SAUDI PROMETRIC PHARMACIST Study Guide 2026

Cocaine causes sympathomimetic toxicity by blocking norepinephrine/dopamine reuptake. In cocaine-associated chest pain/hypertension, non-selective beta-blockers are contraindicated because blocking beta-2 (vasodilation) while leaving alpha-1 (vasoconstriction) unopposed worsens hypertension and coronary vasospasm. Benzodiazepines are first-line.

Hyperkalemia (K+ >5.5 mEq/L) in heart failure is commonly caused by ACE inhibitors (reduce aldosterone, retain K+) and MRAs (spironolactone). Management includes reviewing and potentially reducing/holding potassium-retaining drugs, dietary counseling, and loop diuretics if needed. Carvedilol does not significantly affect potassium.

Unit-dose systems individually package and label each medication dose for a specific patient for a specific time of administration. Studies show unit-dose systems reduce medication administration errors by 50–75% compared to bulk floor stock. Bar code verification further enhances safety at administration.

Tamoxifen requires CYP2D6-mediated conversion to endoxifen (the active metabolite responsible for anti-tumor effect). Strong CYP2D6 inhibitors — especially paroxetine and fluoxetine — dramatically reduce endoxifen levels, potentially reducing tamoxifen's effectiveness. Venlafaxine, citalopram, or mirtazapine are preferred alternatives.

The Saudi Food and Drug Authority (SFDA) is responsible for: drug registration and market authorization, manufacturing facility inspection (GMP compliance), post-marketing surveillance, pharmacovigilance, controlled substance regulation, and ensuring drug quality throughout the supply chain.

Salbutamol is a selective beta-2 adrenergic agonist. Activation of beta-2 receptors in bronchial smooth muscle activates adenylyl cyclase → increases cAMP → activates PKA → phosphorylates myosin light chain kinase → causes bronchial smooth muscle relaxation (bronchodilation).