PARACETAMOL + PHENYLEPHRINE HCl + CHLORPHENAMINE MALEATE

Question 1

APAP, N-Acetyl-p-aminophenol

Answer 1

Paracetamol

Question 2

3-[(1R)-1-hydroxy-2-(methylamino)ethyl]
phenol;hydrochlorid

Answer 2

Phenylephrine HCl

Question 3

(Z)-but-2-enedioic
acid;3-(4-chlorophenyl)-N,N-dimethyl-3-
pyridin-2-ylpropan-1-amine

Answer 3

Chlorphenamine Maleat

Question 4

Paracetamol (PAR), phenylephrine
hydrochloride (PHE) and chlorpheniramine
maleate (CPM) are commonly used in
clinical practice as

Answer 4

antipyretic and analgesic

Question 5

T/F: can Paracetamol (PAR), phenylephrine
hydrochloride (PHE) and chlorpheniramine
maleate (CPM) be used as combination?

Answer 5

True; as antipyretic and analgesic
drugs to ameliorate pain and fever in cold
and flu conditions

Question 6

first choice in the
treatment of acute and chronic pain

Answer 6

Paracetamol

Question 7

also used in the temporary reduction of
fever

Answer 7

Paracetamol

Question 8

alpha-adrenergic agonist that can be used
as a decongestant agent

Answer 8

Phenylephrine Hydrochloride

Question 9

first-generation histamine H1 antagonist used
to prevent the symptoms of allergic
conditions, such as rhinitis and urticaria

Answer 9

Chlorphenamine maleate

Question 10

This
drug can also be used in upper respiratory
tract conditions, such as in the temporary
relief of symptoms associated with hay fever.

Answer 10

Chlorphenamine maleate

Question 11

a toxic metabolite linked to
liver toxicity in cases of paracetamol
overdose, is a component of the drug’s
toxicokinetics

Answer 11

N-acetyl-p-benzoquinone
imine (NAPQI)

Question 12

NAPQUI is rapidly detoxified at
standard therapeutic dosages by conjugation with

Answer 12

glutathione

Question 13

NAPQI attaches to the
______________ proteins of the _______
cells in overdose scenarios where
glutathione is low, resulting in
oxidative stress and toxicity.

Answer 13

mitochondria; liver

Question 14

Strong vasoconstrictor phenylephrine is
absorbed from the ____________ tract somewhat
slowly

Answer 14

digestive

Question 15

peak plasma levels of Phenylephrine happen _________
hours after oral treatment

Answer 15

2.5–6

Question 16

Peak levels of chlorphenamine maleate are
observed _____________ following oral dosage

Answer 16

2.5–6 hours

Question 17

T/f: chlorphenamine maleate has a limited bioavailbility

Answer 17

True: due to first pass effect

Question 18

main organ
where chlorphenamine and its metabolites
are eliminated

Answer 18

Urine

Question 19

main mechanism by which paracetamol
overdose is unsafe.

Answer 19

generation of NAPQI

Question 20

___________ converts a
portion of it into NAPQI, which is typically
eliminated by glutathione

Answer 20

CYP2E1

Question 21

In Paracetamol toxicity

When there is an overdose, oxidative stress,
hepatocellular necrosis, and liver failure are
brought on by ______________ depletion and
NAPQI binding to liver proteins

Answer 21

glutathione

Question 22

In Paracetamol toxicity

acting as
an antidote to replenish glutathione and
support NAPQI detoxification.

Answer 22

N-acetylcysteine

Question 23

negative se of phenylephrine and chlorphenamine even at appropriate dosages

Answer 23

tachycardia, hypertension, and drowsiness

Question 24

Chlorpheniramine is well absorbed following
oral administration, with peak plasma
concentrations reached within _________ hours

Answer 24

2-3

Question 25

Chlorpheniramine is extensively metabolized in the _____________, primarily by cytochrome P450 enzymes, and the metabolites are excreted in the __________

Answer 25

liver; urine

Question 26

elimination half-life of chlorpheniramine is __________hours; can be prolonged with overdose

Answer 26

12-24

Question 27

competitively inhibits the binding of acetylcholine to muscarinic receptors

Answer 27

Chlorpheniramine

Question 28

In overdose, this can lead to anticholinergic toxicity which oral ingestion is the primary cause

Answer 28

Chlorpheniramine

Question 29

It has poor oral bioavailability (38%) in people because of a significant first-pass effect and extensive metabolism by monoamine oxidases in the GI tract and liver

Answer 29

PHENYLEPHRINE HYDROCHLORIDE

Question 30

The oral LD50 in rats and mice is 350 mg/kg and 120 mg/kg, respectively. The half-life is 2–3 hr.

Answer 30

PHENYLEPHRINE HYDROCHLORIDE

Question 31

mainly as an alpha-1 adrenergic receptor agonist with minimal beta-adrenergic action at therapeutic doses

Answer 31

PHENYLEPHRINE HYDROCHLORIDE

Question 32

are found in vascular smooth muscle; agonism causes vasoconstriction

Answer 32

alpha-1 receptors

Question 33

Antidote for Paracetamol toxicity

Answer 33

ACETYLCYSTEINE

Question 34

acts as a hepatoprotective agent by restoring hepatic glutathione

Answer 34

ACETYLCYSTEINE

Question 35

serving as a glutathione substitute to prevent the binding of NAPQI to hepatic macromolecules, and enhancing the nontoxic sulfate conjugation of acetaminophen

Answer 35

ACETYLCYSTEINE

Question 36

Indications for NAC include serum levels that fall in the toxic range according to the

Answer 36

Rumack-Matthew nomogram

Question 37

Acetylcysteine is fully protective against liver toxicity if given within __________after ingestion and can be administered in oral and IV route

Answer 37

8 hours

Question 38

Other management technique for paracetamol toxicity

Answer 38

Decontamination Procedures:

Question 39

Decontamination Procedures for paracetamol toxicity in px presenting within 4 hrs of ingestion

Answer 39

gastric lavage and a single dose of activated charcoal

Question 40

In paracetamol toxicity: If the patient presents with nausea and vomiting, initiate the use of

Answer 40

standard antiemetic agents (eg, metoclopramide, selective 5-HT3 receptor antagonists)

Question 41

may be considered for the treatment of central and/or peripheral anticholinergic syndrome

Answer 41

Physostigmine

Question 42

CHLORPHENAMINE MALEATE antidote

Answer 42

Physostigmine

Question 43

CHLORPHENAMINE MALEATE toxicity management should also include _________ monitoring and initiation of _________ access

Answer 43

cardiac; IV

Question 44

In CHLORPHENAMINE MALEATE toxicity, if the patient presents within ____________ of ingestion, consider gastric lavage and single-dose activated charcoal.

Answer 44

1 hour

Question 45

PHENYLEPHRINE HCl antidote:

Answer 45

no specific antidote

Question 46

PHENYLEPHRINE HCl toxicity treatment is mainly __________

Answer 46

supportive and dependent on symptoms

Question 47

Can be given for Phenylephrine HCl toxicity and as mainstay of treatment for agitation, hypertension, tachycardia, and seizures

Answer 47

Benzodiazepines

Question 48

T/F: Benefits of decontamination in Phenylephrine HCl toxicity are unlikely

Answer 48

True