Pharma Tips-11

76. Hypothyroidism symptoms are fatigue, weight gain, impaired memory, constipation, cold intolerance, dry skin and hair, hypertension, and bradycardia; severe cases may include myxedema coma and hypothermia.

77. Drugs that can cause hypertension are NSAIDs, corticosteroids, OCs, decongestants, cyclosporine, erythropoietin, MAOIs, midodrine, liquorice root, stimulants like cocaine, salt, excessive alcohol use, and sleep apnea.

78. Symbicort = budesonide + formoterol, Advair = fluticasone + salmeterol. 

79. Hemochromatosis pathology in which iron accumulates in the tissues; characterised by bronzed skin and enlarged liver, diabetes mellitus and abnormalities of the pancreas and the joints.

80. Wilson’s disease is a rare inherited disorder of copper metabolism; copper accumulates in the liver and then in the red blood cells and brain. It is treated with copper chelating agents like penicillamine, and pyridoxine 25 mg daily is used to compensate for the antipyridoxine properties of penicillamine. Food rich in copper should be avoided, like peanuts, chocolate, liver, shellfish and mushrooms.

Pharma Tips-10

71. Terbutaline and albuterol are used to treat asthma, exercise induced asthma, main side effects is tremors, anxiety, fear, restlessness, insomnia, confusion, irritability, headache, and psychotic states; dyspnoea, weakness, anorexia, nausea, and vomiting.

72. Anticancer drugs toxicity:

• Renal toxicity: cisplatin, methotrexate (crystallisation).
• Hepatic: 6-MP, bussulfan and cyclophosphamide.
• Cardiac: doxorubicin, daunorubicin.
• Neurologic: vincristine, cisplatin, paclitaxel.
• Immunosuppressant: cyclophosphamide, MTX and cytarabine.
• Others: cyclophosphamide (hemorrhagic cystitis), procarbazine (leukaemia), asparaginase (pancreatitis).

73. Hemorrhagic cystitis caused by cyclophosphamide can be prevented by using mesna, which traps acrolein, the metabolite of the drug, so it is protective.

74. Clozapine= clozaril; olanzapine= zyprexa, quetiapine= seroquel, risperidone= risperdal are 2nd generation antipsychotics.

75. Alcohol withdrawal treatment gives thiamine, Vitamin B1, to prevent Wernicke’s encephalopathy.

Pharma Tips-9

66. Azithromycin is used in pregnancy and does not inhibit P450 enzymes.

67. Clindamycin causes pseudomembranous colitis, neomycin is used topically.

68. Fanconi syndrome occurs from outdated tetracyclines characterized by polyuria, polydipsia, and back pain, and causes photosensitivity.

69. Chloramphenicol causes bone marrow depression, rare aplastic anaemia and gray baby syndrome in neonates and optic neuritis in children; it inhibits the metabolism of phenytoin, sulfonylureas and warfarin.

70. NRTIs (nucleoside reverse transcriptase inhibitors) are zidovudine, stavudine, Didanosine, Zalcitabine, Lamivudine.

Pharma Tips-8

61. AMA is acebutolol; Metoprolol and atenolol are beta 1 selective.

62. Pilocarpine causes miosis by contracting the ciliary muscles, opening the canal of schlemm leads to drainage of aqueous humour and a decrease in IOP. 

63. Alpha 2 agonists’ ↓ NE release ↓ aqueous humour formation ↓ IOP.

64. Beta antagonists block the NE actions, so they decrease aqueous humour formation.

65. Medical conditions and drugs most used to treat:

• Angina--> beta-blockers, CCBs.
• Diabetes and heart failure--> ACEIs, ARBs, and diuretics.
• Post MI--> beta-blockers.
• BPH--> alpha-blockers.

Pharma Tips-7

56. Dopamine acts on dopamine receptors in renal vasculature, causing vasodilation, increasing GFR, and increasing renal blood flow (RBF), and sodium excretion.

57. Dobutamine has beta1>beta2 increases HR, used in CHF and causes tachyphylaxis.
58. NE acts on alpha 1 & 2, beta 1, and has no beta 2 actions, increases HR, and increases PVR.

59. EP low doses affect beta-receptors, and a high dose affects alpha-receptors; it is used in anaphylaxis.

60. Dopamine in low dose effects renal blood flow, medium increases HR.

Pharma Tips-6

51. Alpha1-receptors in the sex organs inhibit ejaculation and in the liver cause glycogenolysis.

52. Alpha2-receptors present in the pre-junctional nerve terminals decrease the release and synthesis of NE, platelet aggregation and decrease insulin secretion.

53. Beta1-receptors in the heart in the SA node increase HR (+ve inotropic effect), AV node increases conduction velocity (+ve dromotropy).

54. Beta2-receptors in the blood vessels cause vasodilation leads to decreased PVR, decreased diastolic pressure, decreased afterload, uterus relaxation, and bronchioles dilation.

55. Beta2-receptors in skeletal muscles increase glycogenolysis, leading to contractility (tremor), in liver cause glycogenolysis, in pancreas increase insulin secretion.

Pharma Tips-5

41. Physostigmine is a tertiary amine that can cross the BBB used in glaucoma and atropine toxicity. 

42. Neostigmine and pyridostigmine are used in ileus and myasthenia gravis.

43. AChE inhibitors poisoning causes (DUMBELS) which are diarrhoea, urination, miosis, bronchoconstriction, excitation (muscle and CNS), and lacrimation, salivation and sweating.

44. The antidote for AChE inhibitor poisoning is Atropine and Pralidoxime (2-PAM) to activate the esterase enzyme; atropine is used first.

45. Vagal stimulation slows the heart caused by a low dose of atropine.

46. Physostigmine, a tertiary amine carbamate, is the antidote to atropine. 

47. Benztropine is used in Parkinsonism and the treatment of dystonias.

48. MAO A in the liver and anywhere it metabolises NE, 5HT, tyramine, and MAO B in the brain it metabolises DA. Cocaine blocks the reuptake of NE.

49. Adrenergic receptors in the eye, alpha1-receptors cause contraction of radial muscles, leading to mydriasis, and in arterioles of skin and viscera cause contraction lead to an increase in afterload and an increase in PVR.

50. Veins alpha1-receptors activation causes contraction, leading to venous return and decreasing the preload. In the bladder, contraction of both the trigone and sphincter leads to urinary retention.