‫ملف معد الجتياز امتحان الفيفا يف سلطنة عمان‬

‫اعداد‪ :‬الصيدالنية نوزت البكور‬

‫‪N.V.F‬‬
‫‪Dr. Nauzat Viva File‬‬
 ‫شكر وتقدير‬
‫قال الشافعي رمحة اهلل عليه‪ " :‬ليس العلم ما ’ حفظ إمنا العلم ما نفع "‪....‬‬

‫احلمد هلل الذي وهبين التوفيق والسداد إلجناز هذا العمل املتواضع راجية من اهلل تعاىل أن يكون هذا امللف دليالً مساعداً وكافياً الجتياز امتحان الفيفا فهو يتضمن ما يلي‪:‬‬

‫‪ .1‬ملخص ألهم األسئلة الشفهية يف املقابلة من شهر ‪1/2023‬وحتى شهر ‪ 5/2023‬مع اإلجابة الصحيحة بإذن اهلل بعد التأكد منها من مواقع طبية معتمدة‪.‬‬

‫‪ .2‬جدول حيتوي كافة املعلومات التفصيلية جلميع األدوية الواردة يف وصفات املقابلة‪.‬‬

‫‪ .3‬جدول حيتوي كافة املعلومات التفصيلية جلميع أدوية ‪ controlled‬يف سلطنة عمان وملاذا تعترب‪controlled‬‬

‫‪ .4‬مراجعة ألهم معلومات الفارما اخلاصة بامتحان الفيفا‪.‬‬

‫ويف اخلتام‪..‬‬

‫أمتنى جلميع الزمالء املتقدمني النجاح والتوفيق وأسأل اهلل أن أكون قد ’وفقت لتقديم ملف مفيد‪ ،‬فما كان فيه صحيحاً فهو من اهلل وما كان خطأً فمن نفسي‪.‬‬

‫دعواتكم باخلري والعافية‪.‬‬

‫الصيدالنية نوزت بكور‬

‫‪1‬‬
 ‫ ملخص أسئلة الفيفا مع األجوبة‬:‫القسم األول‬

Viva Questions and Answers Summary

Q1: How dispense controlled drugs?
Validity:
• 3 days for Narcotic & Psychotropic.
• 10 days for non-Psychotropic.
Dispensing quantity:
• Not more 7 days for Narcotic, Psychotropic, Non- Psychotropic For governmental sector all amount prescribed For private
sector: Not more than 7 days .
• Pregabalin, gabapentin, isotretinoin dispenses for 30 days.
Notes
✓ Take ID of patient and make a copy of it, then attach it with prescription and save in pharmacy for 18 months.
✓ Don’t forget to sign and stamp the prescription and write the date of dispensing.
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Q2: What is prolonged QT interval?
A prolonged QT interval is an irregular heart rhythm. Occur when the heart muscle takes longer to contract and relax than usual.
It can lead to fainting, cardiac arrest and sudden cardiac death.
---------------------------------------
Q3: Antidote for Panadol?

2
N-acetyl cysteine.
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Q4: What is classes of antidiabetic?
1. Biguanide: metformin.
2. DPP4 inhibitors: sitagliptin, linagliptin, sitagliptin.
3. Insulin secretagogues:
a. Sulfonylurea: (2nd generation: glimepiride, glipizide, glyburide, gliclazide)
b. meglitinide: repaglinide, Nate glinide
4. Thiazolidinediones: pioglitazone, rosiglitazone.
5. SGLT-2 inhibitors: dapagliflozin, canagliflozin, empagliflozin.
6. Alpha glucosidase inhibitors: acarbose miglitol.
7. GLP1 agonist: liraglutide.
8. Insulin

Rapid acting Short acting Intermediate acting Long acting

Insulin aspart Insulin detemir
Regular insulin
Insulin type Insulin glulisine NPH insulin
(Humulin R, Novolin
(Humulin N, Novolin N) Insulin glargine
R)
Insulin lispro
Duration 3- 5 hr 3-6 hr 10- 16 hr 24 hr
Onset of action 25 min 1/2- 1 hr 2-4 hr 4 hr

▪ Combination: (intermediate 50 % NPH + short 50 % Regular).

▪ Combination: (75% intermediate acting lispro suspension + 25 % rapid acting lispro solution).
▪ Combination: (70% intermediate acting aspart suspension + 30 % rapid acting aspart solution).

3
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Q5: Dosage Forms & Strengths of diclofenac?
1. diclofenac potassium: tablet 50 mg, capsule 25mg.
2. diclofenac sodium: tablet delayed release 25mg, 50mg, 75mg. tablet extended-release 100 mg .
3. diclofenac sodium 75mg/3ml injection.
4. diclofenac sodium: Powder packet for oral solution 50 mg.
5. diclofenac sodium topical gel/ cream: 1 %, emugel = (combines both a gel and a cream): diclofenac dethylamine 2.23% w/w
Emulgel™ formula helps the active ingredient, diclofenac, penetrate deep through the skin for powerful arthritis pain relief.
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Q6: Nitroglycerin= Glyceryl trinitrate (GTN) uses?
1- For sublingual dosage form Spray: 0.4mg/spray:
Angina: 1-2 spray(s) PRN for angina, may repeat q3-5min, not to exceed 3 sprays in 15 minutes. Spray onto or under tongue; do not
inhale, expectorate or rinse mouth for 5-10 minutes.
Angina, Prophylaxis: 1-2 sprays 5-10 minutes before activities likely to cause angina.
2- For sublingual dosage form (powder):
1 or 2 packets placed under the tongue at the first sign of an angina attack. 1 packet may be used every 5 minutes as needed,
for up to 15 minutes. Do not take more than 3 packets in 15 minutes.
3- For sublingual dosage form tablet 0.5 mg:
Angina Pectoris (Acute Relief): 1 tab SL q5min up to 3 times; use at first sign of angina. Dissolve under tongue or in buccal pouch;
do not rinse mouth or spit for 5 minutes after administration.
Angina Pectoris (Prophylaxis): 1 tablet SL 5-10 minutes before activities likely to provoke angina attacks.
4- For prevention or treatment of angina capsule, extended release 2.5mg, 6.5mg, 9mg
Angina Pectoris (Prophylaxis): ER capsule: Initial 2.5-6.5 mg PO q6-8hr. used every day.
5- Transdermal:
Onset of action 30 min, long for 10- 12 hour.

4
6- nitroglycerin IV: infusion solution (25mg/250mL, 50mg/250mL, 100mg/250mL)- injectable solution 5mg/mL
5 mcg/min Increase by 5 mcg/min q3-5min up to 20 mcg/min, THEN increase by 10 mcg/min, May later increase by 20 mcg/min

Note: Isosorbide dinitrate: drug free period to prevent nitrate tolerance.

.‫ وليس بزيادة الجرعة‬،‫يحدث تحمل النترات مع االستخدام لفترة طويلة ويمكن التغلب عليه بتطبيق فترات قصيرة من إيقاف استخدام النترات‬
.‫ ساعة بين الجرعة المسائية وجرعة اليوم التالي‬14 ‫ إذا كانت حبة سريعة التحرر قم بعمل فاصل بمقدار‬:‫للتأكد من الحصول على فاعلية عالية ومستدامة ينصح بـ‬
.‫ الظهر‬2 :‫ في اليوم التالي يعطى‬،‫ ليال‬12 ،‫ عصرا‬4 ،‫ ص‬8 :‫مثال يعطى الدواء عادة‬
.)‫ الظهر‬12 ،‫ مساء‬6( ‫ ساعة بين الجرعة المسائية وجرعة اليوم التالي‬18 ‫ قم بعمل فاصل‬:‫إذا كانت حبة مديد التحرر‬
.‫وال يجب إيقافه فجأة‬
Q7: If prescribe 50mg for child from ibuprofen how to calculate?
cross multiplication: Brufen syrup concentration is 100mg/5ml, So you need 2.5 ml.
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Q8: dependence vs addiction?
dependence, a physical dependence on a substance.
Addiction, encompasses both a mental and physical reliance on a given substance.
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Q9: Withdrawal symptoms?
Abnormal physical or psychological features that follow the abrupt discontinuation of a drug that has the capability of producing
physical dependence.
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Q10: Adult dosing of paracetamol
The recommended paracetamol dosing for adults and children 12 years and over is 500 to 1000mg every four to six hours as
necessary, with a maximum of 4000mg in any 24 hour period.
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Q11: Child dosing of paracetamol
is 15 mg per kg, which can be given every four to six hours as required, with no more than four doses in 24 hours.

5
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Q12: How to measure kidney function?
1- GFR (glomerular filtration rate): GFR is more accurate in determining if your kidneys are ok.
▪ A GFR of 60 or higher is in the normal range.
▪ A GFR below 60 may mean kidney disease.
▪ A GFR of 15 or lower may mean kidney failure.
2- Serum creatinine:
▪ normal values by gender:
▪ 0.7 to 1.3 mg/dL for adult males.
▪ 0.5 to 1.1 mg/dL for adult females.
3- Creatinine clearance: Normal values are
▪ Male: 97 to 137 mL/min.
▪ Female: 88 to 128 mL/min
4- Blood urea nitrogen
5- Urinalysis.
6- Microalbuminuria.
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Q13: classes of antidepressants?
1. Selective serotonin reuptake inhibitor (SSRIs): citalopram; escitalopram; fluoxetine, paroxetine; sertraline.
2. Serotonin and norepinephrine reuptake inhibitor (SNRI): Duloxetine, venlafaxine.
3. Monoamine oxidase inhibitor (MAOI): selegiline, isocarboxazid, phenelzine, and tranylcypromine.
-------------------------------------------------
Q14: narrow therapeutic index drugs?
Warfarin, Digoxin, Phenytoin, carbamazepine, levothyroxine, phenobarbital, rifampicin, theophylline, aminoglycosides, ciclosporin,
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Q15: narrow therapeutic index definition?

6
Definition: A ratio that compares the blood concentration at which a drug becomes toxic and the concentration at which the drug is
effective. Measure safety of the drug.
LD50/ ED50
Q16: Tuberculosis cause?
The cause of TB is the infection with mycobacterium tuberculosis.
Q17: Tuberculosis Treatment?
isoniazid (INH), rifampin (RIF), ethambutol (EMB), and pyrazinamide (PZA) are considered first-line anti-TB drugs and form the
core of standard treatment regimens.
-------------------------------------------
Q18: The usual treatment of TB is:
▪ 2 antibiotics (isoniazid and rifampicin) for 6 months.
▪ 2 additional antibiotics (pyrazinamide and ethambutol) for the first 2 months of the 6-month treatment period.
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Q19: Consulting of rifampicin?
▪ It causes red urine, stool, saliva, sweat, and tears
▪ Taken on empty stomach
▪ If you take antacid, take it 1 hr before or 2 hrs after rifampicin
▪ Rifampicin is enzyme inducer and you need to adjust the dose of some medications.
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Q20: Drug need to prescribe with isoniazid?
INH we need to give vit B6 to prevent the development of peripheral neuropathy.
on an empty stomach, 1 hour before or 2 hours after a meal.

7
upsets your stomach, take it with food. Antacids may also help.
Q21: Morphine anti dote? Naloxone.
Q22: Thyroxin? For hypothyroidism.
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Q23: Propylthiouracil, carbemazole and methimazole? For hyperthyroidism.
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Q24: Drugs contraindicated for pregnant?
Misoprostol (miscarriage) , Tetracycline (impairment of fetal long bone growth, teeth decolorization for fetus, hepatotoxicity to
mother) , isotretinoin (teratogenic) , warfarin (nasal hypoplasia), methotrexate (miscarriage), valproic acid (dec. mental ability,
Congenital malformations), Griseofulvin.
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Q25: Antidiabetics for pregnant?
Insulin, metformin, glyburide.
-------------------------------------
Q26: Antihypertensive in pregnancy?
Methyldopa, nifedipine, labetalol, hydralazine.
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Q27: What is side effect of corticosteroid inhaler?
Orphanage candida due to dec. immunity in mouth and throat, advice wash mouth after application.

8
Q28: What mean of bacteria resistance?
the capacity of bacteria to withstand the effects of antibiotics that are intended to kill or control them.
To remain alive and effective although in presence of antibiotic.
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Q29: What are the 3 main ways bacteria have resistance?
The three fundamental mechanisms of antimicrobial resistance are
(1) enzymatic degradation of antibacterial drugs.
(2) alteration of bacterial proteins that are antimicrobial targets.
(3) changes in membrane permeability to antibiotics.
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Q30: What is an example of bacterial resistance?
Staphylococcus aureus (or MRSA) and Neisseria gonorrhoeae.
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Q31: What are the diseases related to antibiotic resistance?
pneumonia, tuberculosis, gonorrhea, and salmonellosis.
Antibiotic resistance leads to longer hospital stays, higher medical costs and increased mortality.
--------------------------------------------
Q32: Causes of bacterial resistance?
• Excess use of antibiotic.

9
 • Insufficient control on antibiotic prescriptions.
Q33: patient had penicillin allergy drug can't use it and why?
Cephalosporin, Due to Cross allergy because it contains beta lactam ring.
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Q34: pregnant and ductus closure happened what's the management?
Alprostadil given to pregnant.
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Q35: A 4-week Infant is diagnosed with patent ductus arteriosis to avoid performing surgery give?
Indomethacin (NSAIDS should be used within 14 day of birth) given for infant.
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Q36: NSAID (ibuprofen) C.I n 3rd trimester of pregnancy, why?
cause premature closure of the ductus arteriosus (a vessel that runs from the pulmonary artery to the aorta).
Premature closure of this blood vessel can cause high blood pressure in the lungs of the developing baby (called pulmonary
hypertension).
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Q37: Antihistamine safe in pregnancy?
first generation antihistamines such as chlorpheniramine, hydroxyzine, and dexchlorpheniramine are the safest among
antihistamines to be used in pregnancy. Cause sedation.
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Q38: other antihistamine not cause sedation? Why??

10
The non-sedating antihistamines include cetirizine, desloratadine, fexofenadine, levocetirizine and loratadine, because it doesn't
cross BBB.
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Q39: Why Pregabalin used for 30 days?
because it used for chronic diseases which need long-term treatment.
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Q40: What are the 4 treatments for H. pylori?
This 4-drug regimen includes a PPI (standard dose, bid), clarithromycin (500 mg, bid), amoxicillin (1 g, bid), and
metronidazole (500 mg, bid).
Triple therapy (proton pump inhibitor, clarithromycin and amoxicillin or an imidazole).
Q41: Augmentin side effect??
diarrhea Why?? Due to imbalance between good and bad bacteria in the intestine (Destroy normal flora).
Q42: Why misoprostol controlled??
Because it cause abortion (miss use), other use?? Ulcer, Postpartum Haemorrhage.
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Q43: What will do expiry medicine??
sort out and put in a separate box in store and inform MOH, can dispense it before the end of expiry month date and should be inform
patient to expiry date.
---------------------------------------------
Q44: what are nephrotoxic drugs?

11
aminoglycosides, amphotericin B, cisplatin, contrast dye, and cyclosporine, chronic use of NSAID.
ACE inhibitor, Methotrexate (MTX), Vancomycin, Interferon (IFN).
-------------------------------------------------
Q45: Hepatotoxic drugs?
Acetaminophen, methotrexate, Amoxicillin/clavulanate (Augmentin), Amiodarone, Allopurinol, Azathioprine, Risperidone.
-------------------------------------------
Q46: Doxycycline and clindamycin differences?
Doxycycline and clindamycin are different types of antibiotics.
Doxycycline is a tetracycline antibiotic and clindamycin is a lincosamide antibiotic.

DOXYCYCLINE CLINDAMYCIN

MOA Protein Synthesis Inhibitors / act on 30 s subunit Protein Synthesis Inhibitors / act on 50 s subunit

Pregnancy Category D Category B

effect Bacteriostatic Bacteriostatic

caution Not give under 8 years Given to all pediatric patients, including neonates

Contraindicated with mineral & milk products.

contraindications Contraindicated with antacid allergic reaction to it.
C.I with retinoic acid, cause (‫)ورم كاذب في الرأس‬

12
 Cause Kidney impairment
Safe for use in renal failure because it excreted in feces
Suppress bone & teeth growth
GIT Upset.
Cause Permanent Teeth decolonization
Side effects Pseudomembranous Colitis.
Cause Photosensitivity
Steven Johnson's Syndrome (SJS).
After meal cause stomach upset, stomach
Mylosuppression & Pancytopenia
irritation

For acne (twice daily topical), orally tid or bid.

dose 100 mg bid or 200 once (oral or IV)
vaginal

For acne.
For acne
Respiratory infections, gynecological infections,
indications MRSA, Lyme disease, cholera, brucella,
endometriosis.
syphilis disease, anthrax.
Skin infections, vaginitis, osteoarthritis, blood poisoning
+ve, _ve bacteria and atypical. Streptococci
spectrum Cover MSSA, MRSA. Staphylococci (MSSA – MRSA).
Broad spectrum Anaerobic

Dosage forms Cap, IV infusion Cap, vaginal gel, topical solution, topical cream, amp

Q47: Dexamethasone available dosage form?

ampule, tab, solution (elixir), eye drop, cream (in combination with nystatin), ear drop with ofloxacin.
----------------------------------
Q48: Side effects of corticosteroids?
Obesity, hypertension, diabetes, stomach upset, osteoporosis, infection, peripheral oedema, increase hair growth, dec. growth in
children, hypokalemia, depression, glaucoma, inc. appetite.
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13
Q49: Symbicort composition?
• budesonide and formoterol, used in the management of asthma or chronic obstructive pulmonary disease.
• It contains budesonide, a steroid and formoterol, a long-acting β2-agonist.
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Q50: Side effects of furosemide?

• Ototoxicity.
• Hyperuricemia, hyperglycemia
• hypocalcemia
• Hypokalemia, hypomagnesemia, hyponatremia.
• Metabolic alkalosis.
• Avoid use in sulfa allergy.
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Q51: ACEI, ARBS cause same S.E?
hyperkalemia.
-----------------------------------
Q52: Hypothyroidism treatment?
Thyroxin.
-----------------------------------------
Q53: Thyroxin, dose?
Adults usually start with a dose between 50 micrograms and 100 micrograms taken once a day, on empty stomach at morning
around the same time daily.

14
Q54: Antihistamins?
▪ Fenistil drop for 2 months
▪ Hydroxyzine, desloratedin for 1 year.
▪ cetirizine, levocetirizine, loratadine for 2 years.
▪ Fexofenadine, bilastin for 12 year.

Q55: myopathy meaning?

muscle disease due to dysfunction of muscle fibers, the most common signs and symptoms of myopathies include weakness,
stiffness, cramps, and spasms.
Some common medical conditions that cause myopathy include: diabetes, thyroid disease, lupus, and rheumatoid arthritis.
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Q56: What is hypokalemia?
Low potassium level than (3.5-5 meq/L), causes: drugs as loop diuretics, glucocorticoid, laxatives.
Diseases: as Cushing syndrome, diarrhea, diabetic ketoacidosis, chronic kidney disease.
---------------------------------------------
Q57: Counseling of furosemide?
To decrease hypotension, get up slowly.
Take K supplements.
Avoid drugs that induce ototoxicity like aminoglycoside, vancomycin, salicylates, chemotherapeutic agents such as cisplatin.
Decrease Ca in blood, take supplement when long use.
Decrease (Na, K, Ca, Cl, Mg).

15
Q58: dose of paracetamol of children according to weight?
Dose is 10- 15 mg/kg/ dose- every 4-6 hours.

Q59: is aspirin safe at long term in pregnancy?

Low-dose aspirin (81 mg/day) prophylaxis is recommended in women at high risk of preeclampsia and should be initiated between
12 weeks (3 months) and 28 weeks (7 months) of gestation (optimally before 16 weeks) and continued daily until delivery.
Recommend for use in high-risk factors patients (history of preeclampsia, multifetal gestation, renal disease, autoimmune disease,
type 1 or type 2 diabetes, and chronic hypertension).
or more than one of several moderate-risk factors (first pregnancy, maternal age of 35 years or older, a body mass index greater than
30, family history of preeclampsia).
In the absence of these factors for preeclampsia, do not use aspirin.
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Q60: why glibenclamide cause hypoglycemia?
Because stimulate insulin secretion from beta cell in pancreas to turn sugar to fat and still activate secretion despite serum glucose
decrease causing hypoglycemia.
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Q61: how to determine warfarin dose?
By calculating INR.
only If INR less than 1.5 you can start with warfarin therapy.
Suggested initial dose for (days 1 and 2) is 5 mg, Dosing for (day 3) and beyond increased gradually up to 12.5 mg.
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16
Q62: short acting and long acting beta 2 agonists?
short acting SABA: salbutamol, terbutaline, albuterol.
Long acting LABA: Formoterol, salmeterol.
Long-acting muscarinic antagonists (LAMA): tiotropium bromide.
Q63: what s the beta 1 agonists?
Beta 1 agonists: Epinephrine, Norepinephrine increase HR, BP.
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Q64: how to use metered dose inhaler MDI?
▪ remove the cap of the MDI
▪ shake the inhaler.
▪ Hold the inhaler in the right position
▪ Take deep breath in and then blow out completely to empty the lungs.
▪ Put the mouthpiece of the inhaler or spacer/VHC in your mouth and close your lips around it to form a tight seal
▪ Breathe in slowly and deeply as you puff the medicine into your mouth, then hold your breath for as long as possible
▪ Hold your breath and count to 10 seconds.
▪ Make sure you shake the inhaler in between puffs.
▪ For second puff wait for 1 minute and repeat the same steps.
▪ If using an inhaled corticosteroid, rinse out your mouth with water and spit it out. Rinsing will help to prevent an infection in
the mouth.
‫ ضع القطعة الفموية للبخاخ بين شفتيك وأغلقهما‬،‫ خذ نفس عميق وأطلق زفير قوي إلفراغ الرئتين‬،‫ ثبت البخاخ بوضعية صحيحة‬،‫ رج البخاخ بقوة‬،‫افتح غطاء البخاخ‬
.‫ إلجراء بخة أخرى انتظر دقيقة و اعد الخطوات‬،‫ ثم تنفس طبيعي‬،‫ ثواني‬10 ‫ أمسك نفسل لمدة‬،‫ تنفس ببطء وعميق وخالل ذلك اضغط البخاخ‬،‫جيدا‬
The normal way to use your inhaler (both adults and children) is: 1 or 2 puffs of salbutamol when you need it.
up to a maximum of 4 times in 24 hours (regardless of whether you have 1 puff or 2 puffs at a time).

17
Q65: deference bet metered dose inhaler (MDI) and dry powder inhaler (DPI) accuhaler?
DPI: don’t have gas propellants, it contains a tiny amount of fine powder form that patient can suck in.
DPI: Do not shake the inhaler.
DPI: take a fast, deep, forceful breath in through your mouth.
you do not need to coordinate pressing the canister with inhaling.
-----------------------------------------------------------------
Q66: what do you do if myopathy happened?
1- Take statin at night.
2- lowering dose.
3- take co enzyme 10.
4- convert to bile acids resins as cholestyramine.
Note: pravastatin and Fluvastatin, rosuvastatin may be associated with the lowest incidence of myalgia.
Niacin may increase your risk of muscle breakdown.
----------------------------------------------------------------------
Q67: Can you use aspirin in children?
Reyes syndrome with viral infection (serious liver and brain symptom lead to death).
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Q68: can you use warfarin in pregnancy, why? What is alternative?
No, teratogenic causing nasal hypoplasia. Use LMWH as enoxaparin.
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18
Q69: Strength of paracetamol syr?
120 mg/5 ml- 250 mg/5 ml.
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Q70: Hydralazine?
Direct vasodilator, use in hypertension crisis as preeclampsia in pregnancy, CHF, dose: 25-50-100 mg.
----------------------------------------------
Q71: what is gout and what you use for treat?
Gout is a painful form of arthritis, affect one joint at a time (one big toe).
Treatment of acute attack: 1st line NSAID: (indomethacin, naproxen, sulindac), 2nd line: colchicine. 3rd line: corticosteroid.
Treatment of chronic: allopurinol (dec. uric acid synthesis), probenecid (inc. uric acid excretion).
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Q72: Meaning of syrup, suspension, elixir?
Elixir: clear, sweetened, hydroalcoholic solutions intended for oral use and are usually flavored.
Suspension: the medicine is mixed with a liquid, usually water, a heterogenous mixture fluid whereby the drug particles do not fully
dissolve into the solvent.
Syrup: are thick, viscous, liquid consist of sugar in water mainly.
concentrated aqueous preparations of sugar or non-sugar substitute with or without added flavouring agent
---------------------------------------------------------------
Q73: SOS, OD, BID?

19
SOS: if necessary.
OD: once daily, right eye.
BID: twice daily.
-------------------------------------------------------
Q74: lactulose use and another use?
Osmotic laxative, for chronic constipation, hepatic encephalopathy or coma result from liver disease.
MOA: Colonic acidifier, decreasing ammonia concertation in blood.
Dose: once daily for constipation and 3-4 times daily for hepatic encephalopathy.
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Q75: encephalopathy?
any disease of the brain that alters brain function or structure.
It may be caused by: An infection. Metabolic or mitochondrial dysfunction. Brain tumor or increased pressure in the skull
------------------------------------------
Q76: Salbutamol?
Short beta 2 agonist, relax muscle of airway.
------------------------------------------------------
Q77: fluticasone diskus MOA, uses, type of inhalers?
Corticosteroids, reduce irritation and inflammation. To treat sneezing, itchy runny nose.
MDI, PDI.

20
Q78: potent NSAID example?
▪ Most potent: piroxicam, ketorolac.
▪ Very potent: indomethacin, meloxicam.
▪ Moderate potent: diclofenac, celecoxib.
▪ Least potent: ASA, naproxen, ibuprofen.
----------------------------------------------------
Q79: why dry cough in ACEI?
ACEIs have antihypertensive effects by decrease Na and water retention and also have vasodilator action.
ACE, enzyme responsible on convert AT1 to AT2 and degrade bradykinin to inactive metabolite.
ACEI inhibit conversion of AT1 to AT2 and inhibit the converting of bradykinin to inactive metabolite.
Bradykinin is a vasodilator by (inc. Nitric oxide releasing), but it also responsible for cough and angioedema
By blocking the breakdown of bradykinin, it accumulates in lungs and cause dry cough.
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Q80: How balance hypokalemia from furosemide?
Give K supplements, use spironolactone.
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Q81: CLOPIDOGREL is recommended in pregnancy?
No, give LMWH.
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Q82: What is the first thing you should see in prescription?

21
Name, gender, age, date, doctor specialist.
----------------------------------------
Q83: lisinopril side effects?
Strength: 2.5-5-10-20 mg.
Hyperkalemia, cough, teratogenic, angioedema, postural hypotension, renal insufficiency, lisinopril is an effective antihypertensive
drug for patients with impaired renal function.
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Q84: why atorvastatin (hs) at night?
Because most cholesterol synthesis at night.
To decrease feel of myopathy.
--------------------------------------------------------------
Q85: side effects of sitagliptin?
Nasopharyngitis, URTI, UTI, acute pancreatitis.
---------------------------------------------------------------
Q86: aspirin C.I in children and teenagers?
Especially who recovering from a viral infection – for example a cold, flu or chickenpox.
Risk of ray syndrome (Persistent or recurrent vomiting, Listlessness, irritability or combativeness, confusion).
Aspirin C.I with methotrexate.
------------------------------------------------------

22
Q87: Side effect of metformin?
Metallic taste, vitamin B12 deficiency, wt loss, flatulence.
Q88: Hypothyroidism?
Hypothyroidism is classified as:
▪ Primary: due to an abnormality at the level of the thyroid gland.
▪ Secondary: due to decreased TSH secretion.
▪ Tertiary: due to TRH deficiency.
T4 convert to T3.
--------------------------------------------------
Q89: drug interaction of warfarin?
There are 621 drugs known to interact with warfarin such as:
▪ NSAID, anticoagulant, antiplatelet, SSRI, SNRI --------- ----------(bleeding).
▪ Tamoxifen, raloxifene, clomiphene----- -------------------------------(inc. clotting factors).
▪ Sulphonamides, valproate, phenytoin---------displace warfarin ----(bleeding).
--------------------------------------------------------
Q90: Food-drug interaction of warfarin?
(Green tea, st john's wort, garlic, ginger, gingko, ginseng, glucosamine, use co-enzyme).
‫ غلوكوزامين‬-‫جنسنغ‬-‫جنكو‬-‫ زنجبيل‬-‫ثوم‬
-------------------------------------------------------------
Q91: Drugs teratogenic?
Warfarin, ACEI, ARBS, misoprostol, isotretinoin.

23
Q92: drugs as immunosuppressants?
Antimetabolites: Methotrexate, azathioprine, cyclophosphamide, mycophenolate mofetil or sodium.
Corticosteroid: prednisolone, methylprednisolone.
Biological agents: such as adalimumab and infliximab.
Calcineurin inhibitors: such as tacrolimus and cyclosporine.

Q93: what mean of salbutamol solution?

Salbutamol nebulizer solution for chronic bronchospasm unresponsive to conventional treatment of acute severe asthma.
-------------------------------------------------------------------------
Q94: What is DAMARD drugs?
disease-modifying antirheumatic drugs work to suppress inflammation caused by overactive or abnormal immune responses.
conventional DMARDs are methotrexate, sulfasalazine, hydroxychloroquine, and leflunomide.
------------------------------------------------------------
Q95: Nitrate mono, di, tri?
Nitrate: direct vasodilators used to treat angina and chest pain, caused by lack of oxygen supply to heart muscle and symptoms of
CHF.
Mono: for chronic angina.
Di: for acute attack (sublingual) and chronic (oral).
Tri: emergency state.

24
Q96: dose of Panadol & brufen?
Panadol: Not exceed 4000 mg/ day. 8 tablet /24 hr.
Brufen: 3200 mg per day 800 milligrams per dose, or (4 maximum doses).
---------------------------------------------------
Q97: Type of angina?
▪ stable angina (more common) – attacks have a trigger (such as stress or exercise) and stop within a few minutes of resting
▪ unstable angina (more serious) – attacks are more unpredictable (they may not have a trigger) and can continue despite resting
▪ Variant angina (or Prinzmetal's angina): due to spasm of heart artery.
---------------------------------------------------------
Q98: differences between diclofenac Na and K?
Na: slower in action longer duration.
K: fast action shorter duration.
------------------------------------------------------------
Q99: dosage form not to be breakable?
SR tablet.
--------------------------------------
Q100: Diclofenac precautions?
1- history of cardiovascular events as stroke
2- pregnancy
3- renal impairment

25
4- peptic ulcer
-------------------------------------------
Q101: Why diclofenac CI in pregnancy?
due to fetal malformation as kidney problems and also if taken in the 3rd trimester it causes premature closure of fetus ductus
arteriosus.
-----------------------------------------------------------
Q102: Alternative of Famotidine?
Ranitidine but withdrawn from market in April 2020.
PPI as omeprazole.
-------------------------------------------------------
Q103: which Corticosteroids is controlled
the strongest Betamethasone.
----------------------------------------------------------------
Q104: why spironolactone combined with furosemide and if the furosemide is alone what u should do?
To keep potassium concentration stable in blood
If use furosemide alone should take k supplements.
Hypokalemia effects: arrythmia, muscle cramps, paralysis, respiratory failure, weakness, constipation, hyperlipidemia, decrease
insulin secretion.
-----------------------------------------------------------------

26
Q105: the refresh eye drops?
Artificial tears contain lubricant glycerin, mineral oil, propylene glycol, dextran, methylcellulose, povidone.
Artificial Eye drop 0.3%, Eye drop ophthalmic Lubricant
MOA: promotes wetting and adhesion of tears to the ocular surface.
It is mimic the action of inner tears film layer (mucin)
SE: blurred vision, eye pain and headache
- Counseling for eye drops:
#Sterile don’t touch the tip.
#Store at room temperature between 15 and 30°C.
#Use within 28 days
---------------------------------------------------------------
Q107: what is the condition to use?
Dryness, Blepharitis
‫التهاب الجفن‬
------------------------------------------------------------
Q108: what is the mechanism of action?
Agents like povidone additionally mimic the action of mucin, the inner tear film layer that promotes wetting and adhesion of tears to
the ocular surface.

Q109: patient education about eye drop?

27
 ▪ Wash your hand before and after using eye drop
▪ Remove contact lenses prior to using eye drops wait 15 min to reinsert
▪ Bend your neck back so that you are looking up.
▪ Use one finger to pull down your lower Eyelid.
▪ Administrate One drop.
▪ wait 5 minutes between two drops.

Q110: example of nonselective B Blocker? Propranolol, timolol……

Q111: What is the other use of propranolol?

Propranolol preventing migraine.

28
Q112: What is the doses of warfarin available in pharmacy?
▪ 0.5mg – white tablet.
▪ 1mg – brown tablet.
▪ 3mg – blue tablet.
▪ 5mg – pink tablet
------------------------------------------------------------------------
Q113: If warfarin dose is 7mg what you can do?
Can take 1tab 5mg and 2tab 1mg.
Q114: Mechanism of action and use of mycophenolate?
Inhibit T and B lymphocyte cell proliferation to lower activity of immune system.
Use: organ transplant (kidney, liver, heart).

Q115: What is the color of prescriptions for Pregabalin and gabapentin?

Green color. And dispensed for 30 days.

Q116: Omeprazole S.E?

headache, abdominal pain and diarrhea.

Q117: Clopidogrel S,E?

SEs: upper respiratory tract infections, flu like syndrome, headache and increases the risk of bleeding.
-------------------------------------------------------------------------------------
Q118: Can we use lisinopril and furosemide together?

29
Usually, lisinopril combined with hydrochlorothiazide as brand name, but about drug- drug interaction between lisinopril and
furosemide this need high caution, dose adjustment and monitoring.
Q119: lisinopril cause dry cough, how solved?
Convert to ARBs.
---------------------------------------------------------------
Q120: Why do they prescribed 2 antiplatelet?
This combination (aspirin + Clopidogrel) is recommended in pts with ischemic stroke and recent history of MI or coronary stent
placement.
they reduce the risk of ischemia.
Q121: Cetrizine hydrochloride
5 - 10 mg, non-sedating antihistamine second generation oral antihistamine blocking H1 receptor.

Q122: Asthma drug have narrow therapeutic index?

Theophylline.
-------------------------------------------------------------------------
Q123: Fluticasone/vilanterol?
Corticosteroid and long-acting beta agonist
Use: prophylaxis of asthma

30
Q124: GTN? ((glyceryl trinitrate *nitoglycerin* short acting nitrates.
MOA: it is converted by mitochondrial dehydrogase to nitric oxide which is a potent vasodilator
Uses: chest pain caused by angina.
-------------------------------------------------
Q125: Eye drop should be?
Sterile and isotonic solution.
------------------------------------------------
Q126: Insulin counseling?
▪ Wash hands
▪ Pull cap off insulin pen
▪ Wipe rubber stopper with alcohol swab

31
 ▪ Remove the paper tab from the outer shield
▪ Push the needle onto the pen and twist until it is tight
▪ Pull the outer shield off and put it aside (it will be needed later to remove the needle from the pen)
▪ Pull the inner shield off. Remind your patient that a new pen needle should be used for each injection to help minimize the risk
of infection and pain.

Q127: Fluticasone?
intranasal STEROIDs.
MOA: Block the late-phase reaction to the allergen, reduce airway hyper responsiveness, and are potent and effective anti-
inflammatory medications.
Common SE: Headache, dry nose, nose bleeds, unpleasant taste.

32
Q128: metformin (class and other uses)
Biguanide /weight loss, pcos.
-------------------------------------------------------------------
Q129: after how much time we discharge insulin and wt happen to insulin after this time?
discharge after 28 days, Bcz insulin become invalid.
--------------------------------------------------------------------------------
Q130: insulin pen consuling?
Educate pt how to use pen
-pick an injection site
-dial the dose
-sterilize the area
-press an injection button
-remove the needle from the insulin pen
-dispose the needle
Storage at room temp.
-----------------------------------------------------------------------------
Q131: Tetracycline why contraindication in pregnancy?
cause a baby's milk teeth to be permanently stained and discolored.
----------------------------------------------------------------------------

33
Q132: statin MOA?
Prevent conversion of HMG CoA to mevaonate which is the rate limiting step in cholesterol synthesis.

Q133: HS?
at bed time.
------------------------------------------------
Q134: TPN Full Form?
Total Parenteral Nutrition.
Q135: Insulin storage temperature?

34
 ▪ Unopened and stored Insulin needs to be stored in a refrigerator at a temperature around 2–8°C.
▪ Once you open a vial, keep it stored in the fridge or at room temperature.
▪ Store opened insulin bottles or reservoirs or pens at a room temperature (15°C to 30°C).
▪ Keep insulin away from direct heat and sunlight.
▪ You can store most opened insulin at room temperature for a maximum of 28 days.
▪ Be aware that injecting refrigerated insulin may be painful.
---------------------------------------------------------------------------------------------------
Q136: common liver function tests include:
▪ Alanine transaminase (ALT). ...
▪ Aspartate transaminase (AST). ...
▪ Alkaline phosphatase (ALP). ...
▪ Albumin and total protein. ...
▪ Bilirubin. ...
▪ Gamma-glutamyl transferase (GGT). ...
▪ L-lactate dehydrogenase (LD). ...
▪ Prothrombin time (PT.
----------------------------------------------------------
Q137: Corticosteroids in controlled?
Beclomethasone, clobetasol and fluocinonide.
-------------------------------------------------------------------
Q138: What is mean by syrup?
Solute dissolved in solvent.
-----------------------------------------------------------------------
Q139: Augmentin strength?

35
Suspension:
156, 228, 312,457,625
tablet, chewable
▪ 200mg/28.5mg =228
▪ 400mg/57mg = 457
tablet
▪ 250mg/125mg =375
▪ 500mg/125mg =625
▪ 875mg/125mg = 1000
---------------------------------------------------------------------------------
Q140: Is clopidogrel contraindicated in pregnancy? Why?
Potential increased risk for intrapartum and postpartum hemorrhage. In non-pregnant patients, the use of clopidogrel within 7 days of
surgery is associated with increased risk of significant bleeding.
Alternative drug? Aspirin or lMWH.
------------------------------------------------------------------------------------------------------
Q141: Stamp of controlled drugs?
Doctor stamp, Clinic stamp, Pharmacy stamp.
-------------------------------------------------------------------------------------------------------------------------------------------------
Q142: What are narcotic drugs and why are they considered controlled drugs?
substances that affect mood or behavior, used to treat moderate to severe pain and sometimes consumed for nonmedical purpose and
lead to addiction, that’s why they are dispensed carefully.

36
Q143: How could you deal with expired and nearly to expire drugs?
Expired drugs should be put in one container and contact MOH to deal with it. While nearly to expire drugs should be dispensed
practicing FEFO (first expiry, first out) and FIFO (first in, first out).
I preferred to tell the patient about the duration within which the drug is going to expire.
-------------------------------------------------------------------------------------------
Q144: Calculate an anti-histamine fexofenadine dose for 2 year child?
Anti-histamines are not recommended in this age/ use aerius syr.
-------------------------------------------------------------------------------------------------
Q145: What is the best time to take famotidine?
15-60 minutes before eating food or drinking beverages. Ranitidine was the alternative but it has been off the market `cause of concerns over level
of the contaminant N-nitroso dimethylamine which increases risk of cancer.

----------------------------------------------------------------------------------------
Q146: Counseling of klavox (Augmentin) syrup?
Shake vigorously to reconstitute all powder.
Then add water to the mark, Keep it tightly closed, Store in refrigerator., Discard after 7 days.
It belongs to amino penicillin.
-------------------------------------------------------------------------------------------
Q147: What is Clopidogrel active metabolite?
active metabolite of clopidogrel contains a thiol group which binds to a free cysteine on the P2Y12 receptor and irreversibly blocks
ADP binding and receptor activation.

37
 Approved ages for using certain antihistamines

Q148: Can 2 years old take cetirizine?

Cetrizine syrup formulation 5 mg/ 5 ml: dose for 2.5-5mg od (from 6 month to 5 years).
dose for 5-10mg od (from 6 year to 11 years).
Source: Antihistamines in pediatric allergy DOI:10.4314/EJPAI.V10I1
-------------------------------------------------------------------------------------------------------------------------
Q149: antihistamine and pregnancy?

38
Q150: Why patient’s name and gender are important to be in the prescription?
Because incorrect identification may result in wrong patient, also there are gender-related differences in drugs’ pharmacokinetics, and
gender is important to asl about pregnancy and lactation.
-------------------------------------------------------------------------------------------------------------------
Q151: Does warfarin safe during pregnancy? And if not, what is the alternative?
No it’s not. Only in case of metal heart valve warfarin may be used in 2nd trimester.
LMWH is the safe alternative.
Q152: Which enzyme is responsible for aspirin metabolism?

39
ASA is mainly metabolized by three enzymes:
▪ UDP glucuronosyltransferase 1A6,
▪ cytochrome P450 2C9.
▪ N-acetyl transferase 2 (NAT2)
----------------------------------------------------------------------------------------------------------
Q153: What is the proper time to take hydrochlorothiazide?
In the morning, after breakfast.
------------------------------------------------------------------------------------------------
Q154: What will your advice the patient who taking atorvastatin 40 mg?
I advise not to use this concentration for long time.
Usually it recommended after cardiac surgery, catheter or stent for one or two months, then decrease the concentration gradually due
to it highly incidence to cause myopathy. So, it is preferred to contact with you doctor to discuss this point.
-----------------------------------------------------------------------------------------------------
Q155: What will your advice the patient who taking methotrexate?
Take MTX once weekly and don’t take folic acid in that day.
For Rheumatoid Arthritis: Initial: 7.5 mg PO/IV/IM as a single weekly dose, OR 2.5 mg PO q12hr for 3 sequential doses per week.
For Psoriasis: Initial: 10-25 mg weekly in single PO/SC/IM/IV dose; not to exceed 30 mg/wk
As chemotherapy use 2 - 4 times weekly according to state.
-----------------------------------------------------------------------------------------------------------
Q156: What are Psychotropic drug?

40
Drug used for anxiety disorders, seziure and insomnia.
----------------------------------------------------------------------------------------
Q157: dose of aspirin as analgesic?
300 to 650 mg orally every 4 to 6 hours as needed. Maximum dose: 4 g in 24 hours.
81 or 100 mg as antiplatelet.
----------------------------------------------------------------------------------------------------
Q158: Where is calcium getting absorbed?
in small intestine.
----------------------------------------------------------------------------------------------------
Q159: Can sitagliptin (25-50-100) be used in pregnancy?
Pregnancy Category B: Reproduction studies have been performed in rats and rabbits. Doses of sitagliptin up to 125 mg/kg
(approximately 12 times the human exposure at the maximum recommended human dose) did not impair fertility or harm the fetus.
Source: FDA/ LEAFLET OF JANUVIA.
------------------------------------------------------------------------------------------------------
Q160: Prescription of tramal for 15 days How u dispensed?
I dispense quantity only for 7 days. Be attention it is valid for 3 days from date of writing it.
------------------------------------------------------------------------------------------------------
Q161: Use of aspirin other than antiplatelet?
aspirin is used to treat, and may help prevent, heart attack and stroke. aspirin is the most commonly used antiplatelet drug and the
oldest, has a lot of safety and efficacy studies.

41
-----------------------------------------------------------------------------------------
Q162: is atenolol safe in pregnancy? No
Hydralazine, labetalol, and nifedipine are the recommended first-line treatments for severe hypertension in pregnancy.
----------------------------------------------------------------------------------------
Q163: dose and Max dose of paracetamol for children?
▪ for children under 6 years old: 5ml dose contains 120mg of paracetamol.
▪ for children aged 6 years and older: 5ml dose contains 250mg of paracetamol.
▪ General dosing: 1 month to 18 years: 15 mg/ kg per dose.
▪ Maximum 1 g every 4 hours.
▪ Don't take more than 4 doses in 24 hours and 4 g n 24 hours.
-----------------------------------------------------------------------------------------------------------
Q164: DUPHALAC= LACTOLUSE given for diabetes?
Give in Warnings and precautions.

Q165: what is the difference between salbutamol and fluticasone nasal spray?
fluticasone nasal (nose) spray is a steroid medicine used to prevent and treat symptoms of allergic rhinitis and hay fever, including
sneezing, itchy and runny nose, itchy and watery eyes, and a blocked nose.
Salbutamol is a short-acting, selective beta2-adrenergic receptor agonist used in the treatment of asthma and COPD.

Q166: Tamsulosin?
long-acting alpha 1 blockers, relaxing the muscles in the prostate and bladder so that urine can flow easily.

Q167: phenobarbital elixir? 15mg/5ml Elixir

As an anticonvulsant in the treatment of all forms of epilepsy except absence seizures.

42
Usual adult daily dose: 60-200 mg phenobarbital taken in 2 or 3 divided portions.
Children: initially 3-6mg per kg body weight per day taken in 2 or 3 divided portions.

Q168: phenobarbital and pregnancy and lactation?

Congenital craniofacial, cleft lip and palate have been reported
Patients taking phenobarbital should be adequately supplemented with folic acid before conception and during pregnancy.
Phenobarbital is excreted into breast milk and there is a small risk of neonatal sedation and methaemoglobinaemia in nursing infants.
Breast-feeding is therefore not advisable.
---------------------------------------------------------------------
Q169: eye drop validity?
you should dispose of any unused eye drops 30 days after you first opened the bottle, unopened eye drops usually expire 1-2 years
following their manufacturing date.
------------------------------------------------------------------------
Q170: Why use aspirin in pregnancy?
prevent or delay the onset of preeclampsia, prevent fetal growth restriction, preterm birth, and early pregnancy loss.
---------------------------------------------------------------------------------------
Q171: what happen If hyperkalemia happens?
may cause life-threatening cardiac arrhythmias, muscle weakness, or paralysis.
------------------------------------------------------------------
Q172: Ibuprofen dose in pediatric?

43
Given from 6 month.
Dose of ibuprofen 4- 10 mg/ kg/ dose,
q 6-8 / day prn,
maximum 4 dose/ day.

44
‫القسم الثاني‪ :‬جدول بالمعلومات التفصيلية لألدوية الواردة في وصفات المقابلة‬

‫‪45‬‬
 Drug Class MOA Uses S. E Nots

block COX enzyme to

NSAID Heartburn,
inhibit Analgesic, avoid in
Acetylsalicylic Non-Selective nausea,
1 Prostaglandins and antipyretic and children
acid COX vomiting, GIT
Thromboxane A2 antiplatelet before 12y
inhibitor bleeding
Synthesis
Inhibit XO that
Treatment and
prevent C.I in pregnancy, not
Xanthine prophylaxis for Skin rash,
conversion on use in acute attack of
2 Allopurinol oxidase gout, prevent alopecia,
Xanthine to uric acid gout only as
inhibitor specific types of hepatotoxicity
Dec uric acid con. in prophylaxis.
kidney stone
blood.
Calcium channel HTN, Chronic DHP: vascular
Reflex
blocker in blood Stable Angina, selective.
3 Amlodipine DHP CCB Tachycardia,
vessel causing coronary artery Non DHP: cardio
ankle Edema
Vasodilatation disease selective.
Penicillin All beta lactam
antibiotic antibiotics cause:
beta lactam Allergy.
antibiotics. Acute Interstitial
Nephritis.
Inhibit peptidoglycan Allergy,
Amoxicillin / Amoxicillin – GIT upset \
4 synthesis that inhibit URTI Diarrhea
Clavulanic Acid amino Diarrhea.\ ‫التهاب‬
bacterial cell wall Category B
penicillin) ‫كولون غشائي كاذب‬
Clavulanic Pseudomembranous
acid= beta colitis,
lactamase elevate liver
inhibitor) enzymes.

46
 Bone Marrow
Suppression

promotes wetting and

adhesion of tears to
Change in vision,
Eye the ocular surface. loss of natural
5 Artificial Tears eye irritation and Sterile, isotonic
Lubricant It is mimic the action eye lubricant
pain.
of inner tears film
layer (mucin)
Block B1 receptor of Insomnia,
heart and kidney bradycardia, Brands: Tenormin
Hypertension,
6 Atenolol B1 blocker Lead to decrease sexual 50-100
Angina
Heart rate, decease dysfunction, Norvasc
renin releasing. arrythmia
HMG CoA reductase
inhibitor that leads to Rhabdomyolysis,
Hyperlipidemia
HMG-CoA inhibit Myalgia,
Reduce risk of MI Cause
7 Atorvastatin reductase mevalonic acid Myopathy and
, hyperglycemia,
inhibitor formation which is liver enzyme
Stroke, CVD
rate limiting step in elevation
cholesterol synthesis
Immunosupp Antagonist to
rheumatoid
ressant, purine metabolism
arthritis, crohn’s Leukopenia,
Disease that DMARDs Drug
8 Azathioprine Disease, bone marrow
modifying inhibit DNA, RNA, Brand: IMURAN
ulcerative colitis, suppression
antirheumatic Protein
kidney transplant.
drugs. synthesis
Tricyclic Reuptake inhibitor of Depression, Sedation, postural
9 Amitriptyline antidepressan serotonin migraine hypotension,
ts (TCA) norepinephrine in prophylaxis, weight gain

47
 adrenergic and analgesic of
serotonergic neurons. chronic pain,
nocturnal neurosis
photosensitivity.
Blue–gray
Work on cardia tissue Atrial fibrillation, discoloration
K channel
and slow nerve ventricular occurs on body
blocker
10 Amiodarone impulse in heart fibrillation, areas when
antiarrhythmi
causing rhythm ventricular exposed to
c
control tachycardia sunlight.
Thyroid
disorder.
C.I:
Respiratory, otitis
Hypomagnesaemia
media, and N, V, D
Protein synthesis Hypokalemia
sexually QT prolongation
11 Azithromycin Macrolide inhibitors Heart failure patients
transmitted Hepatotoxicity
50 S subunit Bradycardia
diseases (STD) , GIT upset
MI
skin infection
Hepatic patients
Dystonia
‫خلل التوتر العضلي‬
relief of spasticity
of voluntary
Hyperpolarization of Drowsiness
Skeletal muscle such C.I in pregnancy
afferent ‫ واردة‬fiber Dizziness, vision
12 Baclofen tab muscle disorders as Not related to
terminal causing problems,
relaxant multiple sclerosis, NSAID.
muscle relaxation weakness
other spinal
lesions e.g.,
tumors, motor
neuron disease.

48
 In 3rd trimester cause
inflammatory
non-selective inhibitor premature closure
diseases,
of an enzyme called of the ductus
rheumatoid Hypertension,
cyclooxygenase arteriosus causing
disorders, mild to peptic ulcer and
13 Ibuprofen NSAID (COX) COX is needed high blood pressure
moderate pain, bleeding, kidney
to convert arachidonic in the lungs of the
fever, and liver damage
acid to prostaglandin developing baby
dysmenorrhea,
H2 (PGH2) (called pulmonary
and osteoarthritis.
hypertension).
Act on H3 receptors in
brain.
improving blood flow
to brain and affecting
Vertigo
histamine- nerve cells in inner
Ménière's disease, Nausea, (acid
like ear.
14 Betahistine dizziness, reflux), headache Brand: betaserc
antivertigo
ringing in ears Indigestion
drug dilate the blood
(tinnitus)
vessels within the
inner ear which can
relieve pressure from
excess fluid
increased lipid
profile
impotence.
Block B1 receptor of Avoid Sudden
Hypertension, Decreased libido,
Bisoprolol selective b1 heart and kidney Stop (
15 Angina, cluster mask
fumarate Blocker Lead to decrease Hypertensive
headache, migrain hypoglycemia,
Heart rate and renin crisis) death.
insomnia,
bradycardia,
hypotension

49
 constipation,
Vitamin D3 increase abdominal pain
16 Calcium+ Vit D Ca/vitd3 osteoporosis
absorption of calcium nephrotoxic (
overdose)
Block Angiotensin
converting enzyme
that
inhibit converting
ACE Hypertension, Cough,
17 Captopril angiotensin 1 to
inhibitor Heart Failure Hyperkalemia
angiotensin 2 Causing
vasodilataion and
decrease Na/water
retension
Bradycardia,
Block B receptor postural
decrease Heart rate hypotension,
Non selective
with alpha1 receptor Hypertension, mask C.I: asthma, diabetic,
18 Carvedilol BB + & alpha
blocking Heart failure hypoglycemia, , pregnancy
blocker
effect that cause impotence,
Vasodilataion bronchospasm.
swelling at feet
Inhibit peptidoglycan
Cephalospori Upper respiratory Allergy, GI does cross the blood
synthesis that inhibit
19 Cefuroxime n 2nd tract infection, disturbance( brain barrier to some
bacterial cell wall.
generation Lyme disease diarrhea ) extent
Beta- lactam antbiotic.
Acne, lower
Pseudomembran
respiratory Category B
Protein synthesis ous colitis.
Lincosamide infections, Dose: 10- 20 ‫ملغ \ كغ‬
20 Clindamycin inhibitors Steven
antibiotic gynecological ‫\ يوم كل‬6-8 -‫ساعات‬
Bacteriostatic Johnson's
infections, bone ‫فمويا‬
Syndrome (SJS).
and joint

50
 infections, and Myelosuppressio
skin, septicemia, n & Pancytopenia
intra-abdominal joint pain-
infections heartburn - white
patches in the
mouth
Chlorhexidine antiseptic anti- Tooth and gingiva increased tartar
21 Mouth wash
Mouth Wash bacterial inflammation on teeth
Psychotropic
potentiate GABA
Benzodiazepi Dizziness, controlled
22 Clonazepam receptor and prevent Seizures
ne Fatigue addiction, drug/ green
muscle contractions
prescription.
During and after
PCI, MI, Stroke,
P2Y12 receptor Bleeding,
stable Ischemia.
blocker that headache, nausea, Combined with
23 Clopidogrel anti platelet Primary
prevent platelet stomach and aspirin.
prevention of
aggregation abdominal pain.
thromboembolism
atrial fibrillation
allergic disorders.
mild, binds to the histamine runny nose,
sedative H1 receptor. sneezing, itching, Safe in pregnancy.
drowsiness.
Chlorphenirami first and watery eyes not taken while
24 dry mouth, nose,
ne maleate generation This blocks the action caused by driving because it
and throat.
anti- of endogenous allergies, the causes sedation
histamine histamine common cold, or
the flu.
opiate and reduce coughing, constipation,
mu-opioid receptors, Controlled drugs.
25 Codeine prodrug of centrally acting respiratory
which are involved in narcotic analgesics
morphine analgesic. depression

51
 (Pain the transmission of Treat diarrhea. addiction urine
medicines). pain retention
Calcineurin inhibitor
Rheumatoid
that Nephrotoxicity,
Immunosupp arthritis, organ
26 Cyclosporine suppresses Cellular pain in lower DMARDs drugs
ressant transplantation,
and extremes,
psoriasis,
humoral immunity
Diclofenac
Potassium: COX inhibitor cause
immediate- decrease
Analgesic, GIT ulcer, GI Max dose: 150 mg
release tablets. Prostaglandins and
27 NSAID Antipyretic, Anti bleeding daily.
Sodium: enteric- other
inflammatory (Oral, parental).
coated and inflammatory
delayed-release mediators
tablets
Dose:
Suppress bone & 100 mg bid or 200
teeth growth once (oral or IV).
Acne,
Drug-Induced C.I with retinoic
Protein synthesis Lupus acid.
Antibiotic cholera (300 mg
28 Doxycycline inhibitors. Erythematosus C.I: Magnesium,
Tetracycline. only).
Bacteriostatic. (DILE). Ferrous.
Lyme disease,
Pseudotumor Zinc, Calcium.
Brucellosis
cerebri. Ferric, Aluminum.
Photosensitivity Dairy products.
Antacids.
inhibits the mild to moderate
Cardiac sodium/potassium- heart failure, blurred vision,
29 Digoxin Use in children
glycoside ATPase (sodium chronic atrial dizzy
pump) within the fibrillation.

52
 plasma membrane of
cardiac myocytes.

increases the
intracellular calcium
content which leads
to increased cardiac
contractility.
the alternative to
bacteriostatic inhibits mycobacterial
30 Ethambutol tuberculosis changes in vision ethambutol for TB is
anti TB cell wall synthesis
Moxifloxacin
Block Gastric H2
GI disturbance
receptor leading to Peptic ulcer, H
31 Famotidine H2 Blocker Diarrhea and Famotidine
decrease gastric acid Pylori, GERD
Constipation
production
Vilanterol (LABA) Oral
fluticasone/vilant Asthmatic Fluticasone Chronic Asthma candidiasis, Brand: ELLIPTA
32
erol inhaler (inhaled ,COPD runny nose and inhalation powser
corticosteroid) sore throat
Inhibit Na-K-Cl
Loop diuretic is
cotransporter in the Hypokalemia,
short acting and
ascending limb of Hyponatremia,
potent diuretic.
loop of Henle leading Hypertension, Hypomagnesaemi
33 Furosemide Loop diuretic Cause
to more sodium, Edema a Hypocalcemia,
hyperlipidemia.
chloride, and Alkalosis,
hyperglycemia,
potassium to be Ototoxicity
hyperuricemia
excreted in the urine.
cellulitis and skin irritation. safe to use in
bacterial protein
34 Fusidic acid antibiotic impetigo, and eye itchy or stinging pregnancy. And
synthesis inhibitors
infections eyes breastfeeding

53
 If feeling (nausea)
Take your tablets
Hypoglycemia,
Stimulate Insulin with a meal.
Sulphonyl Weight gain
35 Gliclazide secretion from Beta Type 2 DM to avoid dehydration.
Urea Stomach ache or
pancreatic Cell ...
indigestion
Diarrhea. Drink lots
of fluids
Sulfonyl
Stimulate Insulin
Urea Weight gain,
36 Glimepiride secretion from Beta Treat Type 2 DM C.I if sulfa allergy
Insulin Hypoglycemia
pancreatic Cell
secretagogue
treat diabetes,
including diabetes
oral hypoglycemic
2nd Weight gain, during pregnancy.
Glyburide or stimulates pancreatic
37 generation Type 2 diabetes Hypoglycemia
Glibenclamide beta cells to secrete
sulfonylureas Sulfa allergy Only Glyburide from
insulin
SU group does not
cross the placenta.
Nitrous oxide donor
Flushing,
that works on blood
headache,
vessel
excessive Use sos.
Glyceryl Nitrate causing vasodilation.
sweeting, spray
38 Trinitrate = Vasodilator it is converted by Acute Angina
irregular 0.4mg/spray.
Nitroglycerin Dilate veins mitochondrial
heartbeats,
dehydratases to nitric
orthostatic
oxide
hypotension
Lupus
Direct direct vasodilator that Hypertension,
erythromatus,
39 Hydralazine vasodilator dilates congestive heart Safe for pregnant
Reflux
Dilate artery arteries failure
Tavhycardia

54
 Ribonucleotide
reductase
inhibitor that inhibit
Antimetabolit Nausea,
DNA
e Cancer vomiting, GI
40 Hydroxyurea synthesis hydroxyurea
Chemotherap (Leukemia) disturbance,
lowing or stopping the
y constipation.
growth
of cancer cells in your
body.
inflammation
(swelling), severe
allergies, adrenal
Inhibit transcription of problems,
adrenal gland
inflammatory factors. arthritis, asthma, Stomach ulcer
a steroid problems, high
blood or bone HBP
41 Hydrocortisone (corticosteroi blood sugar
Promote transcription marrow problems, Heart failure are C.I.
d) medicine. (hyperglycemia),
of anti-inflammatory eye or vision
Osteoporosis
genes. problems, lupus,
skin conditions,
and ulcerative
colitis
Moderate potent
Oedema caused
long actig diuretic.
by heart, kidney, S.E:
and liver disease. hypokalemia,
Amlodipine/valsarta
inhibits Na, Cl hyponatremia,
Hydrochloro- Thiazide n/ (HCTZ) is a
42 transport in the distal hypercalcemia,
thiazide diuretic fixed-dose.
convoluted tubule Or from using and/or
BB/HCTZ
certain disease as hypomagnesemia
Enalapril/ HCTZ
estrogen and .
lisinopril/HCTZ
corticosteroids.
losartan/HCTZ

55
 Nitrous oxide
Headache, Free period
donor that work
Isosorbide Nitrate flushing, dose (all day
43 on blood vessel Chronic angina
Dinitrate Vasodilator hypotension doses is taken
causing
Tolerance only in 12 hrs )
vasodilation
induces apoptosis in
sebocytes, leading to a severe nodular controlled non
decrease in sebum acne that has not teratogenic psychotropic drug.
Retinoids, is
production. responded to psychosis, Cleft palate and
44 Isotretinoin a form of
‫يحث على موت الخاليا‬ other treatments, depression, and other birth defects
vitamin A
، ‫المبرمج في الخاليا الدهنية‬ including violent behavior of the face.
‫مما يؤدي إلى انخفاض في‬ antibiotics teratogenic
‫إنتاج الزهم‬
Causes neurological
abnormalities such
inhibit bacterial cell numbness, as psychosis and
wall synthesis. tingling, or convulsion by
antituberculo
45 Isoniazid TB burning pain in increasing serotonin.
sis agents.
mycobacterium hands or feet;
tuberculosis infections The antidote for
isoniazid is
pyridoxine
It absorbs water to
make stool
softener, also Constipation, Safe for pregnant,
Osmotic
46 Lactulose Hepatic Lactulose use in caution for
laxative
decrease amount encephalopathy diabetic
of ammonia in
blood

56
 Allergy, Flu Non sedative
Block H1
Non sedative symptoms relief. Drowsiness, dry antihistamine
47 Levocetirizine Receptor
antihistamine More potent then mouth. CI in children under
peripherally
cetirizine 6 years.
Photosensitivity.
affect cartilages,
neuropathy.
(Decrease
proliferation of
3rd generation once
upper respiratory chondrocytes and
daily.
tract, lower damage cartilage
On empty stomach.
respiratory tract, by decreasing
fluoroquinolo DNA synthesis
48 Levofloxacin skin, skin magnesium
ne antibiotic inhibitors C.I in pregnant and
structures, urinary concentrations).
breastfeeding.
tract, and
C.I less than 16
prostate. Cause urine
years.
stone.
The least one of
fluroquinolone in
causing QT
prolongation.
Block
Angiotensin
converting
enzyme that inhibit Cough,
Convert to ARBS f
ACE converting angiotensin Hypertension, Hyperkalemia
49 Lisinopril cough, use aspirin as
inhibitor 1 to Heart Failure Angioedema
antiinflammation
angiotensin 2 Causing renal impairment
vasodilatation and
decrease
Na/water retention

57
 On pancreas: inc.
insulin, dec, glucagon. reduce food
incretin
On stomach: dec. consumption,
mimetics. Hypoglycemia
Liraglutide/ gastric emptying, dec. type 2 diabetes promote weight
50 GLP-1 N,V,D
injection GIT motility. Weight gain reduction and
receptor constipation
On brain: dec. food improve metabolic
agonist.
intake, dec. water functions.
intake.
peripheral H1 Allergy ( allergic
non sedative headache,
51 Loratadine blocker that relief rhinitis, Skin loratadine
antihistamine Sedation
flue symptoms allergy )
Spastic colon.
symptomatic
treatment of Allergic reaction
may have an
stomach pain Constipation.
Antispasmodi anesthetic effect,
Relaxation of and spasms Transient
c may affect calcium
52 Mebeverine Smooth muscle associated with bradycardia
anticholinergi channels, and
of GIT irritable bowel followed by
c may affect
syndrome and tachycardia.
muscarinic receptors
other Urinary retention
gastrointestinal
illnesses
Inhibit hepatic Metformin safe in
antidiabetic gluconeogenesis, pregnancy.
T2DM, weight
biguanide glycogenolysis Metallic taste, GI Insulin is the first-
53 Metformin loss,
insulin and increase disturbance choice drug for
Polycystic ovary
sensitizer sensitivity of muscles diabetic in
to insulin pregnancy.
interferes with DNA Folic Acid 5mg
Antimetabolit rheumatoid Myelosuppressio
54 Methotrexate synthesis, repair, and supplement used to
e arthritis, psoriasis, n, increase liver
cellular replication by treat folic acid

58
 irreversible inhibition psoriatic arthritis, enzymes ,, liver deficiency caused by
of DHFA reductase cancer fibrosis methotrexate
and thymidylate chemotherapy
synthase enzymes
stimulation of reduce the risk of
prostaglandin NSAID induced
receptors in the gastric ulcers but
stomach reduces not duodenal
controlled non
gastric acid secretion, ulcer.,
synthetic Vaginal psychotropic.
while stimulating
55 Misoprostol prostaglandin bleeding, s.e: fever, Diarrhea,
these receptors in the Incomplete
analog cramps stomach cramps,
uterus and cervix can Abortion.
vaginal bleeding
increase the strength Missed Abortion.
and frequency of Postpartum
contractions and Hemorrhage
decrease cervical tone (PPH).
respiratory
Pain of cancer,
depression
changing the way, that musculoskeletal
opiate addiction urine Cause euphoria,
brain and nervous pain, abdominal
56 Morphine (narcotic) retention, addiction.
system respond to pain, chest pain,
analgesics. constipation, Controlled narcotic
pain. arthritis,
bradycardia,
headache.
hypotention.
Block H/K Atpase
system leading to
decrease gastric acid
Proton Pump Peptic ulcer, H GI disturbance
57 Omeprazole synthesis CI with Clopidogrel
inhibitor Pylori, GERD nausea vomiting
inhibits the final step
of acid production

59
 in organ
transplant
used with other diarrhea.
medicines (eg, Bone marrow
cyclosporine, suppression.
C.I: herpes simplex
steroid medicine). infections.
immunosuppr suppressing cell- infection.
Lupus, blood pressure
essant mediated immune opportunistic fungal
58 Mycophenolate rheumatoid problems.
antimetabolit responses and infection.
arthritis (RA), fast heartbeat.
e antibody formation
vasculitis, swelling of the
Teratogenic.
Crohn's disease, lower legs, ankles
inflammatory eye and feet.
disease as uveitis (hyperglycemia)
(iritis) and
scleritis
allergic rhinitis
and exercise
induced Mental problem. Leukotriene is
Leukotriene bronchoconstricti inflammatory
inhibit Leukotriene
59 Montelukast receptor on upper respiratory mediator released by
D4
antagonist infections, fever, WBC.
asthma symptoms and sore throat (LTRa)
control, dec.
asthmatic attack
antihypertensive ‫يعطى بجرعة صغيرة كي‬
and as an anti- Reflex ‫ال يسبب تسرع القلب‬
CCB anginal tachycardia, ‫االنعكاسي أو بشكل مديد‬
Potent vasodilator
60 Nifedipine R dihydropyridi hypotension, ‫التحرر او بالمشاركة مع‬
Dilate artery and veins
ne (Tocolytic agent oedema, flushing, ،‫حاصرات بيتا‬
for premature headache ‫يعطى مديد التحرر مرة‬
labor). ‫واحدة‬

60
 ‫سريع التحرر مرتين او‬
Topical for )‫ثالثة‬
internal anal ‫ال تستخدم كعالج اسعافي‬
fissure or ‫ وال‬،‫في الهجمات الذبحية‬
hemorrhoid ‫يوقف فجأة‬
Neuraminidase
enzyme inhibitor that
Anti found on surface of
Vertigo
61 Oseltamivir influenza virus. Influenza BRAND: TAMIFLU
abdominal pain
Antiviral prevent influenza
virus to attach to
respiratory tract
Max dose 4g ,
a weak inhibitor of PG Chronic hepatic
Analgesic, Analgesic, Hepatotoxic ,
62 Paracetamol synthesis of COX-1 necrosis (
antipyretic. Antipyretic antidote: N acetyl
and COX-2 overdose)
cysteine
stomach ulcers,
pantoprazole
short-term
covalently binds to the
treatment of Vitamin B 12 Use with clopidogrel
63 Pantoprazole PPI H+/K+ ATP pump to
erosive deficiency
inhibit gastric acid and
esophagitis due to
basal acid secretion.
gastroesophageal.
Drowsiness,
depressed Elixir: Oral,
Phenobarbitone Sedative Potentiate GABA Seizers, neonatal
64 mood, addiction, aromatic,
elixir hypnotic receptor jundaice
respiratory hydroalcoholic
depression.
Thiazolidined Weight gain
increasing the body's does not usually
65 Pioglitazone iones type 2 diabetes Fluid retention
sensitivity to insulin cause hypoglycemia
antidiabetic

61
 Take with food.
First dose at bed
alpha1 time to avoid
alpha 1 blocker cause orthostatic
66 Prazosin blocker HTN, BPH syncope.
Vasodilatation hypotension
short acting Increase dose
gradually.
Twice daily.
Inhibit production of
inflammatory
Glucose
mediators as
intolerance,
(Phospholipase A2
Adrenal
that prevent Asthma,
suppression,
Corticosteroi Prostaglandins and rheumatoid
67 Prednisolone Reduce prednisolone
d leukotrienes). arthritis, multiple
immunity,
sclerosis, COPD.
osteoporosis,
suppresses immune
delay wound
system by reducing
healing.
activity and volume of
immune system
Addiction,
It reduces pain by
withdrawal
reducing Non psychotropic
GABA peripheral symptoms.
messages sent to brain controlled (but green
68 Pregabalin Inducers neuropathy, dizziness,
by nerve but not prescription).
Anti-seizure seizure, drowsiness,
active at GABA Do not drive
blurred vision,
receptor
weight gain
blocking a certain SE: dry mouth,
Anti natural substance Parkinson's ( urine retention,
69 Procyclidine procyclidine
Muscarinic (acetylcholine). disease Tachycardia,
Blurred vision)

62
 decrease muscle
stiffness, sweating,
and the production of
saliva, and helps
improve walking
ability in people with
Parkinson's disease
taken once a day
reversible inhibition at bedtime or two classified as a
indigestion,
of H2-receptors in to four times a probable carcinogen,
heartburn and
H2blocker gastric parietal cells day. NDMA may cause
acid reflux,
70 Ranitidine antacid results in a reduction 30 to 60 minutes cancer only after
gastro-esophageal
medication in both gastric acid before eating or exposure to high
reflux disease,
volume and drinking foods doses over a long
stomach ulcers.
concentration. that cause period of time
heartburn.
treatment of
various
mycobacterial and
gram-positive
bacterial cause urine, saliva,
inhibits bacterial RNA
infections. loss of appetite, sputum, sweat,
polymerase, the
Antibiotic treatment of stomach/abdomin teeth, and tears to
71 Rifampicin enzyme responsible
Anti TB tuberculosis al pain, yellowing turn a reddish-
for DNA
(TB). eyes/skin, orange to reddish-
transcription
Neisseria brown color
meningitidis
bacteria but have
no symptoms of
disease.

63
 Potentiate B2 receptor
Tachycardia,
in
72 Salbutamol B2 agonist Acute Asthma, tremors salbutamol
Bronchi causing
hyperglycemia
Bronchodilation
inhibit the enzyme
dipeptidyl
peptidase 4 (DPP-4).
This enzyme breaks
down the incretins
Gi disturbance
GLP-
Pancreatitis,
1 and GIP,
Diarrhea,
gastrointestinal
Dipeptyl Headache.
hormones released in
73 Sitagliptin peptidase T2DM nervousness or sitagliptin
response to a meal.
inhibitor shakiness,
headache, throat
By preventing
or nasal irritation,
breakdown of GLP-1
and muscle aches
and GIP, they are able
to increase the
secretion of insulin
and suppress the
release of glucagon
Seizures.

Prophylactic of
Na and Ca channel Teratogenic cause
Sodium migraine. Irregular menses,
74 anti-epileptic blocker. spina bifid
Valproate hepatic toxicity
GABA inducer ‫من عيوب األنبوب العصبي‬
mood stabilizer is
used in bipolar
depression

64
 k sparing Aldosterone Hypertension,
Gynecomastia,
diuretic antagonist in Heart failure,
Hyperkalemia.
anti collecting duct causes edema
75 Spironolactone Impotence. spironolactone
androgen, less 2ndry
Brest tenderness,
aldosterone sodium water hyperaldosteronis
irregular menses
antagonist. retention m.
Orthostatic
block alpha 1a that
hypotension,
alpha1 cause Benign prostate
headache
76 Tamsulosin blocker relaxation of urethra hyperplasia,
intraoperative
long acting and urethral stone.
floppy iris
prostate
syndrome (IFIS)
changing the way the
brain and nervous
short-term relief
system respond to
of moderate to
opiate pain.
severe pain. Sleepiness, is not an anti-
analgesics. with a dual
Malignant pain. Constipation. ... inflammatory drug
centrally- mechanism of action
77 Tramadol Back pain. Dry mouth, or muscle relaxer.
acting
Diabetic serotonin psychotropic
synthetic binding at µ-opioid
neuropathy. syndrome.
analgesic receptors and
Migraine.
inhibiting
Osteoarthritis.
noradrenaline and
serotonin re-uptake
Angiotensin receptor
blocker Cough,
that cause vasodilation Hypertension, Hyperkalemia
78 Valsartan ARBs valsartan
and Heart Failure Teratogenic,
decrease Na/water hypotension.
retention

65
 primary, Heat intolerance.
secondary, and Sweating.
tertiary Irregular
tyrosine- hypothyroidism. heartbeats or
Levothyroxine is T4
based thyroid decrease the size palpitations.
Thyroxin responsible for
79 hormone. of enlarged Diarrhea.
(Levothyroxine) regulation of
thyroid glands Weight changes.
metabolism
Synthetic T4 (also called a Hair changes.
goiter) and to Tremors.
treat thyroid Mood changes.
cancer. osteoporosis
Inhibit the essential
enzyme (vitamin K
a lot of Drug
epoxide reductase) Prophylactic for
interactions.
for activating the Pulmonary
Nasal bone
Anticoagulan vitamin K available in embolism, in Bleeding (gum,
hypoplasia cause to
t the body rheumatic heart stool, cough).
80 Warfarin infant if using in
Vitamin K that inhibit disease. purple toe
pregnancy
antagonist. coagulation DVT, PE, acute syndrome.
‫نقص تنسج األنف‬
factors synthesis (10 9 MI, Chronic atrial
Use LMWH instead
7 2) which is function fibrillation.
of it.
of vit K.

Nasal
activation of
decongestion
postjunctional alpha- tremors, Do not use for
and treat nose
adrenergic receptors palpitations, periods of more than
Xylometazoline antihistamine stuffiness. It is
81 found on precapillary hypertension, seven days. not
spray OTC. used to treat a
and postcapillary headache and suitable for children
alpha- runny nose
blood vessels of the light-headedness. under 12 years
adrenergic
nasal mucosa.
agonist.

66
 ‫القسم الثالث‪ :‬أدوية ال ‪Controlled in Oman‬‬

‫‪67‬‬
 Controlled Drugs: Narcotic Drugs

Drug Class MOA Uses S.E Nots

Respiratory depression,
Act on kappa C.I: in asthma, renal
Analgesic, constipation,
Morphine Opioid and mu failure.
1 antidiarrhea, bronchospasm, addiction,
sulphate analgesic receptors in Antidote for opioid
sedation dependance, hypotension,
brain is naloxone
sedation, dry mouth
Cough
Codeine Opioid Less potent than
Opioid suppressant,
2 phosphate receptor Same as morphine morphine in
analgesic analgesic,
Hcl agonists. analgesia
antidiarrhea
50, 100 mg
injection.
Labor pain, Advantage: less
during and Same as morphine + suppress cough
Opioid
Opioid postoperative. convulsion, tachycardia, center, less miosis,
3 pethidine receptor
analgesic Rapid onset of tremor, nephrotoxic, less constipation,
agonists
action and neurotoxic. less 4urinary
duration. retention, safer for
asthma, less
histamine release.
50 mcg/ ml inj.
Postoperative Cross BBB causing More potent in 100
Fentanyl
4 and cancer hallucination, sever fold than morphine
citrate
analgesic. muscle stiffness. and 50 fold than
heroin

68
 4 times faster than
fentanyl.
More CV
5 alfentanil
complication and
respiratory
depression.
Analgesic
during surgery,
6 remifentanil
adjunct to
anesthesia
Naloxone 400 mcg/ ml injection is Opiate antidote

69
 Controlled drugs: Psychotropic drugs

Long acting BNZ for (anxiety, seizure, IBS) less withdrawal symptoms last for 1-3 days.
Drug Class MOA Indications S.E Note
Drowsiness, physical
and mental slowing,
Benzodiazepin potentiate GABA anxiety, seizure, addiction, irritability,
1 Diazepam
e receptor IBS amnesia, dependence,
confusion,
hypotension, apnea.
Midazolam Benzodiazepin potentiate GABA anxiety, seizure,
2 =
‫دورميكوم‬ e receptor IBS
Benzodiazepin potentiate GABA anxiety, seizure,
3 Clorazepate =
e receptor IBS
Chlordiazepoxi Benzodiazepin potentiate GABA anxiety, seizure,
4 =
de e receptor IBS
Benzodiazepin potentiate GABA anxiety, seizure,
5 Flurazepam =
e receptor IBS
Intermediate acting BNZ: for sleep maintenance last for 10- 12
hours
Bromazepam Benzodiazepin Anxiety, agitation,
1 = =
(Lexotan) e insomnia
Benzodiazepin
2 Alprazolam = Panic disorder =
e
Benzodiazepin
3 Lorazepam = anxiety =
e
Benzodiazepin
4 Clonazepam = Seizure in children =
e

70
 Short acting BNZ: for sleep induction and anesthesia induction last for 3- 8 hours
potentiate GABA sleep induction and
Benzodiazepin
1 Oxazepam receptor anesthesia =
e
induction
potentiate GABA sleep induction and
Benzodiazepin
2 Triazolam receptor anesthesia =
e
induction
Flumazenil is antidote for all BNZ
Phenobarbital
Act on GABA
receptors. Neonatal jaundice,
CNS depression, fatal
Phenobarbital antiepileptic Inhibitors of refractory status
in high doses.
glutamate epilepsy
receptors.
Tramadol
Less
causing
U receptors constipation
Serotonin syndrome,
Central acting agonist. and
Acute and chronic seizure, addiction,
Tramadol analgesic inhibit reuptake respiratory
analgesic GIT disturbance, dry
Opiate narcotic of serotonin and depression
mouth, headache
norepinephrine compared to
other
opioids

71
 Controlled drugs: non-Psychotropic drugs
BCG vaccine (tuberculosis (TB) disease)
1 Vaccine Polio vaccine (for poliomyelitis)
DT (Diphtheria vaccination)
immunoglobulin,
2 Biologicals albumin
Factor VIII
Muscle stiffness Why controlled? 2, 3 mg
antiparkinsonia Non selective
3 Apomorphine Advanced Cause addiction, sublingual
n dopamine agonist
Parkinson euphoric state tab
Cause fever
Miscellaneous
Why controlled? 200 mcg
GIT agent Prostaglandin E
4 Misoprostol Stomach ulcer Birth defect, abortion, tab, use
Prostaglandin analogue
premature birth orally and
E analogue
vaginaly
Bronchodilator,
Cause
Inhibit PDE
Why controlled? tachycardia,
(phosphodiesteras
Cause CV, CNS side seizure,
Theophylline e enzyme)- inc.
Xanthine Asthma, bronchitis, effects. fatigue,
5 In pediatric cyclic GMP- inc.
derivatives emphysema Has narrow lightheaded
syrup form) release
therapeutic window, ness ‫دوار‬.
epinephrine from
drug-drug interaction (5-15
(adrenal medulla),
mcg/ml)
bronchodilation
Selective tachycardia,
Why controlled?
inhibition of mouth dry,
All types of Suicidal tendency,
6 Amineptine TCA dopamine and to wt gain,
depression dependence,
lesser extent of orthostatic
addiction.
Norepinephrine hypotension

72
 , urine
retension.
As cream,
Retinoid = Why controlled? cap 20 mg.
retinoic acid- Teratogenic, Brand:
Acne treatment,
promote cornified Cause RETINE A
Synthetic form reduce fine
7 Tretinoin cell detachment, photosensitivity, skin CREAM,
of vitamin A wrinkles, improve
inc. shedding, inc. irritation, worsening ACRETINE
spotty discoloration
corneocyte of acne, redness and CREM,
turnover. discoloration, burning vesanoid 20
mg.
Brand:
ISOTREX
GEL,
Why controlled?
ROACCUT
Teratogenic
ANCE,
(premature birth, birth
SOTRET
defect, cleft palate),
10, 20 mg.
Inhibit sebaceous Sever nodular acne chapped lips, dry skin,
Counseling:
8 Isotretinoin retinoid gland function by not respond to photosensitivity,
use
dec. its size. other treatment mental change
hydration
(headache, depression,
lotion,
psychosis, violent
lipstick,
behavior)
avoid
sunlight,
avoid vit A
supplement
Treat cough caused not treat a
Dextromethorp Non- opioid Cough
9 by flu and cold, not Why controlled? cough that
han antitussive. suppressant.
chronic is caused by

73
 A crosses the blood- CNS depressant, smoking,
semisynthetic brain-barrier and hallucination similar asthma, or
morphine activates sigma to ketamine. emphysema
derivative, opioid receptors S.E: convulsion, .
does not act as on the cough seizures, slow
a mu- receptor center in the breathing, coma,
opioid (e.g. central nervous
morphine, system, thereby
heroin). suppressing the
cough reflex.
Inhibit reuptake
of serotonin
BRAND:
CELLCEPT
cap 250-
500 mg.
Myfortic
tab (180-
Why controlled?
360 m).
suppressing cell- Inc. risk of lymphoma
It is usually
mediated immune and skin cancer, birth
Mycophenolate immunosuppre Organ transplant taken twice
10 responses and defect.
sodium ssant for kidney and liver a day on an
antibody
empty
formation S.E: insomnia, loss of
stomach.
appetite, anxiety.
Use a
sunscreen
with a high
SPF or wear
protective
clothing

74
 carisoprodol
has
interrupts
addictive
neuronal Why controlled?
potential as
communication Cause addiction,
a prodrug of
within the abuse, sedation,
meprobamat
Centrally reticular treat the symptoms dependence.
e and/or
11 Carisoprodol acting muscle formation and of musculoskeletal
potentiator
relaxant spinal cord, pain. S.E: black stool,
of
resulting in convulsion, chest
hydrocodon
sedation and pain, cold sweat, loss
e,oxycodon
alteration in pain of bladder control.
e, codeine,
perception.
and similar
drugs
Why controlled? 2%, 4%
Lighten darken
by decreasing Skin rash, facial cream
patch on skin due
melanin swelling, rebound BRAND:
Depigmenting to hormone
12 Hydroquinone formation by hyperpigmentation, ELDOQUI
agent medicine,
inhibit tyrosinase ochronotic N,
pregnancy, age,
enzyme. (decolorization of ELDOPAQ
injury
skin) UE.
Prevent normal
Antimalaria Why controlled?
growth and
Disease- Retinopathy,
replication of Malaria BRAND:
Hydroxychloro modifying respiratory depression,
13 parasite. Rheumatoid PLAQUENI
quine antirheumatic cardiac arrest, muscle
Dec. activity of arthritis L
drugs weakness, sever
immune system
(DAMARD) dizziness,
(DAMARD)
Used for increasing S.E: endocrine effect: BRAND:
Synthetic Androgen
14 Nandrolones muscle mass or the gynecomastia, DURABLO
testosterone receptor agonist
management of the infertility. IN amp

75
 (Anabolic anemia of renal CV: hypertension, DECA-
steroid) insufficiency, vascular damage, DURAUBO
increase coagulation disorder. LIN amp
hemoglobin and Menstrual
red cell mass, abnormalities
adjunct therapy in
treatment of Why controlled?
postmenopausal Bec. Of anabolic
osteoporosis. properties and
Breast cancer tolerance.
treatment.
Allergic reaction, skin
inhibiting the
frosting.
conduction of
to prevent pain Why controlled?
Topical nerve impulses
caused by Abuse cause tremor,
Ethyl chloride ‫ تخدير‬، ‫مطهرات‬ from sensory
15 injections and hallucination, difficult
spray antiseptic, nerves.
minor surgical walking.
anesthetic. Causing drop of
procedures. Inhalation: cause
skin temperature
euphoria, sleepiness,
to -4 C
irregular heart, death
Bind to DNA to Burning, irritation,
modify gene itching, erythema, dry BRAND:
expression which skin, BETNOVA
induce synthesis hypopigmentation, TE CR,
Relive skin
of anti- glaucoma, cataract. BETAVAL,
inflammation:
16 Betamethasone Corticosteroids inflammatory Why controlled? BETASON
eczema, psoriasis,
protein and Can absorbed in E.
contact dermatitis
inhibit synthesis sufficient amount BETADER
of certain causing systemic M.
inflammatory symptoms (Cr, oint)
mediators.

76
 Brand:
Bind to DNA to
DERMOVA
modify gene
S.E: burning, itching, TE,
expression which
Sever skin dark red spots, skin DERMASO
induce synthesis
Synthetic inflammation atrophy sign. NE,
of anti-
corticosteroid (eczema, psoriasis, Why controlled? CLODERM
17 Clobetasol inflammatory
analogue to contact dermatitis, Can absorbed in ,
protein and
prednisolone. seborrheic sufficient amount GAMAVAT
inhibit synthesis
dermatitis. causing systemic E, POWER
of certain
symptoms CORT
inflammatory
CREAM.
mediators.
(Cr, oint)
Bind to DNA to S.E: acne, unwanted
modify gene hair growth, skin
cream,
expression which discoloration.
gel, ointmen
induce synthesis Why controlled?
Sever skin t or topical
of anti- Reversible
inflammation, solution.
18 Fluocinonide corticosteroid inflammatory suppression of
antipruritic, BRAND:
protein and hypothalamic-
vasoconstrictive. TOPSYM,
inhibit synthesis pituitary- adrenal axis,
TOPSYME
of certain manifestation of
FORT.
inflammatory Cushing's syndrome,
mediators. hyperglycemia.
Block voltage
Epilepsy,
gated ca channel Wt gain, sleepiness,
neuropathy,
hence decrease fatigue, peripheral
anxiety, Lyrca 25,
glutamate and oedema.
19 Pregabalin anticonvulsant fibromyalgia, 50, 75, 100,
sensory Why controlled?
restless leg 300 mg cap.
neuropeptides Addiction, withdrawal
syndrome, shingles
(substance P and symptoms.
after chickenpox.
CGRP) release at

77
 synapse by
decreasing Ca2+
influx.
Block voltage
gated ca channel
Epilepsy, partial
hence decrease
seizure,
glutamate and
neuropathic pain, Suicidal tendency, Neurontin
sensory
restless leg hallucination, 100, 300,
20 Gabapentin anticonvulsant neuropeptides
syndrome, pain of euphoria, 400, 600,
(substance P and
shingles= painful hallucination. 800 cap
CGRP) release at
rash after chick
synapse by
pox.
decreasing Ca2+
influx.

78
 Monitored Drugs
White prescription for both sector
S.E: hypotension,
Sexual dysfunction,
flushing, headache,
Inhibit PDE so inc. erectile dysfunction,
hypotension.
blood flow to penis pulmonary atrial
Why monitored? C.I: alpha
causing erection. hypertension.
1 Sildenafil PDE5 I With nitrate causing agonist and
Relax blood vessel in
vasodilation and sever nitrate.
lungs. In IVF use vaginal to
hypotension may lead
inc. uterus thickness
to death.
for some days
S.E: hypotension,
flushing, headache,
The most
Inhibit PDE so inc. Sexual dysfunction, hypotension.
selective to
blood flow to penis erectile dysfunction, Why monitored?
2 Vardenafil PDE5 I inhibit PDE
causing erection. pulmonary atrial With nitrate causing
so the lest
hypertension vasodilation and sever
side effects
hypotension may lead
to death
S.E: hypotension,
Sexual dysfunction,
flushing, headache,
Inhibit PDE so inc. erectile dysfunction,
hypotension.
blood flow to penis pulmonary atrial
Why monitored?
3 Tadalafil PDE5 I causing erection. hypertension.
With nitrate causing
Relax blood vessel in
vasodilation and sever
lungs Benign prostatic
hypotension may lead
hyperplasia
to death

79
 inhibiting the activity
of the viral
neuraminidase
Prophylaxis ad
enzyme found on the S.E: hallucination, Tamiflu
treatment of
4 Oseltamivir antiviral surface of the virus, tremor or shaking, 30/45/75
symptoms of
which prevents sudden confusion. mg
influenzas A, B
budding from the host
cell, viral replication,
and infectivity.
Triprolidine=
anticholinergic and
block histamine
release, has sedative
Triprolid effects.
ine= Pseudoephedrine has
antihista direct and indirect
Pseudoephe Hypertension
mine. sympathomimetic
drine and Common cold, Sedation, constipation, BRRAND:
5 Pseudoe effect.
triprolidine allergic rhinitis dry mouth, high heart ACTIFED
phedrine 6Indirect stimulation
2.5/60 mg rate.
= of alpha receptor to
deconges release nor-epi.
tant Direct stimulation of
beta receptor cause
vasoconstriction and
hypertension

Alpha1, Cause bronchodilation

Ephedrine + Common cold cream,
beta1, due to beta 2 agonist. Tachycardia, chest pain,
chlorphena allergy, asthma, Brand:
6 beta2 nervousness, dry
mine watery eye, itchy tussive syr
agonist block releasing mouth, sleep disorder.
syrup throat and skin.
histamine.

80
 First
generatio
n
antihista
mine
interrupt the midcycle
follicle-stimulating
hormone (FSH) and
luteinizing hormone
(LH) surge.

inhibits the production

Treat endometriosis. S.E: suppresses ovarian
of estrogen via
Fibrocystic breast function may cause
a inhibition of the
disease. irregular monthly
synthetic hypothalamic-
Premenstrual periods or absence of
hormone pituitary-ovarian axis. Brand:
syndrome. menstrual period.
derived DANOL
7 Danazol Treat PCOs. Hirsutism, acne,
from danazol directly and 100, 200, 50
irreversible Deeping of
ethinyl markedly inhibits mg
treat attacks of voice, hot flushes, inc.
testoster adrenal, ovarian, and
hereditary angioedema liver enzyme.
one testicular
(an immune system Breast atrophy, ovary
steroidogenesis in
disorder). cancer.
vivo. The enzymatic
production of
estradiol,
progesterone, and
testosterone have all
specifically been
found to be inhibited.

81
 antagonizes the
androgen receptor to
induce gene
Female breast cancer.
Androge expression that
Inc. muscle mass in S.E: apnea ‫انقطاع النفس‬ BRAND:
n/ causes the growth
8 Testosterone athletics. Prostate enlargement, TESTOVIR
anabolic and development of
hypogonadism acne, BPH. ON 250 mg
steroid. masculine sex
organs and
secondary sexual
characteristics.

82
 ‫القسم الرابع‪ :‬مراجعة لمعلومات الفارما الخاصة بامتحان الفيفا‬

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