglionic neurons release acetylcholine as their transmitter. The acetylcholine binds to nicotinic receptors on the postganglionic cell. 92- D Comments: Most of the sympathetic postganglionic fibers release norepinephrine. At the target organ norepinephrine interacts with a variety of receptors. 93- B Comments: Activation of alpha-receptors causes contraction or constriction, mostly vasoconstriction. 94- C Comments: Spinal cord is a part of central nervous system. 95- D Comments: The autonomic nervous system is responsible for maintaining the internal environment of the body called “homeostasis”. 96- C Comments: Acetylcholine is synthesized from acetyl coenzyme A (acetyl CoA) and choline. It is action is terminated by acetylcholinesterase. 97- E Comments: Nicotinic receptors are found at the motor end plate, in all autonomic ganglia, and in the adrenal medulla. 98- A Comments: Atropine is the prototype of parasympathetic anticholinergic group of drugs. 99- A Comments: Botulism toxins prevent and/or completely block acetylcholine release.


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100- C Comments: Dantrolene may be used in the treatment of malignant hyperthermia, a side effect associated with the use of general anesthetics. 101- B Comments: Buspirone is an atypical anxiolitic agent that binds to dopamine and serotonin. It is very well preferred when compared with other anxiolitic agents due to its least side, non-drowsiness, no addiction and no CNS depressant activity.


PharmacyPrep.Com Medicinal Chemistry of autocoids and analgesics

PHARMACY PREP

MEDICINAL CHEMISTRY OF AUTOCOIDS AND ANALGESICS 1-The activity of which of the following drug is depends on p-phenyl-N-alkypiperidine moiety? A-Acetaminophen B-Aspirin C-Naproxen D-Diazepam E-Morphine Ans-E 2-Which of the following drug structure is derivative of N-methyl-p-phenyl piperidine (ethyl 1-methyl-4-phenylpiperidine): A-Haloperidol B-Phenytoin C-Meperidine D-Phenobarbital E-Procainamide Ans-C Tips: N-methyl-p-phenyl piperidine is the common to opioid analgesic and ethyl 1-methyl-4-phenylpiperidine is derivative, present in meperidine. 3-Allyl group is present in opioids structure, gives the activity of? A-Agonist B-Partial agonist C-Antagonist D-mixed agonist and antagonist E-Partial antagonist Ans-C Tips: Nalaxone antagonist activity is due to presence of allyl group on opioids structure. 4- For a first generation antihistaminic drug be effective, it must have which of the following molecular characteristics on its structure? I- A terminal tertiary nitrogen II- More than one aryl or heteroaryl group III- Presence of C−C between C−O and C-N groups a) I only b) III only c) I and II only d) II and III only e) All are correct Ans- E Comments: In order for an antihistaminic drug be effective, they must have a terminal tertiary nitrogen and more than one aryl or heteroaryl group on their molecular structure.


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5-Which of the following dose acetylsalicylic acid (ASA) used for its antiplatelet action? A- 81mg B- 325mg C- 650mg D- 975mg E- All of the above Ans-A 6-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 7-What is antidote of acetylsalicylic acid (ASA)? A-N-acetylcysteine B-Flumezanil C-Nalexone D-Naltrexone E-None of the above Ans- 8-Which of the following is the urinary tract analgesic? A-ASA B-Naproxen C-Ibuprofen D-Phenazopyridine E-Sulindac Ans-D 9-Which of the following is the strongest analgesic for acute pain? A-ASA B-Naproxen C-Ibuprofen D-Acetaminophen E-Ketorolac (Toradol) Ans- 10-Which of the following analgesic is least likely cause addiction? A-Morphine B-Heroin C-Codeine D-Tramadol E-Methadone


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Ans-D 11-Tramadol act on? A-NE reuptake only B-NE reuptake and mu receptors C-Mu receptors only D-mu, delta, and kappa receptors E-Delta and kappa receptors only 12-The following groups are essential for antihistamine pharmacological activity: I-Aromatic or heteroaromatic rings in structure II-Tertiary amines in structure III-Chain of alkyl group in structure A-I only B-III only C-I and II only D-II and III only E-All of the above Ans-E 13-H2 receptor antagonist; I. Reduce gastric acid secretion II.Reduce allergic symptoms III.Branchoconstriction A-I only B-III only C-I and II only D-II and III only E-All of the above Ans-A 14-All of the following are side effects of atropine EXCEPT: A-Dry mouth B-Urinary retention C-Constipation D-Clurred vision “sandy eyes” E-Diarrhea Ans-E 15-Which of the following drugs will decrease stomach acid secretions, mechanistically blocking of H2 histaminic receptors. A-Hydroxyzine B-Cetrazine C-Fluoxazine D-Omeprazole


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E-Ranitidine Ans-E Comments: hydroxazine and cetrazine are H1 antagonist Omeprazole---is a Proton pump inhibitor Ranitidine-H2 antagonist. 16-Lipoxigenase function in the following mechanism: A-Conversion of arachidonoic acid to prostaglandin B-Conversion of histidine to histamine C-Conversion of tryptophan to serotonin D-Conversion of arachidonic acid to leukotriene E-Inhibits Leukocyte migration. Ans-D 17-The mechanism of action of aspirin that results in greater effect as an antiplatelet drug is because of: A-Selective COX I inhibitor B-Selective COX II inhibitor C-COX I and COX II inhibitor D-Acetylate cyclooxygenase E-Inhibits lipoxygenase aswell as cyclooxygenase. Ans: D Comments: Aspirin is the only drug that irreversibly inhibits the enzyme. This action permits a longer duration of action causing platelet aggregation and acetylation of 18-Serotonin: A-Imidazole B-tryptophan C-indole D-Piperidine E-pyrrolidine 19-What is the prevention for NSAID induced GI ulcers: A-Omeprazole B-Zantac C- Misoprostol D-Cetrizine E-Calcium hydroxide Ans-


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20-Misoprostol (Cytotec) is used for prevention of NSAID induced ulcers, is classified as: I-PGI II-PGE2 III-PGE1 A-I only B-III only C-I and II only D-II and III only E-All of the above Ans-B 21-The following drug indicated to induce cervical ripening in pregnancy: Latonoprost (Xalatan) Travoprost (Travatan) C-Bimatoprost (Lumigan) D-Misoprostol E-Dinoprostone Ans-E 22-Which of the following prostaglandin inhibitor indicated in the treatment of Open angle glaucoma. A-Latanoprost (Xalatan) B-Timolol C-Bimatoprost (Lumigan) D-Misoprostol E-Dinoprostone Ans-A 23-Prostaglandins contain the following fragment in the structure: I-Cyclopentane ring contain carbonyl and hydroxyl group II-Long chain alkyl group. III-Keto and hydroxyl position indicate subscript of prostaglanding analogs A-I only B-III only C-I and II only D-II and III Only E-All of the above Ans-E 24-What is the mechanism of action of montelukast (Singulair)? A-Leukotriene inhibitors B-LTC4 and LTD4 inhibitors C-Cyclooxygenase inhibitors D-5HT1D inhibitors E-Antihistamines Ans-B


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25-Which of the following can be dispensed without prescription: I-8 mg of codeine II-19 mg /5mL of codeine solution in acetaminophen III- 300mg acetaminophen+8 mg codeine + caffeine A-I only B-III only C-I and II only D-II and III only E-All of the above Ans-D 26-Which of the following does not require prescription: A-Tylenol 1 B-Tylenol 2 C-Tylenol 3 D-Tylenol 4 E-Tylenol 2, 3 and 4 Ans-A

27-Which of the following prescription require written prescription only: A-Tylenol 1--signature B-Tylenol 2 C-Tylenol 3 D-Tylenol 4 E-Tylenol 3 and 4 Ans-D

28-All of the following are propionic acid derivatives EXCEPT: A-Naproxen B-Ibuprofen C-Ketoprofen D-Aspirin E-Carprofen Ans-B 29-Pyrazole ring is present in the following drug structure: A-Aspirin B-Acetominophen C-Celecoxib D-Ibubrofen E-Ketoprofen Ans-C 30-All of the following are catechol amine neurotransmitters; EXCEPT: A-Tyrosine


74



75

B-Dopa C-Dopamine D-Dihydroxyphenylalanine (DOPA) E-Norepinephrine Ans-A 31-Serotonin (5HT) is synthesized from tryptophan, this contain indole ring which catalyzed to 5-hydroxy tryptophan by the following enzyme:

NHN

HNH

NH2

HOOCHO

NH2NH2

HOHOOC

Aromatic aminoacid decarboxylase

Tryptophan (5-HTP) Serotonin (5-HT)

A-Aromatic amino acid decarboxylase B-Tryptophan decarboxylase C-Tryptophan hydroxylase D-Indole hydroxylase E-Tryptophan dehydroxylase Ans-C


PHARMACY PREP.

CARDIOVASCULAR SYSTEM 1-Diuretic characterized for the decrease of Na, K, Cl and Ca. a) Acetozalamide b) Spirolactone c) Hydroclorotiazide d) Furosemide e) Triametrene 2- Thrombolytics (fibrinolytic) agents are contra indicated in I-Myocardial infarction II-Hypertensive patients III-Bleeding from the GIT a) I only b) III only c) I and II only d) II and III only e) All are correct 3- Patient with renal failure and normal liver function is showing sensibility to the drug, this means that a) High accumulation of metabolite b) High concentration of drug protein binding c) High volume of distribution d) High concentration of drug in the systemic circulation e) High accumulation of drugs into tissues 4- Normal osmotic blood pressure in a health adult: a) 280mOsm/L b) 280Osm/L c) 280mOsm/ml d) 280Osm/ml e) 280mOsm/100ml 5-Which increase water permeability at collecting tubules? a) ADH b) Hydroclorothiazide c) Aldosterone d) Triametrene e) Spirolactone


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6- Digoxin is cardiac digitalis widely used in CV which toxicity is increased by I- Erythromycin II- Quinidine III- Cholestyramine a) I only b) III only c) I and II only d) II and III only e) All are correct 7- Acetozalamide, a carbonic anhydrase diuretic and hydroclorothiazide, a thiazide diuretic have an identical molecular group very important in their structure knows as: a) Sulfonamide group b) Pyrimidine group c) Purine group d) Pyrrolidine group e) Ether group 8- A man with blood group AB can receive blood from: a) A b) B c) AB d) O e) All the above 9- When would will advise patient that he may suffer from hypertension and he may need to see a doctor? I- Doctor blood pressure monitor shows BP180/110 II- The pharmacy blood pressure monitor shows BP180/110 III- His monitor shows BP120/80 a) I only b) III only c) I and II only d) II and III only e) All are correct 10-During absolute refractory period the myocardial fiber: a) Receive the strongest stimulation b) It is relaxed but is able to respond to any stimulus c) Respond to the most sensible stimulus d) Do not respond to any stimulus e) None of the above 11- Abnormal persistent dilatation of blood vessels is known as: a) Embolism b) Aneurism


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c) Emphysema d) Starvation e) Atheroscherosis 12- Correct statements regarding embolism include: I- Abnormal dilatation of blood vessel II- Obstruction of a blood vessel by a mass transported in the circulation III- An embolus can be a clot or a foreign material transported in the circulation a) I only b) III only c) I and II only d) II and III only e) All are correct 13- Which of the following statements regarding HEPARIN is/are right I- It is a mucopolysacaride, organic acid present naturally in many tissues especially in lungs and liver. II- It has anticoagulant proprieties that inhibit the conversion of prothrombim to thrombin and fibrinogen to fibrin III- It has antithrombin III as it co-factor a) I only b) III only c) I and II only d) II and III only e) All are correct 14- Heparin and warfarin are very popular anticoagulant agents. What is wrong regarding heparin and warfarin? a) Both have anticoagulant proprieties b) Warfarin has activity only in vivo c) Heparin has activity only in vivo d) Heparin has activity in vivo and in vitro e) All are correct 15- Which of the following calcium channel blockers cause bradycardia I- Nifedipine II- Verapamil III- Diltiazem a) I only b) III only c) I and II only d) II and III only e) All are correct


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16- Important characteristics regarding the blood formed elements may include: I- Red Blood Cells (RBC) is originated from erythrocytes and has a life span of 120 days (4 months) II- Platelets are involved in blood clot and have a life span is 7 to 10 days III- Platelets are originated from megakariocyts a) I only b) III only c) I and II only d) II and III only e) All are correct 17- Warfarin, is an anticoagulant agent has its effect is potentiates by: I- Deficiency of Vitamin K II- Adjunct therapy with heparin III- Adjunct therapy with salicylates a) I only b) III only c) I and II only d) II and III only e) All are correct 18- All are drugs that decrease Low Density Lipoproteins, EXCEPT: a) Colfibrate b) Genfibrozil c) Cimetidine d) Sinvastatin e) Pravastatin 19- A patient with deep vein thrombosis (DVT) can be treated by: I- Streptokinase II- Heparin III- Warfarin a) I only b) III only c) I and II only d) II and III only e) All are correct 20- α-blockers are mainly used in CV complications. One of the biggest cautions in using α-blockers is the development of: a) Tachycardia b) Bradycardia c) Orthostatic hypotension d) Hypotension e) Increase in cardiac output


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21- All of the following are ACE-Angiotensin Covertase Inhibitor, EXCEPT a) Enalapril b) Captopril c) Ramipril d) Lisinopril e) Losartan 22- During inspiration the lowest blood pressure in supine position is: a) Vena cava b) Internal carotid artery c) Aorta artery d) Sciatic artery e) Pulmonary artery 23- Which of the following theories relates the tension, radius of vessel and intraluminal pressure achieved in a blood vessel wall? a) Fick’s law b) Ahhrenius c) LaPlace’s law d) Newtonian law e) Henderson law 24- The first location where blood is present in case of left ventricular failure: a) Liver b) Lung c) Heart d) Kidney e) Brain 25- The blood weights 7 to 8% of the total body weight of a health adult. How much of these percentages are represented approximately in liter of blood? a) 4 to 6L b) 7 to10L c) 7 to 8L d) 10L e) 15L 26- Nitrates are mainly used in angina treatment. True statement regarding nitrates may include: I- Nitrates are esters of nitric acid. II- Nitrates are prodrugs and must be denitrated to exert their therapeutic effect III- Nitrates relaxes vascular smooth muscle and in addition relax bronchial, biliary, gastrointestinal, urethral and uterine smooth muscles. a) I only b) III only c) I and II only


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d) II and III only e) All are correct 27- Which of the following diuretics is used to block Na/H exchange system of the renal tubule: a) Indapamide b) Ouabain c) Spirolactone d) Acetazalamide e) Amiloride 28- Example of diuretic that increases the levels of Cl, causing hypercloremia is: a) Acetazalamide b) Amiloride c) Furosemide d) Ouabain e) Hydroclorotiazide 29- Dobutamine is a direct acting inotropic agent parenteraly used in cardiac emergences and characterized by: I- Increase myocardial contractility, very useful in myocardial infarction. II- Increase cardiac output III- Increase glomerular filtration rate, renal blood flow and sodium excretion a) I only b) III only c) I and II only d) II and III only e) All are correct 30- Spirolactone is an aldosterone antagonist diuretic that competes with aldosterone at: a) Proximal tubule b) Early distal tubule c) Early collecting tubule d) Collecting tubule e) End of collecting tubule 31- Examples of drugs affecting platelet aggregation may include: I- Ticlopidine II- Clopidrogel III- Aspirin a) I only b) III only c) I and II only d) II and III only e) All are correct


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32- What kind of arrhythmia can be caused by an increase in temperature? a) Ventricular premature depolarization b) Atrial fibrillation c) Paroxysmal arrhythmia d) Ventricular tachycardia e) None of the above 33- Prazosin is a sympathetic agent used in hypertension acting as: a) β-adrenergic b) α-adrenergic c) β-adrenergic blocker d) α-adrenergic blocker e) α and β-adrenergic blocker 34- All are side effects of hydroclorothiazide, a thiazide diuretic, EXCEPT: a) Hypokalemia b) Hypoglycemia c) Hyponatremia d) Hypercalcemia e) Hyperuricemia 35- CHF-Congestive Heart Failure is a cardiac disorder: I- Resulted from any cardiac disorder that impairs the ability of the ventricle to deliver adequately quantity of blood to the metabolizing tissues II- Result in poor pump function III- β-blockers are the BEST treatment for CHF. a) I only b) III only c) I and II only d) II and III only e) All are correct 36- Drugs that may affect the normal activity of warfarin include: a) Ibuprofen b) Aspirin c) Vitamin K d) Acetaminophen e) All are correct 37- Glycosides are widely used in the treatment of CHF, glycosides molecular structure consist of steroidal nucleon and: a) Sugars b) Polypeptides c) Carbohydrates d) Proteins


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e) Hormones 38- Sterosis: a) Dilatations of blood vessels b) Increase in cardiac output c) Accumulation of cholesterol in blood vessels d) Narrowing of blood vessels e) High pressure in blood vessels 39- The first tissue that receive the greatest cardiac output at rest: a) Lung b) Liver c) Kidney d) Muscle e) Fat 40- Calcium channel blocker that may cause myocardial infarction as side effect include: I- Diltiazen II- Verapamil III- Nifedipine a) I only b) III only c) I and II only d) II and III only e) All are correct 41- Bradycardia and orthostatic hypotension are characteristic side effects of: I- Guanabenz II- Hydralazine III- Vasodilators a) I only b) III only c) I and II only d) II and III only e) All are correct 42- An important advantage of using dopamine in cardiac shock may include: a) It will not cross BBB and cause CNS effect b) It has no effect on α and β-receptors c) It produces dose-dependent increasing cardiac output and renal perfusion d) It will not increase blood pressure e) It can be given orally 43- Which of the following diuretics may shows an uricosuric activity???? a) Spirolactone b) Furosemide


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c) Chlortalidone d) Triamterene e) Chlorothiazide 44- Ancrod, an antithrombolitic agent is characterized by: I- It is derivated from snake venom II- It depletes fibrinogen III- It is an alternative to heparin a) I only b) III only c) I and II only d) II and III only e) All are correct 45- The use of sildenafil together with atenolol may result in: I- Tremor II- Hypotension III- Visual disturbance a) I only b) III only c) I and II only d) II and III only e) All are correct 46- A diabetic patient suffering from hypertension is having enalapril, however he is complaining from severe dry cough that we can associated as a side effect of the enalapril. Which would be the best choice for changing this medication? a) Ramipril b) Losartan c) Amlodipine d) Indapamide e) Captopril 47- Drug of choice when treating hypertension in a diabetic patient may include: a) ACE inhibitors b) β-Blockers c) Calcium Channel Blockers d) Digitalis e) Nitrates 48- Angina, a cardiovascular complication characterized by the oxygen insufficiency my be aggravated by all of the following, EXCEPT: a) Exercise b) Hot places c) Cold places d) Anger


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e) Over weight 49- Drugs used in the treatment of hypertension associated with renal failure may include: I- Hydralazine II- Furosemide III- Atenolol a) I only b) III only c) I and II only d) II and III only e) All are correct 50- Digitalis is contra indicated in the treatment of: a) Myocardial infarction b) Coronary Heart Diseases c) Congestive Heart Failure (CHF) d) Arrhythmias e) Venous congestion 51- Systemic lupus or erythromatus lupus may be a side effect of: a) Propanolol b) Digoxin c) Cyclophosphamide d) Hydralazine e) Hydroxazine 52- Which is the best describe the proprieties of labetolol: a) β-blocker b) α-blocker c) β1 and α-blocker d) β non selective and α-blocker e) β2-blocker 53- Correct statements regarding blood pressure may include: I- Systolic pressure is the highest arterial pressure during a cardiac cycle. II- Diastolic pressure is the lowest arterial pressure during a cardiac cycle III- Diastolic pressure is crucial in verifying if a person suffers of high blood pressure a) I only b) III only c) I and II only d) II and III only e) All are correct 54- Cholesterol: I- VLDL-Very Low Density Lipoproteins are formed in the liver


84


II- LDL-Low Density Lipoproteins are formed from VLDL and carry LDL cholesterol that is the “bad cholesterol” III- HDL-High Density Lipoproteins are formed in the liver and small intestine. They carry HDL cholesterol that is the “good cholesterol” a) I only b) III only c) I and II only d) II and III only e) All are correct 55- Abnormal levels of lipids can cause all of the following, EXCEPT: a) Atheroscherosis b) Heart attack c) Pancreatitis d) Bone dystrophy e) Stroke 56- Lipid lowering group of drugs include all of the following, EXCEPT: a) Bile acid binders b) Fibric acid derivatives c) Angiotensin inhibitors d) Lipoprotein synthesis inhibitors e) HMG-CoA reductase inhibitors 57- Niacin mechanism of action as lipoprotein synthesis inhibitor is characterized by: a) Decrease the production rate of VLDL that synthesizes LDL b) Block the synthesis of cholesterol c) Decrease lipoproteins production by increasing the breakdown of lipids d) Remove VLDL from bloodstream e) Binds to bile acids in the intestine 58- Lipid lowering drug that binds to bile acids in the intestine causing the acids to be excreted include: a) Clofibrate b) Cholestyramine c) Niacin d) Genfibrozil e) Atorvastatin 59- The safest lipid lowering drug that may be used in pregnancy include: a) Pravastatin b) Genfibrozil c) Cholestyramine d) Sinvastatin e) Clofibrate


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60- Absorbable agents successfully used in patients with high cholesterol include: I- Grapefruit juice II- Nicotinic acid III- Fish oil a) I only b) III only c) I and II only d) II and III only e) All are correct 61- Digoxin may be used in dysrhythmias, however CANNOT be used in one specific type of dysrhythmias that is: a) Atrial tachycardia b) Ventricular tachycardia c) Paroxysmal tachycardia d) Atrial fibrillation e) Flutter 62- Class I sodium channel blocker antidysrhythmic agents include all of the following, EXCEPT: a) Quinidine b) Lidocaine c) Phenytoin d) Propafenone e) Amiodarone 63- Correct statements regarding antidysrhythmic agents may include: I- β-blockers, Na, K and Ca channel blockers are used in treat dysrhythmias II- They are classified according to their ability to alter the action potential of cardiac cells III- Reduce abnormalities of impulse generation and modify the disturbance of impulse conduction within cardiac tissue a) I only b) III only c) I and II only d) II and III only e) All are correct 64- Diuretic that act in the loop of henle include: a) Acetazolamide b) Hydroclorothiazide c) Furosemide d) Spirolactone e) Chlortalidone


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65- All the following diuretics may cause metabolic acidosis, EXCEPT: a) Hydroclorothiazide b) Acetozalamide c) Spirolactone d) Amiloride e) Triametrene 66- Diuretic with pteridine and pyrazine hererocycles rings used in the treatment of nephrogenic diabetes insipidus caused by lithium: a) Spirolactone b) Amiloride c) Indapamide d) Furosemide e) Acetazolamide 67- Best diuretic used in the adjunct treatment of hepatic cirrhosis and renal diseases include: a) Spirolactone b) Amiloride c) Indapamide d) Furosemide e) Acetazolamide 68- Agent with a sulphonamide group on its structure responsible for its functional action and that is considered the first line treatment for mild hypertension: a) β-Blockers b) α-Blockers c) Thiazides diuretics d) Vasodilators e) ACE inhibitors 69- Antihypertensive drug most likely to cause syncope effect or first-dose effect: a) Prazosin b) Clonidine c) Minoxidil d) Guanabenz e) Labetolol 70- Antihypertensive α-blocker used in BPH-Benign Prostate Hypertrophy: a) Prazosin b) Terazosin c) Doxazosin d) Finesteride e) Minoxidil 71- Drug used in the treatment of hypertension that may cause hemolytic anemia.


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a) Clonidine b) Guanabenz c) Thiazides d) Atenolol e) Methyldopa 72- One of the most safe antihypertensice drugs used in pregnancy is: a) Metoprolol b) Captopril c) Sodium nitroprusside d) Methyldopa e) Prazosin 73- Direct vasodilator drug used in the treatment of baldness may include: a) Hydralazine b) Sodium nitroprusside c) Minoxidil d) Enalapril e) Captopril 74- All of the following may be examples of calcium channel blocker, EXCEPT: a) Enalapril b) Amlodipino c) Nifedipeno d) Diltiazen e) Verapamil 75- First line treatment in mild to moderate CFH-Congestive Heart failure include: a) β-Blockers and diuretics b) Glycosides and ACE inhibitors c) Calcium channel blockers d) Vasodilators e) Nitrates 76- Drug used in cardiovascular complications which metabolism produce cyanide: a) Hydralazine b) Nitrates c) Nitroglycerine d) Isosorbid e) Nitroprusside 77- Nitrates used in cardiovascular complications mainly in CHF induce the formation of: a) Nitric oxide b) Cyanide c) Zinc oxide d) Nicotinic acid


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e) Nalidixic acid 78- Angina is a type of: a) Congestive heart failure disease b) Hypertension disease c) Ischemic disease d) Atherosclerosis disease e) Dysrhytmiac disease 79- Examples of common used thrombolytic or fibrinolytics agents may include: I- Streptokinase II- Recombinant tissue plasminogen activators (tPA) III- Warfarin a) I only b) III only c) I and II only d) II and III only e) All are correct 80- All are examples of low molecular weigh heparins (LMWH), EXCEPT: a) Ardeparin b) Enoxaparin c) Dalteparin d) Fragmin e) Alteplase 81- Which of the following β-agonist drugs has no effect in α-agonists receptors? a) Isoproterenol b) Dopamine c) Norepinephrine d) Epinephrine e) Clonidine 82- Which of the following antihypertensive drugs is considered a prodrug: I- Minoxidil II- Methyldopa III- Clonidine a) I only b) III only c) I and II only d) II and III only e) All are correct 83- Predominant sympathetic adrenergic receptor in the heart may include: a) α-receptors b) β-receptors


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c) Mu receptors d) M1-receptors e) D3-receptors 84-What is appropriate action should be advised to the patient if his blood pressure is 250/120 A-Ask patient to relax B-Refer to Dr C-Refer to Emergency D-Offer him antihypertensive drugs E-contact his family member to inform about his blood pressure Ans- 85-Use of nitroglycerine with seldanafil will cause: a-Hypotension b-hypertension C-angina D-CHF E-stroke Ans-A

CORRECT ANSWERS CARDIOVASCULAR SYSTEM

1- D Comments: Furosemide diuretic may cause hyponatremia, hypokalemia, hypocalcemia, and hypomagnesaemia. It also causes hyperglycemia, hyperuricemia and can increase levels of triglicerideos. 2- B Comments: Antithrombolitic agents are completely contra indicated in patients suffering from any internal bleeding. 3- A Comments: The liver with normal function can completely metabolize a drug, however a kidney with poor function-renal failure cannot properly eliminate the drug from the body leading to accumulation of metabolites. 4- A Comments: The osmotic blood pressure may vary from 280 to 300mmol/Kg or mOsm/Kg 5- A Comments: ADH-Anti-Diuretic Hormones increase water reabsorption by increasing the cellular permeability of the collecting ducts. Resulting in a decrease in urine volume with resultant increase in osmolarity. 6- D


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Comments: Both quinidine and cholestyramine have drug interaction with digoxin which induce toxic effects of digoxin. 7- A Comments: Both hydroclorothiazide and acetozalamide have a heterocyclic sulphonamide group on their molecular structure responsible for their functional action. 8- E Comments: A person with blood AB is considered the “universal acceptor” because can accept blood donation from any other group, A, B, AB and O. 9- C Comments: The normal blood pressure in a health adult is 80/120. Any big difference between these valors, mostly in the diastolic pressure the patient should be indicated for medical assistance. 10- D Comments: During absolute refractory period the myocardial fiber do not respond to any stimulus. 11- 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. Emphesema is a reversible form of airway obstruction. 12- D Comments: Embolism is an obstruction of a blood vessel by a mass transported in the circulation. The embolus is this mass transported in the circulation that can be a clot or a foreign material. Abnormal dilatation of a vessel artery is known as aneurysm 13- E Comments: Heparin is amino acid polysaccharide naturally present in the body predominantly in lung and liver tissues. It inhibits the conversion of prothrombim to thrombin and fibrinogen to fibrin using antithrombin III as it co-factor therefore been therapeutically used as anticoagulant. 14- C Comments: Heparin is already naturally present in the body and also act in vitro, it is very useful as anticoagulant in blood donations conservation. Warfarin has only in vivo activity 15- D Comments: Nifedipino is mainly the only calcium channel blocker that does not have bradicardia as side effect. 16- E


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Comments: Blood formed elements are erythrocytes, leukocytes and platelets. Erythrocytes also known as Red Blood Cells form 2% of the whole blood, has a half-life of approximately 120 days and play important rules in the O2 and CO2 transportation. Platelets are originated from megakariocytes and are involved in blood clotting. 17- E Comments: Vitamin K is considered the antidote for Warfarin. When the body has lower vitamin K the tendency is increase the effect of Warfarin. Heparin and salicylates also act as anticoagulant; in adjunct therapy with Warfarin they will have a synergism effect. 18- C Comments: Cimetidine is a H2-antagonist therefore do not decrease LDL 19- D Comments: Patient with “deep” vein thrombosis can be treated with both Warfarin and heparin. Streptokinase would be mainly used in acute myocardial infarction or in other acute coronary artery diseases. 20- C Comments: Orthostatic hypotension is a fall in blood pressure associated with dizziness, syncope and blurred vision occurring upon standing or when standing motionless in a fixed position, one of the most common side effects with α-blockers therapy 21- E Comments: Losartan is an AT-1, Angiotensin receptor blocker. 22- A Comments: During inspiration the lowest blood pressure in supine position is in vena cava 23- C Comments: LaPlace’s Law explains the tension achieved in a blood vessel wall to the radius of vessel and intraluminal pressure. 24- B Comments: Blood leaves the lung and reaches the left ventricle of the heart through pulmonary vein. In case of left ventricular failure the tendency is accumulation of blood in the lung due to blockage of blood circulation from lung through the heart 25- A Comments: The blood is composed of 90% water and 8% plasma protein. A health adult has approximately 5L of blood circulating in the body. 26- E Comments: Nitrates are esters of nitrous or nitric acid that are rendered nonexplosive by the addition of inert excipient such as lactose. Nitrates are prodrugs and must be denitrated to exert their therapeutic effect, denitration liberates nitric oxide, which cause


92


vasodilatation. In addition to the relaxation of vascular smooth muscle, these drugs relax bronchial, biliary, gastrointestinal, urethral and uterine smooth muscles. 27- D Comments: Acetozalamide is a carbonic anhydrase diuretic that blocks Na/H exchange system at the proximal tubule of kidney. 28- A Comments: A common side effect seen with long-term treatment with acetozalamide is hypercloremia and metabolic acidosis. 29- E Comments: Dobutamine is indicated to improve cardiac function during cardiac decompensation or depressed contractility from cardiac or major vascular complications 30- C Comments: Spirolactone is an aldosterone antagonist that binds to aldosterone receptor as competitive antagonist at early collecting tubules of kidney. 31- E Comments: Ticlopidine, clopidrogel and aspirin may be used as antiplatelet agents definitely affecting platelet aggregation. 32- C Comments: Paroxysmal arrhythmia is characterized by sudden recurrence or intensification of arrhythmias that may be caused by an increase in temperature. 33- D Comments: Prazosin is a α-adrenergic blocker used to treat hypertension due to its action in the arteries and veins dilatation. 34- B Comments: Hydroclorothiazide may have hyperglycemia as side effect. 35- C Comments: CHF is a complex clinical syndrome that can results from any cardiac disorder that impairs the ability of the ventricle to deliver adequate quantities of blood to the metabolizing tissues during normal activity or at rest. 36- E Comments: Ibuprofen inhibits the enzymatic metabolism of Warfarin. Acetozalamide and aspirin increases Warfarin activity and vitamin K inhibits the activity of Warfarin. 37- A Comments: Digoxin is a classic example of cardiac glycosides that consist of sugar and steroidal nucleon.


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38- D Comments: Sterosis is the narrowing of blood vessels 39- B Comments: The first tissue that receives the greatest cardiac output at rest is liver, following by kidney and lung. 40- A Comments: Diltiazen is the only calcium channel blocker that may have myocardial infarction as side effect. 41- A Comments: Guanabenz is a sympathomimetic α2-adrenergic agent having bradicardia and orthostatic hypotension as main side effect. 42- C Comments: Dobutamine improve cardiac function, it increases cardiac contraction and vasodilatation of smooth muscles 43- D Comments: Triamterene is a diuretic that exert its effect on the distal renal tubule to inhibit the reabsorption of sodium in exchange for potassium and hydrogen ions. Triamterene may reduce glomerular filtration and renal plasma flow. Via this mechanism it may reduce uric acid excretion. 44- E Comments: Ancrod is designated to use as an antithrombolitic in patients with heparin-induced thrombocytopenia or thrombosis, who requires immediate and continued anticoagulation 45- E Comments: The currently use of sildenafil and β-blockers may result in exacerbated hypotension, blurred vision and tremors. 46- B Comments: Losartan is an AT-1 inhibitor and would be the best choice for treatment of hypertension in a diabetic patient with dry cough that is definitely a side effect of ACE inhibitor, enalapril. 47- A Comments: Although ACE inhibitors increase the risk of hyperkalemia in diabetes mellitus; it is still the most appropriated agent in treating hypertension in diabetic patients because it does not interfere with glucose or insulin metabolism. 48- B


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Comments: Angina occurs when myocardial oxygen availability is insufficient to meet the myocardium oxygen demand. Any condition or factor impairing the oxygen supply such as cold places and exercises can predispose or increase the risk of angina. 49- C Comments: Atenolol is a β-blocker and may not be used in patients with renal failure. 50- A Comments: Digitalis are mainly used in the treatment of all degrees of congestive heart failure and some kind of arrhythmias as atrial fibrillation and atrial flutter. 51- D Comments: Systemic lupus or erythromatus lupus is a side effect of hydralazine. 52- D Comments: Labetalol is a β-non-selective blocker and α-blocker agent used to treat hypertension. It dilates blood vessels without increase the heart rate. 53- E Comments: The normal blood pressure in a health adult is 80/120, where 80 is the systolic and 120 is the diastolic pressure. Systolic pressure is the highest arterial pressure during a cardiac cycle and is measured when the heart contracts while diastolic pressure is the lowest arterial pressure during a cardiac cycle and is measured when the heart is relaxed. 54-E Comments: VLDL-Very Low Density Lipoproteins are formed in the liver and it is the origin of LDL the Low Density Lipoproteins, carry LDL cholesterol that is well known as the “bad cholesterol”, while HDL the High Density Lipoproteins are formed in the liver and small intestine, carry HDL cholesterol and is known as the “good cholesterol. 55- D Comments: Abnormal levels of cholesterol or lipids there is no association with bone dystrophy that is a condition normally called osteoporosis. 56- C Comments: Angiotensin covertazing inhibitors are used to treat hypertension. 57- A Comments: Niacin act as lipoprotein synthesis inhibitor by decreasing the production rate of VLDL, which synthesizes LDL 58- B Comments: Cholestyramine is an insoluble, non-absorbable agent used as bile acid binder in the intestine causing the acids to be excreted. 59- C


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Comments: Cholestyramine is the primary prevention of hyperlipidemia and can be safely used in pregnancy. 60- D Comments: Grapefruit juice interacts with most of the antihyperlipidemic agents. 61- B Comments: Digoxin as antidysrhythmic agent is only used in atrial fibrillation, paroxysmal atrial tachycardia and flutter. 62- E Comments: Class I antidysrhythmics agents are Na channel blockers agents and do not include amiodarone that belongs to class III antidysrhythmics agents inhibiting K channel. 63- E Comments: Antidysrhytmic agents are used to reduce abnormalities of impulse generation and modify the disturbance of impulse conduction within cardiac tissue, they are classifies by classes I, II, III and IV which include β, Na, K and Ca channel blockers 64- C Comments: Furosemide and ethacrynic acid act by inhibition of Na/K dichloride transport system. The are the only diuretics with action on the loop of henle 65- A Comments: Hydroclorothiazide may cause metabolic alkalosis not acidosis. 66- B Comments: Amiloride, a potassium sparing diuretic is used for treatment of nephrogenic diabetes insipid us caused by lithium. 67- D Comments: Furosemide may be the best diuretic used in acute pulmonary edema, hepatic cirrhoses, renal failure and edema associated with CHF. 68- C Comments: Hydroclorothiazide prevents the reabsorption of sodium chloride at distal tubule of kidney and is the primarily treatment of mild hypertension. 69- A Comments: Prazosin is a α1-adrenergic antagonist normally given in doctor’s office due to its first pass effect and syncope effect. 70- B Comments: Terazosin is indicated in the treatment of BPH. It has been show to improve urinary flow and symptoms of BPH.


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71- E Comments: Methyldopa long-term treatment may be associated with anemia. A comb’s test is recommended every six months for patients in methyldopa therapy. 72- D Comments: Methyldopa is a prodrug considered as one of the safest drug for treatment of hypertension during pregnancy. 73- C Comments: Minoxidil is a direct vasodilator used to treat hypertension and alternatively used to treat baldness. 74- A Comments: Enalapril is an ACE-II, Angiotensin Convertazing Enzyme. 75- B Comments: First line treatment of CHF is normally the association of a cardiac glycoside that inhibit Na/K (Na pump) exchange and a vasodilator as ACE inhibitors that inhibits the conversion of angiotensin I to angiotensin II 76- E Comments: Nitroprusside is a direct vasodilator used in cardiac emergences. It is metabolism has cyanide as end product. 77- A Comments: Nitrates act directly relaxing vascular smooth muscle by transformation of nitric oxide causing a peripheral pooling of blood. 78- C Comments: Angina is a kind of ischemic disease characterized by symptoms that occurs when myocardial oxygen availability is insufficient to meet the myocardium oxygen demand. 79- C Comments: Warfarin is an anticoagulant agent. 80- E Comments: All are low molecular weight heparin, which are normally used in the prevention of deep vein thrombosis and reduce the risk of pulmonary embolism. 81- A Comments: Isoproterenol is an adrenergic β1-agonist with no effect in α-receptors. 82- C


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Comments: Prodrugs are drugs that become active only after bioactivation by the body. Minoxidil and methyldopa are examples of prodrugs. 83- B Comments: β-adrenergic receptors are the most abundant receptor in the heart.


PHARMACY PREP

MEDICINAL CHEMISTRY AND PHARMACOLOGY OF CNS DRUGS 1-Which of the following is Not a SSRI A-e-citalopram B-Sertraline C-Trazadone D-Phenelzine E-Proxetine Ans-D 2-Which of the following is the antidote for benzodiazepines? A-Phenobarbital B-Vitamin K C-Flumazenil D-Vitamin D E-Morphine Ans-C 3- All the following are examples of long acting benzodiazepinic, EXCEPT: a) Clonazepan b) Diazepam c) Chlorazepate d) Flurazepan e) Temazepan Ans-E 4-Which of the following is an IRREVERSIBLE side effect resulting form long-term administration of phenothiazine antipsychotics? A. Sedation B. Xerostomia C. Infertility D. Parkinsonism E. Tardive dyskinesia Ans-E


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www.Pharmacyprep.com Pharmacy Prep Review Questions

PHARMACY PREP.

ENDOCRINOLOGY 1- Megaloblastic anemia may be caused due to a result of: I-Folic acid deficiency II-Vitamin B12 deficiency III-Iron deficiency a) I only b) III only c) I and II only d) II and III only e) All are correct 2- The doctor is suspecting that his patient is suffering of hypothyroidism, which assay can be used to confirm his diagnostic? a) Serum TSH b) T4 in urine c) Sensitive TSH d) TSH in urine e) T3 counts 3- Follicle Stimulating Hormone and Luteinizing Hormones levels may be mainly increased during: a) Pregnancy b) Ovulation c) Conception d) Last trimester of pregnancy e) Amenohrrea 4- Which is/are true about placenta: I- The umbilical cord transport nutrients from mother to fetus passing through the placenta. II- The umbilical cord is formed of two umbilical arteries and one umbilical vein III-Placenta is an organ characteristic of true mammals during pregnancy a) I only b) III only c) I and II only d) II and III only e) All are correct 5- Hypothyroidism, my be resulted due to: I- Grave’s disease II- Hashimoto thyroditis III- Treatment with anti-thyroid drugs a) I only b) III only

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c) I and II only d) II and III only e) All are correct 6- Characteristics of hypoparathyroidism may include: I- It is characterized by decrease of Calcium and increase of Phosphorous II -It is a deficiency of thyroid gland III- It is characterized by an increase of calcium and decrease of Phosphorous a) I only b) III only c) I and II only d) II and III only e) All are correct 7- All of the following diseases can be caused by oral contraceptives, EXCEPT a) Epilepsy b) Tromboembolism c) Breast cancer d) Uterine cancer e) Myocardial infarction 8- Hyperaldosteronism, a hyper function of adrenal cortex may be characterized by: I- Abnormality of electrolyte metabolism resulting in high secretion of aldosterone II- Can be treated by aldosterone antagonist: Spirolactone III- Hyperaldosteronism is characterized typically by hypokalemia a) I only b) III only c) I and II only d) II and III only e) All are correct 9- Which is the main hormone secreted by the adrenal cortex and responsible for the regulation of electrolytes and water balance? a) FSH b) Thiazides c) ADH d) Aldosterone e) Vasopressin 10- Ketoacidoses are acidosis accompanied by the accumulation of ketone bodies in the body tissues and fluids and may be a result of: I- Starvation II- Juvenile type diabetes III- Inadequate insulin treatment a) I only b) III only



c) I and II only d) II and III only e) I, II and III 11- What does insulin pump mean? a) Insulin with fast action b) Insulin supply for long period of time c) Insulin with fast absorption d) Insulin rapidly excreted e) Insulin rapidly metabolized 12- Hypofunction of adrenal cortex may cause: a) Cushing disease b) Gray’s disease c) Addison’s disease d) Reye’s disease e) All are wrong 13- Cushing syndrome a disorder of adrenal cortex is mainly due to: I- Hyper function of adrenal cortex II- High secretion of cortisone III- Hypofunction of adrenal cortex a) I only b) III only c) I and II only d) II and III only e) All are correct 14- Correct mechanism of methimazole as antithyroid drug may include: I- Inhibit iodine oxidation II- Catalyze the incorporation of iodine into tyrosine III- Inhibit the synthesis of thyroid hormones a) I only b) III only c) I and II only d) II and III only e) All are correct 15- All of the following cells are normally presented in pancreas, EXCEPT: a) β-cell b) α-cell c) Sertoli cell d) Delta cell e) F-cell



16- Correct statement regarding pernicious anemia may include: a) Due to dietary deficiency of vitamin B12 b) Prevented by oral administration of vitamin B12 c) Treated by parenteral administration of folic acid d) Treated by parenteral administration of vitamin B12 e) Caused by dietary deficiency of iron 17- Iron deficiency may cause a type of anemia known as: a) Pernicious anemia b) Megaloblastic anemia c) Pernicious and megaloblatic anemia d) Microcystic anemia e) All of the above 18- Side effects that may be expected to occur from the administration of oral contraceptives include all the following, EXCEPT: a) Fluid retention b) Headaches c) Hypertension d) Constipation e) Depression 19- The most appropriate insulin for diabetic patients with ketoacidoses may include: a) Crystalline Zinc Insulin b) Ultralent Insulin c) Protamine Insulin d) Extended Insulin Zinc Suspension e) Isophane Insulin 20- Which is not secreted from the anterior pituitary a) Prolactin b) Vasopressin c) Gonadotropin hormones d) LH e) FSH 21- Example of oral antidiabetic agent most likely to cause lactic acidosis is: a) Glyburine b) Chlorpropamide c) Metformin d) Repaglinide e) Acarbose



22- All of the following substance may be classified as steroid hormone, EXCEPT: a) Vitamin D3 b) Estrogen c) Cortisone d) Androgen e) Stilbestrol 23- Medical condition related to hypothyroidism, the decrease of thyroid hormones might include: a) Cushing syndrome b) Addison’s syndrome c) Grave’s disease d) Myxodema or Gull’s disease e) Myasthenia Gravis 24- Examples of rate limit of insulin may include: I- Capillary passage II- Zinc crystalline insulin III- Protein binding a) I only b) III only c) I and II only d) II and III only e) All are correct 25- Wrong statement regarding FSH and LH may include: a) They are hormones b) They are secreted from hypothalamus c) Secreted specifically from posterior pituitary gland d) They increase their concentration during ovulation e) FSH is the folliculum-stimulating hormone 26- False statement regarding insulin may include: a) Fast acting insulins has an onset of action of 30 min b) Protamine zinc insulin is long acting insulin c) Regular and crystalline insulins are used in diabetic patients with ketoacidoses d) Regular insulin is the only one that can be administrated intravenously e) Long acting insulins has a maximum duration of action of 24 hours 27- Correct statements regarding the action and examples of insulin may include: I- Fast acting: Crystalline and acid regular II- Intermediate acting: Zinc suspension, globulin zinc and isophane insulin III- Long acting: Protamin zinc suspension, extended zinc suspension and ultralent. a) I only b) III only c) I and II only



d) II and III only e) All are correct 28- After an insulin dose, hypoglycemia may occurs due to: a) Low carbohydrate diet b) Increase in glucose levels c) Increase in glycogen levels d) High carbohydrate diet e) All are correct 29- Insulin is a hormone secreted by which cells? a) α-cells b) β-cells c) Glucagon d) Amylase e) Pituitary 30- Thyroid glands is extremely important due to its ability to secret: I- Thyroid hormones II- Calcitonin III- Calcium a) I only b) III only c) I and II only d) II and III only e) All are correct 31- Correct statements regarding glucagon, a polypeptide hormone, may include: I- Secreted by the α-cells of pancreas II- It increase blood glucose levels III- Stimulate hepatic gluconeogenesis and glycogenolysis a) I only b) III only c) I and II only d) II and III only e) All are correct 32- Examples of therapeutically used hormones and related drugs may include: a) Adrenocorticosteroids b) Antidiabetic agents c) Thyroid hormones d) Gonadal and pituitaria hormones e) All are correct 33- Examples of gonadotropin hormone may include: a) ACHT



b) FSH c) TSH d) TRH e) Somatropin 34- False statement regarding VASOPRESSIN include: a) It is an antidiuretic hormone b) It is used to treat neurogenic diabetes insipidus c) It is used to treat postoperative abdomen d) It acts on proximal renal epithelium promoting the absorption of water e) It acts on distal renal epithelium promoting the absorption of water 35-Hormone which sustain the corpus luteum in pregnancy is: a) Estrogen b) FSH-Follicle Stimulating Hormone c) Gonadotropin hormones d) Progesterone e) LH and prolactin 36- Characteristics of diabetes insipidus may include: a) Polyuria b) Thirst c) Decrease in antidiuretic hormones levels d) Decrease in osmolarity e) All are correct 37- Drug used in the treatment of diabetes insipidus may include: a) Glyburine b) Metformin c) Oxytocin d) DDAVP-Desmopressin/Vasopressin e) Repaglinide 38- Diabetes insipidus may happen due to drug induction. Drug that may induce the development of diabetes insipidus include: I- Lithium II- Tricyclic antidepressant III- Benzodiazepinics a) I only b) III only c) I and II only d) II and III only e) All are correct 39- Hormone used to improve uterine contraction in labor and to control postpartum bleeding is:



a) Vasopressin b) Oxytocin c) Somatropin d) Prolactin e) Progesterone 40- Which of the following hormones can be classified as non-steroidal synthetic hormone? a) Estradiol b) Ethyl estradiol c) Diethylstilbestrol d) Progesterone e) Estrogen 41- Examples of estrogens antagonists may include: I- Medroxyprogesterone II- Clomiphene III- Tamoxifen a) I only b) III only c) I and II only d) II and III only e) All are correct 42- Which of the following hormone has an aromatic ring in its molecular structure? a) Estrogen b) Progesterone c) Testosterone d) Cortisol e) Ethyl androgen 43- Adrenocorticosteroids hormones are naturally in the body and are synthesized by: a) Hypothalamus b) Pituitaria c) Adrenal cortex d) Adrenal gland e) Pancreas 44- Which of the following is not a side effect associated with corticosteroids treatment? a) Edema b) Hypoglycemia c) Increased susceptibility to infection d) Weigh gain e) Ulcers



45- Which of the following hormone may stimulates the release of TSH-Thyroid Stimulating Hormones: a) ADH b) LFH c) TRH d) LH e) Aldosterone 46- What DEIODINATION means? a) The soma of thyrosyl residues with thyroglobulin proteolysis b) The stimulation of T3 and T4 formation c) The production of iodine by the thyroid gland d) The degradation of thyroid hormones that are eliminated by feces and urine. e) The degradation of iodine 47- Hypothyroidism is due to hypofunction of thyroid gland. Drug(s) used in hypothyroidism treatment may include: I- Levothyroxin (T4) II- Liiothyroxin (T3) III-Propylthyiuracil a) I only b) III only c) I and II only d) II and III only e) All are correct 48- Hyperthyroidism is characterized by high levels of thyroid hormones. Example(s) of drugs used in hyperthyroidism treatment may include: I- Propanolol II- Methimazole III-Propylthyiuracil a) I only b) III only c) I and II only d) II and III only e) All are correct 49- Characteristic symptoms of hypothyroidism may include all of the following, EXCEPT: a) Sensitivity to cold b) Heat intolerance c) Lethargy d) Constipation e) Weight gain 50- Autoimmune Insulin dependent diabetes mellitus is also known as:



I- Diabetes Type I II- Diabetes insipidus III- Diabetes Type II a) I only b) III only c) I and II only d) II and III only e) All are correct 51- Example of antidiabetic agent that reduces gluconeogenesis and increase glucose utilization may include: a) Glyburine b) Chlorpropamide c) Repaglinide d) Metformin e) Acarbose 52- Glyburide is an antidiabetic agent characterized by which of the following mechanism of action? a) Decrease the absorption of carbohydrates thus decreasing postprandial rise of glucose b) Reduces glucogeneogenesis and increase glucose utilization c) Increase peripheral insulin sensitivity d) Stimulates the release of insulin e) Reduce gluconeogenesis only 53- Glyburide and metformin, oral antidiabetic agents are often prescribed together in the treatment of type II diabetes mellitus due to their: a) Antagonist effect b) Addition effect c) Synergistic effect d) Tolerance e) Competitive effect 54- Which of the following statements is/are true regarding regular insulin: I- It is a suspension II- It may be administrated either SC or IV III- It is longer acting than lispro insulin a) I only b) III only c) I and II only d) II and III only e) All are correct 55- Which of the following agents may have the same therapeutic indication as propyltiuracil does?



a) Danazol b) Levothyroxine c) Azathioprine d) Omeprazole e) Methimazole

CORRECT ANSWERS ENDOCRINOLOGY

1- C Comments: Iron deficiency is called mycrocystic anemia while megaloblastic anemia is a deficiency of cyanocobalamin and folic acid. 2- C Comments: Sensitive TSH test has a greater sensitivity in the detection of thyroid disease than any other test. 3- B Comments: FSH and LH are predominantly increased during ovulation. 4- E Comments: Placenta is an organ characteristic of true mammals during pregnancy, joining mother and offspring, providing endocrine secretion and selective exchange of soluble, but not particulate, blood-borne substances through an apposition of uterine and tromphoblastic vascularized parts. 5- D Comments: Grave’s disease is characterized by hyperthyroidism. 6- C Comments: Hypoparathyroidism is a condition produced by greatly reduced function of the para-thyroids possibly due to autoimmune disease or genetic factors, or by removal of those bodies. It leads to fall in calcium levels followed by a rise in plasma phosphate level. 7- A Comments: Epilepsy is a paroxysmal transient disturbance of brain function that may be manifested as episodic impairment or loss of consciousness and it is not associated with contraceptives use. 8- E Comments: Hyperaldosteronism is an abnormality of electrolyte metabolism caused by excessive secretion of aldosterone. The over secretion of aldosterone by adrenal cortex is mainly characterized by hypokalemia.



9- D Comments: Aldosterone is the main mineral corticoid hormone secreted by the adrenal cortex. It is principal activity is the regulation of electrolyte and water balance by promoting the renal retention of sodium and the excretion of potassium. 10- E Comments: Ketoacidoses are acidosis accompanied by the accumulation of ketone bodies (ketosis) in the body tissues and fluids. It can be caused by juvenile diabetes, diabetes acidosis, starvation and inadequate treatment with insulin. 11- B Comments: Insulin pump means insulin that provides insulin for a long period of time. It is normally indicated for selected diabetes patients with widely fluctuating blood glucose levels, irregular or inconsistent work schedule, lifestyles or meals or who achieve less than desired control using frequent injection routines. 12- C Comments: Hypo function of adrenal cortex is well known as Addison’s disease while the hyper function of adrenal cortex is known as Cushing’s syndrome. 13- C Comments: Cushing syndrome is characterized by an increase in cortisone levels resulting from a hyper function of adrenal cortex. 14- E Comments: Methimazole inhibit iodination of tyrosine groups and coupling of these groups to form thyroid hormones, therefore it inhibits thyroid synthesis. 15- C Comments: Sertoli cells are found in the tubules of the testes to which the spermatids become attached. They provide support, protection and nutrition until the spermatids become transformed into mature spermatozoa. 16- D Comments: Pernicious anemia is characterized by deficiency of vitamin B12-cyanocobalamine and therefore should be treated with intramuscularly injection of vitamin B12 because this vitamin is poorly absorbed orally. 17- D Comments: Pernicious anemia is a deficiency of vitamin B12 only while megaloblastic anemia is a deficiency of both vitamin B12 and folic acid. 18- D Comments: Neither constipation nor diarrhea are side effects of oral contraceptives.



19- A Comments: The most appropriate insulin for diabetic patients with ketoacidoses are regular insulin and insulin zinc suspension. 20- B Comments: Vasopressin is an anti-diuretic hormone secreted from the posterior pituitary. 21- C Comments: Lactic acidosis is the main side effect of the oral hypoglycaemic agent biguanide metformin. 22- E Comments: Stilbestrol is an anticancer drug used mainly used in the treatment of breast cancer. 23- D Comments: Hypothyroidism is a hypo function of thyroid gland and responsible for the development of Myxodiema or Gull’s disease. 24- C Comments: Insulin does not bind to protein bounds. 25- C Comments: FSH-Follicle Stimulating Hormone and LH-Luteinizing Hormone are pituitary gonadotropin hormones secreted from the anterior pituitary. 26- E Comments: Ultralent and Extend Insulin Zinc Suspension are examples of long acting insulin that may have their effect up to 28 hours. With an onset of action of 2 to 4 hours. 27- E Comments: Crystalline and acid regular are examples of fast acting insulin with an onset of action of half to one hour. Insulin as zinc suspension, globulin zinc and isophane are classified as intermediate acting insulin with an onset of action of 2 to 4 hours. Insulin with onset of action of 4 to 5 hours are classified as long acting and include protamin zinc suspension, extended zinc suspension and ultralent. 28- A Comments: After an insulin dose, hypoglycemia may occurs due to low carbohydrate diet 29- B Comments: Insulin is a protein hormone secreted by the beta cells of the pancreas. It is secreted in response to elevated blood levels of glucose, amino acids, ketones, fat acids and promotes the efficient storage and utilization of these molecules.



30- C Comments: Calcium is not secreted by the thyroid hormones. 31- E Comments: Glucagon is a polypeptide hormone secreted by the alpha cells of pancreas in response to hypoglycemia or to stimulation by the growth hormone of the anterior pituitary; it stimulates glycogenolysis in the liver by inducing activation of liver phosphorylase. 32- E Comments: Adrenocorticosteroids, antidiabetic agents, thyroid hormones, gonadal and pituitary hormones are all therapeutically used hormones and related drugs. 33- E Comments: FSH-Follicle Stimulant Hormone is a gonadotropin hormone excreted from the anterior pituitary. 34- D Comments: Vasopressin does not act on proximal but on the distal renal epithelium promoting the absorption of water. 35- E Comments: LH and Prolactin sustain the corpus luteum in pregnancy. FSH is increased only during ovulation. 36- E Comments: Diabetes insipidus results in a deficient quantity of antidiuretic hormones being released or produced, and thus failure of tubular reabsorption of water in the kidney. As a result, a large amount of urine of low specific gravity is excreted, followed by dehydration and great thirst. 37- D Comments: Desmopressin and vasopressin an anti-diuretic hormone are the drugs of choice in the treatment of diabetes insipidus. 38- A Comments: One of the most known side effects in the long-term treatment with lithium is diabetes insipidus. 39- B Comments: Oxytocin is therapeutically used to improve uterine contraction in labour and to control postpartum bleeding. It also acts in milk ejection stimulation.



40- C Comments: Diethylstilbestrol is a non-steroidal synthetic estrogen used in oral contraceptives, mainly in “morning after pills”. 41- D Comments: Medroxyprogesterone is a synthetic progestin used in contraceptives agents. 42- A Comments: Estrogen is the only steroid hormone with aromatic ring in the ring A of its molecular structure. 43- C Comments: Adrenal cortex is the responsible for the release of cortisone-adrenocorticosteroids. 44- B Comments: Common side effects with Corticosteroids therapy may include: Edema, weight gain, osteoporosis, GIT effects, hypertension, suppression of pituitary adrenal integrity and increased susceptibility to infections. 45- C Comments: TRH is the Thyroid Regulating Hormone, secreted from the anterior pituitary and responsible for the stimulation of TSH’s release. 46- D Comments: Deiodination is the degradation of thyroid hormones that are eliminated by feces and urine. 47- C Comments: Propylthyiuracil is used in the treatment of hyperthyroidism. 48- E Comments: Propylthyiuracil and Methimazole are main drugs used in the treatment of hyperthyroidism. However propanolol is also used in the short-term preoperative management of thyrotoxic crises. 49- B Comments: Heat intolerance is one of the major side effect of hyperthyroidism. 50- A Comments: Type I diabetes, also called diabetes mellitus is considered insulin dependent. Diabetes insipidus in mainly treated with anti-diuretic hormones and diabetes type II is non-insulin dependent mainly treated with oral hypoglycaemic agents. 51- D




Comments: Metformin is a biguanide agent used in hyperglycemia-treatment of diabetes type II by reducing gluconeogenesis and increasing glucose utilization 52- D Comments: Glyburide as antidiabetic agent is classified as an oral sulfonylurea and act by stimulating the release of insulin. 53- C Comments: Glyburide and metformin are often prescribed together in the treatment of type II diabetes mellitus due to their synergistic effect. Glyburine will stimulate the release of insulin while metformin reduce gluconeogenesis and increase glucose utilization 54- D Comments: Regular insulin is not a suspension, it is a clear solution that is way can be administrated either IV or SC. It is classified as short acting insulin because it acts for up to 7 hours. When compared with lispro insulin, we find that lispro has a faster onset of action than regular insulin. 55- E Comments: Propylthyiuracil and Methimazole are often prescribed together in the treatment of hyperthyroidism.



PHARMACY PREP.

METABOLISM

1-Which of the following is not a drug-metabolizing enzyme? A-CYP3A B-CYP2D6 C-CYP2C9 D-CYP1A2 E-CYP0 Ans-E 2- Pyrrolidine and piperidine are important heterocyclic compounds in the structure of drugs. Which of the following drugs has these heterocyclic rings on its structure? A) Folic acid B) Clonidine C) Tetrodotoxin D) Imipramim E) Atropine 2- E Comments: - Pyrrolidine is a five membered and piperidine six membered, important heterocyclic compounds in the structure of drugs. Atropine is an antimuscarinic agent having pyrrolidine and piperidine heterocyclic rings on its molecular structure. 3- Oxidation of alkyl group results into alcohol, aldehyde and finally carboxylic acids. What type of alkyl group that mostly undergoes oxidation to an acid is known as: a) Terminal alkyl group of aliphatic structure b) Terminal Aromatic alkyl group of structure c) Benzylic alkyl group attached to aromatic ring structure d) Heterocyclic ring structure carbons e) Cyclic ring structure carbons 3- C Comments: 5- Alkyl group attached to aromatic rings would undergo faster oxidation because of resonance effect of aromatic ring. 4- Amines are one of the most common group present in the molecular structure of drugs. Primary amines are mainly metabolized by phase II metabolism: a) Deamination b) Dealkylation c) Acetylation d) Hydrolysis e) Oxidation 4- C


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Comments: Acetylation is a phase II metabolism reaction characterized by the gain of an acyl group, and the main reaction that undergoes primary amines. 5- Molecular structures (drugs) having carboxylic acid, amide, alcohol and/or thio group are mainly metabolized by: a) Oxidation b) Hydrolysis c) Conjugation d) Estherification e) Deamination 5- C Comments: Conjugations are phase II metabolism reactions characterized by an incorporation of endogenous substrate on the molecular structure of drugs normally coming from phase I metabolism reaction. Carboxylic acids are one of the most common groups present in the molecular structure of drugs mainly metabolized by conjugation. 6- Pyridine is a mono heterocyclic compound very important in the activity of many different drugs. The molecular structure 1,4-dihydropyridine is found in: a) Verapamil b) Digoxin c) Clonidine d) Nifedipine e) Diltiazen 6- D Comments: Nifedipine is calcium channel blocker that has 1,4-dihydropyridine on its structure responsible for its mechanism of action. It is also contain nitro fuctional group 7- Quinolone structure may be found in which of the following substances? a) Vitamin K b) Thiamine c) Cyanocobalamin d) Folic acid e) Vitamin A 7- A Comments: Vitamin K has a quinolone on its molecular structure. 8- Steroid structures are common in hormones, such estrogen, progesterone, testosterones. Steroid contain how many cyclohexane and cyclopentane respectively in it skeleton. a) 2 and 3 b) 3 and 2 c) 4 and 1 d) 3 and 1 e) 1 and 3


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8- D Comments: Most of the steroid compounds have three cyclohexanes and one cyclopentane ring on their molecular structure. 9- Phase I metabolism reaction also known as functionalization metabolism, during this phase drug will metabolized to obtain functional groups such as hydroxyl group or carboxyl group and these group in phase II are best metabolized by which of following conjugation reaction: a) Acetylation b) Glucuronidation c) Reduction d) Hydrolysis e) Methylation 9- B Comments: Glucuronidation is the main reaction of phase II metabolism reactions, and are responsible mainly for the metabolism of drugs having hydroxyl, carboxyl and amide group on their molecular structure. Conjugation reactions are the most common reactions of phase II drug metabolism. 10- Imidazoline is a molecular structure that contain a heterocyclic ring and belongs the molecular structure of: a) Prazosin b) Nifedipine c) Atropine d) Clonidine e) Allopurinol 10- D Comments: Clonidine is an antihypertensive drug that depends of its imidazoline molecular structure to be effective. 11-Diazepam is a long acting benzodiazepine metabolized by: A-CYP3A B-CYP2D6 C-CYP2C9 D-CYP1A2 E-CYP0 Ans-A

12- Conjugation reactions are the most common reactions in Phase II metabolism. Glycine contain hydroxyl group and may undergoes conjugation with: A) Carboxylic acid B) Gluthatione conjugates C) Cytochrome P450 D) Sulfonamides conjugates E) Alcohol conjugates 1- A


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Comments: Glycine is a phase II metabolism reaction also known as amino acids conjugation reaction that undergoes conjugation with carboxylic acid 13-Which of the following statins can be taken with grapefruit juice: I-Atorvastatin II-Pravastatin III-Fluvastatin a) I only b) III only c) I and II only d) II and III only e) All are correct Ans-D Tips: Atorvastatin, are metabolized by CYP3A enzyme and this enzyme is inhibited by grapefruit juice, therefore they should not be combined. Fluvastatin, pravastatin, Rosuvastatin are not metabolized by CYP3A 14-The most common metabolic reaction in human being; A-Oxidation B-Hydroxylation C-Glucuronidation D-Glutathione conjugation E-Hydrolysis Ans-C 15-Acetaminophen is considered to be toxic at higher dose (4g/day) and may cause hepatotoxicity. This is due to accumulation metabolic intermediate. Which of the following is enzyme would most likely be deficient? A-Glucuronyl transferase B-Azo reductase C-Methyltransferase D-Glutathione S-transferase (GST) E-Pseudocholinesterase Ans-D Tips: Glutathione conjugation metabolizes N-acetyl benzoquinone to mercapturic acid, hence this reduce toxicity of intermediate. 16-All of the following statement about aspirin metabolism are correct except: A-Aspirin undergo ester glucuronidation B-Aspirin undergo ether glucuronidation C-Aspirin undergo hydroxylation D-Aspirin undergo glycine conjugation E-Aspirin excretes unchanged drug Ans-E


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17-Glucuronidation reactions is phase II metabolic reaction, and it is catalyzed by: A-Glutathione S- transferase B-Azo reductase C-UDP-Glucuronyl transferase D-Methyl transferase E-N-Acetyl transferase Ans-C 18-Which of the following substances has affinity to carbon monoxide: I-Hemoglobin II-Myoglobin III-Cytochrome oxidase A-I only B-III only C-I and II only D-II and III only E-All of the above Ans-E Tips: Hemoglobin, Myoglobin and cytochrome oxidase contain porphyrin ring, and this ring has affinity to oxygen, carbon monoxide and carbon dioxide, cyanide etc.


PHARMACY PREP

BIOPHARMACEUTICS 1-Acetyl salicylic acid (ASA) pH is 3.5 and pKa is 4.5, what percent drug will ionized in the body. A-90% B-99% C-100% D-50% E-9% Ans- Tips: Hasselbach-Handerson equation: % ionization = 100 / 1+10 charge (pH-Pka) Charge = -1 for acid = 100 / 1+10 –1 (-1) = 100 / 11 = 9% - - = + + + = + - + = - + - = - 10 1 = 10 102 = 100 103 = 1000 10-1 = 0.1

10-2 = 0.01

2-Aspirin pH is 3.5 and pKa is 3.5, what percent drug will ionized in the body. A-90% B-99% C-100% D-50% E-9% Ans- 3-Aspirin pH-Pka = 0, what percent drug will ionized in the body. A-90% B-99% C-100% D-50% E-9% Ans-


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4-The pH of blood is 7.4, after administering drug it becomes 7.2 the drug is: I-weak acidic II-weak base III-amphoteric A-I only B-III only C-I and II D-II and III E-All of the above Ans-A Tips: pH of blood is 7.4 turns into 7.2 after addition drug that means, decrease pH is acidic drug. Example of amphoteric solutions is: H2O H+ + OH- 5-Aspirin pH is 3.5 and pKa is 3.5, what percent drug will unionized in the body. A-90% B-99% C-100% D-50% E-10% 6-If the pKa of weak base drug is 6.4 and you have an ambient temperature with pH 4.4 I-The drug will be almost completely ionized II-The drug will be rapidly excreted III-The drug will not be ionized neither excreted a) I only b) III only c) I and II only d) II and III only e) All are correct Ans-C 100/1+10 1(4.4-6.4) 100/1+10 1(-)

= 99% ionized Tips: In the above questions just 0.1% is ionized which is very little and excrete very slowly. Because unionized do not excrete, ionized do excrete. However, Unionized absorb faster, ionized absorb slower 8-Critical solution temperature represents: A-The temperature which concentration of phenol is homogenous solution B-The temperature at phenol vaporizes C-The temperature above which homogenous solution is formed for all concentration of phenol D-Temperature which phenol vapor pressure equals the vapor pressure of water.


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Ans-C 9-The rate of chemical reactions is enhanced by: A-Increase the stirring B-Increasing the temperature of reaction mixture C-Removing the inert solvent D-Increase the rate of cooling E-None of the above Ans-B 10-Correct statement about physiological factors affecting the rate and extent for topical drug absorption include: I-The type of ointment base II-the partition coefficient of the drug molecule III-surfactant in formulations Ans-E 11-If the total body clearance of a drug is 200ml/min in normal healthy adult and renal clearance is 10ml/min then, what is correct in patient. A-Drug is deposited in adipose tissue B-Drug is increased in liver and have recycling C-Drug metabolisms is increased D-Greater accumulation E-drug have no plasma protein binding Ans-C 12-Compared to the sublingual tablet, nitroglycerine ointment is: A-More stable B-More effective C-More prolong effect D-More absorbed E-More local effect Ans-C 13-pH-pka = 1.5, for acidic drug what percent of drug is ionized? A-3.06% B-96% C-2.5% D-100% E-50% Ans-B 14-if a medication if pH = Pka? A-100% solute is ionized B-40% solute is ionized C-50% solute is ionized (1/2)


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D-99% solute is ionized E-95% solute is ionized Ans-C

How to use calculator?SHARP EL-510R Enter: 10 Press : yx

Press: (-)

Enter 1.5 = 101 = 10 10-1 = 0.1 102 = 100 10-2 = 0.01 103 = 1000 10-3 = 0.001

15-Phenobarbital (acidic) pH is 3.4 and pKa is 3.4, what percent drug will ionized in the body. A-90% B-99% C-100% D-50% E-10% Ans- Tips: pH – pKa = 0 is 50% ionized or unionized or PH = pKa is 50%

PharmacyPREP.Com Pharmaceutics Test 1

PHARMACY PREP.

PHARMACEUTICS 1- Buffer salts are added to many drug solutions to maintain the formulation at optimum pH. Which of the following is/are characteristics of a buffer solution: I- Formed from a weak acid or weak base and its salts. II- Addition of a little bit of water or a little increase in the temperature will not affect the pH. III: Addition of a strong acid or a strong base to the solution will not affect the pH. a) I only b) III only c) I and II only d) II and III only e) All are correct 2- Parenteral solutions are used for internal use. What is the most common used vehicle for parenteral drugs? a) Purified water USP b) Water for injection c) Distillate water d) Sterile water for injection USP e) Fractional distillate water. 3-All the following are oral drug solutions, EXCEPT a) Elixirs b) Spirits c) Tinctures d) Fluidextracts e) Lotion 4- All of the following are characteristics of on emulsion, EXCEPT a) Most of emulsions are constituted of two phases: Aqueous and oily phase b) If water is the internal phase, the emulsion is classified as W/O c) If water is the internal phase, the emulsion is classified as O/W d) If water is the external phase, the emulsion is classified as O/W e) Emulsifying agents are added to emulsion to lower the interfacial tension 5- Correct statements regarding emulsifying agents include: I- Lower the interfacial tension stabilizing emulsions II- Acacia and methyl cellulose are examples of emulsifying agents III- Synthetic emulsifying agents are not used in emulsion a) I only b) III only c) I and II only d) II and III only


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e) All are correct 6- In which method of the following pharmaceutics techniques a substance is reduced by addition of a solvent material that is easily removed. a) Trituration b) Pulverization by intervention c) Levigation d) Espatulation e) Sifting 7- Correct statements regarding Trituration include: a) Is the process of mixing powders in a large container rotated by a motorized process b) Is the process when potent substance must be mixed with a large amount of diluents. c) Is the process of reducing the substance to small particles by rubbing it in a mortar with a pestle. d) Is the process of reducing the substance by addition of a solvent that is easily removed after pulverization. e) Is the process of mixing powders by passing them through sifters 8- All of the following are used as diluents in tablet formulation, EXCEPT a) Talc b) Kaolin c) Lactose d) Mannitol e) Starch 9- Characteristics of use of lubricants in tablet formulation include: I- It helps the patient to swallow the tablet. II- Lubricants, glidants and ant adherents have overlapping functions in tablet formulation. III- It reduces the friction that occurs between the walls of the tablet and the walls of the die cavity. a) I only b) III only c) I and II only d) II and III only e) All are correct 10- Which of the following tablet(s) allow absorption through the oral mucosa? I-Sublingual tablets II- Lozenges III- Sugarcoated tablet a) I only b) III only c) I and II only d) II and III only


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e) All are correct 11- A manufacture tablet processing problem that is characterized by the partial or complete separation of the top or bottom crown from the main body of the tablet is know as: a) Lamination b) Picking c) Mottling d) Capping e) Sticking 12- Tablet manufacture problems include: I-Mottling is unequal colour distribution on the tablet surface. II- Sticking is adhesion of tablet material to a die wall III- Humidity is the melting of the tablet a) I only b) III only c) I and II only d) II and III only e) All are correct 13- One of the most common lubricant used in tablet manufacture include: a) Theobroma oil b) Glycerol c) Aluminium stearate d) Sodium stearate e) Magnesium stearate 14 Which of the following propellant used in aerosol products was put out of market due to depletation of the ozone layer? I-Chlorofluorocarbons-CFC II-Dimethyl-Ether III-Hydrofluorocarbons-HFC a) I only b) III only c) I and II only d) II and III only e) All are correct 15- Which of the following equations can be used to easily calculate the pH. of a buffer solutions constituted of a weak acid and its salts. a) Hixson-Crowell equation b) Arrhenius equation c) Stokes equations d) Henderson-Hasselbalch equation e) Noyes-Whitney equation


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16- Arrhenius equation is used when we need calculate the: a) pKa of an acid solution b) Stability of a drug at room temperature c) pH of a buffer solution d) Rate of ionization of a drug e) Solubility of a solution 17- The HLB-Hydrophilic-Lipophilic Balance is applied to: a) Emulsifying agents b) Humectants agent c) Thermo labile agents d) Surfactant agent e) Solubilizing agents 18- An agent with HLB value range of 0-3 is known as: a) Antifoaming agent b) W/O emulsifying agent c) O/W emulsifying agent d) Wetting agent e) Detergents 19- An agent classified as oil in water (O/W) emulsifying agent have its HLB value ranged in: a) 0-3 b) 4-6 c) 7-9 d) 8-18 e) 13-15 20-Suppository base vary well know of its polymorph characteristics: a) Cocoa butter b) Polyethylene Glycol c) Glycerin d) Mineral Oil e) Cotmar 21- All are characteristics of a polymorph drug, EXCEPT: a) It has a two different physical form b) It melts in some determinate temperature, normally high temperatures (>30°C) c) Teobroma oil is a classic example of polymorph drug d) Polymorph drugs are widely used as suppository base e) Polymorph drugs melt in very low temperature (<10°C)


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22- A pharmacist would like to make a compound prescription where he needs to mix 1% of camphor into white petroleum. Which would be the more appropriated technique to be used by the pharmacist a) Trituration b) Levigation c) Pulverization by intervention d) Geometric dilution e) Attrition 23-We can increase the bioavaliability of an ophthalmic preparation by I-Increasing viscosity of preparation II-Addition of a sticking agent III-Increasing volume of the inserted dose a) I only b) III only c) I and II only d) II and III only e) All are correct 24- Autoclaving is sterilization process of: A. Dry heat sterilization B.Steam Sterilization C.Filtration D.Gas sterilization E.Irradiation 25- Acetyl Salicylic Acid is easily hydrolyzed during tablet manufacturing. To avoid manufacture problems we should use: I- Dry granulation II- Direct compression III Wet granulation a) I only b) III only c) I and II only d) II and III only e) All are correct 26- Flocculated suspension upon sedimentation will produce I-Large volume sedimentation II-Clear boundary when particles settle III-Easily resuspended when shaking a) I only b) III only c) I and II only d) II and III only e) All are correct


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27- Methylparaben is used in ophthalmic solution as a) Preservative b) Surfactant c) Viscosity enhancer d) Humectants e) Solubilizing agent 28- The excipients used in tablet formulation have a large variety of functions. Which of the following do not describe a tablet excipient? a) Diluents are fillers designated to make up the required bulk of the tablet b) Binders promote granulation during the dry granulation process c) Disintegrates facilitate disintegration when the tablet reaches the GIT d) Glidants help to promote the flow of tablet granulation e) Emollients help to moisturize the tablet to avoid irritation of oral mucosa 29- What is true regarding DELIQUESCENCE? I- Occurs when the vapor pressure of the saturated aqueous solution is less than the vapor pressure of the water in the ambient air. II- It’s the condition of becoming moist III- It’s the result of the absorption of water from the air a) I only b) III only c) I and II only d) II and III only e) All are correct 30- Substances that have the capacity of absorbing moisture is well known as: a) Hygroscopic b) Hydromorphic c) Hydrophilic d) Hydrophobic e) Amphiphilic 31- Van Der Waal’s forces is an example of a) Hydrogen bound b) Dipole-dipole interaction c) Covalent bound d) Cation-cation interaction e) Anion-anion interaction 32- In order to have hydrogen bound, the molecule should have the following characteristics I- The molecule should be formed of hydrogen and strong electronegative elements II- F, N, O, S, Cl are examples of strong electronegative elements III- Hydrogen bounds can be classified in INTER and INTRA depending the position of the bound in the molecule


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a) I only b) III only c) I and II only d) II and III only e) All are correct 33- Hydrogen bound can be formed with all the following molecules, EXCEPT: a) Ether-ether b) Alcohol-alcohol c) Esther-alcohol d) Water-alcohol e) Esther-Water 34- Correct statements regarding Eutectic Mixture may include: I- Is the mixture of two or more substances that melt at the highest possible temperature II- Is the mixture of two or more substances that melt at the lowest possible temperature III- Eutectic point is the melting point of a eutectic mixture a) I only b) III only c) I and II only d) II and III only e) All are correct 35- Correct statements regarding Partition Coefficient may include: I- It measures the solubility of a substance in octane and water II- It specifies how hydrophilic and hydrophobic a substance is. III- A substance with high partition coefficient is hydrophilic a) I only b) III only c) I and II only d) II and III only e) All are correct 36-All are true statements regarding ADSORPTION, except: a) Separation of a substance from one phase accompanied by its concentration at the surface of another. b) Separation of a substance from one phase to another phase c) An adsorbent agent is capable of holding other molecule onto its surface d) Examples of adsorbent agents are charcoal and powdered cellulose e) Adsorption and absorption are two different processes 37- Which of the following tablets suffer disintegration only when it reaches the small intestine? a) Coated tablet b) Sugar coated tablet c) Enteric coated tablet


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d) Caplets e) Lozenges 38- Binders are used in tablet formulation to make the adhesion of the powdered drug to the inactive drug. Which of the following binder can be used in both wet and dry tablet formulation? a) Cellulose b) Gelatin c) Starch d) Sucrose e) Methyl cellulose 39- What does EFFLORESCENCE means? a) Absorb moisture b) Maintain moisture c) Loss of moisture d) Absorb water e) Loss of carbon dioxide 40- Deflocculating agents are widely used in suspensions: I- They are used to enhance the particles dispersability of a suspension II- They make the suspension easily to redisperse by shaking the suspension III- Deflocculating agents are used in solution, emulsions and suspensions a) I only b) III only c) I and II only d) II and III only e) All are correct 41- Which of the following labels would be the most appropriate to be used in your pharmacy when dispensing a suspension a) “Take with food” b) “Shake well before use” c) “Take with lots of fluids” d) “Rinse mouth after use” e) All the above are correct 42- Antioxidants are added to drug formulation in order to avoid degradation. All of the following are antioxidants, EXCEPT a) Tocopherol b) Ascorbic acid c) EDTA d) Sodium bisulfite e) Sodium benzoate 43- Correct statements regarding Tocopherol include:


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I- It is an antioxidant mainly used in water-soluble formulations II- It is also known as vitamin E III- α-Tocopherol is the strongest tocopherol antioxidant a) I only b) III only c) I and II only d) II and III only e) All are correct 44- 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) <0°C b) 2 to 8°C c) 8 to 15°C d) 15 to 30°C e) >30°C 45- Correct statements regarding vapor pressure may include: I- Vapor pressure is not a colligative propriety II- Increasing solute, decrease the vapor pressure III- Increasing solute, increase the boiling point a) I only b) III only c) I and II only d) II and III only e) All are correct 46- Boric acid is often used to adjust the isotonicity of some drug preparations because of its buffer capacity and anti-infective proprieties. Boric acid is widely used in: a) Ophtalmic solutions b) Nasal solutions c) Otic solutions d) Topical formulations e) Oral solutions 47- Burrow’s solution – Aluminum acetate is known as: a) Colloidion b) Astringent c) Adsorbent d) Absorbent e) Surfactant 48- Which of the following best describe the function of propylene glycol in this formulation? Diazepan IV----------2mls Propileno glycol-----2%


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Ethanol----------------5mls a) Preservative b) Solvent c) Co-solvent d) Surfactant e) None of the above 49- Sodium stearate is classified as: a) Anionic b) Cationic c) Non-ionic d) Hydrophobic e) Amphiphilic 50- Compared to the sublingual tablet, nitroglycerin ointment: a) Provides only local effect b) It a more stable dosage form c) Provides a more prolonged effect d) Is more rapidly absorbed e) Is more rapidly eliminated 51- The dissolution rate of nitrofurantoin tablets may be increased by: a) Micronizing the nitrofurantoin powder b) Decreasing viscosity of the dissolution medium c) Heating the solution medium d) Mechanical agitation e) All of the above increase the dissolution rate of nitrofurantoin tablets 52- Benzocaine with caffeine can for a) Ion-dipole b) Ion-Ion c) Dipole-dipole d) Complex molecule e) No reaction is formed 53- Antioxidants, which mechanistically act as reducing agent, include: I- Ascorbic acid II- Sodium bissulfite III- Citric acid a) I only b) III only c) I and II only d) II and III only e) All are correct 54- Reason for using coating tablets include all of the following, EXCEPT:


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a) To mask the taste of the drug b) To mask the odor of the drug c) To improve the appearance of the drug d) To increase the drug’s release rate e) To protect the drug from stomac acid 55- An ophthalmic solution must be a) Hypertonic b) Isotonic c) Hypotonic d) Amphiphilic e) Lipophilic 56- Use(s) Mineral oil may include: a) Used as laxative b) Used as antioxidant c) In chronic use decrease the absorption of fat-soluble vitamins d) Used as lubricant in suppositories e) All are correct 57- Which decrease tension between solid and liquid? a) Solubilizing agent b) Wetting agent c) Hydrophilic agent d) Emulsifying agent e) Decreasing the particle size of the solid 58- An agent with HLB value range of 14-18 is known as: a) Antifoaming agent b) W/O emulsifying agent c) O/W emulsifying agent d) Wetting agent e) Solubilizing agent 59- In preparing ZnSO4 suppositories using 200mg of its USP value. Refers that dispense value of ZnSO4 is 4 means that: a) ZnSO4 will displace 800mg of cocoa butter b) Cocoa butter displace 800mg of ZnSO4 c) Only 4mg of cocoa butter will be displaced d) 200mg of ZnSO4 will displace 50mg of cocoa butter 60- Addition of mineral oil to a sulphur ointment preparation is called: a) Levigation b) Milling c) Trituration d) Solubilization


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e) Emulsification 61- One part of solvent is required to dissolve one part of solute: a) Slightly b) Sprangly c) Soluble d) Freely soluble e) Very soluble 62- Suitable antioxidants for an aqueous preparation: I-EDTA II-Ascorbic acid III- Tocopherol a) I only b) III only c) I and II only d) II and III only e) All are correct 63- Hydrogen peroxide for TOPICAL use solution: a) 5V b) 10V c) 15V d) 20V e) 30V 64- Benzocaine as a local anesthetic in a TOPICAL preparation should be at least, not less than: a) 1% b) 3% c) 5% d) 10% e) 15% 65- Correct statements regarding Papain may include: I- Proteolitic enzyme used in contact Lents to remove proteins II- Used as preservative in soft contact Lents III- Only available in the ophthalmic office a) I only b) III only c) I and II only d) II and III only e) All are correct


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CORRECT ANSWERS PHARMACEUTICS

1- C Comments: Buffer salts are added to many drug solutions to maintain the formulation at optimum pH. It is formed from a weak acid or weak base and its salts. Buffers solution will be mainly altered if suffer addition of a strong acid or a strong base to the solution. 2- D Comments: Sterile water for injection USP is the most common used vehicle for parenteral drugs, however Water for injection and bacteriostatic water for injection are also used. 3- E Comments: Lotions are only used topically. 4- C Comments: Emulsions are considered two-phase system; if the water is the internal phase, the emulsion is classified as W/O and if the water is the external phase, the emulsion is classified as O/W. 5- C Comments: Emulsifying agents are any compound that lower the interfacial tension and forms a film at the interface stabilizing emulsions. Acacia and methyl cellulose are some of the most common used emulsifying agents and they can be classified as natural or synthetic emulsifying agents. 6- B Comments: Pulverization by intervention is a widely used pharmaceutics technique in which a substance is reduced and subdivided with an additional material (solvent) that is easily removed after pulverization. 7- C Comments: Trituration is a pharmaceutics technique in which the substance is reduced to small particles by rubbing it in a mortar with a pestle. Trituration also describes the process by which fine powders are intimately mixed in a mortar. 8- A Comments: The most common diluents used in pharmacy industry include kaolin, lactose, mannitol, cellulose, powdered sugar, starch and calcium phosphate. 9- D Comments: Lubricants are used in tablet formulation to reduce the friction that occurs between the walls of the tablet and the walls of the die cavity when tablet is ejected. 10- C


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Comments: Sugar coated should be swallowed because the coated sugar provides a barrier to a drug’s objectionable taste and smell, or to improve the appearance of the drug. 11- D Comments: Capping is a manufacture tablet processing problem characterized by the partial or complete separation of the top or bottom crown from the main body of the tablet. 12- C Comments: Manufacture common tablet processing problems involve mottling, sticking and picking. 13- E Comments: Talc, magnesium stearate and calcium stearate are commonly lubricant used in tablet manufacture 14- A Comments: Chlorofluorocarbons-CFC is propellant used in the past in aerosol products, it was put out of market due to depletation of the ozone layer. Nowadays the most used one is Hydro fluorocarbons-HFC. 15- D Comments: Henderson-Hasselbalch equations used to mathematically calculate the pH of a buffer solution. 16- B Comments: Arrhenius equation is used to calculate the stability of a drug at room temperature. 17- D Comments: The HLB-Hydrophilic-Lipophilic Balance is applied to surfactant agent 18- A Comments: Agent with HLB value range of 0-3 is known as antifoaming agent. 19- D Comments: Agent classified as oil in water emulsifying agent has its HLB value ranged between 8-18. 20- A Comments: Cocoa butter is widely used as suppository base due to its polymorph activity. 21- E Comments: Polymorph drug has two different physical form depending the currently temperature that they are present, normally melting in high temperatures (>30C), and


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keeping solid in low temperature (<10C). Theobroma oil or cocoa butter is a classic example of polymorph drug 22- C Comments: Pulverization by intervention is a widely used pharmaceutics technique in which a substance is reduced and subdivided with an additional material (solvent) that is easily removed after pulverization. 23- A Comments: Increasing viscosity of an ophthalmic preparation increases its bioavailability. 24- B Comments: Autoclaving is the sterilization process for steam sterilization. 25- C Comments: Wet granulation tablet manufacturing method cannot be used in the preparation of Acetyl Salicylic Acid because it is easily hydrolyzed during tablet manufacturing. 26- C Comments: Flocculated suspension upon sedimentation will produce a large volume sedimentation and clear boundary when particles settle. 27- A Comments: Methylparaben is commonly used in ophthalmic solution as preservative. 28- E Comments: Emollients are not used as excipients in tablet formulation 29- E Comments: Deliquescence, the condition of become moist, occurs when the vapor pressure of the saturated aqueous solution is less than the vapor pressure of the water in the ambient air as result of the absorption of water from the air 30- A Comments: Hygroscopic is the name given to substances that have the capacity of absorbing moisture. They may be classified as anhydrates or hydrates. 31- B Comments: Van Der Waal’s forces are permanent dipole interactions. 32- E Comments: Hydrogen bound occurs between strong electronegative elements such as F, N, O, S and Cl. They may be classified in INTRA when the hydrogen bound is within the molecule and INTER when the hydrogen bound is in between of two molecules


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33- A Comments: Ethers are groups having no hydrogen molecules therefore cannot form hydrogen bound between them. 34- D Comments: Eutectic Mixture is the mixture of two or more substances that melt at the lowest possible temperature and the eutectic point is the melting point of a eutectic mixture 35- E Comments: Partition Coefficient measures the solubility of a substance in octane and water specifying how hydrophilic and hydrophobic a substance is. 36- B Comments: Adsorption is a process of separating a substance from one phase accompanied by its accumulation or concentration at the surface of another. 37- C Comments: Enteric coated tablet are hardly coated tablet resistant to gastric acid, and suffer disintegration only when it reaches the small intestine. 38- A Comments: Binders are used in tablet formulation to make the adhesion of the powdered drug to the inactive drug. Cellulose is an example of classic binder that can be use in both wet and dry tablet. 39- C Comments: Efflorescence is the process of moisture lost. 40- C Comments: Flocculated agents are widely used in suspensions to enhance the particles dispensability of a suspension providing “no cake”, and making the suspension particles very easy to redisperse by shaking the suspension. Flocculated agents are used only in suspensions 41- B Comments: The most appropriated auxiliary label to use in dispensing a suspension is “Shake well before use” 42- E Comments: Antioxidants are added to drug formulation in order to avoid degradation. All of the following are antioxidants; sodium benzoate is an example of preservative not antioxidant. 43- D


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Comments: Tocopherol also called vitamin E is widely used in pharmacy industry as antioxidant. α-Tocopherol is the strongest tocopherol antioxidant. 44- C Comments: Cool places include rooms wit temperature ranging between 8 to 15°C. 45- D Comments: Vapor pressure is a colligative propriety. 46- A Comments: Boric acid is widely used in ophthalmic solutions as buffer agent due to its capacity to adjust the isotonicity 47- B Comments: Astringent work by coagulating protein when applied to skin or mucous membrane. The protein precipitate forming a protective coat, allowing new tissue to regenerate underneath, Burrow’s solution is a classic example of astringent. 48- C Comments: Propylene glycol is mainly used as co-solvent in parenteral drug formulation. 49- A Comments: Sodium stearate is stiffening and emulsifying anionic agent used in pharmaceutical preparations. 50- C Comments: 50- Compared to the sublingual tablet, nitroglycerin ointment: Provides a more prolonged effect 51- E Comments: The dissolution rate of nitrofurantoin tablets may be increased by micronization of the nitrofurantoin powder, decreasing viscosity of the dissolution medium, heating the solution medium and mechanical agitation 52- D Comments: Benzocaine with caffeine forms a complex molecule. 53- C Comments: Citric acid does not act as reducing agent. 54- D Comments: Coating tablets has a long onset of action due the presence of the coated on its formulation, therefore the coat decrease the drug’s release rate. 55- B Comments: An ophthalmic solution must be isotonic to avoid eye irritation.


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56- E Comments: Mineral oil exerts many different functions in pharmaceutical manufacturing including antioxidant, laxative and lubricant proprieties. 57- B Comments: Wetting agents are normally used in pharmaceutical preparations to decrease tension between solid and liquid. 58- E Comments: Agent with HLB value ranging between 14-18 is known as solubilizing agent. 59- E Comments: The “4” dispensing valour in the preparation of ZnSO4 suppositories means that 200mg of ZnSO4 will displace 50mg of cocoa butter. 60- A Comments: Levigation is the technique used by addition of a liquid to the substance as an intervening agent to reduce the particle size of drug by grinding together. 61- E Comments: Very soluble substances are called for substances that require only one part of solvent to dissolve one part of solute (substance). 62- C Comments: Tocopherol also known as vitamin E is a fat-soluble agent therefore cannot be used in aqueous preparation. 63- B Comments: Hydrogen peroxide is used topically on skin in a maximum concentration of 10V to avoid burns on skin. 64- C Comments: Benzocaine as a local anesthetic in a topical preparation should be at least, not less than 5%. Lesser concentration will not be effective. 65- A Comments: Papain is a proteolitic enzyme used in contact Lens to remove proteins and is available in most of OTC contact lents washers.

BIBLIOGRAPHIC REFERENCE 1- COMPREHENSIVE PHARMACY REVIEW – Lippincott William & Wilkins – Fourth edition


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2- CPS-COMPENDIUM OF PHARMACEUTICALS AND SPECIALITIES - Canadian Pharmacist Association – 2001 edition. 3- MEDICAL DICTIONARY – Dorland’s illustrated – 27th edition. 4- PHARMACY PREP – Lectures series & study guide for Evaluating Examination-TIPS - 2003/2004 5- THERAPUTIC CHOICES – Canadian Pharmacist Association -Third edition 6- USP DI – Drug Information for the Health Care Professional–15th edition – Volume I.

PharmacyPrep.Com Pharmaceutical Additives

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PHARMACEUTICAL ADDITIVES 1-Additives which promote the breaking up of tablets into smaller particles are referred to as: a. Fillers b. Disintegrant c. Lubricants d. Dispersants Ans: b 2- Which of the following polyols should never be used as a sweetening agent because of its severe toxicity? a. Sorbitol b. Glycerol c. Propylene glycol d. Ethylene glycol Ans: d 3-Which of the following dosage forms is a concentrated sugar or sugar substitute? a. Elixirs b. Syrups c. Solutions d. Cerates e. Tinctures Ans: b 4-Certain cellulose derivatives are employed in syrups for which of the following reasons? a. Sweetener b. Viscosity enhancer c. Flavoring d. Caloric agent e. Preservative

Ans: b 5- Antioxidants are added to drug formulation in order to avoid degradation. All of the following are antioxidants, EXCEPT a) Tocopherol b) Ascorbic acid c) EDTA d) Sodium bisulfite e) Sodium benzoate Ans-E 6- Correct statements regarding tocopherol (vitamin E) include:


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I- It is an antioxidant mainly used in water-soluble formulations II- It is also known as vitamin E III- α-tocopherol is the strongest tocopherol antioxidant a) I only b) III only c) I and II only d) II and III only e) All are correct Ans-D 7- Boric acid is often used to adjust the isotonicity of some drug preparations because of its buffer capacity and anti-infective proprieties. Boric acid is widely used in: a) Ophthalmic solutions b) Nasal solutions c) Otic solutions d) Topical formulations e) Oral solutions Ans-A 8- Sodium stearate is classified as: a) Anionic b) Cationic c) Non-ionic d) Hydrophobic e) Amphiphilic Ans-A 9- Antioxidants, which mechanistically act as reducing agent, include: I- Ascorbic acid II- Sodium bisulfite III- Citric acid a) I only b) III only c) I and II only d) II and III only e) All are correct Ans-C 10- Which decrease tension between solid and liquid? a) Solubilizing agent b) Wetting agent c) Hydrophilic agent d) Emulsifying agent e) Decreasing the particle size of the solid Ans-B


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11- An agent with HLB value range of 14 to 18 is known as: a) Antifoaming agent b) W/O emulsifying agent c) O/W emulsifying agent d) Wetting agent e) Solubilizing agent Ans-E


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RHEOLOGY 1-The diagram represent the following flow system:

A-Pseudoplastic flow B-Newtonian flow C-Thixotropy D-Dilatant flow E-Antithixotropy Ans-B 2-The diagram represents which of the following flow system:

A-Pseudoplastic flow B-Newtonian flow C-Thixotropy D-Dilatant flow E-Antithixotropy Ans-A 3-The diagram represents which of the following flow system:


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A-Pseudoplastic flow B-Newtonian flow C-Thixotropy D-Dilatant flow E-Antithixotropy Ans-C 4- Which of the following flow systems shows a yield value? A-Thixotropy B-Pseudoplastic flow C-Dilatent flow D-Newtonian flow E- Plastic flow Ans-E 5- Which of the following dosage forms is likely to show a yield value? I-Ointments II-Flocculated suspensions III-Gels A-I only B-III only C-I and II only D-II and III only E-All of the above Ans-E 6-All are the important reasons for coating tablets: EXCEPT a-To mask the odor of drug B-to improve the flow of drug C-To increase release rate D-To protect from stomach acid


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E-to mask taste of drug Ans-C 7-Loss of moisture is: A-Efflorescence B-Deliquescence C-Hygroscopic D-Polymorphism E-condensation Ans-A 8-Which of the following would be referred to as a Newtonian type of flow? A-pseudoplastic B-Dilatant C-Plastic D-None of the above Ans-D Tips: Newtonian flow is dilute solutions, which obeys Newton’s Law. 9-Which of the following is azo dye? a-Lysol B-pyridium C-Argyrol D-Nitrofurazone E-Hexachlorphene Ans-B 10-What is incorrect about thixotropy? A-Gel to solution B- Solution to gel C- Viscosity decreased D-Flow ability increased E-None of the above Ans-B


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PHARMACEUTICAL DOSAGE FORMS 1-An enteric coated tablet or beads are designed to: I-Pass through the stomach and break up in the intestine. II-To reduce stomach irritation III-Slow disintegration and sustain release dosage forms A-I only B-III only C-I and II only D-II and III only E-All of the above Ans-C 2-All of the following are the purpose of coating tablets EXCEPT: A-Protection from by atmospheric oxygen or humidity B-to provide desired release pattern for drug substance after administration. C-To mask the taste and odour of the drug. D-To allow ease in swallowing tablets E-To increase the potency of drugs.\ Ans-E 3-Methyl paraben and propyl paraben are: A-Antifungal drugs B-Antibacterial preservatives C-Antifungal preservatives D-Increase shelf life of drugs E-increase stability of drugs Ans-C Comments: Methyl paraben and propyl paraben combination may have synergistic effect. 4-Aspirin tablets can be manufactured by the following methods: I-Wet granulation methods II-Dry granulation methods III-Direct compression methods A-I only B-III only C-I and II only D-II and III only E-All of the above Ans-D Tips: aspirin is gets degradation in moisture, therefore wet granulation methods is not used in aspirin manufacturing.


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5-Picking is the problem in the manufacture of: A-cream B-Lotions C-Tablets D-Capsules E-suspensions Ans-C 6-Breaking is the problem in the manufacture of: A-Cream B-Lotions C-Tablets D-Capsules E-suspensions Ans-A Comments: breaking (irreversible) or creaming (reversible) is the problem in emulsions. 7-Lyophilization (freeze dry) method used for: A-drying wet drugs to powder B-powder sterilization methods C-Hormone sterilization methods D-Sublimation methods used in drying wet powder E-Sterilization method used for thermolabile products Ans-D Comments: Freeze dry is drying method for thermolabile substances, mechanistically it works as sublimation. However this is not a sterilization method. 8-Which of the following indicated loss of carbon dioxide: A- Deliquescent B-Efflorescent C-Effervescent D-Hydroscopic E-Hygroscopic Ans- C Comments: Deliquescent absorb water Efflorescent loss of moisture Effervescent loss of carbon dioxide Hydroscopic absorb moisture Hygroscopic absorb moisture 9-In the presence of water sodium bicarbonate reacts with acid to liberate carbon dioxide: A-Deliquescent B-Efflorescent C-Effervescent D-Hydroscopic


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E-Hygroscopic Ans-C Comments: Alka-seltzer tablets have effervescent 10-Upon combination of powder A and powder B, the mixture melting point is lower than powder A and Powder B: A-Efflorescent B-Eutectic point C-Hydroscopic mixture D-Deliquescent mixture E-Low melting point mixture Ans-B Tips: Camphor and menthol may have eutectic properties 11-Flocculating agents: I-Increase dispersion II-Decrease sedimentation III-Increase volume A-I only B-III only C-I and II D-II and III E-All of the above Ans-C Tips: flocculating agents increase dispersion and decrease sedimentation however do not change volume 12-Veegum (Suspending agents) I-decrease viscosity II-Increase viscosity III-Decrease sedimentation A-I only B-III only C-I and II only D-II and III only E-All of the above Ans-D Comments: suspending agents increase viscosity and decrease sedimentation 13-The flow ability of substance can be described by Thixotropy: A-Increases gel viscosity B-Increases fluidity C-Decreases viscosity D-Increase sedimentation E-Decrease sedimentation Ans-B


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14-The primary pharmaceutical use of veegum is as a: A-Emulsifying agent B-Surfactant C-Suspending agent D-sweetener E-Flocculating agent Ans-C Comments: veegum, agar, acacia, pectin, tragacanth are suspending agents 15-The primary pharmaceutical use of surfactant is as a: A-Emulsifying agent B-Surfactant C-Suspending agent D-sweetener E-Flocculating agent Ans: A Comments: surfactants primarily used as emulsifying agents 16-Spans and tweens are: A-Non ionic surfactants B-Anionic surfactants C-Cationic surfactants D-Poly oxyalkylene derivatives E-Suspending agents Ans:A Comments: benzalkonium chloride, spans, tweens, are examples of non ionic surfactants 17-Parenteral solution should be free from: I-Microorganisms II-Microparticulates III-Pyrogen A-I only B-III only C-I and II D-II and III E-All of the above Ans-E Comments paranteral solutions should be sterile (free from microorganism), microparticulates, pyrogens. 18-HEPA filters used in sterile preparations filtration: I-Microorganisms II-Particulates III-Pyrogens A-I only


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B-III only C-I and II D-II and III E-All of the above Comments: C Comments: pyrogens cannot be filtered by HEPA filters 19-All non-sterile surface areas in laminar airflow hood should be swabbed with: I-70% isopropyl alcohol II-70% Ethyl alcohol III-Chlorhexidine A-I only B-III only C-I and II D-II and III E-All of the above Ans-C 20-Acacia is classified as: A-suspending agent B-natural emulsifying agent C-Semi synthetic emulsifying agent D-Flocculating agent E-tablet filler Ans-B 21-Rectal suppositories intended for adult use, approximately weigh. A-10g B-5g C-2g D-1g E-0.5g Ans-C 22-In a dispensing pharmacy, pharmacist usually mixes active powder with large amount of diluent by: A-Levigation B-Geometrical dilution C-Trituration D-Sifting E-Pulverization Ans-B 23-The shell of soft gelating capsules may made by addition of plastic like substance A-Polyethylene glycol (PEG) B-Povidone


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C-Lactose D-Sorbitol E-methyl cellulose Ans-D 24-Which is the smallest size of capsule: A-5 B-2 C-00 D-1 E-000 Ans-A 25-In extemporaneous preparations of suspensions, levigation is used: A-Reduce particle size B-Reduce viscosity C-Increase particle size D-Increase sedimentation rate E-Reduce sedimentation rate Ans-A 26-What are the suitable forms of water can be used in parenteral preparations I-Sterile water for injection USP II-Water for injection USP III-Purified water USP A-I only B-III only C-I and II D-II and III E-All of the above Ans-C 27-Which of the following is the output of albuterol Inhalation aerosol I-Dry mist II-Wet mist III-Stable foam A-I only B-III only C-I and II D-II and III E-All of the above Ans-A 28-In the following formulations Phenol 0.5% Cimetidine HCl


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Water for injection USP What is the role of water for injection USP A.Preservative B.Solvent C.Cosolvent D.Diluent E.Disinfectant Ans-B 30. Absolute bioavailability is the result of comparing a. oral dosage from and IV dosage form b. oral bioavailability from and sublingual form c. oral bioavailability from and IM dosage form d. oral bioavailability from and rectal form Ans: A 31- Which of the following labels would be the most appropriate to be used in your pharmacy when dispensing a suspension a) “Take with food” b) “Shake well before use” c) “Take with lots of fluids” d) “Rinse mouth after use” Ans-B 32- Antioxidants are added to drug formulation in order to avoid degradation. All of the following are antioxidants, EXCEPT a) Tocopherol b) Ascorbic acid c) EDTA d) Sodium bisulfite e) Sodium benzoate Ans-E 33- Correct statements regarding tocopherol (vitamin E) include: I- It is an antioxidant mainly used in water-soluble formulations II- It is also known as vitamin E III- α-tocopherol is the strongest tocopherol antioxidant a) I only b) III only c) I and II only d) II and III only e) All are correct Ans-D


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34- 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) <0°C b) 2 to 8°C c) 8 to 15°C d) 15 to 30°C e) >30 °CAns-C 35- correct statements regarding vapor pressure may include: I- Vapor pressure is not a Colligative propriety II- Increasing solute, decrease the vapor pressure III- increasing solute, increase the boiling point a) I only b) III only c) I and II only d) II and III only e) All are correct Ans-D 36- Boric acid is often used to adjust the isotonicity of some drug preparations because of its buffer capacity and anti-infective proprieties. Boric acid is widely used in: a) Ophthalmic solutions b) Nasal solutions c) Otic solutions d) Topical formulations e) Oral solutions Ans-A 37- Burrow’s solution – Aluminum acetate is known as: a) Colloidion b) Astringent c) Adsorbent d) Absorbent e) Surfactant Ans-B 38- Which of the following best describe the function of propylene glycol in this formulation? Lorazepan ----------2mls Propileno glycol-----2% Ethanol----------------5mls a) Preservative b) Solvent c) Co-solvent


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d) Surfactant e) None of the above Ans-C 39- Sodium stearate is classified as: a) Anionic b) Cationic c) Non-ionic d) Hydrophobic e) Amphiphilic Ans-A 40- Compared to the sublingual tablet, nitroglycerin ointment: a) Provides only local effect b) It a more stable dosage form c) Provides a more prolonged effect d) Is more rapidly absorbed e) Is more rapidly eliminated Ans-C 41- The dissolution rate of nitrofurantoin tablets may be increased by: a) Micronizing the nitrofurantoin powder b) Decreasing viscosity of the dissolution medium c) Heating the solution medium d) Mechanical agitation e) All of the above increase the dissolution rate of nitrofurantoin tablets Ans-E 42- Benzocaine with caffeine can form a) Ion-dipole b) Ion-Ion c) Dipole-dipole d) Complex molecule e) No reaction is formed Ans-D 43- Antioxidants, which mechanistically act as reducing agent, include: I- Ascorbic acid II- Sodium Bisulfite III- Citric acid a) I only b) III only c) I and II only d) II and III only e) All are correct


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Ans-C 44- Reason for using coating tablets include all of the following, EXCEPT: a) To mask the taste of the drug b) To mask the odor of the drug c) To improve the appearance of the drug d) To increase the drug’s release rate e) To protect the drug from stomach acid Ans-D 45- An ophthalmic solution must be a) Hypertonic b) Isotonic c) Hypotonic d) Amphiphilic e) Lipophilic Ans-B 46- Use(s) Mineral oil may include: a) Used as laxative b) Used as antioxidant c) In chronic use decrease the absorption of fat-soluble vitamins d) Used as lubricant in suppositories e) All are correct Ans-E 47- Which decrease tension between solid and liquid? a) Solubilizing agent b) Wetting agent c) Hydrophilic agent d) Emulsifying agent e) Decreasing the particle size of the solid Ans-B 48- An agent with HLB value range of 14-18 is known as: a) Antifoaming agent b) W/O emulsifying agent c) O/W emulsifying agent d) Wetting agent e) Solubilizing agent Ans-E 49- In preparing ZnSO4 suppositories using 200mg of its USP value. Refers that displacement value of ZnSO4 is 4 means that: a) ZnSO4 will displace 800mg of cocoa butter


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b) Cocoa butter displace 800mg of ZnSO4 c) Only 4mg of cocoa butter will be displaced d) 200mg of ZnSO4 will displace 50mg of cocoa butter Ans-D 50- Addition of mineral oil to a sulphur ointment preparation is called: a) Levigation b) Milling c) Trituration d) Solubilization e) Emulsification Ans-A 51-Tubular reabsorption is not dependent on? A-pH of urine B-Ionized form of drug C-Speed of flow of urine D-Metabolism E-pKa Ans-D 52-Renal nephrosis causes I- Glomerular to be permeable II-Leak the proteins to urine III-The capillary membrane becomes impermeable a) I only b) III only c) I and II only d) II and III only e) All are correct Ans-C (I and II) 53-What is the example of humectant? I-Glycerine II-Propylene glycol III-Sorbitol a) I only b) III only c) I and II only d) II and III only e) All are correct Ans-E 54-Definition of colligative properties? A-Elevation of boiling point


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B-Decrease vapor pressure C-Decrease in freezing point D-osmotic pressure E-All of the above Ans-E 55-pH-Pka = 1.5, for acidic drug what percent of drug is ionized? A-3.06% B-97% C-2.5% D-100% E-50% How to use calculator? Enter: 10 Press : yx

Press: (-)

Enter 1.5 = 56-What is the site for intraarticular injection? A-injection in joint spaces B-injection nerves C-injection in spinal cord spaces D-Injection in brain E-injection in fatty tissues 57-Example of oils used in parenteral preparations, Except? A-Sesame oil B-Olive oil C-Cotton seed oil D-Pea nut oil E-Mineral oil 58-What are the HLB values for O/W and w/O emulsions? I-For O/W HLB is 8 – 18 II-For W/O HLB is 4 – 6 III-For O/W HLB is 1 – 3 a) I only b) III only c) I and II only d) II and III only e) All are correct 59-Sodium benzoate is used as? A-Preservative


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B-Solvent C-Co-solvent D-Filler E-Humectants 60-Type of water is used in parenteral preparations? A-Sterile water for injection B-Bacterio static water C-Water for injection D-All of the above Ans- 61-Steam (moisture) sterilization is carried out in? A-Microwave B-Heat sterilization C-Autoclave D-Ethylene oxide E-None of the above Ans-C 62-What are the methods of tablet disintegration? I-Pulverization by intervention II-Levigation III-Trituration a) I only b) III only c) I and II only d) II and III only e) All are correct Ans-E 63-What are the factors effects on sedimentation of suspension? A-Particle size B-Density of particles C-Density of vehicle D-Viscosity of vehicle E-All of the above Ans-E 64-The primary pharmaceutical use of surfactant is as a: A-Emulsifying agent B-Surfactant C-Suspending agent D-Sweetener E-Flocculating agent Ans: A


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Comments: surfactants primarily used as emulsifying agents 65-Spans and tweens are: A-Non ionic surfactants B-Anionic surfactants C-Cationic surfactants D-Poly oxyalkylene derivatives E-Suspending agents Ans: A Comments: spans, tween, are examples of non-ionic surfactants. 66-Benzalkonium chlorides is A-Non ionic surfactants B-Anionic surfactants C-Cationic surfactants D-Poly oxyalkylene derivatives E-Suspending agents 67-Parenteral solution should be free from: I-Microorganisms II-Microparticulates III-Pyrogen A-I only B-III only C-I and III only D-II and III only E-All of the above Ans-E Comments parenteral solutions should be sterile (free from microorganism), micro particulates, pyrogens. 68-HEPA filters used in sterile preparations filtration: I-Microorganisms II-Particulates III-Pyrogens A-I only B-III only C-I and II only D-II and III only E-All of the above Ans: C Comments: pyrogens cannot be filtered by HEPA filters 69-What is size of filters used in sterile water filtration? A-0.22mm B-0.33mm


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C-0.4mm D-0.55mm E-0.66mm 70-All non-sterile surface areas in laminar airflow hood should be swabbed with: I-70% isopropyl alcohol II-70% Ethyl alcohol III-Chlorhexidine A-I only B-III only C-I and II only D-II and III only E-All of the above Ans-E 71-Acacia is classified as: A-suspending agent B-natural emulsifying agent C-Semi synthetic emulsifying agent D-Flocculating agent E-tablet filler Ans-B 72-Rectal suppositories intended for adult use, approximately weigh. A-10g B-5g C-2g D-1 g E-0.5 g 73-In a dispensing pharmacy, pharmacist usually mixes active powder with large amount of diluents by: A-Levigation B-Geometrical dilution C-Trituration D-Sifting E-Pulverization 74-The shell of soft gelatin capsules may make by addition of plastic like substance A-Polyethylene glycol (PEG) B-Povidone C-Lactose D-Sorbitol E-methyl cellulose Ans-D


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75-Which is the smallest size of capsule: A-5 B-10 C-00 D-1 E-000 Ans-A 76-In extemporaneous preparations of suspensions, levigation is used: A-Reduce particle size B-Reduce viscosity C-Increase particle size D-Increase sedimentation rate E-Reduce sedimentation rate Ans-A


PHARMACY PREP.

DRUG DELIVERY SYSTEMS 1.What is meant by intrathecal injection? A. Injection in between the spine B. Injection underneath the tongue C. Injection on thigh D. Injection on bun Ans-A 2-Which provides 100% bioavailability A-Intramuscular B-Intravenous C-Extravenous D-Oral E-Parenteral Ans-B


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PHARMACY PREP

STERILE PREPARATIONS 1-A vertical laminar flow hood is the best choice when preparing parenteral solutions of: A-Penicillin B-Doxycycline C-Cytotoxic agents D-Nicotine formulations E-Aminoglycosides Ans-C 2-The following factor is the cause of most contaminations in sterile preparations: A-Solutions B-Surface area C-Personal D-Clothing E-Equipment Ans-C 3- In sterile preparation, to wipe the surface of laminar flow hood, the following disinfectant can be used: I-70% ethyl alcohol II-Chlorhexidine III-Benzalkonium chloride A-I only B-III only C-I and II only D-II and III only E-All of the above Ans-E 4-Sterile preparation for parenteral solutions? I-Pyrogen free II-Particulate free III-Pathogen free (microorganism free) A-I only B-III only C-I and II only D-II and III only E-All of the above Ans-E 5-The size HEPA filters used for filtration of microorganism (water filtration): A-0.22 mm B-0.33 mm

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C-0.44 mm D-0.55 mm E-0.66 mm Ans-A

PHARMACY PREP EXTEMPORANEOUS PREPARATIONS

1-What are correct instructions should be labelled in the following preparation?

Salicylic acid 2% Lactic acid 6 ml Flexible collodion ad 30 ml

A- Flexible collodion is extremely flammable. B- Tight closed container to prevent ether and alcohol. C- Store away from fire D- All of the above E- None of the above

Ans-D 2-What are correct instructions should be labelled in the following preparation?

Iodine 2% Sodium iodide 2.7%

Alcohol q.s. 30 mL

A- A rubber or plastic spatula is used because iodine is corrosive. B- Can stain C- A and B D- None of the above

Ans-C

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PHARMACY PREP.

PHARMACEUTICAL ANALYSIS 1- By addition of a solute, solubility of non-electrolytes is decreased. This is: a) Common ion effect b) Disintegration c) Salting out d) Salting in e) None of the above 2- Which of the following compound is known as amphiprotic solvent? a) Methanol b) Water c) Acetic acid d) Ethanol e) All are right 3- Molecular ion (M+) or molecular weight is detected by: a) Colorimetry b) Mass spectroscopy c) Spectrophotometry d) Spectrometry e) Ultraviolet detectors 4- Determination of alcohol in blood in done by: a) HPLC b) TLC c) Reverse phase HPLC d) Gas chromatography & Mass spectroscopy (GC-MS) e) Mass spectroscopy 5- Mass spectroscopy is used to: a) Detect traces of unknown chemical structure b) Structure elucidation of unknown chemical c) Traces in environmental samples d) Drug traces in blood samples e) All of the above 6- All of the following detector are used in High Performance Liquid Chromatography (HPLC): EXCEPT: a) Diode Array Detector b) UV detector c) Refractive Index detector


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d) Gamma Rays e) Radioactive detector 7- Mechanism of action of Thin Layer Chromatography (TLC) is by: a) Gas absorption b) Column theory c) Capillary action d) High pressure extraction e) Temperature range theory 8- Lyophilization (freeze dry method) technique used in: I- Sterilization of liquids and solids II- Sterilization of solids only III- To dry heat-sensitive wet powders a) I only b) III only c) I and II only d) II and III only e) All are correct 9- Sterilization of hormone is done by: a) Dry heat b) Lyophilization c) Filtration d) Radiation e) Autoclave 10- Correct statements regarding ethylene oxide sterilization include: I- A gas sterilization method that combines heat and moisture II- Has a high penetration power to sealed containers III- It is used in dry heat sterilization a) I only b) III only c) I and II only d) II and III only e) All are correct 11- In the assay of amphetamines in plasma, it can be extracted by: a) Ether b) Isopropyl alcohol c) Tetrahydrofuran d) Ninhydrin e) Amides 12- Reverse Phase High Performance Liquid Chromatography (RP-HPLC) I- Mobile phase is aqueous solution


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II- The particle size of stationary phase affects resolution III- Utilize high pressure pump to increase efficiency in the resolution 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 proprieties are classified as colligative proprieties, EXCEPT: a) Elevation of boiling point b) Osmotic pressure c) Increase in conductivity d) Lowering of freezing point e) Magnitude of vapor pressure 14- The colligative proprieties of a solution are related to: a) The total number of solute particles b) pH of the solution c) Number of ions d) Ratio of number of ions and number of molecules e) Number of non-ionized molecule 15- Colligative proprieties are important in determining: a) pH b) Tonicity c) Solubility d) Stability e) Sterility 16- What is the plate’s function in TLC? a) Filter b) Increase rate of resolution c) Support mobile phase d) Make resolution e) Support stationary phase 17- At acid/base titration, which affect the reaction? I- Change in the pH of the preparation II- Addition of a specific buffer will increase the reaction III-Addition of a specific buffer will decrease the reaction a) I only b) III only c) I and II only d) II and III only e) All are correct


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18- Atoms with the same number of protons are known as: a) Isotonos b) Isotopos c) Isobaros d) Atomic equivalents e) Isosmotic 19- Instrument used to measure specific gravity by floating in a liquid: a) Picnometer b) Hydrometer c) Thermometer d) Thermostat e) Tensiometer Ans-B Tips: Hydrometer (SWIM in water) 20- Instrument used to measure quantity of two liquids with equal volume: a) Picnometer b) Hydrometer c) Thermometer d) Thermostat e) Tensiometer 21- Solvents can be classified as: a) Amphiprotic b) Protophilic c) Aprotic d) Protogenic e) All are correct 22- Kind of solvent where acids and bases are produced, react and dissociates producing such anion or cation species is called: a) Amphiprotic solvent b) Protophilic solvent c) Aprotic solvent d) Protogenic solvent e) Inert solvent 23- Correct statements regarding TITRATION include: I- Determination of a given component in a solution by addition of a liquid reagent of known strength until a given endpoint is reached. II- Non-aqueous titration can be used in the assay of some materials that cannot be easily titrated in aqueous system. III- Titration is a chromatographic method of substance separation. a) I only b) III only


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c) I and II only d) II and III only e) All are correct 24- The end point of a titration analysis is characterized by: a) Change in color b) Change in solubility c) Change in pH d) Change in dispersability e) Change in particles aggregation 25- Considerations that should be taken in selecting a solvent for an assay analysis: a) Nature and solubility of the sample under investigation b) Side reactions should not occur between the sample in analysis and the solvent c) The solvent should be pure, low toxic and inexpensive d) Solvent should have a high dielectric constant e) If the sample is a weak acid the solvent should also be a weak acid 26- Solvent used in the assay of levodopa and methyldopa include: a) Acetic acid b) Pyridine c) Chloroform d) Formic acid e) Dimethyl formamide 27- Dimethyl formamide is a solvent used in the assay of which of the following drugs? a) Adrenaline b) Sulfonamides c) Cimetidine d) Chlortalidone e) Levodopa 28-Which of the following spectroscopic method is used in detection of nanogram amount of unknown substance? A-Microspectroscopy B-Nanospectroscopy C-Spectroscopy D-Microscopy E-None of the above Ans-C


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CORRECT ANSWERS PHARMACEUTICAL ANALYSIS

1- C Comments: Salting out is characterized when the addition of a solute in a solution cause the decrease of solution solubility, when the addition of a solute cause the increase of solubility is called salting in. 2- E Comments: Amphiprotic is a type of solvent where acids and bases are produced. It reacts and dissociates producing such anion and/or cation species. 3- B Comments: M+ molecular ion is detected by mass spectroscopy that determines the molecular weight of the sample. 4- D Comments: Gas chromatography is a chromatographic method used to separate volatile organic compounds as alcohol, hydrocarbons and aerosols. 5- D Comments: Mass spectroscopy may be used as adjunct in gas chromatography. 6- D Comments: X-rays are not used as detectors in HPLC 7- C Comments: TLC-Thin Layer Chromatography is a very fast and simple chromatographic method that separates organic compounds, progress of organic reactions, and tests the purity of products by capillary theory. 8- B Comments: Freeze dryer is used for the conversion of wet powders to dry powders. 9- D Comments: Radiation is the most appropriated sterilization method for hormones; the only exception is testosterone that is normally sterilized by dry heat sterilization. 10- C Comments: Ethylene oxide sterilization is a very effective technique that combines heat and moisture having a very high penetration power to sealed containers. 11- A


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Comments: Amphetamines can be extracted from plasma by ether. 12- E Comments: HPLC- High Performance Liquid Chromatography is a method that utilizes high-pressure pumps to increase efficiency in the separation. The mobile phase is normally an aqueous solution and the particles size of the stationary phase definitely alters the effect of resolution. 13- C Comments: Colligative properties in physical chemistry, depending on the number of molecules present in a given space, rather than on their size, molecular weight or chemical constitution. The colligative properties of solutions are osmotic pressure, boiling point elevation, freezing point depression, and vapor pressure lowering. 14- A Comments: Colligative properties in physical chemistry of a solution, depending on the number of molecules present in a given space, rather than on their size, molecular weight or chemical constitution. 15- B Comments: 15- Colligative proprieties are important in determining the tonicity of the solution. The colligative properties of solutions are osmotic pressure, boiling point elevation, freezing point depression, and vapor pressure lowering 16- E Comments: The only function of plates in TLC is support the mobile phase that moves by capillary mechanism through the stationary phase (plates). 17- A Comments: Buffers are added to the solutions exactly to avoid the change in the solution’s pH, therefore if added to the solution will not affect the reaction. 18- B Comments: In physical chemistry, isotopes are atoms with the same number of protons. Isotones with the same number of neutrons and isobaros with the same number of mass. 19- B Comments: Hydrometer is an instrument used to measure specific gravity by floating in a liquid 20- A Comments: Picnometer is an instrument used to measure quantity of two liquids with equal volume 21- E


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Comments: Solvents play an important rule in determining acid/base properties in a solution and may be classified depending of their chemical structure and activity as Solvents can be classified as amphiprotic, protophilic, aprotic and protogenic. 22- A Comments: Amphiprotic solvent as water, acetic acid, methanol and ethanol are kind of solvents where acids and bases are produced, react and dissociates producing such anion or cation species. 23- C Comments: Titration is a determination of a given component in a solution by addition of a liquid reagent of known strength until a given endpoint is reached. Non-aqueous titration can be used in the assay of some materials that cannot be easily titrated in aqueous system. 24- A Comments: The end point of a titration analysis is characterized by change in color. Commonly used indicators include triphenyl methane group corants and azo group corants. 25- E Comments: In order to chose the proper solvent to be used in an analysis we need to consider some important points as the nature and solubility of the sample under investigation, and make sure that no any side reaction between the sample in analysis and the solvent will happen. The solvent should be pure, low toxic, inexpensive and have a high dielectric constant. 26- D Comments: Formic acid is a solvent used in non-aqueous titration in the assay of levodopa and methyldopa 27- B Comments: Dimethyl formamide is a solvent used in non-aqueous titration in the assay of sulfonamides, allopurinol and acetozalamide. 28-C

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 – Dorland’s illustrated – 27th edition.


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4- PHARMACY PREP – Lectures series & study guide for Evaluating Examination-TIPS - 2003/2004 5- THERAPUTIC CHOICES – Canadian Pharmacist Association -Third edition 6- USP DI – Drug Information for the Health Care Professional–15th edition – Volume I.

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