Adult OTCs
Children OTCs
Antibiotics
Becoming An Intern
Vaccines
100
38 y.o. M states he has been unable to pass a stool for >3 days. He wants relief ASAP. Which two formulations of laxatives/drug products would provide him with the fastest relief?
Enema, suppository
100
My 4-year-old son has a fever of 101.5. I have a bottle of chewable aspirin, but I don’t have chewable Tylenol or Advil. Can I give him the aspirin?” What medication and dosing regimen would you recommend?
A. Do not use aspirin b/c risk for reye’s syndrome. Give Ibuprofen → 5-10 mg/kg/dose every 6-8 hours
B. No aspirin b/c risk for reye’s syndrome. Give APAP → 20-35 mg/kg/dose every 4-6 hours
C. Chewable aspirin is ok! Use up what you have at home.
D. Crush up some ginger root and make a tea out of it. That should help.
A. Do not use aspirin b/c risk for reye’s syndrome. Give Ibuprofen → 5-10 mg/kg/dose every 6-8 hours
100
19 y.o. F picks up a prescription for nitrofurantoin and asks the pharmacist, “I had Bactrim DS last year, what is different about taking this?”
A. 3 day regimen for Bactrim DS vs 5 days for nitrofurantoin
B. Both BID
C. Your urine won’t change color with Bactrim DS
D. All of the above
D. All of the above
100
True or false: A pharmacy intern can counsel patients on new medications as long as they are within earshot of their preceptor.
True
100
Your pharmacy’s computer system flags a 71-year-old patient as being a candidate for their shingles vaccine. When you inform the patient that you can provide them with the new Shingrix vaccine today in the pharmacy, they say they got a shingles shot at their doctor’s office when they turned 65. How do you respond?
Vaccinate today. CDC recommends re-vaccinating with Shingrix if patient was previously vaccinated with Zostavax
200
85 y.o. F asks, “What can I use for lower back pain? I think I pulled it last week. I haven’t tried anything yet. I take 12 pills per day because I had a heart attack last year, so I’m worried about adding an extra pills to my daily regimen.”
A. OTC Topical Lidocaine Patch
B. Icy Hot Cream
C. Ibuprofen
D. Tylenol
E. A or B is appropriate
E. A or B is appropriate
200
7 y.o. F has watery eyes and is rubbing her hand upward against her nose as she sniffles. The dad is looking for an allergy medication for her. The child has no drug allergies and has not tried anything previously. She cannot swallow pills and is not interested in a nasal spray. What would you recommend?
A. Zyrtec oral solution
B. Claritin oral solution
C. Zyrtec chewable tablets
D. Claritin chewable tablets
E. Any of the above
E. Any of the above
200
70 y.o. M is filling a prescription of amoxicillin with directions to take 1000 mg 1 hour before dental procedure.“Does this need to be taken with food? I don’t want to get my teeth full of food before going to the dentist.”
No, you don’t have to take it with food. A small snack would help if you get nauseous from amoxicillin.
200
When taking a transferred prescription over the phone for a controlled medication (schedule 3-5), what information do you need to include on the prescription that you do not need for other medications?
Provider and transferring pharmacy DEA numbers.
200
A family wants to escape the cold Minnesota winter and are traveling out of the US to warmer weather. They are going to an area with risk of typhoid. Based on the time of year and their upcoming travels they want to get their flu shot and typhoid vaccines at the same time if possible. What do you tell them?
Inactive IM vaccine + oral live vaccine if fine to take at the same time
300
44 y.o. M looking for a “pork free” vitamin D supplement. He picks up a bottle of vitamin D capsules and asks you if these are pork free. You don’t see “pork” or “porcine” anywhere in the ingredients. What do you tell him?
The gelatin in the capsules may contain pork. Advise him to use tablets instead of capsules when choosing OTC supplements/medications (still check ingredients for gelatin) and/or call the manufacturer to verify the gelatin is not sourced from pork.
300
6 y.o. F was hiking in the woods at summer day camp. On the child’s arms are red patches with raised, fluid-filled vesicles that developed this morning. The areas are very itchy and slightly painful when itched. A camp counselor confirmed that they spotted a patch of poison ivy on the hike yesterday. What do you recommend?
A. Zanfel (following package directions) to remove the oil from the poison ivy leaf.
B. Thin film of 1% Hydrocortisone cream to help with itchiness.
C. Calamine lotion
D. Both a & b
D. Both a & b
300
31 y.o. F is picking up a 21 day doxycycline prescription regimen for Lymes disease prophylaxis. What are the 3 most important pieces of information to tell her about taking this prescription?
A. Wear sunscreen and stay out of the sun due to sun sensitivity caused by the medication
B. Avoid dairy, calcium, magnesium supplements 2 hours before/after taking the medication because it can bind to the drug and decrease the effectiveness.
C. You may take it with food to reduce nausea. Take it with a full glass of water.
D. Take it on an empty stomach
E. a, b, and c are correct
E. a, b, and c are correct
300
22 y.o. F says her provider accidentally sent her new zolpidem prescription to your CVS pharmacy instead of the Walgreens pharmacy across the street. The pharmacy hasn't processed the prescription yet. She asks if you can transfer it to the other store. What do you tell her?
No, because it must be filled once before can be transferred
300
Route of administration, angle of administration, and needle length for the following vaccine: flu shot
IM + 90° + 1 inch needle
400
25 y.o. F identifying herself as 9 weeks pregnant. She states, “I am so nauseous. I am having a lot of trouble getting out of bed in the morning. Is there anything you can recommend over-the-counter that won’t hurt my baby?”
Pyridoxine 10-25 mg TID or QID (minimal fetal risk).
400
A 13 y.o. Male is brought to the pharmacy by a parent asking for a recommendation to treat his newly developed acne. Assume he hasn’t tried anything before and has <10 pimples. What would you recommend? Provide one counseling point you’d want to tell them.
A. Benzoyl peroxide 2.5%
B. Benzoyl peroxide 10%
C. Salicylic acid 0.5% (Neutrogena Acne Wash)
D. Adapalene 0.1% (Differin gel)
A. Benzoyl peroxide 2.5%
400
39 y.o. F picking up cephalexin for her daughter who just had her wisdom teeth taken out. Patient is allergic to penicillin (full body rash, age 3). The mom is wondering how different this medication is from penicillin and what the chance is that she will have a reaction to this. What is percent crossover?
5-10%
400
Mom is picking up amoxicillin/clavulanic acid suspension to treat their 2-year-old child’s ear infection. They think their child will be “really fussy” about taking the suspension. Which suggestions are appropriate?
A. Mix it with a little brandy or whiskey because it will also help the child sleep
B. Mix it with a small amount of milk in a bottle and make sure the child drinks all of it
C. Mix it with a small amount of ice cream and make sure the child eats all of it
D. Offer to flavor the suspension with a recommended flavor additive recipe (FlavorRx)
E. B, c, and d are appropriate recommendations
E. B, c, and d are appropriate recommendations
400
It’s fall 2018 and you ask a patient if they want their annual flu shot. They say “no, because last year’s was only 10% effective.” How do you respond?
“You should still get the flu shot because the formulation varies year-to-year to try to cover the strains that will be most prevalent.”
500
Adult OTC vs Rx max daily doses of ibuprofen and acetaminophen?
Ibuprofen → 1200 mg OTC; 3200 mg Rx
Acetaminophen → 3000 mg OTC; 4000 mg Rx
500
A parent calls your pharmacy in a panic, concerned that their child ingested dishwasher detergent they found in a low cabinet. Where is somewhere you can you direct them for the best advise?
SafetyCall; Poison Control
500
Zithromax: What is the generic and common dosing?
Azithromycin: Take 500mg today and 250 mg daily on days 2-5.
500
During your community IPPE you give a PPSV23 shot. You forget how to use the safety feature to cap the needle and end up getting a needle stick. Who do you contact immediately?
500
At what age does the average person with no comorbitidies become eligible to receive PPSV23?
65 years old