Which of the following substances is used to disinfect gloves during compounding sterile products?
A) liquid soap B) 70% isopropyl alcohol
C) sodium hypochlorite 5%
D)sulfuric acid and nitric acid (3:1)
The correct answer is B) 70% isopropyl alcohol
Why?
In sterile compounding (e.g., USP <797>), 70% isopropyl alcohol (IPA) is the standard agent used to disinfect gloved hands. It’s effective against a wide range of microorganisms and acts quickly without leaving residue that could contaminate the sterile preparation.
At a 70% concentration, the water content actually helps the alcohol permeate the cell walls of microorganisms more effectively than 100% alcohol would. It coagulates the proteins and destroys the bacteria.
Why not the others?
❌A) Liquid soap → Used for handwashing, not glove disinfection inside the clean area
❌C) Sodium hypochlorite 5% → Too harsh; used for surface decontamination or spills, not gloves
❌D) Sulfuric acid + nitric acid (3:1) → Extremely corrosive, totally inappropriate and dangerous
📌 Key exam tip: Gloves in sterile compounding are routinely disinfected with 70% IPA.
Which of the following drugs has both an anti-inflammatory and analgesic activity?
A) codeine
B) pethidine
C) ibuprofen
D) paracetamol
The correct answer is: C) Ibuprofen
Why?
Ibuprofen is an NSAID, so it has both analgesic (pain-relieving) and anti-inflammatory actions by inhibiting COX enzymes and prostaglandin synthesis. Since prostaglandins trigger both pain and swelling, ibuprofen effectively addresses both.
Why not the others?
❌A) Codeine → Analgesic only (opioid), no anti-inflammatory effect
❌B) Pethidine → Analgesic only (opioid), no anti-inflammatory effect
❌D) Paracetamol → Analgesic + antipyretic, but very weak / no anti-inflammatory action
📌 Exam pearl:
NSAIDs = analgesic + antipyretic + anti-inflammatory (paracetamol is the exception).
| Drug | Analgesic (Pain) | Anti-Inflammatory | Class |
| Codeine | Yes | No | Opioid |
| Pethidine | Yes | No | Opioid |
| Ibuprofen | Yes | Yes | NSAID |
| Paracetamol | Yes | No | Non-aspirin pain reliever |
Note: Because ibuprofen reduces inflammation, it is often preferred for conditions like arthritis, muscle sprains, or menstrual cramps where swelling is a primary cause of the pain.
Which of the following is an alkylating anticancer agent?
A) cyclophosphamide
B) fluorouracil
C) doxorubicin
D) etoposide
The correct answer is A) cyclophosphamide.
Alkylating agents are a heavy-hitting class of chemotherapy drugs that work by physically attaching an "alkyl group" to DNA. This creates cross-links that prevent the DNA from uncoiling or replicating, which eventually forces the cancer cell to undergo apoptosis (cell death).
Key Facts about Cyclophosphamide
✒Cell Cycle Non-Specific: Unlike some drugs that only work when a cell is actively dividing, alkylating agents can damage DNA at any phase of the cell cycle.
✒Pro-drug: It is inactive when first administered. It must be metabolized by the liver (specifically by cytochrome P450 enzymes) to become active.
✒Side Effects: A unique and "testable" side effect of cyclophosphamide is hemorrhagic cystitis (bleeding in the bladder). This is caused by a byproduct called acrolein. Patients are often given plenty of fluids and a drug called MESNA to protect the bladder.
| Drug | Class | Mechanism of Action |
| Cyclophosphamide | Alkylating Agent | Attaches alkyl groups to DNA (specifically at the Guanine N7 position). |
| Fluorouracil (5-FU) | Antimetabolite | Mimics pyrimidines to "trick" the cell and inhibit DNA synthesis. |
| Doxorubicin | Antitumor Antibiotic | Intercalates between DNA base pairs and inhibits Topoisomerase II. |
| Etoposide | Plant Alkaloid | Inhibits Topoisomerase II, causing DNA strand breaks. |
What is the Latin abbreviation for "after meals"?
A) A.C.
B) A.A.
C)P.C.
D)I.C
The correct answer is C) P.C.
This stands for the Latin phrase "Post Cibum," where Post means after and Cibum means food or meal.
| Abbreviation | Latin Phrase | Meaning |
| A.C. | Ante Cibum | Before meals |
| P.C. | Post Cibum | After meals |
| I.C. | Inter Cibum | Between meals |
| A.A. | Ana | Of each (used in compounding) |
Pro-Tips for Memory
P is for Past: Think of P.C. as the time Past the meal.
A is for Ante: In English, "ante-" is a prefix meaning before (like anteroom or antebellum). So A.C. is Ahead of the meal.
Safety Note: In modern practice, many hospitals and the Institute for Safe Medication Practices (ISMP) discourage using these abbreviations because they can be easily misread. Clear instructions like "Take after meals" are now preferred to prevent medication errors.
Which of the following medications may alter the renal function?
A) isoniazid
B) gentamicin
C) acetaminophen
D) cyclophosphamide
The correct answer is B) gentamicin.
Gentamicin is a powerful aminoglycoside antibiotic known for its nephrotoxicity (toxicity to the kidneys). This occurs because the drug tends to accumulate in the proximal tubule cells of the kidney, which can lead to acute tubular necrosis.
Monitoring Gentamicin
Because gentamicin has a "narrow therapeutic index" (the line between a healing dose and a toxic dose is very thin), pharmacists and doctors use two main methods to protect the kidneys:
1)Serum Creatinine/GFR: Monitoring these blood levels to check how well the kidneys are filtering.
2)Trough Levels: Drawing blood right before the next dose to ensure the drug level has dropped low enough to give the kidneys a "break."
Why not the others?
❌A) Isoniazid → Mainly hepatotoxic, not renal
❌C) Acetaminophen (paracetamol) → Mainly hepatotoxic (renal toxicity is uncommon)
❌D) Cyclophosphamide → Causes hemorrhagic cystitis, not primary renal dysfunction
📌 Exam pearl:
Aminoglycosides = nephrotoxic + ototoxic
Which of the following medications is a class-IA antiarrhythmic agent?
A) quinidine
B) flecainide
C) verapamil
D) amiodarone
The correct answer is A) quinidine.
Antiarrhythmic drugs are categorized using the Vaughan Williams classification system, which organizes them based on their primary mechanism of action on the heart's electrical cycle.
Class IA antiarrhythmics are sodium channel blockers that moderately slow conduction and prolong action potential duration. Examples include: Quinidine, Procainamide, Disopyramide.
Why not the others?
❌B) Flecainide → Class IC (also sodium channel blockers, but they have a very potent effect on slowing conduction without significantly changing the duration of the action potential)
❌C) Verapamil → Class IV (calcium channel blocker, specifically the non-dihydropyridine type). It works primarily on the SA and AV nodes to slow the heart rate.
❌D) Amiodarone → Class III (potassium channel blocker). Its primary job is to prolong the repolarization phase (Phase 3), though it actually has properties of all four classes.
A Quick Memory Trick
If you need to remember the sub-classes of Class I (Sodium Channel Blockers), many students use the mnemonic "Double Quarter Pounder, Lettuce Mayo, Fries Please":
Class IA: Disopyramide, Quinidine, Procainamide
Class IB: Lidocaine, Mexiletine
Class IC: Flecainide, Propafenone
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