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1676. Verapamil increases digoxin levels by reducing its clearance, and also has an additive effect on the heart, causing heart block.

1677. Verapamil is indicated for hypertension, angina, and rate control in supraventricular arrhythmias (e.g., atrial fibrillation and atrial flutter).

1678. Drugs with a hepatic extraction ratio < 0.3 have low first-pass metabolism, while those with > 0.7 undergo extensive first-pass metabolism.

1679. Naloxone is a pure opioid narcotic antagonist.

1680. Aphasia is an impairment of language (expression and/or comprehension), not limited to difficulty speaking alone.

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1671. EFAD = essential fatty acids deficiency.

1672. Ultracet is used for the management of acute pain for 5 days or less.

1673. Dronabinol is available in oral form only.

1674. Granisetron and ondansetron are available in injectable and oral forms.

1675. Rituximab is used to treat non-Hodgkin lymphomas.

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1666. Pirbuterol (maxair) is a β2-agonist.

1667. SSRIs are the drugs of choice for OCD treatment.

1668. Clozapine (clozaril) should be discontinued if the patient's WBC count falls below 3000/mm³.

1669. Modern pneumococcal conjugate vaccines are effective and recommended in children <2 years.

1670. Minocycline not to exceed 200mg/24 hrs in renal-impaired patients.

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1661. A higher AUC indicates greater overall drug exposure in the bloodstream (greater bioavailability), but the actual drug effect depends on both pharmacokinetics and pharmacodynamics.

1662. Rosiglitazone increases HDL, increases LDL, no effect on TGs.

1663. Pioglitazone increases HDL, has no significant effect on LDL, and decreases TGs.

1664. Encephalitis is inflammation of brain tissue, most commonly caused by viral infections; HSV-1 is the most common sporadic cause, with others including CMV, rabies, mumps, and arboviruses.

1665. Febuxostat (uloric) is a xanthine oxidase inhibitor. Reducing the conversion of hypoxanthine → xanthine → uric acid is used for chronic gout management.

Pharma Tips-328

1656. Fluoxetine, Sertraline, Paroxetine, and Fluvoxamine have low cardiotoxicity as SSRIs.

1657. Turbuhaler (budesonide = Pulmicort) should be primed only once on first use and should not be shaken. Clean with a clean dry tissue.

1658. Low K levels increase the toxicity of digoxin.

1659. Mazindol is a CNS stimulant; it is used for short-term management of obesity.

1660. Milk of magnesia (MgOH₂) is not recommended in renal-impaired patients, because it is mainly excreted by the kidneys.

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1651. HSV-1 is responsible for cold sores.

1652. HSV-2 is responsible for genital herpes; HSV-1 can also cause it.

1653. Epstein-Barr virus is responsible for infectious mononucleosis.

1654. Coronavirus is one of the viruses responsible for the common cold.

1655. BMI = weight in kg/(height in meters)².

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1646. The first line of therapy for osteoarthritis is acetaminophen.

1647. Primary failure in diabetes control on sulfonylurea drugs is an insufficient number of β-cells to respond; secondary failure is the drug initially achieves good control but fails to maintain it due to disease progression.

1648. Massaging with oil and shampooing will treat cradle cap and scaly skin in a baby.

1649. Sunscreen should not be used in children く6 months of age, because their metabolic and excretory systems are not fully developed. Higher skin absorption in infants (thin, sensitive skin), greater risk of irritation or allergic reactions.

1650. Human papillomavirus is the cause of common warts. 

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1641. Glucovance = glyburide + metformin.

1642. Acarbose is ∝-glucosidase inhibitor that decreases the absorption of carbohydrates.

1643. Blood flow to fingers has a higher capillary density and blood flow, so they are a reliable site to test the blood sugar level.

1644. Alternate-site blood sugar testing is recommended only when glucose levels are stable, such as: fasting state, 2 hrs after a meal, or 2 hrs after exercise.

1645. Osteoarthritis, also known as degenerative joint disease, has little inflammation and is the most common form of arthritis.

Pharma Tips-324

1636. Clarithromycin may cause QT prolongation if taken with ketoconazole.

1637. Low-dose ASA decreases the secretion of uric acid, hence increasing gouty attacks.

1638. Nicotinic acid competes with the uric acid excretion in the kidneys, increasing uric acid levels and increasing the risk of a gout attack.

1639. Cytotoxic drugs increase nucleic acids due to cell lysis, leading to an increase in uric acid, increasing gout attacks.

1640. Minimum inhibitory concentration (MIC) indicates the lowest concentration of an antibiotic that prevents microbial growth after 18-24 hours of incubation.

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1631. Reason for non-compliance:

• Asymptomatic conditions.
• Chronic conditions.
• Cognitive impairment, especially forgetfulness.
• Complex regimens.
• Multiple daily doses. 
• Patient's fear of side effects.
• Poor communication between patients and practitioners.
• Psychiatric illness.

1632. Meperidine may increase the incidence of seizures.

1633. Bismuth subsalicylate is used for traveller's diarrhoea, may cause constipation, black tongue and stool.

1634. Carbamazepine may cause ataxia and diplopia. 

1635. Sucralfate, aluminium and magnesium antacids decrease the absorption of ciprofloxacin.

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1626. Systemic lupus erythematosus (SLE) like symptoms are induced by hydralazine, INH, quinidine, phenytoin, procainamide, PTU, penicillamine, and carbamazepine.

1627. Neuropathy can be caused by vincristine, INH, amiodarone, nitrofurantoin, and amphotericin B.

1628. Warfarin is a teratogenic agent.

1629. Aspirin has less effect on venous thrombosis.

1630. Alteplase is not indicated for DVT, but for MI.

Pharma Tips-321

1621. Selenium sulfide might cause hair discolouration.

1622. Spironolactone is the drug of choice for diuretic treatment in ascites because it antagonises the effect of aldosterone.

1623. Quinidine has GI side effects, so sustained-release preparations are used to decrease those.

1624. Pentazocine is an opioid agonist and antagonist.

1625. Hydrocodone is a semisynthetic opioid.

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1616. Lanoxin tablets and lanoxicaps (liquid form) have the same potency; lanoxicaps are more absorbed (90-100%) and less variable than lanoxin tablets. Digoxin is recommended with diuretics, ACEIs, and BBs to treat heart failure.

1617. Hydralazine may cause systemic lupus erythematosus (SLE) in long-term therapy; CBC should be performed, and antinuclear antibody titers should be obtained. 

1618. A combination of hydralazine + isosorbide dinitrate decreases mortality in heart failure.

1619. SLE (systemic lupus erythematosus) symptoms may include fatigue, malaise, low-grade fever, joint aches, butterfly rash, chest pain, and overall pain.

1620. Beta-blockers are recommended to treat heart failure due to left ventricular dysfunction, especially HFrEF, unless contraindicated for use or due to side effects like hypotension, bradycardia and bronchospasm.

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1611. Ferrous sulfate (dry) desiccated contains 30% of elemental iron.

1612. Ferrous gluconate contains 12% of elemental iron.

1613. Ferrous fumarate contains 33% of elemental iron. 

1614. Lasix (furosemide) reduces excess sodium and water (decreases venous return to the heart, decreasing preload), recommended for heart failure with oedema, and it has an indirect dilating effect on the lungs (useful in pulmonary congestion).

1615. ACEIs reduce the preload (venous return) by decreasing aldosterone secretion (increasing Na and H2O secretion) and reducing the afterload (vasodilation) by decreasing angiotensin II formation (potent vasoconstrictor).

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1606. Carvedilol is a non-selective β-blocker and α-1 blocker used to treat hypertension and heart failure; the dose must be titrated to the optimal value and should not be discontinued abruptly, as abrupt discontinuation may precipitate an acute coronary event.

1607. Left-sided heart failure presents with shortness of breath, rales, and paroxysmal nocturnal dyspnea. 

1608. HOPE = the Heart Outcomes Prevention Evaluation Trial.

1609. ACEIs are the drugs of choice in patients with hypertension, heart failure, and chronic kidney disease; they reduce cardiovascular deaths, myocardial infarction and stroke incidence.

1610. Ferrous sulfate (hydrous) contains 20% of elemental iron.

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1601. Toxicity may occur for a drug that is highly albumin-bound (more free drug in the blood) for the following cases:

• Hypoalbuminemia.
• Hepatic disease.
• Malnutrition.
• Cancer diseases cause albuminemia (decreased albumin levels). So doses must be monitored.

1602. Salmeterol is a long-acting beta-2 agonist (LABA) with high selectivity for β₂-adrenergic receptors.

1603. LABAs increase the risk of asthma-related deaths (they must be used with inhaled corticosteroids for uncontrolled asthma and should not be used alone), and they are not used for acute asthma.

1604. Myocardial infarction is the leading cause of heart failure in people aged 40-50 years old.

1605. Corticosteroids may cause heart failure ( sodium and water retention).

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1596. Insulin resistance is the need for more than 200 units/day of insulin in the absence of ketoacidosis, which can be caused by obesity, infection, glucocorticoids, and circulating IgG (anti-insulin antibodies). It may resolve without treatment, by insulin switching or with prednisone therapy.

1597. Lanolin is a hydrous wool fat, water-in-oil (W/O), containing 25% water, used as an emulsion base.

1598. Occlusive film can prevent water loss from the skin.

1599. Kaopectate and pepto-bismol both considered as adsorbents (bacteria, toxins and gases).

1600. Dopamine does not cross the BBB.

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1591. The oblique plane passes through the body at an angle.

1592. Warfarin is active in vivo only.

1593. LMWH is active in vivo and minimal in vitro.

1594. Heparin is active in vivo and in vitro.

1595. Epoetin alpha (Eprex) is used in chronic kidney disease to treat anemia due to a decrease in the production of erythropoietin.

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1586. The sagittal plane divides the body into right and left halves.

1587. The midsagittal plane (median plane) divides the body into equal left and right portions. 

1588. The parasagittal plane divides the body into unequal left and right portions. 

1589. The coronal plane (frontal) divides the body into anterior and posterior portions.

1590. The transverse plane (horizontal) divides the body into superior (upper) and inferior (lower) portions.

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1581. Sulfonamide and trimethoprim cause kernicterus (hyperbilirubinemia).

1582. Encephalitis is most commonly caused by a viral infection.

1583. Sodium cromoglycate is a non-steroidal drug with anti-inflammatory properties, used in the prophylaxis of asthma and allergic rhinitis.

1584. Ipratropium is the drug of choice in the treatment of acute exacerbations of COPD.

1585. Antipsychotic drugs are effective in treating bizarre behaviour, delusions, hallucinations, and schizophrenia.

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1576. Sucralfate causes constipation.

1577. Lactulose is used to treat constipation and portal systemic encephalopathy.

1578. Methylation is the reaction that converts norepinephrine to epinephrine.

1579. Pioglitazone increases HDL and decreases triglycerides.

1580. D2 is the major dopaminergic receptor that controls the extrapyramidal system.