SPLE #SPLE

1. SIDE EFFECTS
HEART
Q- CASE BP decrease and HR increase we should give him what ?
Ringer solution
6. Patient has allergic rhinitis doctor prescribe pseudoephedrine you found that he has history of hypertension what to do?
Don’t dispense the prescription – use pseudoephedrine with caution if controlled Hypertension
47. African American women take lisinopril and another hypertensive drug suffer from nose swelling and other symptoms what make her
more suspected to this reaction ?
Ethnicity : if no ethnicity in choices .. choose Drug combination
55. Case: age of pa3ent 60 years have HTN,DM and CHF , calculated CHADS2 ?
CHADS2 Score 3
57. Case patient with HTN ,takes lisinopril and carvedilol , His lab result : HR 55 ,BP 70/100 what is your recommendation ?
reduce dose carvedilol
Q- HTN +epilepsy which antidepressant can be used ? Paroxetine = SSRI drug
Q- Which drug cause pneumonia with prolong use ? Amiodaron + Captopril
160. facial edema with?
Captopril
Q- Dug cause vasoconstriction?
Alpha1 adrenoceptor agonists * vasopressin analogs * epinephrine * norepinephrine. Phenylephrine (Sudafed PE) * dopamine *
dobutamine.
24. the main side effect of alpha antagonist (blocker) as prazosin is ?
Postural hypotension (orthostatic hypotension)
28. syncop may occure with the 1st dose of the folowing ?
Prazosin
51. drug alpha 2 agonist cause ?
decrease hypertenstion
25. loop diuretics (furosemide) cause ?
ototoxicity ( deafness)
29. amikacin cause which of the following adverse effect ?
nephrotoxicity(kidney)
31. The most dangerous adv erse effects of Amikacin is ?
(kidney disease)
17. patient use this cycloserine and amikacin drugs for 6 months and he loss hearing Which drug cause that ?
Amikacin
325- Which drug cause constipation?
Answer: Verapamil
36. which one causes hypotension due to blockage of efferent limb ?
bretylium
37. Which one of the following cause hypertensive crisis if withdrawn suddenly ?
Clonidine
45. Drug used in treatment for Hypertension and migraine ?
clonidine or propranolol
40. A Drug causes sodium and water retention ?
Indomethacin
41. Which of the following induce diarrhea ?
Indomethacin
42. B_blockers are contraindicated for hypertensive patient in case of ?
Asthma
43. Drugs induced cough Except ?
Losartan
48. which of the following true?
ACEI cause dry cough (Dry cough cause by? ACEI)
398- What is component responsible of cough in ACE inhibitor
Bradykinin
44. ACEI contraindication?
renal failure
50. antihypertensive drug act by increase of urination ?
Hydrochlorothiazide
52. side effect of thiazide diuretic:
Hypokalemia
53. drug increase excretion of NA, k & increase reabsorption of uric acid
Hydrochlorothiazide

2. Q- Heart Failure EF less than 40 which medication should be avoided ?
CCB
885- Side effects CCB?
Answer E. Adverse effectsFirst-degree atrioventricular block and constipation are common dose dependent side effects of verapamil.
Dizziness, headache, and a feeling of fatigue caused by a decrease in blood pressure are more frequent with dihydropyridines. Peripheral
edema is another commonly reported side effect of this class. Nifedipine and other dihydropyridines may cause gingival hyperplasia.
INTERACTION
678 - Drug accelerate HF
Gabapentin
131. What is the Anti cancer drug that cause cardiotoxicity?
Doxorubicin
123. Cardiotoxicity is caused by:
Celecoxib
Q- Medication interaction with antihypertensive ? celecoxib
Q- Patient with angina which one can worse his case? Celecoxib
Q- Drug Disease interaction?
Answer: Celecoxib and cardiac toxicity
CYP2C9 (Carvedilol, celecoxib, glipizide, ibuprofen, Irbesartan, losartan) (celecoxib=angina)
3- aspirin NSAIDS > contraindicated with CHD
428 What is medication cause ototoxicity ?
1- Loop diuretics (bumetanide,furosemide,torsemide,(ethacrynic acid mostly to cause deafness when used with other ototoxic drugs
lippincot page 248 2- Vancomycin lippincot page 495
3- Aminoglycoside( amikacin, gentamicin, neomycin, streptomycin, and tobramycin) page 505
4- Macrolides (erythromycin, clarithromycin, azithromycin and telithromycin) lippincot page 508
5- Capreomycin lippincot page 530 6- Cisplatin page 611
ArrhythmiA
721- Amiodarone monitoring? liver
153. Amiodaron Side effect :
Pulmonary febrosis
1.Side effect of amiodarone?
Hyperthyroidism ,
Hypotension, bradycardia, corneal microdeposits, dizziness, ataxia, N/V constipation, tremor, drug-induced lupus erythematosus (DILE)
2. Food not used with amiodarone?
Grapefruit
8. Food interaction with amiodarone ? Increased concentration Grapefruit juice
7. Side effect of phenytoin?
Gingiva hyperplasia
Q- Which medication cause arrhythmia if given IV rapidly? (Phenytoin)
18. Mechanism of phenytoin that decease effect of warfarin ??
Strong enzyme inducer
50. Phenytoin decreases the effect of digoxin because ?
a-liver microsomal enzyme inducer b-Liver microsomal enzyme inhibitor
43. digoxin shouldn't be taken with ?
renal failure
58. digoxin toxicity increased with ?
hypokalemia or hypomagnesmia or renal failure all of them
40. life threatening arrhythmia is side effect of
Digoxin
137. a drug increases the effect of highly bound to plasma protein ?
Digoxin
57.drug need serum level monitoring with quinidine ?
Digoxin
36. anti arrhythmic cause lupus:
Procainamide
18. quinidine(anti arrhythmia) side effect ?
Cinchonism
16. Phenobarbital effect on chloramphenicol
Phenobarbital shortens chloramphenicol’s half-life, thereby reducing its therapeutic Effectiveness
17. Nitro glycrin side effect is ? Headache

3. CKD
6. The most dangerous adverse effects of Amikacin is ?
(kidney disease)
8. Drug cause renal disease(kidney injury) ?
Aminoglycosides
1. Most popular to cause acute kidney injury
NSAID
4. cushing - like syndrome is due to ?
adrenal hyperplasia
14. Mg antacid for patient with renal failure the antacid will cause?
decrease the Elimination Of Mg
64. Magnesium is contraindicated in renal impairment because of ?
Accumulation
70. which of the following may cause acute renal failure ?
IV radiological substance
DIABETES
397 Drugs that causes hypoglycemia mask?( Drug mask hypoglycemia)?
Beta blockers , (Carvedilol )
457 Patient has diabetics what drug is contraindicated
Beta blockers because it mask hypoglycemia
14. Side effect of oral hypoglycemic agent
Hypoglycemia
9. Side effect of metformin
Lactic acidosis
10. Patient develop side effect with metformin
Take with meal
41. metformin and metronidazol cause ?
metallic taste
848 which Oral hypoglycemic causes Acute pancreatitis?
Answer Dipeptidyl peptidase 4 (DPP-4) inhibitors Such as: sitagliptin
11 - What is drug no take DM have acute renal? Dapagliflozin –
985- which drug contraindicated in CHF
Answer Pioglitazone
Q- Pioglitazone contraindication ? HF
56. Pioglitazon side effect ? Hypoglycemia
149. What we have to check before initiate canagliflozine?
Renal function
CHOLESTEROL
1. Risk of myopathy due to which drug
Statin drugs
Q- Medication cause pneumonia in long term ? Simvastatin
732- Which Of The Following Have Interaction With Grapefruit
Answer: Simvastatin
Q- Medication increase the lipid ?
Isotretinoin or Amlodipine
Others: * Beta-Blockers * Prednisone * Amiodarone * Cyclosporine * Anabolic Steroids
3. Gemfibrozil + statin?
Sever myopathy (rhabdomyolysis )
15. Drug make rhabdomyolysis When taken with statin?
Gemfibrozil
23. drug interact with statin:
Ketoconazole
17. Decrease myopathy in statin?
Co enzyme Q 10
20. Drug contraindicated with ischemic heart disease patient with dyslipidemia ?
Celecoxib deficiency
CNS
73. woman taking oxycarbamazipine , after 2 weeks of administration , redness and flushing appear ?
keep using oxycarbamazipine
98. Side effect of atropine
urine retention
110. Dopamine causes:
elevate blood pressure
744 –constipation ? SE/ morphine

4. Q- Which of the following is hepatotoxic ?
Tolcapone
184 Which medication for parkinson causes dizziness?
Answer: Apomorphine, pramipexole, ropinirole, rotigotine
31- Side effect of benzodiazepines
Drowsiness and confusion are the most common side effects of the benzodiazepines. Ataxia occurs at high doses Cognitive impairment
32- Lamotrigine side effect ? Skin rash
33-What Is Lamotrigine Side Effects
Significant : rash, aseptic meningitis, blood dyscrasias, CNS depression, suicidal ideation and behavior
Q- Which of the following is the most likely to be associated with CNS side effects in elderly?
H2-antagonists
42-which of the following anesthetics drug has a higher risk of causing hepatic toxicity ?
Isoflurane
76- Which of the following drugs would decrease the amount of minimum alveolar concentration (MAC) for an anesthetic drug?
. diazepam GIT
Q- Drug cause more peptic ulcer
ketorolac
468- Which is most likely to cause heartburn? -Kcl
NSAIDS
Q- Drug cause GIT side effect ?
Answer: -naproxen
102. A drug induces Water retention
indomethacin
71. Early symptoms of aspirin poisoning are ?
ringing in the ears & blurred vision
108. which of this groups indicate pharmacological toxicity
liver cirrhosis and paracetamol
GOUT
Q-Case with acute gout due to use
Answer: Furosemide
Q-allopurinol genetic is HALA_B will be make. side effect of
Answer: Severe cutaneous adverse reactions
HLA-B*58:01 allele is strongly associated with severe cutaneous adverse reactions (SCAR) during treatment with allopurinol if the patient is
positive for HLA-B*58:01 allele
side effect of allopurinol ?
Fever, sore throat, and headache with a severe blistering, peeling and red skin rash.
Q. What will happen if you give Allopurinol to a patient who is positive for HLA-B5801 variant allele?
Answer It will cause severe cutaneous drug reaction (SCDR)
INFECTIONS
16. Which cause irreversible ototoxicity and defness? Aminoglycoside
12. Antibiotic that cause hearing problem? Aminoglycosides , Gentamycin and Vancomycin
13. Which adverse reaction is irreversible? ototoxicity of gentamycin
33. Which one is reversible SE of aminoglycoside
Nephrotoxicity
75. red man syndrome caused by ?
Vancomycin
42. TMP/SMZ Side. Effect on electrolyte
Hyperkalemia may occur, especially with higher doses
56. which antibiotic more likely to cause diarrhea ?
Augmentin
57. antibiotic with diarrhea as a side effect ?
Amoxicillin combination with clavunic
65. metronidazole used in treatment of ?
clostridium difficile
66. clindamycin cause ?
clostridium difficile
 Clindamycin side effect : pseudomembranous colitis
24. Which drug make teeth discoloration?
Doxycycline
95. Drug cause retinopathy?
Hydrocychlorquin

5. OSTEOBLASTS
609 Side effect of bisphosphate ? Osteonecrosis of the jaw
938 - Drug induce esophageal ulcer ? alendronate
Q- Osteoporosis drug cause gastric ulcer ? Alendronate & Risedronate the most osteoporosis drug cause gastric ulcer
Q- What is the most common side effect of bisphosphonate ? GI Reflux
Q- Alendronate ( bisphosphonate ) is given daily and weekly What is the daily dose ?
5mg prophylactic dally and 35mg weekly
10mg therapeutic dally and 70mg weekly
(39) Which of the following osteoporosis drugs can cause esophageal ulcers?
Alendronate CHILD
11. Medication cause growth retardation?
Glucocorticoids , Betamethasone , Cortisone , Dexamethasone , Hydrocortisone , Methylprednisolone ,
Prednisolone , Prednisone , Triamcinolone
20. gray baby syndrome caused by ?
Chloramphenicol
19. Ceftriaxone what cause on neonate?
Ceftriaxone cause hyperalbunimia in neonate PREGNANCY
58- Antiprogesterone cause abortion.
Mifepristone
1-Which antipsychotic drug is not given to pregnant
Bupropion
3-Drugs if used in the first trimester in pregnancy cause anemia of the fetus ? Ciprofloxacin
Q- drug decrease prolactin and used clinically ? Cabergoline
963Drug reduce prolactin.
Bromocriptine
25-bromocriptine ?
reduce prolactin level
10-The medication is approved for increase prolactin secretion?
dopamie antagonist
21-drug cause hyperprolactinemia
Metoclopramide
Q- Drugs avoided in lactation ?
Anticholinergic, lithium, alcohol, tetracycline, chloramphenicol, hormones
Q- Which anti-hypertensive is most risk for child in breastfeeding?
Atenolol
908- Nursing mother suffers from asthma which of the following drugs can decrease Milk secretion
Ipratropium
10 Which hormone is associated with fetal productive abnormalities?
Androgen
199 -Which one associated with growth restriction in pregnancy?
Lisinopril (ACEIs)
Q- HTN patient want to become pregnant what should be do ?
Stop lisinopril
29-Captopril is contraindicated with ? Pregnancy
283- Vitamin should be avoided in high doses in case of pregnancy?
Vitamin A
284 Laxative should be avoided in pregnancy?
Lubricants, mineral oils ( castor oil)
440 Laxative contraindicated in pregnancy? Castor oil
Q- Antimalarial drug contraindicated in pregnancy? Primaquine
12. The antimalarial to be avoided in patients of glucose-6-phosphate dehydrogenase deficiency ?
Primaquine
16-Drug inhibit Estrogen synthesis ? Tamoxifen
57- antiestrogen cause abortion .. ? Anastrozole
Q- Women on mycophenolate and wan to get pregnancy what is the correct counseling?
DC before 6week
324 Which drug should pregnant stop before pregnancy 1 month?
Isotretonion

6. 581- effect of nicotine in pregnant ? Decrease blood flow to uterine
RESPIRATORY
4. Side effect of albuterol
Tachycardia
1. Side effect of albuterol
Common:
Tachycardia, Nausea , Pharyngitis , Viral gastroenteritis , Vomiting, Backache ,Feeling nervous, Headache, Sinus headache, Tremor, Urinary
tract infectious disease ,Bronchitis, Cough, Nasopharyngitis, Pain in throat, Rhinitis , Sinusitis, Upper respiratory infection, Pain.
2. The most side effect associated with ICS inhaled corticosteroids?
Oral thrush
8. side effect of inhaler corticosteroids
ICS deposition on the oral and laryngeal mucosa can cause adverse effects, such as oropharyngeal candidiasis
31. Respiratory acidosis is caused by
CO2 retention
60. Side effect of diphenhydramine ?
Drowsiness
70. Tyramine containing food interact with
Isoniazid
130. What is the the Side effect of ethambutol?
optic neuropathy
25. drug that makes urine red ?
Rifampicin
27. drug make urine red other than rifampicin?
phenazopyridine (Pyridium), and laxatives containing senna
 . Rifampicin, nitrofurantoin : discoloration of urine , red urine
IMMUNIZATION
6. Immunosupressant cause hairsutism?
Cyclosporine
14. Which following decrease immunity?
Cyclophosphamide
52. Thimerosal (mercury)containing vaccine may cause ?
Autism
MIXED
3. propylthiouracil cause ?
Agranulocytosis
53. A drug for hyperthyroidism associated with a agranulocytosis is ? propyl thiouracil
152. Anti plamelate fibrinoletic ?
Streptokinase
16. which of the following indicator for a toxicity of a drug ?
necrosis of liver by acetaminophen
72. Obese patient what the effect of obesity on absorption of lipid soluble drug ?
no effect
97. main side effect of nitrates ?
Headache
9. gray man syndrome caused by ? Amiodarone
 Gray baby syndrome ----> Chloramphenicol induced
 Gray man syndrome ----> Amiodarone induced
 Red man syndrome ----> Vancomycin induced
 Lupus like syndrome ----> Hydralazine & Procainamide induced
114. Which of the following used to counteract toxicity of a drug after 1 hour of ingestion ?
activated charcoal
INTERACTION
58. The concomitant administration of H2 blockers may ?
increase the dissolution rate of enteric-coated naproxen
99. BPH is worsen by ?
anticholinergic drugs
113. drug and disease interaction:
Furosemide and osteoporosis
 . chlorpheniramine (antihistamine) ⬆ incidence of BPH
 Betahistine dihydrochloride :Miener's disease
 . Diseases cause edema: renal failure, CHF
 . Anesthetic cause: cardiotoxicity