General

Question 1

Drugs with low therapeutic index i.e. narrow margin of safety

Answer 1

Warfarin
Gentamycin
Lithium
Phenytoin
Digoxin
Theophylline

Monitoring of their serum levels is required

Question 2

Phases of clinical trials

Answer 2

Phase I Safety
Phase II Efficacy(therapeutic exploratory study)
Phase III Approval (therapeutic conformation trial)
Phase IV Long term(post marketing survelliance)

“SEAL”

Question 3

Orphan drugs are

Answer 3

Used to diagnose,treat and prevent rare diseases.
Eg. Digoxin antibody (digoxin poisoning)
Fomepizole(methyl alc poisoning)

Question 4

Factors determining selection of drug for administration

Answer 4

Characteristics of the drug
Emergency/routine use
Condition(unconscious vomiting diarrhoea)
Age
Associated diseases
Choice of patient/doctor

Question 5

Routes of drug administration

Answer 5

Local

Systemic(enteral/parenteral)

Question 6

Special drug delivery systems

Answer 6

Ocusert(lower eyelid)
Progestasert(intrauterine contraceptive)
Liposomes(phospholipid vesicles)
Antibodies(immunoglobulins)
Drug eluting stents
Computerized miniature pump(insulin)

Question 7

Ocusert can be used for

Answer 7

Pilocarpine(glaucoma)

Question 8

Liposomes are used for

Answer 8

Amphotericin B (fungal infection)

Question 9

Drugs that is given by eluting stents is

Answer 9

Paclitaxel

Question 10

Mucosal membranes for topical drug administration

Answer 10

Oral cavity (clotrimazole)
Git (neomycin)
Enema(soap water enema)
Eye,ear (gentamicin)
Bronchial inhalation (salbutamol)
Vaginal (candidiasis)
Urethra (lignocaine...anti-arrhythmic)
Skin (clotrinazole)

Question 11

Local route of drug administration

Answer 11

Topical
Intra arterial(triamcinolone in joint spaces in rheumatoid arthritis)

Question 12

Advantages of oral drug administration

Answer 12

Safer
Cheaper
Painless
Self admintered
For repeated /prolonged use

Question 13

Disadvantages of oral route of drug administration

Answer 13

Irritants
Unabsorbables
Digestive juices
High first-pass
Unconscious
Unreliable
Vomiting and diarrhoea
Not for emergency

Question 14

Advantages of sublingual

Answer 14

Quick
Terminable
No first-pass
Self administered

Question 15

Disadvantages of sublingual drug administration

Answer 15

Irritants
Lipd insoluble
Bad taste

Question 16

Drug as suppository

Answer 16

Indomethacin (arthritis)

Question 17

Drug for enema

Answer 17

Diazepam (status epilepticus-children)

Question 18

Disadvantages of parenteral route of drug administration

Answer 18

Aseptic conditions
Sterile
Expensive
Painful
No self administered
Local tissue injury

Question 19

Drug by intradermal route

Answer 19

BCG

Drug senstivity test

Question 20

Subcutaneous injection

Answer 20

Adrenaline

Insulin

Question 21

Depot preparations

Answer 21

Norplant (contraceptive)

Question 22

Injectable routes of drug administration

Answer 22

Intradermal
Subcutaneous
Intravenous
Intra-arterial
Intramuscular
Intra-articular

Question 23

Advantages of intravenous drug administration

Answer 23

Bioavailability
Quick onset
Larger volume can be given
Irritatants
Hypertonics
Constant plasma volume maintained

Question 24

Disadvantages of iv

Answer 24

Local irritation (phlebitis)
No self administration
Aseptic needed
Extravasation(necrosis, sequestration)
No depot

Question 25

Intrathecal injections

Answer 25

Lignocaine(anaesthesia)(anti-arrhythmic) Amphotericin B Given in subarachnoid space

Question 26

Transdermal drugs

Answer 26

``` Scopolamine (motion sickness) Nitroglycerin (angina) Estrogen (hormone replacement) Clonidine (hypertension) Fentanyl (pain) Nicotine (de addiction) ```

Question 27

Advantages of tansdermal

Answer 27

``` Self administration Better compliance Duration prolonged Side effects less Constant concentration no First-pass ```

Question 28

Disadvantages of transdernmal

Answer 28

Expensive Dermatitis Itching Fall off

Question 29

Bioavailbilty

Answer 29

Fraction of drug reaching systemic circulation

Question 30

Bioequavalents and bioinequivalents

Answer 30

2 formulation of same drug produce equal bioavailability Formulation differ- bioinequivalents

Question 31

First pass metabolism

Answer 31

``` Drug pass via Gut wall Portal vein Liver (metabolism) Systemic circulation ```

Question 32

Factors affecting drug absorption

Answer 32

``` Drug property Route Ph- ionisation Food Other drugs Absorbing surface area Git problems ```

Question 33

Factors affecting bioavailability

Answer 33

First-pass Hepatic diseases Interohepatic circulation

Question 34

What is Apparent volume of distribution (aVd)

Answer 34

Hypothetical volume of body fluid in which drug is uniformly distributed(concentration equal to plasma) Total amount of drug in body/conc. Of drug in plasma

Question 35

Redistribution of drug is defined as

Question 36

Lipid soluble drugs that crosses blood brain barrier (BBB)

Answer 36

Barbiturates Diazepam Amphetamine Increased penetration in meningitis and encephalitis

Question 37

Drugs that cross placental barrier

Answer 37

Anaesthetics Morphine Corticosteroid

Question 38

What is biotransformation

Answer 38

``` Chemical alterations in drug Eg. Codiene- morphine Diazepam- oxazepam Levodopa- Dopamine (prodrug) Prednisone- prednisolone ``` Phenobarbitone- hydroxyphenobarbitone

Question 39

Types of ADR

Answer 39

``` A augmented B bizzare C chronic D delayed E end of therapy (withdrawal) F failure of therapy ```

Question 40

Science and activities related to detection, assessment, understanding and prevention of ADR

Answer 40

Pharmacovigilance

Question 41

Idiosyncrasy

Answer 41

Genetically determined abnormal reactivity to a chemical.

Question 42

Cardinal features of drug allergies

Answer 42

``` Severity poorly corelated to dose Similar to allergic. Diseases Prior sensitization + Dechallenge and rechallenge Unrelated to drug pharmacodynamics ```