Pharma

Question 1

Increased body secretions ……….> runny nose. watery eye . sweating. diarrhea + muscle cramp =flu-like symptoms

agitation. insomnia
withdrawal of……….?

Answer 1

Heroin

Question 2

panic attacks + other withdrawal symp.

Answer 2

BDZ withdrawal

Question 3

depression +other withdrawal symp.

Answer 3

cocain

Question 4

N/V +other withdrawal symp.

start 8 hrs after stopping abusing substance

Answer 4

Alcohol

Question 5

Resp.depression + hypotension+ bradycardia + PPP + constipation
Overdose of……?
Tx?

Answer 5

Opiate (Heroin)

Naloxon

Question 6

Tacyapnia+ Tachcardia + Hypertension + arrythmia + Hyperthermia + muscle twitching+ restless and agitation + dilated pupil
Overdose of …….?
Tx?

Answer 6

cocain

Tx……..> benzodiazepines are generally first-line for most cocaine-related problems

Question 7

Tacyapnia+ Tachcardia + Hypertension+ Hyperthermia +
uncontrolled body movement + trismus + hyponatraemia +rhabdomyolysis +colours when eyes open
overdose of……….?
Tx?

Answer 7

Ecstasy
Tx……….>supportive
dantrolene may be used for hyperthermia if simple measures fail

Question 8

Dilated pupil + delusion and Hallucination (see sound or smell colours)
+flusing+ sweating + diarrhea +parasethia + hyperreflexia
Overdose of………..?

Answer 8

LSD

Question 9

Dilated pupil, hypotension, tachycardia, nystagmus

Overdose of ……..?

Answer 9

Carbamazipine

Question 10

CRASH
Cognitive problem
Resp. Depression
Anteretrograde Amnesia
Sedation
Hypotension 
side effects of...............?
Tx of overdose ?

Answer 10

BDZ side effect (lorazepam)

Tx of overdose ………..> Flumazinel

Question 11

Hypothermia, Hypotension, tachycardia, dry mouth, Dilated pupil + blurry vision + metabolic acidosis (Atropin like )
ECG… Wide QRS, PR, QT

Overdose of……….?
Tx?

Answer 11

TCA ( Amitriptyline)

Tx…………..> IV fluids + bicarb to correct metabolic acidosis

Question 12

Coarse tremors + tachcardia+ hypotension + Arrythmia + sezures + hyperthermia +confusion +coma + death
overdose of…….?
Tx?

Answer 12

Lithium
mild-moderate……> IV fluid
severe………………….>Renal dialysis

Question 13

Drugs increase lithium toxicity?

Answer 13

Thiazide 
ACEI
NSAIDs
Metronidazol
Renal failure 
dehydration

Question 14

1-When to monitor Lithium ?

2-best time for measuring lithium level?

Answer 14

1-one week after starting it and then every 3 months

2- 12 hrs after the last dose

Question 15

Tests should be checked before starting lithium ??

Answer 15

RFT + TFT

before starting lithium and then every 6 months

Question 16

drugs cause metabolic acidosis??

Answer 16

(MAAIID)
Metformine
alcohol
aspirin
iron
INH
Digoxin

Question 17

ttt of delerium tremens?

Answer 17

1st line …….> lorazepam

2nd…………..> chlordiazopexide

Question 18

Tx of wernick’s enchephalopathy and koraskoff ?

Answer 18

chlordiazopexide + Thiamine

Question 19

Tx of acute psycosis?

Answer 19

1- If young ……..> Lorazepam or olanzepine

2- If failed or old age……..> Halopridol

Question 20

1-thyroid dysfunction: both hypothyroidism and hyper-thyroidism
2-corneal deposits
3-pulmonary fibrosis/pneumonitis
4-liver fibrosis/hepatitis
5-peripheral neuropathy, myopathy

6-'slate-grey' appearance
7-thrombophlebitis and injection site reactions
8-bradycardia
9-lengths QT interval
side effects of.............?

Answer 20

Amiodaron

Question 21

Amiodarone is enzyme inhibitor
What is the effect of ………
1-Amiodaron + warfarin
2-Amiodaron+ Digoxin

Answer 21

1-decreased metabolism of warfarin, therefore increased INR

2-increased digoxin levels

Question 22

Salivation
Lacrimation
Urination
Defecation/diarrhoea
cardiovascular: hypotension, bradycardia
also: small pupils, muscle fasciculation
overdose of........?
Tx?

Answer 22

organophosphate poisoning

Tx……….>atropine

Question 23

bradycardia
hypotension
heart failure
syncope
overdose of..........?
Tx........?

Answer 23

BB
Tx …….>
1st……>Atropine
2nd…..>in resistant cases glucagon may be used

Question 24

Which drug shouldn’t be taken in cataract surgery due to the risk of intra-operative floppy iris syndrome??

Answer 24

Alpha blockers

Question 25

Tx of CO posining?

Answer 25

If conscious ........> 100% O2 tight fitted mask | If unconscious.............> Intubation and ventilation

Question 26

``` generally unwell, lethargy + GIT symptom (snausea & vomiting, anorexia) confusion yellow-green vision arrhythmias (e.g. AV block, bradycardia) gynaecomastia Toxicity of.........? Tx? ```

Answer 26

Digoxin toxicity Tx.........>Digibind correct arrhythmias monitor potassium

Question 27

Precipitating factors of digoxin toxicity?

Answer 27

1- most imp. one is HypOkalemia + 2-hypoalbuminaemia 3-hypothermia 4-hypothyroidism 5-hypomagnesaemia, hypercalcaemia, hypernatraemia, acidosis 6-drugs: amiodarone, quinidine, verapamil, diltiazem, spironolactone +Also drugs which cause hypokalaemia e.g. thiazides and loop diuretics

Question 28

Main monitoring parameters for Amiodarone

Answer 28

TFT, LFT, U&E, CXR prior to treatment TFT, LFT every 6 months

Question 29

Main monitoring parameters for statins

Answer 29

LFTs at baseline, 3 months and 12 months

Question 30

Main monitoring parameters for ACEI

Answer 30

U&E prior to treatment U&E after increasing dose U&E at least annually

Question 31

Main monitoring parameters for Methotrexate

Answer 31

'FBC and renal and LFTs before starting treatment and repeated weekly until therapy stabilised, thereafter patients should be monitored every 2-3 months'

Question 32

Main monitoring parameters for Azathioprine

Answer 32

FBC, LFT before treatment FBC weekly for the first 4 weeks FBC, LFT every 3 months

Question 33

Main monitoring parameters for lithium

Answer 33

TFT, U&E prior to treatment Lithium levels weekly until stabilised then every 3 months TFT, U&E every 6 months

Question 34

Main monitoring parameters for Na valproate

Answer 34

LFT, FBC before treatment | LFT 'periodically' during first 6 months

Question 35

Main monitoring parameters for Glitazone

Answer 35

LFT before treatment | LFT 'regularly' during treatment