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1421. Zaleplon is used to induce sleep.

1422. Aurothioglucose is a gold preparation; it was used in the treatment of arthritis, and it takes approximately 6 weeks to be effective.

1423. Cefuroxime absorption is increased with food.

1424. Norflox = norfloxacin.

1425. Hyaluronidase is used to enhance the absorption and dispersion of subcutaneous and intramuscular fluids or drugs. By breaking down hyaluronic acid, it reduces tissue resistance, which can help decrease injection-site swelling and discomfort.

Pharma Tips-280

1416. Zostrix is capsaicin. 

1417. Paxil is paroxetine. 

1418. Menopausal age is around 51. 

1419. Vasomotor symptoms of menopausal women are heat intolerance, flushing, perspiration, night sweats, fatigue, mood changes, and reduced productivity. 

1420. FSH and LH will be high if menopause has occurred.

Pharma Tips-279

1411. pH = pKa at half-neutralisation point.

1412. Cystic fibrosis patients clear aminoglycosides more rapidly due to increased renal clearance and volume of distribution, and therefore require individualised dosing intervals and often higher doses.

1413. Polyethene glycol = carbowax.

1414. F = 9/5C + 32. C = 5/9(F - 32).

1415. Avoid taking vitamin C with allopurinol because of the risk of kidney stone formation. 

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1406. Penicillin G is administered by IM injection only because it undergoes hydrolysis in the gastrointestinal tract (GIT).

1407. Niacin causes GIT disturbances and hyperglycemia.

1408. Freons are fluorinated hydrocarbons used as propellants in aerosols.

1409. 15.4 grains = 1g; pint = 473 ml; fluid ounce = 29.57ml.

1410. The normal hardness range for tablets is 3.5 to 7 kg.

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1401. Zolmitriptan (zomig) oral dispersible tablet and spray.

1402. Osteoporosis risk factors are age, gender, caucasian or asian, low weight, menopause, sedentary lifestyle, smoking, and decreased calcium intake. 

1403. Saw palmetto is used for the treatment of benign prostatic hyperplasia (BPH).

1404. Tacrolimus and pimecrolimus are calcineurin inhibitors used in the treatment of eczema. For a good treatment outcome, avoid covering the skin and exposure to UV light; these medicines have no cutaneous atrophy.

1405. Rifampin discolour both urine and faeces (red).

Pharma Tips-276

1396. A meta-analysis should be used to determine the efficacy of an antibiotic.

1397. Trifluridine (Viroptic) is stored under refrigeration.

1398. Valacyclovir is recommended for the treatment of ocular viral infections caused by both herpes simplex virus (HSV) and herpes zoster virus (VZV).

1399. Raloxifene (Evista) is used to prevent osteoporosis in postmenopausal women.

1400. Phenelzine (Nardil) and tranylcypromine (Parnate) are irreversible MAOIs that can cause edema, postural hypotension, insomnia, sexual dysfunction, and a hypertensive crisis when taken with tyramine-rich foods.

Pharma Tips-275

1391. ACE inhibitors (ACEIs) are the drug of choice for treating blood pressure in patients with diabetes.

1392. Doxycycline should not be taken with iron or food, and may cause photosensitivity.

1393. Levothyroxine needs 6 weeks to reach steady state after initial dose adjustment.

1394. Beta-antagonists side effects may include bronchospasm, heart failure, sleep disturbances, dizziness, fatigue, anorexia, nausea, AV block, bradycardia, claudication, Raynaud's, and drowsiness. 

1395. Rizatriptan (maxalt) fastmelt (wafers) can be taken without water.

Pharma Tips-274

1386. Sulfasazine decreases the gastrointestinal absorption of digoxin.

1387. Gentamycin in high doses causes nephrotoxicity and ototoxicity (reversible).

1388. Type I diabetes mellitus has beta cell destruction (insulin deficiency). 

1389. Type II diabetes mellitus is characterised by insulin resistance and defects in secretion (obese).

1390. Diagnosis of diabetes mellitus:-

• Random plasma glucose ⩾ 11.1 mmol/L.
• Fasting plasma glucose (FBG) 8 hours ⩾ 7 mmol/L.
• Plasma glucose level ⩾ 11.1 mmol/L (2 hrs after 75g oral glucose).
• HbA1c ≥ 6.5% (48 mmol/mol).

Pharma Tips-273

1381. Ipratropium (atrovent) causes nosebleeds, dryness of the nose, mouth or throat.

1382. Beclomethasone (maximum effect 7-14 days). Liquids have a greater effect than MDIs.

1383. Olopatadine eye drops cause pruritus, photophobia, and headache.

1384. Hypothyroidism symptoms are fatigue, weight gain, impaired memory, constipation, cold intolerance, dry skin and hair, and bradycardia.

1385. Hyperthyroidism symptoms are weight loss, heat intolerance, diarrhoea, anxiety, palpitations, moist skin, hypertension and hyperflexia.

Pharma Tips-272

1376. Fexofenadine; aluminium, magnesium antacids decrease levels, and fruit juices decrease bioavailability.

1377. Loratadine causes xerostomia and is taken on an empty stomach.

1378. Pseudoephedrine decreases the antihypertensive effect of beta-blockers, and its use is contraindicated with MAOIs or within 14 days of MAOIs discontinuation.

1379. Montelukast causes flu-like symptoms, headache, and abdominal pain.

1380. Levocabastine needs priming; discontinue if no improvement for 3 days.

Pharma Tips 271

1371. Intranasal corticosteroids (INCS) are the preferred treatment for allergic rhinitis.

1372. Aspirin toxicity may include pulmonary oedema, respiratory alkalosis, systemic acidosis, tremor, confusion, and coma; give charcoal and IV fluids plus bicarbonate. 

1373. TCA toxicity may include tachycardia, blurred vision, constipation, urinary retention; give charcoal, bicarbonate to protect the heart. 

1374. First-generation antihistamines to be stopped 2-4 days before skin testing for allergy.

1375. Cetrizine causes somnolence, vomiting, and pharyngitis; it is a metabolite of hydroxyzine.

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1366. Zidovudine (AZT) causes myositis, myocarditis, leukopenia, and liver steatosis (fat formation).

1367. Oxybenzone protects against UVA and UVB. 

1368. First-generation antihistamines cause sedation, learning impairment in children, and increase intraocular pressure (narrow-angle glaucoma). 

1369. Mometasone and fluticasone are recommended in the treatment of allergic rhinitis because of their low systemic bioavailability and absence of growth suppression. 

1370. Budesonide is used as a nasal spray in allergic rhinitis in children. 

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1361. Drugs associated with erectile dysfunction may include acetazolamide, alcohol (acute and chronic use), alpha-blockers, atenolol, barbiturates, carbamazepine, cimetidine, clofibrate, clonidine, digoxin, finasteride, ketoconazole, labetalol, lithium, MAOIs, methadone, phenytoin, metoclopramide, propranolol, phenothiazines, SSRIs, TCAs, and thiazides.

1362. Clomiphene can cause hot flashes and visual disturbances. 

1363. Aluminium, magnesium, and ferrous reduce the absorption of ciprofloxacin. 

1364. Chlorohexidine causes brown teeth.

1365. Sucralfate should be taken on an empty stomach.

Pharma Tips-268

Hierarchy of Scientific Evidence Pyramid

Pharma Tips-267

1356. Meperidine is contraindicated with fluoxetine.

1357. Amlodipine is not used in myocardial infarction.

1358. Norovirus (Norwalk) causes diarrhoea.

1359. Lactose intolerance causes diarrhoea.

1360. Antibiotics, colchicine, laxatives, and magnesium antacids can cause diarrhoea. 

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1351. Endotoxin is a lipopolysaccharide in the cell wall of Gram-negative bacteria and causes intravascular coagulation.

1352. Pyrexia (fever) can be caused by penicillins. cephalosporins, vaccines, heparin, phenytoin, quinidine, carbamazepine, lamotrigine, vancomycin, methyldopa, sulfonamides.

1353. An increase in INR increases the risk of bleeding, while a decrease in INR increases the risk of clotting (coagulation).

1354. Meperidine can cause seizures.

1355. Codiene < meperidine < oxycodone < fentanyl as a pain killer, and the least potent is the most allergic.

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1346. Captopril and alpha-adrenergic blockers decrease insulin resistance.

1347. Acarbose inhibits alpha-glucosidase and decreases glucose levels.

1348. The most effective medications in GERD are proton pump inhibitors. 

1349. Ciprofloxacin is contraindicated in pregnancy. 

1350. Sulfa drugs increase INR.

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1341. Chloasma pigmentation is treated with hydroquinone. 

1342. Dimenhydramine can be taken before the trip by 30 minutes before.

1343. Plan-B side effect is breast tenderness. 

1344. Otitis media can be treated with ceftriaxone IM.

1345. Haemoglobin A1C is monitored every three months.

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1336. Cisplatin is nephrotoxic and causes hearing loss. 

1337. Pinpoint pupil and respiratory depression are caused by narcotic analgesics.

1338. A pregnant woman with a UTI can take amoxicillin.

1339. A patient with renal failure can not take NSAIDS, just acetaminophen.

1340. Mirtazepine causes lower rates of sexual dysfunction. 

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1331. Miacalin spray needs priming, and shaking gently.

1332. Levostin eye drops (levocabastine), shake well before using.

1333. Spiriva do not shake it.

1334. Antiarrhythmic classes:

1. Na channel blockers:

a. Prolong AP (action potential); eg. quinidine, and procainamide. 

b. Shorten AP; eg. lidocaine, and phenytoin. 

c. No effect on AP; eg. flecainide, and propafenone.

2. Beta-blockers (block beta one activation); eg. atenolol, bisoprolol, metoprolol, and sotalol. 

3. Potassium/ multichannel blockers; prolong AP, and suppress atrial and ventricular arrhythmias, eg. amiodarone, dronedarone, dofetilide, and sotalol.

4. Calcium channel blockers; slow AV nodal conduction. eg. verapamil, and dilitiazem.

5. Miscellaneous; eg. adenosine, digoxin, and magnesium.

1335. Fosinopril can be used in renal failure without dose adjustment.

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1326. Over-the-counter products and cold products may contain; acetaminophen, brompheniramine, chlorpheniramine, pyrilamine, diphenhydramine, triprolidine, codeine, dextromethorphan, phenylephrine, pseudoephedrine, ammonium chloride as expectorant, guaifensin, and sodium citrate. 

1327. Normal values for some elements in the body; 

Sodium 135-145 mEq/L

Potassium 3.5-5 mEq/L

Chloride 95-108 mEq/L

Magnesium 1.5-2.2 mEq/L

Calcium 8.5-10.5 mEq/L

Phosphate 2.5-4.5 mEq/L

1328. Pregnant women with candidiasis can use clotrimazole.

1329. Latanoprost causes iris pigmentation.

1330. Mesna is a uroprotectant used to prevent hemorrhagic cystitis caused by cyclophosphamide, and ifosfamide.

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1321. Limewater is calcium hydroxide.

1322. Sweet oil is olive oil. 

1323. Highly protein-bound drugs may include; barbiturates, sulfur, sulfonamides, clofibrate, tolbutamide, salicylate, and warfarin. 

1324. Drugs that inhibit cytochrome P450 may include; allopurinol, warfarin, metronidazole, anabolic agents, chloramphenicol, MAOIs, cimetidine, disulfiram, INH, macrolides antibiotics. 

1325. Drugs that induce cytochrome P450 may include; alcohol, nicotine, chloralhydrate, phenobarbital, cortisone, chlordiazepoxide, prednisone, imipramine, and testersterone.

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1316. Drugs that might cause insomnia include; amantadine, amphetamines, anticholinergics, appetite suppressants, beta2 agonists, beta-blockers, bupropion, caffeine, calcium channel blockers, clonidine, cocaine, alcohol, corticosteroids, daunorubicin, decongestants, diuretics, goserelin, leuprolide, levodopa, LSD, medroxyprogesterone, mefloquine, methylphenidate, nicotine, oral contraceptives, pentostatin, phenytoin, progesterone, quinidine, reserpine, SSRIs, selegiline, theophylline, thyroid hormone.

1317. Drugs that could be taken without food may include; penicillin, labetalol, lansoprazole, cefaclor, levodopa, didanosine, lithium, digoxin, metoprolol, diltiazem, nimodipine, etidronate, penicillamine, furosemide, propranolol, indinavir, rifampin, INH, zafirlukast.

1318. Medications that are not used with antacids may include; digoxin, ketoconazole, fluoroquinolones, quinidine, iron preparations, INH, tetracycline, warfarin, 

1319. Burow's solution contains aluminium acetate (astringent).

1320. Dakin's solution contains sodium hypochlorite.