3 Flashcards
Secondary lymphoid organ?
Tonsils
Ig in asthma ?
IgE
Ig pass placenta?
Ig G
Methotrexate affect ?
Dihydrofolate
Drug category: Oncologic drug:
antimetabolites
Adverse effect : Hepatotoxicity
treatemnt: Leucovorin/ Folinic acid
What cancer treatments interfere with mitosis?
Docetaxel
Drug classification: oncologic drug : plant derivative product: atnimicrotubular agent
MOA: bind to tubulin inhibit mitosis
Adverse effect : Hypersensitivity, Neutropenia
treatment:* Diphenhydramine , Dexamethasone *
Diphenhydramine- drug category: autocoids: histamine : antagonist: H1 antihistamines: Ethanolamines
Diphenhydramine:
* anti-allergy
* sleeping aid
* adjuct parkinsonims
* management of extrapyramidal symptoms (Dystonia, Pseudoparkinsonism)
Dexamethasone-drug category: drugs for endocrine system:Glucocorticoids:Long acting
Dexamethasone- antiemetic
Dexamethasone side effect:
* cushing’s syndrome,
* increase infection ,
* poor wound healing ,
* hyperglycemia ,
* proximal myopathy,
* HPA axis supression
* (note: GCs should not be withdrawn abruptly, taper the dose slowly
Which of the following is human monoclonal
antibody?
Adalimumab
Drug Category: drug for rheumatologic discorder: DMARDs: Tissue necrosis factor (TNF) blockers/ TNF neutralizing agent
What are preventative measures for Clostridium
difficile?
Negative room pressure
Anergy in immunology definition?
Anergy is a state in which the immune system is unable to
mount a normal immune response against a specific antigen
Cytokines?
Interleukins are a group of cytokines
note: Cytokines are small proteins that are crucial in controlling the growth and activity of other immune system cells and blood cells
Cyclization in the chemical structure increase?
Stability
Naranjo score?
The Naranjo Algorithm, or Adverse Drug Reaction Probability
Scale, is a method by which to assess whether there is a causal
relationship between an identified untoward clinical event and
a drug using a simple questionnaire to assign probability
scores.
Google:The Naranjo algorithm, Naranjo Scale, or Naranjo Nomogram is a questionnaire designed by Naranjo et al. for determining the likelihood of whether an adverse drug reaction (ADR) is actually due to the drug rather than the result of other factors.
Disadvantage of primary resources?
Need high skills
MODULE 3
Which medication increase the INR?
Amiodarone
(Amiodarone and its active metabolite inhibit CYP2C9, which
increases the anticoagulation effect of warfarin)
Drug category: Cardiovascular drugs :Anti-arrhythmic drug
image:https://www.researchgate.net/figure/Vaughan-Williams-classification-of-antiarrhythmic-drugs_tbl1_288835115
**International normalized ratio (INR) **is the preferred test of choice for patients taking vitamin K antagonists (VKA).
Affinity, Efficacy, t1/2 !
AFFINITY: REFER TO THE drug binding to receptors at any
given drug concentration
EFFICAY: the ability of an intervention a drug to
produce the desired beneficial effect
T 1⁄2: the time required for plasma concentration of a
drug to decrease by 50%
THE EQUIVALENT DOSES FROM
MORPHINE AND TRANSDERMAL
FENTANYL
page 2 number 15
Medication with half-life 4 hours, What is the
wash period?
24hr
Xalatan use for ?
Glaucoma
Which one of the follow best to be avoid before
surgery?
-Isoflourane
-Desflurane
-Fentanyl
-Diazepam
Pharmacy loss 117000 due to drug expiration, what
is the best methodology?
67first in, first out
Prontosil converted to sulfanilamide By which
reaction?
Reductions
Imipramine and aspirin drug interaction?
A Imipramine increase absorption of aspirin
B Imipramine decrease absorption of aspirin
C Aspirin increase the absorption of imipramine
D Aspirin decrease the absorption of imipramine
C Aspirin increase the absorption of imipramine
Enoxaparin dose?
1mg/ kg BID
Long case with peaked T wave?
Potassium
Long case with tape worm?
praziquantel
Amikacin which organ will be toxic?
Kidney
Long case with Isotretinoin and pharmacist know
that the medication is category X and dispensed to
pregnant patient?
Non-maleficence
Catecholamines enzyme degradation?
-Rapid COMT
- slow COMT
Central dogma?
theory stating that genetic information flows only in one
direction, from DNA, to RNA, to protein, or RNA directly to
protein
which of the following is gram negative bacteria?
Meningitis Neisseria
Captopril SE?
Metallic taste
Infliximab?
TB test
Acetaminophen overdose?
Acetylcysteine
Long case about viral respiratory infection +
asthma?
Oseltamivir
Ciprofloxacin and binder agent Counseling the pt ?
Take cipro 3 hr. before
Administer Ciprofloxacin at least 3 hours before or 3 hours
after binders
Which drug safe in pregnancy?
levothyroxine
Graves diseases?
Methimazole
Myrrh used for what!
Cough
Amphotericin B undergo which reaction?
Hydrolysis
Drug used for HTN, and it mechanism is my
blocking alpha 1 receptor?
Prazosin
Vaccine in hajj?
-Influenza
-Diphtheria
-Rota
-Pneumococcal
Which of the following represent QRS
complex in ECG?
Ventricular depolarization
What is the chemical reaction of aspirin
tablets stored in the bathroom?
Hydrolysis
What resource should be used when searching for the most current clinical
trials on the use of novel anticoagulants for pulmonary embolism?
PubMed
Drug used to treat HTN by alpha 2 blocker?
Clonidine
Which of the following treatment Meningitis empiric treatment regimen H
pylori H?
Ceftriaxone 2g 12 h IV
7-14 day
Healthy Woman afraid from respiratory infection in winter what you
recommend?
-Hand sanitizer
-Vitamin C
-Zinc sulfate
-Ask her to bring
prescription for
Antibiotics
Ranitidine, what is the pharmacophore??
Furan
Benzodiazepines antidote?
Flumazenil
Which of the following is the bioisoster for Ropivacaine?
Levobupivacaine
Cells involved in adaptive immunity?
T cell
2.5% intravenous drug is infused at a rate of 1.5 ml/min. Which of the
amount of the drug That is infused in each hour?
2250 mg
The following prescription is received in a hospital pharmacy: Losartan 25
mg. Take 1 tab BID duration: 3 weeks, Which of the following instructions
will be on the prescription label?
Take 1 tablet twice
daily (42 tablets)
How much of 5% w/v solution would be required to prepare 60 ml of
5mg/ml solution!
6ml
A 20 ml vial of penicillin-G potassium containing 2,000,000 units is available.
Each mg of the-24 drug is equivalent to 1600 units. How many milligrams of
penicillin-G potassium are there in one ml of the solution?
62.50
Pt was playing then suddenly he developed hypoxia and hypovolemia which
system is affected?
Circulatory
Pt with HF on multiple anti failure (ACEI, BB, Spironolactone) which
medication if additional added will have mortality benefits?
Hydralazine/isosorbide
Vit k reverse which anticoagulant?
Warfarin
pt was admitted to ICU what to give for stress ulcer?
IV omeprazole
3yr old boy with symptoms consistent with otitis media what is the ABx of
choice?
Amoxicillin
80-90mg/kg/day
Pro arrhythmic pt what to avoid?
Azithromycin
Azathioprine gene?
TPMT
Codeine to morphine?
Oxidation
NSAID which is best for dysmenorrhea ?
Mefenamic acid
Structure of quinolone, pointed at C7 and asked what its function?
Modification at
C7 alter spectrum.
Pt was having narcotic prescription from Riyadh
and went to a pharmacy in Dammam the
prescription is for pain after major surgery and it’s
for 7 days, but the patient came after 2 days from
the prescription date?
Give the med for the remaining days (5days)
- Don’t give
-Call his physician
Verapamil has drug interactions with?
Diltiazem
Status epileptics case emergency?
lorazepam IV
Nurse went to medication room and wants only
one bag of the gentamicin but she found 2 bags so
what she does?
Take only one bag and return another bag to
the pharmacy
An addicted patient with MRSA and the patient
being treated with home injections at home so we
can discharge him?
Give the pt vancomycin q12h for 2 weeks
-Give the pt vancomycin q24h for 2 weeks
-Give the pt oral vancomycin q24h for 2 weeks
-Don’t discharge him because he’s addicted and
must treated in the hospital
lithium side effect?
Polyuria
Medication that MASK hypoglycemia?
BB
Propylthiouracil side effects?
agranulocytosis
cyclophosphamide?
Hemorrhagic cystitis
Don’t eat, drink, or take any other medications
(including vitamins or antacids) for at least 60
minutes.?
Ibandronate
How to prevent LASA medication error?
Use tall man method
clopidogrel gene:
Cyp2c19
COPD patient ask about recommended vaccine?
Pneumococcal & Influenza
Female patient with asthma came to clinic, she’s
well controlled on Saba her only compliant is chest
tightness and Wheezing I think. What can be added
to resolve the issue
-Budesonide ( ICS )
- Omalizumab
-No change in therapy
-Add salbutamol to albuterol
Patient diagnosed with RSV what’s the therapy?
Supportive therapy and fluid
Which is used to prevent RSV?
palivizumab
A patient with breast cancer had HER2 negative,
now the physician asks whether to use
trastuzumab or not . What is the appropriate
response?
Don’t use trastuzumab since HER2 is negative
and there will be no response
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 MgSO4 to a patient with
epilepsy, which results in the baby being admitted
to NICU. What type of error is this?
process 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 organo-phosphosphate
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 expected impact?
Options were in % reduction in number
of seizures (don’t know answer)
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-
troughlevels within one dosing interval
at steady state (expressed as %).
Identify which drug has higher efficacy and potency from
a dose-response curve.
page 6 number 108
What is a small, circular, double-stranded DNA that is
distinct from a cell’s chromosomal DNA known as?
Plasmid
pharmacist is comparing the clinical outcome of two drugs
with different costs. Which type of pharmacoeconomic
analysis is this?
Cost-effectiveness analysis (CEA)
Definition of SNP. Single nucleotide polymorphism
(change in only one nucleotide).
Which anticancer drugs target the mitosis stage
Vinca Alkaloids and Texans
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?
40 mg
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/zakat +
other expenses])
What enhances the activity of insulin? Chromium 50. 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 nonpharmacological measures were
ineffective!
Topical NSAID (gel or patch).
Which drug is an IV direct thrombin
inhibitor?
Argatroban
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 Years 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.
LOOK AT PAGE 8 NUMBER 146
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) +
SYSTEMIC 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)
Mannitol Structure
look at page 9 nu mber 161
Which chemical structure can cause penicillin allergy?
Beta lactam ring
page 9 nu mber 162
How is amphotericin B metabolized?
Hydrolysis
Which of these ACE inhibitors 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?
look at page 9 number 166
What is the least dominant form of histamine?
look at page 9 number 167
What’s the property of Carboxylic group (COOH)?
look at page 9 number 168
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 TAKING 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 OR 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
1A child who was given codeine experiences dizziness
and respiratory depression, what is the likely cause?
Comparison of the drug with another medication in
which phase in the clinical trial?
Phase 3
What rifampin does to carbamazepine levels?
Decrease the carbamazepine levels
Long case about pt on daptomycin and captopril,
what is the interaction?
Increase risk or severity of myopathy and
rhabdomyolysis
Distribution of ciprofloxacin to?
Adipose tissue firstly , liver and brain later
65 year old woman with DVT is on heparin 1200 units
/ hour. The nurse asks for heparin dosing
recommendation after receiving the hematology test
this morning and aPTT 300. What is the best
recommendation based on hospital heparin protocol?
(for patient take heparin,
you’d want your PTT results to be more like 120 to 140
seconds, and your aPTT to be 60 to 80 seconds)
- Keep the same dose
- Decrease the infusion rate to 1100 /
hour
- Hold the infusion for 60 minutes, then
resume with 1000 units / hour
-Hold the infusion for 60 minutes, then
resume with 900 units / hour
Bacteria purple cocci Pairs color shaped?
Streptococcus pneumonia
Accumulation of toxic chloramphenicol metabolites
and causes gray baby syndrome due to deficiency of?
UDP-glucuronyl transferase
Cytomegalovirus (CMV) infection treatment in organ
transplant patients?
Ganciclovir
Which of the following is the benefit from adding of
polyethylene glycol PEG in some medications?
To extend the half-life of and improve
drug efficacy
Patients travel to Africa and are afraid of travel
diarrhea what is your recommendation?
Don’t eat raw meat choose drinks
carefully
Responsible for the house worker?
MOH
Long case about pt on simvastatin 80 mg form (6
year) his LDL is good he has SLCO1B1 gene positive -
and no rhabdomyolysis or any other toxicity, what is
your plan?
-Counting on simvastatin 80
-Change to simvastatin 40
Pt with decompensated HF which diuretic is drug of
choice?
Furosemide
Pt was prescribed hypnotic anxiolytic and is to be
taken before bedtime, when she wakes up she is still
drowsy, what is the most likely drug?
Ramelteon
-Zolpidem
-Diazepam
- midazolam
Which is good for Ulcerative colitis?
-Sulfasalazine
How do you replace vitamin D in renal failure?
calcitriol
Iron deficiency anemia!
-hypochromic microcytic anemia
Vancomycin level?
After the 3rd dose
Prevalence?
Is the proportion of persons in a population
who have a particular disease or attribute at
aspecified point in time or over a specified
period of time
Pandemic is ?
an epidemic of an infectious disease that has
spread across a large region, for instance
multiple continents or worldwide, affecting a
substantial number of individuals.
Lovastatin high intensity dose?
-40mg
-20m
Long case, drug of choice for anaphylaxis?
-Epinephrine
Long case, woman 57 yr old on the maximum dose
of rosuvastatin and not improved?
-Switch to atorvastatin
-Add ezetimibe
- Add ezetimibe and cholestyramine
Sustained release drug if it was crushed?
Toxic
Which of the following of the hypertensive
therapies is preferred to be used during the acute
phase of ischemic stroke if elevated blood pressure
should be treated?
-Lisinopril
-nicardipine
-hydrochlorothiazide
- metoprolol
A 23-year-old drug addict man was brought to the
Emergency Room with severe agitation and
excitement. He was administered intravenous
diazepam, with no improvement in his condition.
Which of the following is the mostly likely drug the
patient was addicted on?
-Opioids
- Cocaine
-Pregabalin
tetrahydrocannabinol
Patient come to pharmacy with prescription but the
same company not available , you have another
company what do!
- tell the patient go to another pharmacy
- go to doctor to change the prescription
-give the same active ingredient from
different company and Counselling to the
patient
Which statin can use with grapefruit?
Pravastatin (Note: Also we can use
rosuvastatin and Fluvastatin and Pravastatin
and Pitavastatin)
A girl come to pharmacy with eye drops she was
using the opened bottle for 45 days best advice?
-Discard immediately after administration
Discard after 7 days (if not have a
preservative)
- It is ok to use for 60 days
Discard after 28 days (if have a preservative)
Suspending agents are?
Hydrophilic particles
Patient has uncontrolled diabetes and now has back
pain (neuropathic pain)?
Gabapentin
Case of a patient he came and medical team want
to give a medication to cover aspergillosis, they also
want to do TDM and monitoring. Which medication
to give?
-Voriconazole
Fluconazole
-itraconazole
What is the method that used to make strength
from two different strength?
Allegation
Multiple sclerosis with 2 relapse per year?
-Finglimod
-Natalizumab
Which of the following affect t
he ABC classifications?
Volume annual sale
Mannitol structure without name and ask about the
mechanism of action?
-Osmotic diuretics or osmosis
Which of the following documents created by the
World medical Which Association is the statement
of ethical principles for medical research involving
human subjects?
- Ethics Code
- Belmont Report
-Nuremberg Zode
Declaration of Helsinki
A 42-year-old woman presents with complain of
epigastria burning and pain for the last 6 month 33 /
272 significant medical history but reports an allergy
to beta-lactam antibiotics. An office based Urea
Breath Test is performed to diagnose Helicobacter
pylori infection
(see lab result) Test Result
Urea breath test Positive
Which of the following is the most appropriate
treatment regimen?
A) Levofloxacin and lansoprazole for 14 days
B) Omeprazole, clarithromycin, and
amoxicillin for 10 days
C)Omeprazole, clarithromycin, and
metronidazole for 14 days
C)Omeprazole, clarithromycin, and
metronidazole for 14 days
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 distribution systems works
better for medicine requiring a higher level of
control?
a) Bulk ward stock
B) Direct procurement
C) Automated dispensing
C) Automated dispensing
14 years-old man expressesd withdrawal symptoms
from using benzodiazepine drug which included
Irritability and aggression which of the following
types of benzodiazpine is more likely associated
with these symptoms
A) long acting benzodiazepines
B) ultra-short acting benzodiazepines
C)benzodiazepines WITH ACTIVE
METABOLITES
C)benzodiazepines WITH ACTIVE
METABOLITES
From salicylic alcohol to salicylic acid?
Oxidation
Low creatinine
Renal failure
Contraindicated in pregnant women?
-Cyclosporine
-Acretin
-Amoxicillin
