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1136. Total cholesterol levels are highest in the winter and lowest in the summer.

1137. Estrogen replacement therapy can lower total cholesterol and LDL, and

raise HDL.

1138. Total cholesterol levels can increase during pregnancy and remain elevated

for up to 20 weeks after delivery.

1139. Some diuretics can raise triglycerides and total cholesterol.

1140. Birth-control pills can raise LDL and lower HDL.

Pharma Tips-222

1131. Alteplase is indicated for the management of acute ischemic stroke in adults for improving neurological recovery and reducing the incidence of disability. Treatment should only be initiated within 3 hours after the onset of stroke symptoms and after exclusion of intracranial hemorrhage by a cranial computerized tomography (CT) scan or another diagnostic image method.

1132. Apraxia-Inability to perform purposeful learned movements.

1133. Agnosia-Inability to recognize familiar objects by the various senses.

1134. Maldigestion may arise from many drugs use and abuse such as laxatives and gastric antacid products.

1135. Low-Density Lipoproteins (LDL)

Under 130 mg/dl . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Desirable

130-159 mg/dl . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Borderline-high

160 mg/dl and over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . High

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1126. Cyproheptadine is used in a vascular headache and as an appetite stimulant.

1127. Diphenhydramine and dimenhydrinate are antivertigo agents.

1128. Hydroxyzine is an anti-anxiety antihistamine agent.

1129. Methotrexate is used to treat neoplastic disease, rheumatoid arthritis, and psoriasis.

1130. Hydroxychloroquine causes retinopathy because it binds and accumulates to the melanin layer of the eyes.

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1121. Aluminum and magnesium antacids reduce the absorption of ciprofloxacin.

1122. Renal clearance of procainamide decreases by the use of cimetidine because they compete for renal tubular secretion.

1123. Sucralfate decreases the absorption of tetracycline and ciprofloxacin.

1124. Cisapride stimulates serotonin receptors, increases the release of acetylcholine, and increases gastrointestinal motility.

1125. Doxylamine and diphenhydramine are sedatives-hypnotic antihistamines.

Pharma Tips-219

1116. Zalcitabine causes severe oral and esophageal ulcers.

1117. Aluminum antacids cause constipation, but magnesium antacids cause diarrhea.

1118. Calcium carbonate has a fast onset of action and the most prolonged duration of action among all antacids.

1119. Antacids should not be taken more than 2 weeks without the permission of a health care provider.

1120. Antacids decrease the excretion of amphetamine, so increase its side effects and toxicity.

Pharma Tips-218

1111. Itraconazole should be taken after a full meal for optimum absorption.

1112. Doxycycline (Vibramycin) is the most prolonged half-life and the highest lipid-soluble tetracycline, and it is the only one used for the prophylaxis of traveler's diarrhea caused by E.coli.

1113. Amantadine is used for the prophylaxis and treatment of influenza A infections and used for the treatment of parkinsonism. 

1114. Probenecid (uricosuric) decreases renal excretion of antibiotics increasing their serum concentration leading to prolongation of their actions.

1115. Didanosine and stavudine may cause peripheral neuropathy characterized by numbness, tingling, or pain in the feet or hands.

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1106. The relative ototoxicity by aminoglycosides are streptomycin = kanamycin > amikacin = gentamicin = tobramycin > netilmicin.

1107. The relative nephrotoxicity by aminoglycosides are: neomycin > kanaycin = amikacin = gentamicin = netilmicin > tobramycin > streptomycin.

1108. Streptomycin is used along with isoniazid (INH) for the treatment of tuberculosis.

1109. Chloramphenicol may produce gray baby syndrome in neonates which characterized by vomiting, lethargy, anorexia, gray cyanosis shock, and even death.

1110. Atovaquone is an antiprotozoal agent that is used in the treatment and prevention of pneumocystis carinii pneumonia (PCP) in patients intolerant to sulfamethoxazole/trimethoprim (SMZ-TMP).

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1101. Penicillin may cause antibiotic pseudo-membranous colitis which can be treated with vancomycin, cholestyramine, metronidazole, or bacitracin.

1102. Sulfonamides may displace sulfonylureas in the protein binding sites due to higher affinity.

1103. Cefoperazone can be safely administered in renal impairment.

1104. Cefuroxime is the only 2nd generation of cephalosporins that can cross the blood-brain barrier (BBB), however, all 3rd generation can cross BBB.

1105. Azithromycin should be taken without food because food affects the drug bioavailability.

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1096. Bromocriptine long treatment may produce pleural infusion, thickening, and pulmonary infiltrates.

1097. Haloperidol has the lowest sedation and the highest Extrapyramidal side effects (EPS) among all antipsychotics.

1098. Neuroleptic malignant syndrome (NMS) is associated with haloperidol, depot fluphenazine, chlorpromazine, trifluoperazine, and prochlorperazine.

1099. Penicillinase-resistant penicillins such as; methicillin, nafcillin, oxacillin, and dicloxacillin.

1100. Otitis media can be treated with augmentin (amoxicillin + clavulanate).

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1091. Metoclopramide increases the absorption of levodopa by enhancing gastric emptying.

1092. Sinemet treatment after several years may cause akinesia (inability to initiate movement), tremor, and rigidity; this is called the on-off effect of the sinemet.

1093. Drug holiday must be given in the treatment of sinemet to prevent down-regulation of dopamine receptors.

1094. Selegiline dose when exceeds 40mg/day will result in loss of MAO-B selectivity.

1095. Bromocriptine (Parlodel) has the longest duration of action among all Parkinson's drugs (~50hrs half-life).

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1086.  MAOIs should be stopped 2-4 weeks prior to initiation of levodopa to avoid a hypertensive crisis.

1087. Astemizole and cisapride not to be used with fluvoxamine because may produce cardiac toxicity.

1088. Priapism has been reported with the use of trazodone and nefazodone.

1089. Lithium inhibits the uptake of noradrenaline (NA), Dopamine (DA), and serotonin (5-HT).

1090. Antacids may increase the absorption of levodopa.