1 Flashcards
Doctor prescribed 5 mg of Drug X but pharmacist dispensed 3 mg instead. What type
of error is this?
Dispensing error
How can this error be prevented?
Double checking
A doctor prescribes 3300 mg of MgSO4 to a patient with epilepsy, which results in
the baby being admitted to NICU. What type of error is this?
A. prescription error
B. Dispensing error
Prescription error
An elderly patient with diabetes has a HbA1c level of 12% and is on 4 anti-diabetic
medications, one of which is insulin. Patient refuses to take insulin due to fear of
weight gain. What is the most appropriate intervention?
Add Liraglutide for weight
loss if patient is overweight. if patient is not overweight re-assure patient that insulin
is needed due to high A1c and give advice to control weight.
A woman with cancer refuses to receive chemotherapy or surgery. What is the best
course of action?
Explain to her the benefits and risk of not receiving treatment so
she can make an informed decision.
What does the abbreviation OU stand for?
Apply to each eye (both eyes)
What is the anti-dote of organophosphosphate poisoning?
Atropine and Pralidoxime
What is the anti-dote in acetaminophen overdose?
N-Acetylcysteine
What is the anti-dote of benzodiazepines?
Flumazenil
How many natural amino acids in the human body?
20 natural amino acids
A patient with damaged pancreas consumes a high carb meal. The digestion of which
type of carbohydrates will be most affected?
Starch (amylase produced by pancreas
catalyzed digestion of starch into maltose and glucose)
What are the components of fungal cell wall?
Chitin + Glucans + Glycoproteins
Which of these is contains an inhaled cortisone?
Pulmicort, Symbicort
What is a reliable source of clinical studies?
Pubmed
What is the most appropriate anti-convulsant for a pregnant woman?
Lamotrigine
Woman taking levothyroxine has become pregnant. What is the most appropriate
course of action?
Inform prescriber to increase dose
A doctor has increased the dose of a patient’s anti-convulsant. What is the treatment
target?
Zero seizures
What are the secondary lymphoid organs?
Tonsils, Spleen, and Lymph nodes
Which surface protein is expressed by T helper (Th) cells?
CD4
What type of hypersensitivity reaction is hemolytic anemia?
Type 2 hypersensitivity
What Immunoglobulin is involved in allergic asthma?
Immunoglobulin E
Which immunoglobulin is able to pass through placenta?
Immunoglobulin G
Which bacteria causes Plague disease?
Yersinia pestis
Which gram-positive bacteria causes respiratory disease?
Streptococcus pneumonia
What is the definition of flocculation? .
Adherence of particles in a dispersion form to
create larger-sized particles
What is the definition of fluctuation (pharmacokinetic)?
Differences (fluctuations) in
peak-trough levels within one dosing interval at steady state (expressed as %).
Identify which drug has higher efficacy and potency from a dose-response curve.
What is a small, circular, double-stranded DNA that is distinct from a cell’s
chromosomal DNA known as?
Plasmid
A pharmacist is comparing the clinical outcome of two drugs with different costs.
Which type of pharmacoeconomic analysis is this?
a. Cost minimization analysis (CMA
b. Cost benefit analysis (CBA)
c. Cost effectiveness analysis (CEA)
d. Cost utility analysis (CUA)
c. Cost-effectiveness analysis (CEA)
Definition of SNP.
Single nucleotide polymorphism (change in only one nucleotide).
Nucleotides are organic molecules composed of a nitrogenous base, a pentose sugar and a phosphate
Which anticancer drugs target the mitosis stage?
Vina Alkaloids and Taxanes
In which genetic mutation is Imatinib used?
Philadelphia chromosome (BCR-ABL)
Which drug targets dihydrofolate reductase?
Methotrexate
Three questions on identifying types of studies (e.g., retrospective cohort study,
clinical trial, case-controlled study, cross-sectional study).
Which anti-diabetic class does sitagliptin belong to?
DDP-4
What is the maximum statin dose for patient taking verapamil?
10 mg (source:
RxPrep)
A patient who is Hajj visitor is prescribed Diazepam as needed for insomnia, what is
the maximum dose?
15 mg
Drug/supplement that cause heart burn?
Potassium supplements
What requires monitoring in patient receiving spironolactone?
Potassium levels
Which drug has a metallic taste?
Captopril
Which drug causes sulfa allergy?
Dapsone
What is myrrh used for?
Cough/Sore throat/Congestion
What question should be asked to patient on warfarin?
Do you have gum bleeding?
Patient comes to pharmacy with pinpoint pupils, what is the likely cause?
Heroin
Overdose
What are the ‘5 rights’?
right dose, right patient, right drug, right time, right route
What vaccines are required for patient with Asthma/COPD?
Influenza vaccine and
pneumococcal polysaccharide vaccine.
Can a baby receiving antiviral drug take live vaccine?
No, need to wait 48hrs after
stopping antiviral to receive vaccine.
A company made a profit of 120,000, the operating expenses were 5,000, and Zakah
was 8,000, what is the free cash flow?
107,000 (free cash flow = profit – [operating
expenses + tax/zakah + other expenses])
What enhances the activity of insulin?
Chromium
A patient with gastric bypass, which vitamin deficiency will he have?
B12 deficiency
Patient with hypothyroidism, which deficiency is he likely to have?
Iodine deficiency
Which Vitamin D is used in infants?
Cholecalciferol (Vitamin D3)
What is the first-line treatment for patient with osteoarthritis where non-
pharmacological measures were ineffective.
Topical NSAID (gel or patch).
Which drug is an IV direct thrombin inhibitor?
Argatroban/Bivalirudin
A female with hypothyroidism has developed osteoporosis, what is the appropriate
treatment?
Alendronate (High doses of levothyroxine can cause bone resorption)
A patient has received an organ transplant took herbal treatment which caused
organ failure, what is the likely herbal?
St John’s wort
A 60 yo patient presents with meningitis, what is the appropriate treatment?
Ceftriaxone + Vancomycin + Ampicillin
A neonate patient presents with meningitis, what is the appropriate treatment?
Ampicillin + Gentamicin
Which drug causes thyroid toxicity?
Amiodarone
What is the treatment of thyroid toxicity?
Methimazole (withdraw amiodarone if
possible).
Which drug causes pulmonary embolism?
Amiodarone
What is the purpose of granulation in drug formulation?
Produces larger particles
(granules) from fine powder – granules are free-flowing and dust-free making them
easier to compress.
What does mid arm circumference measure?
Measures arm muscle. Used as
indicator of nutritional status in children.
How to check for respiratory infection?
Auscultation
What is the definition of miscibility?
Mixing of substances to form a homogenous
solution without precipitates.
Calculate Vd.
Calculate Absolute bioavailability.
Calculate Phenytoin Correction.
Calculate Creatinine Clearance.
What type of beta-blocker is propranolol?
Non-selective beta-1 and beta-2 inhibitor
What are the health complications of polycythemia (high RBC conc.)?
high blood
pressure (other: gout, headache, blood clots).
Patient vomits two hours after taking levonorgestrel, what is the appropriate course
of action?
If more than two hours, no action. If within two hours, requires repeat
dose or alternative emergency contraception (e.g., IUD).
What is the benefit of conjugate estrogen compared to non-conjugate estrogen?
Prolongs half-life (acts as inactive estradiol reservoir that is slowly converted to
active estrogen).
Patient going into surgery, which medicines should be discontinued?
Depends on
answer choices usually anti-coagulants, anti-platelets, NSAIDs, ACE inhibitors,
diuretics, and MAO inhibitors.
Patient with multiple sclerosis experiences multiple relapses, what is the appropriate
treatment?
Natalizumab
Infant with nasal bleed, what is the likely deficiency?
Vitamin K
What is the best base for dry skin?
Ointment (used for very dry, chapped/cracked
skin).
Patient still suffering from UTI even after adherence to antibacterial treatment,
what is the best course of action?
Change to another antibiotic
Patient is non-adherent and after questioning appears to be unable to pay for
medication due to insurance running out, what is the cause of non-adherence and
what is the best course of action?
Cause: Economic. Solution: talk to patient about
benefits and risks
Patient with Hospital-acquired pneumonia experiences bronchospasm?
Use
bronchodilator (SABA) + Corticosteroid.
Scientists are conducting clinical trials assessing the use of anti-psychotics in
depression, what is the likely concerns?
Risk of extra-pyramidal symptoms and
metabolic problems.
What is the mode of action of mannitol?
Increase osmotic pressure (osmotic diuretic
used to reduce intracranial pressure)
Which chemical structure can cause penicillin allergy?
Beta-lactam ring
How is amphotericin B metabolized?
Hydrolysis
Which of these ACE inhibitors structures are active?
Captopril and Lisinopril
What type of breakdown occurs due to presence of water?
Hydrolysis
What type of reaction causes the conversion of amine (NH3) to a carbonyl (C=O) in a
catecholamine molecule?
Oxidative deamination (catalyzed by MAO enzyme)
What is the least dominant form of histamine?
When both amine groups are
protonated.
What’s the property of Carboxylic group (COOH)?
Acidic
What’s the property of Amine group (NH3)?
Basic
What’s the property of Alkyl group (CH3)?
Neutral
A patient is taking an anti-hypertensive drug, but it is still not controlled, what is the
best course of action?
(Not enough information - answer depends on age, race, and
co-morbidities).
A patient with altered kidney function is taking gentamicin and ampicillin, what is
required?
Both antibiotics require renal dose adjustments
A patient is taking the maximum statin dose and cholesterol levels are still not on
target, what is the appropriate intervention?
Add Ezetimibe
A patient on insulin refuses to take insulin due to fear of weight gain, what is the
best course of action?
Try to explain to patient the benefits of treatment to change
their belief.
A grandmother brings her grandson who is presenting with signs of poisoning, who
should you get more information from?
Parent/Caregiver
A patient is experiencing digoxin toxicity, what treatment should patient receive?
Digoxin Immune Fab (DigiFab) – each 40 mg vial binds 0.5 mg digoxin (max. 20 vials).
What is the advantage of transdermal delivery systems?
Deliver drug at a controlled
rate.
What is the function of the excipient Aspartame?
Artificial Sweetener
Can a patient who is taking Acyclovir receive the Varicella vaccination?
No,
varicella is live vaccine thus must wait 2 days after d/c acyclovir
A nurse was infected with Hepatitis B from infected patient blood, what is the
appropriate treatment?
Hepatitis B Vaccine + Hepatitis B immunoglobulins
Can vaccine and immunoglobulins be given together?
Yes, but at different
body sites (different arms)
What is the best treatment for patient with a deep wound and with unknown
Td history?
Td vaccination and immunoglobulin
Parasitic infection increases which cell type?
Eosinophils
Which cell is responsible for Type I hypersensitivity reactions?
Mast cells
A patient taking 850 mg of metformin twice daily but still has uncontrolled
diabetes, what is the best intervention?
Increase dose of metformin
What is the active form of Vitamin D?
Calcitriol
What do you recommend for a patient that wants something to help with
reducing risk of respiratory tract infections due to cold weather?
Zinc + Vitamin C
A patient who came to receive vaccination was found to have high blood
pressure in two readings, what is the best course of action?
Refer patient to doctor
to receive anti-hypertensive treatment.
Mechanism of action of Fluorouracil?
Thymidylate synthase inhibitor
Which anti-cancer drug works by inhibit formation of microtubules by binding
to tubulin?
Vincristine
Which anti-cancer drug works by stabilizing microtubules thereby preventing
cell division during M phase?
Paclitaxel
What side-effect is cause by cyclophosphamide?
Hemorrhagic cystitis.
What are the symptoms of severe malaria infection?
Bleeding
What is an important information that must be asked to patient with
malaria?
Travel History
How many ATP molecules are produced from 1 glucose molecule?
38
What is the appropriate first-line treatment for patient with severe Alzheimer
disease?
Donepezil
Which antibiotic is the safest?
Cephalexin
A patient has hypoalbuminemia, what effect will this have on phenytoin
levels?
Increase free serum concentration of phenytoin
A patient has symptoms of hyperthyroidism (weight loss, insomnia, increased
sweating etc.) and labs show high T4 levels and low TSH levels, what is the likely
diagnosis?
Hyperthyroidism
A patient on 100 mcg of Levothyroxine becomes pregnant, what is the
appropriate dose to give?
125 mcg (25% increase)
A patient experiences hypoglycemia, what is the likely causative agent?
Glibenclamide (Sulphonylureas)
A doctor shouted at pharmacist, but the pharmacist remained calm and did
not respond, what type of behavior is this?
Passive behavior
A doctor has a research question comparing the efficacy of two different
treatments, what research type is the most appropriate to answer this?
Random
Control Trials (RCTs)
Which of the following is an example of primary resource?
Look for RCTs in
PubMed
What is the interaction of ibuprofen and aspirin?
inhibition of COX-1
preventing binding of aspirin.
What type of pharmacoeconomic analysis compares outcomes of two
interventions in monetary values?
Cost Benefit Analysis
A pharmacist is comparing the cost of two generic drugs, what type of
pharmacoeconomic analysis is this?
Cost minimization analysis, reduction in direct
medical cost.
A patient is taking Azathioprine 6-mercaptopurine has reduced levels of
Thiopurine methyltransferase (TPMT), what is this patient at risk of?
Bone marrow
suppression.
Which drug causes severe diarrhea?
Irinotecan
A patient is taking Irinotecan and has UGT1A1*28 mutation, what is this
patient at risk of?
Neutropenia
A patient is taking Phenytoin and has HLA-B 1502 mutation, what is this
patient at risk of?
Hypersensitivity reaction
What is the most common gene mutation?
SNP
A child who was given codeine experiences dizziness and respiratory
depression, what is the likely cause?
The child is a Rapid metabolizer of CYP 2D6
What is the anti-dote of iron overdose?
Deferoxamine
What is the structural change in SNRI that forms NRI?
Demethylation of the
side-chain tertiary amine to secondary amine
Identify the pharmacophore of fluoroquinolone.
What is the definition of health literacy?
Individuals have the capacity to
understand basic health information to make appropriate health decisions.
What is the reaction that converts salicylic alcohol to salicylic acid?
Oxidation
Calculate clearance constant (Ke).
Calculate corrected calcium levels.
Calculate infusion rate.
Calculate SCr.
What electrolytes are low in refeeding syndrome?
Low magnesium,
potassium, and phosphate
What is low creatinine clearance a measure of?
Renal failure
What is antidote of benztropine?
Physostigmine
Which should be initiated in kidney failure patient with ankle edema and
heart failure?
Furosemide
What is the appropriate antibiotic for patient with penicillin allergy?
Any drug
that does not contain beta-lactam ring (X penicillin, carbapenems, cephlosporins).
The wrong medication was given to patient, what should the manager do?
Identify error and record/report the incidence.
Identify which drug has the highest half-life from time-concentration curve.
Identify which drug has the highest bioavailability from time-concentration
curve.
What is the role of secretin?
Stimulate the secretion of bicarbonate-rich
pancreatic fluid.
What is the accurate way to write prescription to prevent dose errors?
Correct answer is the choice without trailing zeros
- Examples of right answers: 0.1, 0.5
- Examples of wrong answers: 0.10, .1, .5, 0.50, 00.5
What is the least effective way to decrease medication error?
Double check
by an independent employee
What does the QRS on an ECG represent?
Ventricular depolarization
What does the QT interval on ECG represent?
Ventricular action potential
Which agent causes increased pupil size and cause dose dependent
withdrawal?
Naloxone
Which sleep medication causes dose-independent withdrawal symptoms?
Benzodiazepines and Z-drugs
Which agent decreases warfarin’s effect?
Vitamin K
Which vitamin deficiency causes Beri-Beri?
Vitamin B1 (thiamin)
Which vitamin is involved in the conversion of methionine to cysteine?
Vitamin B6 (pyridoxine)
A girl accidently took 2 doses of lamotrigine, what will she likely experience?
Dose-dependent serious skin reactions
A manager asked a pharmacist to make a promotion for the pharmacy, what
is this called?
Marketing
What type of study is a self-controlled study?
Case series (case-controlled
study is a self-controlled study design for which individuals act as their own control
i.e., comparisons are made within individuals).
What is a long-term action plan called?
Strategic plan
Which drug formulation should be stored in the refrigerator?
Suppositories
Which lab results show hypothyroidism?
Low T4 and high TSH
Which drug causes agranulocytosis?
Propylthiouracil (PTU)
Patient with mechanical heart valve is taking warfarin and his INR is 2.5, what
dose adjustment should be done?
Keep the dose as it is.
What is the appropriate treatment for asthmatic patient?
Answer depends on
case.
What is the appropriate treatment for COPD?
Answer depends on case.
Patient is experiencing 2-4 nightmares per week, what type of nightmare
disorder is this?
Moderate Nightmare Disorder (permanent is daily, and mild is less
than 1 per week)
Patient with an acute asthma attack was given salbutamol but has not
improved, which treatment should be added?
Oral Corticosteroids
What is the appropriate paracetamol dose for a child weighing 20 kg?
10-15
mg/kg Q4-6
What is the most common side-effect of lithium therapy?
Weight gain,
hypothyroidism, cognitive effects, ataxia, hand tremor, cogwheel rigidity, thirst,
polyuria/polydipsia, GI upset (nausea/vomiting).
What is the drug interaction of linezolid and citalopram?
Added risk of
serotonin syndrome
Drawing of methicillin sensitive strains.
A patient with rheumatoid arthritis is on methotrexate and leflunomide, what
treatment should be added?
Infliximab (anti-TNFa antibody treatment).
What advice should be given to a patient taking alendronate?
Take on an
empty stomach with a full glass of water while sitting upright
Which laxative should be used in an elderly patient experiencing severe
constipation?
1st line – bulk forming agent, 2nd line – stimulant laxative
Which drug is contraindicated in pregnant women? Tretinoin
(Acretin)
Aminocaproic acid is used to stop bleeding, how should the medication be
given?
Given once an hour or as continuous IV infusion for 8 hours or until bleeding
is controlled.
Which device should be dispensed with an oral liquid medication to child?
Oral syringe or spoon
Pharmacist is listening to patient with crossed over arm, what type of body
language is this?
Closed-off
What is the advantage of IV administration?
Bypass first-pass metabolism
What is the role of vitamin C when given with iron?
Vitamin C (ascorbic acid)
facilitates iron absorption by forming a chelate with ferric iron (Fe3+) at acidic pH
(stomach) and remains soluble at alkaline pH (intestines) thus facilitating absorption
in intestines. Also, vitamin C creates an acidic environment preventing oxidation of
ferrous iron to ferric acid.
A pharmacist was asked to produce 10 x 1 gram suppositories (each
containing 200 mg of drug X). Given that the displacement value Is 4.6, how much
base is required?
9.57g of base
Displacement value of 4.6 means that 4.6g of drug X will replace 1 g of suppository.
Total mass of drug X is 0.2g*10 = 2g
Total mass of suppositories is 1g*10 = 10g
2 g of drug X will displace 0.43g of base (2g/4.6=0.43g)
Therefore, the weight of base required is 10g – 0.43g = 9.57 g of base
Which part of the structure of ranitidine is responsible for its H2-receptor
inhibitory activity?
Furan ring (SAR of H2-antagonist: heterocyclic ring with a polar
nitrogen-containing sidechain).
A patient with renal failure has low calcium levels, what is the appropriate
calcium supplement to give?
Calcitriol (1,25-dihydrocolecalcetrol)
What type of reaction is the addition of piperidine ring to produce
ciprofloxacin?
Nucleophilic substitution in the presence of acid salt (e.g., HCl).
An antibiotic that inhibits the ribosomal subunit 50S inhibits which process of
translation?
Elongation
An antibiotic that inhibits the ribosomal subunit 30S inhibits which process of
translation?
Initiation
An asthmatic patient experiences more than 3 asthmatic attacks per day,
what is the severity classification?
Severe Persistent Asthma (step 4: treat with SABA
+ medium-dose ICS-LABA inhaler)
Asthmatic patient with FEV 75%, what is the recommended treatment?
Moderate Persistent Asthma (step 3: SABA + low-dose ICS-LABA inhaler)
Asthmatic patient with 3 attacks per week, what is the severity classification?
Mild Persistent Asthma (step 2: SABA + low dose ICS)
Asthmatic patient with 2 attacks per week, what is the severity classification?
Intermittent Asthma (step 1: rescue inhaler only – low-dose ICS-formoterol or SABA
+ low-dose ICS)
A patient overdosed on iron supplements and was taken to the hospital
within 2 hours, what is the suitable treatment?
Gastric Lavage
What is the suitable source of information for pediatric treatment?
Harriet
Lane Handbook
What is the first choice of treatment for a patient experiencing hypotension?
IV fluids
How is clearance measured in an adult patient?
Cockcroft & Gault equation
A patient is diagnosed with pulmonary embolism, patient weight is 120 kg
and his is 1.72 m (BMI is 40), what is the appropriate dose?
120 mg BID (1 mg/kg BID
based on TBW).
A case of a patient that smokes cannabis and is experiencing toxicity, what is
the active substance involved?
Tetrahydrocannabinol (THC) is the principle
psychoactive constituent of cannabis
What should be used for patient with atropine-like symptoms due to TCA?
Physostigmine
What vaccinations are required for hajj?
Influenza vaccine and meningococcal
meningitis vaccine
Which medication causes voice hoarseness?
Captopril
A 70 yo woman has dyspepsia and is experiencing pain in her bones and
acetaminophen was not effective for treating pain. What treatment should be given?
Celecoxib
What should be checked for patient given Empagliflozin?
Urogenital infection
What is the purpose of the skin fold test?
Calculate fat percentage
How does Mifepristone cause abortion?
Mifepristone is an anti-progestogen,
which blocks the effect of progesterone making both the cervix and uterine vessels
dilate and causing uterine contraction. It’s usually given in combination with
misoprostol, a synthetic prostaglandin E1 analogue which causes uterine contraction
and ripening of cervix.
A patient is prescribed warfarin but has VKORC1 polymorphism, what is the
suitable intervention?
Start on lower dose and monitor INR
What monitoring is required with Clozapine?
Monitor ANC every week for 6
months then every 2 weeks for 6 months then monthly. Stop therapy when ANC
<1,000/m3.
A patient has experienced agranulocytosis after taking clozapine, what is the
suitable intervention?
Discontinue Clozapine, Restart once ANC >1,500/mm3.
What is the function of PEGylation of medications?
To increase half-life
The wrong drug was prepared to be dispensed to patient, but pharmacist
found the error before medication was given to patient, what type of error is this?
Type B – an error occurred but did not reach patient
A patient with colorectal cancer has poor response to Cetuximab, what is the
likely cause?
Patient has mutated KRAS (Cetuximab only effective on non-mutated
KRAS wild type).
What type of bond does paracetamol make?
Hydrogen bond
What is the definition of a lead compound?
A chemical compound during
drug discovery that has pharmacological or biological activity against target and
thought to be therapeutically useful.
A patient is travelling to an error with outbreaks of salmonella infection, what
should the patient receive before travelling? .
Typhoid vaccine (injection >2 weeks
before travel, oral >1 week before travel)
A patient is at risk of post-operative gram-negative bacterial infection, which
antibiotic should be used?
Cefotetan, Cefoxitin, ampicillin/sulbactam, Ertapenem, or
Metronidazole + (Cefazolin or ceftriaxone).
A patient comes to the pharmacy for emergency contraceptives (Plan B –
Levonorgestrel), what advice should you give her?
Must be taken within 72 hrs of
unprotected sexual intercourse.
Based on the chemical structures, which steroid can be taken via inhalation?
Fluticasone
which pH will aspirin be most stable?
At pH <2
A pharmacist needs to make a solution with concentration 0.5% w/v. The
available stock solutions are 120 ml of 20 mg/5mL solution and 240 ml of 50 mg/5ml solution. How much of the second solution should be added to the first solution to
provide the desired concentration?
24 mL of the 50 mg/5mL solution
with picture solution
What is the best treatment for a boy with motor hyperactivity?
methylphenidate
Which cephalosporin class does ceftazidime belong to?
Class 3 Cephalosporin
A female patient has ulcerative colitis and dysmenorrhea, based on the given
structures, which treatment should be given?
Mefenamic Acid
A patient has albuminuria >300mg/mL, what is the suitable treatment?
Lisinopril
Which anti-hypertensive drug that can be used in patient with bilateral renal
stenosis?
Amlodipine
What is the suitable oral treatment for patient with myelitis scoliosis who is
experiencing 2 relapse per year?
Fingolimod
A robot for automated filling is being used in hospital, what type of error will
this reduce?
Dispending error (e.g., wrong medication, dosage form or dose).
A patient experienced anaphylaxis from prescribed medication, what type of
error is this?
Type H Error
How is hepatic clearance calculated?
Hepatic elimination ratiohepatic blood
flow = hepatic clearance OR rate of hepatic eliminationdrug concentration =
hepatic clearance
How is mortality calculated?
Number of death cases per year/total
population*100,000
How is prevalence calculated?
Number of people with disease/total
population*100,000
Female patient on Finasteride and wants to conceive, what counselling
should be given?
Inform her that she cannot become pregnant while taking
finasteride.
A 65 yo patient is going on summer vacation, his vaccination record shows
that he receives influenza vaccine every year and PCV20 4 years, what vaccination
should he be given?
Hepatitis A
A patient was taken to emergency due to hypoglycemia. The patient was
unaware of hypoglycemia symptoms. Which agent is responsible for masking
symptoms of hypoglycemia?
Beta-blockers
Aspirin is an acid with pKa of 3.5, which is the % ionization in the intestines
(pH= 7.4)?
99.9%
An acidic drug with pKa of 3.5, what is the best pH for it to be absorbed?
pH 1
(acidic drugs are predominantly unionized at pH below their pKa)
A patient is diagnosed with RSV, what is the suitable treatment?
Supportive
treatment (oxygen, IV fluids, etc.).
- Cases when inhaled ribavirin is given: severe lower respiratory infection
with underlying comprising condition (premature neonates,
cardiopulmonary disease, or immunosuppression). - Cases when IM Palivizumab is given: premature infants (<29 weeks
gestation) and children <12 months with respiratory or heart conditions
as monthly prophylaxis during fall/winter season.
Which factor affects the inventory ABC classification?
Annual
consumption/sales value (annual number of units sold x cost per unit)
What type of agents are suspending agents?
Hydrophilic colloids
What is the drug of choice to treat patient with Anaphylaxis?
Epinephrine
What type of anemia is caused by iron deficiency?
Hypochromic microcytic
anemia
Which of the following local organization’s primary mission is to ensure the
safety and quality of healthcare is health institutions?
CBAHI
DNA ligase is the enzyme for ligation of?
2 DNA strands
A 6-year-old boy is brought with complaint of uncontrollable spasm-like
movements and excessive blinking for four months. Chronic motor disorder was
diagnosed. Which of the following is the best management?
Haloperidol (anti-
psychotic is 1st line treatment of tics)
When should trough levels be measured for vancomycin?
30 mins before 4th
dose (after 3rd dose).
Calculation switching between mEq per liter to mEq per gallon.
1 gallon =
3800 mL thus 10 mEq/L = 38 mEq/gallon
Which of the following is a binder agent?
Binder agents: acacia,
starch/cellulose paste, sucrose syrup, compressible sugar, xanthan gum, gelatin.
Calculating therapeutic index from LD50 and TD50.
Calculating specific gravity.
Calculating Bioavailability from absolute AUC.
A patient left her aspirin pills in the bathroom, what will likely happen to
aspirin?
Degradation of aspirin via hydrolysis (bathroom is a warm and humid
environment)
What choice of benzodiazepines should be used in elderly patient?
L-O-T
(Lorazepam, Oxazepam, Temazepam).
Which of the following is a long-acting benzodiazepine?
Diazepam,
Clonazepam, Flurazepam, Quazepam.
What reaction is involved in metabolism of prednisone to active form
prednisolone?
answer is in the image
Which bacteria is a Catalase positive & coagulase positive bacterium?
Staphylococcus aureus
Which amino acids are conjugated in the liver?
Glycine & Taurine
Which amino acids are involved in production of keratin (nail&hair)?
Lysine
(all possible correct answers: Cysteine, Lysine, Arginine, Methionine (CLAM))
A patient is requesting medication for depression, but he does not have a
prescription and he is going away on vacation for a week, what is the best course of
action?
Call prescriber for prescription
Which vaccines are contraindicated in pregnant patient?
Live vaccines
Which of the following is an essential amino acid?
Isoleucine, Lysine, Leucine,
Valine, Methionine, Phenylalanine, Tryptophan, Threonine, Histidine, Arginine
A patient comes to the pharmacy with a prescription, but the brand of
medication prescribed in unavailable, what is the best course of action?
Give the
same active ingredient from different company and counsel patient on the change.
IMAGE PAGE 14
From the table above, what is Drug C?
Angiotensin receptor blocker (e.g.,
Valsartan)
IMAGE PAGE 14
From the table above, what is Drug A?
Direct Renin Inhibitor (e.g., Aliskiren)
Which USP chapter can be used for information of chemotherapy
preparation?
USP 800
What does the abbreviation “gtt OU TID” mean?
one drop to each eye three
times a day.
Which immunoglobulin is involved in passive immunity?
IgG
Which part of immunoglobulin attaches to B-cell?
Heavy chain
Which part of immunoglobulin interacts with antigen?
Variable region of light
and heavy chain (known as Fab: fragment antigen-binding region)
Calculate the CHA2DS2VASc score for 70-year-old male patient with HF who
has hypertension, diabetes, and history of TIA.
Score of 6
(CHF = 1, HTN=1, Age>75=0, DM=1, Stroke/TIA=2, VD=0, Age 65-74=1, Sex(F)=0)
Calculate the CHA2DS2VASc score for 60-year-old female with diabetes and
hypertension.
Score of 3
(CHF = 0, HTN=1, Age>75=0, DM=1, Stroke/TIA=0, VD=0, Age 65-74=0,
Sex(F)=1)
What type of cost is loss of productivity due to illness?
Indirect cost
What does a QALY of 1 mean?
1 year in perfect health
What is the measurement unit of a CUA?
Quality-adjusted Life Years (QALY)
What type of cost is hospital meals?
Direct non-medical cost
What type of cost is hotel price and travel fees?
Direct non-medical cost
What type of cost is emotional distress?
Intangible cost
A pharmacist is comparing the costs of alternative treatments, which have
equivalent outcome. What type of pharmacoeconomic analysis should he conduct?
Cost-minimization Analysis
Define the cost-effectiveness ratio (CER).
Net cost divided by changes in
health outcome.
A question on the structure of a drug’s pharmacophore and asks about the
interactions of different functional groups (e.g., alcohol group: H-bond, ester:
hydrolysis, Alkene: hydrophobic interaction, Carboxylate: ionic interaction).
A question which gives you a structure and asks you to identify the
bioisostere of the molecule.
A bioisostere is a molecule resulting from the exchange of an atom or a functional
group with an alternative, broadly similar, atom or functional group.
image is in page 15
What is the intermediate of epinephrine?
Tyrosine, L-DOPA, Dopamine,
Norepinephrine are all considered intermediates of epinephrine
image is at page 16
What is the active form of Oseltamivir?
Ester hydrolysis to Carboxylate
image is at page 16
What is the reason for the substitution of the ethyl/methyl sidechains of an
ACE inhibitor to a benzyl group?
Improve binding to hydrophobic binding pocket.
image is at page 16
A patient received Vancomycin 1g q12h for 3 days but there was not
improvement. The trough level was 8 mg/L. What is the recommended action?
Increase dose of vancomycin (therapeutic level is 10-20 mg/L)
The doctor prescribed 25 mg/m2 of Drug for a child weighing 18 kg and his
height is 82. Calculate the dose.
16 mg
equation is at page 17
What is the AUC of IV Ceftriaxone considering half-life is 6 hours and initial
concentration is 30 mg.
259.7 mg.h/L
calculation is at page 17
A 62-year-old man is at risk of Type 2 Diabetes and his father has Type 2
Diabetes. He exercises occasionally. How can you decrease the risk?
A- Reduce Body Weight
B- Initiate insulin
C- Increase exercise to 2-3 times per week.
D- Initiate metformin
C- Increase exercise to 2-3 times per week.
If patient is overweight = reduce body weight
If patient’s hbA1c >9% = start insulin or liraglutide
If patient’s hbA1c >6.5% = start metformin
Patient did colorectal surgery and anti-coagulation is required (patient has no
contraindications). What is the suitable treatment?
A- Fondaparinux 2.5 mg during hospitalization
B- Enoxaparin 40 mg OD for 4 weeks
C- Enoxaparin 40 mg OD during Hospitalization
D- Rivaroxaban
B- Enoxaparin 40 mg OD for 4 weeks
Cancer patient with pain. The doctor wants to start codeine treatment, but
patient has 2 copies of CYP2D6 poor metabolizer. What is the suitable treatment?
A- Give lower dose of Codeine
B- Give higher dose of Codeine
C- Give alternative as Codeine causes side-effects.
D- Give alternative as Codeine ineffective.
D- Give alternative as Codeine ineffective.
What is the asthma severity in patient who experiences daily symptoms and
2-3 times night awakening and uses inhaler several times per day?
Moderate
Persistent Asthma
What is the asthma severity in patient who experiences symptoms 2 days per
week, with no exercise limitation and FEV1 >85%?
Intermittent Asthma
What is the suitable treatment for exacerbations in COPD?
Bronchodilator
(e.g., Albuterol or Salbutamol) + oral/iv steroid + antibiotic (azithromycin)
A patient is experiencing runny nose, cough, sneezing, and teary eyes. Which
treatment provides fastest relief?
Phenylephedrine
A patient is experiencing symptoms of allergy. The patient works as a truck
driver. He comes to the pharmacy asking for medicine to treat his allergy. What is
the suitable treatment?
A – Chlorpheniramine (sedating antihistamine)
B – Desloratadine (non-sedating antihistamine)
B – Desloratadine (non-sedating antihistamine)
structure is at page 18 and 19
A patient had a car accident after taking medication. What is the likely
medication that caused this?
Diphenhydramine (sedative)
A patient has hypertensive crisis. The patient’s medications are lisinopril,
metformin, topiramate, and phenylephrine. The patient also eats tyramine-rich
foods during lunch. What is the causative medication?
Phenylephrine (risk of
serotonin syndrome)
A patient with cholesterol level of 195 mg/dl, what is the appropriate
medication?
Atorvastatin 40 mg
A patient comes to the pharmacy for Plan B contraceptives, what advise
should you give her?
Medication needs to be taken within 72 hours aof sexual
intercourse.
A post-menopausal patient with breast cancer is prescribed estrogen
therapy. She is a poor metabolizer of CYP2D6. Which medication will reduce
progression-free survival?
A- Raloxifene – only for prevention of breast cancer
B- Tamoxifen – metabolized to active by CYP2D6
C- Anastrozole – 1st line in postmenopausal women
B- Tamoxifen – metabolized to active by CYP2D6
A 36-year-old patient with BMI of 32 and has been a smoker for 10 years.
Family history shows no history of strokes/MI. What is the appropriate
contraceptive?
Progesterone only pills
Estrogen-containing pills boxed warning: do not use in women >35 years old who
smoke due to risk of serious cardiovascular events.
A child with fever and cough caused by virus. What is the suitable treatment?
A – Paracetamol
B – Cefuroxime
C – Oseltamivir
A – Paracetamol
What is the mode of action of Ciprofloxacin?
DNA gyrase and Topoisomerase
IV inhibitor
What is the function of TATA box?
a type of DNA promoter sequence, which
specifies to other molecules where transcription begins.
A 42-year-old patient with asthma has received pneumococcal vaccine 4
years ago and asks if her needs to take it again. What is the suitable action?
A- Patient does not need another dose until he is 65 years old.
B- Administer PPV23
C- Administer PCV13.
D- Another dose is not needed.
A- Patient does not need another dose until he is 65 years old.
A patient has dyslipidemia, type 2 diabetes, and osteoarthritis (lab results
normal but blood pressure elevated). What is the appropriate treatment?
A- Lisinopril
B- Metformin
A- Lisinopril
Which of the following has an inhibitory effect on mast cells?
Interleukin-10
(not sure about this but only information I found)
A patient receiving TPN has hypomagnesemia, hypophosphatasemia, and
hypokalemia, what is this condition called?
Refeeding Syndrome
A patient with hypotension with hyponatremia, what is the appropriate
treatment?
A- 6-12 mEq/L in 12 hours
B- 6-12 mEq/L in 24 hours
B- 6-12 mEq/L in 24 hours (rapid correction can cause osmotic
demyelination syndrome).
Recommended Na+ correction rate:
§ No more than 0.5 – 1 mmol/L every hr
§ No more than 8-10 mmol/L in 24 hrs
§ No more than 18 mmol/L in 48 hrs
A patient is taking medication (including daptomycin) and has elevated CPK,
which drug caused this?
Daptomycin (causes Rhabdomyolysis and myopathy).
A patient’s ECG show that patient has QT prolongation, T-wave elevation, and
PR prolongation, what is the likely reason?
Hyperkalemia
How can you differentiate between different types of Myocardial Infarction?
Troponin and ECG
A patient is prescribed Rituximab, what monitoring should be conducted
before initiating treatment?
Hepatic Panel
A patient was taking non-pharmacological treatment for rheumatoid arthritis
but has not helped. What treatment should he be given?
Hydroxychloroquine
A patient has hypertension, diabetes, and rheumatoid arthritis. The patient is
taking anti-diabetic and anti-hypertensive medications. Which clinic should the
patient be referred to?
Rheumatoid clinic
A patient is taking hydrochlorothiazide and Eplerenone (and other
medications. hydrochlorothiazide causes hypokalemia. Which of the patient’s
medication will correct this?
Eplerenone (potassium sparing diuretic)
A patient with hypertension, osteoporosis and diabetes is taking amlodipine,
calcium carbonate, metformin, and captopril. The pharmacist found a drug-
interaction. What is the best action?
A- Stop calcium carbonate. (Patient needs this for osteoporosis)
B- Separate amlodipine and calcium carbonate 6 hrs before and after. (No because
type of interaction is pharmacodynamic interaction not pharmacokinetic
interaction).
C- Increase dose of amlodipine. (this could be the answer if BP increased)
D- No change in treatment required (considered a minor interaction, which requires
close monitoring of BP)
D- No change in treatment required (considered a minor interaction, which requires
close monitoring of BP)
A patient is on spironolactone and captopril, what can this cause?
hyperkalemia and hyponatremia
A pharmacist is counselling an elderly patient prescribed anti-psychotic.
During counselling, patient says he takes from wife’s medications to help him sleep.The pharmacist recorded that patient has addiction because he takes meds from
wife. What is the mistake pharmacist made?
A- Write diagnosis that patient has drug addiction
B- Violate the privacy of the patient
A- Write diagnosis that patient has drug addiction
The following prescription is received in a hospital pharmacy:
Losartan 25 mg
Sig: Take 1 tab BID
Duration: 3 weeks
Which of the following instructions will be in prescription label?
A. Take 1 tablet once daily (21 tablets)
B. Take 2 tablets once daily (42 tablets)
C. Take 1 tablet twice daily (42 tablets)
D. Take 2 tablets twice daily (48 tablets)
C. Take 1 tablet twice daily (42 tablets)
A 35-year-old individual is receiving 20 mg of propranolol hydro 4 times daily
as a prophylaxis to migraine attack. The drug bioavailability is 25% due to extensive
first pass effect. What amount of the drug reaches the systemic circulation after
dosing?
A. 2.5 mg
B. 5 mg
C. 7.5 mg
D. 10 mg
B. 5 mg
A hospital has 100 available beds, and they have 3 ambulatory care clinics.
They want to start an ambulatory care service. Which one of the SWOT analysis
categories is this?
Strength (beds are internal resources which hospital has)
image is at page 20
A patient’s digoxin levels were obtained 2 hours after ingestion of digoxin
and digoxin level was 2.7. What is the best course of action?
Do not administer Digifab (Digoxin level needs to be obtained at least 6 hours after
digoxin dose).
Which of the following is related to Lipinski’s rule of 5?
A- Molecular weight > 500 Da
B- Log P <5
C- H-Bond Donors <10
D- H-Bond Acceptors <5
B- Log P <5
image is at page 22
What is the structure of Ethosuximide?
is at page 22
Risperidone pharmacogenomics
Patients with two inactive copies of CYP2D6 (poor metabolizers) may have
decreased metabolism of Risperidone to active metabolite (9-
hydroxyrisperidone)
- Patients with CYP2D6 ultra-metabolism are at increased risk of adverse effects
(e.g. EPS).
Tramadol pharmacogenomics.
Patients with two inactive copies of CYP2D6 (poor metabolizers) may have
decreased metabolism of Tramadol to active metabolite.
- Patients with CYP2D6 ultra-metabolism are at increased risk of toxicity and
adverse effects.
A patient on warfarin has INR of 11 and is experiencing minor bleeding. What
is the suitable intervention?
Stop warfarin and give slow IV vitamin K.
Dose of Naloxone.
0.4 – 2 mg IV/SC/IM/Inhalation if non-opioid dependent.
0.1-0.2 mg if opioid-dependent (to avoid acute withdrawal)
Repeat every 2-3 mins if needed (max. 10 mg).
Dose of Apixaban.
Stroke prophylaxis: 5 mg BID (2.5 mg if age >80 or weight <60 kg).
DVT/PE prophylaxis: 2.5 mg BID.
DVT/PE treatment: 10 mg BID for 10 days then 5 mg BID.
Dose of Rivaroxaban.
15 mg BID for 21 days then 20 mg OD (avoid if CrCl <30).
Dose of Heparin.
VTE prophylaxis: 5,000 units SC Q8-12 hrs
VTE treatment: 80 mg/kg IV bolus (or 18 units/kg/hr if infusion)
ACS/STEMI treatment: 60 units/kg IV bolus (or 12 units/kg/hr if infusion)
What are the side-effects of lamotrigine?
Alopecia and Rash
What is the washout period for Fluoxetine?
5 weeks
pregnant patient with hyperthyroidism, what is the recommended treatment?
PTU for 1t trimester then Methimazole for the 2nd and 3rd trimester
Patient with high TSH and low T3 and T4, waht condition does he have?
Hypothyroidism
acid-base calculations (pka and pH).
the computation is in page 34
Patient with narcotic prescription prescribed 2 days ago and is only valid for 7
days. He is traveling to another country. What should you do?
A- Give 5 days medication
B- Give 7 days medication
C- Refuse to dispense medication
D- Ask patient to get new prescription
A- Give 5 days medication
Can live vaccination be given to child receiving immunoglobulins?
Yes but
different sites
Which laxatives should be given to patient with opioid-induced constipation
due to morphine?
1st line = Stimulants (e.g., senna or bisacodyl) +/- stool softener (e.g., docusate)
2nd line = Methylnaltrexone/Naloxegol (Peripheral opioid mu receptor inhibitors) or
Lubiprostone (calcium-channel activator)
A patient is experiencing cough and mucus. What medication can he use?
Guaifenesin
Which drug has higher potency?
image at page 22
Drug D
Which drug has higher efficacy?
image at page 24
Drug A and Drug B
(Drug A and Drug B both have same efficacy, but drug B has lower potency)
Which drug has shorter half-life.
iamge at page 24
Drug A (the drug with the steeper slope will have rapid clearance and therefore the
shortest half-life – i.e., shorter time to reach half of the peak concentration).
Which drug has higher bioavailability?
image is at page 25
Drug A
Calculation of SPF.
Sun protection factor (SPF) = Time-to-burn (with sunscreen) / Time-to-burn (without
sunscreen)
What is the mechanism of action of methotrexate?
Dihydrofolate reductase
inhibitor
What is the mechanism of action of cyclophosphamide?
Alkylating agent
which causes cross-links between DNA strands.
What is a side-effect of cyclophosphamide?
Hemorrhagic cystitis
What is the treatment of pin worms?
Albendazole/Mebendazole
What is the suitable treatment for a pregnant woman with hypertension?
Labetalol
What is a 2nd mediator during hypersensitivity reactions?
Leukotriene
What is clonidine mode of action?
Alpha-2 receptor agonist
Which medications are considered high alert medications?
Chemotoxic
medications
Patient with CYP2C19* poor metabolizer is prescribed clopidogrel, what is
the likely impact?
Reduced effectiveness of clopidogrel
Patient on dialysis was prescribed sodium polystyrene, what is the reason?
To
reduce potassium levels
What is the suitable antidote in Aspirin toxicity?
Alkalinization with Sodium
Carbonate (increases renal excretion of aspirin)
What are the implications UG1TA1*28 in patient prescribed Irinotecan?
Increases risk of neutropenia especially if two copies (Homozygous)
Questions on (did not specify what the questions are):
- Phenytoin
- St John Wart
- Ergocalciferol
- Pyridoxine
- Type of immunoglobulin
- Abbreviations
A patient case with gastric cancer, which visceral protein parameter should
be measured?
A- Fibrinogen
B- CRP
C- Albumin
D- Hemoglobin
C- Albumin
Low albumin levels indicate poor prognosis in gastric cancer
Patient with lymphoma finished 2nd cycle of chemotherapy with
cyclophosphamide, which drug will be used to lower the toxicity associated with us?
A- Prednisolone
B- Mesna
B- Mesna
Patient on methotrexate, what should be given before treatment?
A- PPI
B- Antibiotics prophylaxis with penicillin
C- Gastrin
D-none of the above
None of the options seem correct since PPI and penicillin are not recommended with methotrexate.
Physical examination in sepsis
A patient with hysterectomy and develops vaginal dryness, what treatment should be given?
A- Estrogen
B- Estrogen and progesterone
C- Lubricant
C- Lubricant
TB is one of the most common infectious diseases prevalent in Saudi Arabia,
the main drugs used are isoniazid and pyrazinamide, which can cause sideroblastic
anemia. Which treatment should be given?
Pyridoxine (vitamin B 6)
what is the definition of affinity ?
The strength of attraction between drug and receptor.Which
drug has highest affinity
Image 371 page 26
drug A
The Naranjo score of reported ADR is 8, what does this mean?
Probable
Naranjo score for assessing whether there is a causal relationship between an
identified clinical event and drug:
Score O: Doubtful
Score 1-4: Possible
Score 5-8: Probable
Score >9: Definite
A patient with sulpha allergy, which drug is contraindicated?
Dapsone
Which carbohydrates are pentose sugars?
Ribose
Pentose sugars: Ribose/Deoxyribose, Lyxose, Xylose
Hexose sugars: Glucose, Galactose, Fructose, Mannose
What is a chemical compound in drug discovery that has pharmacological or
biological activity likely to be therapeutically used, but may nevertheless have
suboptimal structure that requires modification to better to the target?
Lead compound
Classification of variable.
see image in page 27 number 375
A patient comes in with signs of meningitis including a headache. The doctor
lifts the patient’s neck to check if knee flexion occurs. What type of examination is
this?
Brudzinski sign
image at page 28 number 376
What is the dose of naloxone for children?
A room with temperature of 15 – 25 degree Celsius is considered …?
A- Warm room
B- Cool room
C- Room temperature
C- Room temperature
chart is at page 28 number 378
A drug needs to be stored at temperature of 8 to -8 degree Celsius, where
should it be stored?
A- On the table
B- In the freezer
C- In the refrigerator
D- Nitrogenous container
C- In the refrigerator
Which one of the following is the first step in the central dogma?
A- Transcription
B- Translation
C- Replication
D- Splicing
A- Transcription
Steps of central dogma =
1. Transcription – DNA strand is copied into RNA in the nucleus.
2. Splicing – the processing of pre-mRNA to mature mRNA by removing
introns and non-coding sequences.
3. Translation – production of protein from mRNA in the ribosome.
4. Replication – production of new copies of DNA during cell replication.
A patient with hypertension has erectile dysfunction. What is the
recommended treatment?
A- Sildenafil
B- Vacuum device
A- Sildenafil
Note that Sildenafil is contraindicated in serious heart and liver problems
Calculate infusion rate.
Infusion rate = Cl*Css
Infusion rate = Cl*Css
383. Pharmacophore of Proton Pump Inhibitors.
structure image at page 29 number 383
PPIs are weakly basic prodrugs (pKa 4) that are activated by the acidic conditions
found in the canaliculi of parietal cells (pH 1-2). The acidic condition protonates
pyridine nitrogen which makes PPIs accumulate at target site and undergo an acid-
catalysed rearrangement to form a reactive tetracyclic pyridinium sulphenamide
which acts as an irreversible inhibitor by forming a covalent disulfide bond with the
cysteine residues on the proton pump.
Protonation is important for accumulation at target site (canaliculi) and acid-
catalyzed conversion to reactive form. This is dependent on pKa of the pyrimidine
nitrogen.
If there is a discussion between choosing physostigmine and rivastigmine?
A. Replace with Rivastigmine because Physostigmine can produce
amphetamine.
B. Replace with Physostigmine because Rivastigmine can produce
amphetamine.
C. Replace with Physostigmine because has lower SE
D. Replace with Rivastigmine because has lower SE.
A. Replace with Rivastigmine because Physostigmine can produce
amphetamine.
A patient requires dual anti-platelet therapy and has CYP2C19, what is the
suitable combination?
A- Aspirin and Clopidogrel
B- Aspirin and Ticlopidine
C- Ticlopidine and naloxone
D- Ticlopidine and Aspirin
D- Ticlopidine and Aspirin
Which antibiotic causes QT prolongation?
A- Azithromycin
B- Doxycycline
C- Amoxicillin
A- Azithromycin
A patient has experienced signs of toxicity including insufficient urination.
Which mediation is the cause?
A- Quercetin
B- Furosemide
C- Digoxin
A- Quercetin (also cause kidney damage)
What are the side-effects of amphotericin B?
Nephrotoxicity
What advice would you give to patient who is traveling and is scared of
getting malaria?
Methods for preventing malaria:
- Antibiotic prophylaxis (doxycycline daily start 1-2 days before travel and
up to 4 weeks after travel OR chloroquine/mefloquine once weekly start
1-2 weeks before travel and continue up to 4 weeks after travel)
- Insect repellent (20-30% DEET or 20% Picaridin)
- Use bed net treated with permethrin
- Wear long sleeved shirt and long trousers
What is the treatment choice for MSSA infection?
Nafcillin or Oxacillin
Question asking you to calculate the plasma concentration of drug after 10
hours based on Vd, infusion rate, and half-life.
Which one between Daunorubicin (right) and mitoxantrone (left) has higher
cardiotoxicity and why?
Mitoxantrone is less cardiotoxic because it lacks the sugar moiety, which makes
daunorubicin more prone to mitochondrial redox cycling in the cardiomyocytes. This
results in generation of reactive-oxygen species (ROS).
image of structure page 31 number 392
Calculate shelf-life based on the degradation rate (k).
Shelf-life (t90) is the time required for 10% of the drug to degrade (90% remains).
The equation to calculate this is t90 = 0.105/k
The patient took 100 mg of drug with half-life of 5 hours. How much of the
drug will be eliminated in 24 hours?
97%
Patient has a narcotic prescription from Riyadh and went to a pharmacy in
Dammam. The medication is for pain after major surgery and it’s for 5 days, but the
patient came after 2 days from the prescription date?
A- Give the meds for the remaining days (3 days).
B- Call physician
C- Don’t give
A- Give the meds for the remaining days (3 days).
A patient comes to the pharmacy and tells the pharmacist he is a loyal
customer to the pharmacy and likes the pharmacist. 2 days later, the patient comes
to the pharmacy angry and shouting because he says the pharmacist gave him the
wrong information. What should the pharmacist do?
A- Tell him that you gave him the wrong information.
B- Tell him to leave the pharmacy
C- Apologize to patient
D- Ask him what the wrong information is?
D- Ask him what the wrong information is?
What is the mode of action of Doxazocin?
A- blockage post-synaptic alpha-2 receptors
B- blockage pre-synaptic alpha-2 receptors
A- blockage post-synaptic alpha-2 receptors
Which Immunoglobulin crosses placenta?
IgG
A medicine contains water and olive oil, what type of formulation?
Emulsion
Which part of study report is the objectives?
Introduction
What is the treatment of ductus closure?
Indomethacin
How to prevent error due to similar drug names?
Tall man lettering
Which information source can be used to check for drug interactions?
A- Lexicomp
B- Micromedex
A- Lexicomp
B- Micromedex (could also be correct)
Which drug is considered an insulin secretagogue?
A- Glibenclamide
B- Metformin
C- Pioglitazone
D- Dapagliflozin
A- Glibenclamide
Mutation in which enzyme would affect metabolism of Atorvastatin?
A- CYP2C9
B- CYP3A4
C- CYP2D6
D- CYPC19
B- CYP3A4
A pharmacy already has medication for 3500 SAR but has side-effects. There
are two alternative drugs with the same efficacy, drug A costs 3000 SAR and drug B
costs 5000 SAR, what is the best decision?
A- Accept both drugs
B- Reject both drugs
C- Accept A and reject B
D- Reject A and accept B
C- Accept A and reject B
Two medications with different costs and different effects, what type of
pharmacoeconomic analysis should be conducted?
A- Cost-effectiveness analysis
B- Cost-minimization analysis
C- Cost-utility analysis
D- Cost-benefit analysis
D- Cost-benefit analysis
A patient comes with pain in his toe and it’s bleeding, what advice should you
give patient?
Refer to doctor
A 40-year-old patient case and asks what examination should patient
receive?
A- Get checkup for lung cancer
B- Get checkup for diabetes
C- Wait until after age 45 to get diabetes checkup
D- Wait until after age 45 to get lung cancer checkup
C- Wait until after age 45 to get diabetes checkup
Answer depends on patient case:
- Lung cancer screening is indicated for 55–74-year-old patients with at
least 30 pack-year smoking history and have smoked within past 15 years.
Screen earlier if has respiratory disease. - Diabetes screening after age 45 years or before if BMI >25 and have risk
factors (e.g., physical inactivity).
A patient on metformin is experiencing tingling in fingers and toes. What
supplement should be given?
vitamin b12
A 6-year-old boy is brought with complaint of uncontrollable spasm-like
movements and excessive eye linking for four months. Chronic motor disorder
diagnosed. Which of the following is the best management?
A. Pregabalin
B. Haloperidol
C. Methadone
D. Chlorzoxazone
B. Haloperidol
A female patient with epilepsy controlled on valproic acid wants to conceive,
what is the best action?
A. Continue on Valproic acid
B. Stop Valproic acid
C. Switch to Phenytoin
D. Slowly taper down dose and slowly increase dose of Levetiracetam
D. Slowly taper down dose and slowly increase dose of Levetiracetam
What is the benefit of changing carboxylic acid to tetrazole in Losartan?
Improved oral absorption
Structure I has poor oral absorption. Tetrazole ring is a bioisostere of the
carboxylic acid group (they both contain an acidic proton) but tetrazole is 10
times more lipophilic, which improves oral absorption.
image of structure is at page 33 number 413
Which of the following method is successful in reducing medication error and
enhance patient safety in hospitals?
Implementation of computerized physician
order entry (CPOE) system
If an automated dispensing system is used in pharmacy, which error type will
be reduced?
A. Prescribing error
B. Dispensing error
C. Administration error
B. Dispensing error
Type of observational study about relationship between someone who eats
fatty food and obesity.
Association study
Which type of study should be conducted to assess cause of rare disease or
diseases with long latency period?
case control study
The authors report two isolated gastrointestinal tuberculosis in renal
transplant recipients that illustrate the difficulty of making this diagnosis and a brief
review of the literature on its clinical presentation, diagnosis and therapeutic
approach. What is the type of study in the above-mentioned abstract?
case series report
Patient was prescribed hypnotic anxiolytic and is to be taken before bedtime,
when she wakes up – she is still drowsy, what is the most likely causative drug?
A. Ramelteon
B. Zolpidem
C. Diazepam
D. Midazolam
B. Zolpidem
Could also be a diazepam since Zolpidem is not an anxiolytic.
Which one is a long-acting insulin?
Insulin Glargine, Insulin Degludec.
A patient is taking 50 mcg levothyroxine and TSH levels are still high, what
adjustment should be made to treatment?
A. Give dose of 100 mcg and check levels after 6-8 weeks
B. Give dose of 150 mcg and check levels after 6-8 weeks
C. Give dose of 25 mcg and check levels after 6-8 weeks
D. Give dose of 75 mcg and check levels after 6-8 weeks
D. Give dose of 75 mcg and check levels after 6-8 weeks
Beriberi disease is caused by which vitamin deficiency?
Thiamine (vitamin B1) deficiency
An 88-year-old patient takes 60 mg oral morphine for pain, and they want to
switch him to IV morphine every 10 mins, what is the suitable dose?
A. 5 mg every 10 mins
B. 10 mg every 10 mins
C. 20 mg every 10 mins
D. 30 mg every 10 mins
(All of the options are too high)
note : pangitaonon ang answer
Calculation steps:
- Convert daily oral dose to IV equivalent.
a. Oral à IV is 3:1 (60 mg oral = 20 mg IV) - Divide total IV dose by 24 hrs.
a. 20 mg / 24 = 0.8 mg/hr - On-demand (PCA) dose should be 50% of hourly rate.
a. 0.8 mg/hr * 0.5 = 0.4 mg with 10 min lockout.
table is at page 34 in page 423
Which of the following inhibits insulin?
A. Glucagon
B. Glucose
C. Epinephrine
D. Cortisol
C. Epinephrine
What type of reaction converts alanine to glucose?
A- Glycolysis
B- Alaninolysis
C- Oxidative deamination
C- Oxidative deamination
2 Alanine –(deamination)-> 2 Pyruvate –(gluconeogenesis)-> Glucose
What is the purpose of granulation of drug particles?
A. Reduce Flowability
B. Reduce Stability
C. Reduce Surface Area
D. Reduce dust from compounding toxic chemicals.
D. Reduce dust from compounding toxic chemicals.
What is the function of substituents on the pyridine ring of proton-pump
inhibitors?
image of the structure is at page 35 number 427.
Electron donating substituents (R1 = OR, R2 and/or R3= CH3) on the pyridine ring
increases the % ionization of PPI and increases nucleophilic character of the pyridine
nitrogen, which makes it more reactive with the cysteine residue of the proton
pump.
What is the interaction between antihistamines and proton-pump inhibitors?
Antihistamines increase pH of stomach and low pH (acidic) is required for activation
of PPIs.
What is the interaction between omeprazole and clopidogrel?
Omeprazole reduces effectiveness of clopidogrel by inhibiting CYP2C19, which is
required for activation of clopidogrel to active form.
BMI calculation and classifications.
Which of the following drugs requires HLA-B 1502 to be checked before use?
Carbamazepine
A patient with INR of 6.1, what adjustment should be made?
Hold for 1-2
doses.
Which condition requires patient to take Epoetin?
Renal disease
Recommend a safe treatment for patient with chronic constipation.
What is USP chapter 797 used for?
Sterile Production
What does Naranjo score of 3 mean?
Possible
What is the anti-dote for diazepam?
Flumazenil
Patient is infected with Brucella, what is the likely source?
Undercooked
meat, unpasteurized milk, and direct contact with infected animals.
Questions on bacteria classification.
Which of the following polymorphic enzymes is responsible for conversion of
codeine to morphine?
CYP2D6
Which of the following drugs is preferred for a woman who has
dysmenorrhea?
what the structure and page 36 number 441
Answer: C (Mefenamic Acid)
Which of the following structures is aspirin?
image of structure is at page 36
number 442
Answer: A
Which of the following committees is responsible for requests of removing a
drug from hospital formulary?
Pharmacy & Therapeutics Committee
Questions on Hypersensitivity Reactions.
Who responsible for the treatment of house worker?
Ministry of Health
Pregnant with cat, what is she at risk of?
Toxoplasmosis gondii infection
screenshot about Toxoplasmosis gondii infection
at page 37 number 446
Metabolism of Catecholamines?
Rapid COMT
Which one has higher oral bioavailability, Valacyclovir or Acyclovir?
Valacyclovir (L-valine ester of acyclovir) has higher bioavailability and longer
duration of action (less frequent dosing) than acyclovir. It is a pro-drug of
Acyoriclovir activated through metabolism by hydrolase enzyme.
Case of patient that has been taking simvastatin 80 mg he has SLCO1B1 521C
allele – patient has signs of myopathy and elevated CPK, what should be done?
Hold statin for 2-4 weeks and re-start on lower dose or a different statin
(depends on answer choices)
People with SLCO1B1 521C allele have reduced metabolism of simvastatin
therefore lower dose should be given or patient should be switched to a
different statin.
A patient has hyponatremia and hypophosphatemia and needs IV phosphate
and sodium, can these be given through peripheral IV lines?
Antidote of Phosphorous.
Sevelamer
Which class of antidiabetic Empagliflozin belongs to?
SGLT-2 inhibitor
A patient with diabetes, hypertension, and hypercholesteremia is experiencing constipation, what should you do?
What type of communication is writing instructions on label?
Written
Which amino acid contains an imidazole ring?
Histidine
Patient case with insomnia and patient is on multiple medication, which
medication is causing this?
Cortisone
Which one is secondary messenger?
cyclic AMP
Which one causes release of intracellular calcium?
1,4,5-triphosphate (IP-3)
and diacylglycerol (DAG)
What type of reaction is this?
in page 38 number 459
A- Endothermic (uses up protons)
B- Exothermic (releases protons
e.g., phosphate or H+)
A- Endothermic (uses up protons)
Questions on NNT, NNH, and RR.
Question on ranking stability of different Acetylcholine structures.
What is the class of Isoproterenol?
Beta-1 and beta-2 receptor agonist.
What is the end product of purine metabolism?
Uric acid
Question on different structures and asks you to identify racemic molecule.
Question on structures of quinolones (with names) and asks to select one for
treating pneumonia (G.M.L respiratory quinolones were not in the choices).
The label on medication is different to the product in the package. Who
should you report this to?
Quality department of the pharmaceutical company.
A patient has Duchenne muscular dystrophy, which steroid medication is
used to treat this?
Deflazacort
A T2DM patient was well managed with oral medication but with time
developed insulin insufficiency and his HbA1c is 8%, what is the suitable treatment?
long-acting insulin
A patient is prescribed ‘Phenytoin 100 mg dTd 50, 1 p.o.q.d’. The only
available strength is 600 mg. How many tablets is needed?
50 tablets * 100 mg * 1 p= 5,000 mg / 600 mg = 9 tablets (8.33)
Omeprazole contains 30 tablets for 35 SAR. The government wants to reduce
package size to 28 tablets. What will happen to the price?
Reduced by 10 %
Drug A and Drug B both cost 60 thousand dollars to manufacture, 10,0000 of
each drug were produced. Drug A was sold for 40 dollars and Drug B was sold for 80
dollars. How much profit was made?
(40,000 + 80,0000) – 60,000 = 60,000 SAR
Calculate bioavailability if hepatic blood flow is 1500 ml and hepatic
clearance is 200 ml/min?
0.87 or 87%
Hepatic Clearance = Hepatic perfusion * Extraction fraction
Bioavailability = 1 – Extraction fraction
200 ml/min ÷ 1500 ml = 0.13
1 – 0.13 = 0.87
Type of interaction between diclofenac and spironolactone?
Both can cause
hyperkalemia
Which vaccinations are required for COPD patient?
Pneumococcal vaccine
and influenza vaccine.
Which vaccine can pregnant not take?
MMR
What is the role of bentonite?
suspending agent
how many calories in 10 mg of lipid?
90 kcal
A cardiac patient with edema, how can you check heart rate?
Auscultation
Question on how to check for adherence.
what is the role of mosquito in trasmission of malaria?
carrier of malaria
What type of degradation occurs in presence of water?
Hydrolysis
A patient with reduced kidney function is prescribed gentamicin and
ampicillin, which ones require renal adjustment?
both
What is the first line treatment for patient with severe Alzheimer’s disease?
Donepezil
What is the suitable treatment to reduce acute hypertension in patient with
stroke?
Nicardipine
What should be monitored in patient taking Fingolimod?
ECG
A patient with sneezing, cold, and runny nose. Which treatment should you
give?
Pseudoephedrine
A trial compared mortality in patients taking infliximab (7%) and patients
taking old drug (10%). Calculate absolute risk reduction.
3%
Type of interaction between smoking and theophylline.
Smoking decreases
levels of theophylline.
Treatment choice for ulcerative colitis.
Sulfasalazine
The nurse found a different patient name on medication and returned it to
the pharmacy. The pharmacist gave it to the right patient. Which type of error?
Drug to incorrect patient error
Who is more susceptible to risk from over-the-counter medications?
answer: geriatric
(Child – Infant (possible)– Adult – Geriatric)
I chose Geriatric because polypharmacy and co-morbidities increase risk of ADRs
from OTC
Patient has a fracture and the orthologist referred him to the rehabilitator,
what type of classification is this?
Secondary to tertiary care referral
Which antacid medication causes low magnesium levels in patient?
Proton
pump inhibitors
Breastfeeding mother drinks 8 cups of coffee per day and takes anti-
hypertensive, cholesterol, and DM medications. Her baby has sleep disturbance,
what caused that?
Coffee
Two new DM drug both of them reduce HbA1c by 1.5%, drug A cost 5,300
SAR annually and drug B cost 3000 SAR annually, the only DM drug also reduce
HbA1c by 1.5%, and cost 3500 SAR annually. Which of the following is appropriate?
Reject drug A and except Drug B
Gravis disease treatment?
Methimazole
Patient has palpitations, tremor, and weight loss, what is the best choice?
Methimazole
Choice of treatment of pregnant women with hyperthyroidism.
Propylthiouracil
What is the category error for patient supplied amoxicillin with penicillin
allergy?
Category H
What is the category error of supply of one drug instead of another?
Category D
Which is the least statin to interact with grapefruit juice?
Pravastatin
Asthmatic patient uses Ventolin 3 days a week, wakes up 3 times at night,
and asthma interferes with physical activity. What is the asthma severity category?
Persistent mild
Which immunoglobulin IG activates mast cells?
IgE
Which the following committees is dedicated to developing and maintaining
a list of approved medicines for the hospital medicines for the hospital uses?
Pharmacy & Therapeutics Committee
Pharmacist received prescription of hydrocortisone 2% 60g cream. The
available strength is 1% and 2.5% . what is the amount of both concentration you
need to prepare 2%?
40g of 2.5% and 20g of 1%
Drug A with CYP1A2 and another drug B is CYP2D6 inducer, what is the
possible interaction between them?
No interaction
A doctor prescribes drug for short term. What is the appropriate refill for this
prescription?
No refills
what is the carrier of vitamin b12 ?
intrinsic factor
least sedating antipsychotic ?
Risperidone
Healthy male happily married for 25 years now has erectile dysfunction
wants treatment and reluctant to use medicine or injections, which is the most
suitable management.
Vacuum device.
A doctor has contact with patient who has c. difficle, what is the appropriate
action?
Use water and soap
Patient using Rivastigmine tab for alzheimer’s, however he is not tolerant
with it Which of the following is the best alternative drug?
Donepezil
What type of costs is traveling expenses from Jeddah to Riyadh to receive
health care from a pharmacoeconomic perspective?
Direct non-medical
patient he want go to Africa and afraid of travel diarrhea what is the
recommended ?
don’t eat raw meat or fish.
Case of patient who has heart failure and Diabetes mellitus. What is the
recommended for pulmonary edema ?
Furosemide
Case of patient with type 2 diabetes and HbA1C 13% on glargine 22 IU and
aspart 7 before each meal, blood glucose in the morning 118 and bedtime 280 what
is the recommended?
increase aspart before dinner
what is the risk level of contamination when transfer a sterile medication by a
sterile needle to a sterile package?
Low-risk level
Which of the following may decreases heart rate?
Metoprolol
Which one is a non-synonymous single nucleotide polymorphism?
Nonsense
SNP
Calculate prevalence of disease if 500 patients have disease per 10,000
people.
500/10,000*100 = 5%
Which type of heavy metal overexposure causes a blue discoloration to
appear along the gum line of the mouth?
Lead
In which phase of clinical trials is the investigative drug compared with
another drug?
phase III
Patient with TPN and he takes tablet drug, what is the appropriate answer?
sustained release tablets if crushed will cause harm to patient.
What is the cause of cough with Lisinopril?
Bradykinin
Using the tablet to inform patient on the instructions for taking their
medications is what type of communication?
Verbal (choose visual communication if
it’s an option)
A patient is prescribed atropine 1% (E=0.13) in purified water and normal
saline up to 60mL. What is the amount of NaCl required for it to become an isotonic
solution?
0.46 g of NaCl
what the screenshot of the calculation at page 41 number 526
A patient is taking amlodipine and his BP is still uncontrolled, what is the
appropriate drug that can be added?
losartan
Doctor wrote e-prescription for narcotic drug , what should the pharmacist
do ?
Return it to doctor to write a written prescription in addition to e-scrip
Doctor wrote handwriting prescription and pharmacist was confused
between 2 drugs, what should pharmacist do?
do? Call doctor to confirm what is the
right name of drug.
What is the physical exam for peripheral oedema?
pitting test
Acid with 3.2 Pka. What is the best PH for absorption?
pH 1 (predominantly
unionized)
Which hospital can houseworker be treated in?
General Hospital
How does digoxin work in the heart?
Increase cardiac contraction.
Which of the following situations are most likely to be controlled by
administering parenteral calcium as anti-dote?
Verapamil overdose
The function of DNA ligase is the ligation of?
2 DNA strands
Which of the following pairs represent the purine nitrogenous bases?
Guanine (G) and Adenine (A)
Which of the following induce thrombocytopenia?
Unfractioned Heparin
A hospitalized patient with hypertension is prescribed nicardipine HCl IV
infusion at a dose of 5 mg per hour for 4 hours. Nicardipine HCl is available as 10 ml
vial containing 25 mg of nicardipine HCl. How many ml should be used?
8mL
A colleague of yours asked you to identify the content of green leaves herbal
supplement, he’s been using for the past two weeks (as tea drink) to help him lose
weight and boost his energy. He mentioned that he is starting to have the following
symptoms: tremors, palpitation and lack of sleep (insomnia). You prepared aqueous
and organic solutions from the leaves and performed phytochemical screening tests
to identify the plant (see label result)
label and page 41 number 539
Answer : alkaloid
Which parenteral anticoagulant requires routine monitoring of coagulation
lab parameters?
Intravenous Unfractioned Heparin.
Which of the following anti-arrhythmic drugs can be considered as a rate
control drug?
Amiodarone
A patient was started on codeine 15 mg orally as needed for post-operative
pain. One day after starting codeine, the patient presents to ER with confusion,
headache, and SOB. Which of the following most likely described the patient’s
genotype?
Rapid metabolizer of CYP2D6
Which anti-depressant should be used in obese 18 year old girl?
Bupropion
Child weighing 25 kg is prescribed acetazolamide 2.5 mg/kg every 12 hours.
Acetazolamide is available in a liquid dosage form with strength of 25 mg/ml. How
many ml would patient be administered per dose?
2.5mL
what is the clinical use of acetylcysteine?
Mucolytic
which is the most common cause of drug instability?
oxidation
A 20 ml vial of penicillin-G potassium containing 2,000,000 units is available.
Each mg of the drug is equivalent to 1600 units. How many milligrams of penicillin-G
potassium are there in one ml of the solution?
62.5 mg/mL
Which of the following best described the “biopsychosocial approach of
health”?
Broad view that attributes disease outcomes to the variable interaction of
biological factors, physiological factors, and social factors.
A 36-year-old man not known to have any medical illness diagnosed recently
with an active pulmonary tuberculosis. Which of the following is the best initial
treatment?
Isoniazid + Rifampin + Ethambutol + Pyrazinamide
Which antibiotic causes hyperkalemia?
Trimethoprim/sulfamethoxazole
Patient with E. coli UTI and given TMP/SMX but it turns out to be resistant.
What is the appropriate alternative?
Ciprofloxacin
Which of the following documents created by the world medical association
is the statement of ethical principles for medical research involving human subjects?
Declaration of Helsinki
Which of the following best described the pharmacy health literacy
assessment?
Measure how well the pharmacy is serving patients with limited health
literacy skills.
which biosimilar drug is approved for the treatment of moderate to severe alllergic asthma?
Omalizumab
which of the following medications may alter renal function ?
Gentamicin
Which of the following drugs require extra precautions during handling to ensure medication safety?
Methotrexate
A study located a group of subjects with lymphoma and went to identify
which subjects are smokers and which are not. Which of the following study designs
is used to conduct the study in the scenario?
Cross-sectional study
Which of the following vaccines is contraindicated in pregnant women?
BCG vaccine
vaccination case where patient came to take MMR vaccine and has taken immunogloblulin for Hep A last month.What should be done?
Given after 2 months ( need 3 months between
what type of reactions is the conversion of NAD to NADH?
redox reduction reaction
vaccination of major and minor wounds
watch screenshot in page 43 number 561
A pregnant woman has pseudomonas infection . What is the suitable antibiotic option?
Anti-pseudomonal cephalosporins (ceftazidime, cefepime, or ceftaroline) or
Piperacillin/tazobactam.
Which factor predispose children to medical errors?
body weight dosing
A pharmacist asks patient with dermatological problem questions about her problem, what is the goal of the pharmacist?
sell cosmetic medication
a hypertensive patient with BP 177/97 presents to your pharmacy, what should you do ?
refer to see doctor
A patient receiving levofloxacin bolus injection experienced sensitivity
reaction, what is the best action?
A – stop antibiotic
B – give one push
C – Given 45 mins
D – Give 90 mins
D – Give 90 mins
A pharmacy has been suffering losses for 5 years, what is the best strategy
that the new employee should do to improve situation?
SWAT analysis
How can you increase profit in your pharmacy?
Which of the following SNP does not change coding of protein?
A. Synonymous – nonsense
B. Non-synonymous- nonsense
C. Synonymous – missense
D. Non-synonymous – missense
C. Synonymous – missense
see the screenshot in page 44 number 569
What is the impact of modifying the isopropyl group of isoprenaline with
benzene?
Improve binding to target
which benzodiazepine is used in general anxiety disorder (GAD) ?
Alprazolam
Which cortocosteroid is applied topically?
Clobetasol propionate
A patient has drug has drug eluting states, which antiplatelet therapy should be prescribed?
Dual anti-platelet therapy (e.g., Clopidogrel + Aspirin) for at least 6
months
Which lymphocyte is responsible for production of immunoglobulins?
T-
helper lymphocyte
A drug was discovered in year 2000, clinical trials started in 2005, and the
drug was approved in 2010. When will the patent expire?
2020 (drugs are usually patented in the drug development and discovery phase and patient duration is 20
years).
What enzyme is responsible for the oxidation of phenytoin?
CYP2C9
A pharmacist was distracted by colleague and instead of dispensing 5 mg
dispensed 10 mg, how should this error be prevented?
Environmental reconstruction
A pharmacist wants to open pharmacy in rural area. Many pharmacists have
failed in this area. How can pharmacist increase chance of success?
improve health
literacy aids.
When should a company in increase awareness of product?
During sale
decline of product.
A patient with diabetes has high post-prandial blood glucose but fasting
glucose in range. He is taking liraglutide, metformin, and long-acting insulin. Which
one should be adjusted?
Liraglutide (if we increase long-acting insulin it will increase
risk of morning hypoglycemia)
watch screenshot in page 45 number 580.
what the chart at page 45 number 581
Calculating Child Pugh score (case include albumin level, ascites, cirrhosis,
liver enzymes).
Treatment of patient with septic shock.
- IV fluid resuscitation
- norepinephrine (or dopamine) in persistent hypotension (MAP < 65
mmHg or SBP < 90 mmHg) - broad-spectrum antibiotic (e.g., vancomycin, ceftazidime, cefepime,
piperacillin).
A patient taking medications experienced hepatic toxicity, what is the
medication responsible?
Trimethoprim-Sulfamethoxazole
A patient taking medications experiences hyperkalemia, what is the
medication responsible?
Trimethoprim-Sulfamethoxazole
A child swallowed rat poison (Rodenticide). What is the suitable treatment?
Vitamin K
Why are hypertonic solution used in intramuscular injections?
Slightly hypertonic intramuscular injections are used to increase penetration of drug
but can be painful.
What is the side-effect of Bleomycin?
Respiratory Fibrosis
Why are 2 atom linkers added to ramipril?
To improve binding to hydrophobic pocket (see question 287)
What is the equation for drug elimination constant in first order kinetics?
what the formula at page 46 number 589
Calculation of clearance using dose and half-life only.
search for this
Which test can be used to differentiation between P. aeruginosa and E. coli?
Lactose fermentation test
What is coagulase test used for?
Identification of staphylococcus strain.
(Coagulase positive is staphylococcus aureus)
A pharmacist has been late 8 times to work, and policy allows for 3
consecutive days only. Which kind of behavior is considered assertive behavior?
A drug has pKa of 6-7, what would be the best formulation of this drug to
make it have longest shelf-life?
A- Formulate as solution ready to use.
B- Reconstitute with WFI before use.
C- Reconstitute with solution with pH 6.
C- Reconstitute with solution with pH 6.
Example of tertiary sources?
A nurse though a leukemia patient had been discharged and returned his
chemo medications by pneumatic tube to the pharmacy, what was the health
violation and what should she have done?
Chemotherapeutics cannot be
transported in pneumatic tube!
Drugs not transported in pneumatic tube:
- Chemotherapeutics/radiopharmaceutics
- Drugs that cannot be shaken or can foam.
- Blood products.
- Glass bottles/ampoules.
- High alert medication.
- Expensive medication (problem if lost!)
- Flammable/explosive/aerosol drugs.
Systemic review is which type of resource?
Secondary resource
Where to look for data on new clinical trials for management of diabetes?
PubMed
What is the function of the bacterial transpeptidase enzyme?
Catalyze the
nucleophilic carbonyl substitution process required for cross-linking peptidoglycan in
bacterial cell walls.
A patient case with hyperkalemia above 6 and hyponatremia, what’s the first
step treatment and duration?
1- Urgent treatment of hyperkalemia first (according to MOH).
the chart is at page 47 number 600
Clinical case asking for vancomycin dose and interval for administration?
Adult: 0.5-2 g/day PO divided q6-8hr for 7-10 days
Pediatric: 10-15 mg/kg every 12 hours.
Case with vitamin results asking for dose in units, frequency, and duration.
Structure of anti-cancer and asks for the name of the chemical moiety.
Enalaprilat structure and type of interaction in each functional group.
See question 287
COPD classification based on FEV1% gold standard.
table form is at page 48 number 605
Patient came for dry cough medicine, headache, and other symptoms. She
hasn’t been to the clinic in months. She’s taking lisinopril, metformin, etc. What’s the
best intervention?
Refer to healthcare clinic
A long case of patient taking high level of methotrexate chemotherapy, what is the antidote?
Leucovorin
Which drug acts on vitamin K?
Warfarin
At which pH is the drug most stable ( see stability -pH plot below).
page 48 number 609
pH 3-4
Which amino acid is acidic?
(Arginine – Cysteine – Alanine – Methionine)
Cysteine
Patient has an anaphylactic shock, and he was given medication that is
inotropic and chronotropic, which medication was he given?
1. Adrenaline
2. Phenyl ephedrine
3. Isoprenaline
- Isoprenaline
Order of potency of catecholamines in producing both chronotropic and
inotropic effects is isoprenaline > adrenaline > noradrenaline
What is an important factor when comparing two drugs using cost-
minimization analysis?
Must have equivalent effectiveness
A doctor wants to compare between cefazolin and oxacillin in treating
infection, what source should he check?
RCT
What will occur if there is deficiency in phylloquinone?
Bleeding
A patient with breast cancer is CYP2D6 poor metabolizer, which medication
she will not benefit from?
Tamoxifen
Genetic information in virus?
DNA or RNA
A woman is planning to conceive and is taking levothyroxine. What should
you do?
Adjust dose during 1st trimester.
A doctor was in contact with patient with C. difficile. The doctor wiped his
hand with antiseptic wipes.
A- Need to use hand sanitizer.
B- Antiseptic wipe is enough
C- Need to wash hands with soap and water.
C- Need to wash hands with soap and water.
A neonate patient has hypertension. Which medication is dangerous for him?
A- Atenolol
B- Propanol
C- Verapamil
C- Verapamil
A doctor ordered methotrexate syringe and riociguat syringe and were
brough from the pharmacy in the same bag. The nurse told the doctor that methotrexate is usually yellow but the one they received is clear. What should be
done?
A- Should be in separate bag.
B- Should check label.
C- Recall all methotrexate in OR.
D- Give the medication.
B- Should check label.
A patient with diabetes and CVD, what is the suitable treatment?
Canagliflozin
What is the reason for erythromycin instability in acidic conditions?
Ketal formation between hydroxyl group (6 and 12) and ketone at position 9.
scrreenshot information is at page 50 number 622
What is the pharmacophore of glimepiride?
answer is at page 50 number 623
Which one is a 5th generation beta-lactam?
Ceftaroline
Calculation Questions:
- Number of pills to dispense
- Volume of medication to dispense.
- Calculate loading dose (LD)
- Calculate volume of distribution (Vd)
- Calculate absolute bioavailability (question 192 – ORION).
- Calculate infusion rate (question 184 – ORION)
- Calculate Creatinine Clearance.
- Calculate clearance from dose, plasma conc., and t1/2.
What is the safest treatment for pregnant patient with UTI?
Taken from MOH guidelines
screenshot is at page 51 number 626
Question on type of monoclocal antibody
screenshot is at page 51 number 627
Murine/Mouse Antibodies (-omab): all from mouse.
Chimeric Antibodies (-ximab): Constant region from human and variable
region from mouse.
Humanized Antibodies (-zumab): all human except for the complementary-
determining region (CDR), which binds antigen.
Human Antibodies (umab): fully human. Undergoes sequence change to
alter specificity, affinity, of biological function.
Case about COPD and he asked about the drug that affect the prognosis of
the disease:
a) Salmeterol
b) Salbutamol
c) Corticosteroid
d) Ipratropium
c) Corticosteroid
Transdermal Patch advantage for lipid soluble drugs?
a) Faster onset of action
b) Increased bioavailability
c) Near constant rate as IV infusion
c) Near constant rate as IV infusion
Woman taking Methotrexate but radiology scan show progressive joint
deformation which drug should we add?
a) Leflunomide
b) Hydroxychloroquine
c) Etanercept
c) Etanercept
Patient on Metformin, Sitagliptin and Pioglitazone recently diagnosed with
Hepatitis C virus, which drug should he stop?
Pioglitazone
Type 2 DM on insulin glargine and Metformin 750mg XR twice daily his
fasting glucose is normal but postprandial is elevated (281) what is the best
intervention?
a) increase glargine dose
b) Increase Metformin
c) Stop Metformin and switch to another drug
d) Continue on the same regimen
c) Stop Metformin and switch to another drug
Patient taking Vancomycin 1gm Q12H @ infusion rate 1gm/hour he
developed skin rash and redness what is the best course of action?
a) Change the antibiotic
b) Decrease the dose
c) Increase the infusion rate
b) Decrease the dose
Patient on Lisinopril, Amlodipine, Metformin and another drug the patient
will perform iodinated contrast which one need to be restarted after 48hrs of the
contrast?
Metformin
Which of the following communication techniques is the most appropriate at
the message you want to deliver to a patient (or healthcare provider) is received
correctly?
A) Feedback
B) Direct contact
C) High voice tone
D) Non-verbal communication
A) Feedback
Which of the following strategies are used with low literacy patients to
encourage them to change their behavior?
A) Keep information focused and organized
B) Use a normal speaking tone and volume
C) Use briefer educational sessions
D) Use more visual aids
C) Use briefer educational sessions
Which of the following is the most appropriate source for information
compounding medications?
A) Micromedex
B) Orange book
C) A drug information website
D) United states pharmacopeia (USP)
D) United states pharmacopeia (USP)
Approximately 415 million people have been diagnosis with diabetes. Which
of the following terms is referred to in the mentioned statement?
A) Endemic
B) Epidemic
C) Incidence
D) Prevalence
C) Incidence
Which of the following is the function of the pharmacy and therapeutic
committee in a hospital?
A) Responsible for poison management
B) Monitor the adverse reaction reporting
C) Monitor the medication error reporting
D) Responsible for drug formulary management
D) Responsible for drug formulary management
Which of the following method is successful in reducing medication error and
enhance patient safety in hospitals?
A) Performing continuous education sessions on safe dispensing
B) Providing the pharmacy with the most updated drug references
C) Implementation of computerized physician order entry (CPOE) system
D) Encourage medical staff to participate in conferences and scientific
meetings regular
C) Implementation of computerized physician order entry (CPOE) system
Which of the following is the type of studies considers data from multiple
studies of different designs to draw conclusions?
A) Case Series
B) Double-blind study
C) Systematic review
D) Consensus statement
C) Systematic review
A patient was prescribed both frusemide and hydrochlorothiazide, why is
this?
Patient has severe heart failure that is unresponsive to one diuretic
Which of the following committees is responsible for requests of removing a
drug from the hospital formulary?
A) Hospital Patient Safety
B) Mortality and Morbidity
C)Hospital Clinical Research
D)Pharmacy and Therapeutic
D)Pharmacy and Therapeutic
An 8-year-old child had difficulty in breathing, swelling of tips and tongue,
and fainted following eating a piece of cake containing nuts.
Which of the following types of hypersensitivity reactions the child is exhibiting?
A) Immune-complex hypersensitivity
B) Delayed hypersensitivity
C) Cytotoxic hypersensitivity
D) Immediate hypersensitivity
D) Immediate hypersensitivity
Free medical sample drugs (formulary or non-formulary) are provided by
pharmaceutical sales representatives to physicians or members of the health care
team. Which of the following is the most appropriate recommended policy for
dealing with sample drugs?
A) Dispense them directly to the patient
B) Keep them with the rest of original items
C) Keep in outpatient clinics or nursing units
D) Exclude them from in-patient pharmacy, drug store or doctors’ offices
D) Exclude them from in-patient pharmacy, drug store or doctors’ offices
Which of the following viral infections best describes chronic infection?
A) Infection in which host cell dies due to interference with normal cellular
function.
B) Infections in which there is uncontrolled growth or immortalization of the
host cell.
C) Infection in which virus persists within the host cell but new virions are not
synthesized.
D) Infection in which virus persists within the host cell and continues to
replicate the virions
D) Infection in which virus persists within the host cell and continues to
replicate the virions
A patient is admitted to the hospital for the treatment of atrial fibrillation.
During hospital stay, the patient receives IV diltiazem was discharge on oral diltiazem
plus his previous antihypertensive medication verapamil.
Which of the following medication error-reduction programs Would most likely have
helped to prevent this duplication of therapy?
A) Bar Coding
B) High-Risk Drug Protocol
C) Medication Reconciliation
D) Computerized physician order entry
C) Medication Reconciliation
Which of the following is the Vaughan Williams Classification for the
antiarrhythmic drug procainamide?
A) class IV
B) class lll
C) class II
D) class IA
D) class IA
A 16-month-old baby with bronchopulmonary dysplasia is admitted Pediatric
Intensive Care Unit with respiratory distress requiring in (see lab results)
Heart rate 86/min
Respiratory rate 30/min
Temperature 38.6°C
Test Result
Nasal swab Positive for respiratory syncytial virus
What is the best management?
A) Cefuroxime
B) Palivizumab
C)Corticosteroid
D)Intravenous fluids and supportive care
D)Intravenous fluids and supportive care
A patient medication was changed from carbamazepine to phenytoin. The
technician pulled the 100 mg tablets of phenobarbital off instead of the 3 mg tablets.
The pharmacist did not notice that when the prescription was checked. The patient
received a higher phenobarbital and was hospitalized for few days for observation.
Which of the following is the best statement concerning this situation?
A) This is considered as adverse drug reaction
B) The physician should have informed the pharmacist about prescription’s
change
C) The patient should be aware of what he was prescribed and the difference
D) This is preventable medication error if the pharmacy in safety measures
D) This is preventable medication error if the pharmacy in safety measures
A 25-year-old man with leukemia admitted to hematology oncology center.
Who is allowed to read the patient file without additional permission?
A) Patient’s cousin who is working as out-patient nurse in the hospital
B) Medical resident in pediatric who wants to explore the risk leukemia
C) Clinical nutritionist who is assigned to calculate the requires for the patient
D) Pharmacy resident who is planning to do a research cell transplant
C) Clinical nutritionist who is assigned to calculate the requires for the patient
Which of the following means that individuals have the understand basic
health information to make appropriate health?
A) Health literacy
B) Cultural competency
C) Communication skills
A) Health literacy
A 10-year-old boy is brought with complaints of fever sore throat and non-
productive cough for 1 day. Which of the following is best regimen for non-
productive cough?
A. Codeine 10 mg 4 times daily
B. Guaifenesin 50 mg 4 times daily
C. Dextromethorphan 15 mg twice daily
D. Dextromethorphan 30 mg twice daily
D. Dextromethorphan 30 mg twice daily
It is the broad range of health care services provided by in order to optimize
therapeutic outcomes for individual patients. Which of the following is the term used
to describe the above-mentioned definition?
A. Pharmaceutical care
B. Medication counseling
C. Medication reconciliation
D. Medication therapy management
D. Medication therapy management
A 76-year-old cardiac male patient was transferred to the hospital for
palpitation with a heart rate of 177 bpm. He is a heavy smoker, and his past medical
history includes hypertension, hyperlipidemia and coronary artery disease. His
medications include aspirin, clopidogrel, carvedilol, valsartan and atorvastatin. He was diagnosed as having fibrillation. Which of the following is the CHA2DS2-VASC
score for this patient?
A. 1
B. 3
C. 4
D. 6
C. 4
A 57-year-old man who presents to an urgent care clinic with complains of 2-
day history of high fever, muscle/bone ache, headache and loss of appetite. He has
been in his usual state of health and reports close contacts of a sick friend with flu
recently. Which of the following would be the best management?
A. Amoxicillin: 500 mg PO q8h for 10 days
B. Azithromycin: 500 mg PO once daily for 3 days
C. Amoxicillin-clavulanic acid: 1 gm PO q12h for 1 week
D. Support treatment. (e.g., fluids, rest, antihistamine, paracetamol)
D. Support treatment. (e.g., fluids, rest, antihistamine, paracetamol)
Which of the following counselling points is best to discuss with a patient
who is taking levothyroxine?
A. It can be taken with calcium supplements or dietary foods with no
problems
B. Take it in the morning on an empty stomach, at least 30 mins (before
breakfast)
C. If you miss a dose, make sure to double the next scheduled
levothyroxine dose
D. Take it immediately after the breakfast with a large glass of water to
avoid stomach upset
B. Take it in the morning on an empty stomach, at least 30 mins (before
breakfast)
Ropivancaine is an important local anesthetic. The figure shows the chemical
structures of ropivacaine and 4 other local anesthetics (see image). Which of the
following is the bioisoster for ropivacaine?
A. Etidocaine
B. Bupvicaine
C. Mepvicaine
D. Levobupvicaine
A. Etidocaine
structure is at page 57 number 658
Which of the following increases the risk of aspiration during enteral feeding
administration?
A. continuous feeding regimens
B. high gastric residual prior to feeding
C. feeding with high-carbohydrate content
D. feeding a patient while in the upright position
B. high gastric residual prior to feeding
Which of the following is the most appropriate term used to call the two
conformations of the thalidomide?
A. Isomers
B. Epimers
C. Enantiomers
D. diastereomers
C. Enantiomers
A structure of the glibencalmide (glyburide). Which of the following
pharmacophore does Glibencalmide (glyburide) contain?
A. Benzene sulfate urea
B. Benzene sulfinyl urea
C. Benzene sulfhydryl urea
D. Benzene sulphonyl urea
D. Benzene sulphonyl urea
What is the antidote for heparin toxicity?
A. Protamine sulfate
B. Sodium salicylate
C. Naloxone
D. Glucagon
A. Protamine sulfate
Medication order is given to the pharmacist (see table)
Olive oil 60 ml
Vitamin A 60.000 U
Water 120 ml
Sig 15 ml t.i.d
What is likely to be the final form of preparation?
A. A solution
B. A ointment
C. An emulsion (contain oil and water)
D. A suspension
C. An emulsion (contain oil and water)
Which of the following statements best represents the intravenous (IV)
medications in the hospital facilities?
A. IV drugs transmits the highest risk of infection
B. IV drugs are associated with lowest risk of undesirable side effects
C. IV solutions must be hypotonic to ensure compatibility with blood
osmolality
D. IV solutions must be hypertonic to ensure compatibility with blood
osmolality
A. IV drugs transmits the highest risk of infection
Which of the following type of water should be used for reconstitution of
parenteral preparations?
A. Sterile water
B. Distilled water
C. Sterile water for injection
D. Bacteriostatic water for injection
C. Sterile water for injection
Which of the following best describe the main pharmacological property of
cholestyramine?
A. Decreases excretion of cholesterol
B. Lowers high density lipoprotein (HDL) level
C. Increases low density lipoprotein (LDL) level
D. Increase the efficiency of lipoprotein removal
B. Lowers high density lipoprotein (HDL) level
A suspended agent is important for preparing an oral suspension. Which of
the following is the characteristic of this suspending agent?
A. Hydrophilic, to inhibit agglomeration
B. Hydrophobic, to inhibit agglomeration
C. Hydrophilic, to prolong gastric emptying time
D. Hydrophobic, to prolong gastric emptying time
A. Hydrophilic, to inhibit agglomeration
A 47-year-old man is admitted to hospital with atrial arrhythmia and is
prescribed amiodarone. Which of the following is the most likely side effect to be
monitored?
A. ptosis
B. tinnitus
C. Pulmonary toxicity
D. pseudomembranous enterocolitis
C. Pulmonary toxicity
Which of the following glucocorticoids has the lowest potency?
A. Prednisone
B. Triamcinolone
C. Hydrocortisone
D. Dexamethasone
C. Hydrocortisone
Which of the following is the mechanism by which probenecid increases the
duration of action of ampicillin when administered at the same time?
A. Increasing the glomerular filtration
B. Increasing the intestinal absorption
C. Inhibition of renal tubular secretion
D. Inhibition of renal tubular reabsorption
C. Inhibition of renal tubular secretion
A 50-year-old man on warfarin therapy started drinking an herbal tea extra
(one gallon daily). A week later his INR dropped to 1.35 prior to that time, his INR
had been in the range of 2.5-3. Once the herbal tea was discontinued, the patient’s
INR came back up to 2.50.
Which of the following is the content of the herbal tea extract?
A. Anise
B. Ginger
C. Green tea
D. Chamomile
C. Green tea
Green tea contains vitamin K
Ginger, Chamomile, and anise all increase bleeding risk with warfarin
(increase INR)
Which property of nicotine is attributed to abortions?
A. it is a vasodilator
B. it is a potent vasoconstrictor
C. it reduces uterine blood flow
D. it reduces vascular uterine resistance
C. it reduces uterine blood flow
Galactose and D-Mannose are monosaccharide sugar. They have the same
number of carbons and the same functional group, but they differ in their
configurations. This reflects their pharmaceutical uses (see image). Which of the
following types of stereo-isomerization do these sugars represent?
A. isomers
B. epimers
C. anomers
D. diastereomers
B. epimers
Elderly patient suffers from insomnia, BDZ of choice?
A. Oxazepam
B. Diazepam
C. Lorazepam
D. Temazepam
D. Temazepam
3 years girl with dry cough what is recommended?
A. Dextromethorphan
B. Diphenhydramine
C. Honey Vicks
C. Honey Vicks
Which of the following drugs cause insomnia and should be taken in the
morning?
A-Diltiazem
B- Prednisone
C-Salbutamol as needed
B- Prednisone
What is the antidote for atenolol?
Glucagon
Definition of Validity.
The extent to which a concept, conclusion, or measurement can correspond
accurately to the real world. Also, to what extent the study measures what it
is set to do.
(e.g., were the variables controlled, are the samples representative).
Two types of validity:
1. Internal validity: to extent to which the observed difference between
groups can be attributed to the intervention being investigated.
2. External validity: applicability of the study findings to the real-world
patients.
Definition of Credibility.
A measure of the truth value of qualitative research, or whether the study
findings are correct and accurate.
(e.g., is it a trustworthy source, what is the expertise of the author).
Definition of Reliability.
Consistency of the results (if we repeat experiment would we get same
results)
Two types of reliability:
1. Primary: if the same study was repeated in a similar sample would we get
the same results?
2. Secondary: are the findings consistent with other published studies
investigating the same thing.
What is an opsonin?
What type of antibiotic is Adalimumab?
A. Human
B. Humanized
C. Murine
D. Chimeric
A. Human
Doctor wants to add a PDE-5 inhibitor, but patient is already taking
tamsulosin. What instruction should you give to patient?
A. Tadalafil after 4 hours of taking tamsulosin
B. Tadalafil and tamsulosin together.
C. Vardenafil after 4 hours of taking tamsulosin.
D. Vardenafil and tamsulosin together.
What is the mode of action of atropine?
Anti-muscarinic agent
Metabolism of Catecholamine.
see the structure in page 61 number 685
Patient suffering of asthma and hypertension, which medication should they
avoid?
Propranolol
Child with bowel, leg, and bone pain, what should be given?
Ergocholecalciferol
Patient is recently diagnosed with depression and taking citalopram and told
you that he doesn’t want to live, and the medication is doing nothing, how you will
response:
A. “It’s ok it’s depression”
B. “You’re not garbage”
C. “You’re strong and young”
D. “How long you have these symptoms”
D. “How long you have these symptoms”
Isoprenaline is an adrenergic agonist. The isoprenaline analogue shown
below demonstrated that can be drawn?
A. Activity has increased due to increase molecular weight.
B. The analogue has an altered pKa.
C. The extra phenol ring in the analogue is interacting with an addition
binding region in the binding site.
D. The extra substituent is protecting the terminal methyl group of
isoprenaline from metabolic reactions.
C. The extra phenol ring in the analogue is interacting with an addition
binding region in the binding site.
Which antibiotic is time-dependent?
- Beta-lactam
- Glycopeptides
- Macrolides
- Tetracycline
- Vancomycin
Which antibiotic is dose-dependent?
- Fluoroquinolone
- Aminoglycosides
- Metronidazole
- Amphotericin B
Calculating inventory turnover ratio.
look at page 62 number 692
Which of the following medications has the same mode of action as
penicillin?
A. Cephalexin
B. Neomycin
C. Tetracycline
A. Cephalexin
What is the mode of action of topiramate?
Sodium channel blocker (and GABA agonist activity)
A patient has diarrhea, lost weight, and has blue discoloration along the gum
line of the mouth. Which type of heavy metal over-exposure causes?
A. Mercury
B. Lead
C. Chromium
D. Copper
B. Lead
Calculate T1/2 from CrCl and Vd.
1st you need to find Ke= CrCl/Vd
2nd use Ke to calculate t1/2= 0.693/Ke
What is correct regarding tetanus?
A. Tetanus vaccine increases activity of diphtheria vaccine.
B. Tetanus vaccine decreases activity of diphtheria vaccine.
C. Tetanus is exclusively environmental born pathogen.
D. Tetanus is both environmental and transmitted pathogen.
C. Tetanus is exclusively environmental born pathogen.
what is the circled molecule called?
active form of alkylating agents
which molecule is the antidote of opiod?
a. naloxone
b. naltrexone
c. 6H- natrexol
c. nalbuphine
b. naltrexone
structure is at page 63 number 699
what are the side effects of amphotericin B?
nephrotoxicity
what is the treatrment choice for group B streptococcus infection?
Cephalosporin or penicillin
what is the treatment choice for group B Streptococcus infection in patient with penicillin allergy?
vancomycin
Patient case experiencing suicidal thoughts, withdrawal from society and
angry.
A. Haloperidol
B. Risperidone
C. Clozapine
A. Haloperidol
Pyrogen present in containers can be destroyed by heating the container at?
A. 121 C for 30 mins – (if moist heat is used)
B. 210 for 1 hr
C. 121 for 15 mins
D. 180 C for 4 hrs
D. 180 C for 4 hrs
Dehydrogenation (FDA):
- 650 C for 1 minute
- 250 C for 45 mins
- 180 C for 4 hrs
Which one of the following has been mostly participating in pharmacy &
therapeutic committee?
A. Nurse
B. Dietitian
C. Technician
D. Social worker
A. nurse
Convert patient weight from pound to kg.
A child is taking amoxicillin for 7 days and his vaccination is due, what is the
best action?
Give vaccine
What does orphan drug mean?
A drug used to treat or prevent a rare disease.
Case about patient traveling a lot and had provoked DVT, his age is 45 and
weight is 72kg his creatinine level is 10 or 9 (given in mmol/L), which is the best
option?
A. Warfarin 5 mg
B. Apixaban 2.5 mg
C. Enoxaparin 40 OD
D. Enoxaparin 70 BID
B. Apixaban 2.5mg
How can you distinguish enantiomers?
Mirror images of each other but they cannot be superimposed upon one another
what are diastereomers?
They have the same molecular formular and sequence of bonded elements,
but they are non-mirror images and are non-superimposable.
The process of identifying the most accurate list of all medications that the
patient is taking, including name, dosage, frequency, and route, by comparing the
medical record to an external list of medications obtained from a patient, hospital,
or other provider. What is this a definition of?
Medication reconciliation
In a total population of 1000, there are only three deaths. What is the
mortality?
A. 3
B. 300
C. 0.003
D. 3000
C. 0.003
Pharmacy manager wants to restructure narcotic room, who should allow to
enter the room?
A. Narcotic pharmacist and his student interns.
B. nurse in charge
C. physician.
D. only pharmacy “in call” and manager.
B. nurse in charge
when should be mycophenolate be stopped in pregnancy?
A. First trimester.
Mycophenolate must not be taken by women who are pregnant or who
may become pregnant. There is a high risk that mycophenolate will cause
miscarriage (loss of the pregnancy) during the first 3 months of
pregnancy.
A patient has heart failure and stroke but does not have Afib. How would you
search for this in medical website?
Heart failure and stroke without Afib
A patient has received PCI and wants prophylaxis from VTE. What should you
give?
A. LMWH 40 mg daily.
B. LMWH 1 mg/kg.
C. Aspirin 81 mg per day.
D. Clopidogrel 75 mg per day.
A. LMWH 40 mg daily.
calculate vancomycin correction
A 20-year-old female has received all immunization as a child (last
immunization at 11 years old), which vaccine should she receive?
A. Influenza vaccine
B. Hepatitis A vaccine
C. Pneumococcal vaccine
A. Influenza vaccine
A patient is going for Hajj for 45 days and requires Diazepam, how much
should be dispensed?
A. 30 tablets
B. 45 tablets
A. 30 tablets
patient with hyperkalemia (6.1) already given Calcium gluconate, what should you give next?
insulin / dextrose
bacteria which causes meningitis?
Neisseria meningitis
which one is a DHP CCB from the following chemical structure?
structure at page 65 number 723
What type of water is used in TPN/IV admixture? Water for injection
Trimethoprim / sulfonamide dosing is based on which one?
trimethoprim
A lactating mother is complaining of migraine. Her medication has resulted in reduced milk production. Which medication was she prescribed ?
Ergotamine
TB skin test potassium level 6.1, waht is the appropriate recommendation?
Calcium gluconate
Active form of diclofenac?
6- hydroxydiclofenac generated by CYP2C9
structure is in page 66 number 729
Simple instructions to give patient prescribed levothyroxine.
A- take the dose 30 min to 60 min before first meal for hypothyroidism
B- take the dose 30 min to 60 min before first meal for underactive thyroid
B- take the dose 30 min to 60 min before first meal for underactive thyroid
