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Pharmacokinetics
100

Lopressor is known as?

metoprolol 


References

  1. Lexi-Comp Online TM, Lexi-Drugs TM, Hudson, Ohio, Lexi-Comp Inc.; November 9, 2015.
100

An epilepsy patient complains of visual disturbances and swollen gums (gingival hyperplasia). Which medication is the likely cause of this patient's complaints?

phenytoin 

References

  1. Gidal BE, Garnett WR. Epilepsy. In: Dipiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. Pharmacotherapy: A Pathophysiologic Approach. 6th ed. New York, NY: McGraw-Hill; 2005:1041-1042.
  2. Griffin EA Jr, Lowenstein DH. Pharmacology of Abnormal Electrical Neurotransmission in the Central Nervous System. In: Golan DE, ed. Principles of Pharmacology: The Pathophysiologic Basis of Drug Therapy. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2008:230-234.
  3. Lexicomp Online. Lexi-Drugs, Hudson, Ohio: Lexi-Comp, Inc. https://online-lexi-com.srv-proxy1.library.tamu.edu/lco/action/doc/retrieve/docid/patch_f/7489. Accessed: August 13, 2018.
100

The treatment of choice for primary dysmenorrhea in a 12-year-old girl is...

Ibuprofen



References

  1. Epocrates (Epocrates Rx Pro) [IOS application]. Epocrates, inc; Ver 15.4/ Dec 30, 2014.
  2. American Academy of Pediatrics. Ibuprofen dosage table for fever and pain. Healthychildren.org. Web site. Updated May 23, 2016. 
  3. Bernardi M, Lazzeri L, Perelli F, Reis FM, Petraglia F. Advances in pediatrics. https://www-ncbi-nlm-nih-gov.srv-proxy1.library.tamu.edu/pmc/articles/PMC5585876/. Published September 5, 2017. Accessed July 2, 2018.
100

primary lipid target that must be reduced in the treatment of high blood cholesterol?


LDL cholesterol 

References

  1. High Cholesterol. Remedy’sHealthCommunities. Available at: http://www.healthcommunities.com/high-cholesterol/treatment-lifestyle-changes.shtml. Accessed July 15, 2015.
100

What is the most appropriate route of administration for a drug with an elimination half-life of 1 hour?

Intravenous infusion 


References

  1. Yu AC, Shargel L. Nonlinear Pharmacokinetics. In: Shargel L, Yu AC. eds. Applied Biopharmaceutics & Pharmacokinetics, 7e. New York, NY: McGraw-Hill; 2016. http://0-accesspharmacy.mhmedical.com.crusher.neomed.edu/content.aspx?bookid=1592&Sectionid=100671381. Accessed October 25, 2015.
200
another name for Hydrodiuril? 

 hydrochlorothiazide (HCTZ).


References

  1. Lexi-Drugs Online, Hudson, Ohio: Wolters Kluwer Clinical Drug Information, Inc; 2018; July 21, 2018.
200

Which of these scenarios would be appropriate for a pharmacist to report to the FDA MedWatch system?

1. A doctor prescribes a medication that requires documented laboratory testing before dispensing.

2. A patient submits a prescription that appears to be altered.

3. A patient requests an early refill on a Schedule II drug.

4. An unusual adverse event occurred when the patient took a medication.

5. A patient requests a vacation supply of medication.




Scenario 4


References

  1. MedWatch Information & Adverse Event Reporting Program. FDA. https://www.fda.gov/safety/medwatch-fda-safety-information-and-adverse-event-reporting-program. Accessed February 22, 2020.
  2. Marsh DES. Adverse Drug Reactions - Clinical Pharmacology. Merck Manual Professional Edition. https://www.merckmanuals.com/professional/clinical-pharmacology/adverse-drug-reactions/adverse-drug-reactions?query=medwatch. Reviewed July 2018. Modified August 2018. Accessed February 22, 2020.
  3. Cohen MR. Medication Errors: Causes, Prevention, and Risk Management. Boston: Jones and Bartlett; 2000:xvi.
200

How long should patients use a laxative product before consulting a physician?

7 days 

References

  1. Handbook of Nonprescription Drugs, 18th Edition. American Pharmacists Association, 2015. Accessed via www.pharmacylibrary.com. October 2, 2015.
  2. Porter RS, Kaplan JL, Lynn RB, Reddy MT. The Merck Manual of Diagnosis and Therapy. 20th ed. Kenilworth, NJ: Merck Sharp & Dohme Corp., a subsidiary of Merck & Co. inc.; 2018:69-73.
200

What vitamins are fat-soluble?

Vitamin A, Vitamin D, Vitamin E and Vitamin K 

References

  1. Porter RS, Kaplan JL, Lynn RB, Reddy MT. The Merck Manual of Diagnosis and Therapy. 20th ed. Kenilworth, NJ: Merck Sharp & Dohme Corp., a subsidiary of Merck & Co. Inc.; 2018:4. 
  2. DiPiro CV, Schwinghammer TL, DiPiro JT, Wells BG. Pharmacotherapy Handbook. 10th ed. New York, NY: McGraw-Hill; 2017:616-30
200

An intern wrote an order for 3 gm vancomycin (infused over one-half hour) every 24 hours. 

Is the dosing and infusion duration appropriate?

Too high and the infusion duration is too short. 

(A normal dosage regimen of vancomycin is 1 gm q 12 hr given over at least an hour). 


References

  1. McEvoy GK, ed in chief, Snow ED, ed. AHFS: Drug Information. Bethesda, MD: American Society of Health-System Pharmacists; 2015.
300

pharmacologic class of Imitrex..

Serotonin agonist 


References

  1. Crosby, SJ. Headache. Zeind, CS and Carvhalo, MG. Applied Therapeutics: The Clinical Use of Drugs, 11th ed. Philadelphia, PA: Wolters Kluwer, 2018. Available at https://pharmacy-lwwhealthlibrary-com.srv-proxy1.library.tamu.edu/book.aspx?bookid=2324. Accessed August 2, 2018.
  2. Lexicomp Online, Lexi-Drugs Online, Hudson, Ohio: Wolters Kluwer Clinical Drug Information, Inc.; 2018; Available at https://online-lexi-com.srv-proxy1.library.tamu.edu/lco/action/home?siteid=1. Accessed August 2, 2018.
300

What is a well known side effect of the ACE inhibitor captopril?

Cough 


References

Epocrates (Epocrates Rx Pro) [IOS application]. Epocrates, inc; Ver 15.4/ Dec 30, 2014.

300

What is the most important information to tell a patient regarding administration of Synthroid?

Take on an empty stomach. 


References

  1. Singh N, Singh P, and Hershman J. "Effect of Calcium Carbonate on the Absorption of Levothyroxine," JAMA, 2000, 283:2822-25.
    AACE, TES, and ATA Joint Position Statement on the Use and Interchangeability of Thyroxine Products. American Thyroid Association Web site. Available at: http://www.thyroid.org/professionals/advocacy/04_12_08_thyroxine.html. Accessed June 14, 2009.
  2. Lexicomp Onlie. Lexi-Drugs (online database]. Hudson, OH: Wolters Kluwer Clinical Drug Information, Inc., 2018. Available at https://online-lexi-com.srv-proxy1.library.tamu.edu/lco/action/home?siteid=1. Accessed August 2, 2018.
300

What does the classifications of A, B, C, D, and X in the package insert of approved drugs refer to?

fetal risk if taken by a pregnant mother


References

  1. Ung, KD and McNulty, J. Obstetric Drug Therapy. In Alldredge, BK, Corellia, RL, Ernst, ME, Guglielmo, BJ, Jacobson, PA, Kradjan, WA, and Williams, BR. Applied Therapeutics: The Clinical Use of Drugs, 10th ed. Philadelphia, PA: Lippincott, Williams and Wilkins, 2013. Available online at lwwhealthlibrary.com. Accessed Nov. 5, 2015.

 

300

A 27-year-old woman recently received prescriptions for lorazepam and paroxetine for treatment of generalized anxiety disorder. When counseling the patient, it is important to tell her that the full therapeutic effects of lorazepam will occur within how long?

7 days 

References

  1. Lexi-Comp Online. Lexi-Drugs. Hudson, OH: Lexi-Comp Inc; 2015.
400

What is the MOA of Digoxin?

Inhibits the sodium/potassium ATPase pump


References

  1. Lexi-Comp OnlineTM, Lexi-DrugsTM, Hudson, Ohio, Lexi-Comp Inc; September 1, 2015.
  2. DiPiro CV, Schwinghammer TL, DiPiro JT, Wells BG. Pharmacotherapy Handbook. 10th ed. New York: McGraw-Hill; 2017:83.
  3. Epocrates Online. https://online-epocrates-com.srv-proxy1.library.tamu.edu/drugs/197/digoxin. Accessed August 1, 2018.
400

What is the serious side effect associated with Tegretol (U.S. black box warning)

a. QT prolongation 

b. Rhabdomyolsis 

c. Blood dycrasias. 

Blood dyscrasias


References

  1. Hadjikoutis S, Pickersgill TP, Smith PE. Drug points: weight loss associated with levetiracetam. BMJ 2003;327:905.
  2. Tohen M, Castillo J, Baldessarini RJ, et al, "Blood Dyscrasias With Carbamazepine and Valproate: A Pharmacoepidemiological Study of 2,228 Patients at Risk," Am J Psychiatry, 1995, 152(3):413-8.
  3. Epocrates (Epocrates Rx Pro) [IOS application]. Epocrates, inc; Ver 15.4/ Dec 30, 2014.


400

What herbal product is used to prevent UTI?

Cranberry 


References

  1. Cranberry. National Center for Complementary and Integrative Health (NCCIH). https://nccih-nih-gov.srv-proxy1.library.tamu.edu/health/cranberry. Updated November 30, 2016. Accessed on February 6, 2019.
  2. Sihra N, Goodman A, Zakri R, Sahai A, Malde S. Nonantibiotic prevention and management of recurrent urinary tract infection. Nat Rev Urol. 2018;15(12):750-76. doi:10.1038/s41585-018-0106-x.
400

The performance of a specialty pharmacy is being evaluated as it relates to patient health and safety. If the processes meet nationally regarded standards for quality and safety, accreditation will be given. Which agency provides this service?

Joints Commission 


References

  1. Geason KM, Brake H, Agramonte V, Perfetti C. Medications at Transitions and Clinical Handoffs (MATCH) Toolkit for Medication Reconciliation. (Prepared by the Island Peer Review Organization, Inc., under Contract No. HHSA2902009000 13C.) AHRQ Publication No. 11(12)- 0059. Rockville, MD: Agency for Healthcare Research and Quality. Revised August 2012.
  2. Porter RS, Kaplan JL, Lynn RB, Reddy MT. The Merck Manual of Diagnosis and Therapy. 20th ed. Kenilworth, NJ: Merck Sharp & Dohme Corp., a subsidiary of Merck & Co. Inc.; 2018:2907.
400

A clinician wants to administer medication in a way that will avoid first-pass drug metabolism. What routes of administration could the pharmacist suggest?

Inhalation, intravenous, sublingual, and transdermal routes of administration can be used to avoid extensive first-pass metabolism.


References

  1. Porter RS, Kaplan JL, Lynn RB, Reddy MT. The Merck Manual of Diagnosis and Therapy. 20th ed. Kenilworth, NJ: Merck Sharp & Dohme Corp., a subsidiary of Merck & Co. Inc.; 2018:15-7.
  2. Pond SM, Tozer TN. First-pass elimination. Basic concepts and clinical consequences.Clin Pharmacokinet. 1984;9(1):1-25.
500

Pharmacological class of Duragesic is...

Opioid receptor agonist. 


References

  1. Fentanyl. In: IBM Micromedex® DRUGDEX® (electronic version). Truven Health Analytics, Greenwood Village, Colorado, USA. Available at: http://www.micromedexsolutions.com.ezproxy.wilkes.edu/ [Updated July 26, 2018: Accessed August 1, 2018]
  2. Product Information: DURAGESIC(R) transdermal system, fentanyl transdermal system. Janssen Pharmaceuticals Inc (per FDA), Titusville, NJ, 2018.
500

A 13-month-old girl presents to her pediatrician for a vaccination appointment. She is scheduled to receive hepatitis B, influenza, MMRV, and pneumococcal conjugate (PCV13). 2 days after her appointment, her father calls to report a red rash on her trunk and arms. She has been fussy and trying to scratch the rash. Examination of her chart reveals reported allergies to neomycin and penicillin.

Question: What is the most likely cause of the reaction?


MMRV

Hepatitis B, influenza (IIV), and PCV13 do not contain neomycin. Vaccinations do not cause active infections, contrary to what some discredited medical sources claim.


References

  1. Birth-18 Years Immunization Schedule. CDC. 2019. https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html. Accessed September 2, 2019.
  2. Measles Outbreak Protect Families & Communities with MMR Vaccine. CDC. 2019. https://www.cdc.gov/measles/downloads/fs-measles-outbreak-508.pdf. Accessed September 2, 2019.
  3. ProQuad - Highlights of Prescribing Information. FDA. 2005. https://www.fda.gov/media/75195/download. Accessed September 2, 2019.
500

A father calls the pharmacy at 6:00 PM after discovering that his 2-year-old son just ingested 18 orange-flavored chewable acetaminophen tablets. What should the pharmacist instruct the father to provide for his son?

Immediate emergency department visit


References

  1. Ipecac: Don't Use It! National Capital Poison Center. https://www.poison.org/articles/ipecac-do-not-use-it. Accessed January 25, 2019.
  2. Farrell SE. Acetaminophen Toxicity. Medscape. https://emedicine-medscape-com.srv-proxy1.library.tamu.edu/article/820200-overview. Updated January 22, 2018. Accessed January 25, 2019.
500

What refrigerator beyond-use date (BUD) can a low-risk compounding facility assign compounded sterile products?

14 days 


References

  1. Jordan ZT. Aseptic Compounding Technique- Learning and Mastering the Ritual. ASHP; 2018:50-1.
  2. American Society of Health-System Pharmacists. ASHP Guidelines on Compounding Sterile Product.  Retrieved on 11/21/19 https://www.ashp.org/-/media/assets/policy-guidelines/docs/guidelines/compounding-sterile-preparations.ashx  page 119
  3. Pharmaceutical compounding—sterile preparations (general information chapter 797). In: The United States Pharmacopeia, 36th rev., and the National Formulary, 31 ed. Rockville, MD: The United States Pharmacopeial Convention; 2013: 361–98. 
500

Elimination of succinylcholine involves which of the following reactions?

Elimination of succinylcholine involves ester hydrolysis within the systemic circulation.


References

  1. Succinylcholine chloride. Facts & Comparisons eAnswers® [online database]. Available at http://online.factsandcomparisons.com.srv-proxy1.library.tamu.edu/. Accessed Oct 16, 2015.
  2. Fifer, EK. Drugs Affecting Cholinergic Neurotransmission. In Lemke, TL, Williams, DA, Roche, VF and Zito, W, eds.. Foye’s Principles of Medicinal Chemistry, 7th ed.. Baltimore, MD: Lippincott, Williams & Wilkins, 2013. Available online at www. lwwhealthlibrary.com.  Accessed Oct. 16, 2015.