The higher the factor the greater the degree of protection. A28 B Bioavailability is defined as the relative amount of drug that reaches the systemic circulation and the rate at which the drug appears in the circulation. A29 B Disintegration into fine particles is the first process that occurs when a drug is administered as a solid oral dosage form. The effectiveness of a tablet or solid dosage form in releasing the drug depends on the rate of disintegration. Dissolution rate is the rate at which the solid fine particles dissolve in a solvent. A30 A Lorazepam is a short-acting benzodiazepine indicated for use in relieving anxiety and insomnia. Lorazepam may also be administered perioperatively to alleviate pain and in status epilepticus. Imipramine is a tricyclic antidepressant, paroxetine is a selective serotonin re-uptake inhibitor, venlafaxine is a serotonin and adrenaline re-uptake inhibitor and moclobemide is a reversible monoamine oxidase inhibitor. Imipramine, paroxetine, venlafaxine and moclobemide are all classified as antidepressants. Common childhood vaccines include the three-in-one measles, mumps and rubella and the diphtheria vaccine. Infectious mononucleosis, also known as glandular fever, is caused by the Epstein-Barr virus and no vaccine is available. A32 C The rubella virus results in a self-limiting infection characterised by a rash spreading from the face, trunk and hydrocodone ibupro limbs.
The rubella virus has the most serious effect on the fetus. Rubella occurring during pregnancy, especially during the first trimester, may result in spontaneous abortion, stillbirths or congenital malformations. A33 D The first-line agents in the treatment of rheumatoid arthritis are non-steroidal anti-inflammatory drugs such as diclofenac. Diclofenac and indometacin, another NSAID, tend to have similar activity; however, indometacin has a higher incidence of side-effects and therefore diclofenac is more appropriate for initial treatment. Sodium aurothiomalate is classified as a disease-modifying antirheumatic drug and is used as a second-line treatment hydrocodone ibupro in rheumatoid arthritis, but has been superseded by methotrexate, administered weekly. Paracetamol is often indicated in the management of osteoarthritis. Local intra- articular injections of dexamethasone may be administered for the relief of soft-tissue inflammatory conditions. A34 C Patients allergic to penicillin may be cross-sensitive to cephalosporins.
Cephalosporins (cefaclor, first-generation cephalosporin) are therefore avoided in these patients and instead macrolides (for example, erythromycin) are generally administered. A35 D Meloxicam is a partially selective cyclo-oxygenase-2 inhibitor and is therefore less likely to cause gastrointestinal side-effects, such as bleeding, than other NSAIDs. A36 C Paracetamol overdose is most likely to cause hepatic necrosis and to a lesser extent renal necrosis. Hepatic necrosis is maximal within 3-4 hours of ingestion and may lead to encephalopathy, haemorrhage, hypoglycaemia, cerebral oedema and death. Acetylcysteine tends to protect the liver if given within 10-12 hours of paracetamol poisoning. The maximum adult dose of paracetamol is 4 g in 24 hours. A37 B Diazepam, a long-acting benzodiazepine can be used either intravenously (risk of thrombophlebitis) or intramuscularly or rectally (both of the last two routes are associated with slow absorption). Other corticosteroids also available orally include prednisolone, betamethasone, cortisone acetate, methylprednisolone, dexamethasone and fluocortolone. A39 A Hydrocortisone hydrocodone ibupro is the least potent corticosteroid. A40 D Fluticasone is available for inhalation as Flixotide inhaler as well as Flixonase nasal spray. Furosemide, a loop diuretic, inhibits re-absorption from the ascending loop of Henle in the renal tubule. A42 A Loop diuretics should be used with caution in patients with urinary retention, for example, patients with enlarged prostate as they may cause urinary retention.
Small doses and less potent diuretics should be used. A43 C Spironolactone is a potassium-sparing diuretic. It is an aldosterone antagonist and potentiates the action of loop or thiazide diuretics. A44 A Chlorpromazine is an aliphatic antipsychotic with marked sedative properties. A45 C Haloperidol is a butyrophenone that is associated with a high incidence of extrapyramidal side-effects. It brings about a rapid control of agitation and restlessness and is preferred to chlorpromazine in the elderly because it causes less hypotension.
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