Review Book for Evaluating Exam Pharmacy Prep Review Book For Evaluating Exam Misbah Biabani, Ph.D Director Toronto Institute of Pharmaceutical Sciences (TIPS) Inc. Toronto, ON M2N K7 Pharmacy Prep Professional Exams Preparation Center 5460 Yong St. Suites # 209 and 210, Toronto, ON, M2N 6K7 WWW.PHARMACYPREP.COM 416-223-PREP (7737) / 647-221-0457 Toronto Institute of Pharmaceutical Sciences Inc. © 2000 to 2009 TIPS Inc. All Rights Reserved. Copyright © 2000-2009 TIPS Ine, Unauthorized reproduction ofthis manual is strietly prohibited and itis ‘legal to reproduce without permission, This manual is being used during review sessions conducted by PharmacyPrep.www pharmacyprep.com Review Book for Evaluating Exam Disclaimer Your use and review of this information constitutes acceptance of the following terms and conditions: ‘The information contained in the notes intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor or pharmacist can provide you with advice on what is safe and effective for you. Pharmacy prep ‘make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, Pharmacy prep does not assume any responsibility or risk for your use of the pharmacy preparation manuals or review classes. In our teaching strategies, we utilize lecture-discussio small group discussion, demonstrations, audiovisuals, case studies, written projects, role play, gaming techniques, study guides, selected reading assignments, computer assisted instruction (CAD, and interactive video dises (IVD). Our preparation classes and books are not intended as substitute for the advise of NABPLEX®. Every effort has been made to ensure that the information provided herein is not directly or indirectly obtained from PEBC® previous exams or copyright material. These references are not intended to serve as content of exam nor should it be assumed that they are the source of previous examination questions. ©2000-2009 TIPS Ine. All rights reserved. Foreword by Misbah Biabani, Ph.D Coordinator, Pharmacy Prep Toronto Institute of Pharmaceutical Sciences (TIPS) Inc 5460 Yonge St. Suites 209 and 210 Toronto ON M2N 6K7, Canada Copyright © 2000-2009 TIPS Ine. Unauthorized reproduction of this manual is strictly probibited and itis 2 iMlegal to reproduce without permission. This manual is being used during review sessions conducted by PharmacyPrep.aww. pharmacyprep.cor Review Book for Evaluating Exam Content Abbreviations Part I: Biomedical sciences «Human Anatomy Gastrointestinal System |. Nervous System . Cardiovascular System Endocrine System Renal System Liver Funetion and Pathophysiology - Respitatory System |. Urinary System 10. Eye 11. Blood and anes 12. Biochemistry OM3. Clinical Biochemistry 14, Nutrition OPS. Microbiology 446. colt end Molecular Biolo 17. Pharmacogenetics CHOIAWAWNS ia 18. Immunology 19. Immunizations (vaccines) 20. Biotechnology 21. Toxicology Part I: Pharmaceutical Sciences 22. Pharmacy Calculations-Ratio and Proportions 23. Pharmacy Calculations-Dilutions and Allegations 24, Pharmacy Calculations-Dose calculations 25. Pharmacokineties 26, Rates and Orders of reactions 27. Pharmacodynamics Copyright © 2000-2009 TIPS inc. Unauthorized reproduction ofthis manual is strictly prohibited and itis, 3, iMlegal to reproduce without permission. This manval is being used during review sessions conducted by PharmacyPrep.www pharmacyprep.com Review Book for Evaluating Exam 28. Basics of Medicinal Chemisury 29, Medicinal chemistry and Pharmacology of Drugs that act on autonomic nervous system. 30. Medicinal chemistry and Pharmacology of Histamines, Serotonin, Prostaglandin and Non= Steroidal anti-inflammatory Drugs 3.1. Medicinal chemistry and pharmacology of cardiovascular drugs 32. Medicinal chemistry and pharmacology of psychiatric & neurological diseases 33. Medicinal chemistry and pharmacology Endocrine drugs 34. Medicinal Chemistry and Pharmacology of Respiratory Drugs 35. Medicinal Chemistry and Pharmacology of Musculoskeletal Drugs 36. Medicinal Chemistry and Pharmacology of Antimicrobial 37. Drug Metabolism 38. Biopharmaceuties 39. Pharmaceutics 40. Medi formulation ingredients Al. Rheology 42. Pharmaceutical Dosage Forms 43. Drug delivery Systems A, sterile Preparations 45. Extemporaneous Pharmaceutical Preparations 46. Pharmaceutical Analysis Part IT: Social/Behavioural /Administrative Sciences 47. Bioethics and Professional ethics 8. Canadian Healtheare System 49. Canadian Pharmacy Regulations and administration 50. Social and behavioural aspects of pharmacy profession 51. Pharmacy Management 52. Pharmacoeconomies 53. Drug information Resources 54. The new drug approval process 55. Basics of clinical research and Epidemi 56. Biostatisti Copyright © 2000-2009 TIPS Inc. Unauthorized reproduction of this manual is strictly prohibited and itis illegal to reproduce without permission. This manval is being used during review sessions conducted by PharmacyPrepwoww.pharmacyprep.com Review Book for Evaluating Exam Part IV: Pharmacy Practice/ Therapeutics and OTC Drugs 57. Prescription processing and Medication dispensing, 58. Pharmaceutical Care and Drug Related Problems 59. Safety of medications in special populations 60. Identification and prevention of drug toxicity 61. Professional Pharmacy communication skills 62. Therapeutic Drug Monitoring 63. Safe and effective use of medications! Strategies to Prevent Medication errors 64. Adverse Drug Reactions and Management 65. Drug Interactions 66. Pharmaceutical Preparation Storage Conditions 67. OTC and Prescription Drugs for Dermatological Disorders 68. OTC and Prescription Drugs for Ophthalmic, Ear and Mouth Di 69. OTC Drugs antihistamine, decongestants. antitussives, Expectorants 70. OTC Drugs for Nausea, Vomiting, Constipation, Diarrhea, Hemmorrhoids 71. OTC Drugs for Headache. Sports Injuries, Pressure Uleers, Low Back Pain 72. Asthma and Chronic Obstructive Pulmonary Disease (COPD) 73. Smoking cessation ers TA. Insomnia 75. Eating disorders 76. GERD, Uleers, Inflammatory bowel disease (IBD) and Irritable bowel syndrome (IBS) 77. Diabetes Mellitus Type Land Type 2 78. Thyre 79. Contraception 80. Reproductive, Gynaecologic and Genitourinary Disorders 81. Rheumatoid arthritis, osteoarthritis and Gout arthritis 82. Osteoporosis 83. Hypertension 84. Ischemic Heart Disease Copyright © 2000-2009 TIPS Inc. Unauthorized reproduction ofthis manual i strictly prohibited and itis § illegal to reproduce without permission. This manual is being used during review sessions conducted by PharmacyPrep. isordersyaw phanmacyprep.com Review Book for Evaluating Exam 85. stroke 86. Congestive Heart Failure 87. Cardiac Arrhythmias 88. Peripheral vascular diseases 89. Anticoagulants 90. Anxiety Disorder 91. Depression 92. Psvehosis and schizophrenia 93. Dementia 94. Seizures and epilepsy 95. Parkinson's Disease 96. Anti-microbial agents 97. Anticancer drugs and chemotherapy Copyright © 2000-2009 TIPS Inc. Unauthorized reproduction of this manual is strictly prohibited anditis 6 illegal to reproduce without permission. This manual is being used during review sessions conducted by PharmacyPrep.son: PharnaesPrap Com Abbreviation Abbreviations S| — aatag — Tra ae Aion Visa — is i : a Taree 7 Bete meas —[an aim POs Lier Se ee efor bana ES fae — Ae nase Toa aa fg (tse — sie oe Bee AS ee ae ‘bid. “Twice a day ‘bis in die ‘As needed. Prorenaia ee Bas fs : a oa a 7 Wibod Seana a Ba Eieniny maids a Dama ated dx ‘Fracture Four fimes a day ‘Quarter in die’ nl Gram hh aia [Bren fs Bone oa an 7 ae Mat Drop, x RE preseription ff Boe : aie i be ‘Hour s ‘One half Iss 2 1S : Abed tine — | foatsamat fost ee = im fee Sa eee i eat na ae a aE fee y ee a ca w Laas Ta aie whi he bee Pn oar ke Kilogram ir tincture e tie £ a Pas Cass same fea Asan 5 aed ne Mitiesaaiar a Milles La Za ml ‘Milliliter hy ate, tad Iz Ounce La 7 AFA, Spivometer- 4S aewnl. eal Tieng ial ‘icing ‘septi ‘bacteria Ten/o: tend/o tendon Sial/o saliva Tendon/o: tendin/o_ tendon. ‘Sinus/o_ ‘sinus ‘Test/o_ “Testis/testicle Somat/o bods ‘Testicul/o “Testis/testicle Sn neal Tharecle cist Sphere/o round ‘Thromb/o Clot. ‘Sphygm/o pulse Thyr/o_ Thyroid gland_ spir/o_ Breathe: breath ‘Trache/o ‘Trachea ‘Spleen/o_ spleen ‘Tympan/o ‘Spondyl/o ‘Vertebra; vertebral ‘Urethra/o column. Chet Tila Urinary et rout Yas Vel Synovi/o. joint ‘Ven/o ‘Vein Tars/o_ Ankle bones. “Xanth/o pellow ‘Copyright © 2000-2009 TIPS Inc. Unauthorized reproduction of this manual is strictly probibited and it is iMlegal to reproduce without permission, This manual is being used during review sessions conducted by PhatmacyPrep,www PharmacyPrep.Com Abbreviation ai cer Ta re Taman ne Shall in Tat - Belo: Aad = ew saat te Ne at is ae ‘hoc DS fat ii Se os eas eS oe Th cerry rae zr Dials ann ——T sh Mn Ouse ial Ate Within; in re ‘Betore: in font of Tihs Vern Fist : _ =n Sea na 7 cl Tall —] = a Belowsander - ae | eee Abo ASS ae Abie onaeat Be Boo dae . Ta hee Belo ar at Tessa a | 4 An Ee ae nie tf ieee acer a One en = 2: fal Bed poor anormal ——f ass An aaa Yincta ‘Change: after; beyond G Fi vida P-L Ghs Sa cer Sa Poret rama ener is TE ‘ta a - Paine le a Pastis - eer ea os ‘crine To secrete. ¥penia, ‘Decrease number rit “To separate 4pepsia Digestion ‘cyte Cell Vphagia Eating, swallowing eres Cond STE ob Abeer as Biing eee Thee err Lesion Surges eave fea ee | a ol Faia fe Blocd ne Beli coer ere ame Font eee ara nae aa | Busting = food te oe i oe Rapti ae eee ramen ee Hace Spa Poni am eee - eau - peers ie Tela Sean Sleep come eo oo Te mae Sone a Canes ae ne een = a rf Renee Te hea eter {ologist ‘Specialist thorax. ‘Chest: pleural cavity (alone ae ae Tater ba Se ae Ts ae . -Abroral Saiba—— oh Gt Sera en acer ramen cere Copyright © 2000-2009 TIPS Inc. Unauthorized reproduction ofthis manual is strictly prohibited and i is illegal to reproduce without permission, This manual is being used during review sessions conducted by PharmacyPrep.www PharmacyPrep.Com Abbreviation Root Meaniny Root Meaning abdomin/o [abdomen Caio ‘Bladder, sc, urinary bladder ‘Aden/o ‘Gland Cytio Cell dip/o Fat Dacry/o “Tears ‘aminio ammion Dent Tooth tAndrio. ‘Male: man Dermio ‘Skin gio ‘Vessel Dermatfo__| Skin. ‘Ague/o ‘Watery ipllo ‘Two, double }dowabZ7 Arteri/o “Artery Dips/o Thirst Arteriol/o arteriole Duodenfo | Duodenuma Acthrio, joint Durla ‘Dura mater Ather/o. Fat: fatty plague Electro Electricity ‘Audilo ‘Hearing: sound “Embry/o ‘Embryo “Aurlo. ear encephal/o__| Brain bil ‘Bile; gall Tntestines PBlepharlo lid Red Bronch/o ‘bronchus ‘Vulva BronchioVe | bronchiliole Red Bucc/o cheek. Esophag/o___| Esophagus Burs/o joint Fasci/o Fascia Cale calcium Femor/o ‘Femur ceapnia Carbon dioxide Fev/o; fet [Fetus Carcinv Cancer Fibul/o Fibula Cardilo heart Fund/o Fibula Carplo ‘Wrist bone Gastro ‘Fundus enhalla head Gastrfo Stomach Cerebr/o cerebrum PGingive | Gums __['éngdas) hole ‘Bile: gall Glaue/o Silveriara ‘Cholangio [Bile duct Glifo Nerve cell hholecystio | gallbladder ‘Glomenai/o | Glomeralus ‘Chondi/o, cartilage FGlossio ‘Tongue, Coagul/o elotins Glucio ‘Glucose: sugar ‘Cochile/o cochlea Gonadio, Sex glands ‘Col/o Colon Gravidialo—[Pregnane ‘Conjunctivie | conjunctiva Gynio: gynfe | woman Coro heart Gyneclo ‘Woman, ‘Comelo. comnea Hem/o Blood Coronio. heart Hemangio/o | Blood vessel [ca a Hematio, Blood. Cranilo cranium Hepatlo ‘Liver y/o. cold Hiidro Sweat ‘Cutfo, cai | skin Humerlo | Humenis ‘Cutanefo skin, Hydelo ‘Water, fluid ‘Cyan/o Due Leiystervo “uterus Root Meaning Root Meaning Tele eum vo ‘Straight itv. ‘lium Oste/o ‘Bone ‘Immune’o | Protection, ‘Oto Ear isfo Equal Ovarile ‘Ovary jeiunvo jejunum Oxi ‘Oxygen Kali potassium Pachylo “Thick Kinesi/o tears [Pancreatie Pancreas Lactio. Mill Paro ‘Bear, labor, childbirth Lapar/o ‘Abdominal wall Patellolo ‘Knee cap Laryng/o Tarynx. Pectorlo ‘Chest Ligamenio | ligament ped Children Copyright © 2000-2009 TIPS Inc, Unauthorized reproduction of this manual is strictly prohibited and it is igo erode wit peso. Thi manu ising ed rings cp by PharmacyPrep. exdho sda hype Ferd ton, Chand St¥ajightwww PharmacyPrep Cor Abbreviation. Tagua Tongue ‘Children Lip/o Tat Pelvis Eithio stone Perineum, Lumbio lymph Peritone/o | Peritonewma Mammo ‘breast hago Eat Mastio breast Phalanglo ‘Finger and toe bones ‘Melawo black ‘Pharyng/o. Pharynx ‘Menlo ‘Menses, menstruation | Phleb/o. ‘Vein ‘Metacarp/o__| Hand bones Phot/o Light Metatarsio | Foot bone Phren/o Diaphragm forphvo Form shape Pilio Hair ‘Muclo maueus yPneumlo Lung/air ‘Myclo ‘fungus Pod/o, podi | Foot. PMyel/o ‘Bone marrow, spinal con} Proct/o Rectum Pac Mininglo eardrum, Psychlo, psychi | Mind or soul atc/o. sleep Pubjo. Pubis: pubic bone ‘Nas/o nose FPulmoalo ‘Lungs. ‘Nav/o, natal__| Birth, delivery Pylo Pus -Nephr/o ‘Kidney ello ‘Renal pelvis [Neurio. nerve: ‘Quadr/ Four zm Noct/o night, Radifo Radius Nyetallo night Rect/o Rectum veda Ocul/o e Reno ‘Kidney POnychio, nail Retina ‘Retina ophor/a, ovary habdomy/o | Skeletal muscle; stated muscle ‘Opthaimio [eve Rheum ‘Watery discharge ‘Opto eve Rhino Nose Oro mouth Salping/o Fallopian tubes Orchio ‘Testis; testicle Sarclo Flesh Orchid/o “Testis: testicle __['Seminio [semen Onyhom yrosis - neil fuego infer Narco ky sy = pleep webhiog Rhabdomnyiysis — OFF Sfabey Copyright © 2000-2009 TIPS Inc, Unauthorized reproduction ofthis manual is strictly prohibited and itis illegal to reproduce without permission. This manual is being used during review sessions conducted by 4 PharmacyPrep.www PharmacyPrep.Com Human Anatomy (24d,) Human Anatomy This chapter reviews essentials and definitions of systemic human anatomy terminology and provide a basic understanding of how the human body is structured with emphasis on clinical applications. This chapter also reviews cellular mechanism in human physiology. Especial emphasis is on drug- induced diseases and effects of adverse drug reactions various organs. Body movements (1) Abduction vAdduetion ~Asstension J Flexion Dorsiflexion Plantar exion Pronation Supination Eversion Anterior (ventral) Posterior (dorsal) Deep Superficial Proximal Distal Inferior Superior Medial Lateral Supine Prone Recumbent Lateral decubitus Movement away fom the oidine ofthe body (Fig L.1) Movement toward the midline ofthe body (Fig 1.1) Lengthening of steaightening afa flexed limb (Fig. L.2) Bending a part ofthe body Fig. 12) Backward (upward) bending of te foot Bending the sole ofthe foot downward toward the ground act of turning the hand so thatthe palm faces downward act of tuming the hand so thatthe palm is uppermost turing outward Frontside of the body (Example: Abdomen is anterior to te spinal cord) Back ofthe body (Example: Spinal cord is posterior tothe stomach) ‘Away fiom the surface On the surface (Example: superficial veins can be viewed through skin) near the pint of atacbment to the trunk or near the beginning of structure (Example: The proximal end ofthe stomach is atthe esophagus or te proximal end of the upper bone joins wi shoulder bone) Far ror the point of attachment tothe trunk or from the beginning ofa structure (Example: The distal end ofthe stomach is atthe small intestine) Below another structure. Caudal (pertaining tothe head) means inferior in human. (Example: The urinary bladder lis inferior tothe Kidney) Above another structure. Cephalic (pertaining to head) is also used to mean superior (Example: The uterus is located superior to the vaging) pertaining tothe middle or nearer the medial plane of the body pertaining tothe side Example: The litle tes are lateral tothe big toes) Lying on the back (ace is up) (example: the patient isin supine postion during her abdomen examination) “Lying on the belly (lying on histor face) (Example: the backbones can be examined through prone position) Lying down may be prone or supine Lying down onthe side with the x-ray beam horizontal positioned sometimes-alled eroseable lateral ‘Copyright © 2000-2009 TIPS Inc. Unauthorized reproduction of this manual is strictly probibited and its iMlegal to reproduce without permission. This manual is being used during review sessions conducted by 1 PharmacyPrep,www PharmacyPrep.Com Fig 1.3 Inversion/eversion Fig 1.5 Abduction SS ce \ \ \| ‘duction \ \ \ Fig Lt ‘i i Ankle Extensions Flexion ge L \ \ oO Fig ia Human Anatomy oy Circumduction ive all vesucle of abt J) r4 e oo aa) Dorsiflexion/plantar flexion Posterior Frontal Plane (Coronal) j a Fig fioterior Anatomical Planes and Directions Copyright © 2000-2009 TIPS Inc. Unauthorized reproduction of this menval is strictly prohibited and itis illegal to reproduce without permission. This manual is being used during review sessions conducted by 1-2 PharmacyPrep.wwwPharmacyPrep.Com Human Anatomy Anatomical planes (Fig. 1.4) (1) Sagittal plane Separates the body into right and left portions /Midsagittal plane (Median plane) Separates the body/body past into equal right/left portions YParasagittal plane Separates the body into unequal right and left portions Coronal plane Separates the body/body-part into anterior and posterior portions sAransverse plane Divides the body/body-part into superior and inferior portions Oblique plane asses through the body/body-part at an angle Postural Positional Orthostatic Standing upright Human Skeleton (Fig. 1.6) (t - 2. ) shoulder joints consist of; Humerus, scapula, synovial membrane, articular cartilage, articular capsule, articular liquid, and ligament 4% Knee joint consist of: Femur (longest bone), tibia, patella, meniscus, articular cavity, Serous bag, and aiticular capsule Articular cartilage (Fig 1.6) <2 Flip joint (socket and ball consists of ileum, ischium, and pubis (Fig 1.7) gH Patella knee ep bone is present in knee joint Skeletal system — Muscles © Trapezius neck © Triceps bronchi shoulder (anterior) (Biceps bronchi upper arm, andetsighs © Gluteus medium->hip © Psoas muscle hip Largest muscle->gluteus major (which forms part of buttock) e~ Fastest muscle is> eyelid elevator o- Longest muscle-> sartorius muscle (which stretches from the pelvis to below the knee. (more than 15 inches or 40 cm long © Smallest muscle > stapes (found inside the middle ear (less than 0.04 inch (Imm) long). © Strongest muscle-> masseter muscle (which moves the mandible when chewing, It can exert a force equivalent in 100 kg (220 lbs) © Muscle account 40% of total body weight. {LS Biceps and triceps are in arms and thighs a9” Quadriceps > thighs Copyright © 2000-2009 TIPS Inc. Unauthorized reproduction of this manual is strictly prohibited and it is illegal to reproduce without permission. This manual is being used during review sessions conducted by 1-3 PharmacyPrep.wow PharmacyPrep.Com ‘Numan Anatomy Human Skelton Cranium——~ Facial bones ~ — Clavicle Mandible——— Scapula \|_ Humerus —Ribs po tect Radius heant Ulna ium (oF pelvis) — : ee —Carpals Pelvis. — Metacarpals Sacrum toe Bau (Jorg at bone ) (knee cap) Pilla P¥ella——__, _ Fibula | —\ | h Tarsals P sol a gy Metatarsals ecfesnol inj nie \ (_Phalanges Nobienneded to otter boner. \\\ a3 Twat tonnected 7 myscler EBS Calcaneus——— Hipjoin WA Human Skeleton Fig 1.6 jgchiam Side View Synovial tissue ——~ Synovial fluid Patella ——— ea “ i Ligament ~~ Femur ee Garlage —_——— Meniscus Joint capsule Bursa — ——Tibia Figi.7 Female Fig 8 Copyright © 2000-2009 TIPS Inc. Unauthorized reproduetion ofthis manual is strictly probibited and it is illegal to reproduce without permission, This manual is being used during review sessions conducted by 1-4 PharmacyPrep.www.PharmacyPrep.Com Human Anatomy ‘cardiac muscle call Skeletal muscle eel \ -_ == \ Fig 9 Types of muscle cells Types of tissues and functions (Fig 1.9) Four basic types tissues: Epithelial (covering), Connective (support), Muscle (movement), nervous (control/integration) A z of ‘ ‘ ryhere in bed eo Epithetiam —+ Covering, Secretion, absorption, and sensitivity” SARI O34 4 Newves Sysieny ‘® Connective ->Support (cartilage, bone, blood, fibrous tissue of ligament (chondrocytes) © Muscle-> (Movement) Muscle tissue, skeletal muscle tissue, cardiac muscle tissue, smooth muscle tissues. Nervous control and integration ‘© Tissue functions: Protection, absorption, filtration, excretion, secretion, sensory reception 27 Poth tissue: Coveringlining or glandular. Glandlar: 2 basi yes: Endosrin -“dutess"- produce hormones, Exocrine-have ducts — sweat, oil, saliva bile enzymes, mucin (mucus) ‘© Connective Tissue: support protection, insulation, transportation. Characteristics: large extra cellular matrix Four basic classes of connective tissue: Connective Tissue Proper: Loose: adipose, areolar storage, support organs or vessels, Dense: regular, clastic (tendons and ligaments) Canilage- Cushion, structure, support, and laid down before bone Osseous (bone): Bring in beef bone, compact - rigid, spongy ~ marrow Blood: RBCS, WBCs, and platelets, and plasma matrix Copyright © 2000-2009 TIPS Inc. Unauthorized reproduction of this manuel is strictly prohibited and it is illegal to reproduce without permission. This manual is being used during review sessions conducted by 1 PharmacyPrep.wwwPharmacyPrep.Com Human Anatomy Basic Terms Angi = vessels, Angioedema = edema of blood vessels Dips = thirsty Poly dipsea= thirsty Arth Arthritis = Bone and joint inflammation Apnea = Shortness of breath Poiesis Angi = vessels, Angioedema = Allergic reaction cause swelling on tongue and lips Angiogenesis = Formation of new blood vessels Arth = bone and joints Arthritis = Bone and joint inflammation Azotemia = nitrogen waste in blood Phosphetemia = phosophate in blood ‘Uremia= urea in blood Angiorplaty = heart repair Blepharitis = eye lid inflammation Cyst= bladder ladder infection (UTI) Cyte= cells ‘Melanocyte = skin cells, Diptopia = double vision Dips=Thurst Polydipsia = thursty Diaphrosis ~ excessive sweating Dys = difficulty or painful Dyspnea = Difficulty in breathing or painful breathing Dysurea = difficulty in urination Dysmenorthea = painful menstruation Dysphagea = difficulty in swallowing Dystonea = slow movement Dyskinesia = involuntary movement Dysmenorrhea = painful period or painful menstruation Copyright © 2000-2009 TIPS Inc. Unauthorized reproduction ofthis manual is strictly probibited and itis illegal to reproduce without permission. This manual is being used during review sessions conducted by 1-6 PharmacyPrep.www.PharmacvPrep.Com ‘Human Anatomy Dyspepsia = difficulty in digestion Emesis = vomiting Antiemetics = antivomiting drags Emia = blood ‘Anemia = no blood Polycytemia ~ excessive blood cells surgical removal Endo = Endothelial layer Antiemetics = antivomiting drugs Encephalo = brain Encephalitis = brain infection Globin = proteins Gingiva = gum ~ gingival hyperplasia tongue Glossitis = tongue inflammation Gravida = pregnancy Primagravida = first pregnancy Hypovolemia = low body fluids Hemorrhage = bleeding Rrhea = flow or discharge Diarrhea = watery stools Stetormhea = fatty stools Rhinortbea = runny nose Sialorrhea = excessive saliva Gonorrhea = discharge ‘Menorthea = menstruation Amenorrhea = no menstruation Itis = inflammation Hepatitis = liver inflammation Gastronenteritis = GI inflammation Axthitis = Bone joints inflammation Lytic or lysis Hemolytic = blood cells breakdown Intra = within Intracellular = within cell Copyright © 2000-2009 TIPS Inc. Unauthorized reproduction of this manual is strictly prohibited and itis illegal to reproduce without permission. This manual is being used during review sessions conducted by 1-7 PharmacyPrep.wow. PharmacyPrep.Com ‘Human Anatomy Inter = between Interstitial = benween cells or tissue Lytic or lysis Hemolytic = blood cells breakdown Malacia = softening Osteomalacia = bone softening ‘Megaly = enlarge Hepatomegaly = liver enlargement Mal = abnormal ‘Malignancy = abnormal growth Mal= poor Malignancy = abnormal growth Mal nutrition = poor nutrition Petit mal = litle Meta = after ‘Meta analysis = after analysis ‘Metastesis = beyond the tumor ‘Myelo = bone marrow ‘Myelosuppression = bone marrow suppression. Myalgia = muscle pain Allgia= pain Neo = New Neonates = New bom Necrosis Tissue death caused by injury, Example: hypoxia, exposure to toxic chemicals. Neutropenia = decrease in neutrophils Pepsia = digestion Natremia = sodium in blood decrease in number ‘Thrombocytopenenia = decrease in platelets Pepsia= digestion Dyspepsia = difficulty in digestion Copyright © 2000-2009 TIPS Inc. Unauthorized reproduction ofthis manual is strictly probibited and itis illegal to reproduce without permission. This manual is being used during review sessions conducted by PharmacyPrep.www PharmacyPrep.Com ‘Human Anatomy Phagia = swallowing Dysphagia = difficulty in swallowing Phobia = abnormal fear Agarophobia = fear empty spaces Plasty = surgical repair Angiorplaty = heart repair Plegia = paralysis Paraplegia = one side body paralysis, Pnea = breathing Dyspenea = difficulty in breathing ‘Apnea = Shortness of breath (sleep apnea) Poiesis = formation Exythropoiesis = blood formation Pathy = disease Retinopathy = eye diseases Nephropathy ~ kidney disease Neuropathy = nerve disease Myopathy = muscle pain Cardiomyopathy Penia = decrease in number ‘Thrombocytopenia = decrease in platelets Phagia ~ swallowing Dysphagia = difficulty in swallowing Phobia = abnormal fear Agarophobia = fear empty spaces Social phobia = fear of objects Plasty = surgical repair Rhage or thagea = bursting Hemorrhage = bleeding Rehea = flow or discharge Diarthea= watery stools Stetorthea = fatty stools (orlistat= xenical) Rhabdomyolisis = skeletal muscle inflammation (Statin, fibrates and niacin) Rbinorrhea = runny nose Supra = above Supraventricular arrhythmias © atrial arrhythmias ‘Copyright © 2000-2009 TIPS Inc. Unauthorized reproduction of this manual is strictly prohibited and it is, illegal (o reproduce without permission. This manual is being used during review sessions conducted by PharmacyPrep.ww PharmacyPrep.Com ‘Human Anatomy Somnis Insomnia Spasm = twich, Bronchospasm = airways constriction Stenosis = narrowing Renal bilateral stenosis = avoid ACE inhibitors -mucus inflammation (methotrexate) Spiro = breathing Spirometer= tests for breathing (FEV) fast heart beat Xero = dry Xerostomia= Dry mouth Xeropthalmia= dry eye ‘Xeroderma = dry skin Tips Adduction-> foward boty Abduction-> away fren, becky hed, Coot floxor muscles found in--> dirr&—i4—2 parts. limb, Ceol, arm extensor muscles found in ~> 4-2 ttre genes ons Sagittal plane-> divide ta Lpab Midsagital plane (Median plane)-—> "11 2. wpsegal post Parasagittal plane > 2 wencgtal pevlh Pronation=> palm owing gyeind Supination-->. pale, Fave | upward Hip joints have > ilTnom, Wsthinws, pubss Knee capis-> pale I/n ~ paotebing knee qoink. frdotubiad dsiwe — tut iy cancion bo yageuler pith sive — sndrcriee glands, enbea, yeina lind, Pork, 29% Copyright © 2000-2009 TIPS Inc. Unauthorized reproduction ofthis manual is strictly probibited and itis illegal to reproduce without permission. This manual is being used during review sessions conducted by PharmacyPrep.yeww,PharmacyPrep.Com Antiarrhythmic drags Salivary glands ihe ae Esophagus Stomach (1-1. 5) iestragm }——~Spleen ~~ Pancreas ———Transverse colon Gallbladder Duodenum {of small intestine) ¢Zmmon bile duct Small intestine- Se _-—Sigmoid colon A voc tectum sieeo eee —— Descending colon Ascending colon cecum Appendix—— Gastrointestinal System —Fig21 Mouth et Tongue hus bony attachments (styloid proces, hyoid bone) attached tothe floor of the mouth by fresulum. ‘© Posterior exit from mouth guarded by a ring of palatine/lingual tonsils. Enlargement = sore throat, tosis. © Ducted salivary glands open at various points into the mouth. This process involves teeth (muscles of mastication move jaws) and tongue (extrinsic and intrinsic muscles). ‘© Mechanical breakdown, plus some chemical (ptyalin, enzyme in saliva) secretion. ‘© Saliva amylase > does hydrolysis of starch and glycogen into maltose. Esophagus + The esophagus is about 10” long, + Food moves through esophagus by peristalsis. Copyright © 2000-2009 TIPS ine. Unauthorized reproduction of this manual is strictly prohibited and itis illegal to reproduce without permission, This manual is being used during review sessions conducted by 2 PharmacyPrep.www PharmacyPrep. Com Antiarchythmie drugs Basic tissue layers of the gut are: + Mucosa - innermost, moist lining membrane. Epithelium (friction resistant stratified squamous in esophagus, simple beyond) plus a little connective tissue and smooth muscle. + Submucosa - soft connective tissue layer, blood vessels, nerves, lymphatics + Muscularis externa - typically circular inner layer, longitudinal outer layer of stmooth muscle + Serosal Fluid Producing Single Layer Stomach (Fig 2.2) + Cardioesophageal sphincter guarding entrance __s0phagus __— from esophagus. Diaphrage_—*" + Pylori spineter guarding the outlet is much Lower exophage better defined sphincter + Fundus, body and pylorus recognised as distinct Lesser | Fundus Body Stomach regions. ae + Stomach secretes both acid and mucus (for self Gfesr'” —— eater protection) Bugdenat ane + Surface area increased by rugae; serves as Duodenum temporary store for food. The Stomach and Duederum ‘Stomach secretions Fig2.2 t_Secratons Parpose_ o Source Mucus rotects surface from acid ‘Mucus Cell Intrinsic factor__| Vitamin B,, absorption (in small intestine) | Parietal cell ‘Acid GE) Kills bacteria, breaks down food, converts | Parietal cell pepsinogen Pepsinogen Broken down to pepsin (a protease) ___| Chief Cal Gastrin Stimulates acid secretion Cell Dehuemig in nV insie Tale > Peeniciva — ennemin Gastric acid secretion mechanism In the parietal cells CO, and H,O are converted H* and HCO, catalyzed by carbonic anhydrase. Parietal cells secrete HCI into the lumen of the stomach and concurrently absorb HCO* into the blood stream Gastric acid stimulations Gastric acid production is stimulated by three mechanisms ‘Vagal stimulation: Vagal nerve innervates parietal cells and stimulates H’ secretion directly. tamine release: Histamine is released from mast cells in the gastric mucosa and diffuses to nearby patietal cells Gastrin Gastrin is released in response to eating a meal, thus stimulates parietal cells to secrete Ht. Hydrochloric acid + HCI is secreted by parietal cells + Maintains pH at 1.20 L$ for digestion of proteins by pepsin Copyright © 2000-2009 TIPS Inc. Unauthorized reproduction of this manual is strictly prohibited and it is illegal to reproduce without permission. This manval is being used during review sessions conducted by 2-2 PharmacyPrep,www PharmacyPrep.Ci Antiarrhythmic drugs + Converts pepsinogen into pepsin + Germicidal effect on microorganisms Pepsin > Converts proteins into proteases and peptones. Renin (chymosin)-> Present only in infants; helps in coagulation of milk; converts casein of milk into paracasein Lipase > No role in stomach Small testing (duodenum, jejunum, ileum) sd miscenbic Yein— pertal yein —» Vives —s hypiti ven Duodenum ce + First part of the small intestine. heart + C-shaped 10” (inch) long and curves around head of pancreas and entry of common bile duct ueHighest drug absorption in the body. “ Panerease is a large glandular organ attached near the stomach tohele body + Pancrease secretes intestinal enzymes, and these helps in the digestion of earbohydrates Jejunum (8-10 feet) Secretion: + Secretin > Stimulates pancreas to produce watery fuid, high in bicarbonates concentration. + Pancreozymin > Stimulates pancreas to produce a viscous fluid low in bicarbonate concentration + The majority of food absorbed takes place in the jejunum. eum (12 feet) Towards the end of the small intestine, accumulations of lympboid tissue (Peyer’s patches) are more ‘common, Large Intestines (colon) + Jojunum terminates at caecum + Highest basic or pH C2 —I0) + 90-99% inhabitant anaerobic bacteria + Animals digest cellulose in colon ‘The large intestine reabsorbs water then eliminates drier residues as feces Its primary purpose is to extract (absorbed) water from feces. Colon consists of higher flora and fauna in GI tract: 90-59% anaerobic bacteria Example: B. fragilis (anaerobic) and aerobic E.coli Clastdhun ol ¢fficid Diseases of the Gl system Diseases Of The Mouth And Jaw: + Inflammatory disorder + Hospes labialis - (Fiver blisters or cold sores)-HSV1 and HSV2 + Mouth Uleers ~ oral candidiasis (thrush, moniliasis)-Candida albicans + Gingivitis - Fusobacterium Disease of the salivary glands: -& Sjogren syndrome (dry mouth, dry eyes) — autoimmune disease ~ associated with rheumatoid arthritis. Copyright © 2000-2009 TIPS Inc. Unsuthorized reproduction of this manual is strictly probibited and it is illegal to reproduce without permission. This manual is being used during review sessions conducted by 2-3 PharmacyPrep,No GE bleeding or fever ia IBD. Syrqose yoww.PharmacyPrep.Com Antiarrhythmic drugs Diseases of the esophagus: + GERD — Reflux of gastric acid contents into esophagus Diseases of the stomach: ‘Gastritis ~ Caused by NSAIDs, cigaretic smoking, and heavy alcohol Peptic Ulcer -caused by H. pylori and drugs Helicobacter - Diseases of the smal intestine —~ + Duodenal ulcers ~ caused by H. pylori and drugs + Zollinger Ellison syndrome 27 Crolin disease (small intestine or colon) ~ chronic inflammatory condition v2 Celiac disease — caused by sensitivity tofglutenfin cereals ((eweaf di ecre.) iseases of the colon \e~ Ulcerative colitis — mainly colon + Uleerattive proctattis > occurs near reetum © Initable bowel disease (IBD) ~> diarthea, constipation, bloating and eramps. ‘&Pseudomembranous colitis ~ Clostridium difficile over growth (produce exdtoxin)->Diarrhea + Amebic colitis — Entamoeba histolytica + Cholera ~ Vibrio cholera Hernia (Fig 2.3( Esophagus. casresophageal wee ‘ Stomach Nomal stomach Hiatal hernia Hernia ae Hemias: Inguinal hernias 2 types e 1. Inditect; In all age groups (most common type) ‘The sac passes through the inner and outer inguinal rings. Lateral to the interior epigastric vessels and may go to the scrotum (congenital) 2. Direct; Hernia protrudes medial to inferior epigastric vessels through weak muscles in the Hessclbach's triangle. Itis common in adults and old age group. Other Hemias 1. Femoral Hemias; Common in females. It has no sac and passes throuigh the femoral ring, below the inguinal ligament, This hernia is susceptible to obstruction and strangulation, 2. Umbilical Hernias; Protraded through the umbilicus, Seen in pregnancy, ascietes and obesity 3. Epigastric Hemnias; Defect in Linea alba above umbili 4. Spigelian Hemia; Defect in Linea semilunaris. Autonomic inne! ions Cholinergic It is usually excitatory on functions of GI tract Copyright © 2000-2009 TIPS Inc, Unauthorized reproduction of this manual is strictly prohibited and it is illegal to reproduce without permission. This manual is being used during review sessions conducted by 24 PharmacyPrep.vw PharmacyPrep.Com Antiarrhythmic drugs Its carried via the vagus and pelvic nerves ‘Vagus nerve innervates the esophagus, stomach, pancreases and upper large intestine Pelvic nerve innervates the lower large intestine and rectum, and anus Adrenergic It usually inbibitory on the functions of GI tract Direct postganlionic adrenergic innervations of blood vessels and some smooth muscles Digestion and absorption (Fig 2.4) Only monosaccharides such as glucose, fructose, and galactose are absorbed. Most common site of Sees reece es lacove Mallese Seve. gestive enzymes ‘o~ Amylase->hydrolyse starch and glycogen into maltose 1 Maltase-> Converts maltose into glucose + glucose : ¥ Sucrase-Converts sucrose into glucose + fructose 7 Lactase Convers lactose (milk) into glucose + galactose. ¥ Trchalase > degrades carbobydrate to glucose v glitesidye + suernse & Stasth—> glucose galecloce ac Accessory organs of digestion Fig. 24 Pecshose inhibit glues! des © > amie Stecosh dam Spleen ~ > \ AD Armbse — ry bpecty oR Prevent glucese for" Liver eG ce) Celle mt dyed eee ESE teres re commen ie ctf SS ny Meseryeory, AR eonman eps Duodensm S95, tanner Disorder of carbohydrate absorption A Lactose intolerance results ftom absence of brush border lactase. Thus non absorbed lactose cause osmotic diarrhea. Soyamilk 9 hte Ave milk Lipid absorption + Bile acids emulsify lipids in the small intestine, increase surface for digestion. + Pancreatic Lipases -> hydrolyse to lipids to fatty acids, monoglycerides, cholesterol and Iysolecithin, Lipid absorption disorders “Malabsorption of lipids thus cause fatty stools, this also referred as stetorhhea (% Stetorthea can be caused by: + Pancreatic diseases such as pancreatitis, cystic fibrosis, + Hyper secretion of gastrin + Teal resection ‘Copyright © 2000-2009 TIPS Inc. Unauthorized reproduction of this manual is strictly prohibited and it is, illegal to reproduce without permission. This manual is being used during review sessions conducted by 2-5 PharmacyPrep.wow PharmacyPrep.Com Antiarrhythmic drags + Bacterial overgrowth Absorption of Proteins Pancreatic proteases + Trypsin and chymotrypsin are secreted by pancreas which helps in digestion of proteins + Trypsin > It secretes in the inactive form as trypsinogen and is converted to trypsin by enzyme enterokinase + Chymotrypsin-> Secretes in the inactive form as chymotrypsinogen and converted to chymotrypsin by trypsin. Absorption of nucleic acid + Nuclease-> Nucleic acid into nucleotide. + Ribonuclease > Hydrolyses RNA + Deoxyribonuclease > Hydrolyses DNA Absorption of water HO + This isosmotic in the small intestine and gallbladder. Absorption of vitamins + Fat-soluble vitamins (ADEK) are absorbed in small intestine along with other lipids + Vitamin B12 is absorbed in the ileurn and requires intrinsic factor. + Pernicious anemia caused due to oss of gastric parietal cells. This is treated by vitamin B12 injection, Absorption of Calcium _ \\Aiserpion of alsium occur jp spl tse, which assisted by active form of vitamin D ncitydronycholecaleiferoh (hes produced in kidney. eet Chronic renal failure or vitamin D deficiency results in inadequate intestinal Ca absorption, causing tickets in children and osteomalacia in adults. Absorption of iron Itis absorbed as heme iron (iron bound to hemoglobin or myoglobin) or as free Fe {In intestinal cells, heme iron is degraded to Fe™ and released, The free Fe binds to apoferitin and is transported into the blood. ‘Transferrin: Free Fe circulates binds transferring and transports it from small intestine to its storage sites in the liver and from the liver to the bone marrow for the synthesis of hemoglobin Cystic fibrosis = Mult ovgen eee = Tp Pankead Oud marly He Tu ~ isa disorder of pancreatic secretion. ae ~ results from a defect in Cr channels that is caused by a mutation in the eysticflbrasis transmembrane Concepts The following carbohydrates are digested by + Starch + orrylase, + Maltose> malfige + Sucrase > “eucweer + Lactose > acta, Copyright © 2000-2009 TIPS Inc. Unauthorized reproduction of this manual i strictly prohibited and its illegal to reproduce without permission. This manual is being used during review sessions conducted by 2-6 PharmacyPrep.‘wavw.PharmacyPrep.Com Antiarrhythmic drugs + at Hipese + Proteins, nuclgic agid are digested by: + Proteins-> ea + Nuclease > nvekar m9 mueedile 2 Peptidase > geet pephi awh + Enterokinase > Convey bypsinogen to tytn. + Pemicious anemia is caused by > deprieiny of Inbrinsic Abr + Pemicious anemia is treated by > vik Bn Inqedh + Maltase breakdowns maltose 0 > J lycese + glacese- + Suerase breakdowns sucrose to > Wg Feachse + Alcohol dehydrogenase oxidize alwshel bb oldcha te ats + Tiritable bowel symptoms include > connty, dearhbeca, Dlealirg , cxpnsps, TH baaic peak Colney a aan Basic Terms Gastroenterology ‘Study of the stomach and intestines Colonoscopy Process of viewing the colon Cholecystectomy Surgical removal of the gallbladder Dysphagia Difficulty, painful swallowing Peristalsis ‘Wavelike contractions that move food through the digestive tract Endocrinology Study of the secreting glands that make up the endocrine system Endoscopic ‘The process of viewing within Exophthalmia Protuberance of the eye Gingivitis Inflammation of the gums Hematemesis Bloody vomitus; heme Hepatitis Inflammation of the liver Hyperemesis Exeessive vomiting Hyperglycemia Too much sugar in the blood Hyperthyroidism Condition of too much thyroid hormone Hypokalemia Low blood potassium Lithotripsy Crushing of stones (such as kidney stones) Nasogastric Pertaining to the nose and stomach (a tube that travels from nose to stomach) Pancreatitis Inflammation of the pancreas Polydipsia Pertaining to excessive thirst Polyphagia Pertaining to excessive hunger Polyurea Excessive urination Sublingual ‘Under the tongue; lingua = tongue Thyroidectomy Surgical removal of thyroid gland Sialorthea Drooling (excessive saliva) WAlethorthea Fatty diarrhea (oily diarrhea) Copyright © 2000-2009 TIPS Inc, Unauthorized reproduction of this manual is strictly prohibited and it is illegal to reproduce without permission. This manual is being used during review sessions conducted by 2-7 PharmacyPrep.wows PharmacyPrep.Com Antiertiytimic drugs wZ Milk intlevorre couwel ky Milk pyekes albrgicn => No milk a ligize iviolevinn + Solubion=> Soyamnille, lagtzse tree alk tolin dh ve pals ant in > wheal, vie, oat yronued—> lel Geese ye biphi — slruesidave — breakdown 5 wero 45 tanh te poued we Sey mith odbagy due do — Pro been, ae Nith — allergye Lornplonent + laetese, we Saliva secwl” sgntailed by 4 Reonagm Sympolela Copyright © 2000-2009 TIPS Inc. Unauthorized reproduction of this manval is strictly probibited and itis illegal to reproduce without permission. This manual is being used during review sessions conducted by 2- PharmacyPrep.www-PharmacyPrep.Com Antiarrhythmic drugs Nervous System Nervous syste ‘Nervous system pissancasl acanonaey Celtral oer Autonomic sensory + all ogee 3é pt a heist soraes] cUshey

controls voluntary and involuntary movements Cerebellum Controlling balance and modifying body movements. Brain stem consist ofpons and medulla oblongata Spinal cord: vertebral column, epidural space, meninges, spinal cord, dorsal vertebra, and spinal nerve Copyright © 2000-2008 TIPS inc, Unauthorized reproduction of this manual is strictly probibited and it is illegal w reproduce without permission. This manual is being used during review sessions conducted by Bel PharmacyPrep.www.PharmacyPrep.Com Antiarthythmic drugs Corpus aallosum Thalamus ~ Diencephalon- Hygothalamus shall SE Brain stem Pons" - \ Mudulla oblongata \ Cerebellum Spinal cord The Bain Spinal Cord (Fig 3.3) a Meninges ‘The meninges are three concentric membranes that surround and protect brain and spinal cord. ve dura mater outer most membrane DAP Yc Ae arachnoid middle ayer, transparent, Coe flexible ~~ srainstem hepia mater inner layer is fine, an fenes Seqytca he pi ene nerves Enlargement Peripheral NS Ulnar nerve Pass through shoulder to wrist Scisticnerve _pass through buttock and thighs down to foot. Intercostal nerve covers over ribs Thoracic a Blood Bonin Borwvier (BOB) ~ Tt is base belitin cersbral espiling 8 Grubrtipoe! fluid Ta (SF file He venlinko andl Me Lumbar Subsaneid Spe noe ele te Geese OPI FGe Bani frm endo 4 cceg eorua tefins socal ars O Prevent eaape f retuotrananilter (1 os & bheod cineulgbon Ceceyoeal ® pid selebe dongs vw fats ther wat, Fig 3.3 soluble. emg CCopyigt © 2000-2009 TIPS Ine. Unauthorized reproduction ofthis mami srtly prohibited an tis ilgal to reproduce witout permission. This manual is being used during review sessions conducted by 3-2 PharmacyPrep. = Lumbar enlargementais b Por pyemnery, Perksingorriten — def- fy Capri , due Bre wow. PhammacyPrep Com Aniarrhythmie drugs Neuron ‘axon branch yet Amotor neuron Nerve cell consist of: Dendrite, Cell body, Axon, Myelin sheath, Synapse ‘The cells that support, nourish and protect neurons are the neuroglia . ‘The cell body of a neuron is the soma Long extensions off neuronal cell bodies that conduct impulses away from the cell are axons ‘The dark granular substance inside neuronal cell bodies are called Nissl substance. Itis composed of dense collections of ribosomes where protein synthesis occurs. Oligodendrocytes are cells that electrically insulate neuronal axons in the central nervous system. This electrical insulation is referred to as myelin AMiultiple sclerosis is 2 CNS disease where the myelin sheath of motor neurons is degenerating or being destroyed, which interferes with neuronal impulses. This is @ progressive disease that causes widespread motor deficits 5) Synapse (Fi Aves. auitin piesytey Myelin Vesicles ‘Axion of Motor i Synaptic. Neuron Neworeceptor. Coe af . Mitochondria statin pat 5/7 = Motor: End Plate Skeletal Muscle Fiber Neurotransmitter Receptors ‘Copyright © 2000-2009 TIPS Inc, Unauthorized reproduction of this manual is strictly prohibited and it is illegal to reproduce without permission, This manual is being used during review sessions conducted by 3-3 PharmacyPrep.yoww.PharmacyPrep. Com Antiarrhythmic drugs Facial Nerves Ependymal cells are specialized epithelial cells in the CNS that produce corebrospinal fluid In general, positively charged ions are termed cations On the inner cell membrane surface of resting ncuron, there is an accumilation of negative (anionic) charge. In electrical tems, “potential” is synonymous with“ vollage “: ‘An “excitable” cell is one that can quickly and dramatically change ils resting membrane potential, Two types of examples of excitable cells include muscle fibers and neuronal cells, The typical neuronal resting membrane potential measures approximately -70mV Anneuronal impulse is also referred to as an action potential , which indicates that itis a “moving” region of "volt- ‘age change” that migrates along the neuronal cell membrane. Tips ‘I frruiiter of ONS GABAis >inhibiby ef nue + Serotonin consist of > Indole vied + Epinephrine is secreted from-> dena medalla ee hr +_ Nor-epinephrine becomes epinephrine, chs reagtion is catalyzed by > P2 Cry 1diManolanuae Nome hy) wertighe Nene "pup theoigh 9 butch ik dow $ oot Bdpai, Meee Basic Terms Sadevide of thigh, coin Bradykinesia Slow movement Sedatives Reduce anxiety with little effect on motor or mental functions Hypnoties Produce drowsiness and reduce onset of sleep Insomnia Disturbed o fragmented sleep, often associated with physical or emotional illness Anxiolytic, A drug that decreases anxiety Tardive dyskinesia Inappropiate posture of neck, face and limbs + Nerve cells consist of? + What nerves are cause of schiatica pain? ‘+ What is physiological actions and significance of GABA receptors? Reasoning and Pi m Solving A patient is experiencing seintica, what it means? ‘ + Trippin do Seybbeace biel by > Pyptip han bydhory law J teary ht opp ida Preagndiltey ak 10 * Endorphins oe — pe Ye Tee ie cba : Frokeebig ea agers . nn Olle Papier Copyright © 2000-2009 TIPS Inc. Unauthorized reproduction ofthis manual is strictly probbited and itis illegal to reproduce without permission. This manual is being used during review sessions conducted by 3-4 PharmacyPrep.wavwPharmacyPrep.Com Cardiovascular System A, Cardiovascular System Blood circulation (Fig. 4.1) Blood circulation Stomach Hip and legs Fig. 41 Copyright © 2000-2009 TIPS Inc. Unauthorized reproduction of this manual is strictly probibited and it is illegal to reproduce without permission. This manual is being used during review sessions conducted by PharmacyPrep.www PharmacyPrep.Com Cardiovascular System Heart and Great Vessels 4.2) fay lowett BP ile bod wpa ate sometimes 36% | oe Left common carotid artery eperaree es Left subclavian artery a }_— Ronicarch Chigheet BP) Pulmonary trunk Ascending aorta Right Left pulmonary pulmonary — artery (branches) ibranches) tee oe pulmonary pulmonary —s ee Veins eftatrium Pulmonary valve = fish ay (mitral) valve seedy Meee Lemmy SRortievalwen? U9EHC thy, Pivwpa vali Right atrium —~ Rightay | (crleuspia)|~ valve Right ventricle | Left ventricle /_- hpex voce 3 layer & 1 Endocortily ~ caused raily in [. Obalel sungery Of AIT Sryery W/Cerebro Vasaular System (Fig 4.3) Anoeyallin 0 Piha Midste Cerebral Rear Interventricular septum Anerioe Cerebral Artery Posteri cerebral ieery | (e 5 dived fo brain c only nose, LAN feu amma as \ = VON fe ee Ad e" Shovly secunt ie sor Biliy be fo Naciarahoge, salir, phage ot, Sup pV faveied gna — ee iid styl, Beery ‘Copyright © 2000-2009 TIPS Inc. Unauthorized reproduction ofthis manual is strictly prohibited and it is itlegal to reproduce without permission. This manual is being used during review sessions conducted by 4 PharmacyPrep,Cardiovascular System Conduction System of the Heart (Fig 4.4) ? : Conduction system of the heart Arrhythmias Artnythmias develop because of abnormal impulse generation, propagation or both. © Cardiac arrhythmias are related to abnormal electrical activity within the heart resulting in either altered rhythm or impulse conduction. Dysrhythmia—disturbed heart rhythm Arthythmia ~ absence of rhythm Bradycardia - a heart rate that is lower than normal (<60 beats/min). ‘Tachycardia -a heart rate that is higher than normal (> 100 beats/min). Paroxysmal - an arrhythmia that suddenly begins and ends (may occur with fever) ‘Sinus bradycardia - low sinus rate <60 beats/min (between the pacemaker and atria). Sinus tachycardia - high sinus rate of 100-180 beats/min as occurs during exercise or other conditions that lead to increased SA nodel firing rate, Atrial flutter - sinus rate of 250-350 beats/min, Sick sinus syndrome - a disturbance of SA nodal function that results in a markedly variable rhythm (cycles of bradycardia and tachycardia). ‘© Atrial tachycardia a series of 3 or more consecutive arial premature beats oceutring at a frequency >100/min; usually due to abnormal focus within the atria and paroxysmal in nature, ‘This type of rhythm includes paroxysmal atrial tachycardia (PAT). ‘Atrial fibrillation - uncoordinated atrial depolarizations, Junetional escape rhythm - SA node suppression can result in AV node-generated rythm of 40- 60 beats/min (not preceded by p-wave). ‘© AV nodal blocks - a conduction block within the AV node (or occasionally in the bundle of His) that impairs impulse conduction from the atria to the ventricles ‘Types of pacemakers + Natural (main) pacemaker of heart SA node + Latent pacemaker of heart AV node Bundles of His Purkinje fibres Copyright © 2000-2009 TIPS Inc. Unauthorized reproduction of this manual is strictly prohibited and it is, illegal to reproduce without permission. This manual is being used during review sessions conducted by 43 PharmacyPrep.(4 swynw.PharmacyPrep Ci Cardiovascular System Pulse direction: SA node > AV node > Bundles His > Purkinje fibres, Supraventricular arrhythmias (SVA)—arthythmias develops above the bundles of His, Ventricular arviythmias (VA) ->develops below the bundle of His Arshythmias or dysrrbythmias = irregular heart beat [Myocardial action potential curve k a. Myocardial action potential curve reNects action 2 potential, which describe electrical activity of five L | phases. ow ‘This occurs in atrial and ventricular myocytes and eer purkinje fibers Durnidive 9 Ls] Nag i Pyocain tomide Hf yreimide | | + Phase 0: Rapid Depolarization: Na” enters the cell PAliClassIadugs block vapid polarization Phase 1: Early rapid repolarization: K* leaves the Oe tayo dla cave Phase 2: Plateau: Ca enters the cell Chea IK channel blocke,, - Prvederone Phase 3: Final rapid repolarization: K" pumped ouwartiecel > Tb cw — Lyaoceine, Meer Ili, Teainde prety lms Phase 4: Slow depolarization: K" inside the cell emide. and Na’, Ca® out side the cell, P| dauryd . Phase I to starting phase 3 is absolute refractor period or effective reftactory period -> The cell cannot respond to any stimuli During Phase 3 is relative reftactory period -> The cell ability to respond stimuli inereases or cell can respond to strong stimuli Aepotaiation: Clnvoaxd Cuvvent) obey He change in cel Increase Na" influ into cell Decrease K* efflux out to cell sat d) P Repolarization (Hyper palaxizag” / Drueoarrd Carer ae Increase K* effiux out o cell the +ve thease oat y Je" = Increase Cl infu into cell Electrocardiograph Wave Forms The electrical activity occurred during depolarization and repolarization transmitted through electrodes attached to the body and transformed by an electrocardiograph (ECG) in to series of waveforms; P wave: indicated atrial depolarization PR interval: indicates the spread of the impulse from the atria through Purkenje fibres. ‘QRS complex: indicates ventricular depolarization ST segment: indicates phase 2 ofthe action potential- the absolute refractory period T wave: shows phase 3 of the action potential-ventricular repolarization. QT interval } mechanical contraction of the ventricles (Torse de pointes) U wave > caused by hypokalemia Torsade de pointes, Copyright © 2000-2009 TIPS Inc. Unauthorized reproduction ofthis manual is strictly probibited and it is illegal to reproduce without permission, This manual is being used during review sessions conducted by 4-4 PharmacyPrep.www-PharmacyPrep,Com Cardiovascular System This is aso called the Q-T interval. A problem in one of the ion channels can prolong the Q-T interval. A prolonged Q-T interval can increase risk for a type of arrhythmia called torsade de pointes, Drugs and diseases that can lead to QT-prolongation + Phenothiazines and haloperidol Antipsychotics + Type Il antiarchythmic drugs + Inpatients with hepatic failure. Thrombus (blood cot) ThrombugyZ” Clot forming on the sides of e vessel, usually near plaque. Example: Deep vein thrombosis Fig 4.6) Embolus\~ A floating blood clot in the blood siream, ne thus this can lead to embolism. Example Pulmonary embolism (Fig 4.7) forgone Fig. 45 Stenosis X% ~ tonsbittion nm naerewrg af poirg Ancurysm (Bulging of arteries ‘ aacustin ves in hagmorshoge, 4 Nommalaor atm NEM PBedh de teal iE in haan Fig. 46 Tips * Absolute refractor Period or Effective refractory period > Phase | to starting phase 3 is > The cell cannot respond to any stirmuli + Relative reftactory period > During Phase 3 is > The cell ability to respond stimuli increases of Cellean respond @ song simul +X ling heart has deceased SV * nowase SV Inerxce Contact Increase SV when Inereave preload, decrease ae load or Treas contac Stroke volume affected by Contractility, After load, and Preload, SV increased in et exercise, ee Sympiomsof CHF? DYlpnea, eduend, whe fain Sra eter 189! yy Seda lore ae, & steal + Symptoms of angina? (ie Nek shoul oaetjintir eFE am, rears Scions, snc cen! irtonl scp ia cn tevminal nd ey eget + Symptoms of intermittent claudication? Febrinitlieg pen Interneitantly ems G Bem Se + Inotropic = Force of contraction in heart muscles. inotropic (+ ve) = Increase in force of contraction. The -ve inotropic = Decrease in force of contraction. non-dihydropyridine (verspas) ‘Copyright © 2000-2009 TIPS Inc. Unauthorized reproduction of this manual is strictly prohibited and it is illegal to reproduce without permission. This manval is being used during review sessions conducted by 4-5 PharmacyPrep.www.PharmacyPrep,Com Cardiovascular System + Drugs that cause +ve inotropic effect: Digoxin, ACE inhibitors, and dihydropyridine CCBs + Drugs that cause ~ve chronotropic: Digoxin, Beta blockers. + Autonomic effects on force of contraction, heart rate and conduction velocity Chironotropic = Heart rate + Ancgative (-ve) chronotropic effect decreases heart rate by decreasing firing raic of SA node + Contractility and SV decreased by: Beta blockers, CCBs, and diseases such as CHF, + Appositive (+ ve) chronotropic effect increases heart rate by increasing firing rate of SA node + Dromotropic = Conduction velocity + Dromotropic effect produce changes in conduction velocity, primarily in the AV node + Ancgative dromotropie effects decreased by stow AV node conduction action potential from atria to ventricles and increases PR intervals, + Apositive dromotropic effects increased by speeding AV node conduction potential from atrial to ‘ventricles and decreasing PR interval. Basic Terms Angiography Process of recording a vessel Arteries Carry blood away from the heart and have thick walls Arterioles Drain into arteries Bradycardia Pertaining to a slow beast Bronchoscopy Process of viewing the bronchus Capillaries Drain into venules. Bridge arteries and veins, Allows exchange of ‘oxygen and nutrients Capillaries Drain into venules. Bridge arteries and veins, Allows exchange of ‘oxygen and nutrients between blood and tissues. No elastic. Thin (one layer of flattened (squamous) cells Cardiomegaly Enlarged Heart Cardiomyopathy Disease of the heart muscle Chronotropiec ‘Heart rate: chronotropic Dromottopic ‘Conduction velocity Dyspnea Difficulty of breathing Endarterectomy ‘Surgical removal of the inside of an artery Cardiomegaly Enlarged Heart Cardiomyopathy Disease of the heart muscle Chronotropic Heart rate: chronotropic Dromotropic Conduction velocity Dyspnea Difficulty of breathing Endarterectomy Surgical removal of the inside of an artery Hypoxemia ‘Too little oxygen in the blood Inotropic Force of contraction in heart muscles Laryngoscope Instrument for viewing the larynx Lymphoma ‘Tumor of the lymphatic system Myeloma ‘Tumor of the bone marrow Myocarditis Inflammation of the heart muscle Pericardium Lining around the outside of the heart Septicemia Bacterial infection of the blood Copyright © 2000-2009 TIPS Inc. Unauthorized reproduetion of this manval is strictly prohibited and it is, illegal co reproduce without permission, This manual is being used during review sessions conducted by 4-6 PharmacyPrep,weww.PharmacyPrep.Com Tachycardia Thoracentesis ‘Thrombophlebitis Valves ‘Veins ‘Venous dilators Venules Infaret Brain attack (also called stroke) Cerebral embotisin Cerebral hemorthage Cerebral thrombosis Cardiovascular System Pertaining to a fast heart Surgical puncture of the chest Inflammation of a vein due to blood clot formation Found in the heart and veins, but notin the arteries Return blood to the heart, low pressure, have thin walls Nitroglycerin decrease preload Drain into veins Tissue death due to oxygen deprivation Happens when brain cells die because of inadequate blood flow to the brain ‘brain attack that occurs when a wandering clot (embolus) or some ‘other particle forms in a blood vessel away from the brain - usually in the heart ‘A type of stroke occurs when a defective artery in the brain bursts, flooding the surrounding tissue with blood. the most common type of brain attack Copyright © 2000-2009 TIPS Inc. Unauthorized reproduction of this manual is strictly prohibited and it is illegal to reproduce without permission. This manual is being used during review sessions conducted by PharmacyPrep. 4-7www PharmacyPrep Ci Endocrine system pieled] phpieledd [ im (5-6) Endocrine System Endocrine system Consists of a group of organs have NO DUCTS and therefore are also known as DUCTLESS GLANDS seorete hormones directly into the blood stream, The Endocrine Glands Pineal Pituitar irae Parathyrotds (posterion > os Thymus t as ocd — Pancreatic istets Ovaries Testes ; Fig 5.1 Major endocrine glands ‘© Pituitary Gland (present under hypothalamus) Testes Ovaries ‘Thyroid Gland (neck) Adrenal Gland (on kidney) Pancreas Gland (endocrine and exocrine) Other glands © Parathyroid Gland (neck) Copyright © 2000-2009 TIPS Tne, Unauthorized reproduction ofthis manual i sett probibited and itis ‘legal to reproduce without permission, This manual is being used during review sessions conducted by 5-1 PharmacyPrep.wwwv:PharmaeyPrep.Com © Thymus Gland (chest) © Pineal Gland (brain) fammary of endocrine glands Endocrine system Hypothalamus ‘Releasing and Inhibiting Hormone TRH. GnRH Pituitary Hormone ‘Growth hormone. ACTH. TSH, FSH, LH, Prolacting, ADH, Oxytosin ate Thyroid hormone ‘Thyroxin, triiodothyroxine, and calcitonin Parathyroid hormone gland Parathyroid hormone Pancreas, Insulin, and glucagon Adrenal gland Cortisol, Aldosterone, Epinephrine, Norepinephrine Testes ‘Testosterone ‘Ovaries Estrogen, Progesterone (Testosterone) Abia endocrine glands (2.3) _ Endocrine Gland Principal Hormone | Tang ‘issue | Physiologic Effect of Hormone Hypothalamus ‘Releasing and inhibi ‘Anterior pituitary | Controls release of anterior pituitary homonss bormone [Aatetior | Teyoiesimaaing | Thyroid Production of hyoid hormone Pituitary hormone (TSH) Adrenal cortex ‘Adrenocoricouapic [Adrenal corex | Sesretion oF consol (acti ‘Growth hormone”) Bones soft sass | Stimalates rowh of ones and so Falickestmulating | Females avery | Promotes grow of ovarian follicle; hormone (SED Stimulates enrogen szreton Ttcniing hormone [Miles Testes [Stimulates sperm production aH) Females: ovary ‘Stimulates ovulation Stimulates estrogen and progesterone Froth Males Teses | Stimulates esiostrone seen Females bast” | Promotes beast development stmt milk seeetion to (galactonbea) Posterior ‘Vasopressin Kidney (Causes water retention | Pituitary (antidiuretic hormone) | Oxytocin Tiers Canses contraction Breasts Causes ejection of mile [Final Nikon Bran; etevor | Sets the bods “time clock | SS piiany Causes seep in espouse to dainess slee, do | reproductive organs; PT ist babsily other ses Tigraid | Tiyraidbommone Ct, | Mostels Tnareses te metabols aie ae and | secesary for normal growth and Calcitonin wo xne development Ca= Blood > Bones Copyright © 2000-2009 TIPS Inc. 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This manual is being used during review sessions conducted by PharmacyPrep.wow PharmacyPrep.Com Endoerine system Paralliyroid | Parathyroid bormone | Bone, kidney; Tnceease amount of calcium inthe intestine bloodstream, Decreases amount of ‘phosphate inthe bloodstream Ca=Bones ~> Blood Thymus Thymosin Tivmphooyies “Enhances the production af T lymphocytes Pancreas insulin Most cas Promotes use and storage of nuisients Secreted from beta cells particulary glucose, after eating Glussaan Most cells ‘Maintains glucose levels in the Secreted from zlpha bloodstream during periods of no cells food Somasiatie Digestive system | Inhibits digestion and absorption of Secreted from delta cells nutrients ‘Adrenal Epinephrine and Kidney Thereases sodium retention and ae Medulla Norepinephrine potassium secretion ‘Adrenal ‘Aldosterone Kidney Tnereases sodium retention and cortex potassium seeretion sal Most cells Tnereases glucose in the bloodstream ‘Andeogens Females: bone and | Puberty growth spurt and sex drive in brain females “Testes (male) | Testosterone Male sex organs) | Stimulates production of spemns body asawhole | responsible for development of sex cchaateristes; promotes sex drive ‘Ovaries Bsirogen ‘Female sex organs; | Stimulate uterine and breast growth; (iemale) body asawhole "| responsible for sex characteristics Progesterone Uieras Prepares for prograncy ‘magnceluar Porviesiar neuron ©) J ‘wens Releasing and Neon Anterior pituiter te oT TSH ACTH LHL ESH, GH, ‘and pacts Prukary ‘ane Posterior pittary : ‘homnesoxytach Fig 5.2 Sd vasoprean 7 Copyright © 2000-2009 TIPS Inc, Unauthorized reproduction of this manual is strictly prohibited and itis illegal to reproduce without permission. This manual is being used during review sessions conducted by ‘PharmaeyPrep. 5-3www.PharmacyPrep.Com Endocrine system Pituitary Gland Located at the base of the brain. © Consists of two parts: anterior lobe and posterior lobe. © It is some times known as the master gland © It controls the functions of other endocrine glands and is in turn controlled by the hypothalamus. Somatostatin Somatostatin opposes the effects of Growth Hormones-Releasing Hormone (GHRH) Prolactin It is synthesised and secreted by lactotrope cells in the anterior pituitary gland, breast and the decidua, Effects ‘© Stimulates the mammary glands to produce milk (lactation), © Provides the body with sexual gratification after sexual acts © immune tolerance of the fetus by the matemal organism during pregnancy. ‘© Stimulate proliferation of oligodendrocyte precursor cells which differentiate into oligodendrocytes, the cells responsible for the formation of myelin coatings on axons in the central nervous system Thyroid Gland (Fig 5.3) Secretes thyroid hormones, which in turn control the body’s metabolic rate Types of thyroid hormones Thyroxine (T,) ‘Naturally occur in Levo (L) isomer Form produced in the thyroid gland © Converted in the liver and other organs oT, © Controls the rate of metabolism in the body. * Triiodothyronine (T,) * Metabolically active form Calcitonin (a peptide) * Secreied by parafolicalar cells (C- cells) © Reduces blood calcium ion concentration cbiodinace Fig 5.3 Hypocalcemic hormone 14. erate Ge Indeed in treatment of osteoporosis salted VOCE Bact IFrypercatcemiastirn Functions of thyroid hormones: © Grow ‘© Development ‘© Proper function of all body system ‘Copyright © 2000-2009 TIPS Inc. 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PharmacyPrep.Com Endocrine system Maintenance of all body tissues Syeptort of Hypetpit carbohydrate, fat, protein, and vitamin metabolism (Basal Metabolic Rate) “Pradycada «Effects the seeretion of other hormones (insulin, NE, Epi, cortisol, estrogen and testosterones 60 natiprition see Mechanism of action heovieg loos © At the target cell, proteases split protein carrier off from the thyroid hormone and a gee most of, is defodinated to T, ¢ T, (and probably some) ender the cell through membrane transport proteins and — shin Senaj hit, bind to a specific nuclear receptor. — shir speech. * The Tr-Trseepor complex moves ito the muceus, whee it binds o specie sequences of DNA in the promoters of responsive genes, weight goin © Theetfect ofthe hormone-eceptor complex binding to DNA is to modulate gene ~ SeueiPuity br cold expression, either by stimulating or inhibiting transcription of specific genes. ~ Aypenténsion * Pessieney of thyroid hormones + Myxedemo — Aypo thy tid + Divers © Mental retardation : + Haghimots — hy po tyrtid Thyroid disorders Hyperthyroidism © Overactive thyroid gland causing an abundance of thyroid hormone © Thyrotoxicosis is the general term for over activity of the thyroid gland co Diffusely enlarged non tender goiter Nervousness, irritability, amxiety and insomnia Heat intolerance and profuse sweating ‘Weigh loss in spite of increased appetite ‘Tremor and muscle weakness Tachycardia Diarrhea Common forms of hyperthyroidism \-Gfave’s disease (diffuse toxic goiter) ‘Most common form of hyperthyroidism # Autoimmune disorder, antibodies (long-acting thyroid stimulators) bind to and activate TSH receptors \Pfimmer's disease (toxic nodular goiter) =" Léss common than Grave's disease Less common forms ® Jodbasedow phenomenon: Over production of thyroid hormone following sudden inerease in iodine ingestion ® Factitious hyperthyroidism: Occurs with abusive ingestion of thyroid replacement agents, in a misguided effort to lose weight. Copyright © 2000-2009 TIPS Inc. Unauthorized reproduction of this manual is strictly prohibited and it is illegal to reproduce without permission, This manual is being used during review sessions conducted by 5-5 PharmacyPrep.