manan shroff reference guide for foreign pharmacy licensing exam 2014 2015

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www.pharmacyexam.com Krisman

REFERENCE GUIDEFOR FOREIGNPHARMACY

LICENSING EXAM(Questions and Answers )

Manan H. Shroff

2014-2015




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REFERENCE GUIDE FORFOREIGN PHARMACY


DEDICATED

T

O

KRISHNA



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This reference guide is not intended as a substitute for the advice of a physician. Studentsor readers must consult their physician about any existing problem. Do not use any informationin this reference guide for any kind of self-treatment. Do not administer any dose of mentioned drugs in this reference guide without consulting your physician. This is only a review guide for

preparation for the Foreign Pharmacy Licensing board exam.

The author of this reference guide is not responsible for any kind of misinterpreted, incorrect or misleading information or any typographical errors in this guide. Any doubtful or questionableanswers should be checked in other available reference sources.

All rights reserved.

No part of this guide may be reproduced or transmitted in any form or by any means, electroni-cally photocopyed, recorded or otherwise , without prior written permission of the publisher.

RXEXAM ® is a registered trademark of Pharmacy Exam of Krishna Publication Inc . Anyunauthorized use of this trademark will be considered a violation of law.

NAPLEX ® and FPGEE ® are federally registered trademarks owned by the National Associa-tion of Boards of Pharmacy (NABP) and this reference guide is in no way authorized or spon-sored by NABP.




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REFERENCE GUIDEFOR FOREIGNPHARMACY


Manan H. Shroff

2014-2015



PREFACE

Reference Guide For Foreign Pharmacy Licensing Exam Questions and Answers -2014-2015 Edition is specifically written for students preparing for the FPGEE Exam.

It has approximately 1000 FPGEE TYPE questions with answers and complete explanations.

The FPGEE exam puts more emphasis on pharmacy management, statistics, immunology, pharmacology, kinetics and biopharmaceutics, therefore an effort was made to include all ofthese topics in a review guide. To prepare for pharmacology, I would highly recommend that youtake advantage of the Reference Guide For Pharmacy Licensing Exam-Theory.

Our preparation guide covers all the important topics you need to be familiar with to pass theFPGEE . I would recommend that you to go through the FPGEE review guide samplequestions provided by the NABP (you will get one when your approval from theFPGEE arrives) to evaluate the importance of our review materials.

Each answer is explained thoroughly to refresh your memory on specific topics. Please donot go through only the questions and answers. Try to understand and learn the answer’sexplanations. It is the best way to get the most out of this review guide.

I hope my efforts will help you to pass your key exam. I wish you the very best of luck, andany questions or comments are always welcome.

Good Luck,

Manan Shroff




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TABLE OF CONTENTS

SECTION-I

QUESTIONS 7

SECTION-II

ANSWERS 121

SECTION-III

TABLES 243



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1 Benzyl alcohol is classified as:

a. Emulsifying agentb. Preservativec. Diluent

d. Suspending agent

2. Cold cream is an example of:

a. Suspensionb. O/W emulsionc. W/O emulsiond. O/W/O emulsion

3. Egg yolk or egg white is used as:

a. Emulsifying agentb. Suspending agentc. Binderd. Preservative

4. The transfer of a drug from high con-centrated areas to low concentrated areas isgenerally defined as:

a. Infusionb. Levigationc. Diffusiond. Dissolution

5. Which of the following is the most suitable route for administration of insulin ?

a. IMb. SCc. IV

d. IV bolus

6. Noyes Whitney equation is helpful topredict the rate of:

a. Drug diffusionb. Drug dissolution

c. Drug degradationd. Drug oxidation

7. Polymorphism is generally defined asa:

a. Substance that may exist in more thanone crystalline form.

b. Substance that may exist only in meta-stable form.

c. Substance that has different viscositytime to time.

d. Substance that reduces interfacial ten-sion.

8. The minimum concentration of a drugat the receptor site to initiate pharmacologi-cal action is defined as:

a. T max

b. MECc. MTCd. Cmax

9. The area under curve gives useful in-formation about :

a. The amount of drug systematically ab-sorbed.

b. The time to reach peak concentration.

c. The time to reach minimum toxic

concentration.

d. The concentration at which pharma-cological actions of drug would beinitiated.

10. Which of the following is the majorplasma protein involved in drug binding?




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a. Globulinb. Creatininec. Albumind. Glycoprotein

11. Which of the following equations maybe useful to find out the plasma concentrationof a drug ?

a. Vd x P = C p

b. P x C p = V d

c. Vd = P/C p

d. Vd = C p /P

12. The initial dose of a drug through IVbolus to achieve desirable plasma concentra-tion at once is known as:

a. Loading doseb. Maintenance dosec. Replacement dosed. Degradation dose

13. Which of the following is/are usefulto measure glomerular filtration rate ?

I. CreatinineII. InulinIII. Albumin

a. I onlyb. I and II onlyc. II and III onlyd. All

14. The rapid degradation of a drug byliver enzymes in a liver is defined as:

a. Third pass effect of metabolismb. First pass effect of metabolismc. Rapid degradationd. Liver elimination

15. The normal renal creatinine clearancevalue lies between:

a. 200 to 300 ml/minb. 80 to 120 ml/min

c. 30 to 60 ml/mind. 10 to 20 ml/min

16. Which of the following is an exampleof an oligosaccharide ?

a. Glucoseb. Sucrosec. Starchd. Glycogen

17. Which pyrimidine base is found only inRNA?

a. Cytosineb. Thyminec. Uracild. Adenine

18. Heparin is classified as a(n):

a. Heteropolysacharideb. Oligosaccharidec. Homopolysacharided. Monosaccharide

19. Ribonucleic acid exists in all of thefollowing forms EXCEPT :

a. r RNAb. m RNA

c. q RNAd. t RNA

20 . Which of the following structures is ahost for Kreb’s cycle ?

a. Mitochondriab. Golgi bodies



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c. Cytoplasmic membraned. Ribosome

21. The synthesis of glucose from sources other than carbohydrates is generally known

as:

a. Glycolysisb. Gluconeogenesisc. Glycogenolysisd. Glucogenesis

22. Which of the following amino acidsshould be considered an essential amino

acid(s) for the body ?

I. PhenylalanineII. LeucineIII. Tryptophan

a. I onlyb. I and II onlyc. II and III onlyd. All

23. Which of the following enzymes ca-

talyses the coupling of two molecules of nucleotides to form DNA ?

a. Transferaseb. Ligasec. Isomerased. Aldehyde dehydrogenase

24. A nucleotide is a building block of:

a. Sphingomideb. Nucleic acidc. Amino acidd. Starch

25. Which of the following cells are in-volved with immune responses of the body?

I. B lymphocytesII. T lymphocytesIII. Neutrophils

a. I only

b. I and II onlyc. II and III onlyd. All

26. Which of the following immunoglo-bulin levels are elevated during asthma ?

a. IgMb. IgDc. IgEd. IgA

27 All of the following tests are requiredto check sensitivity of class A weighing pre-scription balance EXCEPT :

a. Arm ratio testb. Rider graduated beam testc. Shift testd. U test

28. The ratio of the mass of an objectmeasured in a vacuum at specific tempera-ture to volume (in ml) of an object at the sametemperature is defined as:

a. Absolute densityb. Specific gravityc. Relative densityd. Apparent density

29. The mean blood pressure of Mr. Hamis:

01/01/00 80 mm hg 04/04/00 90 mm hg01/02/00 82 mm hg 01/05/00 85 mm hg01/03/00 81.5 mm hg 01/06/00 83 mm hg




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a. 81.5b. 85.6c. 83.58d. 84.20

30. The deviation of data from its mean isgenerally described by:

a. The averageb. The standard deviationc. The precisiond. The accuracy

31 . The reproducibility of results of anumber of experiments is generally known as:

a. Precisionb. Biasc. Accuracyd. Closelessness

32. If the value of p = 0.6 in binomial dis-tribution, what is the probability of failure ?

a. 0.2b. 0.4

c. 0.3d. 1.0

33. The α α α α α error is generally consideredsignificant at:

a. 1%b. 3%c. 5%d. 10%

34. When the hypothetical value of a pa-rameter is the same as the observed value of aparameter, the error should be considered:

a. Alfa-errorb. Beta-errorc. Gema-errord. Infinitive

35. Find out the degrees of freedom in aChi-square test in a 2x2 contingency table (as-sume tests are independent).

a. 1

b. 2c. 3d. 4

36 The F distribution generally compares:

a. Two meansb. Two variancesc. Three meansd. Three variances

37. Which of the following elements hasthe highest electronegativity ?

a. Clb. Fc. Brd. I

38. Which of the following molecules hasthe largest dipole movement ?

CH3 CI

C C

CH3 Cl

FIGURE - I



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CH3 H

C C

H CH3

FIGURE-2

H F

C C

F H

FIGURE-3

CH3 F

C C

CH3 F

FIGURE-4

a. Fig Ib. Fig IIc. Fig IIId. Fig IV

39. Which of the following molecules hasthe highest boiling point?

a. H2Ob. H2Sc. H2Sed. HCN

40. The bond between NH 3 and CO 2 is bestdescribed as a:

H ON C

HH.....................O

a. Hydrophobic interaction forceb. Ion dipole or ion induced dipole forcec. London forced. Van der walls force

41. The process of transforming a soliddirectly to a vapor state is generally definedas:

a. Evaporationb. Meltingc. Sublimationd. Levigation

42 . The characteristic of solid substancesto exhibit more than one crystalline or amor-

phous form is defined as:

a. Isomerismb. Polymorphismc. Zwitter ion

d. Coupling

43. Which of the following molecules rep-resents CIS form ?

H Cl

C C

H Cl

FIGURE - I




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H H

C C

H Cl

FIGURE - 2

H Cl

C C

Cl Cl

FIGURE - 3

H H

C C

H H

FIGURE - 4

a. Fig Ib. Fig IIc. Fig III

d. Fig IV

44. Which of the following drugs is anangiotensin receptor antagonist ?

a. Lisinoprilb. Losartanc. Methyldopad. Captopril

45. According to Fick’s law of diffusion,which of the following is inversely propor-tionate to the rate of diffusion ?

a. The area of the solid.

b. The difference between the concentra-tion of solute to concentration of solute in stagnant layer.

c. Diffusion coefficient.

d. The length of the stagnant layer.

46. Acetone is classified as a:

a. Polar solventb. Nonpolar solventc. Semipolar solventd. Dipolar solvent

47 The process of degradation of ioniccompounds into cations and anions in a pres-ence of water is defined as:

a. Solvationb. Hydrationc. Activationd. Degradation

48. What happens to the solubility of al-cohol as the molecular weight of alcohol in-

creases ?

a. Reducesb. Increases

c. Remain unchangedd. Insoluble in water

49. The degradation of Riboflavin bylight is classified as:

a. Oxidationb. Reductionc. Photochemical degradationd. Racemization

50. The degradation of Penicillin G Procaine is highest in:

a. Solutionb. Suspensionc. Elixird. Tablet



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51 The rate of oxidation is influenced by allof the following EXCEPT :

a. Temperatureb. Radiation

c. Presence of catalystd. Hydrolysis

52. Which of the following are character-istics of pseudoplastic flow ?

I Viscosity of the flow generally de-creases with an increase in the rate of shears.

II No yield value has been found withflow.

III. Suspension of tragacanth follows thepseudoplastic’s flow.

a. I onlyb. I and II onlyc. II and III onlyd. I, II and III only

53. Which of the following is NOT trueabout microemulsion ?

a. The mean diameter of a droplet gener-ally lies between 10 to 200 nm.

b It is a thermodynamically stablesystem.

c It requires a cosurfactant.d. It is intermediate in property between

solution and emulsion.

54. A system with considerable interactionbetween dispersed phase and dispersion me-

dium is known as:

a. Lyophilicb. Lipophyliticc. Lyophobicd. Radioactive colloids

55. To balance the following equation, howmany molecules of NH 4Cl would be required?

(NH 4)2S+NICl 2—— NIS + NH 4CL

a. 1b. 2c. 3d. 4

56. The random motion of solute particlesin colloidal dispersion is known as:

a. Newtonian flowb. Brownian motionc. Stoke’s lawd. Non-Newtonian flow

57. Which of the following about floccu-lated suspension is NOT true?

a. Particles of suspension form loose ag-gregates.

b. Rate of sedimentation is very low.c. The time to form sediment is less.d. The sedimentation is easy to redis-

perse.

58. The rate of sedimentation is indepen-dent of :

a. The viscosity of dispersion medium.b. The diameter of suspended particles.c. The difference in densities between

dispersed medium and dispersedphase.

d. The lipophilic nature of particles.

59. Which of the following compounds is an acetanilide ?

a CH 3CONHC 6H5

b. CH 3CHOc. C 6H5CH=N.C 6H5

d. C 6H5N=NC 6H5




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60. The spontaneous isomerization of twostereoisomers in aqueous solution that causes

specific rotation is known as:

a. Zwitter ion rotation

b. Micelle rotationc. Mutarotationd. Steriorotation

61. Which of the following is a polysaccharide?

a. Dextroseb. Dextranc. Lactosed. Sucrose

62. The susbstance that is isolated from thebrain and produces fatty acid, galactose and

sphingosine upon hydrolysis is known as:

a. Sterolsb. Phospholipidsc. Glycolipidsd. Saponins

63. Which of the following is NOT a hy-drolyzed product of lecithins ?

a. Fatty acidb. Glycerolc. Phosphoric acidd. Spingosine

64.

NH

Which of the following is an active moiety of theabove compound ?

a. Carboxylic acidb. Imidazole

c. Pyrolined. Aniline

65. Albumin is an example of a:

a. Simple proteinb. Conjugated proteinc. Derived proteind. Hydrolysed protein

66. NH

Fluorination

NH

OFluorination of above compound will resultinto a well known cancer drug known as:

a. Methadone

b. 5-fluorouracilc. 6-mercaptopurined. Procainamide

67. For microbial assay of vitamin B-12 ,the test organism should be :

a. L.leichmanib. L.plantarumc. P.aeruginosad. S.pneumonia

68. Which of the following is NOT classifiedas a titrimetric method of analysis?

a. Direct titrationb. Gravimetric titrationc. Complexation reactiond. Redox reaction

CH2CH

2NHCOOHN



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69. Hemolytic anemia with abnormal he-moglobin is generally found in patients with :

a. Vitamin B-12 deficiency anemiab. Sickle cell anemia

c. Iron deficiency anemiad. Folic acid deficiency anemia

70. All of the following drugs may causehemolysis in a patient with G6PD deficiencyEXCEPT :

a. Chloroquineb. Sulfonamidec. Dimercaptrold. Penicillin

71. Which of the following drugs is use-ful in a Rh negative mother with a Rh posi-

tive infant ?

a. Rho gamb. Octeroide acetatec. Immunoglobulind. Pneu-immune

72. Which of the following is NOT trueabout PKU ?

a. It is a disease usually characterized bymental abnormalities.

b. A high concentration of phenylpyruvic-acid is found in urine.

c. It occurs due to excessive secretionof Phenylalanine hydroxylase enzyme.

d. A guthrie test is normally performed

to detect it.

73. The metabolite product of epinephrine and norepinephrine is :

a. Gama butyric acidb. Vanillymandelic acidc. Homovanillic acidd. 5 Hydroxyindoleacetic acid

74. Which of the following is an anaerobic organism ?

a. L. pneumonphlliab. Cl. tetani

c. N. meningitisd. E. coli

75. Which of the following organisms isresponsible for causing most of the UTI ?

a. S. pharyngitisb. E. colic. N. gonorrhead. T. palladium

76. The accurate diagnostic test for a pa-tient with cystic fibrosis is :

a. Mantoux testb. Sweat testc. Breath testd. Sick test

77. The allergic skin reaction character-ized by wheel formation is known as:

a. Eczemab. Urticariac. Impetigod. Erythema

78. Which of the following about diabe-tes insipidus is NOT true?

a. It is a disease usually characterized by

polyuria, polydypsia, and severe thirst.b. The urine volume sometimes increases

16 to 24 liters a day.c. It is thought to occur due to over-

activity of ADH.d. A patient should be monitored for

dehydration.




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79. In which kinetic reaction is the rate of re-action independent from concentration ?

a. First orderb. Zero order

c. Pseudo first orderd. Second order

80. The initial degradation of a drug byliver enzymes after oral administration of thedrug is known as:

a. Enzymatic degradationb. First pass metabolismc. Relative bioavailabilityd. Fick’s degradation

81. Which of the following factors DOESNOT affect the protein binding of a drug ?

a. The availability of protein for binding.b. Binding affinity of protein to the drug.c. The presence of competing substances

for protein binding.d. The concentration of a drug at its

receptor site.

82. In which of the following conditionsis an increase in plasma protein albumin found?

a. Severe burnsb. Cystic fibrosisc. Traumad. Hypothyroidism

83. Which of the following drugs is an H 2 re-ceptor antagonist ?

a. Hydroxyzineb. Cimetidinec. Diphenhydramined. Omeprazole

84. Which of the following drugs is indicatedfor reducing elevated blood concentration of

ammonia in blood ?

a. Lactulose

b. Diphenoxylatec. Sucralfated. Calcium polycarbophill

85. Patients with hemophilia have a defi-ciency of :

a. RhoDb. AHFc. ADHd. ACE

86. Sodium polystyrene sulfonate is foundto lower :

a. Serum K + concentrationb. Serum Na + concentrationc. Serum Al +3 concentrationd. Serum Ca +2 concentration

87. Which of the following cells are gen-erally found to be elevated in a patient withpolycythemia vera?

a. Reticulocytesb. Erythrocytesc. Leukocytesd. Thrombocytes

88 . Which of the following antihypertensivedrugs acts by blocking alfa-1 receptors ?

I. DoxazosinII. TerazosinIII Prazosin

a. I onlyb. I and II onlyc. II and III onlyd. I, II, and III only



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89 . Which of the following receptor’s stimu-lation prevents the release of noradrenaline ?

a. Alpha-1 receptorsb. Beta-1 receptors

c. Alpha-2 receptorsd. Beta 2 receptors

90 . Hypertrichosis is generally associatedwith the use of

a. Hydralazineb. Minoxidilc. Methyldopad. Clonidine

91 . The preferable route for SodiumNitroprusside is

a. Intramuscularb. Oralc. Intravenousd. Subcutaneous

92. An overdose of sodium nitroprussidegenerally causes

a. Severe hypotensionb. Hypertensionc. Renal failured. Severe edema

93 . The use of Sodium Nitroprussideshould be strictly restricted by :

a. Adult men

b. Adult womenc. Neonatesd. Children

94. Which of the following hypertensive drugsis known as an inodilator ?

a. Nitroglycerinb. Milrinonec. Dipyridamoled. Digoxin

95. Which of the following is a Class-1Aarrhythmic agent ?

a. Lidocaineb. Procainamidec. Encainided. Atenolol

96. Which of the following blood cho-lesterol lowering drugs is an HMG-COA in-hibitor ?

a. Gembifrozilb. Lovastatinc. Cholestyramined. Niacin

97. A patient with acute hypercapniashould be treated with which of the following?a. Doxapram

b. Dopaminec. Disopyramided. Ipecac

98. Which of the following drugs is foundto be mucolytic or reduces the viscosity of mucous ?

a. Dextromethorphanb. Acetylcysteine

c. Terbutalined. Benzonatate

99. Which of the following drugs is indicatedas uterine relaxant for women in labor ?

a. Ephedrineb. Terbutaline




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c. Isoetharined. Metaproterenol

100. Which of the following is an atropine -like drug?

a. Retrovirb. Ipratropiumc. Carvedilold. Latanoprost

101 . Which of the following is a centrally acting muscle relaxant ?

a. Dantrolene

b. Cyclobenzaprinec. Bromocriptined. Amphetamine

102 . Which of the fo llowing ant i-Parkinson’s drugs is a dopamine receptor ago-nist?

a. Carbidopab. Benztropinec. Bromocriptined. Amantadine

103. Which of the following diuretics actsthrough inhibition of carbonic anhydrase en-zyme?

a. Furosemideb. Acetazolamidec. Spironolactoned. Hydrochlorothiazide

104 . Which of the following is a common ad-verse effect of metolazone?

a. Seizureb. Electrolyte lossc. S.L.E.d. Neuroleptic malignant syndrome

105. Which of the following diuretics causehyperkalemia when used concurrently withCaptopril ?

I. Amiloride

II. SpironolactoneIII. Triamterene


106 . Probenecid may competitively inhibitthe renal tubular secretion of :

I. MethicillinII. MethotrexateIII. Dapsone


107. Which of the following can be admin-

istered for treatment of insulin overdose ?

I. GlucagonII. I.V. DextroseIII. Lidocaine


108. Which of the following sulfonylurea agents is indicated for the treatment of diabe-tes insipidus ?

a. Glyburideb. Chlorpropamidec. Glipizided. Tolbutamide



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109 . The deficiency of vitamin A may cause

a. Osteoporosisb. Night blindnessc. Scurvy

d. Anemia

110. Which of the following can be usedfor the treatment of Methotrexate overdose ?

a. Mephytonb. Leucovorin Ca +2

c. Pyridoxined. Niacin

111. Which of the following benzodiaz-epines can be safely administered to a geriat-ric patient ?

a. Chlordiazepoxideb. Alprazolamc. Oxazepamd. Prazepam

112. The active metabolite of Primidone is

I. PhenobarbitalII. PEMAIII. Trimethadione


113. Which of the following drugs should not

be used with Fluoxetine?

a. Tranylcypromineb. Digoxinc. Amitriptylined. Lidocaine

114. Which of the following is not classified asan insect control chemical ?

a. Insecticidesb. Repellents

c. Attractantsd. Antiseptics

115. Which of the following is NOT trueabout Barium sulfate?

a. It is medicinally used in roentgeno-graphy for the examination of thestomach and colon.

b. It is a clear solution.c. The principle adverse effect is

constipation.d. It needs to be mixed well with food or

strained through gauze before it isadministered to a patient.

116 . The addition of Ascorbyl palmitate inthe manufacturing process serves as a :

a. Preservativeb. Antioxidant

c. Coloring agentd. Flavoring agent

117. Epinephrine hydrochloride solutioncan be stabilized by adding a small amount of

a. Sodium metabisulfiteb. Sodium bisulfitec. Sulfur dioxided. Potassium benzoate

118. Which of the following are classified as certified colors ?

I. FD and CII. D and CIII. External D and C




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119 . Which of the following is not considereda primary taste ?

a. Salineb. Sweetc. Spicyd. Bitter

120. A 500 mg dose of a drug administeredvia I.V. injection produces a plasma concentra-

tion of 2.5 mcg/ml after 16 hours. If the initialplasma concentration of the drug is 10 mcg/ml,bioavailability is 1, and volume of distribution is120,000 L, what is the half-life of the drug?

a. 2 hoursb. 8 hoursc. 5 hoursd. 15 hours

121. Sweet taste of a compound is generallyattributed to :

a. Presence of H +ionsb. Presence of OH - ionsc. Presence of cations and anionsd. Presence of alkaloids

122. The alcohol content of low iso-alco-hol elixir is :

a. 8 to 10 %b. 15 to 23 %c. 50 to 80 %d. 73 to 78%

123. Erythema multiform is generally de-scribed as:

a. The presence of erythematous maculesand papules.

b. The presence of hair on skin.c. The presence of large flaccid bullae on

skin.

d. The presence of scaling andsloughing on entire skin.

124. The antidote for Acetaminophen tox-icity is :

a. EDTAb. N-acetylcysteinec. Mesnad. Diazepam

125. Which of the following drugs maycause cholestatic jaundice ?

I. ChlorpromazineII. Erythromycin estolateIII. Indomethacin

a. I onlyb. I and II onlyc. II and III only

d. I, II, and III only

126. The principal adverse effect of Clinda- mycin is :

a. ARF (acute renal failure)b. TEN (toxic epidermal necrolysis)c. AAC (antibiotic associated colitis)d. ADR (adverse drug reaction)

127. Which of the following is a major adverseeffect of Chloramphenicol ?

a. Thrombocytopeniab. Aplastic anemiac. Hemolytic anemiad. Agranulocytosis



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387. Which of the following ratios is the bestindicator of a pharmacy’s profitability ?

a. Net profit to net salesb. Net profit to net worth

c. Net profit to total assetd. Net profit to inventory

388. Which of the following ratios generallyindicates the efficiency of a pharmacy ?

a. Net profit to total assets.b. Inventory turnover ratec. Capitalization of net profitd. Net profit to net sales

389 . All of the following indicate the ratiothat measures the efficiency of a pharmacyEXCEPT:

a. Inventory turnover rateb. Net sales to inventoryc. Acid testd. Net sales to net working capital

390. The acceptable ratio for net profit tonet sales would be:

a. Less than 1%b. 1 to 2 %c. 2 to 3 %d. 5 to 7%

391. What would be the acceptable ratio for10 year old pharmacy’s net profit to net worth?

a. 1%b. 5%c. 15%d. 50%

392. Which of the following is true about netprofit to inventory ratio?

I. It indicates profitability as well as theefficiency of pharmacy.

II. It can be used for new and old phar-macies.

III. It increases with an increase in salesof the pharmacy.


393. Manan Pharmacy’s net profit to total as-sets ratio is found to be 15%. This will indicatethe pharmacy’s profitability is :

a. Goodb. Excellentc. Outperformd. Worst

394. Manan’s Pharmacy’s part of the finan-cial balance sheet is as follows:

YEAR 2000 SALES

RX $600,000Merchandise $150,000Total $750,000Cost of goods sold $500,000Beginning inventory $200,000Ending inventory $220,000

What would be the inventory turnoverrate for Manan’s Pharmacy?

a. 4.3b. 2.38c. 3.5d. 6.0




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395. The inventory turnover rate of the abovepharmacy would :

a. Meet the expectationb. Below the expectation

c. Exceed the expectationd. Cannot calculate

396. The net sales of the above pharmacy are840,000. Find out the ratio of net sales to inven-tory of the above pharmacy. [assume inventoryof above pharmacy at time of calculation is$210,000]

a. 8b. 4c. 10d. 12

397. Find out the net worth of Manan’sPharmacy?

Total current assets = $150,000Total fixed assets = $40,000Total liabilities = $75,000

a. 2.55b. 115,000c. 35,000d. 1.3

398. Which of the following ratios best de-scribes the account receivable collectiontimes?

a. year end account receivable

mean credit sales per day

b. annual credit salestotal account receivable

c. total account receivable 365

d. annual credit sales 24

399. Which of the following classes of recallsshould be considered a potential hazard to health?

a. Class I

b. Class IIc. Class IIId. Class IV

400. Which of the following categories indi-cates the use of a drug is restricted during preg-nancy ?

a. Ab. Bc. Xd. C

401. Liqu id ity generally expresses apharmacy’s ability to meet its:

a. Assetsb. Current liabilityc. Inventoryd. Prepaid expenses

402. The acid test generally measures apharmacy’s :

a. Financial positionb. Liquidityc. Profitabilityd. Inventory

403. Which of the following is generally NOTincluded in current assets ?

a. Cashb. Accounts payablec. Accounts receivabled. Inventory

404. Which of the following would generallybe considered the fixed assets of a pharmacy?



53


a. Inventoryb. Fixtures and equipmentc. Cashd. Accounts receivable

405. All of the following can be considered thecurrent liability of a pharmacy EXCEPT

a. Accounts payable.b. Notes payable within 1 year.c. Accrued expenses.d. Notes payable beyond 1 year.

406. Find out the Acid test (quick ratio) of Manancare Pharmacy from Table 1?

a. 202/1b. 1.47/1c. 13/1d. 1/1

TABLE 1

A CURRENT ASSETS

Cash $ 50,000

A/C receivable $ 75,000Inventory $ 100,000Prepaid expenses $ 10,000Total current assets $ 235,000

B FIXED ASSETS

Fixtures and equipment $ 30,000Deposits $ 5000Total fixed assets $ 35,000

TOTAL ASSETS $ 270,000

C CURRENT LIABILITIES

A/C payable $ 70,000Notes payable (1 yr) $ 5,000Accrued expenses $ 10,000Total current liabilities $ 85,000

D LONG TERM LIABILITY

Notes payable (>1 yr) $ 20,000Total liabilities $ 105,000Net worth $ 165,000

Cost of goods sold $ 490,000

407. Which of the following does NOTmeasure the pharmacy’s liquidity ?

a. Acid test ratiob. Current ratioc. Net sales to inventoryd. Inventory to its net working capital

408. Total liabilities to net worth ratio of Manancare Pharmacy is :

a. Acceptableb. Below expectationc. Exceeds the expectationd. Cannot be calculated

409. The investment in fixed assets of MananCare Pharmacy :

a. Exceeds the requirementb. Is below the requirementc. Meet’s the requirementd. Cannot be calculated

410. Manancare Pharmacy wants to sell its pre-scription files. The Manancare Pharmacy own-ers asks $350,000 for the existing prescriptionfile.

The Manancare Pharmacy provides the follow-ing data upon request.

Total new RX dispensed in $ 80,000past 2 years.

The % of Rx that has one 40%or more refill left




54

The average RX price $ 50

Net profit % % 15

What would be your answer to the owner of the

pharmacy?

a Price is okay.b. Price is too high.c. Price is breaking even.d Cannot be calculated.

411. “Manancare Pharmacy” marksdownthe price of analgesic balm from $3 to $2. If the mark down of the price increases the sales of analgesic balm from 60 tubes to 80 tubes , whatwould be the coefficient of elasticity of this prod-uct ?

a. 1b. 2c. 0.25d. 0.5

412. When relative change in revenue is sameas the relative change in price, it is known as:

I. Unitary elasticityII. Inelastic demandIII. Elastic demand


413. Find out the retail price of a box of insulinsyringes if the cost complement of the product is55% and the cost of one box of insulin is $9.00.

a. $4.95b. $16.30c. $15.11d. $13.95

414. Find out the % markup of Vasotec pre-scription if 30 tablets of Vasotec 5 mg retail priceis $75 and the cost of the drug is $45.

a. 55%b. 75%c. 66%d. 10%

415. Find out the retail price of one box of insulin syringes if :

The cost of complement = 55%The known retail markup = 45%

The cost of syringes = $9.00

a. 4.95b. 13.95c. 16.30d. 15.11

416. For Manancare Pharmacy, the totalrent for the whole store including the Phar-macy department is $10,000. The size of the phar-macy is 600 ft 2 and the size of the whole store is

5000 ft 2 . On the basis of above figures, whatwould be the rent of the pharmacy alone?

a. $ 1000b. $ 2000c. $ 1200d. $ 800

417. The funding for Medicare programs isgenerally obtained from:

I. Social security taxesII. Premiums paid by participantIII. State government




55


418. In a patient cost sharing plan, when apatient has to pay a specified amount of thecost of prescriptions and a third party will pay theremainding cost of prescriptions, it is known as:

a. Copaymentb. Coinsurancec. Deductibled. Retrospective payment

419. A person who works for an insurancecompany, provides the statistical data that in-dicates the risk associated with serving the popu-lation, and determines the premiums to cover allthe estimated expenses is known as:

a. Pharmacy managerb. Actuaryc. Sponsord. Vendor

420. The maximum amount that will be paidby a third party to a pharmacy when the drugis available from more than one source is definedas:

a. Maximum allowable cost (MAC)b. Estimated acquisition cost (EAC)c. Actual acquisition cost (AAC)d. Average wholesale price (AWC)

421. When a patient pays a full predeter-mined amount to the provider at the begin-ning of each month it is known as:

a. Concurrent reimbursement

b. Prospective reimbursementc. Retrospective reimbursementd. Cash reimbursement

422. The increase in the number of taking theforeign pharmacy exam is as follows:

Year Students taking the exam.

1981 3501982 4201983 5301984 6001985 6201986 6351987 7001988 850

Find out the mean of the above data:

a. 601b. 588

c. 720d. 520

423. What would be the median of theabove example?

a. 350b. 850c. 610d. 635

424. A random sample of the blood glucoseconcentration of 100 patients has a mean of 130 and a median of 155. The frequency dis-tribution of the sample is:

a. Normally distributedb. Positively skewedc. Negatively skewedd. Cannot be calculated

425. All of the following can be a shape of frequency of distribution EXCEPT:

a. Bell shaped distributionb. Skewed shape distributionc. U shape distributiond. T shape distribution




56

426. What would be the Pearsonian coefficientof skewness if a sample has a mean of 55 and amedian of 45. The standard deviation of thesample is 35.

a. 0.90b. 1.0c. 0.85d. 0.35

427. Which of the following about a Bino-mial experiment is NOT true?

a. Each trial results in an outcome that isclassified as success or failure.

b. The repeated trials are dependent uponprevious experiment.

c. The experiment generally consists of n-repeated trials.

d. The probability of success remainsconstant from trial to trial.

428. What is the mean binomial distribution if the probability of success is 0.60 in 50 trials ?

a. 5

b. 3c. 8d. 4

429. If the blood pressure measurement of 5 people is 110, 135, 140, 125 and 115 re-spectively . What would be the range of the set of the above observations?

a. 110

b. 30c. 125d. 140

430. When plotting t distribution curves, if sample size of 20 is taken from a normal popula-tion, what would be the degree of freedom in thet distribution?

a. 40b. 19c. 10d. 2

431. Find out the degree of freedom in a 2 x 3contingency table Chi-square test when it isapplied to test the hypothesis of independence of two variables?

a. 3b. 2c. 4d. 1

432. The average length of time it takes stu-dents to finish an exam is 180 minutes, with astandard deviation of 36 minutes. A new ex-amination procedure using modern comput-ers is being tested. A random sample of 50students had an average examination time of 150minutes, with a standard deviation of 40 minutesunder the new system. Test the hypothesis thatthe population mean is now less than 180 minutes.This hypothesis would result in ?

a. One sidedb. Two sidedc. Three sidedd. Cannot be calculated

433. In protein, Amino acids are joined co-valently by :

a. Hydrogen bondb. Peptide bond

c. Oxygen bondd. Disulfide bond

434. The secondary structure of proteinconsists of :

I. Alfa-helixII. Beta-sheetIII. Beta-bend



57



435. The denaturation of protein can occurin the presence of :

I. HeatII. Strong acidIII. Organic solvent


436. Which of the following about sicklecell anemia is NOT true?

a. It is a genetic disorder resulting fromthe production of a variant hemoglo-bin.

b. It is characterized with pain, lifelonghemolytic anemia and tissue hypoxia.

c. The replacement of leucine at the sixthposition of the Beta-globulin chain forglutamate is generally responsible forcausing it.

d. The form Hbs has an extremely lowsolubility compared to Hba whichresults into the aggregation of molecules that form or create sickleshaped red blood cells.

437. The enzyme with its cofactor is generallyknown as:

a. Coenzymeb. Holoenzymec. Apoenzymed. Prosthetic group

438. The process in which the release of en-ergy from energy rich molecules such as glucoseand fatty acid occurs in mitochondria is knownas:

a. Oxidative decarboxylationb. Oxidative phosphorylationc. Oxidative deaminationd. Oxidative dehydrogenation

439. The breakdown of complex molecules suchas protein, lipid and polysaccharide into simplemolecules such as carbon dioxide, water andammonia is known as:

a. Aerobic glycolysisb. Catabolic reactionc. Anabolic reactiond. Gluconeogenesis

440. What would be the end product of gly-colysis in the cell with mitochondria ?

a. Glucoseb. Glycogenc. Pyruvate

d. Lactate

441. Which of the following substance lev-els is found to be deficient in a patient withG6PD deficiency?

a. Alfa-antitrypsin in reduced formb. Bradykinin in reduced formc. Glutathione in reduced formd. Trypsin in elevated form

442. Which of the following causes hemolyticanemia in patients with G6PD deficiency?

I. Oxidant drugII. Ingestion of fava beansIII. Certain types of infections




58


443. Which of the following should be classi-fied as a disaccharide?

a. Riboseb. Lactosec. Glycoproteind. Glycosaminoglycans

444. The pairs of structure that are mirrorimages of each other are known as:

a. Isomersb. Enantiomersc. Epimersd. Muta rotation

445. In humans, the principle storage of glycogen is found in the :

I. Skeletal muscleII. LiverIII. Spleen


446. Which of the following substances shouldbe classified as a polysaccharide?

a. Glucoseb. Hyaluronic acidc. Sucrosed. Glycoprotein

447. Which of the following agents acts asan emulsifying agent for metabolism of lipidin duodenum?

a. Gastric lipaseb. Bile saltc. Pancreatic juiced. Secretion

448. Which of the following about steatorrheais NOT TRUE ?

a. It causes a loss of lipid, essential fattyacid and lipid soluble vitamin in fe-ces.

b. The oversecretion of bile salt may im-pair the absorption of fat soluble vita-mins.

c. The inhibition of secretion of pancre-atic juice from the pancreas generallyresults in steatorrhea.

d. The absorption of vitamins such asvitamin C, thiamine, and riboflavin arenot affected by the condition of steatorrhea.

449. Which of the following is a building

block of membrane of nerve tissue?

a. Prostaglandinb. Spingomyelinc. Thromboxaned. Leukotriene

450. The term cholelithiasis is generally referredto as:

a. Obstruction of the stomach by choles-terol stone.

b. Obstruction of the pancreas by choles-terol stone.

c. Obstruction of the gall bladder by cho-lesterol stone.



59


d. Obstruction of the spleen by cholesterolstone.

451. Which of the following is NOT a func-tion of Luteinizing hormone?

a. It initiates the testosterone synthesis inthe Leydig cells of the testis.

b. It simulates the process of spermatogenesis.

c. It induces ovulation in females.

d. It stimulates synthesis of progesteroneand estrogen in the corpus luteum.

452. The total energy required by an individualcan be found by calculating :

I. BMRII. Thermic effect of foodIII. Physical activity

a. I onlyb. I and II only

c. II and III onlyd. I, II and III only

453. Which of the following is considered pro-tein deficient malnutrition?

I. KwashiorkorII. MarasmusIII. Steatorrhea


454. Which of the following is NOT a watersoluble vitamin?

a. Thiamineb. Vitamin Dc. Niacind. Pyridoxine

455. Which of the following is a good sourceof Vitamin K?

a. Cabbage and cauliflowerb. Fatty fish and liverc. Vegetable oilsd. Yellow and green vegetables and fruit

456. The end product of purine catabolism is:

a. Alantoinb. Uric acidc. Hypoxanthined. Xanthine

457. The small and circular extrachromosomalDNA molecules that carry genetic information forfuture generations in bacteria are known as :

a. Lysozymesb. Plasmidsc. Mitochondriad. Cytoplasm

458. Which of the following RNA typescomprises 80% of the RNA in the cell?

I. Ribosomal RNAII. Transfer RNAIII. Messenger RNA


459. Which of the following types of RNAcarries genetic information from DNA to cy-tosol for protein synthesis ?




60

I m RNAII t RNAIII r RNA

a. I only

b. I and II onlyc. II and III onlyd. I, II and III only

460. Which of the following codons aregenerally known as stop or nonsense codons?

I UAGII. UGAIII. UAA


461. Which of the following types of micros-copy is used to observe the unstained living ordifficult to stain organisms?

a. Dark field

b. Bright fieldc. Transmission electrond. Scanning electron

462. The mycobacterium species of bacteriais generally stained with:

a. Gram stainb. Schaeffer-fulton stainc. Acid fast staind. Flagellar stain

463. Which of the following classes of cellshave no nucleus ?

a. Eukaryoticb. Prokaryoticc. Homokaryoticd. Heterokaryotic

464. Bacteria with two or more flagella isgenerally known as:

a. Monotrichousb. Amphitrichous

c. Lophotrichousd. Peritrichous

465. The moving of bacteria away from thelight is known as :

a. Chemotaxisb. Phototaxisc. Pilid. Escapetaxis

466. To find out if a substance is carcino-genic which of the following tests should bepreformed ?

I. Ames test .II. Pyrogen testIII. Biopsy of cells


467. The synthesis of protein and lipids in cellsis generally carried out by :

a. Mitochondriab. Endoplasmic reticulumc. Golgi apparatusd. Lysozymes

468. The growth of bacteria remains constantin which of the following phases?

a. Lag phaseb. Log phasec. Stationary phased. Decline phase



121


ANSWERS




122

1 (b) Benzyl alcohol is classified as a preserva-tive. Preservatives prevent the growth of micro-organisms and prevent deterioration of pharma-ceutical dosage forms. The ideal preservative musthave the following characteristics:

It must be effective against a broad spectrum of microorganisms. It must be stable for the lifetimeof the product. It must be nontoxic, soluble, pal-atable in test and odor and compatible with otheringredients in the formulation.

Commonly used preservatives:

* phenol * benzoic acid* benzyl alcohol * chlorobutanol* thiomersal * benzalkonium* cresol * cetylpyridinium

2 (c) Cold cream is an example of W/O emul-sion. It is a biphasic liquid dosage form, in whichdisperse phase and the dispersion medium areliquids. Emulsion is classified by five different cat-egories:

Water in Oil (W/O) : Oil is continuous phase and

water is a disperse phase, i.e. lotions and lini-ments.

Oil in water (O/W) : Water is continuous phaseand oil is a dispersed phase i.e. most of the oralemulsions to unmask the oil taste of a medication.

Microemulsion : Unlike emulsions, microemulsionis a transparent with a small particle size. It is be-lieved to be thermodynamically unstable. Theparticle size of microemulsion lies between 10 to

200 nm. It is generally used for the solubilizationof the drug in pharmaceutical dosage form.

Nanoparticles : As the name suggests, the par-ticle size of this kind of emulsion is limited tonanograms. They are useful for the preparationof globulins and toxoids. Tetanus toxoid and hu-man immunoglobulin G are examples of nanoparticles emulsion.

Multiple emulsions : Water in Oil in ware (W/O/ W), Oil in water in Oil (O/W/O). The w/o/wemulsions are generally more preferable for prepa-ration of various pharmaceutical dosage forms.They are used to prolong the duration of action

of various drugs, to localize drug in the body andto prepare cosmetics.

3 (a) Egg yolk or egg white is useful as an emul-sifying agent. It lowers the interfacial tension be-tween disperse phase and dispersion medium. Itcan be classified as natural or synthetic.

Commonly used emulsifying agents:

* Acacia * Tragacanth* Gelatin * Methylcellulose* Pectin * Agar* Spans * Tweens* Sodium lauryl sulfate.

4 (c) The transfer of a drug from a high concen-trated area to a low concentrated area is definedas “Diffusion”.

The addition of a levigating agent into a

solid to blend to make paste is defined as “Levi-gation” i.e. the addition of glycerine to the pow-der of sulfa.

5 (b) The most suitable route for administrationof insulin is subcutaneous, since it has been foundthat absorption of insulin via this route is slow andtherefore the chance of acute hypoglycemia is veryrare.

6 (b) Noyes Whitney equation helps to find out

the rate of dissolution of a drug. The rate of dissolution is a rate-limiting step in the drug’sbioavailability.

dC = Dc S x (Cs - C)dt h



123


C : Concentration of drug at time tDc : Diffusion coefficient of drugS : Surface area of drug particlesCs : Solubility of drug in diffusion layerh : Thickness of the diffusion layer

surrounding the particles

7 (a) A substance that may be exhibited in morethan one type of crystal structure is known asPolymorphism and different structures are knownas polymorphous i.e Theobroma oil, diamondsand methylprednisolone.

8 (b) The minimum concentration of a drug atthe receptor site which initiates pharmacologicalaction is defined as Minimum Effective Concen-tration (MEC). Ideally drug concentration shouldbetween MEC and MTC. Other terminology in-cludes :

MTC : Defined as the minimum toxic concentra-tion. The concentration above MTC producesadverse and toxic effect.

Tmax : Time to reach maximum concentration(Cmax) in a blood.

9 (a) Area Under Curve (AUC) provides infor-mation about the amount of drugs that are sys-tematically absorbed.

10 (c) Albumin is the major plasma protein in-volved in binding of drugs. Drug binding inhibitsthe clearance of the drug from the liver and kid-ney. It limited the availability of free drugs to vari-ous receptor sites.

Profound increase in drug binding mayreduce the effects of the drug or decrease in drugbinding may increase the toxic or adverse effectsof drugs.

Drugs having a high affinity for proteinbinding may displace a low affinity for proteinbinding, such as oral sulfonylurea displaces thecoumadin from protein binding.

* Factors that affect protein binding :

I HypoalbuminemiaII Renal impairment and uremiaIII Pregnancy- protein binding is de-

creased in last trimester of pregnancy.IV Age-protein binding is less in neonantand children.

11 (c) The hypothetical volume of distribution of drug can be calculated on the basis of followingformula : V d = P

Cp

Vd = Volume of distributionP = Amount of drug in the bodyCp = Plasma concentration of drug

The volume of distribution is very usefulin estimating the plasma concentration of the drugwhen the amount of drug is known. It helps toestablish the dose of drug to achieve the specificplasma concentration of drug. It is a direct mea-sure of the extent of distribution. Drugs that arehighly bound to plasma protein have a less V dand vice versa. This indicates that drugs with high

protein binding capacity may distribute less in tis-sues and other body fluids. Likewise, if the drugis extensively distributed in the tissues and bodyfluids, Vd would be high.

12 (a) The initial dose of a drug through I.V.bolus to achieve desirable plasma concentrationat once is defined as the Loading dose of drug.The replacement of metabolic loss of a drug fromtime to time to sustain the minimum effective con-centration of drug (MEC) is defined as a mainte-

nance dose.

13 (b) The creatinine (endogenous substanceobtained from creatinine phosphate during musclemetabolism) and Inulin (exogenous substance, apolysaccharide) are useful to measure the rate of glomerular filtration.



125


I rRNA (Ribosomal RNA)II mRNA (Messenger RNA)III tRNA (Transfer RNA)

rRNA : It is found in association with a number of

proteins as the component of ribosomes. It helpsin the synthesis of protein. 80% of RNA in thecell consists of rRNA.

mRNA : It is know as messenger RNA. As itsname suggests it conveys the specific genetic in-formation from DNA to the cytosol to preparethe site for specific protein synthesis. 5 % of RNAin the cell consists of mRNA.

tRNA : It is known as transfer RNA. It makesabout 15% of RNA in the cell. Each tRNA car-ries the specific amino acid to the site of proteinsynthesis. Each tRNA molecule contains antic-odon (three base nucleotide sequences) that gen-erally recognize the codon on mRNA.

20 (a) Mitochondria is the host for Kreb’s cycle.It is known as the powerhouse of the cell. A se-ries of oxidative reactions occur in mitochondria,and energy from such reactions is stored as ATP.

Energy in the form of ATP is usable by cells fortheir activities.

The Golgi apparatus consists of a stack of flattened membrane sacs. It helps in storingvarious substances transformed from the endo-plasmic reticulum in a small secretory vesicle.These vesicle fuse to the plasma membrane andsecrete the contents of vesicles into the extracel-lular portion of cells. The Golgi apparatus alsohelps in the formation of plasma and the lyso-

some membrane.

Lysosomes are extremely small organellesmade by the Golgi apparatus. They contain di-gestive enzymes that help in digestion of starch,glycogen and fat. They fuse with vacuoles (cellsthat store glycogen, starch and fat) and releasedigestive enzymes into vacuoles.

A cell nucleus is absent in prokaryoticcells. It is only found in eukaryotic cells.

In the cytoplasm, one can see tubes anda plate like structures distributed all over the cell

which known as the endoplasmic reticulum. It canbe smooth or rough. Smooth endoplasmic reticu-lum helps in the synthesis of lipids. Rough endo-plasmic reticulum has numerous ribosomes thatattach to its surface and which give it a rough tex-ture. Rough endoplasmic reticulum helps in syn-thesis of proteins.

21 (b) The synthesis of glucose from sources otherthan carbohydrates is known as gluconeogenesis.The other choices include :

Glycolysis: Breakdown of sugar into pyruvateor lactate.

Glycogenesis: The synthesis of glycogen fromglucose.

Glycogenolysis: The breakdown of glycogen intoglucose.

22 (d) All. The lists of the essential amino acidsincludes :

* Isoleucine* Arginine* Methionine* Leucine* Lysine* Threonine* Tryptophan* Valine

* Phenylalanine* Histidine

23 (b) DNA ligase catalyzes the coupling of twomolecules of DNA. DNA transferase catalyzesthe transfer of various groups such as phosphateand amino groups. DNA hydrolases hydrolysesthe various substances. DNA lyase catalyzes the




126

removal of various functional groups other thanthe process of hydrolysis. DNA isomerase cata-lyzes various isomerizations.

24 (b) Nucleotides are the building blocks of

nucleic acid. Nucleic acids consists of long chainsof nucleotides.

25 (b) B lymphocytes and T lymphocytes arethe primary cells of immune responses of the body.

26 (c) Immunoglobulins are protein of the anti-bodies class. They can be subdivided into fivemajor categories.

IgG: It is the major immunoglobulin foundin blood. It accounts for 75% of the serum immu-noglobulin and 20% of plasma protein. It is theonly immunoglobulin that can cross the placentalbarrier to provide protection to the fetus. It is theonly class of immunoglobulin whose Fc regioncan be recognized by phagocytosis and NK cells.

IgM: It is the first immunoglobulin pro-duced by the body in response to antigen. It ac-counts for 5 to 10% of total immunoglobulins. It

is the first immunoglobulin that is formed by thefetus, however it cannot cross the placenta dueto its large size.

IgA: It is the major immunoglobulin inexternal body secretions such as saliva, tears andurine. It accounts for 10% of total immunoglobu-lins.

IgE: This immunoglobulin plays an impor-tant role in combating helminth and allergy reac-

tions produced such as drugs, pollens or foods.The level of this immunoglobulin is found to behighly elevated in patients with allergy conditionsuch as asthma and hay fever.

IgD: It accounts for 1% of total immuno-globulins. It serves as an antigen receptor site inthe early stages of immune response.

27 (d) U test. Arm ratio test, Rider and gradu-ated beam test and shift test are commonly em-ployed tests for checking sensitivity of class Aprescription balance. The minimum weighablequantity for class A prescription balance is 120

mg.

28 (a) The ratio of the mass of an object mea-sured in a vacuum at a specific temperature to thevolume (in ml) of an object at the same tempera-ture is defined as Absolute density.

Specific gravity : The ratio of the mass of a sub-stance to the mass of an other substance an equalvolume taken as standard.

Relative density : The mass of 1 ml of a standardsubstance at a specified temperature, relative towater at 4 o C.

Apparent density : The ratio of mass of an objectmeasured in air at specific temperature to the vol-ume of the object in ml at the same temperature.

29 (c) The mean blood pressure of Mr. Hamcan be calculated as follows:

80 + 82 + 81.5 + 90 + 85 + 83 6

= 83.58

30 (b) The deviation of data from its mean oraverage is defined as standard deviation. The re-producibility of the series of measurements isknown as precision. Accuracy is defined as close-ness of measurements to the true value.

31 (a) The reproducibility of results of a num-ber of experiments is generally known as preci-sion.

32 (b) The sum of the all probabilities (failureand success) in binomial distribution is equal to 1,therefore if the probability of success is p = 0.6,the probability of failure (q) should be 0.4.



127


p + q = 1q = 1-p = 1-0.6 = 0.4

33 (c) The alfa-error in “Null Hypothesis” is alsoknown as level of significance. It commonly ischosen as 5%. This means that the error shouldbe considered as significant if the difference be-tween observed value and hypothetical value ismore than 5%. The more conservative approachwould be to chose at the level of 1%.

The second type of error is defined asbeta error. It is defined as no difference betweenobserved value of parameter and hypotheticalvalue of parameter.

For example, if we assume that Mr. Raj’sblood pressure should be 100 mm Hg, we cansay that hypothetical value of experiment is H 0 =100.

Alternative is could include all valuesgreater than or less than 100 upon actual mea-surement of blood pressure. If the measured valueof blood pressure is 100, we can say that betaerror occurrs, and if it is less than 95 or greaterthan 105 (5% difference), it would be consid-

ered as alfa-error.34 (b) When the hypothetical value of a param-eter is the same as the observed value of a pa-rameter, the error should be considered Beta er-ror.

35 (a) The degree of freedom in a chi-squaretest is defined as (R-1) x (C-1), therefore thedegree of freedom in 2 x 2 contingency tablewould be (2-1) x (2-1) = 1.

36 (b) The “F” distribution is used to comparetwo variances. It is defined by the ratio of vari-ances, with n 1 -1 in the numerator and n 2-1 inthe denominator of the ratio. The “t” distributionis useful for a comparison of two means.

37 (b) Fluorine has the highest electronegativitycompared to other given choices.

38 (d) In the figure IV F atom is more negativethan the C atom and therefore electrons are dis-

placed more towards F atom. This will make themolecule more polar.The F atom has more electronegativity

than Cl, H and CH3, therefore the correct choicewould be “d”.

In the choice “C” two “F” atoms standopposite to each other and nullify each other ef-fects.

39 (a) The high boiling point of H 2O (100 o)compared to H

2S (-60 o) and H

2Se (-41 o) is

attributed the ability of O to make more H-bondscompared to S and Se. The strength of the mostH-bond ranges from 1 to 7 kcal/mole.Hydrogen bonding is also responsible for highersolubility of polyhydroxy compounds.

40 (b) Due to electrostatic attraction, the nega-tive pole of one molecule will try to line up withthe positive pole of neighboring molecule.

O=C <..........NR 3This type of attraction is known as dipole-dipoleattraction and has a strength of 1 to 7 kcal/mole.

Sometimes electrons are concentrated in one re-gion of the atom or molecule, and this displace-ment of electrons generally causes a nonpolarmolecule to become a polar molecule which re-sults in an instantaneous dipole. Slowly, electronsin a neighboring atom or molecule may be dis-

placed to produce a dipole this is called processof induction. A newly formed dipole is known asan induced dipole or debey force. Debey forcehas a strength of about 1 to 3 kcal/mole.

The attraction between two induced dipolemolecules is known as dipole-induced dipoleinteraction, dispersion force or London force, This




128

bond has a strength of about 0.5 to 1 kcal/mole.Ion dipole or ion induced dipole bond; in a polarsubstance, the positive end of one dipole tries toline up with the negative end of an other dipole.

Hydrophobic bond: The association of nonpolar groups in an aqueous solution such aswater, due to the tendency of aqueous solventsto exclude nonpolar molecules.

41 (c) The process of transforming a solid to avapor without intermediate change to the liquid isdefined as sublimation. The transform of solid toa liquid is a defined as melting and the transfer of liquids to a vapor is defined as evaporation.

42 (b) The characteristic of solid substances toexhibit more than one crystalline or amorphousform is defined as polymorphism.

43 (a) The arrangement of geometric isomers inwhich two ions (in our case Cl) can either be alongthe same edge of the square (cis) or on oppositecorners (trans).

Generally trans-isomers are more stable com-

pared to cis-isomers.

X Y

C C

X Y

[CIS ISOMER]

X Y

C C

Y X

[ TRANS ISOMER ]

44 (b) Cozaar (Losartan) is classified as angio-tensin II receptor antagonist. It blocks the bind-ing of angiotensin II to AT receptors. It is indi-cated for the treatment of hypertension. The rec-ommended dose of the drug is 50 mg per day

with or without food. Hyperkalemia, diarrhea,hypotension, tachycardia and angioedema arereported side effects of the drug.

45 (d) According to Fick’s law of diffusion, therate of diffusion is directly proportional to the areaof the solid, the concentration difference betweenthe concentration of solute in the stagnant layer atthe surface of solid and its concentration on thefarthest side of the stagnant layer and diffusioncoefficient. It is inversely proportional to the lengthof stagnant layer.

The driving force behind the movement of thesolute molecules through the stagnant layer is thedifference in concentration of solute at C1 and itsconcentration at C2.

Rate of solution = D x A X (C 1 - C2) L

D = Diffusion coefficient

A = Surface area of solidC1 = Concentration near to stagnant layerC2 = Concentration of solute to other side

of stagnant layer.L = The length of the stagnant layer

46 (c) Acetone is classified as a semipolar sol-vent. Water is classified as a polar and benzene isclassified as a non-polar solvent.

47 (b) The process of degradation of ionic salt

into cations and anions in the presence of water isknown as hydration. If the solvent is other thanwater, the process is known as solvation.

48 (a) As the molecular weight of alcohol in-creases, the solubility of alcohol decreases. Asthe molecular weight of alcohol increases, thechances of formation of hydrogen bonds between



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water and OH groups of alcohol decreases,therefore high molecular weight alcohols arepoorly soluble in water.

49 (c) The degradation of Riboflavin by light is

an example of photochemical degradation. Lightgenerally catalyzes oxidation and reduction of photoexcited species of such drugs. Riboflavinand phenothiazine are examples of such drugs.

50 (a) The degradation of Penicillin G Procaineis the highest in a solution, since the hydrolysis of Penicillin G procaine is catalyzed by hydrogen orhydroxide ions.

51 (d) The rate of oxidation is influenced by tem-perature, radiation and the presence of a cata-lyst. It is not affected by hydrolysis. Ephedrine,ascorbic acid, phenothiazine and vitamin A areexamples of pharmaceutical products that oxidizevery easily.

52 (d) A large number of pharmaceutical prod-ucts such as liquid dispersion of methyl cellulose,carboxymethylcellulose, tragacanth and sodiumalginate follows pseudoplastic flow. The viscosity

of the pseudoplastic flow decreases with an in-crease in rate of shear. It does not have the yieldvalue.

Normally, as shearing stress increases, thedisarranged particles of the solute try to get alongwith the direction of flow. At certain levels witheach successive shearing stress, the greater rateof shear can be achieved with minimum stress. Inaddition, some of the solute molecules (entrappedbetween solvent molecules) may be released,

which reduces apparent viscosity of the flow.Pseudoplastic flow is known as a “shear thinningsystem”.

Generally, non-newtonian flow can beclassified in three classes of flow: plastic, pseudo-plastic, and dilatant.

The material that exhibits the plastic flowis known as the Bingham body. Plastic flow has ayield value, which means that it does not start toflow until shear stress exceeds the yield value,and therefore plastic flow curve does not pass

through the origin but rather intersects the shear-ing stress axis.

Concentrated suspension with flocculatedparticles generally follows the plastic flow. Plasticflow has a yield value because of the presence of van der walls force between flocculated particles,and the need to break such force before it existsin the flow.

The third type of flow is described asDilatant flow. It is also known as a “shear thick-ening system” in which the viscosity of the systemincreases with increase in shear stress. It is gen-erally observed more with suspension that con-tains a high percentage of dispersed solid (about50% or greater of small deflocculated particles).

The system that follows conversion fromgel to sol upon applying shear stress and reformsback to gel from sol upon resting is defined as

Thixotropy. The application of thixotropy is veryuseful in the formulation of pharmaceutical prod-ucts. For example, the well formulated thixotropysuspension will not settle out readily and will be-come fluid upon shaking.

53 (b) Microemulsion is the liquid dispersion of water and oil that is made homogeneous and trans-parent by the addition of surfactant and cosur-factant. It is not a thermodynamically stable. Thedroplet size of microemulsions lie between 10 to

200 nm. They are intermediate in property be-tween solution and emulsion.

54 (a) A system with considerable interactionbetween the disperse phase and dispersion me-dium is known as Lyophilic dispersion or solventloving dispersion. If the dispersion medium iswater, the system is known as hydrophilic.




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Hydrophilic suspension is subdivided in to threecategories:

I True solution, i.e. acacia and povidonesolution.

II Gells or jellies, i.e. gels of methylcellulose, gelatin and starch

III Particulate dispersions, i.e. suspensionof bentonite

Lipophilic or Oleophilic dispersions have a highaffinity for oily substances such as benzene, veg-etable oils, essential oils, and mineral oil etc.

55 (b) 2.

(NH4)2S + NICl2 = NIS + 2 NH 4Cl

56 (b) The random motion of solute particles incolloidal dispersion is known as Brownian mo-tion.

57 (b) Flocculated suspensions have the follow-ing characteristics:

* The rate of sedimentation is high. A sedi-ment generally forms rapidly compared todeflocculated particles. The sediment is looselypacked and can be easily redispersed with mini-mum stress. Particles in sediment do not bindtightly to each other. The suspension with floccu-lated particles has a clear supernatant region.

In contrast, the rate of sedimentation of deflocculated suspension is slow, but once the

particles settle at the bottom of the container it isvery difficult to redisperse them. Sediment formsslowly and particles in sediment are tightly packed.The supernatant remains the cloudy.

In pharmacy practice suspension withflocculated particles is the most acceptable.

58 (d) The relation of the rate of sedimentationwith various parameters can be expressed byStoke’s law.

V = 2r 2 (P1 - P2) g

9n

V = velocity of sedimentation incm/sec

r = radius of the particles in cmP1 = density of disperse phase in

g/cm3

P2 = density of dispersion mediumin g/cm 3

n = viscosity of dispersion me-dium

g = gravity acceleration 980.7 cm/ sec2

The rate of sedimentation is independent of thelipophilic nature of particles.

59 (a) CH3CONHC 6H5

60 (c) The spontaneous isomerization of two iso-mers in an aqueous solution causes specific rota-

tion which is known as mutarotation.61 (b) Dextran is an example of a polysaccha-ride. Other polysaccharides include:

* Dextrin* Inulin* Starch* Cotton* Soy polysaccharides

62 (c) Lipids can be divided into five classesaccording to their chemical structure.

Glycolipids : Also known as Cerebro-sides. They are isolated from the brain. Upon hy-drolysis, they yield fatty acid, galactose and sph-ingosine. They are also known as galactolipidsdue to the presence of galactose, such asphrenosin, kerasin.



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Phospholipids : Known as Phosphatides.They are esters consist of fatty acid, phosphoricacids and nitrogenous compounds, such as leci-thin.

Sterols : The sterols are alcohols struc-

turally related to steroids. They are obtained formplants and animals such as cholesterol and ergos-terol.

Waxes : Waxes are defined as high mo-lecular weight esters. They consist of monohy-dric alcohol and high molecular weight fatty acids,such as spermaceti.

Fixed oils and fats : They are esters of glycerol and fatty acids, such as olive oil. Fixedoils such as lard, which are solid at room tem-perature are known as fat.

63 (d) Sphingosine is not a hydrolysed productof lecithin. Lecithins are phospholipids and aregenerally hydrolysed to fatty acid, phosphoric acidand nitrogenous compounds other than sphin-gosine.

64 (b) Imidazole is an active moiety of the listedcompound.

65 (a) Albumin is an example of simple protein.

Protein is generally classified in three differentcategories:

I Simple proteinII Conjugated proteinIII Derived protein

Simple protein : Naturally occurring pro-

teins, which upon hydrolysis yield only alpha-amino acids such as albumins, globulins, prola-mines, glutelins and albuminoids.

Conjugated protein: Conjugated proteinsare further classified on the nature of prostheticgroups.

Prosthetic gp Example

Phosphoprotein Phosphoric acid casein, ovovitellin

Nucleoprotein Nucleic acid nuclein

Glycoprotein Carbohydrate mucins

Chromoprotein Colored gp hemoglobin

Lipoprotein Lipids lecithin

Metalloprotein Metals tyrosinase, arginase, xanthine oxidase

Derived proteins: They are formed fromprimary or conjugated proteins by the actions of the acid, alkali, heat, water, enzyme or alcohol.They generally differ in physical and chemicalproperties from the protein they are derived from.They subdivide into primary derived protein (De-natured protein) or secondary derived protein.

66 (b) 5- Fluorouracil . It is classified as a cyto-toxic substance. It is a pyrimidine antagonist. It isindicated for the treatment of the rectum, stom-ach, colon, pancreas and breast cancers.Esophagopharyngitis, myocardial ischemia, an-gina, photophobia and decreased vision are re-ported side effects of the drug.

67 (a) L.leichmanni is the most widely used testorganism for microbial assay of vitamin B 12.L.plantarum is generally used for microbial assay

of Niacin and Calcium pantothenate.

68 (b) Gravimetric analysis is not con-sidered a titrimetric method of analysis. Titrimet-ric methods of analysis generally include :

I Acid base titrationsII Precipitation reactions




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III Redox reactionsIV Complexation reactionsV Large anion and large cation reactions

Gravimetric methods of analysis include:

I Weighing drugs after separationII Weighing a derivative after separationIII Weighing a residue after ignition

Spectrometric methods of analysis include:

I ColorimetryII UV absorptionIII IR absorptionIV Fluorimetric emissionV NMR absorptionVI Atomic absorption

Electrochemical methods of analysis include :

I VoltammeteryII Potentiometery

Chromatographic methods of analysis include :

I Gas chromatographyII HPLCIII TLC

69 (b) Sickle cell anemia and Beta-thalassemiaare hemolytic anemias associated with abnormalhemoglobins. Due to poor solubility of such ab-normal hemoglobins in a reduced state, semic-rystalline bodies are formed inside of RBC. Thesecrystalline bodies are pointed and elongated in-side of the cell, and rupture the red blood cells.

The detection of sickle-cell disease canbe done by viewing red cell sickling in the pres-ence of the reducing agent sodium metabisulfite,or by quantitative determination of turbidity pro-duced by dithionite following the reduction of HbSto deoxyHbS in RBC.

G6PD-Hemolytic anemia :

The enzyme glucose-6-phosphate dehydrogenaseis necessary to maintain the reduce glutathionelevel (GSH) in red blood cells. This enzyme is

necessary to prevent the hemolysis. The deficiencyof this enzyme may cause severe hemolytic anemiain patients with the use of certain oxidant drugssuch as primaquine, sulfonamide, nitrofuran, na-lidixic acid, probenecid, chloroquine anddimercaptol.

Glutathione is an antioxidant which pre-vents the oxidation of hemoglobin to methemo-globin. NADPH is required to keep glutathionein a reduced state and G6PD is needed to con-vert NADP to NADPH. When RBC’s are defi-cient in G6PD, the amount of NADPH is notadequate to keep glutathione in a reduced state,so free radicals accumulate inside of red bloodcells and cause the oxidation of hemoglobin tomethemoglobin.

70 (d) Except Penicillin, all of the mentionedmedications may cause hemolytic anemia in pa-tients with G6PD deficiency.

71 (a) Rho gam is a useful drug for treatment of an Rh negative mothers with an Rh positive infant.In Rh negative mother, Rh positive antigens maytransfer from Rh positive fetuses to the mothervia placenta. This may lead to production of Rhpositive antibodies in the mother’s blood. Thesesame antibodies may transfer back from themother’s blood into fetus via the placenta, andproduce antigen-antibody reactions. This leadsto lysis of red blood cells in the fetus, and miscar-

riage. Rho gam prevents the formation of anti-Rhantibodies in an mother who bears a Rh positivefetus.

72 (c) PKU is a disease characterized by an el-evated serum concentration of phenylalanine andthe presence of phenylpyruvic acid in urine. Thedeficiency of enzyme phenylalanine hydroxylase



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is responsible for this. Phenylalanine hydroxylaseconverts the phenylalanine to tyrosine. The dis-ease is associated with mental deficiency.

The Guthrie test is performed to detect

PKU. The agar medium with serum or blood onthe surface is impregnated with alanine at a con-centration sufficient to inhibit the growth of B.subtitis. Phenylalanine reverses this inhibition andbacterial inhibition assay is a direct measure of phenylalanine.

73 (b) The metabolic product of epinephrine andnor epinephrine is vanillymandelic acid.Homovanillic acid is a metabolic product of dopamine and 5 hydroxyindoleacetic acid is of serotonin.

74 (b) Clostridium tetani is an anaerobic organ-ism that causes tetanus. Below are important or-ganisms and the disease produced by those or-ganisms.

Gram Positive Microorganisms

Organisms Disease

Propionibacterium acne Acne

Bacilus anthracis Anthrax

Streptococcus pneumonia MeningitisPneumonia

Streptococcus mutane Dental caries

Streptococcus pyrogens Food poison

Pharyngitis Rheumatic fever

Staphylococcus aureus Food poisonSkin infectionWound infectionToxic shock-syndrome

Enterococcus faecalis Endocarditis

Gram Negative Organisms

Organisms Disease

Hemophilus influenza Meningitis

Neisseria meningitis Meningitis

Gardenerella vaginitis Bacterial vaginitis

Vibrio cholera Cholera

Hemophilus aegyptius Conjunctivitis

Campylobacteria sp Food poisoning

Shigella Food poisoningShigellosis

Salmonella Food poisoningSalmonellosis

Neisseria gonorrhea GonorrheaLegionella pneumophilia Legionnaire’s

disease

Borrelia burgdorferi Lyme disease

Helicobacter pyroli Peptic ulcer

Yersinia pestis Plague

Klebsiella pneumonia Pneumonia

Salmonella typhi Typhoid

Treponema pallidum Syphilis

Chalmydia trachosis Trachoma




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Bordetella pertussis Whoopingcough

Anaerobic Microorganisms

Organisms Disease

Clostridium botulinum Botulism

Corynebacterium diptheria Diptheria

Clostridium perfringen Gas gangrene

Clostridium difficile P.colitis

Clostridium tetani Tetanus

Miscellaneous

Organisms Disease

Mycobacterium lepre Leprosy

Mycobacterium tuberculosis Tuberculosis

Important viral diseases

Organisms Disease

Varicella-zoster Chickenpox

Epstein Barr Burkitt,Lymphoma,Infectious

Mononucleosis

Cytomegalovirus Cytomegalic

inclusiondisease

Herpes simplex Herpes

HIV Aids

Paramyxovirus Mumps

Rabies Rabies

Poliovirus Poliomyelitis

Rubella Rubella

Varicella zoster Shingles

Variola virus Smallpox

Yellow fever Yellow fever

75 (b) E.coli is responsible for causing most of urinary tract infections (UTI).

76 (b) A sweat test helps to confirm cystic fi-brosis. The sweat of patients with cystic fibrosisusually contains 3 to 5 times higher concentra-tions of chloride ions than patients without the dis-ease.

77 (b) Urticaria or hives is a skin reaction char-acterized by wheal formation. The lesions are well-circumscribed discrete wheals with erythemato-sus raised serpiginous borders and blanched cen-ters. The lesion is associated with intense pruritus

or burning. Urticaria or formation of wheals is nota life-threatening condition itself, but it may indi-cate the patient is more susceptible to anaphylac-tic reactions.

Eczema: It is also known as Atopic der-matitis and is characterized by itching. The ap-pearance and distribution of lesions depend onthe age of the patient. It can be further subdi-vided into infant-type atopic dermatitis, child-hood-type atopic dermatitis and adult-type atopic

dermatitis.

Allergic contact dermatitis: It is a com-mon skin disease caused by direct contact withsubstances such as acid and alkali, or by exces-sive use of soap.



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Exfoliative Dermatitis: It is also known aserythroderma syndrome. It is a fatal complicationthat occurs due to other poorly controlled der-matitis reactions.

Erythema multiform: It is a skin reactionresult of systematic allergic reaction to variousagents such as Stevens-Johnson syndrome.

Impetigo: It is a superficial bacterial in-fection of the skin. The causative organisms arecoagulase -positive staphylococci and betahemolytic streptococci. It is more common in chil-dren.

78 (c) Diabetes insipidus is a disorder that usu-ally occurs due to a decrease in production of Antidiuretic Hormone (ADH). It is characterizedby a severe increase in thirst, polyuria and poly-dipsia. The urine volume increase is up to 16 to24 liters per day. Patients should be watched fordehydration.

79 (b) The rate of reaction is independent of concentration in zero order kinetic.

Zero order reaction: The rate of changein the concentration of reactants and productsdepends on factors other than concentration of reactants, e.g. photochemical reactions.

V = - dc = k , t 1/2 = a dt 2k

First order reaction: The rate of change in the concentration of reactants is pro-portional to the first power of the concentration

of a single reactant.

V = -dx = k (a - x) dt

-dx = k (a - x) dt

k = 2.303 log a t (a - x)

t1/2 = 0.693 k

Second order reaction: The rate of change in theconcentration of reactants and products is pro-portional to either the second power of concentration of one reactant or a single powerof concentration of two reactants.

- dx = k (a - x) (b - x) dt

kt = x a ( a - x)

t1/2

= 1/ka

Pseudo First order reactions: In sec-ond order reaction, if one of the reactant presentin a very large amount then, rate of such reactionusually depends on the concentration of large re-actant and independent of the concentration of the second reactant, this type of reaction is usu-

ally described as a pseudo first order reaction,such as hydrolysis of ethyl acetate in the pres-ence of an excess amount of water.

CH3COOC 2H5 + H2O (excess)

CH3COOH + C 2H5OH

80 (b) The initial degradation of drugs by the liverafter oral administration the of the drug is defined

as First Pass Effect of metabolism.

81 (d) The concentration of a drugs at the re-ceptor site does not affect the protein binding of the drug. The factors that affect the protein bind-ing of drugs are :




136

* Type of proteins available for binding.

* The protein binding affinity and capac-ity of the drug.

* The presence of competing substancesfor protein binding.* The disease condition that may alter

the amount of protein available forbinding.

The lists of the conditions or diseases that maydecrease albumin levels in plasma and therebydecrease the protein binding includes :

* Burns* Pregnancy* Cystic fibrosis* Chronic liver disease* Chronic renal failure* Trauma

The conditions that may increase albumin levelsin plasma and thereby increase the protein bind-ing includes:

* Hypothyroidism82 (d) In hypothyroidism, the plasma albuminlevel is found to be elevated.

83 (b) Tagamet (Cimetidine) is an H 2 receptorantagonist indicated for treatment of GERD andheartburn. It has a powerful cp450 inhibition prop-erty. The recommended dose of the drug is 400mg b.i.d. Diarrhea, pancreatitis, and headacheare reported side effects of the drug.

84 (a) Lactulose is indicated for treatment of hyperammonia. It is degraded into organic acidwhich decrease the ph of the colonic contents.The acidic contents of the colon entraps the am-monia as ammonium ions and reduces the con-centration in the blood.

85 (b) A patient with hemophilia has a deficiencyof coagulation factor VIII, known as Antihemo-philic factor (AHF). The deficiency of this en-zyme will result in severe coagulation defect. It isindicated for treatment of hemorrhage in patients

with Hemophilia A or to prevent bleeding in vari-ous surgical procedures.

86 (a) Sodium polystyrene sulfonate re-duces the elevated serum concentration of po-tassium (hyperkalemia). It is an ion exchange resinthat replaces the potassium ions for sodium ions.The recommended dose of the drug is 15 grams,one to four times a day. Constipation, anorexia,and gastric irritation are reported side effects of the drug.

87 (b) Polycythemia and erythrocytosisare conditions in which there is an increase in thenumber of erythrocytes found. In contrast, leu-kemia is a condition in which there is an increasein the number of leukocytes. Thrombopenia isassociated with a decrease in thrombocytescounts.

88 (d) Doxazosin, Terazosin and Pra-

zosin are specific alpha-1 blockers. They are in-dicated for treatment of hypertension and BPH.The major side effects of these agents are firstdose syncope and tachycardia.

89 (c) The stimulation of alpha-2 recep-tors prevents the release of noradrenaline i.e.clonidine and methyldopa.

The function of other receptors:

Alpha-1 receptors: Stimulation of thesereceptors may result in the constriction of bloodvessels that supply to skeletal muscles, thereforealpha-1 blockers are very good vasodilators.These include Prazosin and Terazosin, Doxazosin.

Beta-1 receptors: Stimulation of thesereceptors may increase the cardiac rate. Agents



137


of this class are helpful in the treatment of cardio-genic shock. Inhibition of these receptors helps incontrolling hypertension, therefore beta blockersare indicated for treatment of hypertension i.e.propranolol and atenolol

Beta-2 receptors : Stimulation of thesereceptors dilate vascular smooth muscles, there-fore most of the bronchodilators are good Beta-2 stimulators. These include albuterol, andsalmeterol.

90 (b) Hypertrichosis (increase in hair growth)is a side effect associated with the use of Loniten(Minoxidil). This adverse effect of Minoxidil hasbeen used for treatment of male pattern baldness.Minoxidil is classified as an antihypertensive agent.It is indicated for the treatment of hypertensionand male pattern baldness. The recommendeddose of the drug is 5 mg per day. Hypotension,tachycardia, edema, nausea and vomiting are re-ported side effects of the drug.

91 (c) The most preferable route for the admin-istration of Sodium nitroprusside is intravenousbecause of the short half life of the drug.

92 (b) Overdose of sodium nitroprusside gen-erally results in hypertension instead of hypoten-sion. The overdose of this agent results in cya-nide poisoning, which in turn stimulates the ca-rotid chemoreceptors, responsible for causinghypertension and tachycardia.

93 (c) The use of Sodium nitroprusside shouldbe strictly restricted in infants due to a lack of enzyme rhodanase that converts the cyanide into

sodium thiocyanate.

94 (b) Primacor (Milrinone) is known as an in-odilator since it has inotropic as well as vasodila-tion properties. It is a selective inhibitor of cAMPphosphodiesterase enzymes in cardiac and vas-cular muscles. It is indicated for the treatment of CHF. The recommended dose of the drug is 50

mcg/kg administered slowly via I.V. infusion, overten minutes. Arrhythmia, tachycardia, hypoten-sion, and thrombocytopenia are reported sideeffects of the drug.

95 (b) Procainamide is a class IA arrhythmicagent. Here is the classification of antiarrhythmicagents:

Class IA : Procainamide, quinidine, disopyramide

Class IB : Phenytoin, lidocaine, mexiletin, tocainide

Class IC : Propafenone, Flecainide, Moricizine

Class II : All the beta blockers

Class III : Sotalol, Bretylium, Amiodarone

Class IV : All the calcium channel blockers.

96 (b) Mevacor (Lovastatin) is a lipid loweringdrug that acts by inhibition of the HMG COAreductase enzymes. This enzyme is responsible

for the conversion of 3-hydroxy 3 mehtylglutaryl-coenzyme A to mevalonate, the precursor for ste-rols including cholesterol. The inhibition of biosynthesis of cholesterol reduces the cholesterolin hepatic cells, which stimulates the synthesis of LDL receptors. These will all reduce the synthe-sis of cholesterol. It is indicated for the treatmentof hypercholesterolemia. Abdominal cramps,pain, diarrhea, constipation, dyspepsia, myalgia,and arthralgia are reported side effects of the drug.The recommended dose of the drug is 20 mg once

daily with an evening meal. The other agents inthe same class are:

* Fluvastatin* Atrovastatin* Pravastatin* Cerivastatin




138

97 (a) Doxapram is indicated as the respiratorystimulant agent in postanesthesia and in chronicobstructive pulmonary disease associated withacute hypercapnia. The respiratory stimulant toeffect of this agent is attributed to its ability to

stimulate the respiratory center in the medulla viacarotid chemoreceptors.Ipecac is widely used as an emetic in ac-

cidental poisoning. It is also used as an expecto-rant.

Dopamine is formed by the decarboxy-lation of 3,4-dihydroxyphenylalanine (DOPA). Itis a precursor to noradrenalin and is also itself aneurotransmitter in CNS. It is indicated for treat-ment of cardiac shock. The vasodilation offeredby dopamine is very important in drawing theblood in the kidney and small bowel during anischemic attack. The diuretic property of dopaminehelps to preserve the renal tubules. The cardiacstimulation improves the deteriorated cardiacfunction. Hypotension is a principal adverse ef-fect of the drug.

Disopyramide is classified as a class IAantiarrhythmic agent. It has profound anticholin-ergic side effects with severe A.V. node suppres-sion properties. It should be carefully used in pa-

tients with congestive heart failure with glaucomaand urinary hesistancy. The major adverse effectsreported are dry mouth, constipation, urinary re-tention and blurred vision.

98 (b) Acetylcysteine is classified as an expec-torant, an agents that loose as and liquefying themucous, soothes irritated mucosa and makecoughs more productive. It generally decreasesthe viscosity of bronchial secretions and facilitiesthe excretion of cough. It is also indicated as an

antidote to minimize hepatic toxicity in acute ac-etaminophen overdose. Other expectorants in-clude: guaifenesin, ipecac, potassium iodide andsodium iodide, terpin hydrate.

Dextromethorphan and benzonatate areclassified as antitussive agents, the substances thatspecifically inhibit or suppress the act of cough-ing. Benzonatate acts peripherally by anesthetiz-

ing strech receptors in the respiratory passage andreducing the cough reflexes. Dextromethorphanand codeine act centrally by depressing the coughcenter in the medulla.

Terbutaline is indicated as a bonchodilator

for asthma patients and as a uterine relaxant inpremature labor.

99 (b) Terbutaline is indicated as uterine relaxantfor women in labor.

100 (b) Ipratropium is an atropine-like drug. It isindicated for the treatment of asthma and chronicobstructive pulmonary disease. Dryness of mouth,irritation in the throat, blurred vision and mildbradycardia have been reported with the drug.

Retrovir is indicated for treatment of HIV.Anemia and neutropenia have been reported.Retrovir induced anemia can be treated by theuse of Epogen.

Carvedilol is a new beta blocker just re-cently introduced in the market. It is indicated fortreatment of CHF.

Latanoprost is a prostaglandin analog in-dicated for treatment of glaucoma. It should berefrigerated.

101 (b) Cyclobenzaprine is indicated for treat-ment of muscle spasm associated with acute,painful musculoskeletal conditions. It is ineffec-tive in treating muscle spasm due to a central ner-vous system disease.

Dantrolene sodium is indicated in con-trolling treatment of spasticity resulting from up-per motor neuron disorders such as spinal cordinjury, stroke, cerebral palsy or multiple sclero-

sis. It is not indicated for skeletal spasm resultingfrom rheumatic disorders. The major adverse ef-fect reported with Dantrolene is hepatotoxicity.

Bromocriptine is indicated for treatmentof Parkinsons. It is a dopamine receptor agonist.The principal adverse effect associated with theuse of Bromocriptine is lung toxicity.



139


Amphetamine is indicated for treatmentof Attention Deficit Hyperactivity Disorder. It is acontrolled II drug. Central system stimulation andinsomnia have been reported with use of Amphet-amine.

102 (c) Parlodel (Bromocriptine) is classified asan antiparkinsons drug. It is indicated for the treat-ment of Parkinsonism. It is a dopamine receptoragonist. The recommended dose of the drug is2.5 mg to 5 mg twice daily with meals. Pulmo-nary dysfunction is the principal side effect of thedrug.

103 (b) Diamox (Acetazolamide) acts throughthe inhibition of carbonic anhydrase enzymes. Itis indicated for treatment of glaucoma, epilepsyand edema. The recommended dose of the drugis 250 mg to 1000 mg per day. Nausea, vomit-ing, seizure, bone marrow depression, electro-lytes loss, hemolytic anemia, and toxic epidermalnecrosis are reported side effects of the drug.

104 (b) Zaroxolyn (Metolazone) is classified asa thiazide diuretic. It increases the excretion of Na, Cl, and H 2O. It is indicated for the treatment

of edema associated with CHF, renal disease andnephrotic syndrome. The recommended dose of the drug is 5 to 20 mg once daily. Electrolyte lossis a common complication of Metolazone therapy.

105 (d) ACE inhibitors therapy associated withan increase in serum concentrations of potassium.Amiloride, Spironolactone and Triamterene arepotassium sparing diuretics and may cause hy-perkalemia if used simultaneously with ACEinhibitors.

106 (d) All. Probenecid may competitively inhibitthe renal tubular secretion of penicillin, sulfony-lurea, sulfonamide, naproxen, indomethacin, clofi-brate, aminosalicylic acid and pantothenic acid.

107 (b) The I.V. dextrose and glucagon canbe administered for the treatment of insulin

overdose. Glucagon and dextrose cause an in-crease in blood glucose concentration and helpsin relieving hypoglycemia and insulin overdosetoxication.

108 (b) Diabinese (Chlorpropamide) is classi-fied as a sulfonylurea agent. It is indicated for thetreatment of diabetes and as a secondary therapyto treat partial central diabetes insipidus. It hasbeen successfully used as an antidiuretic to re-duce polyuria in patients with this disorder. Hy-poglycemia, severe diarrhea, and water retentionare reported side effects of the drug. The recom-mended dose of the drug is 200 mg to 500 mgper day for treatment of diabetes insipidus.Desmopressin is considered as primary therapyfor treatment of diabetes insipidus.

109 (b) A deficiency of vitamin A generally causesnight blindness. Below are vitamins and theirdeficiency induced diseases.

Vitamin Sources Diseases

Vit A carrots, milk night blindnessfish, liver, oil,

eggsVit B1 germinated beriberi(Thiamin) cereals

Vit B2 milk, yeast, cheilitis(Riboflavin) eggs, meat,

green veg.

Vit B12 milk, liver pernicious anemia(Cyanocobalamin)

Nicotinic acid leafy veg., pellagra(Niacin) wheat, nuts,

pulses

Folic acid green veg., macrocyticcurd, liver anemia




140

Vit C citrus fruits scurvy(Ascorbic) lemon, amla

tomato, green veg.

Vit B6 liver, meat, peripheral

(Pyridoxine) green veg neuropathy

Vit D butter, eggs, rickettsia(Calciferol) cod liver oil, osteoporosis

shark liver oil

Vit E leafy veg.,(Tocopherol) milk

Vit K veg, tomato, bleedingsoybean disorder

110 (b) Methotrexate overdose can be treatedby administering Wellcovorin (Leucovorin Ca).It is a derivative of tetrahydrofolic acid. It is indi-cated to reduce the toxicity associated with over-dose of folic acid antagonists, such asMethotrexate, Pyrimethamine, and Trimethoprim.Allergic reactions such as urticaria and anaphylaxisare reported side effects of the Leucovorin. Itshould be carefully used with 5 FU since the

former enhances the toxicity of the later.111 (b) Alprazolam, Lorazepam, Temazepam,Zolpidem, Zaleplon and Triazolam are short act-ing benzodiazepines and are more preferable touse for older or geratic patients because of theirshort half lives.

112 (b) Mysoline (Primidone) is a prodrug me-tabolites to phenobarbital and phenyl ethylmalonamide. Its sedative, hypnotic and anticon-

vulsion effects are attributed to its ability toincrease the concentration of GABA in the brain.It is indicated for the treatment of tonic-clonicseizure. Ataxia, vertigo, drowsiness, diplopia,nystagmus, nausea and vomiting are reported sideeffects of the drug. The recommended dose of the drug is 100 to 125 mg at bed time.

113 (a) Prozac (Fluoxetine) is classified as anSSRI. It has a prolonged half life. It takes 3 to 5weeks to get the drug completely out of the body.It should be carefully prescribed with MAO in-hibitors. Insomnia is the principal side effect of

the drug. The recommended dose of the drug is20 to 40 mg per day. The concurrent use of thesetwo medications will result in severe hypertensivecrisis. Tranylcypromine is an MAO-A inhibitorand should be avoided by patients takingFluoxetine.

114 (d) Antiseptic controls the growth of micro-organisms and should not be classified as an in-sect control chemical. Insect control chemicalsmay be classified in to four different categories:insecticides, fumigants, repellents, and attracta-nts.

Insecticides: They are further classi-fied according to the type of action that results inthe destruction of insects.

I Stomach poisonII Contact insecticideIII Fumigant

Stomach poison : In this method, the insecticidesare mixed with food that is consume by insects,such as in the control of leaf feeding insects.

Contact insecticides : This is the most commonuse for control of insecticides. In this method, in-secticides should be placed where the contact of insects with the insecticide can be easily achieved.

Fumigants : They are gases or vapors of insecti-cides for the control of insects, usually in closed

spaces.

Repellants : Certain insecticide chemicals possessthe repellant action. This will cause insects to avoidsuch places treated with such insecticides.

Attractants: In this method, the insects are at-tracted by various means such as foods particlessuch as sugar, milk and molasses to feed poisonthem.



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115 (b) It is a suspension form of Barium sulfatemedically used in roentgenography for the exami-nation of the stomach and colon. The principaladverse effect of Barium sulfate is constipation. Itshould be mixed well with food or strained through

gauze before administered to the patient.The solution form of Barium ion is highlytoxic, therefore it is recommended to indicate thefull name of the drug when prescribing. For ex-ample “Barium sulfate” instead of “Barium.”

116 (b) Ascorbyl palmitate is classified as anantioxidant agent that prevents or inhibits the oxi-dations in various pharmaceutical formulations andtherefore prevents the deterioration of variousformulations. These include butylated hydroxya-nisole, ehtylenediamine, potassium metabisulfite,sodium bisulfite and sodium metabisulfite.

A preservative is a substance that inhibitsthe growth of microorganisms and prevents thevarious formulations to get deteriorated from vari-ous microbes such chlorobutanol, dehydroaceticacid, potassium benzoate and potassium sorbate.

Coloring agents may be defined as sub-

stances used for the purpose of imparting color,such as red ferric oxide, carbon black, titaniumdioxide and alizarin.

Flavoring agents may be defined as com-pounds used for the purpose of imparting fla-vors. There are four basics or primary tastes-sweet, bitter, sour and saline. Mannitol, lemon oil,orange oil, peppermint oil, sucrose, vanilla andwild cherry syrup are used for flavoring purposes.

117 (b) Epinephrine hydrochloride solution canbe stabilized by the addition of a small amount of sodium bisulfite, which is an antioxidant.

118 (d) All mentioned choices (FD and C, Dand C, external D and C dyes) are classified ascertified colors.

119 (c) Spicy is not classified as a primary taste.Sweet, sour, bitter and saline are primary tastes.

120. (b) The initial plasma concentration of thedrug is 10 mcg/ml, therefore:

Mcg/ml Hours

10 mcg/ml 05 mcg/ml 8 hours2.5 mcg/ml 8 hours

Total = 16 hours

The half-life of the drug should be 8 hours.

121 (b) The sweet taste of a compound isattributed to the presence of polyhydroxy groups.The sweetness of a compound increases with anincrease in the number of hydroxy groups such asamino and amide groups that contain compounds.

The sour taste of a compound is attrib-uted to the presence of hydrogen ions and lipidsolubility of compounds such as acid, tannins,phenol, lactones and alum.

The presence of cations and anions in thesame compound imparts the saltiness to the com-

pound, i.e. KBr, NH 4Cl and NaCl.Free bases such as alkaloid and amides(molecular weight greater than 300) may imparta bitter taste to the compound, i.e. amphetamines.

122 (a) The alcohol content of low alcoholic elixiris 8 to 10%, and for high alcoholic elixir it is 73 to78%.

123 (a) Erythema multiform (EM) is classified asa dermatological reaction. It is characterized by

the presence of erythematosus macules and pap-ules peripherally, i.e. hands, feet, trunk, legs andforearms.

Toxic epidermal necrolysis (TEN) is gen-erally caused by drugs and group II staphylococci.It is also known as Lyell’s syndrome. It is charac-terized by the presence of erythema all over the




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body. Drugs that may cause this are: penicillin,phenylbutazone, allopurinol, chloramphenicol andsulfonamide.

Steven-johnson syndrome is a severevariant form of erythema multiform (EM). It is

characterized by the presence of erythematosusmacules and papules peripherally, as well as onthe mucous membrane. The skin becomes hem-orrhagic. The drugs that may cause this are sul-fonamide, penicillin, phenytoin, allopurinol, phe-nobarbital and chlorpropamide.

Hirsutism or hypertrichosis is defined asthe presence of hair all over the body. It is a prin-ciple adverse effect of Minoxidil. It is now usedfor the treatment of baldness.

124 (b) N-acetylcysteine is found to be aneffective antidote for the treatment of acetami-nophen overdose. The toxic metabolic productof acetaminophen damages the liver by bindingto the cells of the liver. The normal dose of ac-etaminophen does not cause this since only a smallamount of metabolites form, which may be easilyconjugated with glutathione in the liver.

125 (b) Chlorpromazine, erythromycin estolate,

chlorpropamide, trazodone, certain tricyclic anti-depressants, sulindac and methyldopa may pro-duce cholestatic jaundice. The disease is usuallycharacterized by the presence of fever, chills,nausea, vomiting, anorexia and myallgias.

126 (c) The principal adverse effect of Clindamycin is AAC (antibiotic associated coli-tis). It is classified in the macrolide group of anti-biotics. Severe diarrhea is a reported side effectof the drug.

127 (b) Aplastic anemia is a major adverse effectof Chloramphenicol. The bone marrow toxicityof chloramphenicol is further classified as doserelated or not dose related. The dose relatedeffects of chloramphenicol can be reversed bywithdrawing the drug. The second type, dose notrelated, is fatal and life-threatening. It does not

depend on the duration or dose of therapy andcannot be prevented by withdrawing the drug.

128 (d) Drugs that may cause hemolysis in a pa-tient with G6PD deficiency include: quinine, sul-

fonamide, nitrofurantoin, primaquine, aspirin,phenacetin, quinidine and isosorbide dinitrate.

Immune hemolytic anemia is most com-monly found with methyldopa. Anemia usuallybegins 18 weeks to 4 years after treatment .Mefenamic acid, levodopa and streptomycin arealso reported to cause immune hemolytic ane-mia. Hemolytic anemia is induced by drugs, andreturns to normal rapidly with discontinuation of therapy.

Erythromycin does not producehemolytic anemia in patients with G6PD defi-ciency.

129 (b) Ringing or buzzing (tinnitus) in the ear isassociated with salicylate. It is dose related andgenerally appears at a serum concentration of 20mg/dl or higher. Salicylate induced hearing lossmay return to normal within 3 days after discon-

tinuation of the drug.Permanent hearing loss is reported with

aminoglycoside antibiotics. Neomycin is the mostoto and nephro toxic among the aminoglycosides.

Minocycline, a derivative of tetracyclineis also an ototoxic drug and its use requires greatcaution in older patients.

Loop diuretics such as furosemide,

bumetanide and ethacrynic acid also possess theability to produce ototoxicity.

130 (b) Mellaril (Thioridazine) is classified as anantipsychotic drug. It is indicated for the treat-ment of schizophrenia. Pigmented retinopathy isthe most common side effect of the drug. Theseverity of this side effect is dose and therapy




178

study of a particular drug after the common ad-verse effects reported by number of patients issuch a review. In this review method, there is noscope to modify the patient’s therapy (since theevent has occurred).

Prospective utilization review is generallycarried out before the patient receives the drug.Such as checking a patient’s profile before thepatient receives the drug.

Concurrent utilization review is carriedout at the time when the patient is receiving thedrug.

378 (b) Nolvadex (Tamoxifen) is an es-trogen receptor antagonist indicated for treatmentof breast cancer. Pulmonary embolism, throm-boembolic order, hepatic necrosis, nausea, vom-iting, and diarrhea are reported side effects of thedrug. The recommended dose of the drug is 10to 20 mg b.i.d.

379 (b) Carrots are a good source of vi-tamin-A.

380 (c) Bleeding from the gums, hemor-rhage and retarded healing are important signs of scurvy. Defective bones and teeth are generallyreported with osteomalacia and rickettsia due toa deficiency of Vitamin D.

381 (b) The deficiency of thiamine gen-erally causes the disease Beri-Beri. The patient’sweight and appetite generally decreases and thepatient gets easily tired. Neuritis may occur.

382 (c) The deficiency of Vitamin B 12generally causes pernicious anemia.

383 (b) Green vegetables, liver, curd andpulses are good sources of folic acid.

384 (c) Abnormal destruction of RBC isgenerally classified as hemolytic anemia.

385 (a) Deficiency of Iron normallycauses hypochromic anemia. Hyperchromic ane-mia is normally reported with a deficiency of folicacid and vitamin B12.

386 (c) Ferrous fumarate contains a highamount of elementary iron (33%). Below is thelist of iron salts and their iron contents.

Ferrous sulfate 20%Dried ferrous sulfate 30%Ferrous gluconate 12%Ferrous fumarate 33%

387 (b) Net profit to net worth ratio isthe best indicator of a pharmacy’s profitability,because it compares the net profit to net invest-ment in the pharmacy.

388 (b) Inventory turnover rate generallydescribes the efficiency of a pharmacy. It is gen-erally calculated by dividing the cost of the goodssold by the average of beginning and ending in-ventory.

389 (c) An acid test generally measures

the liquidity of the pharmacy. It can be calculatedby dividing the sum of cash and accounts receiv-able by the current liabilities.

390 (d) The acceptable ratio of Net profitto net sales generally lies between 5 to 7%.

391 (c) The acceptable Net profit to networth ratio for a 10 year old pharmacy would be15%. The target value for this ratio would be 20%.A 40% figure can be achieved in a new phar-

macy.

392 (d) All. This ratio is calculated bydividing profit by inventory. It is a good indicatorof profitability as well as efficiency. It can be usedfor new and old pharmacies. It increases with anincrease in sales of a pharmacy.



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393 (a) The normal target value for netprofit to total asset ratio is between 10 to 20%.Manan Pharmacy’s net profit to total asset ratiois 15%, so it would be considered good.

394 (b) The inventory turnover rate canbe calculated by dividing cost of goods sold bythe average of beginning and ending inventory.

Cost of goods sold = $ 5,00,000Beginning inventory = 2,00,000Ending inventory = 2,20,000

IN TOR = cost of goods soldbeg inv + end inv

2 = 5,00,000 200,000 + 220000

2

= 2.38

The inventory turnover rate should be a minimumof 4 with a target of 6 or higher. MananPharmacy’s turnover rate is below expectations.

395 (b)

396 (b) The ratio of net sales to inven-tory can be calculated as :

= 750,000210,000

= 4

397 (b) Net worth can be calculated by

subtracting total liabilities from total assets.

Net worth = Total assets - total liabilities = 190,000 - 75,000 = 1,15,000

398 (a)

399 (a) Class I type of recalls should beconsidered a potential hazard to health. The prod-uct in question may cause temporary or medi-cally reversible adverse health consequencesshould be classified as a class II type recall. The

product in question is not likely to cause any ad-verse health consequences should be classifiedas a class III type of recall.

400 (c) Category X is contraindicated inpregnancy. Below are the categories and theireffect on pregnancies.

A = Controlled studies show norisk.

B = No evidence of risk in humans.C = Risk cannot be ruled out.D = Positive evidence of risk.

401 (b) Liquidity generally expresses apharmacy’s ability to meet its current liabilities.

402 (b) The acid test generally measuresa pharmacy’s liquidity.

403 (b) Accounts payable are generally

not included in current assets. Cash, accountsreceivable and inventory are part of current as-sets.

404 (b) Fixtures and equipment would beconsidered fixed assets of a pharmacy.

405 (d) Notes payable beyond 1 year areconsidered Long-term liabilities of the pharmacy.Accounts payable, accrued expenses and notespayable within 1 year are considered current li-

abilities of the pharmacy.

406 (b) Acid Test ratio can be calculatedby dividing the sum of cash and accounts receiv-able by the current liabilities.

= 50,000 + 75,000 85,000 = 1.47




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407 (c) Net sales to inventory measuresthe efficiency of the pharmacy.

408 (b) Below expectation.

= Total liabilities Net worth

= 105,000 x 100 165000

= 63.63%

The target value for Total liabilities to net worthration would be 50% or less.

409 (c) The investment of Manan Phar-macy in a fixed asset meets requirements. Thetarget value for this ratio would be 20% or be-low.

= Fixed assets x 100Net worth

= 35000 x 100165000

= 21%410 (b) The price of a prescription filecan be calculated by the following equation:

V = [ (F x R) P] N where

V = Price of prescription file.

F = Total new prescription is dis-pensed in past two years.

R = The % of prescriptions withone or more refill left.

P = The pharmacy’s average pre-scription price.

N = Net profit %

V = [ (80,000 x 0.4) x 50] 0.15= $ 240,000

The owner of the Manan Care Pharmacy is ask-ing $ 350,000 for an existing prescription file,

therefore the asking price is too high.

411 (a) E = Q where P

E = Coefficient of elasticityQ = % of sales quantities changeP = % of price change

In our example, the sales quantities of analgesicbalm has been changed from 60 to 80 (33%change), and the price of balm has changed from3 to 2 (33%). Therefore elasticity of coefficientwould be :

= 33 33= 1

412 (a) When a relative change in rev-enue is the same as relative change in price, it is

known as unitary elasticity.When the relative change in revenue is

less than the relative change in price, it is knownas inelastic demand.

If the relative change in revenue is greaterthan the relative change in price, it is said to beelastic demand.

413 (b) $16.30

R = C P

R = Retail price of drugC = Cost of drugP = Cost complement in %



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Therefore the retail price of insulin would be

= 9.00 0.55= $ 16.30

Cost complements % + % mark up = 100%

414 (c) 66%

The retail price of a drug is $75, therefore themark up on prescriptions would be $30 ($ 75 - $45).

For a $ 45 drug, $ 30 would be the mark up.For a $100 drug ?30 x 100 / 45 = 66% make up

415 (c) $16.30

MU/C = Known retail mark upcost of complement

= 45/55 = 0.81 = 81%R = cost of drug x (100 + MU/C)

= 9 x (181%)= 9 x 1.81 = $ 16.30

416 (c) $ 1200

Rx rent = Total rent x space ratio= 10,000 x 600/5000= $1200

417 (b) The funding for Medicare pro-grams is generally obtained from social security

tax and premiums paid by the participants.

418 (a) Copayment: It is a patient costsharing plan in which the patient has to pay aspecified amount ( normally $ 10 to $ 15) of thecost of prescriptions and a third party will pay theremainder.

Coinsurance: It is a part of a patient costsharing plan in which the patient pays a specifiedpercentage of all the losses incurred.

Deductible: A part of a patient cost shar-

ing plan in which the patient has to pay a fixedamount of the cost (normally $ 250) within a spe-cific period of time (normally 1 year) before thebenefit is paid by third parties. i.e. Total healthcare cost for Mr.X for year 1999 is $1500 andhis deductible is $250, then, the third party willonly pay benefits after the patient pays $ 250 outof his pocket.

Capitation: A form of prospective reim-bursement in which an institution will pay a fixedamount of money to the service provider phar-macy for each patient. In this type of payment,the pharmacy will only make money when the costof medications dispensed to the patient is less thanthe fixed cost provided by the institution.

419 (b) A person who works for an in-surance company and provides the statistical datathat indicates the risk associated with serving thepopulation, and determines the premiums to cover

all the estimated expenses, is known as an actu-ary.

420 (a) The maximum amount that will bepaid by a third party to a pharmacy when thedrug is available from more than one source isdefined as MAC, or maximum allowable cost

Estimated acquisition cost (EAC): Thethird party’s estimate of the prices paid by a phar-macist for a particular drug product.

Actual acquisition cost (AAC): The ac-tual price paid by a pharmacy after all trade, vol-ume and cash discounts.

Average wholesale price (AWP): Thepublished list price of a particular product.




182

421 (b) If a patient pays a full predeter-mined amount to the provider at the beginning of each month is known as Prospective reimburse-ment.422 (b) Mean = 588

= 350+420+530+600+620+635+700+8508

= 588

423 (c) The median of a sample is themiddle value of an experiment. If the sample iseven then calculate the average of the middle val-ues, for example in our experiment the middlevalues are 600 and 620, therefore the medianwould be :

= 600 + 620 2= 610

424 (c) Negatively skewed. The fre-quency distribution of a sample is calculated by= Mean - Median (Mode) = 130 - 155 = -25

If the value of (mean-mode) is negative,the frequency distribution of the sample would benegatively skewed. If the value is positive thenthe frequency distribution of the sample would bepositively skewed.

425 (d) The frequency of distribution canbe bell shaped, skewed, U shaped and or Jshaped.

426 (c) The Pearsonian coefficient can be

calculated by the following formula:

3 (Mean - Median) Standard deviation

= 3 (55 - 45) 35= 0.85

427 (b) Each trial in a Binomial experi-ment comes out a success or failure. The repeatedtrial are independent of previous experiments. Theexperiments generally consists of “n” repeatedtrials. The probability of success remains constant

from trial to trial.An example of this is tossing a quarterfor “n” times to get heads (tails would be consid-ered a failure) each time.

428 (b) The mean of binomial distributioncan be calculated by :

Mean = n x p= 50 x 0.6= 3

429 (b) The range of a set can be calcu-lated by the difference between the highest valueand the lowest value of the experiment.

= 140 - 110= 30

430 (b) The degree of freedom for a tdistribution can be calculated by = n-1 :

= 20-1= 19.

431 (b) The degree of freedom for chi-square test can be calculated by= ( R-1) x (C-1)= (2-1) x (3-1) = 2

432 (a) One sided.

433 (b) Amino acids are joined by pep-

tide bonds in proteins.

434 (d) The secondary structure of pro-tein consists of alfa-helix, beta helix and beta-bend.

435 (d) The denaturation of protein canoccur in the presence of heat, strong acid or or-ganic solvent.



183


436 (c) Sickle cell anemia is a genetic dis-order resulting from the production of variant he-moglobin. It is characterized by pain, lifelonghemolytic anemia and tissue hypoxia. The replace-ment of valine at the sixth position of the beta -

globulin chain for glutamate is responsible for this.The formation of HbS has extremely low solubil-ity compared to HbA, and results in aggregationof molecules to form or create sickle shaped redblood cells.

437 (b) The enzyme with its cofactor isknown as Holoenzyme. Apoenzyme refers to theprotein portion of the holoenzyme. Nonproteincofactors (i.e. Zn +2, Fe+2 ) required for the ac-tivities of certain enzymes are known as Coen-zymes.

438 (b) The process in which the releaseof energy from energy-rich molecules such as glu-cose and fatty acid occurs in mitochondria is com-monly referred to as Oxidative phosphorylation.

439 (b) The breakdown of complexmolecules such as protein, lipid and polysaccha-ride into simple molecules such as carbon diox-

ide, water and ammonia is known as catabolicreaction.

440 (c) Pyruvate is the end product of glycolysis in cells that contain mitochondria. Thecells that lack mitochondria produce lactate in-stead of pyruvate as the end product of glycoly-sis.

441 (c) Glutathione in reduced form isdeficient in patients with G6PD deficiency. Cer-

tain oxidant drugs such as sulfamethoxazole andprimaquine produce hemolytic anemia in patientswith G6PD deficiency.

442 (d) All. Oxidant drug, ingestion of fava beans, and certain types of infections maycause hemolytic anemia in patients with G6PDdeficiency.

443 (b) Lactose is classified as a disac-charides. It consists of glucose and galactose.

444 (b) The pairs of structure that aremirror images of each other are known as enanti-

omers.

445 (b) The principal storage of glyco-gen in the body is found in the skeletal musclesand liver.

446 (b) Hyaluronic acid, heparin andchondroitin are classified as polysaccharides.

447 (b) Bile salts act as an emulsifyingagent for metabolism of lipid in duodenum

448 (b) Steatorrhea is a result of impropersecretion of bile salts from the liver and pancre-atic juice from the pancreas. It normally causes aloss of lipid, fatty acid and lipid soluble vitaminsin feces. The water soluble vitamins such as vita-min C, thiamine and riboflavin have no effect ontheir absorption.

449 (b) Sphingomyelin is a building block

of membrane of nerve tissue.450 (c) An obstruction of the gall blad-der by a cholesterol stone is defined as cholelithi-asis.

451 (b) Luteinizing hormone induces tes-tosterone synthesis in Leydig cells of the testisand ovulation in females. It also stimulates syn-thesis of estrogen and progesterone in the corpusluteum. Follicle stimulating hormone (FSH) and

testosterone stimulate spermatogenesis in the tes-tis.

452 (d) All. BMR, thermic effect of foodand physical activity help in the calculation of en-ergy required by an individual.




184

453 (b) Kwashiorkor is a protein-defi-cient malnutrition disorder. It is usually seen inchildren. Skin lesions, edema, anorexia,depigmented hair and a decrease in plasma albu-min concentration are common symptoms asso-

ciated with this disease.

Marasmus is also known as a proteindeficit disorder. It occurrs due to chronic defi-ciency of calories and can occur even in the pres-ence of intake of adequate protein. Weakness,anemia and extreme muscle weakness are com-mon symptoms associated with this disease.

454 (b) Vitamin D is not a water solublevitamin. It plays an important role in increasingthe uptake of calcium by the intestine. Deficiencyof this vitamin causes osteoporosis, rickettsia andhypocalcemia.

455 (a) Cabbage, spinach, cauliflower,liver and egg yolk are principal sources of vitaminK. The deficiency of this vitamin causes bleedingdisorder.

456 (b) The end product of purine ca-

tabolism is uric acid. The serum concentration of uric acid plays an important role in precipitatinggout. Certain mammals further oxidize uric acidinto allantoin, and this further degrades (only inanimals) to urea or ammonia.

457 (b) The small and circular extrach-romosomal DNA molecules in bacteria that carrygenetic information for future generations areknown as plasmids.

458 (a) Ribosomal RNA comprises 80%of total RNA. Transfer RNA comprises 15% of total RNA and Messenger RNA comprises 5%of the total RNA.

459 (a) Messenger RNA (mRNA) car-ries genetic information from the DNA to cytosolfor protein synthesis.

460 (d) All. UAG, UGA and UAA areknown as Termination codons, Stop codons orNonsense codons. When one of these codonsappears in an mRNA chain, it indicates that thepeptide chain synthesis coded by the mRNA is

about to be complete.

AUG is classified as Initiation codon inthe process of peptide chain synthesis.

461 (a) Dark field microscopy is indi-cated to observe microorganisms that do not stainor are difficult to stain.

Bright field microscopy is the mostly em-ployed microscopic method. It uses visible light.The microorganism generally appears colored ona light background.

Phase contrast microscopy is used toobserve the internal structure of unstained micro-organisms. The specimen should be visualized indifferent degrees of brightness and darkness.

Normarski microscopy is also useful forthe observation of finer details of internal struc-

tures of unstained organisms. It produces threedimensional images. It has better resolution thanPhase contrast microscopy.

Transmitting electron microscopy useselectron beams instead of light rays. It is used tostudy a thin section of cells for the details of inter-nal structure, and is very expensive.

Scanning electron microscopy also useselectron beams instead of light rays, however it

produces three dimensional views of the surfacesof specimens.

462 (c) Acid fast stains generally stain themycobacterium species of bacteria, such as M.leprare and M.tuberculosis.




463 (b) All living cells can be classifiedas prokaryotic or eukaryotic. Most of theprokaryotic cells such as bacteria are unicellularorganisms. These cells lack a nucleus and othermembrane bound structures.

Eukaryotic cells have a nucleus and mem-brane bound structures. Most plants, animals andfungi fall into this class.

464 (c) Most bacteria are able to movethrough the long, thin, helical structure known asflagella. Bacteria with only one flagella located atone end are known as monotrichous, bacteria withtwo flagella located at each end are known asamphitrichous, bacteria with two or more flagellalocated at one or both ends are known as lo-photrichous and bacteria with flagella all over thebody are known as peritrichous.

465 (b) Bacteria that can move awayfrom (negative phototaxis) or move towards(positive phototaxis) the light are known as pho-totaxis.

The movement of bacteria toward oraway from certain substances in their environment

by an unknown mechanism is known as chemot-axis.

466 (a) An AMES test can be used tofind out whether a substance has the capabilityto produce carcinogen. A cancer producing prop-erty is usually associated with the mutagenic (ca-pability of a substance to alter DNA) property of a substance, so determining that a substance iscapable of producing mutagenicity is the first stepto identify carcinogenicity of the substance.

In an AMES test, the growth medium thatlacks histidine is inoculated with salmonella that

stance has the ability to produce mutagenicity andvice versa.

467 (b) The synthesis of protein and lip-ids in cells is generally carried out by endoplas-

mic reticulum.

468 (c) The growth of bacteria remainsconstant in the stationary phase, it dramaticallyincreases in the log phase and decreases in thedecline phase.

469 (b) Moisture, pH, temperature, oxy-gen, hydrostatics pressure, osmotic pressure andradiation are the physical factors needed for thegrowth of the bacteria.

Carbon source, nitrogen source, vitamins,trace elements, sulfur and phosphorus are nutri-tional factors for the growth of bacteria.

470 (c) When the transfer of genetic in-formation from one cell to another cell is carriedout by the plasmid, it is known as conjugation.

471 (a) A Genome (a component of the

bacterio phage) carries the genetic informationsnecessary for replication of new phage particles.The tail sheath of bacteriophage normally helps inthe transformation of genome from the head intothe cytoplasm of the host cell. The plate and tailfibers normally help the bacteriophage to attachto the specific receptor site on the cell wall of thesusceptible host bacterium.

472 (c) The reduction of the numbers of pathogenic microorganisms, up to such an extent

they are not able to produce any kind of disease,is known as disinfection.

manan shroff reference guide for foreign pharmacy licensing exam 2014 2015

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