Kuwait MOH Pharmacist Exam flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Heparin mechanism of action

Heparin binds antithrombin III and accelerates inactivation of thrombin and factor Xa. Its effect is monitored by aPTT, and protamine sulfate is the antidote for overdose.

Warfarin mechanism of action

Warfarin inhibits vitamin K epoxide reductase, decreasing synthesis of factors II, VII, IX, X and proteins C and S. Effect is monitored by INR and reversed by vitamin K1.

First-order elimination kinetics

In first-order kinetics a constant fraction of the drug is eliminated per unit time, so half-life is constant and equals 0.693 divided by the elimination rate constant.

Aminoglycoside ribosomal target

Aminoglycosides bind the bacterial 30S ribosomal subunit, causing misreading of mRNA and bactericidal, concentration-dependent killing. Dose-limiting toxicities are nephrotoxicity and ototoxicity.

Lithium therapeutic range

Serum lithium is usually maintained at 0.6-1.2 mEq/L. Toxicity presents with coarse tremor, ataxia, vomiting and confusion, and renal and thyroid function require periodic monitoring.

Metformin key counselling points

Metformin is first-line therapy for type 2 diabetes and rarely causes lactic acidosis. It is withheld around iodinated contrast when renal function is poor, and gastrointestinal upset is reduced by taking it with food.

INR target in atrial fibrillation

For stroke prevention in non-valvular atrial fibrillation, warfarin is titrated to a target INR of 2.0-3.0, whereas mechanical mitral valves generally require 2.5-3.5.

Phenytoin therapeutic range

Total phenytoin is therapeutic at 10-20 mcg/mL. It shows saturable zero-order kinetics, so small dose increases can cause toxicity, and free levels rise in hypoalbuminemia.

Tall man lettering

Tall man lettering uses mixed capitalization, such as DOBUTamine versus DOPamine, to highlight look-alike, sound-alike drug names and reduce selection errors during prescribing, dispensing and administration.

High-alert medications

High-alert medicines carry an increased risk of harmful error. Examples include insulin, heparin, opioids, concentrated potassium chloride and chemotherapy, which need independent double-checks and standardized storage.

Legal prescription elements

A valid prescription contains patient identifiers, date, drug name, strength, dose, route, frequency, duration, quantity, and the prescriber's signature with licence details.

Medication reconciliation definition

Medication reconciliation is a formal process of obtaining and comparing a patient's full medication list at admission, transfer and discharge to prevent omissions, duplications and dosing errors.

t90 shelf life calculation

For first-order degradation, t90, the time for 10% potency loss, equals 0.105 divided by the rate constant k, and usually defines the product shelf life.

Bioequivalence 90% confidence interval

Two products are bioequivalent when the 90% confidence intervals for the ratios of AUC and Cmax fall within 80-125% of the reference product.

Magnesium stearate tablet function

Magnesium stearate is a tablet lubricant that prevents sticking to punches and dies. Excess amount or over-mixing slows dissolution and weakens tablet bonding.

Noyes-Whitney dissolution equation

Dissolution rate is proportional to surface area and the concentration gradient across the diffusion layer, and inversely proportional to layer thickness, so particle size reduction increases dissolution.

Enalapril as prodrug

Enalapril is an ester prodrug hydrolyzed in the liver to enalaprilat, a potent angiotensin converting enzyme inhibitor. The prodrug strategy improves oral bioavailability.

Sulfonamide structure-activity requirements

Sulfonamides need a free para-amino group and an unsubstituted sulfonamide nitrogen for activity. They act as false substrates for dihydropteroate synthase in bacterial folate synthesis.

Ester versus amide anesthetics

Ester local anesthetics such as procaine and benzocaine are hydrolyzed by plasma esterases and can cause allergy through para-aminobenzoic acid; amide agents are more stable and hepatically metabolized.

S-warfarin potency

Warfarin is a racemic mixture. S-warfarin is roughly 3-5 times more potent as a vitamin K antagonist and is metabolized mainly by CYP2C9, the principal site of drug interactions.

Drug registration in Kuwait

Pharmaceutical products must be registered with the Kuwait Ministry of Health before marketing, with the Kuwait Drug and Food Control Administration assessing quality, safety and efficacy data.

Narcotic prescription requirements

Narcotic and controlled medicines require a special prescription, cannot be refilled, and every supply must be entered in a dedicated register kept available for authority inspection.

Pharmacist confidentiality duty

Pharmacists must keep patient health information confidential and disclose it only with consent or where legally required, and must not dispense prescription medicines without valid authorization.

Adverse drug reaction reporting

Suspected adverse drug reactions should be reported to the national pharmacovigilance authority, especially serious or unexpected reactions and those involving newly marketed medicines.

Laminar airflow hood use

Horizontal laminar airflow hoods protect non-hazardous sterile products. Hazardous drugs such as cytotoxics require a Class II biological safety cabinet that also protects the operator.

0.22 micrometer filter purpose

A 0.22 micrometer membrane filter sterilizes heat-labile solutions by removing bacteria and spores, whereas 0.45 micrometer filters are used for clarification and do not ensure sterility.

Bacillus stearothermophilus indicator

Spores of Bacillus stearothermophilus serve as the biological indicator for moist heat autoclave sterilization because they are highly resistant to saturated steam.

Beyond-use date aqueous orals

Compounded water-containing oral preparations without preservative are typically assigned a 14-day refrigerated beyond-use date, while nonaqueous dosage forms may be assigned up to 180 days.

Foxglove cardiac glycosides

Digitalis purpurea leaves contain cardiac glycosides such as digitoxin and digoxin, which inhibit sodium-potassium ATPase, raising intracellular calcium and increasing cardiac contractility.

Belladonna tropane alkaloids

Atropa belladonna yields atropine and hyoscyamine, tropane alkaloids that competitively block muscarinic acetylcholine receptors, producing mydriasis and anticholinergic effects.

Dragendorff reagent use

Dragendorff's reagent detects alkaloids by producing orange-red precipitates. Alkaloids are nitrogen-containing basic plant compounds with pronounced pharmacological activity.

Catharanthus roseus alkaloids

Catharanthus roseus, the Madagascar periwinkle, is the source of vincristine and vinblastine, dimeric indole alkaloids that bind tubulin and arrest mitosis at metaphase.