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A18 D Vaginal infections caused by fungi (vaginal candidiasis) are best treated with topical preparations containing imidazoles. Generally, pessaries are preferred to cream formulations. Gyno-Daktarin pessary contains miconazole (imidazole antifungal). Canesten cream containing clotrimazole (imidazole antifungal) would be an alternative to the pessary. In case of recurrence, a single dose of oral fluconazole (triazole antifungal) 150 mg capsule may be effective. Betadine douche containing povidone-iodine is less effective hydrocodone ibuprofen bt than the imidazole preparations. Ortho-Gynest cream contains estriol, which is used in vaginal atrophy in post-menopausal women. Lamisil tablets containing terbinafine are not indicated in vaginal candidiasis. A19 D Omeprazole and rabeprazole inhibit gastric acid formation by blocking the hydrogen-potassium ATPase pump hence the name proton pump inhibitors.

Misoprostol is a synthetic prostaglandin analogue having antisecretory properties, thus helping in the healing of gastric ulcers. Misoprostol is used in elderly patients taking non-steroidal anti-inflammatory drugs and in patients in whom the non-steroidal anti-inflammatory drugs cannot be discontinued. Ranitidine decreases the gastric acid output by antagonising the histamine H2- receptor. Proton pump inhibitors, misoprostol and ^-receptor antagonists can all be used in the treatment and prophylaxis of gastric ulcers. A20 A Cradle cap is a form of seborrhoeic dermatitis of the scalp presenting in babies up to 3 months hydrocodone ibuprofen bt of age. The condition appears as scales and crusts on the baby's scalp. It is not contagious and, although it tends to affect babies with a predisposition to food allergy, cradle cap is not a food allergy. The condition, which may be associated hydrocodone ibuprofen bt with nappy rash, resolves spontaneously within a year. First-line treatment is the application of almond oil, arachis oil or baby oil on to the scalp, leaving it overnight and then washing it off the next day. A21 A The structure is an 18-carbon steroid and represents estradiol, an oestrogen. A22 E Daktarin cream containing the imidazole antifungal miconazole, is a brand marketed by Janssen-Cilag. A23 B Otrivine drops containing the nasal decongestant xylometazoline, is a brand marketed by Novartis. A24 D Rhinocort Aqua is the proprietary preparation of a topical nasal spray containing the corticosteroid budesonide and is marketed by AstraZeneca.

Buscopan contains hyoscine butylbromide, which is a quaternary ammonium compound with antimuscarinic properties. It is used as an antispasmodic and therefore may be useful in irritable bowel syndrome.

Hyoscine butylbromide, as with all antimuscarinics, must be used with caution in patients with prostatic hypertrophy, as they may lead to urinary retention. A26 C Voltarol is a proprietary preparation of diclofenac. Diclofenac, like all the nonsteroidal anti-inflammatory drugs, may lead to bronchoconstriction (particularly when used systemically) and therefore must be used with caution in asthma.

A27 D Natrilix is a proprietary preparation of indapamide, a thiazide diuretic and hence may cause gout as a side-effect. A28 A Acetazolamide is a carbonic anhydrase inhibitor, used primarily in glaucoma to reduce aqueous humour production. Acetazolamide may cause blood disorders including agranulocytosis (deficiency of neutrophils) hydrocodone ibuprofen bt as a side-effect. A29 B Amoxicillin is a broad spectrum penicillin antibiotic. Antibiotics tend to cause pseudomembranous colitis as a result of colonisation of the colon by Clostridium difficile following antibiotic therapy. A30 C Atracurium is a non-depolarising muscle relaxant, which may cause respiratory depression as a side-effect. A31 A Doxorubicin is a chemotherapeutic anthracycline antibiotic, which may cause cardiotoxicity through the free-radical mechanism. Cardiotoxicity limits the clinical usefulness as a result of which doxorubicin has a total cumulative dose of about 450 mg/m2 body surface area. Patients with pre-existing cardiac disease, elderly patients and patients who have received myocardial irradiation must be treated cautiously and cardiac monitoring may be required. A32 B Methotrexate is an antimetabolite chemotherapeutic agent, which may also be used for severe resistant psoriasis. The dose is usually administered orally once a week. Haematological and biochemical parameters are monitored throughout treatment.

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