Pharma Tips-350

1766. Carbamazepine treats seizures and trigeminal neuralgia and may cause aplastic anaemia and agranulocytosis.

1767. Migraine decreases gastric emptying, limiting the effectiveness of analgesics. 

1768. Hypothyroidism increases sensitivity to digoxin and opioids.

1769. Hyperthyroidism increases sensitivity to warfarin and decreases sensitivity to digoxin.

1770. Topiramate may increase the risk of nephrolithiasis during treatment; more hydration is recommended.

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1761. Oxacillin and nafcillin are useful to treat β-lactamase-producing staphylococcal infections. 

1762. Acitretin is used to treat psoriasis; it is CI in pregnancy, so two negative pregnancy tests must be done before taking it, and two effective birth control methods must be used for one month before starting and for 3 years after stopping it.

1763. Mesalamine is a metabolite of sulfasalazine, and it is used to treat chronic ulcerative colitis.

1764. Tigecycline could be used to treat methicillin- and vancomycin-resistant bacteria; it is a structural analogue of tetracycline. 

1765. Antacids may decrease the absorption of gabapentin; it should be taken 2 hours after antacids. 

Pharma Tips-348

1756. NNRTIs include delavirdine, efavirenz, and nevirapine.

1757. Infliximab is used to treat rheumatoid arthritis, Crohn's disease, ulcerative colitis, and ankylosing spondylitis.

1758. Almotriptan is used for acute migraine.

1759. Metoclopramide could be used for symptomatic gastroesophageal reflux and diabetic gastroparesis.

1760. Lactase enzyme is used to manage lactose intolerance.

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1751. Heart rate and blood pressure are the parameters to watch when administering beta-blockers to patients with MI for acute treatment; if the heart rate and BP are too low, don't give beta-blockers.

1752. Hyperkalemia can be treated by stabilising the cardiac membrane with IV calcium, shifting potassium intracellularly with insulin and dextrose, and removing potassium from the body with dialysis or potassium-binding agents such as sodium polystyrene sulfonate. 

1753. Elemental iron percentage in ferrous gluconate is 12%, in ferrous sulfate is 20%, and in ferrous fumarate is 33%.

1754. Protease inhibitor antivirals include amprenavir, indinavir, nelfinavir, ritonavir, and saquinavir. Other HIV protease inhibitors include atazanavir, darunavir, fosamprenavir, and lopinavir.

1755. NRTIs (nucleoside reverse transcriptase inhibitors) include zalcitabine, lamivudine, and stavudine. Other important NRTIs include abacavir, emtricitabine, didanosine, tenofovir, and zidovudine.

Pharma Tips-346

1746. Henderson-Hasselbalch equation describes the pKa and pH of a weak acid or base.

1747. The Noyes-Whitney equation describes the rate of dissolution of a solid drug.

1748. Amiodarone has a very long half-life (up to 50 days); the therapeutic effect may be delayed for weeks, and side effects may persist for up to 4 months after therapy ends.

1749. Propranolol is used to treat hyperthyroidism because it provides symptomatic relief and reduces tachycardia, sweating and tremor; it also inhibits the conversion of thyroxine (T₄) to triiodothyronine (T₃).

1750. Tenecteplase (TNKase) is easier to administer than tissue plasminogen activator (t-PA) as a single IV bolus dose for acute management of MI. 

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1741. Controlled release dosage forms are:

1. Dospan = erosion core tablet.
2. OROS = osmotic drug delivery system.
3. TDDS = transdermal drug delivery system.
4. Pennkinetic = ion exchange resin delivery system. 
5. HBS = hydrodynamically balanced system.

1742. Azathioprine, basiliximab, and cyclosporine are used after a kidney transplant.

1743. The Cockcroft-Gault equation is a common method for estimating creatinine clearance (age-, weight-, and gender-based).

1744. Fick's law describes drug diffusion via passive transport (from high to low concentration).

1745. The law of mass action describes the rate of a chemical reaction in terms of the reactants' concentration.

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1736. Anticholinergic side effects include dry mouth, blurred vision, constipation, urinary retention, tachycardia, hallucinations, ataxia, mental slowing, confusion, and memory impairment. Anticholinergic drugs should be used with caution in patients with narrow-angle glaucoma, as they can increase intraocular pressure and may precipitate an acute glaucoma attack.

1737. Anticholinergic drugs are equally effective as a group, but their use is limited by their anticholinergic side effects and reduced effectiveness against bradykinesia.

1738. Drugs that are used to treat parkinsonism are pergolide and bromocriptine, which directly stimulate dopamine receptors. Levodopa is converted to dopamine in the brain; amantadine stimulates the presynaptic release of dopamine; and selegiline inhibits MAO-B and prevents the breakdown of dopamine in the brain. Pramipexole and ropinirole are non-ergot dopamine agents, and tolcapone and entacapone, COMT inhibitors, delay the breakdown of dopamine in the brain.

1739. Dopa-decarboxylase converts levodopa to dopamine, but this reaction is important to happen inside the brain. If the patient is taking pyridoxine (B6), which is a coenzyme for dopa-decarboxylase, that means more levodopa is converted to dopamine peripherally, so less dopamine in the brain.

1740. For the on-off therapy of levodopa for parkinsonism, the use of pramipexole or ropinirole has shown effectiveness as a adjunctive therapy. 

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1731. Diphenhydramine could be used to treat mild, symptomatic tremor in Parkinson's patients.

1732. Biperiden is an anticholinergic agent in the treatment of parkinsonism, the daily dose is 2 - 8 mg, with a maximum dose that could reach up to 16mg.

1733. Benztropine, an anticholinergic drug for parkinsonism, dose 1-6 mg.

1734. Pramipexole is a non-ergot dopamine receptor agonist; the daily dose ranges from 1.5 to 4.5 mg for the treatment of parkinsonism.

1735. Tolcapone 300-600 mg and entacapone 200-1600 mg are both COMT inhibitors; they are adjunctive therapies to levodopa/carbidopa (wearing off) and increase levodopa bioavailability.

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1726. TB testing is performed when the patient uses infliximab, due to its immunosuppressive properties.

1727. Secondary parkinsonism may be caused by dopamine antagonists, such as phenothiazines and butyrophenones (e.g., haloperidol), as well as dopamine-depleting agents such as reserpine.

1728. Secondary parkinsonism may be caused by poisoning with certain chemicals and heavy metals, including manganese, mercury, and cobalt.

1729. Secondary parkinsonism may be caused by infectious diseases such as viral encephalitis and neurosyphilis.

1730. Secondary parkinsonism may be caused by cerebrovascular disease (vascular parkinsonism), neurodegenerative diseases of the CNS, and metabolic disorders.

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1721. Vasopressin and oxytocin are released by the posterior pituitary gland.

1722. Metoprolol is a selective β₁‑blocker. Non‑selective beta‑blockers (e.g., timolol) decrease aqueous humour production; metoprolol does not significantly do so.

1723. Valacyclovir is indicated for the treatment of shingles and genital herpes.

1724. Tegaserod is a 5-HT₄ agonist, used for irritable bowel syndrome in women with constipation predominant.

1725. Ritonavir is a protease inhibitor; it is used for HIV.

Pharma Tips-340

1716. Out-patient on lithium takes 900- 1200 mg to maintain 0.6-0.8 mEq/L (lithium levels). Blood sampling is performed 10-12 hrs after the last dose (usually just before the morning dose).

1717. Desmopressin is used to treat primary nocturnal enuresis.

1718. Insulin glargine is a long-acting insulin analogue; it is used only by subcutaneous route.

1719. Cilastatin is a renal dipeptidase inhibitor; it is co-administered with imipenem to prevent renal metabolism of imipenem.

1720. Growth hormone (somatotropin) is released by the anterior pituitary gland. 

Pharma Tips-339

1711. 25 µg of liothyronine (T₃) is equivalent to 100 µg of levothyroxine sodium (T₄).

1712. Thiamine (Vitamin B₁) deficiency may cause Wernicke's syndrome or Korsakoff's syndrome.

1713. Folic acid deficiency leads to megaloblastic anaemia.

1714. Folic acid supply to pregnant women is essential to prevent neural tube defects, especially fetal spina bifida.

1715. Zollinger-Ellison syndrome results from pancreatic adenomas (gastrin-producing islet cells) or duodenal gastrinomas. It is characterised by ulcer pain and diarrhoea, with proton pump inhibitors  (PPIs) as the drug of choice.

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1706. Pneumonia, cor pulmonale, ciprofloxacin, and heart failure increase serum theophylline levels.

1707. Smoking decreases theophylline serum levels by increasing its elimination.

1708. Verapamil slows impulse conduction within the AV node, so it is used to treat tachycardia.

1709. Atomoxetine is not a CNS stimulant.

1710. PICC = peripherally inserted central catheter, sterilely inserted into the vena cava.

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1701. Long-term use of methotrexate causes hepatotoxicity.

1702. Methotrexate is available in tablet and injection forms.

1703. Chlamydia trachomatis is the most causative organism of non-gonococcal urethritis.

1704. Heart rate, cardiac contractility, fluid volume within the cardiac ventricles, and myocardial wall tension reflect the heart's oxygen demand.

1705. Acute coronary syndrome represents unstable angina, ST- and non-ST-elevated myocardial infarction.

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1696. Administration of antibiotics before surgery (1-2 hours) to prevent infections.

1697. To prepare a parenteral nutrition emulsion correctly, the usual order is:

1. Add the amino acid solution to the dextrose solution.
2. Then add the fat emulsion (fatty oil/lipid emulsion).
3. Mix gently.

1698. Zinc helps in wound healing and burns.

1699. Doxorubicin and cyclophosphamide both cause alopecia.

1700. Doxorubicin causes cardiomyopathy, leucopenia, and hepatotoxicity.

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1691. Homocysteine is linked to increase the risk of heart disease.

1692. Colchicine causes diarrhoea and nausea.

1693. Minoxidil (Rogaine) is used topically to treat alopecia.

1694. Finasteride (Propecia) is used orally to treat alopecia.

1695. Tachycardia is an early sign of theophylline toxicity.

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1686. The normal range of intraocular pressure is between 10 and 20 mmHg.

1687. Epoetin-alfa (epogen) stimulates erythropoiesis.

1688. Lansoprazole and alprazolam both may cause constipation.

1689. Lansoprazole should be given before a meal (food decreases absorption) and can be given with juice.

1690. Megaloblastic anaemia is caused by the deficiency of vitamin B₁₂ and /or folic acid.

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1681. Dysarthria is difficulty in pronouncing words.

1682. Apraxia is the loss of the ability to execute learned movements.

1683. Ataxia is the lack of coordination of muscle movements.

1684. Atresia is a condition in which a body orifice is closed or absent.

1685. Levobutolol is a β-blocker; it is used to treat glaucoma by reducing the production of aqueous humour.

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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.