Medication Review

Question 1

A structured evaluation of a patient‘s medicines with
the aim of optimizing medicines use and improving health
outcomes

Answer 1

Pharmaceutical Care Network Europe (PCNE)

Question 2

entails detecting drug-related problems and
recommending interventions

Answer 2

MEDICATION REVIEW

Question 3

Different Factors to Determine Proper Medication
Prescription and Individualized Patient Use

Answer 3

Indication
Dose
Frequency
Duration of Therapy
Route of Administration
Therapeutic Duplication
Allergies
Drug Interactions
Other Patient Factors

Question 4

T/F: Drug dose must be optimized based on clinical guidelines
and recommendations, as well as individual patient
parameters such weight, renal and hepatic functions, body
surface area, clinical response, etc.

Answer 4

true

Question 5

EFFECTS OF MEDICATIONS WITH LONG-TERM USE:
Laxatives

Answer 5

Dependence

Question 6

EFFECTS OF MEDICATIONS WITH LONG-TERM USE:
Opioid analgesics

Answer 6

Dependence and Addiction

Question 7

EFFECTS OF MEDICATIONS WITH LONG-TERM USE:
Nitrates

Answer 7

Tolerance

Question 8

EFFECTS OF MEDICATIONS WITH LONG-TERM USE:
Corticosteroids

Answer 8

Adrenal insufficiency

Question 9

FACTORS TO CONSIDER IN DRUG ADMINISTRATION:

Answer 9

Target Site
Patient Status
Dosage Formulation

Question 10

T/F: Extended-release tablets should be
crushed, thus, these are not
recommended for patients on NGT

Answer 10

true

Question 11

A patient is on Metoclopramide (antiemetic) 10 mg IV
every 8H RTC and Ondansetron (also an antiemetic) 4 mg
IV every 8H as needed for nausea and vomiting

Answer 11

THERAPEUTIC DUPLICATION

Question 12

A patient is on Fentanyl patch 50 mcg every 72H
transdermally and Morphine 10 mg tab, 1 tab every 8H as
needed for breakthrough pain

Answer 12

THERAPEUTIC DUPLICATION

Question 13

A patient is on Tramadol 50 mg cap, 1 cap every 6H as
needed for pain and Tramadol 50 mg IV every 8H as
needed for pain

Answer 13

THERAPEUTIC DUPLICATION

Question 14

Use of 2 or more medications belonging to the same
therapeutic class or with the same mechanism of action or
with the same target site of action together

Answer 14

THERAPEUTIC DUPLICATION

Question 15

A patient is on Ceftriaxone 2g IV once daily for CAP and to
be given Cefazolin 2g IV for 1 dose as preoperative
antibiotic prophylaxis

Answer 15

THERAPEUTIC DUPLICATION

Question 16

A patient is on Enoxaparin 40mg every 12H
subcutaneously and Warfarin 1mg tab, 1 tab once daily

Answer 16

THERAPEUTIC DUPLICATION

Question 17

also called “hypersensitivity” reaction to a drug

Answer 17

ALLERGIES

Question 18

Sensitivity of a patient to a different drug which possesses
similar structures to a known allergy-causing agent for the
patient

Answer 18

CROSS-SENSITIVITY (OR CROSS-REACTIVITY)

Question 19

Intradermal injection or pricking with a
small amount of a diluted drug to
determine reactivity based on a control
test

Answer 19

Skin Testing

Question 20

Usually used for antimicrobial agents

Answer 20

Skin Testing

Question 21

Intravenous administration of a small
amount of a drug to determine reactivity
based on patient response

Answer 21

Test Dosing

Question 22

Conversion of a patient with a drug
allergy from a highly sensitive state to a clinically tolerable state by temporarily
modifying patient response to a drug to
allow safe treatment

Answer 22

Desensitization

Question 23

WHAT FDA PREGNANCY SAFETY CATEGORY:

Controlled studies in women fail to demonstrate
a risk to the fetus in the first trimester (and
there is no evidence of risk in later trimesters)

Answer 23

A

Question 24

WHAT FDA PREGNANCY SAFETY CATEGORY:

Possibility of fetal harm is remote

Answer 24

A

Question 25

WHAT FDA PREGNANCY SAFETY CATEGORY: Animal studies have shown no fetal risk but no controlled studies in pregnant women

Answer 25

B

Question 26

WHAT FDA PREGNANCY SAFETY CATEGORY: Animal studies have shown adverse effect that was not confirmed in women during first trimester (and there is no evidence of risk in later trimesters)

Answer 26

B

Question 27

WHAT FDA PREGNANCY SAFETY CATEGORY: Animal studies have revealed adverse effects on the fetus and there are no controlled studies in women

Answer 27

C

Question 28

WHAT FDA PREGNANCY SAFETY CATEGORY: Studies in humans and animals are not available

Answer 28

C

Question 29

WHAT FDA PREGNANCY SAFETY CATEGORY: Positive evidence of human fetal risk is available but the benefits may outweigh the risk for life-threatening or serious diseases for which safer drugs cannot be used or are ineffective

Answer 29

D

Question 30

WHAT FDA PREGNANCY SAFETY CATEGORY: Studies in animals or humans have shown fetal abnormalities OR there is evidence of fetal risk based on human experience OR both

Answer 30

X

Question 31

WHAT FDA PREGNANCY SAFETY CATEGORY: The risk of use of the drug in pregnant women clearly outweighs any possible benefit

Answer 31

X

Question 32

WHAT FDA PREGNANCY SAFETY CATEGORY: Contraindicated for women who are or may become pregnant

Answer 32

X

Question 33

LACTATION SAFETY CATEGORY: Drug which has been taken by a large number of breastfeeding mothers without any observed increase in adverse effects in the infant

Answer 33

L1

Question 34

LACTATION SAFETY CATEGORY: Controlled studies in breastfeeding women fail to demonstrate a risk to the infant and the possibility of harm to the breastfeeding infant is remote; or the product is not orally bioavailable in an infant

Answer 34

L2

Question 35

LACTATION SAFETY CATEGORY: Drug which has been studied in a limited number of breastfeeding women without an increase in adverse effects in the infant;

Answer 35

L2

Question 36

LACTATION SAFETY CATEGORY: There are no controlled studies in breastfeeding women, however the risk of untoward effects to a breastfed infant is possible; or, controlled studies show only minimal non-threatening adverse effects

Answer 36

L3

Question 37

LACTATION SAFETY CATEGORY: And/or, the evidence of a demonstrated risk which is likely to follow use of this medication in a breastfeeding woman is remote

Answer 37

L2

Question 38

Drugs should be given only if the potential benefit justifies the potential risk to the infant

Answer 38

L3

Question 39

There is positive evidence of risk to a breastfed infant or to breastmilk production, but the benefits of use in breastfeeding mothers may be acceptable despite the risk to the infant

Answer 39

L4

Question 40

if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective

Answer 40

L4

Question 41

Studies in breastfeeding mothers have demonstrated that there is significant and documented risk to the infant based on human experience, or it is a medication that has a high risk of causing significant damage to an infant

Answer 41

L5

Question 42

The risk of using the drug in breastfeeding women clearly outweighs any possible benefit from breastfeeding

Answer 42

L5

Question 43

The drug is contraindicated in women who are breastfeeding an infant

Answer 43

L5

Question 44

no known or theoretical contraindications for their use, and it is considered safe for the mother to take the drug and continue to breastfeed

Answer 44

Compatible with Breastfeeding

Question 45

cause side-effects in the infant but have either not been observed to do so or have only occasionally caused mild side-effects

Answer 45

Compatible with Breastfeeding: Monitor Infant for Side-Effects

Question 46

T/F: For Drugs Compatible with Breastfeeding but MAY produce side effects, If the mother cannot stop taking the drug, she may need to stop breastfeeding and feed her baby artificially until her treatment is completed

Answer 46

True

Question 47

reported to cause side-effects in the infant, especially if the side-effects could be serious

Answer 47

Avoid if possible: Monitor Infant for Side-Effects

Question 48

Drugs classified this way may reduce breastmilk production

Answer 48

Avoid if possible: May Inhibit Lactation

Question 49

have dangerous side-effects on the baby

Answer 49

Avoid

Question 50

US FDA initiative that revised label requirement for medications regarding pregnancy and breastfeeding safety from previously-assigned letters to ____________

Answer 50

summary of available data

Question 51

New Labeling Category include

Answer 51

○ Pregnancy (includes Labor and Delivery) ○ Lactation (includes Nursing Mothers) ○ Females and Males of Reproductive Potential (newest category)

Question 52

4 Headings of Pregnancy in the new labeling category

Answer 52

Pregnancy Exposure Registry Risk Summary Clinical Considerations Data

Question 53

Lactation 3 Headings in the new labeling category

Answer 53

Risk Summary Clinical Considerations Data

Question 54

Females and Males reproductive potential 3 Headings in the new labeling category

Answer 54

Pregnancy Testing Contraception Infertility

Question 55

Off label use Instances

Answer 55

1 Unapproved indication 2 Doses outside the recommended therapeutic range 3 Unusual route of administration 4 Use in other patient population 5 Unapproved concentration / dilution / preparation

Question 56

Reasons for Off-Label Use

Answer 56

1 No approved drug as treatment for the condition 2 Conventional treatment had no therapeutic effect 3 Patient is unable to take approved treatment (allergy, contraindicated with other comorbidities, intolerance to side effects, etc.) 4 Conventional treatment is inaccessible 5 Clinical trials of already-marketed drugs for new indications may show effectiveness