The Saudi Commission for Health Specialties (SCFHS) Exam

 Here are multiple-choice questions (MCQs) relevant to pharmacy practice and preparation for exams like the SCFHS:

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Pharmacology

Medications to Avoid During Pregnancy or With Certain Diseases

1. Medications to Avoid During Pregnancy

Pregnancy introduces unique risks, as many medications can harm the developing fetus. Drugs to avoid include:

Over-the-Counter (OTC) Medications: Benefits and Harms

What Are OTC Medications?

OTC medications are drugs that can be purchased without a prescription to treat minor, self-limiting conditions like

Types of epilepsy

Epilepsy is a neurological condition characterized by recurrent seizures caused by abnormal electrical activity in the brain. The types of epilepsy are classified based on the origin of the seizures and their clinical features, as per the International League Against Epilepsy (ILAE).

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1. Generalized Epilepsy

Seizures begin in and affect both sides of the brain simultaneously.

Types of Generalized Seizures:

antiepileptic drugs

Here’s a classification of antiepileptic drugs (AEDs) based on their categorization as first-line or second-line treatments and the types of epilepsy they are typically used for:

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1. Generalized Epilepsy

First-Line Drugs

The appropriate dose of a medication for children

The appropriate dose of a medication for children can be calculated using various methods, depending on the drug, child's weight, age, or body surface area (BSA). Here are some common equations:

1. Weight-Based Dosage (mg/kg):

Common Antibiotics and Dosing for Children:

Amoxicillin

Indications: Respiratory infections, ear infections, and streptococcal pharyngitis

Dose:

Cholinergic pharmacology

sympathetic nervous system

Antiepileptic agents

Drug name	MOA	Dose mg\day	Adm.	S\E	Notes
Phenytoin	1	150-600	Orally after meals, IV in severe attacks like st. epilepticus.	·         Gingival hyperplasia (interferes with collagen synthesis so can be used externally in treatment of burns, wound, diabetes ulcers) ·         Decrease vit.B12 absorption (pernicious anemia). ·         Increase folic acid metabolism (megaloblastic anemia). ·         Increase Ca++ metabolism (osteomalacia). ·         Decrease ADH and insulin (hyperglycemia and glucosuria). ·         Hirsutism. ·         Teratogenic. ·         Hepatotoxic.	·         Causes fetal hydantoin syndrome (cleft lip, cleft palate, congenital heart disease, mental deficiency). ·         It induces P-450 activity so increases metabolism of other drugs like antiepileptics, anticoagulants, oral contraceptives, antibiotics and other agents.
Carbamazepine	1	200-2000	Orally, high lipid soluble	·         Osteomalacia. ·         Anemia. ·         Coma, respiratory depression. ·         Vertigo, drowsiness, ataxia, diplopia, nausea, vomiting. ·         Hepatotoxic.	·         It induces liver enzymes. ·         May be used as analgesic in trigeminal neuroalagia and after tooth extraction.
Phnobarbitone	2	60-180	Oral	·         Sedation ·         Ataxia ·         Vertigo, hangover. ·         Behavior disturbances.	·         Sedative, anxiolytic ·         Enzyme inducers.
Primidone	2	250-1000	Oral	Metabolized into Phenobarbital, has the same actions as Phenobarbital.
Valproic acid	2	400-3000	Oral	·       N,V, sedation, ataxia, tremors. ·       Hepatotoxic. ·       Rash, alopecia. ·       Thrombocytopenia. ·       Weight gain.	·         Causes cleft lip.
Ethosuximide	1	500-1500	Orally	·         Dizziness, insomnia, agitation, anxiety, inability to concentrate. ·         Irritation to stomach, N,V. ·         Urticaria. ·         Leucopenia, aplastic anemia, thrombocytopenia.	---
Benzodiazepines			·         orally ·         IV in severe attacks. ·         Rectally in febrile seizure.	·             Tolerance. ·              Drowsiness, sedation, fatigue, behavior       disturbances. ·             Respiratory depression. ·             Cardiac depression with IV adm.	·         Clonazepam and Clorazepate are used for chronic treatment. ·         Diazepam for acute attacks, and rectally for febrile epilepsy.

** Phenytoin, Phenobarbitone, Primidone cause vit. K deficiency in new born leading to bleeding. (give vit. K injection) 

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Macrolide Antibiotics Comparison

·         Structure

·         Mechanism of action

·         Spectrum of activity

·         Indications and uses

·         Pharmacologic properties

·         Drug interactions

·         Key differences

·         Conclusions

·         Brief comparison

Cephalosporin Antibiotics

Cephalosporins are the most frequently prescribed class of antibiotics. They are structurally and pharmacologically related to the penicillins. Like the penicillins, cephalosporins have a beta-lactam ring structure that interferes with synthesis of the bacterial cell wall and so are bactericidal (which means that they kill bacteria).

Aminoglycosides

Aminoglycosides are derived from various species of Streptomyces.

In 1943, Selman Waksman, together with his co-workers, discovered that a fungus Streptomyces griseus produced an antibiotic substance which they named "streptomycin." Selman Waksman was awarded the Nobel Prize in Physiology or Medicine in 1952 for his discovery of streptomycin.

Macrolides

The macrolide antibiotics are derived from Streptomyces bacteria, and got their name because they all have a macrocyclic lactone chemical structure. The macrolides are bacteriostatic, binding with bacterial ribosomes to inhibit protein synthesis. Erythromycin, the prototype of this class, has a spectrum and use similar to penicillin. Newer members of the group, azithromycin and clarithyromycin, are particularly useful for their high level of lung penetration. Macrolide antibiotics are used to treat respiratory tract infections (such as pharyngitis, sinusitis, and bronchitis), genital, gastrointestinal tract, and skin infections.

Tetracyclines

Tetracyclines got their name because they share a chemical structure that has four rings. They are derived from a species of Streptomyces bacteria. Tetracycline antibiotics are broad-spectrum bacteriostatic agents, which inhibit bacterial protein synthesis. Tetracyclines may be effective against a wide variety of microorganisms, including rickettsia and amebic parasites.

Fluoroquinoloness

Fluoroquinolones (fluoridated quinolones) are the newest class of antibiotics. Their generic name often contains the root "floxacin". They are synthetic antibiotics, and not derived from bacteria. Fluoroquinolones belong to the family of antibiotics called quinolones. The older quinolones are not well absorbed and are used to treat mostly urinary tract infections. The newer fluoroquinolones are broad-spectrum bacteriocidal drugs that are chemically unrelated to the penicillins or the cephalosporins. Because of their excellent absorption fluoroquinolones can be administered not only by intravenous but orally as well.

Cephalosporins

Cephalosporins have a mechanism of action identical to that of the penicillins. However, the basic chemical structure of the penicillins and cephalosporins differs in other respects, resulting in some difference in the spectrum of antibacterial activity. Like the penicillins, cephalosporins have a beta-lactam ring structure that interferes with synthesis of the bacterial cell wall and so are bactericidal. Cephalosporins are derived from cephalosporin C which is produced from Cephalosporium acremonium.

Penicillins

The penicillins are the oldest class of antibiotics. Penicillins have a common chemical structure which they share with the cephalosporins. Penicillins are generally bactericidal, inhibiting formation of the cell wall. Penicillins are used to treat skin infections, dental infections, ear infections, respiratory tract infections, urinary tract infections, gonorrhea.

There are four types of penicillins:

Antibiotic resistance

Antibiotics are extremely important in medicine, but unfortunately bacteria are capable of developing resistance to them. Antibiotic-resistant bacteria are germs that are not killed by commonly used antibiotics. When bacteria are exposed to the same antibiotics over and over, the bacteria can change and are no longer affected by the drug.