General pharma Flashcards
1
Q
Simple diffusion passive
A
Non-ionized drugs
Acidic: Aspirin/barbiturates
Basic: Amphetamine
2
Q
Max drug absorption?
A
Small intestine (if oral)
3
Q
pK value
A
pH at 50% ionized and 50% non-ionized
4
Q
first pass metabolism in liver
A
only oral route all rest bypass liver (IV bypasses 100% and rectal 50% bypass)
5
Q
drugs with high FPM (nigga phak lakisha)
A
Nitroglycerin - angina sublingual
Propranolol - tachycardia control - do no give to asthma pt)
Lignocaine - arrythmia V. tachycardia digoxin toxicity
6
Q
T max
A
rate of absorption
7
Q
C max
A
max plasma concentration
8
Q
AUC - area under curve
A
extent of absorption (bioavailability)
9
Q
Bioavailability
Depends on absorption and 1/FPM
A
IV 100%
10
Q
Bioequivalence
allowed 80-120
A
Same Bioavailability
exception: phenytoin
11
Q
Drug with highest vol of distribution
A
Chloroquine - malaria - 15000L - bulls eye maculopathy
12
Q
Plasma protein binding of acidic drugs
A
Albumin - barbiturates - sulphonamide highest
13
Q
Plasma protein binding of alkaline drugs
A
Alpha-1 acid glycoprotein - opioids, LA
14
Q
weak acidic drug poisoning
A
forced alkaline diuresis
15
Q
forced alkaline diuresis done by
A
Na bicarbonate (acetazolamide also)
16
Q
weak alkaline drug poisoning
(amphetamine)
A
forced acidic diuresis
17
Q
forced acidic diuresis done by
A
ammonium chloride (cranberry juice)
18
Q
alkaline drugs
A
I-N-E suffix
19
Q
kernicterus
A
bilirubin deposition in brain
20
Q
sulfonamides (or any sulfa drug) can cause which brain disorder in neonates?
A
kernicterus by displacing bilirubin from albumin
21
Q
Amphetamine antidote
Forced acidic diuresis
A
amm. chloride or cranberry juice
22
Q
verapamil (CCB) antidote
A
Ca gluconate/chloride
gluconate by IV best 10% 10 min 10 mL
23
Q
warfarin antidote
A
vit k1
24
Q
organophosphate antidote
A
atropine + oxime pam
25
digoxin antidote
digibind, lignocaine, KCl
26
benzodiazepine antidote
flumazenil
27
opioids antidote
naloxone - best
28
methanol/ethylene glycol antidote
fomepizole, ethanol, folate
29
belladona/dhatura antidote
phystigmine
30
TCA/amitrypthaline antidote
sod. bicarbonate
31
propranolol (b-blocker) antidote
Glucagon
32
fluoxetine active form?
nor-fluoxetine
33
allopurinol active form?
oxypurinol
34
diazepam active form?
oxazepam
35
spironolactone active form?
canrenone
36
codeine active form?
morphine
37
primidone active form?
phenobabitone
38
Universal inhibitors
AMAs - macrolides, quinolones, azoles, cimetidine, grape fruit juice
39
Universal Inducers
rifampicin - TB
antiepileptic
chronic alcoholics and smokers
40
antiepileptic inhibitor
valporate
41
Estrogen + rifampicin
CYP3A4 - OCP fail
42
Cisapride erythromycin/ketoconazole
Astemizole +
Terfinadine
CYP3A4 - QT increase = arrythmia
43
erythromycin/ketoconazole
inhibitor
44
clopidogrel
antiplatelet
45
clopidogrel + omeprazole
CYP2C19 - MI/stroke because of antiplatelet failure
46
omeprazole
inhibitor
47
Best antiplatlet
aspirin
48
Tamoxifen + fluoxetine
Breast ca antigen?
CYP2D6 - Metastasis
49
Fastest receptors
Ionotropic receptors - nn and nm
GABA-A
Glutamate
Nicotinic
5-HT3
50
GABA a
barbi and benzo
51
GPCR
Metabotropic receptors
most common receptor
muscarinic
histamine
5-HT
GABA b
Alpha-Beta
serotonin
ACh
C-AMP
Ca
Most pituitary and hypothalamus hormones
52
Protein kinase receptors
Tyrosine - insulin
JAK - growth and prolactin
53
intracellular receptors
cytoplasmic - Glucorticoids, mineralocorticoids, sex steroids, vit d, androgens
nuclear - vit a, PPAR, thyroxine, estrogen
54
First order kinetics
elimination depending on PC
constant fraction eliminated
half-life constant
clearance constant
55
Zero order elimination
elimination - constant
constant amount
half-life depending on PC
56
Loading dose
volume of distribution * target concentration
chloroquinoline
57
Maintenance dose
clearance * target concentration
58
t1/2 (half-life)
0.693/K = 0.693*vd/cl
59
physiological antagonist feature
receptor different
60
pharmacological antagonist feature?
receptor same
61
thalidomide during pregnancy cause what deformity in baby?
phocomelia
62
lithium during pregnancy caused which anomaly in baby?
ebstein anomaly, cardiac malformation
63
ACE inhi
renal agenesis
64
Warfarin causes what anomaly in new born if given during pregnancy?
chondroplasia punctata
65
Carbimaszole causes which congenital defect?
aplasia cutis
66
Tetracyclines cause what defect?
bone, teeth and cartilage defect
67
valporate
spina bifida
68
z-injection technique
iron, haloperidol (anti-psychotic)
69
schedule H
prescription drugs
70
schedule G
given under medical supervision
71
schedule X
Narcotics and psychotropic (ketamine)
72
phase 1, who is involved? Open or closed label? What is tested? Number of patients?
humans - healthy - open label - max tolerable dose - 10-50 patients
73
phase 2 drug testing features?
exploratory, 100-500 patients, RCT + blinding, proof of concept
74
phase 3
therapeutic, 1000-5000 patients, RCT + blinding, confirm actual dose
75
phase 4
post marketing surveillance, open label, rare/missed adverse effects + interactions + newer indications
76
phase 0
micro-dosing, non-mandatory
77
What is pharmacovigilance? HQ in India and world?
monitor adverse drug reaction (vigiflow)
Ghaziabad - Sweden upsala
78
therapeutic index
TD50/ED50
more than 2 = broad
less than 2 - narrow
79
therapeutic index indicator for?
safety
80
Narrow therapeutic index drugs?
Phenytoin, digoxin, theophylline, lithium
81
Lithium dosage and toxicity?
0.5-1.2 safe
toxic - more than 1.5
coarse tremors - more than 2
severe/dialysis - more than 5
82
tensilon test is used for?
for myasthenia gravis, drug improves the condition
83
tensilon test drug used?
edrophonium - ameliorative test (neostigmine also)
84
myasthenia gravis TOC?
cholinergic - pyridostigmine, neostigmine
surgery - thymectomy
85
acute myasthenia gravis/crisis DOC?
IV immunoglobulins
86
Alzheimer's/dementia receptor?
muscarinic receptors M1
87
cholinergic drugs for dementia/Alzheimer's
memory enhancers
Donepezil
Galantamine
Rivastigmine - patch
and DO NO USE ANTI-Cholinergic drugs - dhatura
88
most common muscarinic receptor in brain
M1 - dimag
M2 - dil
89
NDMA drug for memory enhancing
Memantine
90
Anti-smoking drugs
varenicline - partial nicotine receptor agonist
91
Rotigotine patch for?
Parkinson's
92
Anti-smoking drug used as patch/gum
Nicotine
93
Smoking anti-depressant
Bupropion - Dopamine + nor-adrenaline reuptake therapy, decreases suicide risk, Risk = seizures
94
Smoking anti-epileptic
Topiramate
95
Drug for cardiac stress test
Dobutamine - IV - Acts on B1
96
drug for Cardiogenic shock with oliguria
Dopamine - IV - Acts on D1B1A1
97
Drug for Anaphylactic shock
Epi/Adrenaline - 0.5 mg 1:1000 IM - histamine
98
Drug for overactive bladder
Beta-3 agonist - mirabegron
99
Drug for Hypertension in pregnancy
Labetalol, both oral and IV (3rd gen beta blocker-vasodilation)
100
Drug for Hypertension in pregnancy + asthma
Nifedipine (ca-cannel blocker)
101
Drug for congestive heart failure
Carvedilol, nebivolol (3rd gen beta blocker-vasodilation)
102
drug for Hypertrophic obstructive cardiomyopathy, akathisia and performance anxiety
Propranolol
103
DOC ADHD
Methylphenidate
104
Narcolepsy DOC
Modafinil
105
Which anti-epileptic drug is DOC for obesity?
Zonisamide and Topiramide
106
Which anti-depressant drug is DOC for obesity?
Bupropione (+Naltrexone)
107
Which anti-diabetic drug is DOC for obesity?
Liraglutide and Simaglutide
108
Which melanocortin receptor stimulant drug is DOC for obesity?
Setmelanotide - only for diabetic obese patient
109
Which lipase inhibitor drug is DOC for obesity?
Orlistat - fat in stool
110
Which Sympathetic stimulant drug is DOC for obesity?
Phentermine + Topiramide combination used
111
DOC Atrial fibrillation
Rate controller
Beta blocker - esmolol
CCB - Verapamil/Diltiazem
Digoxin
112
DOC Normal Sinus Rhythm
Ibutilide - Best
Dofetilide
Amiodarone
Vernakalant
Class 3 drugs
113
DOC anti-coagulant post AF
Oral = DTI + Xa inhibitor
Dabigatran + rivaroxaban
or warfarin
114
TOC Atrial fibrillation
DC shock
115
Acute SVT DOC
Adenosine injection
CCBs (Verapamil)
116
Prevention of Recurrence SVT DOC
Verapamil
117
WPW syndrome DOC
Flecainide
118
WPW syndrome drugs to avoid
Beta blockers
CCBs
Digoxin
119
VD/VF (monomorphic)
Lignocaine or Lidocaine
also used for MI and digoxin toxicity
120
VD/VF DOC (monomorphic)
Amiodarone
DC shock
121
Blue man syndrome
Amiodarone
122
DO NOT USE Amiodarone for?
Torsades de pointes or polymorphic VT
123
Polymorphic VT sign
Long QT
124
Amiodarone side effect
Thyroid issue, lungs, myocardium, liver
125
Amiodarone half life
3-8 weeks (56 days)
126
Torsades de pointes or polymorphic VT DOC
IV mg. sulphate
127
Mg. Sulphate antidote
Ca gluconate
128
DOC congenital QT
Propranolol (beta blocker)
129
First sign of Mg sulphate toxicity
loss of knee tendon jerk
130
DOC sinus bradycardia
Atropine IV
131
DOC first degree Heart block
Atropine IV
132
DOC second degree Heart block
Atropine IV
133
DOC second degree Heart block - Mobitz type 2
Pacemaker
134
DOC complete heart block
Pacemaker
135
Atropine not effective in?
Denerved heart or transplanted heart
136
Hyperkalemia DOC emergency
Insulin + glucose
Ca gluconate
Salbutamol
137
Chronic Hyperkalemia DOC
K binders
138
Benign Prostatic hyperplasia with hypertension DOC
Tamsulosin
139
DOC pheochromocytoma
Phenoxybenzamine
140
Name the drugs with high first pass metabolism given orally in high doses?
A - antidepressants - Imipramine
B - beta blockers - propranolol
C - CCB - Verapamil
M - morphine
A - Albuterol, Salbutamol
N - Nitrates
141
Name the drugs with high first pass metabolism not given orally?
Lignocaine - local anesthetic
Natural steroids like: estrogen, progesterone, testosterone, aldosterone, hydrocortisone
142
Loading dose calculation
Volume of distribution/plasma concentration
Depends on volume of distribution
143
Maintenance dose calculation
Clearance/plasma concentration
Depends on clearance and half life
144
Dialysis is effective for which drugs?
Aspirin, barbiturates, lithium
145
Dialysis is not effective for which drugs?
Amphetamines
Verapamil
Organophosphates
Isoniazid
Digoxin
Diazepam
146
What is hoffman's elimination?
Inactivation of the drug in the body by spontaneous molecular arrangements without any enzyme
Atracurium
147
Atracurium drug specifications?
It's a muscle relaxant which blocks signals between nerves and muscles
Used during surgical procedures
148
MC Subtype of CYP450?
CYP3A4
149
Theophylline is metabolized by which CY450 enzyme Subtype?
CYP1A2
150
Warfarin is metabolized by which CY450 enzyme Subtype?
CYP2C9
151
Clopidogrel and PPI (Omeprazole) is metabolized by which CY450 enzyme Subtype?
CYP2C19
152
CYP2D6 metabolizes which drugs?
(second MC Subtype of cytochrome P450)
BAAAT
Beta blockers
Antidepressants - SSRIs
Anti arrhythmic
Anti psychotics
Tamoxifen
153
PCM is metabolized by which CY450 enzyme Subtype?
CYP2E1
154
Acetylation drugs
Sulphonamide
Hydralazine
IHN
Procainamide
These drugs and cause SLE
155
Fast acetylators can cause?
Hepatotoxicity
156
Drug prescription criteria?
Safety
Tolerability
Efficacy
Price
157
When is Iron dose given?
Before meal or 30 minutes after
milk deceases ferrous sulphate absorption
158
Why don't we give sulpha drugs to neonates?
Causes unconjugated bilirubin deposition in brain because no blood-brain barrier causing seizures - Kernicterus
159
Which anti-TB is inducer?
Rifampicin
160
Which anti-epileptic is inhibitor?
Valproate
161
Receptor for Aldosterone?
Cytoplasmic
162
Receptor for Spironolactone?
Cytoplasmic
163
Receptor for Adrenaline?
GPCR - alfa, beta
164
Receptor for TSH?
GPCR - pituitary gland hormone
165
Receptor for Thyroxine?
Nuclear
166
Purinergic receptors act via?
GPCR
167
Opoid receptor?
GPCR
168
Angiotensin receptor?
GPCR
169
If ED50 is low means?
Drug is more potent
ED50 is marker for potency
170
Therapeutic index is marker for?
Drug safety
171
Neurotransmitter and receptor for skeletal musles?
Ach
Receptor NM
under somatic n. system
172
Efferent nerve fibers are found in?
Both sympathetic and parasympathetic n. system
173
Sympathetic pathway's location in spinal cord?
Dorso-lumbar/Thoraco-lumbar
T1 to L2/L3
Ganglia are away from organs
174
Parasympathetic pathway's location in spinal cord?
Cranio-sacral (bohot upar and bohot neeche)
Cranial nerves (3, 7, 9, 10) and S2-S4
Ganglia are near the organs
175
Sympathetic preganglionic neurotransmitter?
ACh - NN
Nicotinic receptor = Ionotropic
176
Parasympathetic preganglionic neurotransmitter?
ACh - NN
177
Sympathetic postganglionic neurotransmitter?
Stress hormones
ACh - Nor adrenaline (main)
Dopamin: Vasodilation
ACh: Sweat glands secretions
Adr: Adrenal medulla
178
Parasympathetic postganglionic neurotransmitter?
ACh - M
179
In stress and fear which pathway?
Sympathetic
Pupils dilated, fight or flight
180
In relax and digest which pathway?
Parasympathetic
181
Precursor of Ach and its blocker drug?
Choline
Blocker Hemicolinium - decreases ACh production - rate limiting step
182
Drug which breaks storage vesicles of ACh?
Vesamicole
183
Drug which blocks release of ACh?
Botulinum toxin
184
Drugs for receptor ACh blockers?
Agonists and antagonists
185
5 levels where we can block function of ACh?
1. stop production of ACh
2. Break the storage vasicles of ACh
3. Stop release of ACh - botulinum toxin
4. Block ACh receptors
5. Block ACh-esterase enzyme that breaks ACh
186
M1 receptors present in?
Stomach - acid secretion
brain - memory and cognition
187
M2 receptors present in?
Heart (bradycardia action)
188
M3 receptors present in?
Smooth muscles
secretory glands
sweat glands
blood vessels (vasodilation action)
189
M4 receptors present in?
Pre-synaptic or rate limiters
190
Which muscarinic receptors are stimulatory?
M1 and M3
191
Which muscarinic receptors are inhibitory?
M2 and M4
192
Name the nicotinic receptors
NN and NM
193
Antibody against which receptor causes myasthenia gravis?
Nicotinic NM
present in skeletal muscle NM junction and stops contraction/depolarization
194
NN receptors are present on?
Ganglia
195
Use and receptor of Bethanechol?
Receptor M3 which means it works on bladder and intestine and used in cases of atonic bladder or atonic ileus
196
Why is ACh not used?
Very short acting
197
Which drug is used in challenge test for bronchial asthma?
Methacholine
Now not used, now we use salbutamol
198
Where do we get Muscarine cholinergic drug from?
Mushroom alkaloid
Antidote is Atropine
199
DOC dry mouth (Xerostomia) and its receptor?
Cevimeline, M3
works on secretory glands and increases salivation
200
Use of Pilocarpine?
acts on M3 and causes Miosis so used in glaucoma
201
Side effects of Pilocarpine
Pain and accommodation spasm - ciliary muscle spasm
Peripheral retinal detachment (long term)
Punctum blockage
Decreased vision due to miosis
202
DOC ACh/Atropine/belladonna/dhatura overdose?
Physostigmine
crosses blood brain barrier because its lipid soluble
203
Name Tough DGR drugs (anticholinesterase)?
Tacrine
Donepezil
Galantamine
Rivastigmine
204
Tough DGR drug which is hepato-toxic?
Tacrine - NOT USED
205
Which tough DGR drug is available as patch?
Rivastigmine
206
Uses of tough DGR drugs?
Alzheimer's disease, increase memory and cognition
207
Which anticholinesterase drug is an NMDA blocker?
Memantine
208
Name lipid soluble anticholinesterase drugs
Physostigmine - DOC Atropine, dhatura, belladona toxicity
Tacrine - not carbamate, rest all are carbamates
Donepezil DOC Dementia/Alzheimeir's
Galantamine
Rivastigmine - available at patch
209
Name water soluble anticholinesterase drugs
Edrophonium/Tensilon
Pyridostigmine - DOC myasthenia gravis
Neostigmine - DOC cobra bite given with atropine
ALL HAVE DIRECT NM ACTION
210
Drug used for diagnosis of Myasthenia gravis?
Edrophonium/Tensilon - because its short acting
211
Which water soluble anticholinesterase drug is longest acting?
Pyridostigmine
that's why DOC for Myasthenia gravis
212
Which drug is used for Ameliorative test?
Edrophonium/Tensilon
213
Name nicotinic uses of Neostigmine
Myasthenia gravis
Cobra bite - Neurotoxic - given along side atropine
Reversal of NM blockers
214
Name muscrinic uses of Neostigmine
Atonic bladder and ileus
215
Why is atropine given along with neostigmine in cobra bite?
to stop muscarinic side effects
216
Signs of OP and carbamate poisioning?
increased secrestions (sweat, tears, saliva)
Miosis - pinpoint pupil
Low HR - M2 receptor stimulation
217
DOC OP and carbamate poisioning?
Atropine - M blocker
Repeat till atropinization which means till you see signs of mucosal dryness and pupil dilation
218
When do we see best effect of Oximes in OP poisoning?
In early poisoning within 30 min
219
Name some oximes
Pralidoxime PAM - used in India
Diacetyl monoxime DAM - in foreign
Obidoxime
220
Name the drug we get at patch behind ear for motion sickness?
Hyoscine (scopolamine)
221
Where do we get hyoscine from?
Hyoscyamus Niger
222
Other uses of hyoscine?
Truth serum in narco test
223
Uses of Atropine?
OP poisoning
carbamate poisoning
early mushrooms poisoning
224
Name natural alkaloid anticholinergic drugs?
Atropine and hyoscine
225
Name semisynthetic anticholinergic drugs?
- Homatropine - eyedrops for mydriasis
- Hyoscine butyl bromide - SM relax, antispasmodic
- Ipratropium bromide and Tiotropium bromide - DOC COPD and asthma
226
Rx Parkinsons drug?
THP - benzhexol, procyclidine and biperiden
Central anticholinergics
227
Synthetic anticholinergics for mydriasis eyedrops?
cyclopentolate and tropicamide
228
Which Synthetic anticholinergic is used as preanesthetic to decrease secretions?
Glycopyrrolate
229
Which Synthetic anticholinergic is used as DOC for peptic ulcers?
Pirenzepine and telenzepine - works on M1and decreases acid secretion
230
6 drops given to newborns with colic, which drug?
Dicyclomine - antispasmodic
231
Name all SOFT synthetic anticholinergic drugs
Solifenacin
Oxybutynin
Flavoxate - UTI/uretheral spasms
Tolterodine
Trospium
All used for Bladder detrussor muscles in overactive bladder or urge incontinence
232
Name 3 nerve gases
Tabun, Sarin, Soman
233
Drug used for obesity?
Simaglutide
234
EMERGENCY acute heart failure, which drug is used to improve cardiac function?
Dobutamine - 2-5 mcg/kg/min IV drip/ infusion
235
A drug which is selective for secretory inhibition and does not go to the brain?
Glycopyrrolate
236
DOC to control BP preoperatively?
Phenoxybenzamine - pro drug - slower action lasts longer
237
DOC to control BP intra-operatively?
Phentolamine
238
First dose hypotension is seen in?
Alpha-1 blockers - started low dose - zosin suffix - given at bedtime
239
Dales vasomotor reversal Rx of pheochromocytoma?
First Alfa blockers then beta blockers
240
Aldosterone receptor?
GPCR
241
HTN + Bone pain + older age + pedal edema DOC?
HCT
242
DOC Mountain sickness?
Acetazolamide
243
DOC Motion sickness?
Hyoscine
244
DOC Morning sickness?
Doxylamine
245
Dose of primaquine for p. vivax in malaria for G6PD deficiency pts?
Weekly dose (because it causes hemolysis)
246
Nature of acidic drugs in stomach?
Unionized > Ionized
247
Nature of basic drugs in intestine?
Unionized > Ionized
248
Overall max absorption from oral route happens in?
SI
249
Name the substances that inhibit Iron sulphate absorption in stomach?
Food - phytates
Tannic acid in tea
Ca in milk
Thats why Iron given either before or 30 min after food with ascorbic acid
250
First pass metabolism mainly occurs in?
Liver
251
How to avoid first pass metabolism?
Parantral/sublingual
252
Effect of Lignocaine + Adrenaline?
decrease Lignocaine absorption = increased LA effect
253
what happens if we give Xylocaine (LA) with epinephrine?
Increased risk of dry gangrene due to peripheral vasoconstriction
254
What does AUC indicate?
Extent of absorption = Bioavailability
255
Cmax is?
Max plasma conc
256
Tmax is?
Rate of abs
257
Which blood barrier is stronger?
Blood brain barrier
258
Which drugs have highest plasma protein binding?
Sulpha drugs = hence not given to children because they can cause unconjugated bilirubin to reach brain and cause Kernicterus (sulpha drugs bind with plasma protein and displace other compounds like aspirin and bilirubin which increase their effect)
259
Use of Thiopentone sodium?
Induction of anesthesia - ultra short action duration - example of redistribution
260
Which is the best muscle relaxant drug for intubation?
Succinyl choline (2-3 min)
261
Which plasma protein basic drugs bind to?
alfa-1 acidic glycoprotein
262
Name extra-hepatic sites of drug metabolism
Plasma - esterase enzyme
Eg ACh - esmolol
SCh
263
Suffix -ium/-curium means?
Muscle relaxant
264
Which muscle relaxant can be given to liver and kidney pt?
Atracurium
265
Which drugs show phase 1 metabolism?
Catabolic/nonsynthetic/functionalization
Lipophilic
CYP450 dependent -
Oxidation-Reduction-Hydrolysis-Cyclization and Decyclization
266
Which drugs show phase 2 metabolism?
Synthetic/conjugation
Hydrophilic/water soluble
MC Glucuronidation
also sulfation, acetylation etc
267
Name 3 methods of drug metabolism?
Inactivation
Active metabolite from active drug - long effect
Activation of prodrug
268
Name active metabolites of following drugs:
Diazepam
Fluoxetine
Spironolactone
Amitriptyline
Codeine
Allopurinol
Primidone
Diazepam - Oxazepam
Fluoxetine - Nor-fluoxetine - long acting SSRI - 2 weeks
Spironolactone - Canrenone
Amitriptyline - Nor-triptyline
Codeine - Morphine
Allopurinol - Oxypurinol
Primidone - Phenobarbitone
269
Active form of Levodopa?
Dopamine - noradrenaline
270
Phase 1 metabolism is dependent on?
CYP450
271
MC subtype of CYP450?
CYP3A4
272
Enzyme in Kriggler najjer syndrome?
Glucoronil-transferase
273
Name some Inducer drugs
Anti-epileptics: Phenytoin
Phenobarbitone
Carbamazepine
Smokers
Chronic alcoholics
Rifampicin
274
Name some Inhibitor drugs
- Antimicrobial: Ciprofloxacin, erythromycin, ketoconazole, cemtidine
- Grape fruit juice
- Valproate
275
Name CAT drugs
Cisapiride
Astemazole
Terfendine
276
CAT + _______ increases effect of CAT drugs
Ketoconazole/cemtidine
causes CAT toxicity = QT prolonged = arrythmia
277
TOC mild acid drug poisioning?
Urine alkalization - sodabicarb
Eg Aspirin
278
TOC mild alkali drug poisioning?
Acidify urine - NH4Cl/grapefruit juice
Eg Amphetamine CNS stimulant (MDMA/ecstasy)
279
Soda bi-carb is DOC for toxicity of?
Aspirin
Barbiturates
Sulphonamides
Metabolic acidosis
280
How many half lives needed for almost removal of First order kinetic drugs?
4-5 half lives
281
Drug that follows true zero order?
Alcohol
282
Drug that follows pesudo zero order?
Phenytoin
First then zero
283
Clearance is constant in?
First order drugs - safer drugs - exponential curve
284
Rate of elimination is constant in?
Zero order - Alcohol
285
Define steady state PC
When we keep repeating the drug to achieve a steady state pc
4-5 t1/2 for almost complete elimination
286
Example of physical MOA
Osmotic diuretic, bulk laxatives
287
Example of transporter MOA
SGLT-1 WHO-ORS
SGLT-2 Glifozin - Used in diabetes and HF
288
Name Enzymatic receptors
TK - insulin
GC - Nitric oxide (cyclic GMP)
Growth hormone
Prolactin
289
DOC Heparin toxicity
Protamine
290
Atropine used of OP and carbamate poisoning, which type of antagonism is this?
Pharmacological - same receptor
291
MOA activated charcoal
Decreased toxin absorption in stomach - used in gastic lavage
292
Conditions in which activated charcoal is CI?
Corrosive - Acid/base poisoning
Kerosene
293
Examples of Physiological antagonism
Adrenaline for histamine - DOC
Glucagon for insulin - DOC
Different receptor
294
Best data is collected in which phase?
Phase 3 - efficacy and safety is tested
295
Prescription drugs are?
Schedule H
296
Schedule G drugs should be taken by?
Advise of RMP
297
Vaccines come in which schedule drugs?
Schedule C/C1
298
Schedule Y drugs are?
Clinical trial
299
Schedule X drugs are?
Narcotics and psychotropics
300
No of drugs designated as essential drugs in India?
384 drugs - NLEM 2022
301
Orphan drugs are used for?
Rare disease
<1/500000
Hard to get and mostly life saving
costly with less profit
302
What type of drug should be given as sustained release?
Drugs with short duration of acting requiring prolonged administration
303
DOC HACE
Dexamethasone
304
DOC HAPE
Nifedipine
305
DOC mountain sickness
Acetazolamide
306
DOC Cholera in pregnancy/children
Azithromycin
307
DOC Cholera in Adults
Doxycycline
308
Gray baby syndrome is associated with use of?
Chloramphenicol
309
Drug used to perform stress echo?
Dobutamine
310
Diabetic macular edema can be caused by which anti-diabetic drug?
Thiazolidinedones
311
Active compound of which ACE inhibitor is available for IV use?
Analapril (available as enalaprilat)
312
DOC severe digoxin toxicity?
Fab fragments of digoxin antibodies
313
Drug that is useful for rheumatoid arthritis but not useful for osteoarthritis
Infliximab
314
HIV Pre-exposure prophylaxis drug
Tenefovir-emitricitabine
315
How does mechlorethamine work?
Makes bridge between 2 parallel DNA strands causing disruption and damage
All alkylating agents work like this
316
Asthma drug that selectively inhibits binding of histamine to H1 receptors?
Fexofenadine
317
Drug that is not used in atrial arrhythmias? (Or only used in ventricular arrhythmias)
Mexiletine
318
Cardiotoxic AB
Doxorubicin
319
Jarish-hexheimer reaction is seen in?
Penicillin tx for syphilis
320
Tafinoquine is used in?
Radical cure of P. Vivax
321
Half life formula
0.693(0.7) X Vd
-----
Clearance
322
AB that doesn't require dose reduction in renal failure
Doxycycline
323
Cornea verticulata/whorl like cream pattern lines seen with use of?
Nitarsudil
324
DOC Refractive intractable rheumatoid chorea?
Sodium valproate
325
DOC used in BPH early stage for urinary symptoms relief
Temsulosin
326
MC form of heart disease in HIV patients
Coronary heart disease - due to antiviral therapy
327
Epidemic typhus vector
Lice
328
DOC Cryptococal meningitis
Flucystosine + amphotericin B
329
Serological marker post HBV vaccination
Anti-HBs
330
Parasites that exhibit antigenic variation
T. Brucei gambiense
T. Brucei rhodesiense
Plasmodium spp
Giardia lamblia
