Missed Questions RxPrep Flashcards
(194 cards)
1
Q
What is the definition of a type II error?
A- alternative hypothesis accepted in error
B- null hypothesis accepted in error
C- study too small to detect a difference between groups
D- null hypothesis rejected in error
E- clinical trial has too many confounding variables
A
B- null hypothesis accepted in error
2
Q
A study reports mean blood pressure, mean A1c, and mean LDL cholesterol. Which type of data is represented? A. nominal B. discrete C. categorical D. ordinal E. continuous
A
E. continuous
3
Q
Definition of specificity A. % positive when disease not present B. % positive when disease is present C. 1 - Type II error D. % negative when disease not present E. % negative when a disease is present
A
D. % negative when disease not present (true negative)
4
Q
Which of the following is true regarding statistical power of a study?
A. statistical power and type II error are not related
B. risk of type II error can be eliminated if statistical power is high enough
C. high statistical power increases confidence that the null hypothesis was rejected correctly
D. power is 1 - alpha
E. trial without adequate statistical power is at risk of a type II error
A
C. a high statistical power increases confidence that null hypothesis was rejected correctly
5
Q
Which of the following are available as chewable tablets? A. cipro, augmentin, and cefixime B. cipro, augmentin, and fluconazole C. cipro, bactrim, and fluconazole D. amox, bactrim, and cephalexin E. amox, augmentin, and cefixime
A
E. amox, augmentin, and cefixime
6
Q
Which of the following statements regarding ciprofloxacin oral suspension is INCORRECT
A. this medication should only be given through feeding tubes, as it is not sweetened or flavored for oral use
B. the pt’s blood sugar may be affected
C. this agent may prolong the QT interval
D. this agent can cause peripheral neuropathies
E. this medication should be shaken prior to use
A
A. this medication should only be given through feeding tubes, as it is not sweetened or flavored for oral use
(oil-based, so will adhere to tubing)
7
Q
SELECT ALL THAT APPLY. Which of the following po antibiotic suspensions require refrigeration? Cubicin Ceftin Levaquin Septra Keflex
A
Ceftin and Keflex
8
Q
Which of the following classes of antibiotics exhibit concentration-dependent killing? A. tetracyclines B. quinolones C. streptogramins D. carbapenems E. macrolides
A
B. quinolones
Others: aminoglycosides and daptomycin
9
Q
Which of the following IV antimicrobials are compatible in D5W only? A. Bicillin LA & Zosyn B. Synercid & Bactrim C. acyclovir and ampicillin D. doxycycline and Cipro E. Cubicin and vancomycin
A
B. Bactrim and Synercid
10
Q
Cefotetan is a 2nd generation cephalosporin that is useful in colorectal surgery prophylaxis because of which of the following? A. anaerobic activity B. MRSA activity C. increased activity against S. pneumo D. atypical coverage E. Pseudomonas coverage
A
A. anaerobic activity
cefotetan and cefoxitin also cover B frag
11
Q
Which of the following antibiotics can cause a disulfiram-like reaction? A. cefaclor B. cefuroxime C. cefprozil D. cefotaxime E. cefotetan
A
E. cefotetan
12
Q
SELECT ALL THAT APPLY Which of the following are potential treatment options VRE E. faecalis SSTI status-post C-section? A. Levaquin B. Rifaximin C. Cubicin D. Merrem E. Zyvox
A
Cubicin & Zyvox
13
Q
Generic substitution for ReoPro A. eptifibatide B. abciximab C. bivalirudin D. alteplase E. tirofiban
A
B. abciximab
14
Q
All of the following are antiplatelet agents that can be used in the treatment of ACS except: A. eptifibatide B. aspirin C. dalteparin D. ticagrelor E. clopidogrel
A
C. dalteparin
Dalteparin is an anticoagulant, not an antiplatelet agent.
15
Q
What is the MOA of tenecteplase?
A. binds to fibrin and converts plasmin to plasminogen
B. binds to antithrombin and converts thrombin to fibrin
C. binds to thrombin and converts fibrinogen to fibrin
D. binds to fibrin and converts plasminogen to plasmin
E. binds to thrombin and converts fibrin into fibrinogen
A
D. binds to fibrin and converts plasminogen to plasmin
16
Q
If PCI is not possible, pt should receive fibrinolytic within what period of time from first medical contact?
A. STEMI patients are not candidates for fibrinolytic therapy
B. 30 minutes
C. 120 minutes
D. 4.5 hours
E. 60 minutes
A
C. 120 minutes.
17
Q
Which of the following medications should not be given to a patient presenting to the ED with a STEMI due to increased mortality? A. Cardizem B. Atacand C. Vasotec D. Procardia E. Demadex
A
D. Procardia IR nifedipine is associated with increased mortality in acute setting Cardizem= diltiazem Atacand= candesartan Vasotec= enalapril Demadex= torsemide
18
Q
Which of the following lab tests is the most sensitive marker for selecting myocardial damage in a patient with an ACS? A. troponins B. BNP C. myoglobin D. CK-MB E. C-reactive protein
A
A. Troponins
19
Q
Signs of cinchonism from quinidine:
A. confusion, tremor, and dyspnea
B. loss of smell, gingival hyperplasia, and headache
C. dry mouth, constipation, and urinary retention
D. blurred vision, blue skin discoloration, and insomnia
E. ringing in the ears, blurred vision, and confusion
A
E. ringing in the ears, blurred vision, and confusion
20
Q
What is the therapeutic range for digoxin when used for atrial fibrillation? A. 0.8-2 ng/mL B. 2.5-3.5 ng/mL C. 5-10 ng/mL D. 0.5-0.9 ng/mL E. <0.5 ng/mL
A
A. 0.8-2 ng/mL
HF range: 0.5-0.9 ng/mL
21
Q
CAST is a landmark arrhythmia trial where pts were randomized to use of certain antiarrhythmics vs placebo to suppress PVCs after MI. which antiarrhythmic was associated with inc. mortality in CAST? A. mexiletine B. amiodarone C. flecainide D. ibutilide E. quinidine
A
C. flecainide
22
Q
Lopressor acts as an antiarrhythmic by blocking which of the following ion channels in the SA and AV nodes? A. Mg B. K C. Na D. Cl E. Ca
A
E. Ca
Both calcium channel blockers and beta blockers block calcium channels in SA & AV nodes
23
Q
Which antiarrhythmic drug carries a boxed warning regarding a positive antinuclear antibody (ANA)? A. sotalol B. dofetilide C. procainamide D. amiodarone E. propafenone
A
C. procainamide
24
Q
Which of the following statements regarding amiodarone is correct?
A. amiodarone is available only as IV injection
B. amiodarone is administered 4x/d when treating arrhythmias
C. long IV infusions should be administered in glass or polyolefin containers
D. pts taking amiodarone should be monitored for tachycardia and hypertension
E. unlike other antiarrhythmic drugs, amiodarone is not proarrhythmic
A
C. long IV infusions should be administered in glass or polyolefin containers
25
Which of the following represents the correct combination of dose-effect relationships for dopamine?
Low dose =
Medium dose=
High dose=
+ inotropic effect / vasopressor effects / renal vasodilation
Low dose = renal vasodilation
Medium dose = positive inotropic effect
High dose = vasopressor effects
26
```
What receptor effect should be expected from a dopamine drip running at 44 mL/hr (pt 200 lb)
A. dopamine-1 receptor agonism
B. alpha-1 receptor agonism
C. beta-1 receptor antagonism
D. alpha-1 receptor antagonism
E. beta-1 receptor agonism
```
B. alpha-1 receptor agonsim
| dopamine doses > 10 mcg/kg/min are considered high dose, which is correlates to alpha-1 agonsim
27
SELECT ALL THAT APPLY
Which of the following statements concerning milrinone are correct?
A. milronone is a vasodilator
B. milrinone is a positive inotrope and increases contractivity in the heart
C. milrinone is administered IV only
D. monitor BP, HR, renal function, and ECG when using this agent
E. milrinone is an alpha-2 agonist
A. milronone is a vasodilator
B. milrinone is a positive inotrope and increases contractivity in the heart
C. milrinone is administered IV only
D. monitor BP, HR, renal function, and ECG when using this agent
28
```
Which of the following agents is associated with a risk of cyanide toxicity?
A. nitroprusside
B. eplerenone
C. nesiritide
D. nitroglycerin
E. enalaprilat
```
A. nitroprusside
29
SELECT ALL THAT APPLY
Which of the following statement(s) describe the action of a drug that is a selective beta-2 agonist?
A. the drug is expected to block the activity of natrual catecholamines leading to decreased HR and BP
B. the drug is expected to mimic the effect of GABA in the CNS
C. the drug is expected to stimulate beta adrenergic receptors
D. the drug is expected to relax bronchial smooth muscle and relieve bronchoconstriction
E. the drug is expected to block beta adrenergic receptors
C. the drug is expected to stimulate beta adrenergic receptors
D. the drug is expected to relax bronchial smooth muscle and relieve bronchoconstriction
30
```
What is the correct receptor pharmacology that explains the utility of vasopressin in the maintenance of blood pressure?
A. alpha-1 agonist
B. vasopressin antagonist
C. dopamine-1 agonist
D. vasopressin agonist
E. beta-1 agonist
```
D. vasopressin agonist
31
Which of the following statements is INCORRECT regarding Nimbex?
A. patient must receive adequate analgesia prior to Nimbex usage
B. Nimbex binds to the GABA receptor and blocks actions of endogenous GABA
C. a peripheral nerve stimulator can be used to monitor Nimbex
D. patient must receive adequate sedation prior to Nimbex usage
E. a continuous infusion of Nimbex requires mechanical ventilation
B. Nimbex binds to the GABA receptor and blocks actions of endogenous GABA
NMBAs bind to the ACh receptor, not GABA
32
```
Which of the following agents is a depolarizing NMBA?
A. pancuronium
B. atracurium
C. succinylcholine
D. vecuronium
E. cisatracurium
```
C. succinylcholine
Succ is the only depolarizing NMBA. it is not used long-term in the ICU but it is generally reserved for intubation
33
```
Generic for Natrecor
A. nesiritide
B. naloxone
C. nitroprusside
D. eplerenone
E. nebivolol
```
A. nesiritide
34
```
Which of the following is not an IV hemostatic agent?
A. Kcentra
B. Praxbind
C. Amicar
D. Amidate
E. NovoSeven
```
D. Amidate
Amidate (etomidate) is used for agitation or sedation
35
```
What is the MOA of phentolamine?
A. alpha-adrenergic antagonist
B. calcium channel antagonist
C. beta-adrenergic agonist
D. beta-adrenergic antagonist
E. alpha-adrenergic agonist
```
A. alpha-adrenergic antagonist
36
Which of the following statements concerning Japanese encephalitis is correct?
A. Japanese encephalitis vaccine is a live-attenuated vaccine
B. If a pregnant female contracts Japanese encephalitis, the infant will have a greater likelihood of microcephaly
C. The vaccine is called Ixiaro
D. Transmission is through sexual contact
E. Vaccine is contraindicated with egg allergy
C. the vaccine is called Ixiaro
37
Choose the correct statement concerning terms for disease transmission
A. In malaria, the mosquito is the host and the contaminated water is the vector
B. In malaria, the mosquito is the host and the human is the reservoir
C. In malaria, the mosquito is the vector that carries the pathogen from one vector (an infected human) to another vector (another infected human)
D. In malaria, the mosquito is the host and the human is the vector
E. In malaria, the mosquito is the vector that carries the pathogen from one host (an infected human) to another host
E. In malaria, the mosquito is the vector that carries the pathogen from one host (an infected human) to another host
38
```
Malaria is transmitted by various strains of this type of mosquito
A. Aednia
B. Anopheles
C. Coquilettidia
D. Culex
E. Orthopodomylinii
```
B. anopheles
39
Which of the following statements concerning primaquine is correct?
A. it cannot be used during pregnancy
B. toxicities include hemolytic anemia
C. pts must be tested for protein c deficiency prior to treatment with primaquine
D. primaquine is taken daily for 1-2 days pre-travel, during, and for 7 days post-travel
E. patients must be tested for g6pd deficiency prior to treatment with primaquine
A. it cannot be used during pregnancy
B. toxicities include hemolytic anemia
D. primaquine is taken daily for 1-2 days pre-travel, during, and for 7 days post-travel
E. patients must be tested for g6pd deficiency prior to treatment with primaquine
40
Which of the following best describes the kinetics of phenytoin?
A. phenytoin exhibits zero order, then first order kinetics
B. phenytoin exhibits kinetics consistent with the Frank Starling curve
C. phenytoin exhibits first order kinetics only
D. phenytoin exhibits second order kinetics only
E. phenytoin exhibits first order, then zero order kinetics
E. phenytoin exhibits first order, followed by zero order kinetics (also known as saturable or Michaelis-Menten kinetics)
41
```
Zarontin is primarily used for which type of seizure
A. complex partial seizures
B. absence seizures
C. generalized seizures
D. partial seizures
E. status epilepticus
```
B. absence seizures
| Zarontin = ethosuximide
42
The boxed warnings of felbamate include:
A. serious skin reactions & hepatic failure
B. renal & hepatic failure
C. pneumonitis and serious skin reactions
D. pneumonitis and renal failure
E. hepatic failure and aplastic anemia
E. hepatic failure and aplastic anemia
43
```
Which allele should be tested prior to initiation of carbamazepine in Asian patients?
A. 3103
B. 5701
C. 1503
D. 1502
E. 2C19*2
```
D. 1502
| HLA-B*1502 should be tested- if positive, another drug should be used unless benefits outweigh the risks
44
```
Which of the following anticonvulsants are associated with oligohydrosis?
A. phenytoin
B. carbamazepine
C. topiramate
D. lamotrigine
E. lacosamide
```
C. topiramate
| both topiramate & zonisamide can cause this
45
```
Which of the following ADRs are possible with zonisamide? SELECT ALL THAT APPLY
A. dec. sweating
B. pancreatitis
C. contraindicated in sulfa allergy
D. weight loss
E. kidney stones
```
A. decreased sweating
C. contraindicated in sulfa allergy
D. weight loss
E. kidney stones
AEDs that are associated with pancreatitis are VPA
46
```
Which of the following formulations dissolves rapidly with a sip of liquid?
A. Phenytek
B. Carbatrol
C. Spritam
D. Oxtellar XR
E. Trokendi XR
```
C. Spritam (levetiracetam)
| with ZipDose technology
47
```
which of the following are boxed warnings for valproate and divalproex? SELECT ALL THAT APPLY
A. teratogenicity
B. hepatic failure
C. SJS&TEN
D. pulmonary fibrosis
E. pancreatitis
```
A & B & E- teratogenicity, hepatic failure, and pancreatitis
48
```
The warning for Topamax during pregnancy concerned the following birth defect:
A. mental retardation
B. shortened stature
C. tetralogy of fallot
D. cleft lip/palate
E. spinabifida
```
D. cleft lip/palate
49
Whihc of the following are true regarding alvimopan? SELECT ALL THAT APPLY
A. it has a boxed warning for MI when used long-term
B. should be limited to 15 doses max
C. it is safe to use in patients with chronic opioid therapy
D. brand name Entereg
E. REMS drug
A. it has a boxed warning for MI when used long-term
B. should be limited to 15 doses max
D. brand name Entereg
E. REMS drug
50
```
Which of EK's meds are most likely contributing to constipation? SELECT ALL THAT APPLY
A. APAP
B. ferrous sulfate
C. propranolol
D. morphine
E. darifenacin
```
B. ferrous sulfate
D. morphine (opioid)
E. darifenacin (anticholinergic)
51
```
Which formulation of niacin has the highest risk for liver damage?
A. Slo-Niacin
B. Niacor
C. Inositol hexanicotinate
D. Niaspan
E. Inositol hexaniacinate
```
A. Slo-niacin
52
```
Which of the following drugs could adversely affect the lipid profile? SELECT ALL THAT APPLY
A. beta-blockers
B. cyclosporine
C. prednisone
D. montelukast
E. risperidone
```
A. beta-blockers
B. cyclosporine
C. prednisone
E. risperidone
53
```
Which of the following medications should be avoided with simvastatin? SELECT ALL THAT APPLY
A. Biaxin
B. Theo-24
C. Plavix
D. Vfend
E. Lopid
```
A. Biaxin
D. Vfend
E. Lopid
54
```
Which medications elevate potassium? SELECT ALL THAT APPLY
A. Demadex
B. Altoprev
C. Inspra
D. Aldactone
E. Yasmin
```
C. Inspra (eplerenone)
D. Aldactone (spironolactone)
E. Yasmin (drospirinone)
Demadex (torsemide) decreases K. Altoprev (lovastatin XR) has no effect on K
55
```
Which of the following drugs can be dispensed to a patient taking a MAOi without concern? SELECT ALL THAT APPLY
A. methylphenidate
B. Claritin-D
C. Prempro
D. Xalatan
E. Boniva
```
C. Prempro (estrogen / medroxyprogesterone)
D. Xalatan (latanoprost ophthalmic)
E. Boniva (ibandronate)
56
```
The pharmacist must reduce the doses of the following medications when dispensing amiodarone. SELECT ALL THAT APPLY
A. digoxin
B. pravastatin
C. clarithromycin
D. warfarin
E. lithium
```
A. digoxin & D. warfarin
57
T/F Induction has a "lag" effect which means the full effect of adding an inducer is not seen right away, and it takes time for the induction to dissipate once the inducer has been discontinued
True
58
T/F Inhibition has a "lag" effect which means the full effect of adding an inhibitor is not seen right away, and it takes time for the inhibition to dissipate once the inhibitor has been discontinued
False
59
```
Imitrex + Sarafem + Ultram. Patient is at risk for the following symptoms. SELECT ALL THAT APPLY
A. diarrhea
B. tachycardia, sweating
C. muscle twitching/rigidity, shivering
D. acute bradycardia
E. agitation
```
A. diarrhea
B. tachycardia, sweating
C. muscle twitching/rigidity, shivering
E. agitation
** Symptoms of serotonin syndrome **
60
Itraconazole, ketoconazole, and voriconazole have safety issues including: SELECT ALL THAT APPLY
A. w/ severe renal impairment, it is safer to use IV voriconazole only, due to excipients in the tablets and PO suspension
B. voriconazole metabolism is initially first order, but can become zero-order with higher doses, and toxicity can result
C. all are CYP 3A4 inhibitors; the dose of 3A4 substrates given simultaneously may need to be lowered
D. voriconazole is an enzyme substrate and is subject to many drug interactions
E. itraconazole and ketoconazole have pH dependent absorption; avoid use of these drugs that raise pH such as antacids
B. voriconazole metabolism is initially first order, but can become zero-order with higher doses, and toxicity can result
C. all are CYP 3A4 inhibitors; the dose of 3A4 substrates given simultaneously may need to be lowered
D. voriconazole is an enzyme substrate and is subject to many drug interactions
E. itraconazole and ketoconazole have pH dependent absorption; avoid use of these drugs that raise pH such as antacids
61
A patient with atrial fibrillation is using warfarin. the INR is stable at 2.3. select the interaction that can occur with the addition of these other medications:
A. if Aleve is added, INR will stay the same and bleeding risk would be elevated
B. if naproxen is added, INR will increase and bleeding risk would be elevated
C. if naproxen is added, INR will decrease and bleeding risk will be reduced
D. if clopidogrel is added, INR will increase and bleeding risk will be elevated
E. if APAP is taken at a 1-time dose of 500mg, INR will stay the same but bleeding risk will be lowered
A. if Aleve is added, INR will stay the same and bleeding risk would be elevated
62
```
Which medication can a patient take safely with phenelzine?
A. eletriptan
B. sumatriptan
C. Treximet
D. zolmitriptan
E. rizatriptan
```
A. eletriptan
sumatriptan, rizatriptan, and zolmitriptan are contraindicated with MAOi's.
63
Which of the following are correct counseling points of Transderm Scop? SELECT ALL THAT APPLY
A. apply the patch 1 hour before the activity expected to cause motion sickness
B. carefully wash hands after application and do not touch eyes if there is any medication on fingers
C. peel off backing from the patch and apply to clean, dry, hairless area of the skin behind the ear
D. if motion sickness continues after 3 hours, apply second patch behind the other ear
E. press firmly for at least 30 seconds to make sure patch sticks well, especially around the edges
B. carefully wash hands after application and do not touch eyes if there is any medication on fingers
C. peel off backing from the patch and apply to clean, dry, hairless area of the skin behind the ear
E. press firmly for at least 30 seconds to make sure patch sticks well, especially around the edges
must be placed at least 4 hours before the activity. only use 1 patch at a time
64
How rapidly should a patient in hypertensive emergency be reduced?
A. 40% by the next day
B. 25-30% in the next 10 minutes
C. 5-10% in the next 4-6 hours
D. as fast as possible to reach the goal of <130/80
E. 15-20% in the next hour
E. 15-20% in the next hour
BP should be reduced no more than 25% within the 1st hour
65
```
What are the labeled indications for Aldactone?
SELECT ALL THAT APPLY
A. HF
B. COPD
C. diabetes
D. pulmonary HTN
E. HTN
```
HF & HTN
66
```
Which of the following are possible side effects from the use of nicardipine? SELECT ALL THAT APPLY
A. peripheral edema
B. gingival hyperplasia
C. hypokalemia
D. flushing
E. hyperuricemia
```
A. peripheral edema
B. gingival hyperplasia
D. flushing
67
```
Which of the following medications are direct vasodilators? SELECT ALL THAT APPLY
A. doxazosin
B. labetalol
C. methyldopa
D. hydralazine
E. minoxidil
```
D. hydralazine
E. minoxidil
doxazosin- alpha blocker
labetalol- beta blocker
methyldopa-
68
```
SH is a 55 yo WM newly diagnosed wtih HTN and no other known medical conditions. His BP runs between 162-170/97-99. Choose an appropriate initial treatment regimen for this patient. SELECT ALL THAT APPLY
A. Ziac
B. HCTZ & labetalol
C. losartan & HCTZ
D. amlodipine and benazepril
E. Exforge
```
C. losartan & HCTZ
D. amlodipine and benazepril
E. Exforge (amlodipine & valsartan)
69
```
Pt presents with hypertensive urgency. Which of the following medications should not be used to treat this condition?
A. captopril
B. hydralazine
C. labetalol
D. nifedipine IR
E. clonidine
```
D. nifedipine IR
This can cause an acute drop in BP which can lead to MI and other ischemic complications.
70
```
Pt taking Janumet, Motrin, Hyzaar, and Zantac. Which of the following medications would be appropriate to add for better BP control?
A. hydralazine
B. Toprol XL
C. HCTZ
D. lotensin
E. Adalat CC
```
E. Adalat CC (nifedipine)
Hyzaar- losartan + HCTZ
CCB is next in line to be added
71
Which of the following best describes why it is important that K levels be maintained in the range of 4-5 mEq/L when a patient is taking digoxin?
A. K levels lower than this range allow more digoxin to act at the Na/K/ATPase pump
B. K levels lower than this range inactivate the Na/K/ATPase pump
C. digoxin causes a reduction in potassium levels
D. digoxin is displaced at the binding site when K levels are lower than this range
E. digoxin is an ineffective positive inotrope when potassium levels are lower than this range
A. K levels lower than this range allow more digoxin to act at the Na/K/ATPase pump
digoxin & potassium compete for the binding site at the Na/K/ATPase pump. when serum K is low, there is less competition and the toxicity of digoxin is potentiated.
72
```
Which of the following is the brand name for bisoprolol?
A. Zebeta
B. Betapace
C. Brevibloc
D. Diabeta
E. Betaseron
```
A. Zebeta
Betapace- sotalol
Brevibloc- esmolol
Diabeta- glyburide
Betaseron- Interferon beta-1b
73
```
Which of the following medication could possibly worsen a patient's HF (EF 33%)
SELECT ALL THAT APPLY
A. carbamazepine
B. prednisone
C. verapamil
D. itraconazole
E. ramipril
```
B. prednisone
C. verapamil
D. itraconazole
74
```
Pt has been newly prescribed Lasix. He should be counseled regarding the following side effects from the use of this drug: SELECT ALL THAT APPLY
A. hypercalcemia
B. orthostatic hypotension
C. hyperglycemia
D. hypouricemia
E. hypokalemia
```
B. orthostatic hypotension
C. hyperglycemia
E. hypokalemia
75
```
Which of the following antiarrhythmics should be avoided in pts with systolic HF? SELECT ALL THAT APPLY
A. procainamide
B. flecainide
C. mexiletine
D. quinidine
E. propafenone
```
```
A. procainamide
B. flecainide
C. mexiletine
D. quinidine
E. propafenone
```
76
```
Which of the following agents will help to lower triglycerides? SELECT ALL THAT APPLY
A. Trilipix
B. WelChol
C. Vascepa
D. Niacin
E. Lovaza
```
A. Trilipix
C. Vascepa
D. Niacin
E. Lovaza
77
```
Which of the following agents used for treatment of BPH is contraindicated with BiDil?
A. tadalafil
B. silodosin
C. doxazosin
D. alfuzosin
E. finasteride
```
A. tadalafil
PDE-5 inhibitors are contraindicated with nitrates.
78
```
Which of the following is an appropriate generic substitution for Detrol?
A. solifenacin
B. oxybutynin
C. darifenacin
D. trospium
E. tolterodine
```
E. tolterodine- Detrol
A. solifenacin- Vesicare
B. oxybutynin- Ditropan, Oxytron
C. darifenacin- Enablex
D. trospium- Sanctura
79
```
Which of the following is/are contraindicated in a patient newly diagnosed with narrow angle glaucoma? SELECT ALL THAT APPLY
A. Vesicare
B. Ditropan XL
C. Noctiva
D. Detrol LA
E. Myrbetriq
```
Vesicare (solifenacin), Ditropan XL (oxybutynin), Detrol LA (tolterodine)- anticholinergic/antimuscarinic agents
Noctiva (desmopressin) and Myrbetriq (mirabegron) are not anticholinergic
80
Drugs used for urge incontinence bind to a specific subtype of anticholinergic receptor. Choose the correct statement concerning the receptor:
A. these drugs bind primarily to the muscarinic M2 receptor on the bladder muscle wall
B. these drugs bind primarily to the nicotinic N2 receptor on the bladder muscle wall
C. these drugs bind primarily to the muscarinic M1 receptor on the bladder muscle wall
D. these drugs bind primarily to the nicotinic N3 receptor on the bladder muscle wall
E. these drugs bind primarily to the muscarinic M3 receptor on the bladder muscle wall
E. these drugs bind primarily to the muscarinic M3 receptor on the bladder muscle wall
81
Which of the following is true regarding treprostinil?
A. it should be kept on ice packs during infusion
B. sc administration can cause significant pain at the infusion site
C. short half life of 5 mins
D. inhaled treprostinil is delivered 6-9 times daily
E. brand name Ventavis
B. sc administration can cause significant pain at the infusion site
82
```
Which of the following are ADEs of epoprostenol? SELECT ALL THAT APPLY
A. HTN
B. constipation
C. jaw pain
D. hepatotoxicity
E. flushing
```
jaw pain & flushing (c & e)
others include hypotension, headache, nausea, vomiting, and diarrhea
83
Which of the following are true regarding riociguat? SELECT ALL THAT APPLY
A. it is used only off-label for PAH
B. increases risk of VTE
C. it is a soluble guanylate cyclase stimulator
D. it is approved for chronic thrombolic pulmonary htn
E. it is safe to use in combination with nitrates
C. it is a soluble guanylate cyclase stimulator
| D. it is approved for chronic thrombolic pulmonary htn
84
```
which of the following describes the MOA of epoprostenol?
A. soluble guanylate cyclase stimulator
B. PDE-5 inhibitor
C. endothelin receptor antagonist
D. prostacyclin analogue
E. IV CCB
```
D. prostacyclin analogue
85
```
a pregnant woman needs treatment for PAH. which of the following are safest to use in pregnancy? SELECT ALL THAT APPLY
A. macitentan
B. ambrisentan
C. tadalafil
D. riociguat
E. epoprostenol
```
C & E- tadalafil & epoprostenol
REMS programs for endothelial receptor antagonists (-entan's) & riociguat regarding embryo-fetal toxicity
86
```
MOA of donepezil
A. norepi reuptake inh
B. centrally acting anticholinergic
C. NMDA receptor antagonist
D. ACh inhibitor
E. decarboxylate inhibitor
```
D. ACh inhibitor
87
```
What are possible side effects of Namenda ER?
A. diarrhea & rash
B. tachycardia & SOB
C. nausea & metallic taste in mouth
D. bradycardia & cough
E. dizziness & headache
```
E. dizziness & headache
other ADEs include confusion & constipation
88
Which of the following are correct counseling statements for Exelon patch? SELECT ALL THAT APPLY
A. remove patch after 24 hrs and fold in half with sticky sides together for safe disposal
B. remove the patch prior to MRI or skin will burn
C. prior to applying, lubricate skin well to reduce irritation
D. apply patch once weekly
E. apply patch on back, upper arm or chest, and always change site from day-to-day so skin does not become irritated
A. remove patch after 24 hrs and fold in half with sticky sides together for safe disposal
E. apply patch on back, upper arm or chest, and always change site from day-to-day so skin does not become irritated
B. Exelon does not need to be removed prior to MRI (doesn't contain metal)
C. patches will not stick well if lubricated
D. patches are q24hr
89
```
which of the following regimens can be used in a patient w/ severe Alzheimers? SELECT ALL THAT APPLY
A. Namenda monotherapy
B. high dose (23mg) Aricept
C. Aricept + Exelon
D. Namenda + Aricept
E. Razadyne + Exelon
```
A. Namenda monotherapy
B. high dose (23mg) Aricept
D. Namenda + Aricept
90
```
Which of the following can worsen dementia? SELECT ALL THAT APPLY
A. Ditropan XL
B. diphenhydramine
C. buspirone
D. Ativan
E. fluoxetine
```
A. Ditropan XL
B. diphenhydramine
D. Ativan
91
Which of the following statments is true regarding dolasetron?
A. it should not be given IV CINV
B. it doesn't have a risk of QT prolongation
C. it is available in a patch
D. brand name is Kytril
E. only sustained-release injection should be used for CINV
A. it should not be given IV CINV
Dolasetron (Anzemet) is not indicated for IV administration due to QT prolongation risk.
92
```
a pharmacist receives a prescription for Zuplenz. Which drug should be dispensed?
A. palonosetron/netupitant
B. dolasetron
C. granisetron
D. ondansetron
E. netupitant
```
D. ondansetron (this is the film formulation)
palonosetron/netupitant- Akynzeo
dolasetron- Anzemet
granisetron- Kytril, Sancuso, Sustol, Granisol
93
```
Choose correct chemotherapeutic medication : adjunctive medication pair
A. cisplatin : mesna
B. irinotecan : leucovorin
C. ifosfamide : amifostine
D. docetaxel : dexrazoxane
E. FU : uridine triacetate
```
E. FU : uridine triacetate
cisplatin : fluids/amifostine
irinotecan: atropine +/- loperamide
ifosfamide: MESNA + fluids
94
```
Highest incidence of hand-foot syndrome
A. rituximab
B. FU
C. Kytril
D. thalidomide
E. vincristine
```
B. fluorouracil
capecitabine (prodrug of FU) also results in hand-foot syndrome
95
Which of the following are recommended for highly emetogenic chemotherapy. SELECT ALL THAT APPLY
A. Akynzeo + dexamethasone
B. olanzapine + dexamethasone + palonosetron
C. fosaprepitant + dexamethasone + ondansetron
D. fosaprepitant + dexamethasone + rolapitant
E. aprepitant + dexamethasone + prochlorperazine
A. Akynzeo + dexamethasone
B. olanzapine + dexamethasone + palonosetron
C. fosaprepitant + dexamethasone + ondansetron
NK-1 inh + dexamethasone + 5HT3 receptor antagonist +/- olanzapine
96
```
What drug should be dispensed for Sancuso?
A. rolapitant
B. dolasetron
C. netupitant
D. ondansetron
E. granisetron
```
E. granisetron transdermal patch is Sancuso
rolapitant- Varubi
dolasetron- Anzemet
ondansetron- Zofran/Zuplenz
97
```
hand-foot syndrome is associated with use of which of the following
A. liposomal doxorubicin
B. vincristine
C. cisplatin
D. epirubicin
E. docetaxel
```
A. liposomal doxorubicin (Doxil & Lipodox50)
hand-foot syndrome also associated wtih cytarabine
98
```
which of the following agents reduces renal damage with cisplatin therapy
A. Mesnex
B. Ethyol
C. Procrit
D. Zinecard
E. Vistogard
```
B. Ethyol (amifostine)
Mesnex- mesna
Procrit- epogen
Zinecard- dexrezoxane
Vistogard- uridine triacetate
99
Which of the following statements are true regarding extravasation of chemotherapy? SELECT ALL THAT APPLY
A. extravasation is the leakage of drug from a vein into extravascular space
B. glucarpidase can be used for extravasation from irinotecan
C. cold compresses should be used for all agents except vinca alkaloids & etoposide
D. warm compresses should be used for all agents except vinca alkaloids & etoposide
E. dexrazoxane can be used for anthracycline extravasation
A. extravasation is the leakage of drug from a vein into extravascular space
C. cold compresses should be used for all agents except vinca alkaloids & etoposide
E. dexrazoxane can be used for anthracycline extravasation
vinca alkaloids + etoposide require warm compresses
100
```
When various powders are mixed and the mixture has a lower melting point than the individual drugs, what is this type of mixture called?
A. hygroscopic
B. effervescent
C. deliquescent
D. eutectic
E. efflorescent
```
D. eutectic
Eutectic mixtures have better penetration than any of the components by itself. p. 194
101
```
What does PLO stand for?
A. polaxamer lecithin organogel
B. pluronic lecithin organogel
C. potassium lecithin organogel
D. pluronic liquid organogel
E. palmitate lecithin organogel
```
B. pluronic lecithin organogel
PLO gel is a transdermal vehicle
102
```
Select the agents used as thickeners
A. Arlacel, Span, Myrf, Tween
B. Alginic acid
C. Acacia, agar, and gelatin
D. lanolin, Aquaphor, Aquabase
E. petrolatum
```
C. Acacia, agar, and gelatin
p. 198
103
Default BUD for H2O containing PO formulation is _______ from date of preparation?
A. 6 months
B. 14 days
C. 1 year
B. 14 days from date of peparation
104
```
What is the density factor used to calibrate?
A. a suppository mold
B. a torsion balance
C. an ointment slab
D. an oral tablet punch
E. an electronic balance
```
A. a suppository mold
105
A qualified certifier is visiting a compounding pharmacy to certify air quality of compounding area. When does the ante-room need to be at least ISO?
A. when the ante-room opens into an ISO 7 buffer room
B. when the ante room opens into a positive pressure buffer room
C. when the ante room opens into an ISO 5 buffer room
D. when the ante room opens into an ISO 8 buffer room
E. when the ante room opens into a negative pressure buffer room
E. when the ante room opens into a negative pressure buffer room
For hazardous drug perparation, the ante room opens must be at least ISO 7 when it opens into a negative pressure buffer room
106
Which of the following rooms need at least 30 air changes per hour?
A. non-sterile hazardous drug room
B. containment segregated compounding area used to prepare sterile hazardous drugs
C. storage room for hazardous APIs
D. room that contains dedicated refrigerator used to store chemo drugs
E. buffer room used to prepare sterile hazardous drugs
E. buffer room used to prepare sterile hazardous drugs
the other rooms require at least 12 air changes per hour
107
Which of the following drugs are considered hazardous? SELECT ALL THAT APPLY.
A. a drug that causes oligospermia
B. a drug that can cause pregnant women to give birth to babies with cleft lip
C. a drug that can cause anaphylaxis
D. a drug that can cause severe liver injury at low doses
E. a drug that causes respiratory depression
A. a drug that causes oligospermia (low sperm count decreasing fertility)
B. a drug that can cause pregnant women to give birth to babies with cleft lip
D. a drug that can cause severe liver injury at low doses
Hazardous drugs: teratogenic, carcinogenic, genotoxic, have reproductive toxicity, and can cause organ toxicity at low doses
108
When is it acceptable to turn off a class I BSC if the pharmacy is open 12 hours daily?
A. The BSC should be turned off when it is not in use as it is used to prepare non-sterile preparations
B. The BSC must operate continuously if it is supplying some or all of the negative pressure in the room
C. The BSC can be turned off when it is not in use if it is located in a room with four fixed walls that extend from ceiling to the floor
D. The BSC must operate continuously if it is supplying some or all of the positive pressure in the room
E. The BSC must operate continuously with no exceptions
B. The BSC must operate continuously if it is supplying some or all of the negative pressure in the room
109
Which of the following are considered containment secondary engineering controls? SELECT ALL THAT APPLY.
A. Class I BSC
B. containment segregated compounding area (C-SCA)
C. compounding aseptic isolator
D. the buffer room where chemotherapy drugs are prepared
E. laminar horizontal airflow workbench
B. containment segregated compounding area (C-SCA)
D. the buffer room where chemotherapy drugs are prepared
the containment secondary engineering control (C-SEC) is the room that contains the containment primary engineering control (C-PEC)
110
Which of the following is correct in sanitizing a class II biological safety cabinet for sterile hazardous drugs?
A. the surfaces must be disinfected before being decontaminated
B. a spray bottle should be used to apply the sanitizing agent directly to the surfaces of the biological safety cabinet
C. the deactivation step is only required when sanitizing class I biological safety cabinets
D. 70% sterile isopropyl alcohol is used as the primary cleaning agent
E. peroxide-containing agents can be used to both deactivate and decontaminate surfaces
E. peroxide-containing agents can be used to both deactivate and decontaminate surfaces
All areas and equipment used for handling HDs must be deactivated, decontaminated, and cleaned in this order at least once daily. Sterile compounding areas must be disinfected as a final step.
111
A technician must withdraw 43.2 mL solution. what size syringe should be used?
A. 50 mL
B. 60 mL
B. 60mL syringe
the smallest syringe should be used as long as it is not more than 75% full when filled to reduce the risk of the plunger pulling completely off the syringe barrel
112
```
The ifosfamide vial is partially used with 1/3 solution remaining. What color waste bin should be used?
A. black
B. red
C. yellow
D. blue
E. it doesn't matter
```
A. black
Black Container: bulk antineoplastic waste (partially empty IV bags, syringes, or vials)
113
```
Sterile HDs require 2 pairs of each of the following garb are required:
SELECT ALL THAT APPLY
A. shoe covers
B. chemotherapy gloves
C. hair covers
D. face shields
E. chemotherapy gowns
```
A. shoe covers
| B. chemotherapy gloves
114
Which of the following drugs are considered potentially hazardous? SELECT ALL THAT APPLY
A. a drug that can cause endometrial cancer
B. a drug that causes infertility
C. a drug that causes suicidal ideation & behavior
D. a drug that inhibits histone deacetylase (important for DNA structure)
E. a drug that causes hypotension and syncope
A. a drug that can cause endometrial cancer
B. a drug that causes infertility
D. a drug that inhibits histone deacetylase (important for DNA structure)
115
```
Which of the following products can be used to decontaminate chemotherapy spills?
A. 70% sterile IPA
B. phenolics
C. quarternary ammonium compounds
D. sodium thiosulfate
E. sodium hypochloride
```
E. sodium hypochloride
Sodium hypochloride = bleach. commonly used to decontaminate surface areas exposed to hazardous drugs
116
```
After a pharmacy technician has finished preparing the tretinoin oral suspension, what color waste bin should the technician use to throw away the disposable mortar and pestle?
A. blue
B. grey
C. black
D. red
E. yellow
```
E. yellow
Trace chemotherapy waste (empty vials, empty syringes, empty IV bags, IV tubing, used gloves, used gowns, and used pads) are thrown away in yellow containers
117
```
What type of hood/isolater can be used to prepare tretinoin oral solution? SELECT ALL THAT APPLY
A. containment ventilated enclosure
B. positive pressure clean bench
C. horizontal laminar airflow workbench
D. class I BSC
E. compounding aseptic isolator
```
```
A. containment ventilated enclosure
D. class I BSC
```
Must be handled in negative pressure.
118
```
Which of the following drugs are considered hazardous? SELECT ALL THAT APPLY
A. colchicine
B. tacrolimus
C. estradiol
D. Bio-Statin
E. Mifeprex
```
A. colchicine
B. tacrolimus
C. estradiol
E. Mifeprex
119
After donning the first pair of gloves, how many times should the technician change his gloves within a 12-hour shift?
at least 23 times.
Gloves need to be changed every 30 minutes & if it is torn, punctured, or contaminated
120
Which containment primary engineering controls can be ordered to prepare hazardous drugs? SELECT ALL THAT APPLY
A. class II biological safety cabinet
B. integrated vertical laminar airflow
C.compounding aseptic isolators
D. laminar airflow workbench
E. compounding aseptic containment isolators
```
A. class II biological safety cabinet
E. compounding aseptic containment isolators
```
121
Which respirators are appropriate to prepare chemotherapy in a BSC? SELECT ALL THAT APPLY
A. powered air-purifying respirator
B. an elastomeric half-mask
C. a full-facepiece, chemical cartridge-type respirator
D. N95 respirator
E. surgical face mask
A. powered air-purifying respirator
C. a full-facepiece, chemical cartridge-type respirator
these are required when HD spills larger than what can be contained with spill kit, deactivactivating/decontaminating/cleaning workspace, and known or suspected airborne exposure to powders or vapors
122
```
Multidose vial of Herceptin to be used to prepare IV admixtures for several patients. What is the risk level?
A. low risk with 12-hour BUD
B. low risk
C. immediate use
D. medium risk
E. high risk
```
D. medium risk
Medium risk includes batch preparations and TPN preparation
123
```
If one squeezes out enough steroid cream to stretch the length from the fingertip to the first joint, what is the approximate skin area this medication will treat?
A. ~ area of hand
B. ~ area of one finger
C. ~ area of hand and arm
D. ~ area of one leg
E. ~ area from foot to knee
```
A. ~ area of hand
Fingertip unit ~ 1/2 gram
124
```
Which of the following agents is not used first line for scabies due to neurotoxicity/seizures and requires a Med Guide if dispensed?
A. benzyl alcohol lotion
B. Ovide
C. lindane
D. permethrin
E. spinosad
```
C. Lindane
Ovide- malathion
spinosad- Natroba
125
what does SPF indicate?
A. degree of protection from UVA
B. degree of protection from UVB
C. amount of time the product will last if patient stays in the sun, up to 5 hours duration
D. the amount of time product will last if patient gets wet
E. moisturizing efficacy
B. degree of protection from UVB
indicates sunburn protection, or UVB blockade
126
```
Which medications cannot be used if a patient is taking isotretinoin? SELECT ALL THAT APPLY
A. St. John's wort
B. tetracyclines
C. steroids
D. vita D supplements
E. vita A supplements
```
A. St. John's wort
B. tetracyclines
C. steroids
E. vita A supplements
p. 502
127
Choose the correct statement concerning ketoconazole shampoo (Nizoral AD)
A. this product should not be applied to open sores or irritated skin
B. this is a prescription-only product
C. this shampoo should be applied continuously (daily) in order to prevent flaking
D. it is important not to use acid-suppressing agents when using Nizoral AD
E. this shampoo is the first-line recommendation for dandruff
A. this product should not be applied to open sores or irritated skin
128
```
Brand name for imiquimod
A. Aldara
B. Reopro
C. Orencia
D. Plenaxis
E. Campral
```
A. Aldara
ReoPro- abciximab
Orencia- abatacept
Plenaxis- abarelix
Campral- acamprosate
129
```
If systemic ketoconazole is used to treat onychomycosis, which of the following medications must be stopped during ketoconazole therapy?
A. amlodipine
B. rabeprazole
C. multivitamin supplement
D. carvedilol
E. digoxin
```
B. rabeprazole
Requires acidic medium for adequate absorption. No acid-suppressive agents of any type can be used concurrently.
130
```
Which of the following agents is flammable?
A. permethrin
B. Ovide
C. Lindane
D. Spinosad
E. benzyl alcohol lotion
```
B. Ovide
| AndroGel is also flammable
131
A pharmacist is discussing oral isotretinoin with a prescriber. Which statements are correct?
A. this medication is pregnancy category X- use causes severe birth defects if pregnancy occurs while using this medication
B. due to the birth defect risk, this is a REMS drug. it can only be dispensed by a pharmacy registered with the pregnancy risk management iPLEDGE program
C. the progestin-only contraceptive is not adequate as a form of birth control in females using isotretinoin
D. patients should be instructed that they will have dry skin; use a lip moisturizer and carry a water bottle to keep well-hydrated
E. the patient cannot get pregnant while taking this medication and for six months afterwards
A. this medication is pregnancy category X- use causes severe birth defects if pregnancy occurs while using this medication
B. due to the birth defect risk, this is a REMS drug. it can only be dispensed by a pharmacy registered with the pregnancy risk management iPLEDGE program
C. the progestin-only contraceptive is not adequate as a form of birth control in females using isotretinoin
D. patients should be instructed that they will have dry skin; use a lip moisturizer and carry a water bottle to keep well-hydrated
Patients cannot become pregnant one month before, during, and one month after treatment.
132
Which of the following statements concerning sunscreens are correct? SELECT ALL THAT APPLY
A. all sunscreens should be reapplied at least every 2 hours and after going in H2O, no sunscreens are truly waterproof
B. if a patient would normally burn in 10 mins, using SPF 5 will cause them to burn in 50 minutes (5 x 10)
C. UVA & UVB exposure increases the risk of skin cancer
D. water resistant means the sunscreen is resistant for somewhere between 40-80 minutes
E. if a person is avoiding the sun, they may require vita E supplementation
A. all sunscreens should be reapplied at least every 2 hours and after going in H2O, no sunscreens are truly waterproof
B. if a patient would normally burn in 10 mins, using SPF 5 will cause them to burn in 50 minutes (5 x 10)
C. UVA & UVB exposure increases the risk of skin cancer
D. water resistant means the sunscreen is resistant for somewhere between 40-80 minutes
patients will require vita D, not vita E
133
A patient has suspected onychomycosis and the physician is considering systemic terbinafine therapy. Choose the correct statement:
A. 8 weeks are required for toenail treatment
B. if starting terbinafine, monitor for hepatotoxicity
C. KOH smears are rarely required for this condition; it is generally sufficient to use a visual inspection
D. Sporanox is the brand name
E. 4 weeks are required for fingernail treatment
B. if starting terbinafine, monitor for hepatotoxicity
A- 12 weeks req'd for toenail
C- KOH are always used first
D- Lamisil is the brand name. Sporanox is brand for itraconazole.
E- 6 weeks req'd for fingernail
134
Choose the correct statement concerning Duac
A. Duac contains isotretinoin
B. Duac can be stored at room temperature for up to 2 months
C. prior to dispensing, store in freezer
D. Duac cannot bleach clothing
E. Duac contains erythromycin and benzoyl peroxide
B. Duac can be stored at room temperature for up to 2 months
Duac should be stored in the refrigerator prior to dispensing. It contains clindamycin & benzoyl peroxide, where benzoyl peroxide can bleach clothing.
135
A 44 yo Asian female has struggled with eczema patches since she was a child. She typically uses Aveeno colloidal oatmeal bath. She has never used anything else and found that this product provided moderate relief. She is at her annual physical and the physician has written a Rx for Elidel. Choose the correct statement.
A. Elidel is not indicated currently
B. it is likely that the insurance company will provide coverage
C. the drug is considered first line for this type of presentation
D. she should be using oral steroids instead
E. she should be using diphenhydramine or a similar product instead prior to the use of this agent
A. Elidel is not indicated currently
Eczema should be treated first with topical steroids, and Protopic/Elidel (tacrolimus/pimecrolimus) should only be used if the patient has failed topical steroid therapy.
136
```
If a beta blocker is required for glaucoma, which medication would be the best option in a patient with breathing problems?
A. timolol
B. carteolol
C. betaxolol
D. levobunolol
E. metipranolol
```
C. betaxolol (Betoptic)
137
Choose the correct counseling statement concerning dorzolamide
A. dorzolamide comes in a combination medication with timolol called Diamox Sequels
B. dorzolamide capsules are used for altitude sickness
C. unlike other glaucoma medications, this drug does not cause any ocular ADRs
D. this drug should be used with caution in patients with sulfonamide allergy
E. this drug is a cholinergic which increases aqueous outflow
D. this drug should be used with caution in patients with sulfonamide allergy
carbonic anhydrase inhibitor, decreasing aqueous outflow.
138
```
Which of the following drugs that is used for malaria Ppx can cause optic neuropathy with possible vision loss?
A. isoniazid
B. doxycycline
C. isotretinoin
D. chloroquine
E. ethambutol
```
D. chloroquine
chloroquine is contraindicated in pts with underlying retinal or visual changes
139
```
ES, an 82 year old male with COPD has difficulty breathing. He finds little relief from daily use of Advair Diskus and Spiriva. Which condition is most likely in this patient?
A. diabetic ketoacidosis
B. anion gap acidosis
C. lactic acidosis
D. respiratory acidosis
E. respiratory alkalosis
```
D. respiratory acidosis
Pt is unable to breathe out CO2. Since CO2 is an acid when dissolved in blood, this will cause acidosis.
140
```
Calcium levels may decrease with the chronic use of these drugs: SELECT ALL THAT APPLY
A. Tekturna-HCT
B. Dyazide
C. Bumex
D. Topamax
E. Boniva
```
C. Bumex
D. Topamax
E. Boniva
All loop diuretics will decrease serum calcium. Thiazide diuretics may increase serum calcium.
141
```
Which of the following medications are known to contribute to drug-induced hemolysis and would require discontinuation in a patient who developed hemolysis after the use of the drug?
SELECT ALL THAT APPLY
A. quinine
B. methyldopa
C. naloxone
D. quinidine
E. linezolid
```
A. quinine
B. methyldopa
D. quinidine
See anemia chapter; test will be positive for a Coombs test
142
```
Which of the following drugs can contribute to low serum sodium levels? SELECT ALL THAT APPLY
A. Lexapro
B. Tegretol
C. Lithobid
D. Trileptal
E. Demadex
```
A. Lexapro
B. Tegretol
D. Trileptal
E. Demadex
Lithium may cause increased serum, not decreased.
143
```
Which of the following drugs should not be dispensed to a patient with known G6PD deficiency? SELECT ALL THAT APPLY
A. chloroquine
B. dapsone
C. tigecycline
D. tranexamic acid
E. methylene blue
```
A. chloroquine
B. dapsone
E. methylene blue
Anemia chapter has a full list
144
```
A pt had transient intravascular hemolysis during treatment with IVIG. The hemolysis was mediated by anti-A antibody present in the treatment. What signs and symptoms could indiciate hemolysis? SELECT ALL THAT APPLY
A. blood in stool
B. hematuria
C. positive ANA
D. positive Coombs
E. negative Coombs
```
B. hematuria
| D. positive Coombs
145
```
Which of the following antiepileptic drugs can cause metabolic acidosis?
A. Tegretol
B. Keppra
C. Topamax
D. Dilantin
E. Onfi
```
C. Topamax
146
```
Which of the following causes is most likely with an elevated CRP?
A. acute renal failure
B. prostate cancer
C. SLE
D. acute gouty crystallization
E. HIV infection
```
C. SLE
CRP is an indicator of inflammation, but it is not very specific. It is usually used to monitor inflammatory conditions such as SLE and RA, but can also be + in acute infection
147
```
Which of the following medications will need to have the level adjusted due to a low albumin?
SELECT ALL THAT APPLY
A. phenytoin
B. lisinopril
C. warfarin
D. valproate
E. calcium
```
A. phenytoin
C. warfarin
D. valproate
E. calcium
148
```
Drugs that require renal adjustment in renal impairment:
SELECT ALL THAT APPLY
A. dabigatran
B. gentamicin
C. enoxaparin
D. voriconazole
E. fluconazole
```
A. dabigatran
B. gentamicin
C. enoxaparin
E. fluconazole
149
```
Which of the following agents is not used to lower serum K?
A. sodium polystyrene sulfonate
B. insulin + dextrose
C. albuterol
D. calcium gluconate
E. all of the above
```
D. calcium gluconate
the sole purpose of calcium used in this situation is to stabilize cardiac tissue
150
The proper sequence of drawing up regular and NPH insulin into a single syringe is:
A. First regular, then NPH
B. First NPH, then regular
C. either insulin may be drawn up first
D. these insulins cannot be mixed in the same syringe
E. these insulins should not be used together
A. first regular, then NPH
clear then cloudy!
151
```
Which of the following are available in concentration of 200 u/mL
A. regular
B. aspart
C. NPH
D. lispro
E. glargine
```
D. lispro
152
```
Once opened, how many days is Afreeza stable at room temperature?
A. 21 days
B. 7 days
C. 14 days
D. 3 days
E. 10 days
```
D. 3 days
153
```
Which of the following are side effects seen with dapagliflozin that should be discussed with the patient? SELECT ALL THAT APPLY
A. pancreatitis
B. diabetic ketoacidosis
C. hypotension
D. UTI
E. acute liver failure
```
B. diabetic ketoacidosis
C. hypotension
D. UTI
154
```
One serving of carbohydrates typically contains how many grams?
A. 15 g
B. 30 g
C. 5 g
D. 10 g
E. 20 g
```
A. 15 g
155
```
Which of the following are possible risks when taking pioglitazone?
SELECT ALL THAT APPLY
A. pancreatitis
B. hepatic failure
C. risk of fractures
D. edema
E. weight gain
```
B. hepatic failure
C. risk of fractures
D. edema
E. weight gain
156
```
Stability of Humulin N pen at room temperature
A. 30 days
B. 28 days
C. 15 days
D. 14 days
E. 42 days
```
D. 14 days
157
```
Treatment for hypoglycemia? SELECT ALL THAT APPLY
A. 1 serving of glucose gel
B. 1-2 glucose tablets
C. 4 oz diet soda
D. 4 oz milk
E. 4 oz OJ
```
A. 1 serving glucose gel
E. 4 oz OJ
3-4 tablets are needed, soda must be non-diet, if milk is used needs 8oz
158
```
Pt with HF/Hx of MI has just been diagnosed with hypothyroidism. Pt is 5'0 and 103 lbs. What is the appropriate starting dose of levothyroxine in this patient?
A. 75-100 mcg daily
B. 25-50 mcg daily
C. 12.5-25 mcg daily
D. 50-75 mcg daily
E. 100-150 mcg daily
```
C. 12.5-25 mcg daily
Pts with known CAD are started at 12.5-25 mcg/day
159
Which of the following statements concerning thyroid function are correct?SELECT ALL THAT APPLY
A. total daily T3 results from peripheral conversion of T4 to T3
B. in normally functioning system, TSH stimulates secretion of T4 and minimally T3
C. T3 is 3-4 times as potent as T4
D. T4 is 3-4 times as potent as T3
E. elevations in T4 inhibit the secretion of TSH, and a negative feedback loop is created
A. total daily T3 results from peripheral conversion of T4 to T3
B. in normally functioning system, TSH stimulates secretion of T4 and minimally T3
C. T3 is 3-4 times as potent as T4
E. elevations in T4 inhibit the secretion of TSH, and a negative feedback loop is created
160
Which of the following is correct regarding drug interactions of propylthiouracil?
A. PTU can increase anticoagulant effect of warfarin
B. PTU should be separated from melatonin
C. PTU can decrease anticoagulant effect of warfarin
D. there are no drug interactions present in the regimen
E. PTU is contraindicated with Zyvox
C. PTU can decrease anticoagulant effect of warfarin
this puts the patient at an increased risk of clotting
161
Pt presents with thyroid storm for treatment. An order for propylthiouracil is written. What other medications should be initiated?
A. Liotrix, APAP, Lugol's soln, and dexamethasone
B. SSKI, propranolol, dexamethasone, and APAP
C. KCl, APAP, propranolol, and dexamethasone
D. KCl, ThyroShield, and metoprolol
E. levothyroxine, SSKI, magnesium, and ASA
B. SSKI, propranolol, dexamethasone, and APAP
Pts with thyroid storm must be treated with SSKI/Lugol's Soln, a beta blocker, a corticosteroid, and APAP
162
CU takes warfarin for Afib and has been discharged from the hospital with new medications: levothyroxine, amiodarone, and diltiazem. Which of the following are correct statements
SELECT ALL THAT APPLY
A. addition of levothyroxine will increase the patient's risk of DVT
B. addition of amiodarone can lead to a supratherapeutic INR
C. addition of diltiazem can lead to a subtherapeutic INR
D. addition of diltiazem can decrease levels of levothyroxine
E. addition of levothyroxine can lead to a supratherapeutic INR
B. addition of amiodarone can lead to a supratherapeutic INR
E. addition of levothyroxine can lead to a supratherapeutic INR
Levothyroxine can increase the INR. amiodarone causes a large increase in the INR and the warfarin dose should be decreased. both drugs put the patient at an increased risk of bleeding, NOT clotting.
163
```
Which of the following drugs can cause hyperthyroidism? SELECT ALL THAT APPLY
A. amiodarone
B. prednisone
C. iodine
D. lithium
E. thyroid hormone taken in excess
```
A. amiodarone
C. iodine
E. thyroid hormone taken in excess
both amiodarone and interferons can cause either hypo or hyperthyroidism. lithium can only cause hypothroidism
164
Which of the following is a correct statement concerning Armour Thyroid? SELECT ALL THAT APPLY
A. it is not synthetic, it is derived from pork thyroid gland
B. some patients prefer it
C. it contains both T3 and T4
D. it will raise TSH
E. it is not the preferred agent for treating hypothyroidism
A. it is not synthetic, it is derived from pork thyroid gland
B. some patients prefer it
C. it contains both T3 and T4
E. it is not the preferred agent for treating hypothyroidism
No proof that Amour Thyroid works better; but it is manufactured USP and according to GMPs.
165
```
PTU can have this effect of blood cells
A. high WBC (leukocytosis)
B. low WBC (leukopenia)
C. decreased RBC
D. increased plt (thrombocytosis)
E. decreased plt
```
B. low WBC (leukopenia)
166
```
Which of the following hormone formulations used for vasomotor symptoms should be recommended as monotherapy in a female with a uterus?
A. Estrace
B. Climara
C. Vivelle-Dot
D. Premarin
E. ClimaraPro
```
E. ClimaraPro
in women with a uterus, estrogen must be given with a progestin (estrogen cannot be given unopposed)
167
```
Dry painful intercourse. Underwent total hysterectomy. Which of the following medications may provide benefit and reduce exposure to systemic estrogen
A. Climara
B. Estring
C. Vivelle-Dot
D. Premphase
E. Prempro
```
B. Estring
168
```
Which of the following treatments for osteoporosis causes hypercalcemia?
A. ibandronate
B. denosumab
C. teriparatide
D. calcitonin
E. risedronate
```
C. teriparatide
All other options cause hypocalcemia
169
```
Which of the following drugs or conditions can lower testosterone? SELECT ALL THAT APPLY
A. Effexor
B. Coreg
C. normal aging process
D. cimetidine
E. methadone
```
C. normal aging process
D. cimetidine
E. methadone
Other meds that lower testosterone include spironolactone and chemotherapy agents used for prostate cancer
170
```
Which of the following formulations contains estrogen + progestin?
A. Provera
B. Femring
C. Premarin
D. Minivelle
E. Premphase
```
E. Premphase
171
```
What is the most common application site for the Vivelle Dot and most estrogen patches?
A. upper thigh
B. buttocks
C. back
D. hip
E. lower abdomen
```
E. lower abdomen
172
SJ has breast cancer and is receiving Soltamox. What is the MOA?
A. nonselective norepinephrine receptor modulator
B. nonselective estrogen receptor modulator
C. selective norepineprhine receptor modulator
D. aromatase inhibitor
E. selective estrogen receptor modulator
E. selective estrogen receptor modulator
173
Which of the following information is incorrect?
A. propofol can cause the urine to be green
B. mitoxantrone can cause the urine to be blue
C. rifampin can cause the urine to be red
D. cyclophosphamide can cause the urine to be brown
E. doxorubicin can cause the urine to be red
D. cyclophosphamide can cause the urine to be brown
Cyclophosphamide is not known to discolor urine, but can cause hemorrhagic cystitis.
174
```
Choose the likely side effects from the usage of aromatase inhibitors. SELECT ALL THAT APPLY
A. thrombocytopenia
B. leukopenia
C. hot flashes
D. edema
E. osteoporosis
```
C. hot flashes
D. edema
E. osteoporosis
+ cardiovascular events, DVT/PE. do not take with tamoxifen or any form of estrogen!!
175
```
Which of the following agents is not an alkylating agent
A. melphalan
B. ifosfamide
C. carmustine
D. fluorouracil
E. cyclophosphamide
```
D. fluorouracil
5-FU is an anti-metabolite
176
```
Xeloda is...
A. cabazitaxel
B. capecitabine
C. erlotinib
D. etoposide
E. oxaliplatin
```
B. capecitabine
177
anastrazole MOA
A. blocks the estrogen receptor in breast tissue
B. blocks the enzyme responsible for conversion of aroma to aromatase
C. blocks the enzyme responsible for conversion to estrogen
D. blocks androgen receptors
E. acts as an estrogen agonist in breast tissue
C. blocks the enzyme responsible for conversion to estrogen
aromatase inhibitors block aromatase, the enzyme responsible for conversion to estrogen. in premenopausal women, most estrogen is synthesized in ovaries rather than peripherally, so these are approved in post-menopausal only
178
```
Which of the following is least likely to cause neutropenia
A. methotrexate
B. thalidomide
C. bleomycin
D. vinblastine
E. lenalidomide
```
C. bleomycin
179
```
Maximum lifetime dose of bleomycin
A. 200 units
B. 550 mg/m2
C. 400 units
D. 550 units
E. 400 mg/m2
```
C. 400 units
pulmonary toxicity
180
```
Which of the following needs to be refrigerated
A. nilotinib
B. sunitinib
C. erlotinib
D. etoposide
E. imatinib
```
D. etoposide
181
Which of the following is not associated with tyrosine kinase inhibitors?
A. oral bioavailability may be altered if taken with food
B. an acneform rash that indicates drug is working
C. QT prolongation
D. hyperthyroidism
E. hypertension
D. hyperthyroidism
TKI's cause hypOthyroidism & diarrhea
182
```
Arsenic trioxide has which of the following boxed warning?
A. neurotoxicity
B. hypersensitivity reactions
C. GI bleeding
D. prolonged prothrombin time
E. QT prolongation
```
E. QT prolongation
Tretinoin is first line for acute promyelocytic leukemia
183
```
Which of the following must be taken with food? SELECT ALL THAT APPLY
A. thalidomide
B. Xeloda
C. Rituxan
D. Aromasin
E. Gleevec
```
A. thalidomide
B. Xeloda
D. Aromasin
E. Gleevec
184
```
Treatment with rituximab could increase risk of reactivating which of the following?
A. EBV
B. rubella
C. hepC
D. CMV
E. hepB
```
E. hepB
185
```
What should the patient's pharmacogenomics testing show in order to use rituximab?
A. positive for B-cell antigen CD19
B. positive for B-cell antigen CD3
C. positive for B-cell antigen CD5
D. positive for B-cell antigen CD20
E. positive for B-cell antigen CD30
```
D. positive for B-cell antigen CD20
186
```
Carboplatin is dosed using which of the following?
A. Calvert formula
B. Rumack-Matthew Nomogram
C. Mostellar Formula
D. Hartford Nomogram
E. Dubois-Dubois formula
```
A. Calvert formula
used with the desired AUC and GFR
187
```
Which of the following medications can cause pulmonary fibrosis? SELECT ALL THAT APPLY
A. carmustine
B. bleomycin
C. doxorubicin
D. busulfan
E. cisplatin
```
A. carmustine
B. bleomycin
D. busulfan
B's and nitrosureas (-mustines) cause pulmonary fibrosis
188
```
KRAS-negative patients can receive which of the following medications:
A. rituximab
B. imatinib
C. cetuximab
D. capecitabine
E. lenalidomide
```
C. cetuximab
189
```
Which of the following medications carries a boxed warning that encompasses epistaxis/hemoptysis?
A. leucovorin
B. bevacizumab
C. fluorouracil
D. compazine
E. oxaliplatin
```
B. bevacizumab
BBW: severe and fatal bleeding
190
```
Which of the following should be prepared in a non-PVC container and infused with non-PVC tubing? SELECT ALL THAT APPLY
A. etoposide
B. doxorubicin
C. vincristine
D. docetaxel
E. paclitaxel
```
A. etoposide
D. docetaxel
E. paclitaxel
latTin- taxanes
191
```
Which of the following are cell-cycle nonspecific? SELECT ALL THAT APPLY
A. vincristine
B. fluorouracil
C. alkylating agents
D. cisplatin
E. doxorubacin
```
C. alkylating agents
D. cisplatin
E. doxorubacin
alkylating agents, anthracyclines, and platinum-based agents are nonspecific. vincirstine is M phase and fluorouracil is S-phase
192
```
Which of the following medications requires EGFR positive expression?
A. imatinib
B. trastuzumab
C. cetuximab
D. lenalidomide
E. rituximab
```
C. cetuximab
193
```
Which of the following analgesic agents are considered serotonergic?
SELECT ALL THAT APPLY
A. hydromorphone
B. codeine
C. meperidine
D. methadone
E. tramadol
```
C. meperidine
D. methadone
E. tramadol
194
```
Which of the following side effects can occur from excessive use of ProAir HFA? SELECT ALL THAT APPLY
A. hyperglycemia
B. headache
C. hypokalemia
D. bradycardia
E. nervousness & anxiety
```
A. hyperglycemia
C. hypokalemia
E. nervousness & anxiety
Other symptoms include tremor, shakiness, cough, and tachycardia
