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Canadian Pharmacy Review

Pharmacy Prep

Pharmaceutical Sciences
Review and Guide
Misbah Biabani, Ph.D
Director
Toronto Institute of Pharmaceutical Sciences (TIPS) Inc.
Toronto, ON M2N K7

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Canadian Pharmacy Review


Disclaimer

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Foreword by
Misbah Biabani, Ph.D
Coordinator, Pharmacy Prep
Toronto Institute of Pharmaceutical Sciences (TIPS) Inc
5460 Yonge St. Suites 209 and 303
Toronto ON M2N 6K7, Canada

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Canadian Pharmacy Review

Content
Part II: Pharmaceutical Sciences
19-Pharmacy Calculations
20-Pharmacokinetics
21-Rates and Orders of reactions
22-Pharmacodynamics
23-Basics of Medicinal Chemistry
24-Medicinal chemistry and Pharmacology of Drugs that act on autonomic nervous system
25-Medicinal chemistry and Pharmacology of Histamines, Serotonin, Prostaglandin and NonSteroidal anti-inflammatory Drugs
26-Medicinal chemistry and pharmacology of cardiovascular drugs
27-Medicinal chemistry and pharmacology of psychiatric & neurological diseases
28-Medicinal chemistry and pharmacology Endocrine drugs
29-Drug Metabolism
30-Biopharmaceutics
31-Pharmaceutics
32-Pharmaceutical Additives
33-Rheology
34-Pharmaceutical Dosage Forms
35-Drug delivery Systems
36-Sterile Preparations
37-Extemporaneous Pharmaceutical Preparations
38-Pharmaceutical Analysis

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Pharmacy Calculations

PHARMACY PREP.
GENERAL CALCULATIONS
1- Given a Rx and the signature is: Start 40mg and decrease 5mg everyday until finish.
How many days the patient will take to finish this Rx.
a) 8 days
b) 7 days
c) 6 days
d) 5 days
e) 4 days
2- you have a stock solution of 1:750 and would like to prepare 60mls of 1:10.000, how
much you need to use of the stock solution?
a) 2.4mls
b) 4.6mls
c) 1.3mls
d) 46mls
e) 0.46mls
3-How many tablets each containing 25g, will provide the equivalent of 0.5 mg of
sodium Liothyronine?
A-10 tablets
B-15 tablets
C-20 tablets
D-25 tablets
E-30 tablets
4-How much drug should be added to 30 ml of water to make 10% w/w solution ?
A-10g
B-90g
C-3.3g
D-6.6g
E-9.9g
5-Syrup is an 85% w/v solution of sucrose in water .it has a density of 1.313g/ml .how
many milliliters of water should be used to make 125 ml of syrup?
A-106.2g
B-164.1g
C-57.8g
D-125g
E-1.33g

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Pharmacy Calculations

6- Dissociation factor (i) plays an important role in determining the contribution of a


substance towards isotonicity. If it is assumed that HCl undergoes 80% dissociation, what
will be its dissociation factor?
a) 2.3
b) 3.2
c) 6.1
d) 3.6
e) 1.6
7- Calcium gluconate injection contains 0.1g of Ca2(C6H11O7)/ ml. If the NaCl
equivalent of calcium gluconate is 0.16, the injection is:
a) Hypotonic
b) Iso-osmotic
c) Isotonic
d) Hypertonic
e) Opisthonic
8- Assuming you have alcohol 95% and need to prepare 60mls of alcohol 12%. How
much of alcohol 95% should be used to make this new concentration of alcohol?
a) 4.32mls
b) 7.57mls
c) 8.64mls
d) 6mls
e) 6.57mls
9- You are giving ZnCl2 0.7%, phenilephrine 0.1% and boric acid 1.1% with E values
0.16, 0.32 and 0.5 respectively. This solution will be:
a) Isotonic
b) Hypertonic
c) Hypotonic
d) Iso-osmotic
e) Isotonicity cannot be finding.
10- You receive a Rx with the following signature: Start with double dose of 5mls, than
take 2.5mls BID for 7 days. How many mls of amoxicillin suspension should be
dispensed to this patient:
a) 30mls
b) 35mls
c) 40mls
d) 45mls
e) 50mls
11- Rx; Prednisone 5mg
Start 40mg and decrease 5mg everyday until finish.
How many tablets should be dispensed?
a) 30 tablets
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Pharmacy Calculations

b) 35 tablets
c) 36 tablets
d) 40 tablets
e) 12 tablets
12- An inhaler contains 120 doses. How many days the patient will take to finish the
entire inhaler with this signature: Use 2 inhalers in each nostril every morning and at
bedtime
a) 7 days
b) 10 days
c) 20 days
d) 15 days
e) 30 days
14- What is the sensitivity of a balance that can weight 120mg of a substance and has a
permissible error of 5%?
a) 6mg
b) 16mg
c) 66mg
d) 26mg
e) 1.6mg

CORRECT ANSWERS
1- A

40mg / 5mg tablets = 8 days of treatment

2- B

1:750 = 0.13%
1:10.000 = 0.01%

C1 . V1 = C2 . V2
0.13 x V1 = 0.01 x 60
0.13V = 0.6

V= 4.6ml

3-C
0.5 mg=500 g
Number of tablets = 500 / 25=20 tablets
4-C
The mass of the final solution in this case in unknown, we only have the mass of
solvent (water ) as 30 ml will weight 30 grams .
So know we need a solution which contains 10 grams (10%) of drug in 100 grams
of the solution (solvent + drug )
In this case the solvent will represent 100 10 = 90%
So if 90% 30 grams, how much is 10%?
The weight of the drug is = 10* 30/90 = 3.33
5-C
Density of solution =mass / volume
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Pharmacy Calculations

1.313 = weight of solution / 125


therefore the weight of the solution will be 164.125 g
now we have 85 grams of sucrose in 100 ml of solution
Therefore for 125 ml of solution we need: (125 *85)/100=106.25 grams
the weight of water in this solution =164.125 106.25 = 57.875
6- E

7- D
8- B

Dissociation factor of HCl = H(1) + Cl(1) = 2


2----------100%
X-----------80%
1.6
C1 x V1 = C2 x V2 95 x V1 = 12 x 60 V1 = 7.57mls

9- C

0.7 x 0.16 + 0.1 x 0.32 + 1.1 x 0.5 = 0.00112 + 0.00032 + 0.0055


100
100
100
= 0.00694
NaCl = 0.9 = 0.009 > 0.00694 = Hypotonic
100

10- C

5mls-start dose + (5mls/day x 7days) = 5 + 35 = 40mls

11- C

40mg = 8 tablets decrease one tablet every day until finish.

12- D

Two inhalers in each nostril every morning and at bedtime


2
x
2 nostril
x 2 (morning+night) = 8 doses daily
120 doses 8 doses daily = 15 days supply

13- C

SR = Weight x Error 15 = weight x 5 = 300mg


100

14- A

SR = Weight x Error SR = 120mg x 5 = 6mg


100

BIBLIOGRAPHIC REFERENCE
1- COMPREHENSIVE PHARMACY REVIEW Lippincott William & Wilkins
Fourth edition
2- CPS-COMPENDIUM OF PHARMACEUTICALS AND SPECIALITIES - Canadian
Pharmacist Association 2001 edition.
3- MEDICAL DICTIONARY Dorlands illustrated 27th edition.
4- PHARMACY PREP Lectures series & study guide for Evaluating ExaminationTIPS - 2003/2004

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Pharmacy Calculations

5- THERAPUTIC CHOICES Canadian Pharmacist Association -Third edition


6- USP DI Drug Information for the Health Care Professional15th edition Volume I.

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Pharmacy Calculations

EE review Book and Guide


Chapter Calculations Answers
In dosing the drug gentamicin in pediatric patients, for every 1 mg/kg of gentamicin
administered, serum drug concentrations are expected to increase by 2.5 g/ml. What
would be the expected serum drug concentration following an administration of a 2.5
mg/kg dose of gentamicin?
A-5 g/ml
B-6.25 g/ml
C-10 g/ml
D-2.5 g/ml
Ans: B
_1 mg/kg__ = 2.5 mg/kg
2.5 g / ml
X
X = 6.25 g /ml
An elixir is to contain 250 mg of an alkaloid in each teaspoonful dose. How many grams
of the alkaloid will be required to prepare 5 litres of the elixir?
A-0.25g
B-5g
C-250g
D-2.5g
Ans: C
=

__Xg___ 0.25 g
5000 ml 5 ml
X= 250 g

A pediatric product contains 100mg of erythromycin ethylsuccinate in each dropperful


(2.5ml) of the product. How many kilograms of erythromycin ethylsuccinate would be
required to prepare 5000 pint-size bottles?
A-74.6 kg
B-84.6 kg
C-99.5 kg
D-94.6 kg
Ans: D
1 pint = 473 ml
473 ml x 5000 = 2, 365,000 ml
0.0001 kg = ____ X_____
X = 94.6 kg
2.5 ml
2, 365,000 ml
A physician places a patient on a daily dose of 48 units of U 80 insulin (80units/mL).
How many ml should the patient inject each day?
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A-0.4 ml
B-0.5 ml
C-0.6 ml
D-0.25 ml
Ans: C
U- 80 insulin
80 U = 48 units
1ml
X
X= 0.6 ml
A 20-ml vial of biologic solution is labeled 2.0 megaunits. How many units of drug are
present in every ml of solution?
A2000
B1000
C100,000
D10,000
Ans:
1Megaunit = 1000KU
1KU = 1000 units
2.0 M units x 1000 KU_ x 1000 units
1M units
1KU

= 1000,000 units

X= 2 x 1000 x 1000 = 100,000 units


20
A prescription calls for 10 units of a drug to be taken 3 times a day. How much will the
patient have taken after 7 days?
A-21.0 units
B-0.21 units
C-2.10 units
D-210 units
Ans:D
10 units x 3 x 7 = 210 units
A physician orders Meprobamate 0.2 g. How much is to be administered if the dose on
hand is 400 mg. in each tablet?
A-do not dispense
B-give 2 tablets
C-give 1 tablet
D-give tablet
Ans:
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Pharmacy Calculations

200 mg = _1_ tab


400mg
2
The usual initial dose of chlorambucil is 150 g per kg of body weight once a day. How
many milligrams should be administered to a person weighing 154 lbs.?
A-10.5 mg
B-18 mg
C-15 mg
D-8 mg
Ans:A
154 lbs x_1 kg__ = 70 kg
2.2 lbs
150 g_ = _ X_
1 kg
70 kg
X = 10, 500 g
= 10.5 mg
An initial heparin dose of not less than 150 units/kg of body weight has been
recommended of open-heart surgery. How many ml of an injection containing 5000
heparin units per milliliter should be administered to a 300-pound patient?
A-5.1 l
B-4.1 l
C-5.1 ml
D-4-.1 ml
Ans: D
300 lbs x _1kg_ = 136.36 kg
150 units = _ X___ = 20, 454.54 units
1 kg
136.36 kg
_5000 u_ = 20454.54 u
1 ml
X
X= 4.1 ml
The pediatric dose of cefadroxil is 30 mg/kg/day. If a child is given a daily dose of 2
teaspoonful of a suspension containing 125 mg of cefadroxil per 5 ml, what is the weight
in lb. of the child?
A-19.5 lbs.
B-18.8 lbs.
C-18.3 lbs.
D-18.1 lbs.
Ans: C
_125 mg_ x 2 = 250 mg
5 ml
5 ml
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Pharmacy Calculations

_250 mg_ = _30mg_


X
1 kg
X = 8.33 kg
8.33 kg x 2.2 lbs = 18.33 lbs
1 kg
If the loading dose of Kanamycin is 7 mg/kg of body weight, how many grams should be
administered to a patient weighing 130 lbs.?
A-0.492 g
B-0.414 g
C-414 g
D-0.485 g
Ans: B
130 lbs x _1kg_ = 59.09 kg
2.2 lbs
7 mg = _ X__
1 kg
59.90 kg
X= 413.63 mg
= 0.414 g
The adult dose of a liquid medication is 0.1 ml/kg of body weight as single dose. How
many teaspoonfuls should be given to a patient weighing 220 lbs.?
A-2 tsp.
B-2.5 tsp.
C-2 tbsp.
D-2.5 tbsp.
Ans:A
220 lbs x _1 kg_ = 100 kg
lbs
0.1 mL = _X_
1 kg
100 kg
X = 10 ml
= 2 tsp
If a prescription order requires 25 g of concentrated HCI (density 1.18 g/ml), what
volume should the pharmacist measure?
A-29.50 ml
B-0.0212 ml
C-23.0 ml
D-21.2 ml
Ans: D
W= 25 g
D= 1.17 g/ml
V= _M_ = _25_ = 21.2 ml
D
1.18
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Pharmacy Calculations

If the dose of a drug is 0.5 mg/kg body weight/day, how many mg will a 35 lb infant
receive per 24 hours?
A-7.9 mg
B-7.1 mg
C-7.2 mg
D-7.4 mg
Ans: A
35 lbs x _1 kg_ = 15.9 kg
2.2 lbs
0.5 mg = __X__
1 kg
15.9 kg
X = 7.9 mg
What is the weight of 60 ml of oil whose density is 0.9624 g/ml?
A-5.770 g
B-57.7 g
C-6.0 g
D-0.577 g
Ans: B
V = 60 ml
D = 0.9624 g/ml
D = _M_
V
M=DxV
= 0.9624 x 60
= 57.7
A prescription calls for 0.3 g of phosphoric acid with a specific gravity of 1.71. How
many millilitres should be used in compounding the prescription?
A-0.5
B-0.7
C-0.18
D-0.3
Ans:C
D = _M_ = _g_
V
ml
V = _M_ = _ 0.3 g_
D
1.71 g/ml
X = 0.18 ml

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Pharmacy Calculations

How many ml of 0.9% (w/v) NaCl solution should be prepared from 250 ml of 25%
(w/v) solution?
A-3750
B-2500
C-6944.4
D-9
Ans:
Q1C1 = Q2C2
(X)(0.9)= 250(25)
X = 6944.4 ml
A patient is determined to have 0.8 mg of glucose in each millilitre of blood. Express the
concentration of glucose in the blood as mg%.
A-800 mg%
B-0.8 mg%
C-8 mg%
D-80 mg%
Ans: D
mg% __X mg__
0.8 mg = __X__
1 ml
100 ml
X = 80 mg %

How many mL of a 1:400 (w/v) stock solution should be used to make 4 liters of a
1:2000 (w/v) solution?
A-1000mL
B-200 mL
C-800 mL
D-1600mL
Ans: C
_1 g_ = __X__ = 2 g
2000ml 4000mL
XmL =
2g

400mL
1g

= 800 mL

C1V1 = C2V2
1g x 2000mL = C2 x 4000mL
If a patient is determined to have 100 mg % of blood glucose, what is the equivalent
concentration in terms of mg/dL?
A-1 mg/dL
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Pharmacy Calculations

B-10 mg/dL
C-40 mg/dL
D-100 mg/dL
Ans:D
_mg_ = __mg__
dL
100 mL
=100 mg /dL

Strong Iodine Solution USP contains 5% w/v iodine. How many mg of iodine are
consumed daily if the usual dose is 0.3 mL t.i.d.?
A-15 mg
B-90 mg
C-22.5 mg
D-45 mg
Ans: D
_5_ = _X_
0.9
X = 0.045 g x 1000
= 45 mg
Express in percentage the fluoride concentration in drinking given in 0.6 ppm.
A-0.06%
B-0.00006%
C-0.0006%
D-0.006%
E-0.06%
Ans: B
___0.6g____ = _X_
1,000,000
100
X = 0.00006%
How many grams of dextrose are required to prepare 4 litres of a 5% solution?
A-0.2 g
B-200 g
C-2 g
D-20 g
Ans-B
x
=
5g
4000 mL
100 mL
Change to percent the number 1/300.
A-3%
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Pharmacy Calculations

B-33%
C-3.3%
D-1/3%
Ans:D
_1_ = _X_
300 100
_1/3_ = 0.33% = 1/3%
100
A Pharmacy tech adds 75 mL of strong iodine solution USP (5.0% w/v) to 1 litre of
sterile water for irrigation. What is the % w/v of iodine present?
A-0.35%
B-0.375%
C-0.53%
D-0.60%
Ans:A
Q1C1 = Q2C2
75(5) = (1075)X
X = 0.35%
How many grams of potassium citrate are needed to prepare 1 litre of 10%?
A-1000 g
B-50 g
C-100 g
D-10 g
Ans:C
_X_ = _10_
1000 100
X = 100
How many grams of a drug are required to make 120 mL of a 25% solution?
A-30 g
B-10 g
C-12.0 g
D-120 g
Ans: A
_X_ = _25_
120
100
X = 30
Calcium hydroxide topical solution contains 170 mg of calcium hydroxide per 100 mL at
15 C. Express this concentration as ratio strength.
A-1: 688
B-1: 888
C-1: 588
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D-1: 788
Ans:
170 mg 0.17 g = 1_
100 ml
100 ml
X
X = 588 1:588
How many mg of isofluorophate are contained in 15 g of a 1: 10,000 ophthalmic solution
of isoflurophate in peanut oil?
A-1.7 mg
B-1.9 mg
C-1.8 mg
D-1.5 mg
Ans:D
___1 g__ = _ X_
10,000 mg 15 g
X = 1.5 mg
Express 0.2 % in a ratio strength.
A-1:5000
B-1:50
C-1:500
D-1:5
Ans:C
_0.2_ = _1_
100
x
0.2 X = 100
X = 500
How much of a substance is needed to prepare 1L of a 1: 10,000 solution?
A-0.1 g
B-10 g
C-0.01 g
D-1.0 g
Ans: A
_ 1_ = _ X _
10,000 1000
X = 0.1 g
A cupric chloride injection (0.4 mg Cu/mL) is used as an additive to IV solution for TPN.
What is the final ration strength of copper in the TPN solution if 2.5 mL of the injection
is added to enough of the IV solution to prepare 500 mL?
A-1: 500

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Pharmacy Calculations

B-1:5000
C-1: 500,000
D-1: 50,000
Ans: C
_0.4 mg__ = X___
1 ml
2.5 ml
X = 1 mg 0.001 g

0.001 g = _1_
500 ml
X
X = 500,000
1: 500,000

How many milliliters of a 23.5% (w/v) concentrate of Sodium Chloride solution should
be used in preparing 650 mL of a stock solution such that 30 mL diluted to liter will yield
a 1: 5000 solution?
A-0.2 mL
B-4.33 mL
C-18.44 mL
D-11.75 mL
Ans: C
_ 1_ = __X_
1000

X = 0.2 g

0.2 g_ = _ X _
30 ml
650 ml

X = 4.33 g

23.5
100

X = 18.44 ml

= 4.33 g
X

You have a stock solution of 50% Sodium citrate and you were asked to prepare 300 mL
of a 10% solution. How many mL is needed?
A-20
B-15
C-30
D-60
Ans: D
Q1C1 = Q2C2
X (50) = 300(10)
X = 60
How many milliliters of 1:16 solution of sodium hypochlorite should be used in
preparing 5,000 mL of a 5% solution of sodium hypochlorite for irrigation?
A-800 ml
B-2500 ml
C-4000 ml
D-300 ml
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Pharmacy Calculations

Ans: C
Q1C1 = Q2C2
(X) 6.25% = (5000)(5%)
X = 5% x 5000mL
6.25%
X = 4000 ml
Prepare 1000 ml of KMnO4 1:12,000 compresses out of KMnO4 1: 8,000.
A-Add 333.3 mL water to 1000 mL KMnO4 1: 8,000
B-Add 666.6 mL water to 333.3 mL KMnO4 1: 8,000
C-Add 333.3 mL KMnO4 1: 8,000 and enough water to make final volume 1000 mL
D-Add 333.3 mL water to 666.6 mL KMnO4 1: 8,000
Ans-D
C1V1 = C2V2
0.0125.x = 0.0083 . 1000
x=
How many millilitres of 24% (w/v) concentrate of saline solution should be used in
preparing 600 mL of a solution such that 10mL diluted to a litre will yield a 0.09%
solution?
A-300 ml
B-150 ml
C-50.0 ml
D-225 ml
Ans-D
_ 0.09_
100

= __X_
1000

X = 0.9 g

0.9 g_ = _ X _
10 ml
600 ml

X = 54 g

24
100

X = 225 ml

= 54_
X

The only source of Sodium Chloride is in the form of tablets, each containing 5.0 g. How
many tablets should be used in preparing 3000 litres of a solution of such strength that 20
mL diluted to 100 mL with water will yield a 0.9% (w/v) solution?
A-60,000 tablets
B-27,000 tablets
C-12,000 tablets
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Pharmacy Calculations

D-9,000 tablets
Ans-B
_ 0.9_
100

= __X_
100

0.9 g_ = _ X _
20 ml
3,000,000 ml
135,000 g
5g

X = 0.9 g
X = 135,000 g

= 27, 000 tabs

How many grams of 10% (w/w) ammonia solution can be made from 1800 g of 28%
(w/w) strong ammonia solution?
A-6428.57 g
B-5040 g
C-50,400 g
D-642.86 g
Ans: B
Q1C1 = Q2C2
(10) X = (1800)(28)
X = 5040 g

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PHARMACY PREP.
PHARMACOKINETIC CALCULATIONS
1- A dose of 240mg was given to a patient, his total body clearance is 3.5L/min and the
drug excreted unchanged in the urine is 80mg. What is his non-renal clearance?
a) 240mls
b) 2.4L
c) 3.3L
d) 1.16L
e) 1160mls
2- A dose was given, after 2 hours, the plasma concentration was 64 mg, t1/2=0.7hrs.
After 7 hours from the initial dose, what is the drug's concentration?
a) 0.0mg
b) 1mg
c) 2mg
d) 3mg
e) 4mg
3- What is the absolute bioavailability of tablet A?
TABLET A-----------------50mg---------------AUC 40
IV PUSH -------------------10mg---------------AUC 50
a) 80%
b) 0.16%
c) 16%
d) 8%
e) 25%
4- If the rate of infusion of the drug is 500mg q8hours and clearance is 7.3L/hr. Find
steady state concentration
a) 85.6mg/L
b) 856mg/L
c) 8.56g/L
d) 8.56mg/L
e) 5.86mg/L
5- A drug was found to have zero order kinetic: 100 mg after 6 days 99 mg.
How long it will take to eliminate the entire drug from the body?
a) 100 days
b) 200 days
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c) 300 days
d) 600 days
e) 900 days
6- Ampicilin in 5% dextrose degrades by first order kinetic, at rate constant of 0.026 h.
What is the shelf life of ampicilin?
a) 4hr
b) 8hr
c) 2hr
d) 16hr
e) 12hr
7- Approximately 50% of cloxacillin is excreted unchanged in the urine. If the normal
dosage schedule for cloxacillin is 125mg q6h, a patient with renal function 20% of
normal should receive:
a) 25mg q6h
b) 31.25mg q6h
c) 62.5mg q6h
d) 75mg q6h
e) 125mg q12h
8- Drug which dose is 1500 mg is given every 24 hours. The renal clearance of this drug
is 1.2 mg/dL. Calculate the clearance in ml/min.
a) 88.6 ml/min
b) 76.8 ml/min
c) 86.8 ml/min
d) 66.8 ml/min
e) 43.6 ml/min
9- If a drug is 50% metabolized. What is the percentage of blood concentration after
4hrs?
a) 50%
b) 25%
c) 12.5%
d) 6.25%
e) 3.12%
10- A new antifungal was given at a dose of 5mg/Kg by a single intravenous bolus
injection to a 32 years old female who weighted 75Kg. The antifungal has an elimination
half-life of 2 hours and apparent volume of distribution of 0.28L/Kg.
What is the initial plasma drug concentration in this patient?
a) 36mg/L
b) 1.8mg/L
c) 17.9mg/L
d) 1.79mg/L
e) 19mg/L
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11- Following the anterior information, calculate the predicted plasma concentration at 8
hours after the dose:
a) 15mg/L
b) 111mg/L
c) 11.1mg/L
d) 1.11mg/L
e) 2.64mg/L
12-Following the same anterior information, calculate how much drug remains in the
patient body, 8 hours after the administrated dose:
a) 23mg
b) 112mg
c) 100mg
d) 15.3mg
e) 84.4mg
13- Following the anterior information, how long after the dose is exactly 75% eliminated
from the patient body?
a) 2 hours
b) 4 hours
c) 6 hours
d) 8 hours
e) 10 hours
Let us assume the following characteristics of the drug in a 70kg man.
-Therapeutic effective plasma concentration: 2.0mg/L
-Biologic half-life: 80minutes
-Apparent volume of distribution: 0.70Kg/L
14- What is the recommended rate of infusion for this drug?
a) 85mg/min
b) 58mg/min
c) 0.85mg/min
d) 8.5mg/min
e) 0.085mg/min
15- What is the total body clearance for this patient?
a) 33L/min
b) 43mls/min
c) 43L/min
d) 0.43L/min
e) 0.43mls/min
16- Still following the information of the anterior questions, calculate the corresponding
loading dose:
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a) 98mg
b) 160mg
c) 48mg
d) 24mg
e) 100mg
CORRECT ANSWERS
1- B

240mg-------100% of dose
3.5L------100% Total Clearance
80mg-------- X
X-------- 33% Renal Clearance
X=33%
X=1.16L of Renal Clearance
CLhepatic=CLt-CLr
CLh=3.5-1.16= 2.4L

or
240 mg ---------------- 3.5L/min
80 mg------------------?
CLhepatic=CLt-CLr
CLh=3.5-1.16= 2.4L
2- A

3- C

Dose --------After 2 hours-------64mg


64mg-----after t1/2 of 0.7hr-----32mg
32mg-----after t1/2 of 0.7hr-----16mg
16mg-----after t1/2 of 0.7hr-----8mg
8mg-----after t1/2 of 0.7hr-------4mg
4mg-----after t1/2 of 0.7hr-------2mg
2mg-----after t1/2 of 0.7hr-------1mg
1mg-----after t1/2 of 0.7hr-------0.5mg
TOTAL: 6.9 hr---Approximately---0.5mg = 0mg
We need to multiply the IV dose by 5 to find the same dosage so:
IV Push---------------50mg---------------AUC 250

Bioaval = AUC Tablet A = 40 = 0.16 X 100 = 16%


AUC IV Push
250
4- D

Css = Rate of infusion = 500/8 = 8.56mg/L


Clearance
7.3

5- D

1mg--------6days
100mg----- X

6- A

T90% = 0.105 = 0.105 = 4hours


K
0.026h

X= 600 days

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7- D
Patient has normal non-renal function (liver), so patient should receive 62.5mg dose and
patient has 20% renal function, i.e 12.5 mg. so total dose is 62.5+12.5mg=75 mg.
or
Patient has 20% of normal renal function,
so 50-20=30%
50%-----------125mg q6h
30%-----------X
X = 75mg q6h
[dose/frequency for ri] / [dose/frequency for normal]

8- C

1.2mg/dL--------100ml(dL)
1500mg---------X
X = 125.000mls

125.000mls--------1.440min (60min x 24hrs)


X---------------1min
X = 86.8ml/min

9- D

Drug concentration = 100%


t1/2 (decrease the drug by half) = 50%
2t1/2 = 25% 3t1/2 = 12.5% 4t1/2 = 6.25%

10- C

Cp = Do
Vd

11- D

Cp initial = 17.9mg/L and elimination t1/2 is 2hours


Cp = 17.9 after 2 hours = 8.95
Cp = 8.95 after 2 hours = 4.47
Cp = 4.47 after 2 hours = 2.23
Cp = 2.23 after 2 hours = 1.11 IN 8 HOURS

Cp = 5mg/L = 17.8mg/L
0.28L/kg

12- A

D = 375mg after t/1/2 of 2 hours = 187.5mg


after t1/2 of 2 hours = 93.75..Continue the same as the anterior
question!!!
After 8 hours you will have 23mg
13- B

Initial dose = 375mg and elimination t1/2 is 2hours


Cp = 375mg after 2 hours = 187.5 50%
Cp = 187.5mg after 2 hours = 93.75 25%
4 hours

75%

14- C

R = K x Vd x Css

K = 0.693/80min = 0.0087
Vd = 0.70 x 70Kg = 49L

15- D

CLT = K x Vd ClT = 0.0087 x 49 = 0.43L/min

R = 0.0087 x 49 x 2 = 0.85mg/min

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16- A

LD = Vd x Css LD = 49 x 2 = 98mg
BIBLIOGRAPHIC REFERENCE

1- COMPREHENSIVE PHARMACY REVIEW Lippincott William & Wilkins


Fourth edition
2- CPS-COMPENDIUM OF PHARMACEUTICALS AND SPECIALITIES - Canadian
Pharmacist Association 2001 edition.
3- MEDICAL DICTIONARY Dorlands illustrated 27th edition.
4- PHARMACY PREP Lectures series & study guide for Evaluating ExaminationTIPS - 2003/2004
5- THERAPUTIC CHOICES Canadian Pharmacist Association -Third edition
6- USP DI Drug Information for the Health Care Professional15th edition Volume I.

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PHARMACY PREP.
RATES AND ORDERS OF REACTIONS
1-Plot of log of concentration against time produces a straight line with a:
A-Slope of K/2.303
B-Slope of K/t1/2
C-Slope of Ko
D-slope of K/2.303
E-slope of K/0.693
Ans-A
2-AUC of drug can be determined by a graph using the following rule
I-Trapezoidal rule
II-Ficks first law
III-Rule of nine
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans-A
3-Determine the F value for a capsule AUC 20 mg/dL/hour with 100 mg dose when i.v
of same drug AUC is 25 mg/dL/hour with 100 mg dose.
A-20%
B-60%
C-40%
D-80%
E-100%
Ans-D
AUC po x 100 = 80%
AUC iv
4-Determine the F value for a capsule AUC 20 mg/dL/hour with 50 mg dose when i.v of
same drug AUC is 25 mg/dL/hour with 100 mg dose.
A-20%
B-60%
C-40%
D-80%
E-160%
Ans-E
AUC po x 100
AUC iv
AUC po = 20 x 2 = 40 mg = 1.6 x 100 = 160%
25 mg
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5-Two drugs to be pharmaceutical equivalent, the drugs must:
I-contain same exipient
II-Contain it salts
III-Same therapeutic moiety
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans:D
6-The time it takes to infused drug to reach plasma steady state concentration (Css)
depends on:
I-Elimination half-life of drug.
II-Fraction of free excreted in urine
III-Plasma concentration curve
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans-A
7-A 40 year old patient who weighs 70 kg, needs intravenous infusion of amoxicillin. The
desired Css of drug is 15mg/dL. The physician ordered antibiotic infused for 10 hours.
Amoxicillin has t1/2 = 1 hour and Vd = 9L.
What rate of iv is recommended for this patient? (no loading dose was given);
A-135 mg/hr
B-936 mg/hr
C-1000 mg/hr
D-333 mg/hr
E-400 mg/hr
AnsTips:
Css = R___
K x Vd
R = Rate of infusion
K = first order elimination constant
Vd = volume of distribution
R = Css x k x Vd
R = 15 0.693 x 9000 =
100 1 hour
= 935.54 mg/hr

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PHARMACY PREP
PHARMACODYNAMICS
1. Lethal dose LD50 is classified as:
I-Dose causes 50% of toxic response in tests
II-Dose causes 50% of effect response in tests
III-Dose cause 50% of death response in tests
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans-B
2.
a)
b)
c)

The km value of an enzyme is numerically equal to


Half the maximum velocity expressed in moles/liter
Velocity of a reaction divided by substrate concentration
Substrate concentration in moles/litre necessary to achieve half the maximum velocity
of a reaction
d) Maximum velocity divided by half the substrate concentration in moles necessary to
achieve maximum velocity
e) Substrate concentration divided by velocity of a reaction
Ans-C

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Medicinal Chemistry

PHARMACY PREP.
MEDICAL CHEMESTRY
1.Which of the following drug structure can form epimers
A.-lactam antibiotics
B.Quinolones
C.Tetracycline
D.Sulfanilaminde
E.Erythromycin
Ans-C
Comments: tetracycline epimerizes to epitetracyclin, which is more stable than
tetracyclins
2- Pyrrolidine and piperidine are important heterocyclic compounds in the structure of
drugs. Which of the following drugs has these heterocyclic rings on its structure?
A) Folic acid
B) Clonidine
C) Tetrodotoxin
D) Imipramim
E) Atropine
2- E
Comments: - Pyrrolidine is a five membered and piperidine six membered, important
heterocyclic compounds in the structure of drugs. Atropine is an antimuscarinic agent
having pyrrolidine and piperidine heterocyclic rings on its molecular structure.
3- Allylic is a common group in the molecular structure of drugs. Which of the following
groups is commonly called a vinyl group?
A) H2C=CH
B) H3CO
C) H2C=CHCH2
D) H3CC
E) HCC
3- C
Comments: Vinyl group is the univalent group CH2=CH-CH2
4- Diastereoisomers that have the opposite configuration at only one of two or more
tetrahedral stereogenic centres present in the respective molecular entities are epimers.
Interconversion of epimers are epimerization. Which of the following class of antibiotics
known to have epimerization properties
a) B-lactams
b) Quinolones
c) Vancomycin
d) Tetracyclines
e) Cephalosporins
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4- D
Comments: Tetracycline is an important group of anti-infective agents that suffer in vivo
an important metabolism reaction. The transfer of tetracycline to epi-tetracycline is called
epimerization. Epimerization is the reaction responsible for the transfer of tetracycline to
epi-tetracycline
5- Oxidation of alkyl group results into alcohol, aldehyde and finally carboxylic acids.
What type of alkyl group that mostly undergoes oxidation to an acid is known as:
a) Terminal alkyl group of aliphatic structure
b) Terminal Aromatic alkyl group of structure
c) Benzylic alkyl group attached to aromatic ring structure
d) Heterocyclic ring structure carbons
e) Cyclic ring structure carbons
5- C
Comments: 5- Alkyl group attached to aromatic rings would undergo faster oxidation
because of resonance effect of aromatic ring.
6- Amines are one of the most common group present in the molecular structure of drugs.
Primary amines are mainly metabolized by phase II metabolism:
a) Deamination
b) Dealkylation
c) Acetylation
d) Hydrolysis
e) Oxidation
6- C
Comments: Acetylation is a phase II metabolism reaction characterized by the gain of an
acyl group, and the main reaction that undergoes primary amines.
7- Compound considered an constitutional isomer of hexane include:
a) Cyclohexane
b) Cyclopentane
c) 1-methyl-pentane
d) 1-methyl-cyclohexane
e) None of the above
7- C
Comments: Isomers are compounds that have the same molecular formula but different
chemical structure, hexane and 1-methyl-pentane are examples of isomerism.
8- Structure Activity Relationship (SAR) studies of cholinergic drugs indicate that:
I- Maximum activity is achieved when the quaternary nitrogen is three carbons removed
from the ester group
II- Structures which display a quasi-ring conformation exhibit antimuscarinic activity
III- One methyl group of the trimethylammonium group can be replaced by an ethyl
group with only slight loss of activity.
a) I only
b) III only
c) I and II only
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Medicinal Chemistry

d) II and III only


e) All are correct
8- D
Comments: Parasympathetic cholinergic drugs have their effect based on nature of their
structural molecule. To be effective, cholinergic drugs most display a quasi-ring
conformation. One methyl group of the trimethylammonium group can be replaced by an
ethyl group with only slight loss of activity
9- Molecular structures (drugs) having carboxylic acid, amide, alcohol and/or thio group
are mainly metabolized by:
a) Oxidation
b) Hydrolysis
c) Conjugation
d) Estherification
e) Deamination
9- C
Comments: Conjugations are phase II metabolism reactions characterized by an
incorporation of endogenous substrate on the molecular structure of drugs normally
coming from phase I metabolism reaction. Carboxylic acids are one of the most common
groups present in the molecular structure of drugs mainly metabolized by conjugation.
10- For an antihistaminic drug be effective, it must have which of the following
molecular characteristics on its structure?
I- A terminal tertiary nitrogen
II- More than one aryl or heteroaryl group
III- Presence of CCC between CO
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
10- C
Comments: In order for an antihistaminic drug be effective, they must have a terminal
tertiary nitrogen and more than one aryl or heretoaryl group on their molecular structure.
11- Arrange the following groups from the most reactive to the least reactive:
COOH CH4 OCH3 COO
a) COOCOOHOCH3CH4
b) COOHCH4 COOOCH3
c) OCH3 COOHCOOCH4
d) CH4OCH3COOCOOH
e) COOHOCH3CH4 COO
11- A
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Comments: Molecules may be classified as more or less reactive depending in the


presence of hydrogen and oxygen. Less hydrogen molecules and more oxygen molecules
increase the reactivity of the compound or substance.
12- Conformational isomerism are stereo isomers produced by;
I- rotation around single bond
II- typically rapidly interconverting at room temperature
III- They can be enantiomers
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
12- C
Comments: Isomerism are compounds that have the same molecular formula but different
chemical structures, and may be classified in many different ways depending of structure.
One example is conformational isomerism that is characterized by: The relationship
between isomers that differ only by rotations around single bond. The molecules must be
stereoisomers.
Conformational isomerisms are stereoisomers produced by rotation around single bond,
typically rapidly interconverting at room temperature. They are normally classified as
enantiomers and diastereomers.
13- Geometrical isomerism may be classified in CIS and TRAS depending the spatial
position of the molecule around a bond with restricted rotation, which of the following is
an example of geometrical isomerism?
a) Butene
b) 1-Butene
c) 2-Butene
d) 3-Butyne
e) 1-Butane
13- C
Comments: Geometric isomers may be classified as CIS and TRANS depending the
spatial position of the molecule around a bond with restricted rotation. 2-Butene is an
example of molecule having geometric isomerism.
14- Cylcohexane may form chair and boat conformations. At each carbon has equatorial
and axial conformations. For compounds 1,4-dimethyl-cyclohexane what is the
conformation of the 2-methyl groups in is:
a) Equatorial-equatorial
b) Conformational-conformational
c) Equatorial-spatial
d) Geometric-geometric
e) Spatial-spatial
14- A
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Comments: Equatorial-equatorial is a structural formation of a molecule occurring at the


same distance from each extremity of an axis.
15- Strength of acids and base may depends on several electronic factors of molecule,
Which of the following electronic factors makes cloroacetic acid is stronger than acetic
acid due to:
a) Higher ionization effect
b) Higher molecular weight
c) Higher disintegration rate
d) Electron withdrawal effect
e) All are right
15- D
Comments: Higher the electron withdrawing effect higher the acidity. The halogens F, Cl,
Br, I has higher electron withdrawing effect. The cloroacetic acid is stronger than acetic
acid due to higher molecular weight.
16- Pyridine is a mono heterocyclic compound very important in the activity of many
different drugs. The molecular structure 1,4-dihydropyridine is found in:
a) Verapamil
b) Digoxin
c) Clonidine
d) Nifedipine
e) Diltiazen
Ans-D
Comments: Nifedipine is calcium channel blocker that has 1,4-dihydropyridine on its
structure responsible for its mechanism of action. It is also contain nitro fuctional group
17- Quinolone structure may be found in which of the following substances?
a) Vitamin K
b) Thiamine
c) Cyanocobalamin
d) Folic acid
e) Vitamin A
17- A
Comments: Vitamin K has a quinolone on its molecular structure.
19- Steroid structures are common in hormones, such estrogen, progesterone,
testosterones. Steroid contain how many cyclohexane and cyclopentane respectively in it
skeleton.
a) 2 and 3
b) 3 and 2
c) 4 and 1
d) 3 and 1
e) 1 and 3
19- D

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Comments: Most of the steroid compounds have three cyclohexanes and one
cyclopentane ring on their molecular structure.
20- Phase I metabolism reaction also known as functionalization metabolism, during this
phase drug will metabolized to obtain functional groups such as hydroxyl group or
carboxyl group and these group in phase II are best metabolized by which of following
conjugation reaction:
a) Acetylation
b) Glucuronidation
c) Reduction
d) Hydrolysis
e) Methylation
20- B
Comments: Glucuronidation is the main reaction of phase II metabolism reactions, and
are responsible mainly for the metabolism of drugs having hydroxyl, carboxyl and amide
group on their molecular structure. Conjugation reactions are the most common reactions
of phase II drug metabolism.
21- Which of the following is the strongest acid?
a) Acetic acid
b) Hydrochloric acid
c) Perchloric acid
d) Benzylic acid
e) Carboxylic acid
21- C
Comments: Perchloric acid is one of the strongest acids due to its molecular structure.
22- The most common reactions in stomach is hydrolysis. Which of the following
functional group is more susceptible to hydrolysis?
a) R-COO-R
b) R-O-R
c) R-NHCH3
d) R-COOH
e) R-CH=O
22- A
Comments: Amides and esters are the only groups undergoing hydrolysis.
23- The Bronsted-Lowry theory describe acid is a proton (hydrogen ion) donor. Phenol is
an acid. The acidic properties of phenol is due to:
a) Stable Cation resonance
b) Weak dissociation
c) Common ion effect
d) Stable anion resonance
e) Fast dissociation is lipophilic solutions
23- D
Comments: Phenol is a weak acid due to stable anion resonance
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25- Wrong statement regarding optical isomerism include:


a) To be optimal isomer molecule should contain minimum one chiral or stereogenic
center
b) Diastereomers are non superimposable mirror image
c) Optical isomer rotate plane polarized light
d) Enantiomers are non-superimposable mirror images
e) Has one or more chiral center
25- Ans: B
Comments: Diastereomers must have more than one stereogenic center and are not
mirror image, they have superimposed image.
26- R-COOH is an acid while R-OH is not due to:
a) Presence of dipole
b) Presence of stable anionic resonance
c) Presence of stable cationic resonance
d) Presence of stable non-ionic resonance
e) Complexation
26- Ans:B
Comments: R-COOH is an acid while R-OH is not due to presence of stable anionic
resonance, an indication of the extent of activity of free radicals in an organic reaction.
Factors that influence stability of conjugate bases (anions) are size, electronegativity,
resonance.
The factors to consider: Two of the factors which influence the ionization of an acid are,
the strength of the bond being broken, the stability of the ions being formed.
o Acetic acid: pKa=4.76
o Phenol: pKa=10.00
o Ethanol pKa=16.00
27- The pH value is calculated mathematically as the:
a) Log of the hydroxyl ion (OH ) concentration
b) Negative log of the OH concentration
c) Log of the hydrogen ion (H+) concentration
d) Negative log of the H+ concentration
e) Ratio of H+/OH concentration
27- Ans: D
Comments: pH is the measure of the acidity or basicity of a solution that is calculated
mathematically as the negative log of the H+ concentration
28- This reaction is known as: NH4+ + OH
a) First order reaction
b) Ionization reaction
c) Neutralization reaction
d) Equilibrium reaction

H2O + NB3

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e) Protonated reaction
28- C
Comments: NH4+ + OH H2O + NB3 is an example of neutralization
reaction.
29- Correct statements regarding bioisosters may include:
I- Molecules containing one different group or atom but electronically equivalent
II- May act as antagonist to a normal metabolite
III- Molecules that differs only in the length of the side chain
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
29-Ans: C
Comments: Bioisosters are functional group or atoms that impact similar physical and
chemical properties on biological activity of molecule.
30-Which of the following is the molecular structure of isotretinoin, used in oral
treatment of acne?
a) 13-CIS Retinoic acid
b) 13-TRANS Retinoic acid
c) 13-CIS-TRANS Retinoic acid
d) Retinoic acid
e) None of the above
30- A
Comments: The molecular structure of isotretinoin, used in oral treatment of acne is 13CIS Retinoic acids. The TRANS molecular structure is only used in topical preparations.
31- Morphine is the prototype of opioid analgesics. The analgesic activity of morphine is
dependent of which molecular structure?
a) Phenolic hydroxyl group
b) p-phenyl-N-alkylpiperidine
c) Methyl substitution
d) Piperidine
e) Phenolic amino group
31- B
Comments: The analgesic activity of morphine is dependent of p-phenyl-Nalkylpiperidine
32- Imidazoline is a molecular structure that contain a heterocyclic ring and belongs the
molecular structure of:
a) Prazosin
b) Nifedipine
c) Atropine
d) Clonidine
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e) Allopurinol
32- D
Comments: Clonidine is an antihypertensive drug that depends of its imidazoline
molecular structure to be effective.
33-Which of the following cardiovascular medications chemically classified as
glycoside?
A-Digoxin
B-Warfarin
C-Nitrates
D-Nitrites
E-Cholestyramine
Ans-A
CORRECT ANWERS
MEDICAL CHEMESTRY
1-C
Comments: tetracycline epimerizes to epitetracyclin, which is more stable than
tetracyclins
2- E
Comments: Atropine is an antimuscarinic agent having pyrrolidine and piperidine
heterocyclic rings on its molecular structure.
3- A
Comments: Vinyl group is the univalent group CH2:CH.
4- E
Comments: Epimerization is the reaction responsible for the transfer of tetracycline to
epi-tetracycline
5- A
Comments: 5- Terminal alkyl group easily undergoes oxidation to an acid.
6- C
Comments: Acetylation is a phase II metabolism reaction characterized by the gain of an
acyl group, and the main reaction that undergoes primary amines.
7- C
Comments: Isomers are compounds that have the same molecular formula but different
chemical structure, hexane and 1-methyl-pentane are examples of isomerism.
8- D
Comments: Parasympathetic cholinergic drugs have their effect based on nature of their
structural molecule. To be effective, cholinergic drugs most display a quasi-ring

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conformation. One methyl group of the trimethylammonium group can be replaced by an


ethyl group with only slight loss of activity
9- C
Comments: Conjugations are phase II metabolism reactions characterized by an
incorporation of endogenous substrate on the molecular structure of drugs normally
coming from phase I metabolism reaction. Molecular structures (drugs) having
carboxylic acid, amide, alcohol and/or thio group are mainly metabolized by a
conjugation.
10- C
Comments: In order for an antihistaminic drug be effective, they must have a terminal
tertiary nitrogen and more than one aryl or heretoaryl group on their molecular structure.
11- A
Comments: Molecules may be classified as more or less reactive depending in the
presence of hydrogen and oxygen. Less hydrogen molecules and more oxygen molecules
increase the reactivity of the compound or substance.
12- C
Comments: Conformational isomerisms are stereoisomers produced by rotation around
single bond, typically rapidly interconverting at room temperature. They are normally
classified as enantiomers and diastereomers.
13- C
Comments: Geometric isomers may be classified as CIS and TRANS depending the
spatial position of the molecule around a bond with restricted rotation. 2-Butene is an
example of molecule having geometric isomerism.
14- A
Comments: Equatorial-equatorial is a structural formation of a molecule occurring at the
same distance from each extremity of an axis.
15- B
Comments: Choracetic acid is stronger than acetic acid due to higher molecular weight
16- D
Comments: Nifedipine is calcium channel blocker that has 1,4-dihydropyridine on its
structure responsible for its mechanism of action.
17- A
Comments: Vitamin K has a quinolone on its molecular structure.
18- E
Comments: As much higher is the pKa of the drug stronger will be the acid.

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19- D
Comments: Most of the steroid compounds have three cyclohexanes and one
cyclopentane ring on their molecular structure.
20- B
Comments: Glucuronidation is the main reaction of phase II metabolism reactions, and
are responsible mainly for the metabolism of drugs having hydroxyl, carboxyl and amide
group on their molecular structure.
21- C
Comments: Chloracetic acid is one of the strongest acids due to its molecular structure.
22- A
Comments: Amides and esters are the only groups undergoing hydrolysis.
23- D
Comments: Phenol is a weak acid due to stable anion resonance
24- E
Comments: Molecules may be classified as more or less water-soluble depending in the
presence of hydrogen and oxygen. Less hydrogen molecules and more oxygen molecules
increase the water solubility of the compound or substance.
25- B
Comments: Diastereomers must have more than one stereogenic center and are not
mirror image, they have superimposed image.
26- B
Comments: R-COOH is an acid while R-OH is not due to presence of stable anionic
resonance, an indication of the extent of activity of free radicals in an organic reaction.
27- D
Comments: pH is the measure of the acidity or basicity of a solution that is calculated
mathematically as the negative log of the H+ concentration
28- C
Comments: NH4+ + OH H2O + NB3 is an example of neutralization
reaction.
29- C
Comments: Bioisosters are functional group or atoms that impact similar physical and
chemical properties on biological activity of molecule.
30- A

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Comments: The molecular structure of isotretinoin, used in oral treatment of acne is 13CIS Retinoic acids. The TRANS molecular structure is only used in topical preparations.
31- B
Comments: The analgesic activity of morphine is dependent of p-phenyl-Nalkylpiperidine
32- D
Comments: Clonidine is an antihypertensive drug that depends of its imidazoline
molecular structure to be effective.
BIBLIOGRAPHIC REFERENCE
1- COMPREHENSIVE PHARMACY REVIEW Lippincott William & Wilkins
Fourth edition
2- CPS-COMPENDIUM OF PHARMACEUTICALS AND SPECIALITIES - Canadian
Pharmacist Association 2001 edition.
3- MEDICAL DICTIONARY Dorlands illustrated 27th edition.
4- PHARMACY PREP Lectures series & study guide for Evaluating ExaminationTIPS - 2003/2004
5- THERAPUTIC CHOICES Canadian Pharmacist Association -Third edition
6- USP DI Drug Information for the Health Care Professional15th edition Volume I

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NERVOUS SYSTEM
1- Which of the following cytochrome is mainly the benzodiazepinic action?
a) 1A2
b) 3A4
c) 2D6
d) 2C9
e) 3C2
2- When the use of MAO antidepressant is associated with some medications cause a
serotonergic syndrome, an example of class of medication that normally cause this
syndrome
a) Tricycle antidepressants
b) Birth control pills
c) -Blockers
d) Digitalis
e) H1 inhibitors
3.Scabies preferred treatment in pregnancy, lactation and children less than two months
old;
I.Permethrin 5%
II.Lindane
III.Precipitated sulfur 6% in petrolatum
A.I only
B.III only
C.I and II only
D.II and III only
E.All of the above
4- Which of the following is not a side effect of an opioid analgesic for example
morphine:
a) C.V depression
b) Constipation
c) Sedation
d) CNS depression
e) Dilatation of eye pupil
5- Example of peptide neurotransmitter that binds to opioids receptors include:
a) Acetylcholine
b) Norepinephrine
c) Epinephrine
d) Enkephalins
e) GABA

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6- Alzheimer is a progressive disease characterized by relentless and loss of mental


function due to lack of:
a) Thiamine
d) Dopamine
c) Acetylcholine
d) Norepinephrine
e) Serotonin
7.Topical yeast preparations may be necessary in a diaper dermatitis that has been
ongoing for more than three days since it is likely colonized with Canadida and may need
preventative anti yeast therapy. What are the topical anti yeast preparation causes stains:
I.miconozole 1%
II.Clotrimazole 2%
III.Nystatin
A.I only
B.III only
C.I and II only
D.II and III only
E.All of the above
8- CNS depressant that cause retinal damage (ocular damage) include:
a) Ethanol
b) Alcohol
c) Methanol
d) Propylalcohol
e) Isopropylalcohol
9- Thiopental is used in anesthesia due to high distribution in body tissues and fast onset
of action, we can classify thiopental as:
a) General anesthetic
b) Local anesthetic
c) Opiate
d) Barbiturate
e) Benzodiazepinic
10- Which of the following agents may be used as thiopental antagonist?
a) Flumazenil
b) Naloxone
c) Naltrexone
d) Atropine
e) Aminophilin
11- Which of the following is not classified as SSRIs antidepressant?
a) Fluoxetine
b) Phenelzine
c) Paroxetine
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d) Citalopram
e) Sertraline
12- The effect of inhalation anesthesia may be determined by:
I- Concentration of the drug in the alveolar airway
II- MAC-Minimum Alveolar Concentration
III- Inhalation anesthesia in not used in children
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
13- Sumatriptan is widely used in migraine treatment acting on:
a) 5HT1D/1B agonist
b) 5HT1D/1B antagonist
c) 5HT2 agonist
d) Enkephalin
e) Dopamine
14- Benztropine is used in treatment of extra pyramidal syndrome acting as:
a) Cholinergic
b) Anticholinergic
c) Dopaminergic
d) Dopamine antagonist
e) Serotoninergic
15- Correct statements regarding chlorpromazine may include:
I- A phenothiazine anti-psychotic drug
II- Long-term treatment produces tardive dyskinesia
III- Contra indicated in Parkinsons disease because decrease dopamine.
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
16- Benzodiazepinics as antianxiety agent action:
I- Enhance GABA transmission
II- Act on GABA-A
III- Binds with BZ1 and BZ2 receptors
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
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17- Agent classified as short acting antidepressant may include:


a) Lorazepan
b) Amitriptiline
c) Fluoxetine
d) Trazodone
e) Citalopram
18- Toxin that inhibit sodium sensitivity channels may include:
a) Tetrodotoxin
b) Bungarotoxin
c) Botulism toxin
d) Edrophonium
e) None of the above
19- Drug considered as the drug of choice in the treatment of status epileptics include:
a) Oral diazepam
b) Diazepam IV
c) Carbamazepine IV
d) Oral phenytoin
e) Clorazepate IV
20- Examples of drug(s) used in petit mal epilepsy treatment may include:
I- Valproic acid
II- Gabapentin
III- Diazepam
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
21- Dopamine deficiency in the nigrostriatal pathway cause:
a) Alzheimers disease
b) Parkinsons disease
c) Schizophrenia
d) Serotoninergic syndrome
e) Seizures
22- Characteristics regarding Parkinsons disease may include which of the following?
I- Primary: Loss of substantia nigra neurons
II- Secondary: Loss or interference in the action of dopamine in the basal gland
III- Secondary Parkinson may be the results of long-term treatment with anti-psychotic
drugs
a) I only
b) III only
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c) I and II only
d) II and III only
e) All are correct
23- Parkinsons disease may be treated with all of the following agents, EXCEPT:
a) Amantadine
b) Selegiline
c) Pergolide
d) Levodopa
e) Donezepil
24- The action of acetylcholine in the motor endplates and in the celiac ganglia is
described as:
a) Nicotinic stimulation
b) Muscarinic stimulation
c) Dopaminic stimulation
d) Adrenergic stimulation
e) Serotonine stimulation
25- Correct statements regarding schizophrenia may include:
I- Characterized by long term-standing paranoid delusion
II- Treated by anti-psychotic medication
III- Onset of age incidence is normally in later 20s early 30s.
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
26- Which of the following factors would be important in determining the concentration
of drug that would be reached in the cerebrospinal fluid for treatment of meningitis
I- Oil/Water partition coefficient
II- Plasma binding protein
III- pKa of the drug
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
27- Select the drug whose major metabolites have therapeutically significant
pharmacological activity
a) Oxazepan
b) Nitrazepan
c) Diazepan
d) Triazolan
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e) Clonazepan
28.Leukotriene modifiers, zafirleukast indicated in long term care or mild asthma
symptoms over 15 years of age patient; zafirleukast administration with meals:
I.Decreases bioavailability
II.Take atleast 1 hour before and 2 hours after meals
III.Increases bioavailbility
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
29- Drug commonly used with local anesthetic to decrease the absorption and increase
the time of action of anesthesia include:
a) Epinephrine
b) Adrenaline SC
c) Isoproterenol
d) Aminophiline
e) Salmeterol
30- The mechanism of antipsychotic effect of phenothiazines is thought to:
a) Improvement of cholinergic transmission
b) Blockage of catecholamines re-uptake
c) Blockage of dopamine receptors
d) Blockage of enkephalinergic neurons
e) Prolactin release
31- Correct statements regarding codeine may include:
I- Used as antitussive especially in children not less than 2 years old
II- Opiod analgesic
III- Cause extreme addiction and drug dependency
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
32- Pilocarpine normally used in the treatment of glaucoma may cause which of the
following effects?
I- Mydriasis effect
II- Cholinergic drug
III- Miosis effect
a) I only
b) III only
c) I and II only
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d) II and III only


e) All are correct
33- Correct statements regarding carbidopa + levodopa include:
I- Used as drug of choice in Alzheimers disease
II- Carbidopa inhibit dopa-decaboxylase enzyme allowing levodopa reach the brain
without suffer alterations
III- Levodopa is a pro-drug that can cross blood brain barrier
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
34- Mechanism of action of levodopa may include:
a) Inhibit the dopamine re-uptake
b) The small amount that reaches the brain is decarboxylated to dopamine
c) Inhibit dopa-decarboxylase enzyme increasing the levels of dopamine
d) Inhibit the action of dopamine
e) Improve the balance between cholinergic and dopaminergic activity resulting in an
increased level of acetylcholine
35- Tardive dyskinesia is mainly characterized by an involuntary movement of mouth
and tongue that can be a side effect of long term treatment with:
a) Phenothiazine
b) Chlorpromazine
c) Dopamine antagonist drugs
d) Antispychotic drugs
e) All are correct
36- Competitive non-depolarizing neuromuscular blocker may include:
a) Pancuronium
b) Succinylcholine
c) Nicotine
d) Bungarotoxin
e) Tetradotoxin
37- Correct statements regarding succinylcholine may include which of the following?
I- Non-competitive depolarizing neuromuscular blocker
II- Used in general anesthesia providing skeletal relaxation
III- It is a sympathetic agent
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
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38- Examples of drug(s) that may cause secondary-Parkinsons disease include:


a) Haloperidol
b) Phenothiazines
c) Chlorpromazine
d) Clozapine
e) All can cause secondary Parkinsons disease
39- Opioids may be used as all the following agents, EXCEPT:
a) Antitussive
b) Analgesic
c) Antidiarrhea
d) Anti-inflammatory
e) Pre-anesthetic
40- Which of the following is the strongest morphine analog opioid agent?
a) Methadone
b) Heroin
c) Codeine
d) Hydrocodone
e) Oxycodone
41- Which of the following opioids can be used as antidiarrheal agent?
a) Diphenoxylate
b) Butorphanol
c) Propoxyphene
d) Pentazocine
e) Methadone
42- Morphine may be used in adjunct treatment of which of the following conditions?
a) Increase intracranial pressure
b) High blood pressure
c) Emphysema
d) Asthma
e) Pulmonary edema secondary to left ventricular failure
43- Anticholinergic drugs may be used to treat which of the following conditions?
I- Parkinsons disease
II- Spasms and ulcers
III- Organophosphates overdose
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
44- Example of antianxiety drug with great antihistaminic effect may include:
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a) Diazepan
b) Hydroxazine
c) Memprobamate
d) Chlorodiazepoxide
e) Oxazepan
45- For a sympathomimetics drug to be effective it should:
I- Fits in receptor
II- Bind to plasma proteins
III- Compete at the site where the neurotransmitter is released
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
46- Damage of the auxiliary nerve is thought to produce:
a) Paralysis of the 5th finger
b) Impaired sensation
c) Numbness of extremities
d) Inability to bend the elbow
e) Paralysis of hand
47- A hypertensive patient suffering from depression can be taking all of the following,
EXCEPT:
a) Clonidine
b) Methyldopa
c) Reserpine
d) Guanithidine
e) Hydralazine
48- Drug considered as the drug of choice in the treatment of bipolar-maniac depression
may include:
a) Carbamazepine
b) Lithium
c) Phenytoin
d) Diazepam
e) Valproic acid
49- Which of the following vitamins accelerate the metabolism of phenytoin?
a) Vitamin A
b) Vitamin B
c) Vitamin C
d) Folic acid
e) Vitamin E

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50- Drugs classified as long acting benzodiazepinic include:


a) Diazepam
b) Lorazepan
c) Triazolan
d) Alprazolan
e) Temazepan
51- Drugs classified as intermediate acting benzodiazepinic include:
a) Triazolan
b) Midazolan
c) Diazepan
d) Lorazepan
e) Oxazepan
52- All the following are examples of long acting benzodiazepinic, EXCEPT:
a) Clonazepan
b) Diazepam
c) Chlorazepate
d) Flurazepan
e) Temazepan
53- Chemical mediator that is released from the end nerve of sympathetic system:
I- Adrenaline
II- Noradrenaline
III- Acetylcholine
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
54- Chemical mediator that is released from the end nerve of parasympathetic system:
I- Adrenaline
II- Noradrenaline
III- Acetylcholine
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
55- One of the major inhibitory neurotransmitter in the brain and mediates include:
a) GABA
b) Serotonin
c) Acetylcholine
d) Enkephalin
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e) Epinephrine
56- Which of the following may stimulates adrenaline release from adrenal medulla?
a) Acetylcholine in very low doses
b) Nicotine in very low doses
c) Bilirrubine
d) Noradrenaline
e) None of the above
57- Tolerance of narcotics is normally characterized by which of the following
statements?
I- Decrease duration of analgesia
II- Decrease sensitivity to receptors
III- The dose should be first adjusted instead to change for a stronger narcotic.
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
58- All are examples of amides local anesthetics, EXCEPT:
a) Mepivacaine
b) Bupivacaine
c) Lidocaine
d) Procaine
e) Prilocaine
59- Which of the following anesthetics metabolites is characterized by its PABA
structure?
a) Amides local anesthetics
b) Ester type local anesthetics
c) All local anesthetics
d) All general anesthetics
e) Lidocaine
60- The CNS Central Nervous System is mainly constituted of:
I- Brain
II- Spinal cord
III- Thoracic Lumbar
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
61- All the following group of drugs have direct action on CNS, EXCEPT:
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a) Cardiotonics
b) Analgesics
c) Anesthetics
d) Antidepressives
e) Antipsychotics
62- All of the following are important neurotransmitters, EXCEPT:
a) Acetylcholine
b) Dopamine
c) Norepinephrine
d) Muscarinic-M1
e) Serotonin
63- Catecholamines neurotransmitter may include:
I- Dopamine
II- Norepinephrine
III- Epinephrine
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
64- Agents well known as precursor of dopamine include:
a) Epinephrine
b) Tyrosine
c) Tyramine
d) Norepinephrine
e) Thiamine
65- Reaction that converts norepinephrine to epinephrine is normally called:
a) Chatecholinization
b) Methylation
c) Oxidation
d) Deamination
e) Glutathione conjugation
66- Neurotransmitter with an indole group in its structure include:
a) Serotonin
b) Acetylcholine
c) Histamine
d) Dopamine
e) PABA
67- Example of amino acid neurotransmitter may include:
a) Tyrosine
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b) Thiamine
c) Histamine
d) Glycine
e) Glutamate
68- Examples of cholinergic neuroreceptors may include:
I- Muscarinic receptors
II- Nicotinic receptors
III- Serotoninergic receptors
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
69- The major dopaminergic receptor that controls the extrapyramidal system include:
a) D1
b) D2
c) D3
d) D4
e) D5
70- Which of the following is an example of pure narcotic antagonist?
a) Pentazocine
b) Butorphanol
c) Naltrexone
d) Naloxone
e) C and D are pure narcotic antagonists
71- Example of opioid used in the treatment of alcoholism include:
a) Morphine
b) Naloxone
c) Hydrocodone
d) Naltrexone
e) Codein
72- Opioid widely used during labor due to its less liability to induce neonate respiratory
depression include:
a) Meperidine
b) Morphine
c) Methadone
d) Fenthanyl
e) Oxycodone
73- Intense pruritus and vasodilatation are side effects of classic opioids due to
stimulation and release of:
a) Adrenaline
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b) Histamine
c) Serotonin
d) Mu receptors
e) Histadine
74- Examples of neurotransmitters used by barbiturates drugs include:
I- Benzodiazepinics neurotransmitters
II- GABA
III- Glycine neurotransmitters
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
75- Primidone is a prodrug that when biotransformed become:
a) Carbamazepine
b) Risperidone
c) Phenobarbital
d) Lorazepan
e) Phenytoin
76- MAO-Monoamine Oxidase inhibitor increases the bioavailability of biogenic amines
and are mainly used to treat depression. A classic example of MAO is:
a) Doxepine
b) Reserpine
c) Venlafaxine
d) Desipramine
e) Phenelzine
77- Example of less sedating TCAs-Tricyclic Antidepressants include:
a) Desipramine
b) Clomipramine
c) Amitriptiline
d) Imipramine
e) Nortriptiline
78- Tricyclic antidepressant with effect in serotonin system used to treat maniac
compulsive disorders include:
a) Lithium
b) Phenelzine
c) Clomipramine
d) Desipramine
e) Nortriptiline
79- Which of the following is a wrong statement regarding lithium?
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a) Most effective psychiatric medication used to treat bipolar depression


b) Interfere with trans membrane Na exchange
c) Takes 2 to 3 weeks to start to show pharmacological effect
d) Weight gain and weight loss is a side effect of lithium therapy
e) Blood levels less than 1.5mEq/L cause over dose symptoms.
80- Antipsychotic drugs are effective in treating all of the following conditions,
EXCEPT:
a) Bizarre behavior
b) Dellutions and hallucinations
c) Schizophrenia
d) Parkinsons disease
e) Alzheimers disease
81- Mechanism that best describe the action of general anesthetics include:
a) Reversible block nerve impulse conduction
b) Reversible loss of sensation at their administration site
c) Binds to specific membrane Na ion, restricting Na permeability in response to partial
depolarization
d) Inhibit sensory, autonomic reflex and skeletal muscles inducing analgesia, amnesia
and loss of consciousness
e) Do not produce loss of consciousness
82-Mechanism of action of local anesthetics may include:
a) Reversible block nerve impulse conduction
b) Reversible loss of sensation at their administration site
c) Binds to specific membrane Na ion, restricting Na permeability in response to partial
depolarization
d) Do not produce loss of consciousness
e) All are correct
83- Example of general anesthetic with malignant hyperthermia as side effect include:
a) Isoflurane
b) Halothane
c) Sevoflurane
d) Nitrous oxide
e) Fentanyl
84- Volatile liquid general anesthetic that is more recommended to be used in children
include:
a) Halothane
b) Sevoflurane
c) Isoflurane
d) Enflurane
e) Nitrous oxide

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85- Endorphins may be classified as which of the following?


a) Endogenous neurotransmitter
b) A new class of topical anti-inflammatory agents
c) Neuromuscular blocking agents
d) Biogenic amines believed to cause schizophrenia
e) Endogenous opioid peptides
86- Example of MAO-B inhibitor used to treat Parkinsons disease include:
a) Hydralazines
b) Phenelzine
c) Selegeline
d) Clomipramine
e) Levodopa
87- Characteristics of agonist drugs may include which of the following statements?
a) Bind to a receptor site and produces 100% of biological response
b) Bind to a receptor site but do not produces 100% of the biological response
c) Bind to a receptor site and produces 100% biological response only when given in high
doses
d) Bind to receptor site and block the biological response
e) Bind to the receptor site and block the biological response in 50%
88- Drug dosages that can kills 50% of the experimental animals receiving the drug is
called:
a) Effective dose
b) Minimum dose effect
c) Lethal dose
d) Maximum dose effect
e) Therapeutic index
89. Inhaled carticosteroids indicated in asthma long term prevention symptoms,
suppression, control of inflammation: space/holding chamber devices and mouth washing
after inhalation.
I.Decreases local side effects
II.Decrease systemic absorption
III.Increases systemic absorption
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
90- The action of acetylcholine released from parasympathetic fibers in visceras are
mediated by which receptor?
a) Muscarinic
b) Nicotinic
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c) Adrenergic
d) Dopaminic
e) Serotonergic
91- Which of the following neurotransmitter is used by all preganglionic fibers of the
autonomic nervous system?
a) Dopamine
b) Acetylcholine
c) Epinephrine
d) Norepinephrine
e) GABA
92- The major neurotransmitter for sympathetic postganglionic fibers is known as:
a) Dopamine
b) Acetylcholine
c) Epinephrine
d) Norepinephrine
e) GABA

93- Stimulation of blood vessels by 1-receptors may causes:


a) Dilation
b) Constriction
c) Increase in blood flow
d) Vasodilatation
e) All are wrong
94- The peripheral nervous system is anatomically divided in:
I- Somatic Nervous System
II- Autonomic Nervous System
III-Spinal cord
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
95- Part of nervous system responsible for body homeostasis:
a) Central Nervous System
b) Somatic Nervous System
c) Spinal cord
d) Autonomic nervous system
e) Brain
96- Acetylcholine is an ester neurotransmitter synthesized from:
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a) Gluthamine
b) Tyrosine
c) Acetyl CoA
d) Dopa
e) Cathecolamines
97- Nicotinic receptors are mainly found in:
I- Motor end plate
II- Adrenal medulla
III-Autonomic ganglia
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
98- Prototype of muscarinic antagonist class of drugs:
a) Atropine
b) Scopolamine
c) Ipratropium
d) Benztropine
e) Oxybutynin
99- Botulism toxins are used in the treatment of prolonged muscle spasm where a small
amount of the toxin is injected directly into a muscle fiber, causing the muscle to relax.
What is the action of botulism toxins in acetylcholine?
a) It blocks the release of acetylcholine
b) It increase the release of acetylcholine
c) It inhibit the nicotinic receptors
d) It stabilizes the serum acetylcholine
e) It increase the action of acetylcholine
100- Malignant hyperthermia can be a side effect of general anesthetics and may be
treated by:
a) Aminophillin
b) Terbutaline
c) Dantrolene
d) Pancuronium
e) Dobutamine
101- Which of the following antianxiety agents causes the least sedation?
a) Diazepan
b) Buspirone
c) Chlordiazepoxide
d) Oxazepan
e) Chlorazepate
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102-What is drug of choice in Petit-mal seizure?


A-Diazepam
B-Phenytoin
C-Carbamazepine
D-Valproic acid and ethosuximide
E-Gabapentin
Ans-D
103-Valproic acid is used in treatment of
a- Petit-mal
b- Grand-mal
c- Fabrile seizure in children
d- All of the above
e- A and C only
Ans-D
104-Anticonvulsive agent that cause kidney stones?
A-Topiramate
105-Phenytoin causes elevation of blood glucose levels by?
A-Increasing insulin degradation
B-Decreasing insulin release
C-Increasing glucose absorption
D-increasing glycogen release
Ans-B
106-Side effects of phenytoin are?
A-Gingival hyperplacia
B-Steven Jhonson syndrome
C-Hirsutism
D-All of the above
E-A and C
Ans-D
107-Epilepsy cause due to deficiency of?
A-Sodium ion
B-GABA
C-Serotonin
D-Dopamine
E-Acetyl choline
Ans-B
108-Early symptoms of epilepsy are?
A-Part of brain is involved
B-Sensory seizure or focal motor seizure
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C-Patient is conscious
D-All of the above
Ans-D
109-Which one of the following CNS receptors is directly coupled to an ion channels,
and this do not involve secondary messenger system?
A-Alpha (NE)
B-D2 (DA)
C-Ach (N)
D-5HT (serotonin)
E- None of the above
Ans-C
Tips; Ach receptors, in the CNS are present on less than 5% of the neuronal population.
110-All of the following are antimuscarinic drugs that are used in treatment of
antipsychotic induced parkinsonism, Except:
A-Benzotropin
B-Trihexphenidyl
C-Bromocriptine
D-Diphenhydramine
E-Procyclidine
111-What type of local anesthetic is the most effective?
A-The most hydrophilic
B-The most lipophilic
C-The least hydrophilic
D-The least lipophilic
Ans-B
112-Metabolism of local anesthetic takes place in?
A-Skin
B-Tissue
C-Liver
D-Gut
E-Local area
Ans-C
CORRECT ANSWERS
NERVOUS SYSTEM
1- B
Comments: Generally benzodiazepinics binds to the most abundant cytochrome P-450 in
the body: 3A4.
2- A

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Comments: - Serotoninergic syndrome is characterized by agitation, neuromuscular


rigidity, hypotension, coma and death. It mainly happens with the concomitant use of
MAO antidepressant with other medication that also have interference in the serotonin
neuroreceptors an example of drugs that may cause this syndrome is clomipramine,
meperidine and Selective serotonin re-uptake inhibitors antidepressives.
3- B
Comments: Scabies preferred treatment in pregnancy, lactation and children less than two
months old is Precipitated sulfur 6% in petrolatum. Pemethrin 5% is currently preferred
treatment for adults and children older than two months. Lindane 1% has convulsions as
side effect.
Ref: Patient Selfcare, P.613 1st edition, CPhA, Canada
4- E
Comments: Morphine causes a miosis side effect therefore diminishes eye pupil.
5- D
Comments: Enkephalins are pentapeptides that bind to opioid receptors. They act as
neurotransmitter or neuromodulators at many locations in the brain and spinal cord and
play a part in pain perception, movement, mood, behaviour and neuroendocrine
regulation.
6- C
Comments: Comments: Alzheimers is a progressive disease characterized by a
imbalance of acetylcholine and dopamine, low levels of acetylcholine and high levels of
dopamine.
7- B
Comments: Nystatin known to cause staining
8- C
Comments: Methanol when is metabolized form formaldehyde that is a very toxic
substance causing retinal damage.
9- D
Comments: Thiopental is a barbiturate mainly used as adjunct in general anesthesia.
10- E
Comments: Aminophillin is considered the thiopental antagonist drug.
11- B
Comments: Phenelzine is a MAO-Monoamino Oxidase inhibitor antidepressant.
12- C

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Comments: Inhalation anesthesia is the most used method of general anesthesia for
children
13- A
Comments: Sumatriptan activate serotonin receptors-5HT1B/1D agonists. It is used in the
abortive treatment of migraine.
14- B
Comments: Benztropine is a parasympathetic anti-cholinergic agent used specifically in
the treatment of extra pyramidal syndrome-Parkinsons disease.
15- E
Comments: Chlorpromazine is a phenothiazine anti-psychotic drug completely contra
indicated in Parkinsons disease because decrease dopamine levels and may cause tardive
diskinesia, abnormal movements of tongue and mouth, as side effect of its long-term
therapy.
16- C
Comments: Benzodiazepinics bind to GABA-A and enhance its transmission.
17- D
Comments: Trazodone is the shortest acting antidepressant agent.
18- A
Comments: Tetradotoxin is a toxin that inhibits sodium sensitivity channels.
19- B
Comments: Diazepan IV is the most appropriate drug in treating status epileptics due to
its fastest onset of action.
20- A
Comments: Valproic acid is the drug of choice in the treatment of petit-mal epilepsy.
Phenobarbital and clonazepan are also used.
21- B
Comments: Parkinsons disease is mainly caused by hypofunction of nigrostriatal
pathway resulting in decrease of dopamine levels and increase of acetylcholine levels.
22- E
Comments: Parkinsons disease is characterized by a decrease in dopamine levels causing
tremors and muscular rigidity among other symptoms. It can be classified as primary,
when occurs loss of substantia nigra neurons and secondary, when occurs loss or
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interference in the action of dopamine in the basal gland, normally due to drug induction
as per example long-term treatment with anti-psychotic drugs.
23- E
Comments: Donezepil is used in the treatment of Alzheimers disease and it is completely
contra-indicated in Parkinsons because of decrease in dopamine levels.
24- A
Comments: Nicotinic receptors are found at the motor end plate, in all autonomic ganglia
and in the adrenal medulla.
25- E
Comments: Schizophrenia is a mental disorder characterized by disturbances in form and
content of thought, delusions, hallucinations, mood disorder, loss of sense of self and
relationship to the external world and behavior. Antipsychotic drugs mainly treat it.
26- E
Comments: Oil/Water partition coefficient is one of the most important considerations
when choosing a drug for treatment of meningitis because completely water-soluble
drugs cannot cross blood brain barrier. As much the drug is bound to plasma protein less
drug will reach the site of action. PKa of the drug is other very important factor to be
considered when determining the concentration of drug that would reach the
cerebrospinal fluid
27- C
Comments: Diazepan metabolites have therapeutically significant pharmacological
activity.
28- C
Comments: Zafirleukast with meals deccreases bioavailability.
29- A
Comments: Epinephrine is a vasoconstrictor used in adjunct with local anesthesia to
increase the duration of action of local anesthetic agents.
30- C
Comments: Antispychotic drugs are used to reduce the intensity and frequency of
psychotic symptoms. They act primarily by blocking dopamine receptors.
31- C
Comments: Codeine is not a strong opioid analgesic. It is classified as moderate.
Although it may cause addiction as most of all opioids, codeine is not well known as a
drug that causes extremely dependency or strong drug dependency.
32- D
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Comments: Pilocarpine is a parasympathetic cholinergic agent that causes miosis.


33- D
Comments: Carbidopa + Levodopa is the drug of choice in the treatment of Parkinsons
disease, levodopa when used alone loss part of its action due suffer decarboxylation from
dopa-decarboxylase enzyme, thus carbidopa is used in combination to inhibit dopadecarboxylase enzyme allowing levodopa reach the brain without suffer alterations
34- B
Comments: Levodopa is a prodrug that cross blood brain barrier however it loss most of
its action in the way to reach the brain crossing blood brain barrier just a small amount of
the drug that is decarboxylated to dopamine.
35- E
Comments: Tardive dyskinesia is mainly characterized by an involuntary movement of
mouth and tongue that can be a side effect of long-term treatment with phenothiazines,
dopamine antagonist drugs and other antispychotic drugs.
36- A
Comments: Pancuronium is a nicotinic antagonist neuromuscular junction blocker acting
as competitive non-depolarizing agent.
:
37- C
Comments: Succinylcholine is a nicotinic antagonist neuromuscular junction blocker
acting as non-competitive depolarizing agent. It is mainly used as adjunct in general
anesthesia providing skeletal relaxation.
38- E
Comments: Secondary Parkinsons disease can be induced by most of antipsychotic drugs
due to decrease in dopamine levels by the blockage of dopamine neurotransmitters.
39- D
Comments: Opioids have no action as anti-inflammatory agents.
40- B
Comments: Heroin is the strongest morphine analog.
41- A
Comments: Diphenoxylate, well known as lomotil, and loperamide are opioids used in
the treatment of diarrhea.
42- E
Comments: Morphine also may be used in adjunct treatment of pulmonary edema
secondary to left ventricular failure.

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43- E
Comments: Anticholinergic drugs as benztropine can be used to treat Parkinsons disease.
Scopolamine another anticholinergic drug is used to treat spasms and ulcers and atropine,
the anticholinergic prototype can be used to treat organophosphates overdose, so all are
correct answers.

44- B
Comments: Hydroxazine is an antianxiety drug with great antihistaminic effect
45- A
Comments: One of the most important considerations in the effectiveness of a drug is fit
it into receptor to produce the biological or pharmacological response.
46- D
Comments: Damage of the auxiliary nerve will lead to inability to bend the elbow.
47- C
Comments: Reserpine is used in the treatment of hypertension and should be avoid in
patients suffering depression because it acts depleting tissues and central nervous system
stores of catecholamines and serotonin.
48- B
Comments: Lithium is the most effective psychiatric medication used to treat bipolar
depression disorder
49- D
Comments: Phenytoin deplete the body of folate stores, supplementation with folic acid
may result in lowered serum phenytoin concentration and possible loss of seizure control,
therefore, an increase in phenytoin dosage is necessary in patients who receives folate
supplementation.
50- A
Comments: Diazepan is one of the longest acting benzodiazepinic with duration of action
up to 48 hours.
51- D
Comments: Intermediate acting benzodiazepinics include: Alprazolan, bromazepan,
lorazepan and temazepan.
52- E
Comments: Temazepan is an intermediate acting benzodiazepinic.
53- C

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Comments: Noradrenaline and adrenaline are chemical mediator that are released from
the end nerve of sympathetic system
54- B
Comments: Acetylcholine is the only chemical mediator that is released from the end
nerve of parasympathetic system
55- B
Comments: GABA is a neurotransmitter permeable to Cl ions and the major inhibitor of
Central Nervous System.

56- B
Comments: Nicotine in low doses stimulates the release of adrenaline from adrenal
medulla.
57- E
Comments: Tolerance of narcotics results in a decrease of sensitivity to receptors and
therefore decreases in the duration of analgesia.
58- D
Comments: Procaine is an ester local anesthetic.
59- B
Comments: Ester local anesthetics have similar structure with GABA neurotransmitter.
60- C
Comments: Thoracic lumbar is part of peripheral nervous system.
61- A
Comments: Cardiotonics interfere with autonomic-peripheric nervous system.
62- D
Comments: Muscarinic-M1 is a cholinergic neuroreceptor, not neurotransmitter.
63- E
Comments: Dopamine, epinephrine and norepinephrine are catecholamines
neurotransmitters due the presence of a catecholamine group on their molecular structure.
64- B
Comments: Tyrosine is the precursor of dopamine.

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65- B
Comments: Norepinephrine is converted to epinephrine through mediation of phenylethanol-amine-methyl transferase enzyme by a reaction called methylation.
66- A
Comments: Serotonin is 5HT-5-Hydroxyl-Tryptamine permeable to Na and K ions with
an indole group on its molecular structure.
67- D
Comments: Glycine is the only amino acid neurotransmitter.
68- C
Comments: Cholinergic neuroreceptors include only muscarinic and nicotinic receptors.
69- B
Comments: D2 dopamine neuroreceptor is the one responsible for the control of extrapyramidal syndrome.
70- E
Comments: Pentazocine and buthorphanol are mixed agonist and antagonist agents
therefore cannot be considered pure as naltrexone and naloxone.
71- D
Comments: Naltrexone is given orally in the treatment of alcoholism.
72- A
Comments: Meperidine is the opioid analgesic of choice administrated during labor due
to its less liability to induce neonate respiratory depression.
73- B
Comments: Classic opioid can prompt the release of histamine causing intense pruritus
and vasodilatation. The best example for these symptoms is morphine.
74- D
Comments: Barbiturates use glycine and GABA neurotransmitters. Benzodiazepinic
neurotransmitters are the use exclusive of benzodiazepinic drugs.
75- C
Comments: Primidone is a barbiturate prodrug that when biotransformed in the body
become Phenobarbital, the longest acting barbiturate.
76- E
Comments: Phenelzine is a hydralazine monoamine oxidase inhibitor used to treat
depression.
77- A
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Comments: Desipramine is the least sedating tricyclic antidepressant while amitriptiline is


the most sedating one.
78- C
Comments: Clomipramine enhance the action of biogenic amines by inhibiting their reuptake. It also exert action on serotonin system, therefore it may be used to treat maniac
compulsive disorders.
79- E
Comments: Main side effects of lithium therapy include: Loss of appetite, nausea, mild
diarrhea, dizziness, tremors, excessive urination, thirst and diabetes insipidus.
80- D
Comments: Antipsychotic drugs act by blocking dopamine receptors; therefore they
cannot be used to treat Parkinsons disease that is already characterized by decrease in
dopamine levels.
81- D
Comments: General anesthetics induce a combined state of analgesia, amnesia, loss of
consciousness, inhibition of sensory and autonomic reflex and skeletal muscle relaxant.
82- E
Comments: Local anesthetics reversible block nerve impulse conduction producing
reversible loss of sensation only at administration site, therefore they do not produce loss
of consciousness.
83- B
Comments: Halothane is a volatile liquid used in inhaled anesthesia and may cause
malignant hyperthermia.
84- A
Comments: Halothane is the most recommended general anesthetic in the anesthesia
induction of children.
85- E
Comments: Endorphin are opioids endogenous neurotransmitters.
86- C
Comments: Selegeline is the only MAO-B used in the treatment of Parkinsons disease. It
blocks the central catabolism of dopamine; it is indicated in the early stage of Parkinsons
and in adjunct of levodopa treatment.
87- A
Comments: An agonist drug is a compound that binds to a receptor and produces the
biological response.

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88- C
Comments: The lethal dose is the dose that kills 50% of the animals that receive it. The
lethal dose is mainly compared with the effective dose to determine the therapeutic
window of a drug. Effective methodology in determining both the range of effective drug
concentration and the safety of the drug.
89- C
Comments: Decrease local side effect, and systemic absorption
90- A
Comments: All of the parasympathetic postganglionic fibers release acetylcholine. At the
target organ acetylcholine interacts with muscarinic receptors.
91- B
Comments: All preganglionic neurons release acetylcholine as their transmitter. The
acetylcholine binds to nicotinic receptors on the postganglionic cell.
92- D
Comments: Most of the sympathetic postganglionic fibers release norepinephrine. At the
target organ norepinephrine interacts with a variety of receptors.
93- B
Comments: Activation of alpha-receptors causes contraction or constriction, mostly
vasoconstriction.
94- C
Comments: Spinal cord is a part of central nervous system.
95- D
Comments: The autonomic nervous system is responsible for maintaining the internal
environment of the body called homeostasis.
96- C
Comments: Acetylcholine is synthesized from acetyl coenzyme A (acetyl CoA) and
choline. It is action is terminated by acetylcholinesterase.
97- E
Comments: Nicotinic receptors are found at the motor end plate, in all autonomic ganglia,
and in the adrenal medulla.
98- A
Comments: Atropine is the prototype of parasympathetic anticholinergic group of drugs.
99- A
Comments: Botulism toxins prevent and/or completely block acetylcholine release.

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100- C
Comments: Dantrolene may be used in the treatment of malignant hyperthermia, a side
effect associated with the use of general anesthetics.
101- B
Comments: Buspirone is an atypical anxiolitic agent that binds to dopamine and
serotonin. It is very well preferred when compared with other anxiolitic agents due to its
least side, non-drowsiness, no addiction and no CNS depressant activity.

BIBLIOGRAPHIC REFERENCE
1- COMPREHENSIVE PHARMACY REVIEW Lippincott William & Wilkins
Fourth edition
2- CPS-COMPENDIUM OF PHARMACEUTICALS AND SPECIALITIES - Canadian
Pharmacist Association 2001 edition.
3- MEDICAL DICTIONARY Dorlands illustrated 27th edition.
4- PHARMACY PREP Lectures series & study guide for Evaluating ExaminationTIPS - 2003/2004
5- THERAPUTIC CHOICES Canadian Pharmacist Association -Third edition
6- USP DI Drug Information for the Health Care Professional15th edition Volume I.

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Medicinal Chemistry of autocoids and analgesics

PHARMACY PREP
MEDICINAL CHEMISTRY OF AUTOCOIDS AND ANALGESICS
1-The activity of which of the following drug is depends on p-phenyl-N-alkypiperidine moiety?
A-Acetaminophen
B-Aspirin
C-Naproxen
D-Diazepam
E-Morphine
Ans-E
2-Which of the following drug structure is derivative of N-methyl-p-phenyl piperidine (ethyl 1methyl-4-phenylpiperidine):
A-Haloperidol
B-Phenytoin
C-Meperidine
D-Phenobarbital
E-Procainamide
Ans-C
Tips: N-methyl-p-phenyl piperidine is the common to opioid analgesic and ethyl 1-methyl-4phenylpiperidine is derivative, present in meperidine.
3-Allyl group is present in opioids structure, gives the activity of?
A-Agonist
B-Partial agonist
C-Antagonist
D-mixed agonist and antagonist
E-Partial antagonist
Ans-C
Tips: Nalaxone antagonist activity is due to presence of allyl group on opioids structure.
4- For a first generation antihistaminic drug be effective, it must have which of the following
molecular characteristics on its structure?
I- A terminal tertiary nitrogen
II- More than one aryl or heteroaryl group
III- Presence of CC between CO and C-N groups
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
Ans- E
Comments: In order for an antihistaminic drug be effective, they must have a terminal tertiary
nitrogen and more than one aryl or heteroaryl group on their molecular structure.
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5-Which of the following dose acetylsalicylic acid (ASA) used for its antiplatelet action?
A- 81mg
B- 325mg
C- 650mg
D- 975mg
E- All of the above
Ans-A
6-Anti-inflammatory action of ASA is due to?
A-Irreversible inhibition of platelet aggregation
B-Prevention of prostaglandin synthesis
C-Inhibition of COX-I receptors
D-Inhibition of Cox-1 and Cox-II receptors
E-Inhibition of Cox-II receptors
Ans-B
7-What is antidote of acetylsalicylic acid (ASA)?
A-N-acetylcysteine
B-Flumezanil
C-Nalexone
D-Naltrexone
E-None of the above
Ans8-Which of the following is the urinary tract analgesic?
A-ASA
B-Naproxen
C-Ibuprofen
D-Phenazopyridine
E-Sulindac
Ans-D
9-Which of the following is the strongest analgesic for acute pain?
A-ASA
B-Naproxen
C-Ibuprofen
D-Acetaminophen
E-Ketorolac (Toradol)
Ans10-Which of the following analgesic is least likely cause addiction?
A-Morphine
B-Heroin
C-Codeine
D-Tramadol
E-Methadone
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Ans-D
11-Tramadol act on?
A-NE reuptake only
B-NE reuptake and mu receptors
C-Mu receptors only
D-mu, delta, and kappa receptors
E-Delta and kappa receptors only
12-The following groups are essential for antihistamine pharmacological activity:
I-Aromatic or heteroaromatic rings in structure
II-Tertiary amines in structure
III-Chain of alkyl group in structure
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans-E
13-H2 receptor antagonist;
I. Reduce gastric acid secretion
II.Reduce allergic symptoms
III.Branchoconstriction
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans-A
14-All of the following are side effects of atropine EXCEPT:
A-Dry mouth
B-Urinary retention
C-Constipation
D-Clurred vision sandy eyes
E-Diarrhea
Ans-E
15-Which of the following drugs will decrease stomach acid secretions, mechanistically blocking
of H2 histaminic receptors.
A-Hydroxyzine
B-Cetrazine
C-Fluoxazine
D-Omeprazole
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E-Ranitidine
Ans-E
Comments: hydroxazine and cetrazine are H1 antagonist
Omeprazole---is a Proton pump inhibitor
Ranitidine-H2 antagonist.
16-Lipoxigenase function in the following mechanism:
A-Conversion of arachidonoic acid to prostaglandin
B-Conversion of histidine to histamine
C-Conversion of tryptophan to serotonin
D-Conversion of arachidonic acid to leukotriene
E-Inhibits Leukocyte migration.
Ans-D
17-The mechanism of action of aspirin that results in greater effect as an antiplatelet drug is
because of:
A-Selective COX I inhibitor
B-Selective COX II inhibitor
C-COX I and COX II inhibitor
D-Acetylate cyclooxygenase
E-Inhibits lipoxygenase aswell as cyclooxygenase.
Ans: D
Comments: Aspirin is the only drug that irreversibly inhibits the enzyme. This action permits a
longer duration of action causing platelet aggregation and acetylation of
18-Serotonin:
A-Imidazole
B-tryptophan
C-indole
D-Piperidine
E-pyrrolidine
19-What is the prevention for NSAID induced GI ulcers:
A-Omeprazole
B-Zantac
C- Misoprostol
D-Cetrizine
E-Calcium hydroxide
Ans-

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20-Misoprostol (Cytotec) is used for prevention of NSAID induced ulcers, is classified as:
I-PGI
II-PGE2
III-PGE1
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans-B
21-The following drug indicated to induce cervical ripening in pregnancy:
Latonoprost (Xalatan)
Travoprost (Travatan)
C-Bimatoprost (Lumigan)
D-Misoprostol
E-Dinoprostone
Ans-E
22-Which of the following prostaglandin inhibitor indicated in the treatment of Open angle
glaucoma.
A-Latanoprost (Xalatan)
B-Timolol
C-Bimatoprost (Lumigan)
D-Misoprostol
E-Dinoprostone
Ans-A
23-Prostaglandins contain the following fragment in the structure:
I-Cyclopentane ring contain carbonyl and hydroxyl group
II-Long chain alkyl group.
III-Keto and hydroxyl position indicate subscript of prostaglanding analogs
A-I only
B-III only
C-I and II only
D-II and III Only
E-All of the above
Ans-E
24-What is the mechanism of action of montelukast (Singulair)?
A-Leukotriene inhibitors
B-LTC4 and LTD4 inhibitors
C-Cyclooxygenase inhibitors
D-5HT1D inhibitors
E-Antihistamines
Ans-B
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25-Which of the following can be dispensed without prescription:


I-8 mg of codeine
II-19 mg /5mL of codeine solution in acetaminophen
III- 300mg acetaminophen+8 mg codeine + caffeine
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans-D
26-Which of the following does not require prescription:
A-Tylenol 1
B-Tylenol 2
C-Tylenol 3
D-Tylenol 4
E-Tylenol 2, 3 and 4
Ans-A
27-Which of the following prescription require written prescription only:
A-Tylenol 1--signature
B-Tylenol 2
C-Tylenol 3
D-Tylenol 4
E-Tylenol 3 and 4
Ans-D
28-All of the following are propionic acid derivatives EXCEPT:
A-Naproxen
B-Ibuprofen
C-Ketoprofen
D-Aspirin
E-Carprofen
Ans-B
29-Pyrazole ring is present in the following drug structure:
A-Aspirin
B-Acetominophen
C-Celecoxib
D-Ibubrofen
E-Ketoprofen
Ans-C
30-All of the following are catechol amine neurotransmitters; EXCEPT:
A-Tyrosine
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B-Dopa
C-Dopamine
D-Dihydroxyphenylalanine (DOPA)
E-Norepinephrine
Ans-A
31-Serotonin (5HT) is synthesized from tryptophan, this contain indole ring which catalyzed to 5hydroxy tryptophan by the following enzyme:

HOOC

NH2

NH2

NH2

HO

HOOC

N
H

N
H
Tryptophan

HO

(5-HTP)

Aromatic amino
acid decarboxylase

N
H
Serotonin
(5-HT)

A-Aromatic amino acid decarboxylase


B-Tryptophan decarboxylase
C-Tryptophan hydroxylase
D-Indole hydroxylase
E-Tryptophan dehydroxylase
Ans-C

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PHARMACY PREP.
CARDIOVASCULAR SYSTEM
1-Diuretic characterized for the decrease of Na, K, Cl and Ca.
a) Acetozalamide
b) Spirolactone
c) Hydroclorotiazide
d) Furosemide
e) Triametrene
2- Thrombolytics (fibrinolytic) agents are contra indicated in
I-Myocardial infarction
II-Hypertensive patients
III-Bleeding from the GIT
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
3- Patient with renal failure and normal liver function is showing sensibility to the drug,
this means that
a) High accumulation of metabolite
b) High concentration of drug protein binding
c) High volume of distribution
d) High concentration of drug in the systemic circulation
e) High accumulation of drugs into tissues
4- Normal osmotic blood pressure in a health adult:
a) 280mOsm/L
b) 280Osm/L
c) 280mOsm/ml
d) 280Osm/ml
e) 280mOsm/100ml
5-Which increase water permeability at collecting tubules?
a) ADH
b) Hydroclorothiazide
c) Aldosterone
d) Triametrene
e) Spirolactone

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6- Digoxin is cardiac digitalis widely used in CV which toxicity is increased by
I- Erythromycin
II- Quinidine
III- Cholestyramine
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
7- Acetozalamide, a carbonic anhydrase diuretic and hydroclorothiazide, a thiazide
diuretic have an identical molecular group very important in their structure knows as:
a) Sulfonamide group
b) Pyrimidine group
c) Purine group
d) Pyrrolidine group
e) Ether group
8- A man with blood group AB can receive blood from:
a) A
b) B
c) AB
d) O
e) All the above
9- When would will advise patient that he may suffer from hypertension and he may need
to see a doctor?
I- Doctor blood pressure monitor shows BP180/110
II- The pharmacy blood pressure monitor shows BP180/110
III- His monitor shows BP120/80
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
10-During absolute refractory period the myocardial fiber:
a) Receive the strongest stimulation
b) It is relaxed but is able to respond to any stimulus
c) Respond to the most sensible stimulus
d) Do not respond to any stimulus
e) None of the above
11- Abnormal persistent dilatation of blood vessels is known as:
a) Embolism
b) Aneurism
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c) Emphysema
d) Starvation
e) Atheroscherosis
12- Correct statements regarding embolism include:
I- Abnormal dilatation of blood vessel
II- Obstruction of a blood vessel by a mass transported in the circulation
III- An embolus can be a clot or a foreign material transported in the circulation
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
13- Which of the following statements regarding HEPARIN is/are right
I- It is a mucopolysacaride, organic acid present naturally in many tissues especially in
lungs and liver.
II- It has anticoagulant proprieties that inhibit the conversion of prothrombim to thrombin
and fibrinogen to fibrin
III- It has antithrombin III as it co-factor
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
14- Heparin and warfarin are very popular anticoagulant agents. What is wrong regarding
heparin and warfarin?
a) Both have anticoagulant proprieties
b) Warfarin has activity only in vivo
c) Heparin has activity only in vivo
d) Heparin has activity in vivo and in vitro
e) All are correct
15- Which of the following calcium channel blockers cause bradycardia
I- Nifedipine
II- Verapamil
III- Diltiazem
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct

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16- Important characteristics regarding the blood formed elements may include:
I- Red Blood Cells (RBC) is originated from erythrocytes and has a life span of 120 days
(4 months)
II- Platelets are involved in blood clot and have a life span is 7 to 10 days
III- Platelets are originated from megakariocyts
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
17- Warfarin, is an anticoagulant agent has its effect is potentiates by:
I- Deficiency of Vitamin K
II- Adjunct therapy with heparin
III- Adjunct therapy with salicylates
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
18- All are drugs that decrease Low Density Lipoproteins, EXCEPT:
a) Colfibrate
b) Genfibrozil
c) Cimetidine
d) Sinvastatin
e) Pravastatin
19- A patient with deep vein thrombosis (DVT) can be treated by:
I- Streptokinase
II- Heparin
III- Warfarin
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
20- -blockers are mainly used in CV complications. One of the biggest cautions in using
-blockers is the development of:
a) Tachycardia
b) Bradycardia
c) Orthostatic hypotension
d) Hypotension
e) Increase in cardiac output

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21- All of the following are ACE-Angiotensin Covertase Inhibitor, EXCEPT
a) Enalapril
b) Captopril
c) Ramipril
d) Lisinopril
e) Losartan
22- During inspiration the lowest blood pressure in supine position is:
a) Vena cava
b) Internal carotid artery
c) Aorta artery
d) Sciatic artery
e) Pulmonary artery
23- Which of the following theories relates the tension, radius of vessel and intraluminal
pressure achieved in a blood vessel wall?
a) Ficks law
b) Ahhrenius
c) LaPlaces law
d) Newtonian law
e) Henderson law
24- The first location where blood is present in case of left ventricular failure:
a) Liver
b) Lung
c) Heart
d) Kidney
e) Brain
25- The blood weights 7 to 8% of the total body weight of a health adult. How much of
these percentages are represented approximately in liter of blood?
a) 4 to 6L
b) 7 to10L
c) 7 to 8L
d) 10L
e) 15L
26- Nitrates are mainly used in angina treatment. True statement regarding nitrates may
include:
I- Nitrates are esters of nitric acid.
II- Nitrates are prodrugs and must be denitrated to exert their therapeutic effect
III- Nitrates relaxes vascular smooth muscle and in addition relax bronchial, biliary,
gastrointestinal, urethral and uterine smooth muscles.
a) I only
b) III only
c) I and II only
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d) II and III only
e) All are correct
27- Which of the following diuretics is used to block Na/H exchange system of the renal
tubule:
a) Indapamide
b) Ouabain
c) Spirolactone
d) Acetazalamide
e) Amiloride
28- Example of diuretic that increases the levels of Cl, causing hypercloremia is:
a) Acetazalamide
b) Amiloride
c) Furosemide
d) Ouabain
e) Hydroclorotiazide
29- Dobutamine is a direct acting inotropic agent parenteraly used in cardiac emergences
and characterized by:
I- Increase myocardial contractility, very useful in myocardial infarction.
II- Increase cardiac output
III- Increase glomerular filtration rate, renal blood flow and sodium excretion
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
30- Spirolactone is an aldosterone antagonist diuretic that competes with aldosterone at:
a) Proximal tubule
b) Early distal tubule
c) Early collecting tubule
d) Collecting tubule
e) End of collecting tubule
31- Examples of drugs affecting platelet aggregation may include:
I- Ticlopidine
II- Clopidrogel
III- Aspirin
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct

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32- What kind of arrhythmia can be caused by an increase in temperature?


a) Ventricular premature depolarization
b) Atrial fibrillation
c) Paroxysmal arrhythmia
d) Ventricular tachycardia
e) None of the above
33- Prazosin is a sympathetic agent used in hypertension acting as:
a) -adrenergic
b) -adrenergic
c) -adrenergic blocker
d) -adrenergic blocker
e) and -adrenergic blocker
34- All are side effects of hydroclorothiazide, a thiazide diuretic, EXCEPT:
a) Hypokalemia
b) Hypoglycemia
c) Hyponatremia
d) Hypercalcemia
e) Hyperuricemia
35- CHF-Congestive Heart Failure is a cardiac disorder:
I- Resulted from any cardiac disorder that impairs the ability of the ventricle to deliver
adequately quantity of blood to the metabolizing tissues
II- Result in poor pump function
III- -blockers are the BEST treatment for CHF.
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
36- Drugs that may affect the normal activity of warfarin include:
a) Ibuprofen
b) Aspirin
c) Vitamin K
d) Acetaminophen
e) All are correct
37- Glycosides are widely used in the treatment of CHF, glycosides molecular structure
consist of steroidal nucleon and:
a) Sugars
b) Polypeptides
c) Carbohydrates
d) Proteins
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e) Hormones
38- Sterosis:
a) Dilatations of blood vessels
b) Increase in cardiac output
c) Accumulation of cholesterol in blood vessels
d) Narrowing of blood vessels
e) High pressure in blood vessels
39- The first tissue that receive the greatest cardiac output at rest:
a) Lung
b) Liver
c) Kidney
d) Muscle
e) Fat
40- Calcium channel blocker that may cause myocardial infarction as side effect include:
I- Diltiazen
II- Verapamil
III- Nifedipine
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
41- Bradycardia and orthostatic hypotension are characteristic side effects of:
I- Guanabenz
II- Hydralazine
III- Vasodilators
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
42- An important advantage of using dopamine in cardiac shock may include:
a) It will not cross BBB and cause CNS effect
b) It has no effect on and -receptors
c) It produces dose-dependent increasing cardiac output and renal perfusion
d) It will not increase blood pressure
e) It can be given orally
43- Which of the following diuretics may shows an uricosuric activity????
a) Spirolactone
b) Furosemide
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c) Chlortalidone
d) Triamterene
e) Chlorothiazide
44- Ancrod, an antithrombolitic agent is characterized by:
I- It is derivated from snake venom
II- It depletes fibrinogen
III- It is an alternative to heparin
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
45- The use of sildenafil together with atenolol may result in:
I- Tremor
II- Hypotension
III- Visual disturbance
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
46- A diabetic patient suffering from hypertension is having enalapril, however he is
complaining from severe dry cough that we can associated as a side effect of the
enalapril. Which would be the best choice for changing this medication?
a) Ramipril
b) Losartan
c) Amlodipine
d) Indapamide
e) Captopril
47- Drug of choice when treating hypertension in a diabetic patient may include:
a) ACE inhibitors
b) -Blockers
c) Calcium Channel Blockers
d) Digitalis
e) Nitrates
48- Angina, a cardiovascular complication characterized by the oxygen insufficiency my
be aggravated by all of the following, EXCEPT:
a) Exercise
b) Hot places
c) Cold places
d) Anger
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e) Over weight
49- Drugs used in the treatment of hypertension associated with renal failure may
include:
I- Hydralazine
II- Furosemide
III- Atenolol
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
50- Digitalis is contra indicated in the treatment of:
a) Myocardial infarction
b) Coronary Heart Diseases
c) Congestive Heart Failure (CHF)
d) Arrhythmias
e) Venous congestion
51- Systemic lupus or erythromatus lupus may be a side effect of:
a) Propanolol
b) Digoxin
c) Cyclophosphamide
d) Hydralazine
e) Hydroxazine
52- Which is the best describe the proprieties of labetolol:
a) -blocker
b) -blocker
c) 1 and -blocker
d) non selective and -blocker
e) 2-blocker
53- Correct statements regarding blood pressure may include:
I- Systolic pressure is the highest arterial pressure during a cardiac cycle.
II- Diastolic pressure is the lowest arterial pressure during a cardiac cycle
III- Diastolic pressure is crucial in verifying if a person suffers of high blood pressure
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
54- Cholesterol:
I- VLDL-Very Low Density Lipoproteins are formed in the liver
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II- LDL-Low Density Lipoproteins are formed from VLDL and carry LDL cholesterol
that is the bad cholesterol
III- HDL-High Density Lipoproteins are formed in the liver and small intestine. They
carry HDL cholesterol that is the good cholesterol
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
55- Abnormal levels of lipids can cause all of the following, EXCEPT:
a) Atheroscherosis
b) Heart attack
c) Pancreatitis
d) Bone dystrophy
e) Stroke
56- Lipid lowering group of drugs include all of the following, EXCEPT:
a) Bile acid binders
b) Fibric acid derivatives
c) Angiotensin inhibitors
d) Lipoprotein synthesis inhibitors
e) HMG-CoA reductase inhibitors
57- Niacin mechanism of action as lipoprotein synthesis inhibitor is characterized by:
a) Decrease the production rate of VLDL that synthesizes LDL
b) Block the synthesis of cholesterol
c) Decrease lipoproteins production by increasing the breakdown of lipids
d) Remove VLDL from bloodstream
e) Binds to bile acids in the intestine
58- Lipid lowering drug that binds to bile acids in the intestine causing the acids to be
excreted include:
a) Clofibrate
b) Cholestyramine
c) Niacin
d) Genfibrozil
e) Atorvastatin
59- The safest lipid lowering drug that may be used in pregnancy include:
a) Pravastatin
b) Genfibrozil
c) Cholestyramine
d) Sinvastatin
e) Clofibrate

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60- Absorbable agents successfully used in patients with high cholesterol include:
I- Grapefruit juice
II- Nicotinic acid
III- Fish oil
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
61- Digoxin may be used in dysrhythmias, however CANNOT be used in one specific
type of dysrhythmias that is:
a) Atrial tachycardia
b) Ventricular tachycardia
c) Paroxysmal tachycardia
d) Atrial fibrillation
e) Flutter
62- Class I sodium channel blocker antidysrhythmic agents include all of the following,
EXCEPT:
a) Quinidine
b) Lidocaine
c) Phenytoin
d) Propafenone
e) Amiodarone
63- Correct statements regarding antidysrhythmic agents may include:
I- -blockers, Na, K and Ca channel blockers are used in treat dysrhythmias
II- They are classified according to their ability to alter the action potential of cardiac
cells
III- Reduce abnormalities of impulse generation and modify the disturbance of impulse
conduction within cardiac tissue
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
64- Diuretic that act in the loop of henle include:
a) Acetazolamide
b) Hydroclorothiazide
c) Furosemide
d) Spirolactone
e) Chlortalidone

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65- All the following diuretics may cause metabolic acidosis, EXCEPT:
a) Hydroclorothiazide
b) Acetozalamide
c) Spirolactone
d) Amiloride
e) Triametrene
66- Diuretic with pteridine and pyrazine hererocycles rings used in the treatment of
nephrogenic diabetes insipidus caused by lithium:
a) Spirolactone
b) Amiloride
c) Indapamide
d) Furosemide
e) Acetazolamide
67- Best diuretic used in the adjunct treatment of hepatic cirrhosis and renal diseases
include:
a) Spirolactone
b) Amiloride
c) Indapamide
d) Furosemide
e) Acetazolamide
68- Agent with a sulphonamide group on its structure responsible for its functional action
and that is considered the first line treatment for mild hypertension:
a) -Blockers
b) -Blockers
c) Thiazides diuretics
d) Vasodilators
e) ACE inhibitors
69- Antihypertensive drug most likely to cause syncope effect or first-dose effect:
a) Prazosin
b) Clonidine
c) Minoxidil
d) Guanabenz
e) Labetolol
70- Antihypertensive -blocker used in BPH-Benign Prostate Hypertrophy:
a) Prazosin
b) Terazosin
c) Doxazosin
d) Finesteride
e) Minoxidil
71- Drug used in the treatment of hypertension that may cause hemolytic anemia.
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a) Clonidine
b) Guanabenz
c) Thiazides
d) Atenolol
e) Methyldopa
72- One of the most safe antihypertensice drugs used in pregnancy is:
a) Metoprolol
b) Captopril
c) Sodium nitroprusside
d) Methyldopa
e) Prazosin
73- Direct vasodilator drug used in the treatment of baldness may include:
a) Hydralazine
b) Sodium nitroprusside
c) Minoxidil
d) Enalapril
e) Captopril
74- All of the following may be examples of calcium channel blocker, EXCEPT:
a) Enalapril
b) Amlodipino
c) Nifedipeno
d) Diltiazen
e) Verapamil
75- First line treatment in mild to moderate CFH-Congestive Heart failure include:
a) -Blockers and diuretics
b) Glycosides and ACE inhibitors
c) Calcium channel blockers
d) Vasodilators
e) Nitrates
76- Drug used in cardiovascular complications which metabolism produce cyanide:
a) Hydralazine
b) Nitrates
c) Nitroglycerine
d) Isosorbid
e) Nitroprusside
77- Nitrates used in cardiovascular complications mainly in CHF induce the formation of:
a) Nitric oxide
b) Cyanide
c) Zinc oxide
d) Nicotinic acid
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e) Nalidixic acid
78- Angina is a type of:
a) Congestive heart failure disease
b) Hypertension disease
c) Ischemic disease
d) Atherosclerosis disease
e) Dysrhytmiac disease
79- Examples of common used thrombolytic or fibrinolytics agents may include:
I- Streptokinase
II- Recombinant tissue plasminogen activators (tPA)
III- Warfarin
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
80- All are examples of low molecular weigh heparins (LMWH), EXCEPT:
a) Ardeparin
b) Enoxaparin
c) Dalteparin
d) Fragmin
e) Alteplase
81- Which of the following -agonist drugs has no effect in -agonists receptors?
a) Isoproterenol
b) Dopamine
c) Norepinephrine
d) Epinephrine
e) Clonidine
82- Which of the following antihypertensive drugs is considered a prodrug:
I- Minoxidil
II- Methyldopa
III- Clonidine
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
83- Predominant sympathetic adrenergic receptor in the heart may include:
a) -receptors
b) -receptors
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c) Mu receptors
d) M1-receptors
e) D3-receptors
84-What is appropriate action should be advised to the patient if his blood pressure is
250/120
A-Ask patient to relax
B-Refer to Dr
C-Refer to Emergency
D-Offer him antihypertensive drugs
E-contact his family member to inform about his blood pressure
Ans85-Use of nitroglycerine with seldanafil will cause:
a-Hypotension
b-hypertension
C-angina
D-CHF
E-stroke
Ans-A
CORRECT ANSWERS
CARDIOVASCULAR SYSTEM
1- D
Comments: Furosemide diuretic may cause hyponatremia, hypokalemia, hypocalcemia,
and hypomagnesaemia. It also causes hyperglycemia, hyperuricemia and can increase
levels of triglicerideos.
2- B
Comments: Antithrombolitic agents are completely contra indicated in patients suffering
from any internal bleeding.
3- A
Comments: The liver with normal function can completely metabolize a drug, however a
kidney with poor function-renal failure cannot properly eliminate the drug from the body
leading to accumulation of metabolites.
4- A
Comments: The osmotic blood pressure may vary from 280 to 300mmol/Kg or mOsm/Kg
5- A
Comments: ADH-Anti-Diuretic Hormones increase water reabsorption by increasing the
cellular permeability of the collecting ducts. Resulting in a decrease in urine volume with
resultant increase in osmolarity.
6- D
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Comments: Both quinidine and cholestyramine have drug interaction with digoxin which
induce toxic effects of digoxin.
7- A
Comments: Both hydroclorothiazide and acetozalamide have a heterocyclic
sulphonamide group on their molecular structure responsible for their functional action.
8- E
Comments: A person with blood AB is considered the universal acceptor because can
accept blood donation from any other group, A, B, AB and O.
9- C
Comments: The normal blood pressure in a health adult is 80/120. Any big difference
between these valors, mostly in the diastolic pressure the patient should be indicated for
medical assistance.
10- D
Comments: During absolute refractory period the myocardial fiber do not respond to any
stimulus.
11- B
Comments: Aneurysm is an abnormal dilatation of a blood vessel while embolism is an
obstruction of airway by a mass transported in the circulation. Emphesema is a reversible
form of airway obstruction.
12- D
Comments: Embolism is an obstruction of a blood vessel by a mass transported in the
circulation. The embolus is this mass transported in the circulation that can be a clot or a
foreign material. Abnormal dilatation of a vessel artery is known as aneurysm
13- E
Comments: Heparin is amino acid polysaccharide naturally present in the body
predominantly in lung and liver tissues. It inhibits the conversion of prothrombim to
thrombin and fibrinogen to fibrin using antithrombin III as it co-factor therefore been
therapeutically used as anticoagulant.
14- C
Comments: Heparin is already naturally present in the body and also act in vitro, it is very
useful as anticoagulant in blood donations conservation. Warfarin has only in vivo
activity
15- D
Comments: Nifedipino is mainly the only calcium channel blocker that does not have
bradicardia as side effect.
16- E
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Comments: Blood formed elements are erythrocytes, leukocytes and platelets.
Erythrocytes also known as Red Blood Cells form 2% of the whole blood, has a half-life
of approximately 120 days and play important rules in the O2 and CO2 transportation.
Platelets are originated from megakariocytes and are involved in blood clotting.
17- E
Comments: Vitamin K is considered the antidote for Warfarin. When the body has lower
vitamin K the tendency is increase the effect of Warfarin. Heparin and salicylates also act
as anticoagulant; in adjunct therapy with Warfarin they will have a synergism effect.
18- C
Comments: Cimetidine is a H2-antagonist therefore do not decrease LDL
19- D
Comments: Patient with deep vein thrombosis can be treated with both Warfarin and
heparin. Streptokinase would be mainly used in acute myocardial infarction or in other
acute coronary artery diseases.
20- C
Comments: Orthostatic hypotension is a fall in blood pressure associated with dizziness,
syncope and blurred vision occurring upon standing or when standing motionless in a
fixed position, one of the most common side effects with -blockers therapy
21- E
Comments: Losartan is an AT-1, Angiotensin receptor blocker.
22- A
Comments: During inspiration the lowest blood pressure in supine position is in vena
cava
23- C
Comments: LaPlaces Law explains the tension achieved in a blood vessel wall to the
radius of vessel and intraluminal pressure.
24- B
Comments: Blood leaves the lung and reaches the left ventricle of the heart through
pulmonary vein. In case of left ventricular failure the tendency is accumulation of blood
in the lung due to blockage of blood circulation from lung through the heart
25- A
Comments: The blood is composed of 90% water and 8% plasma protein. A health adult
has approximately 5L of blood circulating in the body.
26- E
Comments: Nitrates are esters of nitrous or nitric acid that are rendered nonexplosive by
the addition of inert excipient such as lactose. Nitrates are prodrugs and must be
denitrated to exert their therapeutic effect, denitration liberates nitric oxide, which cause
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vasodilatation. In addition to the relaxation of vascular smooth muscle, these drugs relax
bronchial, biliary, gastrointestinal, urethral and uterine smooth muscles.
27- D
Comments: Acetozalamide is a carbonic anhydrase diuretic that blocks Na/H exchange
system at the proximal tubule of kidney.
28- A
Comments: A common side effect seen with long-term treatment with acetozalamide is
hypercloremia and metabolic acidosis.
29- E
Comments: Dobutamine is indicated to improve cardiac function during cardiac
decompensation or depressed contractility from cardiac or major vascular complications
30- C
Comments: Spirolactone is an aldosterone antagonist that binds to aldosterone receptor as
competitive antagonist at early collecting tubules of kidney.
31- E
Comments: Ticlopidine, clopidrogel and aspirin may be used as antiplatelet agents
definitely affecting platelet aggregation.
32- C
Comments: Paroxysmal arrhythmia is characterized by sudden recurrence or
intensification of arrhythmias that may be caused by an increase in temperature.
33- D
Comments: Prazosin is a -adrenergic blocker used to treat hypertension due to its action
in the arteries and veins dilatation.
34- B
Comments: Hydroclorothiazide may have hyperglycemia as side effect.
35- C
Comments: CHF is a complex clinical syndrome that can results from any cardiac
disorder that impairs the ability of the ventricle to deliver adequate quantities of blood to
the metabolizing tissues during normal activity or at rest.
36- E
Comments: Ibuprofen inhibits the enzymatic metabolism of Warfarin. Acetozalamide and
aspirin increases Warfarin activity and vitamin K inhibits the activity of Warfarin.
37- A
Comments: Digoxin is a classic example of cardiac glycosides that consist of sugar and
steroidal nucleon.
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38- D
Comments: Sterosis is the narrowing of blood vessels
39- B
Comments: The first tissue that receives the greatest cardiac output at rest is liver,
following by kidney and lung.
40- A
Comments: Diltiazen is the only calcium channel blocker that may have myocardial
infarction as side effect.
41- A
Comments: Guanabenz is a sympathomimetic 2-adrenergic agent having bradicardia and
orthostatic hypotension as main side effect.
42- C
Comments: Dobutamine improve cardiac function, it increases cardiac contraction and
vasodilatation of smooth muscles
43- D
Comments: Triamterene is a diuretic that exert its effect on the distal renal tubule to
inhibit the reabsorption of sodium in exchange for potassium and hydrogen ions.
Triamterene may reduce glomerular filtration and renal plasma flow. Via this mechanism
it may reduce uric acid excretion.
44- E
Comments: Ancrod is designated to use as an antithrombolitic in patients with heparininduced thrombocytopenia or thrombosis, who requires immediate and continued
anticoagulation
45- E
Comments: The currently use of sildenafil and -blockers may result in exacerbated
hypotension, blurred vision and tremors.
46- B
Comments: Losartan is an AT-1 inhibitor and would be the best choice for treatment of
hypertension in a diabetic patient with dry cough that is definitely a side effect of ACE
inhibitor, enalapril.
47- A
Comments: Although ACE inhibitors increase the risk of hyperkalemia in diabetes
mellitus; it is still the most appropriated agent in treating hypertension in diabetic patients
because it does not interfere with glucose or insulin metabolism.
48- B

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Comments: Angina occurs when myocardial oxygen availability is insufficient to meet
the myocardium oxygen demand. Any condition or factor impairing the oxygen supply
such as cold places and exercises can predispose or increase the risk of angina.
49- C
Comments: Atenolol is a -blocker and may not be used in patients with renal failure.
50- A
Comments: Digitalis are mainly used in the treatment of all degrees of congestive heart
failure and some kind of arrhythmias as atrial fibrillation and atrial flutter.
51- D
Comments: Systemic lupus or erythromatus lupus is a side effect of hydralazine.
52- D
Comments: Labetalol is a -non-selective blocker and -blocker agent used to treat
hypertension. It dilates blood vessels without increase the heart rate.
53- E
Comments: The normal blood pressure in a health adult is 80/120, where 80 is the
systolic and 120 is the diastolic pressure. Systolic pressure is the highest arterial pressure
during a cardiac cycle and is measured when the heart contracts while diastolic pressure
is the lowest arterial pressure during a cardiac cycle and is measured when the heart is
relaxed.
54-E
Comments: VLDL-Very Low Density Lipoproteins are formed in the liver and it is the
origin of LDL the Low Density Lipoproteins, carry LDL cholesterol that is well known
as the bad cholesterol, while HDL the High Density Lipoproteins are formed in the
liver and small intestine, carry HDL cholesterol and is known as the good cholesterol.
55- D
Comments: Abnormal levels of cholesterol or lipids there is no association with bone
dystrophy that is a condition normally called osteoporosis.
56- C
Comments: Angiotensin covertazing inhibitors are used to treat hypertension.
57- A
Comments: Niacin act as lipoprotein synthesis inhibitor by decreasing the production rate
of VLDL, which synthesizes LDL
58- B
Comments: Cholestyramine is an insoluble, non-absorbable agent used as bile acid binder
in the intestine causing the acids to be excreted.
59- C
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Comments: Cholestyramine is the primary prevention of hyperlipidemia and can be
safely used in pregnancy.
60- D
Comments: Grapefruit juice interacts with most of the antihyperlipidemic agents.
61- B
Comments: Digoxin as antidysrhythmic agent is only used in atrial fibrillation,
paroxysmal atrial tachycardia and flutter.
62- E
Comments: Class I antidysrhythmics agents are Na channel blockers agents and do not
include amiodarone that belongs to class III antidysrhythmics agents inhibiting K
channel.
63- E
Comments: Antidysrhytmic agents are used to reduce abnormalities of impulse
generation and modify the disturbance of impulse conduction within cardiac tissue, they
are classifies by classes I, II, III and IV which include , Na, K and Ca channel blockers
64- C
Comments: Furosemide and ethacrynic acid act by inhibition of Na/K dichloride transport
system. The are the only diuretics with action on the loop of henle
65- A
Comments: Hydroclorothiazide may cause metabolic alkalosis not acidosis.
66- B
Comments: Amiloride, a potassium sparing diuretic is used for treatment of nephrogenic
diabetes insipid us caused by lithium.
67- D
Comments: Furosemide may be the best diuretic used in acute pulmonary edema, hepatic
cirrhoses, renal failure and edema associated with CHF.
68- C
Comments: Hydroclorothiazide prevents the reabsorption of sodium chloride at distal
tubule of kidney and is the primarily treatment of mild hypertension.
69- A
Comments: Prazosin is a 1-adrenergic antagonist normally given in doctors office due
to its first pass effect and syncope effect.
70- B
Comments: Terazosin is indicated in the treatment of BPH. It has been show to improve
urinary flow and symptoms of BPH.
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71- E
Comments: Methyldopa long-term treatment may be associated with anemia. A combs
test is recommended every six months for patients in methyldopa therapy.
72- D
Comments: Methyldopa is a prodrug considered as one of the safest drug for treatment of
hypertension during pregnancy.
73- C
Comments: Minoxidil is a direct vasodilator used to treat hypertension and alternatively
used to treat baldness.
74- A
Comments: Enalapril is an ACE-II, Angiotensin Convertazing Enzyme.
75- B
Comments: First line treatment of CHF is normally the association of a cardiac glycoside
that inhibit Na/K (Na pump) exchange and a vasodilator as ACE inhibitors that inhibits
the conversion of angiotensin I to angiotensin II
76- E
Comments: Nitroprusside is a direct vasodilator used in cardiac emergences. It is
metabolism has cyanide as end product.
77- A
Comments: Nitrates act directly relaxing vascular smooth muscle by transformation of
nitric oxide causing a peripheral pooling of blood.
78- C
Comments: Angina is a kind of ischemic disease characterized by symptoms that occurs
when myocardial oxygen availability is insufficient to meet the myocardium oxygen
demand.
79- C
Comments: Warfarin is an anticoagulant agent.
80- E
Comments: All are low molecular weight heparin, which are normally used in the
prevention of deep vein thrombosis and reduce the risk of pulmonary embolism.
81- A
Comments: Isoproterenol is an adrenergic 1-agonist with no effect in -receptors.
82- C
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Comments: Prodrugs are drugs that become active only after bioactivation by the body.
Minoxidil and methyldopa are examples of prodrugs.
83- B
Comments: -adrenergic receptors are the most abundant receptor in the heart.
BIBLIOGRAPHIC REFERENCE
1- COMPREHENSIVE PHARMACY REVIEW Lippincott William & Wilkins
Fourth edition
2- CPS-COMPENDIUM OF PHARMACEUTICALS AND SPECIALITIES - Canadian
Pharmacist Association 2001 edition.
3- MEDICAL DICTIONARY Dorlands illustrated 27th edition.
4- PHARMACY PREP Lectures series & study guide for Evaluating ExaminationTIPS - 2003/2004
5- THERAPUTIC CHOICES Canadian Pharmacist Association -Third edition
6- USP DI Drug Information for the Health Care Professional15th edition Volume I.

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PHARMACY PREP
MEDICINAL CHEMISTRY AND PHARMACOLOGY OF CNS DRUGS
1-Which of the following is Not a SSRI
A-e-citalopram
B-Sertraline
C-Trazadone
D-Phenelzine
E-Proxetine
Ans-D
2-Which of the following is the antidote for benzodiazepines?
A-Phenobarbital
B-Vitamin K
C-Flumazenil
D-Vitamin D
E-Morphine
Ans-C
3- All the following are examples of long acting benzodiazepinic, EXCEPT:
a) Clonazepan
b) Diazepam
c) Chlorazepate
d) Flurazepan
e) Temazepan
Ans-E
4-Which of the following is an IRREVERSIBLE side effect resulting form long-term
administration of phenothiazine antipsychotics?
A. Sedation
B. Xerostomia
C. Infertility
D. Parkinsonism
E. Tardive dyskinesia
Ans-E

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Pharmacy Prep Review Questions

PHARMACY PREP.
ENDOCRINOLOGY
1- Megaloblastic anemia may be caused due to a result of:
I-Folic acid deficiency
II-Vitamin B12 deficiency
III-Iron deficiency
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
2- The doctor is suspecting that his patient is suffering of hypothyroidism, which assay
can be used to confirm his diagnostic?
a) Serum TSH
b) T4 in urine
c) Sensitive TSH
d) TSH in urine
e) T3 counts
3- Follicle Stimulating Hormone and Luteinizing Hormones levels may be mainly
increased during:
a) Pregnancy
b) Ovulation
c) Conception
d) Last trimester of pregnancy
e) Amenohrrea
4- Which is/are true about placenta:
I- The umbilical cord transport nutrients from mother to fetus passing through the
placenta.
II- The umbilical cord is formed of two umbilical arteries and one umbilical vein
III-Placenta is an organ characteristic of true mammals during pregnancy
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
5- Hypothyroidism, my be resulted due to:
I- Graves disease
II- Hashimoto thyroditis
III- Treatment with anti-thyroid drugs
a) I only
b) III only
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c) I and II only
d) II and III only
e) All are correct
6- Characteristics of hypoparathyroidism may include:
I- It is characterized by decrease of Calcium and increase of Phosphorous
II -It is a deficiency of thyroid gland
III- It is characterized by an increase of calcium and decrease of Phosphorous
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
7- All of the following diseases can be caused by oral contraceptives, EXCEPT
a) Epilepsy
b) Tromboembolism
c) Breast cancer
d) Uterine cancer
e) Myocardial infarction
8- Hyperaldosteronism, a hyper function of adrenal cortex may be characterized by:
I- Abnormality of electrolyte metabolism resulting in high secretion of aldosterone
II- Can be treated by aldosterone antagonist: Spirolactone
III- Hyperaldosteronism is characterized typically by hypokalemia
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
9- Which is the main hormone secreted by the adrenal cortex and responsible for the
regulation of electrolytes and water balance?
a) FSH
b) Thiazides
c) ADH
d) Aldosterone
e) Vasopressin
10- Ketoacidoses are acidosis accompanied by the accumulation of ketone bodies in the
body tissues and fluids and may be a result of:
I- Starvation
II- Juvenile type diabetes
III- Inadequate insulin treatment
a) I only
b) III only

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c) I and II only
d) II and III only
e) I, II and III
11- What does insulin pump mean?
a) Insulin with fast action
b) Insulin supply for long period of time
c) Insulin with fast absorption
d) Insulin rapidly excreted
e) Insulin rapidly metabolized
12- Hypofunction of adrenal cortex may cause:
a) Cushing disease
b) Grays disease
c) Addisons disease
d) Reyes disease
e) All are wrong
13- Cushing syndrome a disorder of adrenal cortex is mainly due to:
I- Hyper function of adrenal cortex
II- High secretion of cortisone
III- Hypofunction of adrenal cortex
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
14- Correct mechanism of methimazole as antithyroid drug may include:
I- Inhibit iodine oxidation
II- Catalyze the incorporation of iodine into tyrosine
III- Inhibit the synthesis of thyroid hormones
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
15- All of the following cells are normally presented in pancreas, EXCEPT:
a) -cell
b) -cell
c) Sertoli cell
d) Delta cell
e) F-cell

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16- Correct statement regarding pernicious anemia may include:


a) Due to dietary deficiency of vitamin B12
b) Prevented by oral administration of vitamin B12
c) Treated by parenteral administration of folic acid
d) Treated by parenteral administration of vitamin B12
e) Caused by dietary deficiency of iron
17- Iron deficiency may cause a type of anemia known as:
a) Pernicious anemia
b) Megaloblastic anemia
c) Pernicious and megaloblatic anemia
d) Microcystic anemia
e) All of the above
18- Side effects that may be expected to occur from the administration of oral
contraceptives include all the following, EXCEPT:
a) Fluid retention
b) Headaches
c) Hypertension
d) Constipation
e) Depression
19- The most appropriate insulin for diabetic patients with ketoacidoses may include:
a) Crystalline Zinc Insulin
b) Ultralent Insulin
c) Protamine Insulin
d) Extended Insulin Zinc Suspension
e) Isophane Insulin
20- Which is not secreted from the anterior pituitary
a) Prolactin
b) Vasopressin
c) Gonadotropin hormones
d) LH
e) FSH
21- Example of oral antidiabetic agent most likely to cause lactic acidosis is:
a) Glyburine
b) Chlorpropamide
c) Metformin
d) Repaglinide
e) Acarbose

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22- All of the following substance may be classified as steroid hormone, EXCEPT:
a) Vitamin D3
b) Estrogen
c) Cortisone
d) Androgen
e) Stilbestrol
23- Medical condition related to hypothyroidism, the decrease of thyroid hormones might
include:
a) Cushing syndrome
b) Addisons syndrome
c) Graves disease
d) Myxodema or Gulls disease
e) Myasthenia Gravis
24- Examples of rate limit of insulin may include:
I- Capillary passage
II- Zinc crystalline insulin
III- Protein binding
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
25- Wrong statement regarding FSH and LH may include:
a) They are hormones
b) They are secreted from hypothalamus
c) Secreted specifically from posterior pituitary gland
d) They increase their concentration during ovulation
e) FSH is the folliculum-stimulating hormone
26- False statement regarding insulin may include:
a) Fast acting insulins has an onset of action of 30 min
b) Protamine zinc insulin is long acting insulin
c) Regular and crystalline insulins are used in diabetic patients with ketoacidoses
d) Regular insulin is the only one that can be administrated intravenously
e) Long acting insulins has a maximum duration of action of 24 hours
27- Correct statements regarding the action and examples of insulin may include:
I- Fast acting: Crystalline and acid regular
II- Intermediate acting: Zinc suspension, globulin zinc and isophane insulin
III- Long acting: Protamin zinc suspension, extended zinc suspension and ultralent.
a) I only
b) III only
c) I and II only

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d) II and III only


e) All are correct
28- After an insulin dose, hypoglycemia may occurs due to:
a) Low carbohydrate diet
b) Increase in glucose levels
c) Increase in glycogen levels
d) High carbohydrate diet
e) All are correct
29- Insulin is a hormone secreted by which cells?
a) -cells
b) -cells
c) Glucagon
d) Amylase
e) Pituitary
30- Thyroid glands is extremely important due to its ability to secret:
I- Thyroid hormones
II- Calcitonin
III- Calcium
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
31- Correct statements regarding glucagon, a polypeptide hormone, may include:
I- Secreted by the -cells of pancreas
II- It increase blood glucose levels
III- Stimulate hepatic gluconeogenesis and glycogenolysis
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
32- Examples of therapeutically used hormones and related drugs may include:
a) Adrenocorticosteroids
b) Antidiabetic agents
c) Thyroid hormones
d) Gonadal and pituitaria hormones
e) All are correct
33- Examples of gonadotropin hormone may include:
a) ACHT

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b) FSH
c) TSH
d) TRH
e) Somatropin
34- False statement regarding VASOPRESSIN include:
a) It is an antidiuretic hormone
b) It is used to treat neurogenic diabetes insipidus
c) It is used to treat postoperative abdomen
d) It acts on proximal renal epithelium promoting the absorption of water
e) It acts on distal renal epithelium promoting the absorption of water
35-Hormone which sustain the corpus luteum in pregnancy is:
a) Estrogen
b) FSH-Follicle Stimulating Hormone
c) Gonadotropin hormones
d) Progesterone
e) LH and prolactin
36- Characteristics of diabetes insipidus may include:
a) Polyuria
b) Thirst
c) Decrease in antidiuretic hormones levels
d) Decrease in osmolarity
e) All are correct
37- Drug used in the treatment of diabetes insipidus may include:
a) Glyburine
b) Metformin
c) Oxytocin
d) DDAVP-Desmopressin/Vasopressin
e) Repaglinide
38- Diabetes insipidus may happen due to drug induction. Drug that may induce the
development of diabetes insipidus include:
I- Lithium
II- Tricyclic antidepressant
III- Benzodiazepinics
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
39- Hormone used to improve uterine contraction in labor and to control postpartum
bleeding is:

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a) Vasopressin
b) Oxytocin
c) Somatropin
d) Prolactin
e) Progesterone
40- Which of the following hormones can be classified as non-steroidal synthetic
hormone?
a) Estradiol
b) Ethyl estradiol
c) Diethylstilbestrol
d) Progesterone
e) Estrogen
41- Examples of estrogens antagonists may include:
I- Medroxyprogesterone
II- Clomiphene
III- Tamoxifen
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
42- Which of the following hormone has an aromatic ring in its molecular structure?
a) Estrogen
b) Progesterone
c) Testosterone
d) Cortisol
e) Ethyl androgen
43- Adrenocorticosteroids hormones are naturally in the body and are synthesized by:
a) Hypothalamus
b) Pituitaria
c) Adrenal cortex
d) Adrenal gland
e) Pancreas
44- Which of the following is not a side effect associated with corticosteroids treatment?
a) Edema
b) Hypoglycemia
c) Increased susceptibility to infection
d) Weigh gain
e) Ulcers

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45- Which of the following hormone may stimulates the release of TSH-Thyroid
Stimulating Hormones:
a) ADH
b) LFH
c) TRH
d) LH
e) Aldosterone
46- What DEIODINATION means?
a) The soma of thyrosyl residues with thyroglobulin proteolysis
b) The stimulation of T3 and T4 formation
c) The production of iodine by the thyroid gland
d) The degradation of thyroid hormones that are eliminated by feces and urine.
e) The degradation of iodine
47- Hypothyroidism is due to hypofunction of thyroid gland. Drug(s) used in
hypothyroidism treatment may include:
I- Levothyroxin (T4)
II- Liiothyroxin (T3)
III-Propylthyiuracil
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
48- Hyperthyroidism is characterized by high levels of thyroid hormones. Example(s) of
drugs used in hyperthyroidism treatment may include:
I- Propanolol
II- Methimazole
III-Propylthyiuracil
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
49- Characteristic symptoms of hypothyroidism may include all of the following,
EXCEPT:
a) Sensitivity to cold
b) Heat intolerance
c) Lethargy
d) Constipation
e) Weight gain
50- Autoimmune Insulin dependent diabetes mellitus is also known as:

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I- Diabetes Type I
II- Diabetes insipidus
III- Diabetes Type II
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
51- Example of antidiabetic agent that reduces gluconeogenesis and increase glucose
utilization may include:
a) Glyburine
b) Chlorpropamide
c) Repaglinide
d) Metformin
e) Acarbose
52- Glyburide is an antidiabetic agent characterized by which of the following
mechanism of action?
a) Decrease the absorption of carbohydrates thus decreasing postprandial rise of glucose
b) Reduces glucogeneogenesis and increase glucose utilization
c) Increase peripheral insulin sensitivity
d) Stimulates the release of insulin
e) Reduce gluconeogenesis only
53- Glyburide and metformin, oral antidiabetic agents are often prescribed together in the
treatment of type II diabetes mellitus due to their:
a) Antagonist effect
b) Addition effect
c) Synergistic effect
d) Tolerance
e) Competitive effect
54- Which of the following statements is/are true regarding regular insulin:
I- It is a suspension
II- It may be administrated either SC or IV
III- It is longer acting than lispro insulin
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
55- Which of the following agents may have the same therapeutic indication as
propyltiuracil does?

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a) Danazol
b) Levothyroxine
c) Azathioprine
d) Omeprazole
e) Methimazole
CORRECT ANSWERS
ENDOCRINOLOGY
1- C
Comments: Iron deficiency is called mycrocystic anemia while megaloblastic anemia is a
deficiency of cyanocobalamin and folic acid.
2- C
Comments: Sensitive TSH test has a greater sensitivity in the detection of thyroid disease
than any other test.
3- B
Comments: FSH and LH are predominantly increased during ovulation.
4- E
Comments: Placenta is an organ characteristic of true mammals during pregnancy,
joining mother and offspring, providing endocrine secretion and selective exchange of
soluble, but not particulate, blood-borne substances through an apposition of uterine and
tromphoblastic vascularized parts.
5- D
Comments: Graves disease is characterized by hyperthyroidism.
6- C
Comments: Hypoparathyroidism is a condition produced by greatly reduced function of
the para-thyroids possibly due to autoimmune disease or genetic factors, or by removal of
those bodies. It leads to fall in calcium levels followed by a rise in plasma phosphate
level.
7- A
Comments: Epilepsy is a paroxysmal transient disturbance of brain function that may be
manifested as episodic impairment or loss of consciousness and it is not associated with
contraceptives use.
8- E
Comments: Hyperaldosteronism is an abnormality of electrolyte metabolism caused by
excessive secretion of aldosterone. The over secretion of aldosterone by adrenal cortex is
mainly characterized by hypokalemia.

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9- D
Comments: Aldosterone is the main mineral corticoid hormone secreted by the adrenal
cortex. It is principal activity is the regulation of electrolyte and water balance by
promoting the renal retention of sodium and the excretion of potassium.
10- E
Comments: Ketoacidoses are acidosis accompanied by the accumulation of ketone
bodies (ketosis) in the body tissues and fluids. It can be caused by juvenile diabetes,
diabetes acidosis, starvation and inadequate treatment with insulin.
11- B
Comments: Insulin pump means insulin that provides insulin for a long period of time. It
is normally indicated for selected diabetes patients with widely fluctuating blood glucose
levels, irregular or inconsistent work schedule, lifestyles or meals or who achieve less
than desired control using frequent injection routines.
12- C
Comments: Hypo function of adrenal cortex is well known as Addisons disease while
the hyper function of adrenal cortex is known as Cushings syndrome.
13- C
Comments: Cushing syndrome is characterized by an increase in cortisone levels
resulting from a hyper function of adrenal cortex.
14- E
Comments: Methimazole inhibit iodination of tyrosine groups and coupling of these
groups to form thyroid hormones, therefore it inhibits thyroid synthesis.
15- C
Comments: Sertoli cells are found in the tubules of the testes to which the spermatids
become attached. They provide support, protection and nutrition until the spermatids
become transformed into mature spermatozoa.
16- D
Comments: Pernicious anemia is characterized by deficiency of vitamin B12cyanocobalamine and therefore should be treated with intramuscularly injection of
vitamin B12 because this vitamin is poorly absorbed orally.
17- D
Comments: Pernicious anemia is a deficiency of vitamin B12 only while megaloblastic
anemia is a deficiency of both vitamin B12 and folic acid.
18- D
Comments: Neither constipation nor diarrhea are side effects of oral contraceptives.

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19- A
Comments: The most appropriate insulin for diabetic patients with ketoacidoses are
regular insulin and insulin zinc suspension.
20- B
Comments: Vasopressin is an anti-diuretic hormone secreted from the posterior pituitary.
21- C
Comments: Lactic acidosis is the main side effect of the oral hypoglycaemic agent
biguanide metformin.
22- E
Comments: Stilbestrol is an anticancer drug used mainly used in the treatment of breast
cancer.
23- D
Comments: Hypothyroidism is a hypo function of thyroid gland and responsible for the
development of Myxodiema or Gulls disease.
24- C
Comments: Insulin does not bind to protein bounds.
25- C
Comments: FSH-Follicle Stimulating Hormone and LH-Luteinizing Hormone are
pituitary gonadotropin hormones secreted from the anterior pituitary.
26- E
Comments: Ultralent and Extend Insulin Zinc Suspension are examples of long acting
insulin that may have their effect up to 28 hours. With an onset of action of 2 to 4 hours.
27- E
Comments: Crystalline and acid regular are examples of fast acting insulin with an onset
of action of half to one hour. Insulin as zinc suspension, globulin zinc and isophane are
classified as intermediate acting insulin with an onset of action of 2 to 4 hours. Insulin
with onset of action of 4 to 5 hours are classified as long acting and include protamin zinc
suspension, extended zinc suspension and ultralent.
28- A
Comments: After an insulin dose, hypoglycemia may occurs due to low carbohydrate diet
29- B
Comments: Insulin is a protein hormone secreted by the beta cells of the pancreas. It is
secreted in response to elevated blood levels of glucose, amino acids, ketones, fat acids
and promotes the efficient storage and utilization of these molecules.

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30- C
Comments: Calcium is not secreted by the thyroid hormones.
31- E
Comments: Glucagon is a polypeptide hormone secreted by the alpha cells of pancreas in
response to hypoglycemia or to stimulation by the growth hormone of the anterior
pituitary; it stimulates glycogenolysis in the liver by inducing activation of liver
phosphorylase.

32- E
Comments: Adrenocorticosteroids, antidiabetic agents, thyroid hormones, gonadal and
pituitary hormones are all therapeutically used hormones and related drugs.
33- E
Comments: FSH-Follicle Stimulant Hormone is a gonadotropin hormone excreted from
the anterior pituitary.
34- D
Comments: Vasopressin does not act on proximal but on the distal renal epithelium
promoting the absorption of water.
35- E
Comments: LH and Prolactin sustain the corpus luteum in pregnancy. FSH is increased
only during ovulation.
36- E
Comments: Diabetes insipidus results in a deficient quantity of antidiuretic hormones
being released or produced, and thus failure of tubular reabsorption of water in the
kidney. As a result, a large amount of urine of low specific gravity is excreted, followed
by dehydration and great thirst.
37- D
Comments: Desmopressin and vasopressin an anti-diuretic hormone are the drugs of
choice in the treatment of diabetes insipidus.
38- A
Comments: One of the most known side effects in the long-term treatment with lithium is
diabetes insipidus.
39- B
Comments: Oxytocin is therapeutically used to improve uterine contraction in labour and
to control postpartum bleeding. It also acts in milk ejection stimulation.

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40- C
Comments: Diethylstilbestrol is a non-steroidal synthetic estrogen used in oral
contraceptives, mainly in morning after pills.
41- D
Comments: Medroxyprogesterone is a synthetic progestin used in contraceptives agents.
42- A
Comments: Estrogen is the only steroid hormone with aromatic ring in the ring A of its
molecular structure.
43- C
Comments: Adrenal cortex is the responsible for the release of cortisoneadrenocorticosteroids.
44- B
Comments: Common side effects with Corticosteroids therapy may include: Edema,
weight gain, osteoporosis, GIT effects, hypertension, suppression of pituitary adrenal
integrity and increased susceptibility to infections.
45- C
Comments: TRH is the Thyroid Regulating Hormone, secreted from the anterior pituitary
and responsible for the stimulation of TSHs release.
46- D
Comments: Deiodination is the degradation of thyroid hormones that are eliminated by
feces and urine.
47- C
Comments: Propylthyiuracil is used in the treatment of hyperthyroidism.
48- E
Comments: Propylthyiuracil and Methimazole are main drugs used in the treatment of
hyperthyroidism. However propanolol is also used in the short-term preoperative
management of thyrotoxic crises.
49- B
Comments: Heat intolerance is one of the major side effect of hyperthyroidism.
50- A
Comments: Type I diabetes, also called diabetes mellitus is considered insulin dependent.
Diabetes insipidus in mainly treated with anti-diuretic hormones and diabetes type II is
non-insulin dependent mainly treated with oral hypoglycaemic agents.
51- D

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Comments: Metformin is a biguanide agent used in hyperglycemia-treatment of diabetes


type II by reducing gluconeogenesis and increasing glucose utilization
52- D
Comments: Glyburide as antidiabetic agent is classified as an oral sulfonylurea and act
by stimulating the release of insulin.
53- C
Comments: Glyburide and metformin are often prescribed together in the treatment of
type II diabetes mellitus due to their synergistic effect. Glyburine will stimulate the
release of insulin while metformin reduce gluconeogenesis and increase glucose
utilization
54- D
Comments: Regular insulin is not a suspension, it is a clear solution that is way can be
administrated either IV or SC. It is classified as short acting insulin because it acts for up
to 7 hours. When compared with lispro insulin, we find that lispro has a faster onset of
action than regular insulin.
55- E
Comments: Propylthyiuracil and Methimazole are often prescribed together in the
treatment of hyperthyroidism.

BIBLIOGRAPHIC REFERENCE
1- COMPREHENSIVE PHARMACY REVIEW Lippincott William & Wilkins
Fourth edition
2- CPS-COMPENDIUM OF PHARMACEUTICALS AND SPECIALITIES - Canadian
Pharmacist Association 2001 edition.
3- MEDICAL DICTIONARY Dorlands illustrated 27th edition.
4- PHARMACY PREP Lectures series & study guide for Evaluating ExaminationTIPS - 2003/2004
5- THERAPUTIC CHOICES Canadian Pharmacist Association -Third edition
6- USP DI Drug Information for the Health Care Professional15th edition Volume I.

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PHARMACY PREP.
METABOLISM
1-Which of the following is not a drug-metabolizing enzyme?
A-CYP3A
B-CYP2D6
C-CYP2C9
D-CYP1A2
E-CYP0
Ans-E
2- Pyrrolidine and piperidine are important heterocyclic compounds in the structure of
drugs. Which of the following drugs has these heterocyclic rings on its structure?
A) Folic acid
B) Clonidine
C) Tetrodotoxin
D) Imipramim
E) Atropine
2- E
Comments: - Pyrrolidine is a five membered and piperidine six membered, important
heterocyclic compounds in the structure of drugs. Atropine is an antimuscarinic agent
having pyrrolidine and piperidine heterocyclic rings on its molecular structure.
3- Oxidation of alkyl group results into alcohol, aldehyde and finally carboxylic acids.
What type of alkyl group that mostly undergoes oxidation to an acid is known as:
a) Terminal alkyl group of aliphatic structure
b) Terminal Aromatic alkyl group of structure
c) Benzylic alkyl group attached to aromatic ring structure
d) Heterocyclic ring structure carbons
e) Cyclic ring structure carbons
3- C
Comments: 5- Alkyl group attached to aromatic rings would undergo faster oxidation
because of resonance effect of aromatic ring.
4- Amines are one of the most common group present in the molecular structure of drugs.
Primary amines are mainly metabolized by phase II metabolism:
a) Deamination
b) Dealkylation
c) Acetylation
d) Hydrolysis
e) Oxidation
4- C

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Comments: Acetylation is a phase II metabolism reaction characterized by the gain of an
acyl group, and the main reaction that undergoes primary amines.
5- Molecular structures (drugs) having carboxylic acid, amide, alcohol and/or thio group
are mainly metabolized by:
a) Oxidation
b) Hydrolysis
c) Conjugation
d) Estherification
e) Deamination
5- C
Comments: Conjugations are phase II metabolism reactions characterized by an
incorporation of endogenous substrate on the molecular structure of drugs normally
coming from phase I metabolism reaction. Carboxylic acids are one of the most common
groups present in the molecular structure of drugs mainly metabolized by conjugation.
6- Pyridine is a mono heterocyclic compound very important in the activity of many
different drugs. The molecular structure 1,4-dihydropyridine is found in:
a) Verapamil
b) Digoxin
c) Clonidine
d) Nifedipine
e) Diltiazen
6- D
Comments: Nifedipine is calcium channel blocker that has 1,4-dihydropyridine on its
structure responsible for its mechanism of action. It is also contain nitro fuctional group
7- Quinolone structure may be found in which of the following substances?
a) Vitamin K
b) Thiamine
c) Cyanocobalamin
d) Folic acid
e) Vitamin A
7- A
Comments: Vitamin K has a quinolone on its molecular structure.
8- Steroid structures are common in hormones, such estrogen, progesterone,
testosterones. Steroid contain how many cyclohexane and cyclopentane respectively in it
skeleton.
a) 2 and 3
b) 3 and 2
c) 4 and 1
d) 3 and 1
e) 1 and 3
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8- D
Comments: Most of the steroid compounds have three cyclohexanes and one
cyclopentane ring on their molecular structure.
9- Phase I metabolism reaction also known as functionalization metabolism, during this
phase drug will metabolized to obtain functional groups such as hydroxyl group or
carboxyl group and these group in phase II are best metabolized by which of following
conjugation reaction:
a) Acetylation
b) Glucuronidation
c) Reduction
d) Hydrolysis
e) Methylation
9- B
Comments: Glucuronidation is the main reaction of phase II metabolism reactions, and
are responsible mainly for the metabolism of drugs having hydroxyl, carboxyl and amide
group on their molecular structure. Conjugation reactions are the most common reactions
of phase II drug metabolism.
10- Imidazoline is a molecular structure that contain a heterocyclic ring and belongs the
molecular structure of:
a) Prazosin
b) Nifedipine
c) Atropine
d) Clonidine
e) Allopurinol
10- D
Comments: Clonidine is an antihypertensive drug that depends of its imidazoline
molecular structure to be effective.
11-Diazepam is a long acting benzodiazepine metabolized by:
A-CYP3A
B-CYP2D6
C-CYP2C9
D-CYP1A2
E-CYP0
Ans-A
12- Conjugation reactions are the most common reactions in Phase II metabolism.
Glycine contain hydroxyl group and may undergoes conjugation with:
A) Carboxylic acid
B) Gluthatione conjugates
C) Cytochrome P450
D) Sulfonamides conjugates
E) Alcohol conjugates
1- A

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Comments: Glycine is a phase II metabolism reaction also known as amino acids
conjugation reaction that undergoes conjugation with carboxylic acid
13-Which of the following statins can be taken with grapefruit juice:
I-Atorvastatin
II-Pravastatin
III-Fluvastatin
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
Ans-D
Tips: Atorvastatin, are metabolized by CYP3A enzyme and this enzyme is inhibited by
grapefruit juice, therefore they should not be combined. Fluvastatin, pravastatin,
Rosuvastatin are not metabolized by CYP3A
14-The most common metabolic reaction in human being;
A-Oxidation
B-Hydroxylation
C-Glucuronidation
D-Glutathione conjugation
E-Hydrolysis
Ans-C
15-Acetaminophen is considered to be toxic at higher dose (4g/day) and may cause
hepatotoxicity. This is due to accumulation metabolic intermediate. Which of the
following is enzyme would most likely be deficient?
A-Glucuronyl transferase
B-Azo reductase
C-Methyltransferase
D-Glutathione S-transferase (GST)
E-Pseudocholinesterase
Ans-D
Tips: Glutathione conjugation metabolizes N-acetyl benzoquinone to mercapturic acid,
hence this reduce toxicity of intermediate.
16-All of the following statement about aspirin metabolism are correct except:
A-Aspirin undergo ester glucuronidation
B-Aspirin undergo ether glucuronidation
C-Aspirin undergo hydroxylation
D-Aspirin undergo glycine conjugation
E-Aspirin excretes unchanged drug
Ans-E

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17-Glucuronidation reactions is phase II metabolic reaction, and it is catalyzed by:


A-Glutathione S- transferase
B-Azo reductase
C-UDP-Glucuronyl transferase
D-Methyl transferase
E-N-Acetyl transferase
Ans-C
18-Which of the following substances has affinity to carbon monoxide:
I-Hemoglobin
II-Myoglobin
III-Cytochrome oxidase
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans-E
Tips: Hemoglobin, Myoglobin and cytochrome oxidase contain porphyrin ring, and this
ring has affinity to oxygen, carbon monoxide and carbon dioxide, cyanide etc.

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PHARMACY PREP
BIOPHARMACEUTICS
1-Acetyl salicylic acid (ASA) pH is 3.5 and pKa is 4.5, what percent drug will ionized in
the body.
A-90%
B-99%
C-100%
D-50%
E-9%
AnsTips: Hasselbach-Handerson equation:
% ionization = 100 / 1+10 charge (pH-Pka)
Charge = -1 for acid
= 100 / 1+10 1 (-1)
= 100 / 11 = 9%
- - = +
+ + =+
- +=+- =10 1 = 10
102 = 100
103 = 1000
10-1 = 0.1
10-2 = 0.01
2-Aspirin pH is 3.5 and pKa is 3.5, what percent drug will ionized in the body.
A-90%
B-99%
C-100%
D-50%
E-9%
Ans3-Aspirin pH-Pka = 0, what percent drug will ionized in the body.
A-90%
B-99%
C-100%
D-50%
E-9%
Ans-

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4-The pH of blood is 7.4, after administering drug it becomes 7.2 the drug is:
I-weak acidic
II-weak base
III-amphoteric
A-I only
B-III only
C-I and II
D-II and III
E-All of the above
Ans-A
Tips: pH of blood is 7.4 turns into 7.2 after addition drug that means, decrease pH is
acidic drug.
Example of amphoteric solutions is: H2O H+ + OH5-Aspirin pH is 3.5 and pKa is 3.5, what percent drug will unionized in the body.
A-90%
B-99%
C-100%
D-50%
E-10%
6-If the pKa of weak base drug is 6.4 and you have an ambient temperature with pH 4.4
I-The drug will be almost completely ionized
II-The drug will be rapidly excreted
III-The drug will not be ionized neither excreted
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
Ans-C
100/1+10 1(4.4-6.4)
100/1+10 1(-)

= 99% ionized

Tips: In the above questions just 0.1% is ionized which is very little and excrete very
slowly. Because unionized do not excrete, ionized do excrete. However, Unionized
absorb faster, ionized absorb slower
8-Critical solution temperature represents:
A-The temperature which concentration of phenol is homogenous solution
B-The temperature at phenol vaporizes
C-The temperature above which homogenous solution is formed for all concentration of
phenol
D-Temperature which phenol vapor pressure equals the vapor pressure of water.
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Ans-C
9-The rate of chemical reactions is enhanced by:
A-Increase the stirring
B-Increasing the temperature of reaction mixture
C-Removing the inert solvent
D-Increase the rate of cooling
E-None of the above
Ans-B
10-Correct statement about physiological factors affecting the rate and extent for topical
drug absorption include:
I-The type of ointment base
II-the partition coefficient of the drug molecule
III-surfactant in formulations
Ans-E
11-If the total body clearance of a drug is 200ml/min in normal healthy adult and renal
clearance is 10ml/min then, what is correct in patient.
A-Drug is deposited in adipose tissue
B-Drug is increased in liver and have recycling
C-Drug metabolisms is increased
D-Greater accumulation
E-drug have no plasma protein binding
Ans-C
12-Compared to the sublingual tablet, nitroglycerine ointment is:
A-More stable
B-More effective
C-More prolong effect
D-More absorbed
E-More local effect
Ans-C
13-pH-pka = 1.5, for acidic drug what percent of drug is ionized?
A-3.06%
B-96%
C-2.5%
D-100%
E-50%
Ans-B
14-if a medication if pH = Pka?
A-100% solute is ionized
B-40% solute is ionized
C-50% solute is ionized (1/2)
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D-99% solute is ionized
E-95% solute is ionized
Ans-C
How to use calculator?SHARP EL-510R
Enter: 10
Press : yx

Press: (-)
Enter

1.5 =
101 = 10
10-1 = 0.1
2
10 = 100
10-2 = 0.01
103 = 1000
10-3 = 0.001
15-Phenobarbital (acidic) pH is 3.4 and pKa is 3.4, what percent drug will ionized in the
body.
A-90%
B-99%
C-100%
D-50%
E-10%
AnsTips: pH pKa = 0 is 50% ionized or unionized or PH = pKa is 50%

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Pharmaceutics Test 1

PHARMACY PREP.
PHARMACEUTICS
1- Buffer salts are added to many drug solutions to maintain the formulation at optimum
pH. Which of the following is/are characteristics of a buffer solution:
I- Formed from a weak acid or weak base and its salts.
II- Addition of a little bit of water or a little increase in the temperature will not affect the
pH.
III: Addition of a strong acid or a strong base to the solution will not affect the pH.
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
2- Parenteral solutions are used for internal use. What is the most common used vehicle
for parenteral drugs?
a) Purified water USP
b) Water for injection
c) Distillate water
d) Sterile water for injection USP
e) Fractional distillate water.
3-All the following are oral drug solutions, EXCEPT
a) Elixirs
b) Spirits
c) Tinctures
d) Fluidextracts
e) Lotion
4- All of the following are characteristics of on emulsion, EXCEPT
a) Most of emulsions are constituted of two phases: Aqueous and oily phase
b) If water is the internal phase, the emulsion is classified as W/O
c) If water is the internal phase, the emulsion is classified as O/W
d) If water is the external phase, the emulsion is classified as O/W
e) Emulsifying agents are added to emulsion to lower the interfacial tension
5- Correct statements regarding emulsifying agents include:
I- Lower the interfacial tension stabilizing emulsions
II- Acacia and methyl cellulose are examples of emulsifying agents
III- Synthetic emulsifying agents are not used in emulsion
a) I only
b) III only
c) I and II only
d) II and III only
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Pharmaceutics Test 1

e) All are correct


6- In which method of the following pharmaceutics techniques a substance is reduced by
addition of a solvent material that is easily removed.
a) Trituration
b) Pulverization by intervention
c) Levigation
d) Espatulation
e) Sifting
7- Correct statements regarding Trituration include:
a) Is the process of mixing powders in a large container rotated by a motorized process
b) Is the process when potent substance must be mixed with a large amount of diluents.
c) Is the process of reducing the substance to small particles by rubbing it in a mortar
with a pestle.
d) Is the process of reducing the substance by addition of a solvent that is easily removed
after pulverization.
e) Is the process of mixing powders by passing them through sifters
8- All of the following are used as diluents in tablet formulation, EXCEPT
a) Talc
b) Kaolin
c) Lactose
d) Mannitol
e) Starch
9- Characteristics of use of lubricants in tablet formulation include:
I- It helps the patient to swallow the tablet.
II- Lubricants, glidants and ant adherents have overlapping functions in tablet
formulation.
III- It reduces the friction that occurs between the walls of the tablet and the walls of the
die cavity.
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
10- Which of the following tablet(s) allow absorption through the oral mucosa?
I-Sublingual tablets
II- Lozenges
III- Sugarcoated tablet
a) I only
b) III only
c) I and II only
d) II and III only
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e) All are correct


11- A manufacture tablet processing problem that is characterized by the partial or
complete separation of the top or bottom crown from the main body of the tablet is know
as:
a) Lamination
b) Picking
c) Mottling
d) Capping
e) Sticking
12- Tablet manufacture problems include:
I-Mottling is unequal colour distribution on the tablet surface.
II- Sticking is adhesion of tablet material to a die wall
III- Humidity is the melting of the tablet
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
13- One of the most common lubricant used in tablet manufacture include:
a) Theobroma oil
b) Glycerol
c) Aluminium stearate
d) Sodium stearate
e) Magnesium stearate
14 Which of the following propellant used in aerosol products was put out of market due
to depletation of the ozone layer?
I-Chlorofluorocarbons-CFC
II-Dimethyl-Ether
III-Hydrofluorocarbons-HFC
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
15- Which of the following equations can be used to easily calculate the pH. of a buffer
solutions constituted of a weak acid and its salts.
a) Hixson-Crowell equation
b) Arrhenius equation
c) Stokes equations
d) Henderson-Hasselbalch equation
e) Noyes-Whitney equation
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16- Arrhenius equation is used when we need calculate the:


a) pKa of an acid solution
b) Stability of a drug at room temperature
c) pH of a buffer solution
d) Rate of ionization of a drug
e) Solubility of a solution
17- The HLB-Hydrophilic-Lipophilic Balance is applied to:
a) Emulsifying agents
b) Humectants agent
c) Thermo labile agents
d) Surfactant agent
e) Solubilizing agents
18- An agent with HLB value range of 0-3 is known as:
a) Antifoaming agent
b) W/O emulsifying agent
c) O/W emulsifying agent
d) Wetting agent
e) Detergents
19- An agent classified as oil in water (O/W) emulsifying agent have its HLB value
ranged in:
a) 0-3
b) 4-6
c) 7-9
d) 8-18
e) 13-15
20-Suppository base vary well know of its polymorph characteristics:
a) Cocoa butter
b) Polyethylene Glycol
c) Glycerin
d) Mineral Oil
e) Cotmar
21- All are characteristics of a polymorph drug, EXCEPT:
a) It has a two different physical form
b) It melts in some determinate temperature, normally high temperatures (>30C)
c) Teobroma oil is a classic example of polymorph drug
d) Polymorph drugs are widely used as suppository base
e) Polymorph drugs melt in very low temperature (<10C)

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22- A pharmacist would like to make a compound prescription where he needs to mix 1%
of camphor into white petroleum. Which would be the more appropriated technique to be
used by the pharmacist
a) Trituration
b) Levigation
c) Pulverization by intervention
d) Geometric dilution
e) Attrition
23-We can increase the bioavaliability of an ophthalmic preparation by
I-Increasing viscosity of preparation
II-Addition of a sticking agent
III-Increasing volume of the inserted dose
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
24- Autoclaving is sterilization process of:
A. Dry heat sterilization
B.Steam Sterilization
C.Filtration
D.Gas sterilization
E.Irradiation
25- Acetyl Salicylic Acid is easily hydrolyzed during tablet manufacturing. To avoid
manufacture problems we should use:
I- Dry granulation
II- Direct compression
III Wet granulation
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
26- Flocculated suspension upon sedimentation will produce
I-Large volume sedimentation
II-Clear boundary when particles settle
III-Easily resuspended when shaking
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
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27- Methylparaben is used in ophthalmic solution as


a) Preservative
b) Surfactant
c) Viscosity enhancer
d) Humectants
e) Solubilizing agent
28- The excipients used in tablet formulation have a large variety of functions. Which of
the following do not describe a tablet excipient?
a) Diluents are fillers designated to make up the required bulk of the tablet
b) Binders promote granulation during the dry granulation process
c) Disintegrates facilitate disintegration when the tablet reaches the GIT
d) Glidants help to promote the flow of tablet granulation
e) Emollients help to moisturize the tablet to avoid irritation of oral mucosa
29- What is true regarding DELIQUESCENCE?
I- Occurs when the vapor pressure of the saturated aqueous solution is less than the vapor
pressure of the water in the ambient air.
II- Its the condition of becoming moist
III- Its the result of the absorption of water from the air
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
30- Substances that have the capacity of absorbing moisture is well known as:
a) Hygroscopic
b) Hydromorphic
c) Hydrophilic
d) Hydrophobic
e) Amphiphilic
31- Van Der Waals forces is an example of
a) Hydrogen bound
b) Dipole-dipole interaction
c) Covalent bound
d) Cation-cation interaction
e) Anion-anion interaction
32- In order to have hydrogen bound, the molecule should have the following
characteristics
I- The molecule should be formed of hydrogen and strong electronegative elements
II- F, N, O, S, Cl are examples of strong electronegative elements
III- Hydrogen bounds can be classified in INTER and INTRA depending the position of
the bound in the molecule
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a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
33- Hydrogen bound can be formed with all the following molecules, EXCEPT:
a) Ether-ether
b) Alcohol-alcohol
c) Esther-alcohol
d) Water-alcohol
e) Esther-Water
34- Correct statements regarding Eutectic Mixture may include:
I- Is the mixture of two or more substances that melt at the highest possible temperature
II- Is the mixture of two or more substances that melt at the lowest possible temperature
III- Eutectic point is the melting point of a eutectic mixture
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
35- Correct statements regarding Partition Coefficient may include:
I- It measures the solubility of a substance in octane and water
II- It specifies how hydrophilic and hydrophobic a substance is.
III- A substance with high partition coefficient is hydrophilic
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
36-All are true statements regarding ADSORPTION, except:
a) Separation of a substance from one phase accompanied by its concentration at the
surface of another.
b) Separation of a substance from one phase to another phase
c) An adsorbent agent is capable of holding other molecule onto its surface
d) Examples of adsorbent agents are charcoal and powdered cellulose
e) Adsorption and absorption are two different processes
37- Which of the following tablets suffer disintegration only when it reaches the small
intestine?
a) Coated tablet
b) Sugar coated tablet
c) Enteric coated tablet
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d) Caplets
e) Lozenges
38- Binders are used in tablet formulation to make the adhesion of the powdered drug to
the inactive drug. Which of the following binder can be used in both wet and dry tablet
formulation?
a) Cellulose
b) Gelatin
c) Starch
d) Sucrose
e) Methyl cellulose
39- What does EFFLORESCENCE means?
a) Absorb moisture
b) Maintain moisture
c) Loss of moisture
d) Absorb water
e) Loss of carbon dioxide
40- Deflocculating agents are widely used in suspensions:
I- They are used to enhance the particles dispersability of a suspension
II- They make the suspension easily to redisperse by shaking the suspension
III- Deflocculating agents are used in solution, emulsions and suspensions
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
41- Which of the following labels would be the most appropriate to be used in your
pharmacy when dispensing a suspension
a) Take with food
b) Shake well before use
c) Take with lots of fluids
d) Rinse mouth after use
e) All the above are correct
42- Antioxidants are added to drug formulation in order to avoid degradation. All of the
following are antioxidants, EXCEPT
a) Tocopherol
b) Ascorbic acid
c) EDTA
d) Sodium bisulfite
e) Sodium benzoate
43- Correct statements regarding Tocopherol include:
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I- It is an antioxidant mainly used in water-soluble formulations


II- It is also known as vitamin E
III- -Tocopherol is the strongest tocopherol antioxidant
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
44- You received a new drug in your pharmacy and the manufacture instructions tell you
to keep this drug in a cool place. Which temperature should you keep this drug?
a) <0C
b) 2 to 8C
c) 8 to 15C
d) 15 to 30C
e) >30C
45- Correct statements regarding vapor pressure may include:
I- Vapor pressure is not a colligative propriety
II- Increasing solute, decrease the vapor pressure
III- Increasing solute, increase the boiling point
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
46- Boric acid is often used to adjust the isotonicity of some drug preparations because of
its buffer capacity and anti-infective proprieties. Boric acid is widely used in:
a) Ophtalmic solutions
b) Nasal solutions
c) Otic solutions
d) Topical formulations
e) Oral solutions
47- Burrows solution Aluminum acetate is known as:
a) Colloidion
b) Astringent
c) Adsorbent
d) Absorbent
e) Surfactant
48- Which of the following best describe the function of propylene glycol in this
formulation?
Diazepan IV----------2mls
Propileno glycol-----2%
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Ethanol----------------5mls
a) Preservative
b) Solvent
c) Co-solvent
d) Surfactant
e) None of the above
49- Sodium stearate is classified as:
a) Anionic
b) Cationic
c) Non-ionic
d) Hydrophobic
e) Amphiphilic
50- Compared to the sublingual tablet, nitroglycerin ointment:
a) Provides only local effect
b) It a more stable dosage form
c) Provides a more prolonged effect
d) Is more rapidly absorbed
e) Is more rapidly eliminated
51- The dissolution rate of nitrofurantoin tablets may be increased by:
a) Micronizing the nitrofurantoin powder
b) Decreasing viscosity of the dissolution medium
c) Heating the solution medium
d) Mechanical agitation
e) All of the above increase the dissolution rate of nitrofurantoin tablets
52- Benzocaine with caffeine can for
a) Ion-dipole
b) Ion-Ion
c) Dipole-dipole
d) Complex molecule
e) No reaction is formed
53- Antioxidants, which mechanistically act as reducing agent, include:
I- Ascorbic acid
II- Sodium bissulfite
III- Citric acid
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
54- Reason for using coating tablets include all of the following, EXCEPT:
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a) To mask the taste of the drug


b) To mask the odor of the drug
c) To improve the appearance of the drug
d) To increase the drugs release rate
e) To protect the drug from stomac acid
55- An ophthalmic solution must be
a) Hypertonic
b) Isotonic
c) Hypotonic
d) Amphiphilic
e) Lipophilic
56- Use(s) Mineral oil may include:
a) Used as laxative
b) Used as antioxidant
c) In chronic use decrease the absorption of fat-soluble vitamins
d) Used as lubricant in suppositories
e) All are correct
57- Which decrease tension between solid and liquid?
a) Solubilizing agent
b) Wetting agent
c) Hydrophilic agent
d) Emulsifying agent
e) Decreasing the particle size of the solid
58- An agent with HLB value range of 14-18 is known as:
a) Antifoaming agent
b) W/O emulsifying agent
c) O/W emulsifying agent
d) Wetting agent
e) Solubilizing agent
59- In preparing ZnSO4 suppositories using 200mg of its USP value. Refers that dispense
value of ZnSO4 is 4 means that:
a) ZnSO4 will displace 800mg of cocoa butter
b) Cocoa butter displace 800mg of ZnSO4
c) Only 4mg of cocoa butter will be displaced
d) 200mg of ZnSO4 will displace 50mg of cocoa butter
60- Addition of mineral oil to a sulphur ointment preparation is called:
a) Levigation
b) Milling
c) Trituration
d) Solubilization
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e) Emulsification
61- One part of solvent is required to dissolve one part of solute:
a) Slightly
b) Sprangly
c) Soluble
d) Freely soluble
e) Very soluble
62- Suitable antioxidants for an aqueous preparation:
I-EDTA
II-Ascorbic acid
III- Tocopherol
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
63- Hydrogen peroxide for TOPICAL use solution:
a) 5V
b) 10V
c) 15V
d) 20V
e) 30V
64- Benzocaine as a local anesthetic in a TOPICAL preparation should be at least, not
less than:
a) 1%
b) 3%
c) 5%
d) 10%
e) 15%
65- Correct statements regarding Papain may include:
I- Proteolitic enzyme used in contact Lents to remove proteins
II- Used as preservative in soft contact Lents
III- Only available in the ophthalmic office
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct

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CORRECT ANSWERS
PHARMACEUTICS
1- C
Comments: Buffer salts are added to many drug solutions to maintain the formulation at
optimum pH. It is formed from a weak acid or weak base and its salts. Buffers solution
will be mainly altered if suffer addition of a strong acid or a strong base to the solution.
2- D
Comments: Sterile water for injection USP is the most common used vehicle for
parenteral drugs, however Water for injection and bacteriostatic water for injection are
also used.
3- E
Comments: Lotions are only used topically.
4- C
Comments: Emulsions are considered two-phase system; if the water is the internal
phase, the emulsion is classified as W/O and if the water is the external phase, the
emulsion is classified as O/W.
5- C
Comments: Emulsifying agents are any compound that lower the interfacial tension and
forms a film at the interface stabilizing emulsions. Acacia and methyl cellulose are some
of the most common used emulsifying agents and they can be classified as natural or
synthetic emulsifying agents.
6- B
Comments: Pulverization by intervention is a widely used pharmaceutics technique in
which a substance is reduced and subdivided with an additional material (solvent) that is
easily removed after pulverization.
7- C
Comments: Trituration is a pharmaceutics technique in which the substance is reduced to
small particles by rubbing it in a mortar with a pestle. Trituration also describes the
process by which fine powders are intimately mixed in a mortar.
8- A
Comments: The most common diluents used in pharmacy industry include kaolin,
lactose, mannitol, cellulose, powdered sugar, starch and calcium phosphate.
9- D
Comments: Lubricants are used in tablet formulation to reduce the friction that occurs
between the walls of the tablet and the walls of the die cavity when tablet is ejected.
10- C
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Comments: Sugar coated should be swallowed because the coated sugar provides a
barrier to a drugs objectionable taste and smell, or to improve the appearance of the
drug.
11- D
Comments: Capping is a manufacture tablet processing problem characterized by the
partial or complete separation of the top or bottom crown from the main body of the
tablet.
12- C
Comments: Manufacture common tablet processing problems involve mottling, sticking
and picking.
13- E
Comments: Talc, magnesium stearate and calcium stearate are commonly lubricant used
in tablet manufacture
14- A
Comments: Chlorofluorocarbons-CFC is propellant used in the past in aerosol products,
it was put out of market due to depletation of the ozone layer. Nowadays the most used
one is Hydro fluorocarbons-HFC.
15- D
Comments: Henderson-Hasselbalch equations used to mathematically calculate the pH of
a buffer solution.
16- B
Comments: Arrhenius equation is used to calculate the stability of a drug at room
temperature.
17- D
Comments: The HLB-Hydrophilic-Lipophilic Balance is applied to surfactant agent
18- A
Comments: Agent with HLB value range of 0-3 is known as antifoaming agent.
19- D
Comments: Agent classified as oil in water emulsifying agent has its HLB value ranged
between 8-18.
20- A
Comments: Cocoa butter is widely used as suppository base due to its polymorph activity.
21- E
Comments: Polymorph drug has two different physical form depending the currently
temperature that they are present, normally melting in high temperatures (>30C), and
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keeping solid in low temperature (<10C). Theobroma oil or cocoa butter is a classic
example of polymorph drug
22- C
Comments: Pulverization by intervention is a widely used pharmaceutics technique in
which a substance is reduced and subdivided with an additional material (solvent) that is
easily removed after pulverization.
23- A
Comments: Increasing viscosity of an ophthalmic preparation increases its bioavailability.
24- B
Comments: Autoclaving is the sterilization process for steam sterilization.
25- C
Comments: Wet granulation tablet manufacturing method cannot be used in the
preparation of Acetyl Salicylic Acid because it is easily hydrolyzed during tablet
manufacturing.
26- C
Comments: Flocculated suspension upon sedimentation will produce a large volume
sedimentation and clear boundary when particles settle.
27- A
Comments: Methylparaben is commonly used in ophthalmic solution as preservative.
28- E
Comments: Emollients are not used as excipients in tablet formulation
29- E
Comments: Deliquescence, the condition of become moist, occurs when the vapor
pressure of the saturated aqueous solution is less than the vapor pressure of the water in
the ambient air as result of the absorption of water from the air
30- A
Comments: Hygroscopic is the name given to substances that have the capacity of
absorbing moisture. They may be classified as anhydrates or hydrates.
31- B
Comments: Van Der Waals forces are permanent dipole interactions.
32- E
Comments: Hydrogen bound occurs between strong electronegative elements such as F,
N, O, S and Cl. They may be classified in INTRA when the hydrogen bound is within the
molecule and INTER when the hydrogen bound is in between of two molecules

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33- A
Comments: Ethers are groups having no hydrogen molecules therefore cannot form
hydrogen bound between them.
34- D
Comments: Eutectic Mixture is the mixture of two or more substances that melt at the
lowest possible temperature and the eutectic point is the melting point of a eutectic
mixture
35- E
Comments: Partition Coefficient measures the solubility of a substance in octane and
water specifying how hydrophilic and hydrophobic a substance is.
36- B
Comments: Adsorption is a process of separating a substance from one phase
accompanied by its accumulation or concentration at the surface of another.
37- C
Comments: Enteric coated tablet are hardly coated tablet resistant to gastric acid, and
suffer disintegration only when it reaches the small intestine.
38- A
Comments: Binders are used in tablet formulation to make the adhesion of the powdered
drug to the inactive drug. Cellulose is an example of classic binder that can be use in both
wet and dry tablet.
39- C
Comments: Efflorescence is the process of moisture lost.
40- C
Comments: Flocculated agents are widely used in suspensions to enhance the particles
dispensability of a suspension providing no cake, and making the suspension particles
very easy to redisperse by shaking the suspension. Flocculated agents are used only in
suspensions
41- B
Comments: The most appropriated auxiliary label to use in dispensing a suspension is
Shake well before use
42- E
Comments: Antioxidants are added to drug formulation in order to avoid degradation. All
of the following are antioxidants; sodium benzoate is an example of preservative not
antioxidant.
43- D

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Comments: Tocopherol also called vitamin E is widely used in pharmacy industry as


antioxidant. -Tocopherol is the strongest tocopherol antioxidant.
44- C
Comments: Cool places include rooms wit temperature ranging between 8 to 15C.
45- D
Comments: Vapor pressure is a colligative propriety.
46- A
Comments: Boric acid is widely used in ophthalmic solutions as buffer agent due to its
capacity to adjust the isotonicity
47- B
Comments: Astringent work by coagulating protein when applied to skin or mucous
membrane. The protein precipitate forming a protective coat, allowing new tissue to
regenerate underneath, Burrows solution is a classic example of astringent.
48- C
Comments: Propylene glycol is mainly used as co-solvent in parenteral drug formulation.
49- A
Comments: Sodium stearate is stiffening and emulsifying anionic agent used in
pharmaceutical preparations.
50- C
Comments: 50- Compared to the sublingual tablet, nitroglycerin ointment: Provides a
more prolonged effect
51- E
Comments: The dissolution rate of nitrofurantoin tablets may be increased by
micronization of the nitrofurantoin powder, decreasing viscosity of the dissolution
medium, heating the solution medium and mechanical agitation
52- D
Comments: Benzocaine with caffeine forms a complex molecule.
53- C
Comments: Citric acid does not act as reducing agent.
54- D
Comments: Coating tablets has a long onset of action due the presence of the coated on
its formulation, therefore the coat decrease the drugs release rate.
55- B
Comments: An ophthalmic solution must be isotonic to avoid eye irritation.

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56- E
Comments: Mineral oil exerts many different functions in pharmaceutical manufacturing
including antioxidant, laxative and lubricant proprieties.
57- B
Comments: Wetting agents are normally used in pharmaceutical preparations to decrease
tension between solid and liquid.
58- E
Comments: Agent with HLB value ranging between 14-18 is known as solubilizing
agent.
59- E
Comments: The 4 dispensing valour in the preparation of ZnSO4 suppositories means
that 200mg of ZnSO4 will displace 50mg of cocoa butter.
60- A
Comments: Levigation is the technique used by addition of a liquid to the substance as an
intervening agent to reduce the particle size of drug by grinding together.
61- E
Comments: Very soluble substances are called for substances that require only one part of
solvent to dissolve one part of solute (substance).
62- C
Comments: Tocopherol also known as vitamin E is a fat-soluble agent therefore cannot
be used in aqueous preparation.
63- B
Comments: Hydrogen peroxide is used topically on skin in a maximum concentration of
10V to avoid burns on skin.
64- C
Comments: Benzocaine as a local anesthetic in a topical preparation should be at least,
not less than 5%. Lesser concentration will not be effective.
65- A
Comments: Papain is a proteolitic enzyme used in contact Lens to remove proteins and is
available in most of OTC contact lents washers.
BIBLIOGRAPHIC REFERENCE
1- COMPREHENSIVE PHARMACY REVIEW Lippincott William & Wilkins
Fourth edition

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2- CPS-COMPENDIUM OF PHARMACEUTICALS AND SPECIALITIES - Canadian


Pharmacist Association 2001 edition.
3- MEDICAL DICTIONARY Dorlands illustrated 27th edition.
4- PHARMACY PREP Lectures series & study guide for Evaluating ExaminationTIPS - 2003/2004
5- THERAPUTIC CHOICES Canadian Pharmacist Association -Third edition
6- USP DI Drug Information for the Health Care Professional15th edition Volume I.

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Pharmaceutical Additives

PHARMACY PREP
PHARMACEUTICAL ADDITIVES
1-Additives which promote the breaking up of tablets into smaller particles are referred to as:
a.
Fillers
b.
Disintegrant
c.
Lubricants
d.
Dispersants
Ans: b
2- Which of the following polyols should never be used as a sweetening agent because
of its severe toxicity?
a. Sorbitol
b. Glycerol
c. Propylene glycol
d. Ethylene glycol
Ans: d
3-Which of the following dosage forms is a concentrated sugar or sugar substitute?
a. Elixirs
b. Syrups
c. Solutions
d. Cerates
e. Tinctures
Ans: b
4-Certain cellulose derivatives are employed in syrups for which of the following reasons?
a. Sweetener
b. Viscosity enhancer
c. Flavoring
d. Caloric agent
e. Preservative
Ans: b
5- Antioxidants are added to drug formulation in order to avoid degradation. All of the
following are antioxidants, EXCEPT
a) Tocopherol
b) Ascorbic acid
c) EDTA
d) Sodium bisulfite
e) Sodium benzoate
Ans-E
6- Correct statements regarding tocopherol (vitamin E) include:
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I- It is an antioxidant mainly used in water-soluble formulations


II- It is also known as vitamin E
III- -tocopherol is the strongest tocopherol antioxidant
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
Ans-D
7- Boric acid is often used to adjust the isotonicity of some drug preparations because of its
buffer capacity and anti-infective proprieties. Boric acid is widely used in:
a) Ophthalmic solutions
b) Nasal solutions
c) Otic solutions
d) Topical formulations
e) Oral solutions
Ans-A
8- Sodium stearate is classified as:
a) Anionic
b) Cationic
c) Non-ionic
d) Hydrophobic
e) Amphiphilic
Ans-A
9- Antioxidants, which mechanistically act as reducing agent, include:
I- Ascorbic acid
II- Sodium bisulfite
III- Citric acid
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
Ans-C
10- Which decrease tension between solid and liquid?
a) Solubilizing agent
b) Wetting agent
c) Hydrophilic agent
d) Emulsifying agent
e) Decreasing the particle size of the solid
Ans-B

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Pharmaceutical Additives

11- An agent with HLB value range of 14 to 18 is known as:


a) Antifoaming agent
b) W/O emulsifying agent
c) O/W emulsifying agent
d) Wetting agent
e) Solubilizing agent
Ans-E

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PHARMACY PREP
RHEOLOGY
1-The diagram represent the following flow system:

A-Pseudoplastic flow
B-Newtonian flow
C-Thixotropy
D-Dilatant flow
E-Antithixotropy
Ans-B
2-The diagram represents which of the following flow system:

A-Pseudoplastic flow
B-Newtonian flow
C-Thixotropy
D-Dilatant flow
E-Antithixotropy
Ans-A
3-The diagram represents which of the following flow system:
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A-Pseudoplastic flow
B-Newtonian flow
C-Thixotropy
D-Dilatant flow
E-Antithixotropy
Ans-C
4- Which of the following flow systems shows a yield value?
A-Thixotropy
B-Pseudoplastic flow
C-Dilatent flow
D-Newtonian flow
E- Plastic flow
Ans-E
5- Which of the following dosage forms is likely to show a yield value?
I-Ointments
II-Flocculated suspensions
III-Gels
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans-E
6-All are the important reasons for coating tablets: EXCEPT
a-To mask the odor of drug
B-to improve the flow of drug
C-To increase release rate
D-To protect from stomach acid
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E-to mask taste of drug
Ans-C
7-Loss of moisture is:
A-Efflorescence
B-Deliquescence
C-Hygroscopic
D-Polymorphism
E-condensation
Ans-A
8-Which of the following would be referred to as a Newtonian type of flow?
A-pseudoplastic
B-Dilatant
C-Plastic
D-None of the above
Ans-D
Tips: Newtonian flow is dilute solutions, which obeys Newtons Law.
9-Which of the following is azo dye?
a-Lysol
B-pyridium
C-Argyrol
D-Nitrofurazone
E-Hexachlorphene
Ans-B
10-What is incorrect about thixotropy?
A-Gel to solution
B- Solution to gel
C- Viscosity decreased
D-Flow ability increased
E-None of the above
Ans-B

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PHARMACY PREP
PHARMACEUTICAL DOSAGE FORMS
1-An enteric coated tablet or beads are designed to:
I-Pass through the stomach and break up in the intestine.
II-To reduce stomach irritation
III-Slow disintegration and sustain release dosage forms
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans-C
2-All of the following are the purpose of coating tablets EXCEPT:
A-Protection from by atmospheric oxygen or humidity
B-to provide desired release pattern for drug substance after administration.
C-To mask the taste and odour of the drug.
D-To allow ease in swallowing tablets
E-To increase the potency of drugs.\
Ans-E
3-Methyl paraben and propyl paraben are:
A-Antifungal drugs
B-Antibacterial preservatives
C-Antifungal preservatives
D-Increase shelf life of drugs
E-increase stability of drugs
Ans-C
Comments: Methyl paraben and propyl paraben combination may have synergistic effect.
4-Aspirin tablets can be manufactured by the following methods:
I-Wet granulation methods
II-Dry granulation methods
III-Direct compression methods
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans-D
Tips: aspirin is gets degradation in moisture, therefore wet granulation methods is not
used in aspirin manufacturing.

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5-Picking is the problem in the manufacture of:
A-cream
B-Lotions
C-Tablets
D-Capsules
E-suspensions
Ans-C
6-Breaking is the problem in the manufacture of:
A-Cream
B-Lotions
C-Tablets
D-Capsules
E-suspensions
Ans-A
Comments: breaking (irreversible) or creaming (reversible) is the problem in emulsions.
7-Lyophilization (freeze dry) method used for:
A-drying wet drugs to powder
B-powder sterilization methods
C-Hormone sterilization methods
D-Sublimation methods used in drying wet powder
E-Sterilization method used for thermolabile products
Ans-D
Comments: Freeze dry is drying method for thermolabile substances, mechanistically it
works as sublimation. However this is not a sterilization method.
8-Which of the following indicated loss of carbon dioxide:
A- Deliquescent
B-Efflorescent
C-Effervescent
D-Hydroscopic
E-Hygroscopic
Ans- C
Comments:
Deliquescentabsorb water
Efflorescentloss of moisture
Effervescentloss of carbon dioxide
Hydroscopicabsorb moisture
Hygroscopicabsorb moisture
9-In the presence of water sodium bicarbonate reacts with acid to liberate carbon dioxide:
A-Deliquescent
B-Efflorescent
C-Effervescent
D-Hydroscopic
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E-Hygroscopic
Ans-C
Comments: Alka-seltzer tablets have effervescent
10-Upon combination of powder A and powder B, the mixture melting point is lower
than powder A and Powder B:
A-Efflorescent
B-Eutectic point
C-Hydroscopic mixture
D-Deliquescent mixture
E-Low melting point mixture
Ans-B
Tips: Camphor and menthol may have eutectic properties
11-Flocculating agents:
I-Increase dispersion
II-Decrease sedimentation
III-Increase volume
A-I only
B-III only
C-I and II
D-II and III
E-All of the above
Ans-C
Tips: flocculating agents increase dispersion and decrease sedimentation however do not
change volume
12-Veegum (Suspending agents)
I-decrease viscosity
II-Increase viscosity
III-Decrease sedimentation
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans-D
Comments: suspending agents increase viscosity and decrease sedimentation
13-The flow ability of substance can be described by Thixotropy:
A-Increases gel viscosity
B-Increases fluidity
C-Decreases viscosity
D-Increase sedimentation
E-Decrease sedimentation
Ans-B
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14-The primary pharmaceutical use of veegum is as a:


A-Emulsifying agent
B-Surfactant
C-Suspending agent
D-sweetener
E-Flocculating agent
Ans-C
Comments: veegum, agar, acacia, pectin, tragacanth are suspending agents
15-The primary pharmaceutical use of surfactant is as a:
A-Emulsifying agent
B-Surfactant
C-Suspending agent
D-sweetener
E-Flocculating agent
Ans: A
Comments: surfactants primarily used as emulsifying agents
16-Spans and tweens are:
A-Non ionic surfactants
B-Anionic surfactants
C-Cationic surfactants
D-Poly oxyalkylene derivatives
E-Suspending agents
Ans:A
Comments: benzalkonium chloride, spans, tweens, are examples of non ionic surfactants
17-Parenteral solution should be free from:
I-Microorganisms
II-Microparticulates
III-Pyrogen
A-I only
B-III only
C-I and II
D-II and III
E-All of the above
Ans-E
Comments paranteral solutions should be sterile (free from microorganism),
microparticulates, pyrogens.
18-HEPA filters used in sterile preparations filtration:
I-Microorganisms
II-Particulates
III-Pyrogens
A-I only
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B-III only
C-I and II
D-II and III
E-All of the above
Comments: C
Comments: pyrogens cannot be filtered by HEPA filters
19-All non-sterile surface areas in laminar airflow hood should be swabbed with:
I-70% isopropyl alcohol
II-70% Ethyl alcohol
III-Chlorhexidine
A-I only
B-III only
C-I and II
D-II and III
E-All of the above
Ans-C
20-Acacia is classified as:
A-suspending agent
B-natural emulsifying agent
C-Semi synthetic emulsifying agent
D-Flocculating agent
E-tablet filler
Ans-B
21-Rectal suppositories intended for adult use, approximately weigh.
A-10g
B-5g
C-2g
D-1g
E-0.5g
Ans-C
22-In a dispensing pharmacy, pharmacist usually mixes active powder with large amount
of diluent by:
A-Levigation
B-Geometrical dilution
C-Trituration
D-Sifting
E-Pulverization
Ans-B
23-The shell of soft gelating capsules may made by addition of plastic like substance
A-Polyethylene glycol (PEG)
B-Povidone
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C-Lactose
D-Sorbitol
E-methyl cellulose
Ans-D
24-Which is the smallest size of capsule:
A-5
B-2
C-00
D-1
E-000
Ans-A
25-In extemporaneous preparations of suspensions, levigation is used:
A-Reduce particle size
B-Reduce viscosity
C-Increase particle size
D-Increase sedimentation rate
E-Reduce sedimentation rate
Ans-A
26-What are the suitable forms of water can be used in parenteral preparations
I-Sterile water for injection USP
II-Water for injection USP
III-Purified water USP
A-I only
B-III only
C-I and II
D-II and III
E-All of the above
Ans-C
27-Which of the following is the output of albuterol Inhalation aerosol
I-Dry mist
II-Wet mist
III-Stable foam
A-I only
B-III only
C-I and II
D-II and III
E-All of the above
Ans-A
28-In the following formulations
Phenol 0.5%
Cimetidine HCl
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Water for injection USP
What is the role of water for injection USP
A.Preservative
B.Solvent
C.Cosolvent
D.Diluent
E.Disinfectant
Ans-B
30. Absolute bioavailability is the result of comparing
a. oral dosage from and IV dosage form
b. oral bioavailability from and sublingual form
c. oral bioavailability from and IM dosage form
d. oral bioavailability from and rectal form
Ans: A
31- Which of the following labels would be the most appropriate to be used in your
pharmacy when dispensing a suspension
a) Take with food
b) Shake well before use
c) Take with lots of fluids
d) Rinse mouth after use
Ans-B
32- Antioxidants are added to drug formulation in order to avoid degradation. All of the
following are antioxidants, EXCEPT
a) Tocopherol
b) Ascorbic acid
c) EDTA
d) Sodium bisulfite
e) Sodium benzoate
Ans-E
33- Correct statements regarding tocopherol (vitamin E) include:
I- It is an antioxidant mainly used in water-soluble formulations
II- It is also known as vitamin E
III- -tocopherol is the strongest tocopherol antioxidant
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
Ans-D

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34- You received a new drug in your pharmacy and the manufacture instructions tell you
to keep this drug in a cool place. Which temperature should you keep this drug?
a) <0C
b) 2 to 8C
c) 8 to 15C
d) 15 to 30C
e) >30C
Ans-C
35- correct statements regarding vapor pressure may include:
I- Vapor pressure is not a Colligative propriety
II- Increasing solute, decrease the vapor pressure
III- increasing solute, increase the boiling point
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
Ans-D
36- Boric acid is often used to adjust the isotonicity of some drug preparations because of
its buffer capacity and anti-infective proprieties. Boric acid is widely used in:
a) Ophthalmic solutions
b) Nasal solutions
c) Otic solutions
d) Topical formulations
e) Oral solutions
Ans-A
37- Burrows solution Aluminum acetate is known as:
a) Colloidion
b) Astringent
c) Adsorbent
d) Absorbent
e) Surfactant
Ans-B
38- Which of the following best describe the function of propylene glycol in this
formulation?
Lorazepan ----------2mls
Propileno glycol-----2%
Ethanol----------------5mls
a) Preservative
b) Solvent
c) Co-solvent
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d) Surfactant
e) None of the above
Ans-C
39- Sodium stearate is classified as:
a) Anionic
b) Cationic
c) Non-ionic
d) Hydrophobic
e) Amphiphilic
Ans-A
40- Compared to the sublingual tablet, nitroglycerin ointment:
a) Provides only local effect
b) It a more stable dosage form
c) Provides a more prolonged effect
d) Is more rapidly absorbed
e) Is more rapidly eliminated
Ans-C
41- The dissolution rate of nitrofurantoin tablets may be increased by:
a) Micronizing the nitrofurantoin powder
b) Decreasing viscosity of the dissolution medium
c) Heating the solution medium
d) Mechanical agitation
e) All of the above increase the dissolution rate of nitrofurantoin tablets
Ans-E
42- Benzocaine with caffeine can form
a) Ion-dipole
b) Ion-Ion
c) Dipole-dipole
d) Complex molecule
e) No reaction is formed
Ans-D
43- Antioxidants, which mechanistically act as reducing agent, include:
I- Ascorbic acid
II- Sodium Bisulfite
III- Citric acid
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct

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Ans-C
44- Reason for using coating tablets include all of the following, EXCEPT:
a) To mask the taste of the drug
b) To mask the odor of the drug
c) To improve the appearance of the drug
d) To increase the drugs release rate
e) To protect the drug from stomach acid
Ans-D
45- An ophthalmic solution must be
a) Hypertonic
b) Isotonic
c) Hypotonic
d) Amphiphilic
e) Lipophilic
Ans-B
46- Use(s) Mineral oil may include:
a) Used as laxative
b) Used as antioxidant
c) In chronic use decrease the absorption of fat-soluble vitamins
d) Used as lubricant in suppositories
e) All are correct
Ans-E
47- Which decrease tension between solid and liquid?
a) Solubilizing agent
b) Wetting agent
c) Hydrophilic agent
d) Emulsifying agent
e) Decreasing the particle size of the solid
Ans-B
48- An agent with HLB value range of 14-18 is known as:
a) Antifoaming agent
b) W/O emulsifying agent
c) O/W emulsifying agent
d) Wetting agent
e) Solubilizing agent
Ans-E
49- In preparing ZnSO4 suppositories using 200mg of its USP value. Refers that
displacement value of ZnSO4 is 4 means that:
a) ZnSO4 will displace 800mg of cocoa butter
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b) Cocoa butter displace 800mg of ZnSO4
c) Only 4mg of cocoa butter will be displaced
d) 200mg of ZnSO4 will displace 50mg of cocoa butter
Ans-D
50- Addition of mineral oil to a sulphur ointment preparation is called:
a) Levigation
b) Milling
c) Trituration
d) Solubilization
e) Emulsification
Ans-A
51-Tubular reabsorption is not dependent on?
A-pH of urine
B-Ionized form of drug
C-Speed of flow of urine
D-Metabolism
E-pKa
Ans-D
52-Renal nephrosis causes
I- Glomerular to be permeable
II-Leak the proteins to urine
III-The capillary membrane becomes impermeable
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
Ans-C (I and II)
53-What is the example of humectant?
I-Glycerine
II-Propylene glycol
III-Sorbitol
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
Ans-E
54-Definition of colligative properties?
A-Elevation of boiling point
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B-Decrease vapor pressure
C-Decrease in freezing point
D-osmotic pressure
E-All of the above
Ans-E
55-pH-Pka = 1.5, for acidic drug what percent of drug is ionized?
A-3.06%
B-97%
C-2.5%
D-100%
E-50%
How to use calculator?
Enter: 10
Press : yx

Press: (-)
Enter

1.5 =

56-What is the site for intraarticular injection?


A-injection in joint spaces
B-injection nerves
C-injection in spinal cord spaces
D-Injection in brain
E-injection in fatty tissues
57-Example of oils used in parenteral preparations, Except?
A-Sesame oil
B-Olive oil
C-Cotton seed oil
D-Pea nut oil
E-Mineral oil
58-What are the HLB values for O/W and w/O emulsions?
I-For O/W HLB is 8 18
II-For W/O HLB is 4 6
III-For O/W HLB is 1 3
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
59-Sodium benzoate is used as?
A-Preservative
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B-Solvent
C-Co-solvent
D-Filler
E-Humectants
60-Type of water is used in parenteral preparations?
A-Sterile water for injection
B-Bacterio static water
C-Water for injection
D-All of the above
Ans61-Steam (moisture) sterilization is carried out in?
A-Microwave
B-Heat sterilization
C-Autoclave
D-Ethylene oxide
E-None of the above
Ans-C
62-What are the methods of tablet disintegration?
I-Pulverization by intervention
II-Levigation
III-Trituration
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
Ans-E
63-What are the factors effects on sedimentation of suspension?
A-Particle size
B-Density of particles
C-Density of vehicle
D-Viscosity of vehicle
E-All of the above
Ans-E
64-The primary pharmaceutical use of surfactant is as a:
A-Emulsifying agent
B-Surfactant
C-Suspending agent
D-Sweetener
E-Flocculating agent
Ans: A
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Comments: surfactants primarily used as emulsifying agents
65-Spans and tweens are:
A-Non ionic surfactants
B-Anionic surfactants
C-Cationic surfactants
D-Poly oxyalkylene derivatives
E-Suspending agents
Ans: A
Comments: spans, tween, are examples of non-ionic surfactants.
66-Benzalkonium chlorides is
A-Non ionic surfactants
B-Anionic surfactants
C-Cationic surfactants
D-Poly oxyalkylene derivatives
E-Suspending agents
67-Parenteral solution should be free from:
I-Microorganisms
II-Microparticulates
III-Pyrogen
A-I only
B-III only
C-I and III only
D-II and III only
E-All of the above
Ans-E
Comments parenteral solutions should be sterile (free from microorganism), micro
particulates, pyrogens.
68-HEPA filters used in sterile preparations filtration:
I-Microorganisms
II-Particulates
III-Pyrogens
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans: C
Comments: pyrogens cannot be filtered by HEPA filters
69-What is size of filters used in sterile water filtration?
A-0.22mm
B-0.33mm
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C-0.4mm
D-0.55mm
E-0.66mm
70-All non-sterile surface areas in laminar airflow hood should be swabbed with:
I-70% isopropyl alcohol
II-70% Ethyl alcohol
III-Chlorhexidine
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans-E
71-Acacia is classified as:
A-suspending agent
B-natural emulsifying agent
C-Semi synthetic emulsifying agent
D-Flocculating agent
E-tablet filler
Ans-B
72-Rectal suppositories intended for adult use, approximately weigh.
A-10g
B-5g
C-2g
D-1 g
E-0.5 g
73-In a dispensing pharmacy, pharmacist usually mixes active powder with large amount
of diluents by:
A-Levigation
B-Geometrical dilution
C-Trituration
D-Sifting
E-Pulverization
74-The shell of soft gelatin capsules may make by addition of plastic like substance
A-Polyethylene glycol (PEG)
B-Povidone
C-Lactose
D-Sorbitol
E-methyl cellulose
Ans-D

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75-Which is the smallest size of capsule:
A-5
B-10
C-00
D-1
E-000
Ans-A
76-In extemporaneous preparations of suspensions, levigation is used:
A-Reduce particle size
B-Reduce viscosity
C-Increase particle size
D-Increase sedimentation rate
E-Reduce sedimentation rate
Ans-A

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PHARMACY PREP.
DRUG DELIVERY SYSTEMS
1.What is meant by intrathecal injection?
A. Injection in between the spine
B. Injection underneath the tongue
C. Injection on thigh
D. Injection on bun
Ans-A
2-Which provides 100% bioavailability
A-Intramuscular
B-Intravenous
C-Extravenous
D-Oral
E-Parenteral
Ans-B

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PHARMACY PREP
STERILE PREPARATIONS
1-A vertical laminar flow hood is the best choice when preparing parenteral solutions of:
A-Penicillin
B-Doxycycline
C-Cytotoxic agents
D-Nicotine formulations
E-Aminoglycosides
Ans-C
2-The following factor is the cause of most contaminations in sterile preparations:
A-Solutions
B-Surface area
C-Personal
D-Clothing
E-Equipment
Ans-C
3- In sterile preparation, to wipe the surface of laminar flow hood, the following
disinfectant can be used:
I-70% ethyl alcohol
II-Chlorhexidine
III-Benzalkonium chloride
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans-E
4-Sterile preparation for parenteral solutions?
I-Pyrogen free
II-Particulate free
III-Pathogen free (microorganism free)
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans-E
5-The size HEPA filters used for filtration of microorganism (water filtration):
A-0.22 mm
B-0.33 mm
167

C-0.44 mm
D-0.55 mm
E-0.66 mm
Ans-A

168

PHARMACY PREP
EXTEMPORANEOUS PREPARATIONS
1-What are correct instructions should be labelled in the following preparation?
Salicylic acid 2%
Lactic acid 6 ml
Flexible collodion ad 30 ml
ABCDEAns-D

Flexible collodion is extremely flammable.


Tight closed container to prevent ether and alcohol.
Store away from fire
All of the above
None of the above

2-What are correct instructions should be labelled in the following preparation?


Iodine 2%
Sodium iodide 2.7%
Alcohol q.s. 30 mL
ABCDAns-C

A rubber or plastic spatula is used because iodine is corrosive.


Can stain
A and B
None of the above

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PHARMACY PREP.
PHARMACEUTICAL ANALYSIS
1- By addition of a solute, solubility of non-electrolytes is decreased. This is:
a) Common ion effect
b) Disintegration
c) Salting out
d) Salting in
e) None of the above
2- Which of the following compound is known as amphiprotic solvent?
a) Methanol
b) Water
c) Acetic acid
d) Ethanol
e) All are right
3- Molecular ion (M+) or molecular weight is detected by:
a) Colorimetry
b) Mass spectroscopy
c) Spectrophotometry
d) Spectrometry
e) Ultraviolet detectors
4- Determination of alcohol in blood in done by:
a) HPLC
b) TLC
c) Reverse phase HPLC
d) Gas chromatography & Mass spectroscopy (GC-MS)
e) Mass spectroscopy
5- Mass spectroscopy is used to:
a) Detect traces of unknown chemical structure
b) Structure elucidation of unknown chemical
c) Traces in environmental samples
d) Drug traces in blood samples
e) All of the above
6- All of the following detector are used in High Performance Liquid Chromatography
(HPLC): EXCEPT:
a) Diode Array Detector
b) UV detector
c) Refractive Index detector
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d) Gamma Rays
e) Radioactive detector
7- Mechanism of action of Thin Layer Chromatography (TLC) is by:
a) Gas absorption
b) Column theory
c) Capillary action
d) High pressure extraction
e) Temperature range theory
8- Lyophilization (freeze dry method) technique used in:
I- Sterilization of liquids and solids
II- Sterilization of solids only
III- To dry heat-sensitive wet powders
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
9- Sterilization of hormone is done by:
a) Dry heat
b) Lyophilization
c) Filtration
d) Radiation
e) Autoclave
10- Correct statements regarding ethylene oxide sterilization include:
I- A gas sterilization method that combines heat and moisture
II- Has a high penetration power to sealed containers
III- It is used in dry heat sterilization
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
11- In the assay of amphetamines in plasma, it can be extracted by:
a) Ether
b) Isopropyl alcohol
c) Tetrahydrofuran
d) Ninhydrin
e) Amides
12- Reverse Phase High Performance Liquid Chromatography (RP-HPLC)
I- Mobile phase is aqueous solution
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II- The particle size of stationary phase affects resolution
III- Utilize high pressure pump to increase efficiency in the resolution
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
13- All of the following proprieties are classified as colligative proprieties, EXCEPT:
a) Elevation of boiling point
b) Osmotic pressure
c) Increase in conductivity
d) Lowering of freezing point
e) Magnitude of vapor pressure
14- The colligative proprieties of a solution are related to:
a) The total number of solute particles
b) pH of the solution
c) Number of ions
d) Ratio of number of ions and number of molecules
e) Number of non-ionized molecule
15- Colligative proprieties are important in determining:
a) pH
b) Tonicity
c) Solubility
d) Stability
e) Sterility
16- What is the plates function in TLC?
a) Filter
b) Increase rate of resolution
c) Support mobile phase
d) Make resolution
e) Support stationary phase
17- At acid/base titration, which affect the reaction?
I- Change in the pH of the preparation
II- Addition of a specific buffer will increase the reaction
III-Addition of a specific buffer will decrease the reaction
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct

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18- Atoms with the same number of protons are known as:
a) Isotonos
b) Isotopos
c) Isobaros
d) Atomic equivalents
e) Isosmotic
19- Instrument used to measure specific gravity by floating in a liquid:
a) Picnometer
b) Hydrometer
c) Thermometer
d) Thermostat
e) Tensiometer
Ans-B
Tips: Hydrometer (SWIM in water)
20- Instrument used to measure quantity of two liquids with equal volume:
a) Picnometer
b) Hydrometer
c) Thermometer
d) Thermostat
e) Tensiometer
21- Solvents can be classified as:
a) Amphiprotic
b) Protophilic
c) Aprotic
d) Protogenic
e) All are correct
22- Kind of solvent where acids and bases are produced, react and dissociates producing
such anion or cation species is called:
a) Amphiprotic solvent
b) Protophilic solvent
c) Aprotic solvent
d) Protogenic solvent
e) Inert solvent
23- Correct statements regarding TITRATION include:
I- Determination of a given component in a solution by addition of a liquid reagent of
known strength until a given endpoint is reached.
II- Non-aqueous titration can be used in the assay of some materials that cannot be easily
titrated in aqueous system.
III- Titration is a chromatographic method of substance separation.
a) I only
b) III only
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c) I and II only
d) II and III only
e) All are correct
24- The end point of a titration analysis is characterized by:
a) Change in color
b) Change in solubility
c) Change in pH
d) Change in dispersability
e) Change in particles aggregation
25- Considerations that should be taken in selecting a solvent for an assay analysis:
a) Nature and solubility of the sample under investigation
b) Side reactions should not occur between the sample in analysis and the solvent
c) The solvent should be pure, low toxic and inexpensive
d) Solvent should have a high dielectric constant
e) If the sample is a weak acid the solvent should also be a weak acid
26- Solvent used in the assay of levodopa and methyldopa include:
a) Acetic acid
b) Pyridine
c) Chloroform
d) Formic acid
e) Dimethyl formamide
27- Dimethyl formamide is a solvent used in the assay of which of the following drugs?
a) Adrenaline
b) Sulfonamides
c) Cimetidine
d) Chlortalidone
e) Levodopa
28-Which of the following spectroscopic method is used in detection of nanogram
amount of unknown substance?
A-Microspectroscopy
B-Nanospectroscopy
C-Spectroscopy
D-Microscopy
E-None of the above
Ans-C

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CORRECT ANSWERS
PHARMACEUTICAL ANALYSIS
1- C
Comments: Salting out is characterized when the addition of a solute in a solution cause
the decrease of solution solubility, when the addition of a solute cause the increase of
solubility is called salting in.
2- E
Comments: Amphiprotic is a type of solvent where acids and bases are produced. It reacts
and dissociates producing such anion and/or cation species.
3- B
Comments: M+ molecular ion is detected by mass spectroscopy that determines the
molecular weight of the sample.
4- D
Comments: Gas chromatography is a chromatographic method used to separate volatile
organic compounds as alcohol, hydrocarbons and aerosols.
5- D
Comments: Mass spectroscopy may be used as adjunct in gas chromatography.
6- D
Comments: X-rays are not used as detectors in HPLC
7- C
Comments: TLC-Thin Layer Chromatography is a very fast and simple chromatographic
method that separates organic compounds, progress of organic reactions, and tests the
purity of products by capillary theory.
8- B
Comments: Freeze dryer is used for the conversion of wet powders to dry powders.
9- D
Comments: Radiation is the most appropriated sterilization method for hormones; the
only exception is testosterone that is normally sterilized by dry heat sterilization.
10- C
Comments: Ethylene oxide sterilization is a very effective technique that combines heat
and moisture having a very high penetration power to sealed containers.
11- A
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Comments: Amphetamines can be extracted from plasma by ether.
12- E
Comments: HPLC- High Performance Liquid Chromatography is a method that utilizes
high-pressure pumps to increase efficiency in the separation. The mobile phase is
normally an aqueous solution and the particles size of the stationary phase definitely
alters the effect of resolution.
13- C
Comments: Colligative properties in physical chemistry, depending on the number of
molecules present in a given space, rather than on their size, molecular weight or
chemical constitution. The colligative properties of solutions are osmotic pressure,
boiling point elevation, freezing point depression, and vapor pressure lowering.
14- A
Comments: Colligative properties in physical chemistry of a solution, depending on the
number of molecules present in a given space, rather than on their size, molecular weight
or chemical constitution.
15- B
Comments: 15- Colligative proprieties are important in determining the tonicity of the
solution. The colligative properties of solutions are osmotic pressure, boiling point
elevation, freezing point depression, and vapor pressure lowering
16- E
Comments: The only function of plates in TLC is support the mobile phase that moves by
capillary mechanism through the stationary phase (plates).
17- A
Comments: Buffers are added to the solutions exactly to avoid the change in the
solutions pH, therefore if added to the solution will not affect the reaction.
18- B
Comments: In physical chemistry, isotopes are atoms with the same number of protons.
Isotones with the same number of neutrons and isobaros with the same number of mass.
19- B
Comments: Hydrometer is an instrument used to measure specific gravity by floating in a
liquid
20- A
Comments: Picnometer is an instrument used to measure quantity of two liquids with
equal volume
21- E
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Comments: Solvents play an important rule in determining acid/base properties in a
solution and may be classified depending of their chemical structure and activity as
Solvents can be classified as amphiprotic, protophilic, aprotic and protogenic.
22- A
Comments: Amphiprotic solvent as water, acetic acid, methanol and ethanol are kind of
solvents where acids and bases are produced, react and dissociates producing such anion
or cation species.
23- C
Comments: Titration is a determination of a given component in a solution by addition of
a liquid reagent of known strength until a given endpoint is reached. Non-aqueous
titration can be used in the assay of some materials that cannot be easily titrated in
aqueous system.
24- A
Comments: The end point of a titration analysis is characterized by change in color.
Commonly used indicators include triphenyl methane group corants and azo group
corants.
25- E
Comments: In order to chose the proper solvent to be used in an analysis we need to
consider some important points as the nature and solubility of the sample under
investigation, and make sure that no any side reaction between the sample in analysis and
the solvent will happen. The solvent should be pure, low toxic, inexpensive and have a
high dielectric constant.
26- D
Comments: Formic acid is a solvent used in non-aqueous titration in the assay of
levodopa and methyldopa
27- B
Comments: Dimethyl formamide is a solvent used in non-aqueous titration in the assay of
sulfonamides, allopurinol and acetozalamide.
28-C

BIBLIOGRAPHIC REFERENCE
1- COMPREHENSIVE PHARMACY REVIEW Lippincott William & Wilkins
Fourth edition
2- CPS-COMPENDIUM OF PHARMACEUTICALS AND SPECIALITIES - Canadian
Pharmacist Association 2001 edition.
3- MEDICAL DICTIONARY Dorlands illustrated 27th edition.

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4- PHARMACY PREP Lectures series & study guide for Evaluating ExaminationTIPS - 2003/2004
5- THERAPUTIC CHOICES Canadian Pharmacist Association -Third edition
6- USP DI Drug Information for the Health Care Professional15th edition Volume I.

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manual is being used during review sessions conducted by PharmacyPrep.

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