State Medical Faculty Diploma in Pharmacy Final Exam cheat sheet

Bioavailability F = (AUC oral / AUC IV) × (Dose IV / Dose oral); absolute F compares extravascular to IV, relative F compares two non-IV products.

First-pass hepatic extraction reduces oral bioavailability: F = f × (1 − E_H), where f is the fraction absorbed intact and E_H is hepatic extraction ratio.

Noyes–Whitney dissolution rate: dM/dt = (D·A/h)·(C_s − C), so dissolution speeds up with smaller particles (larger A), higher solubility, and thinner diffusion layer.

Stokes' law sedimentation velocity v = d²(ρ_p − ρ_l)g / 18η; viscosity increase slows settling and stabilizes suspensions.

Higuchi square-root release: Q = k_H·t^0.5 for matrix diffusion-controlled systems; zero-order release gives Q = k_0·t.

Henderson–Hasselbalch: for weak acids pH = pKa + log([A⁻]/[HA]); absorption of a weak acid is favored in the unionized (low pH) gastric environment.

Tablet hardness (crushing strength) is measured in kp or N; friability is tested by tumbling and should generally be below 1% weight loss.

Sterilization by moist heat uses saturated steam at 121 °C, 15 psi for 15–20 min (F0 ≥ 8–12 min) to achieve a 10⁻⁶ sterility assurance level.

pH = pKa + log([base]/[acid]) for buffer design; maximum buffer capacity occurs when pH = pKa, and capacity rises with total buffer concentration.

A chiral center requires four different substituents; enantiomers differ in optical rotation but have identical achiral physical properties, while diastereomers differ in all physical properties.

Ester prodrugs are hydrolyzed by esterases to release the active acid/alcohol; amide prodrugs hydrolyze more slowly, giving longer duration.

Bioisosteric replacement (e.g., –OH/–NH₂, –S–/–O–, carboxyl/tetrazole) retains activity while modifying potency, metabolism, or solubility.

The Hammett equation log(K/K₀) = σρ quantifies substituent electronic effects; electron-withdrawing groups (positive σ) accelerate nucleophilic attack at esters.

Aromaticity requires a planar cyclic conjugated system with 4n+2 π electrons (Hückel rule); pyrrole, furan, and thiophene are aromatic heterocycles.

pKa predicts ionization: weak bases (e.g., amines, pKa ~9–10) are protonated and water-soluble at gastric pH but more lipid-permeable at plasma pH.

Spectrophotometric assay uses Beer–Lambert law A = εbc; linearity is validated across the working concentration range for quantitative pharmaceutical analysis.

Alkaloids are basic nitrogen-containing plant constituents (e.g., morphine, quinine, atropine) extracted with acidified water then precipitated by basification with an organic solvent.

Glycosides yield a sugar plus aglycone on hydrolysis; cardiac glycosides (digitalis) act on Na⁺/K⁺-ATPase and require careful drying to preserve potency.

Essential oils are volatile, steam-distillable terpenoids (e.g., menthol, eugenol); fixed oils are non-volatile triglycerides saponifiable with alkali.

Tannins are polyphenols that precipitate proteins and gelatin; they are classified as hydrolyzable (gallic/ellagic) or condensed (proanthocyanidins).

Pharmacognostic identification uses macroscopic organoleptic features, microscopy (stomata type, trichomes, calcium oxalate crystals), and chemical tests (e.g., Dragendorff for alkaloids).

Resins and gums: resins are insoluble in water and soluble in alcohol (e.g., colophony), while gums are hydrophilic polysaccharides that swell in water (e.g., acacia).

Plant collection and drying affect secondary metabolite yield; enzymatic degradation is minimized by rapid drying at controlled temperature, and storage must avoid light and moisture.

Standardization of crude drugs expresses content of marker constituents (e.g., % alkaloid) to ensure batch-to-batch therapeutic consistency.

Receptor occupancy follows the Hill–Langmuir relation: E = Emax·[D]/(Kd + [D]); Kd is the concentration giving half-maximal occupancy.

Competitive antagonists shift the dose–response curve right without reducing Emax; non-competitive antagonists reduce Emax.

Therapeutic index = TD50/ED50 (or LD50/ED50); a small index signals narrow safety margin and need for monitoring.

First-order elimination: t½ = 0.693·Vd/CL; steady state is reached in about 4–5 half-lives, and loading dose = Vd × target concentration.

Cytochrome P450 induction (e.g., rifampicin, phenytoin) lowers substrate plasma levels; inhibition (e.g., ketoconazole, erythromycin) raises them and risks toxicity.

Organophosphate poisoning is treated with atropine (muscarinic block) plus pralidoxime (reactivates acetylcholinesterase before aging); activated charcoal adsorbs many poisons if given early.

Paracetamol overdose depletes glutathione and produces NAPQI; N-acetylcysteine replenishes glutathione and is most effective within 8–10 hours.

Drugs acting on the autonomic system: muscarinic agonists (pilocarpine) increase secretions, beta-blockers reduce heart rate, and alpha-blockers cause orthostatic hypotension.

A prescription-only medicine may be dispensed only on the prescription of a registered medical practitioner; schedule classification determines whether a drug is prescription, pharmacy-only, or general sale.

Narcotic and psychotropic substances require special record-keeping, secure storage, and prescription retention; dispensing without authorization is a criminal offence.

A prescription must contain prescriber identity and registration number, patient details, drug name, strength, dosage form, dose, and date; ambiguous or incomplete prescriptions must be clarified before dispensing.

Labelling requirements include drug name, strength, quantity, batch number, expiry date, storage conditions, and specified warnings (e.g., 'keep out of reach of children').

Expired, adulterated, misbranded, or spurious drugs must be quarantined and destroyed per local regulations; they may not be sold or redistributed.

Pharmacists have a legal duty of confidentiality and must retain dispensing records for the period set by national law, making them available to inspectors on request.

Substitution of a prescribed brand requires legal authority and prescriber or patient consent; generic substitution rules vary by jurisdiction.

A pharmacy must be registered and supervised by a qualified pharmacist; unregistered practice or employing unqualified staff is a punishable offence.

Pharmaceutical care is the responsible provision of drug therapy to achieve definite outcomes that improve quality of life; it requires identifying, resolving, and preventing drug-related problems.

The SOAP note structure (Subjective, Objective, Assessment, Plan) documents clinical pharmacy interventions in a standardized, auditable format.

Therapeutic drug monitoring is indicated for drugs with narrow therapeutic index and good concentration–effect correlation (e.g., digoxin, lithium, phenytoin, aminoglycosides, vancomycin).

Hospital formulary management uses a Pharmacy and Therapeutics Committee to select drugs on efficacy, safety, cost, and availability; the formulary is reviewed periodically.

Adverse drug reaction reporting uses causality assessment (e.g., Naranjo scale) and spontaneous reporting systems; serious reactions must be reported promptly to the regulator.

Medication adherence is measured by pill counts, refill records, and validated questionnaires; non-adherence is classified as primary (not filling) or secondary (incorrect use).

Pharmacoeconomic evaluation types: cost-minimization, cost-effectiveness (cost per outcome), cost-utility (cost per QALY), and cost-benefit (monetary outcomes).

Good storage and distribution practice in hospitals requires temperature monitoring, stock rotation (FEFO), and segregation of high-alert medications to reduce medication errors.