Module 3: Dispensing Flashcards by JANE DAISIREE RANCAP

Which of the following factors are associated with a patient’s non-adherence to the prescribed therapeutic regimen?
A. How do often the medication is taken
B. The cost of the medication
C. The duration of therapy
D. All of these
E. None of these

All of these

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The part of the prescription that is understood to mean “thou take” or “you take”
A. Medications prescribed
B. Signatura
C. Rx symbol
D. Superscription
E. Subscription

Rx symbol

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The part of the prescription that is also known as the inscription
A. Medications prescribed
B. Signatura
C. Rx symbol
D. Superscription
E. Subscription

Medications prescribed

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The part of the prescription that refers to the dispensing directions to the pharmacist
A. Medications prescribed
B. Signatura
C. Rx symbol
D. Superscription
E. Subscription

Subscription

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Which of the following is a dispensing direction for the pharmacist?
A. Gtt i-ii ou BID
B. M ft caps dtd #50
C. Inh 2 puffs PO q 4 to 6 h prn difficulty breathing
D. Ii tabs PO q 4 h
E. 50 units SC q AM

M ft caps dtd #50

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The packaging suitable for dispensing bulk powders
A. Round vials
B. Wide-mouth bottles
C. Dropper bottles
D. Ointment jars
E. Collapsible tubes

Wide-mouth bottles

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Which is TRUE regarding auxillary labells?
I. Emphasizes important aspects of the dispensed medication
II. Provides cautionary statements from the pharmacist regarding the dispensed medication
III. Are available in different colors to give them prominence once attached to the medication container
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I, II and III

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An example of an auxillary label
I. Shake well
II. Take with food
III. May cause drowsiness
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I, II and III

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A sample of dispensing error

I. Providing the incorrect medication
II. Providing the incorrect dosage strength and dosage form
III.Undetected interactions with other medications

A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I, II and III

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A risk factor for adverse drug reactions
I. Patient age
II. Concurrent medications taken
III. Ethnicity and genetics
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I, II and III

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Factor contributing to the occurrence of a drug interaction
I. Multiple pharmacological effects
II. Multiple prescribers
III. Use of over the counter products
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I, II and III

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Which of the following statements is TRUE regarding patient variables affecting drug response.
I. Taking sedatives and alcoholic beverages together could result to an excessive depressive response.
II. Food may often affect the rate of extent of absorption of a drug from the GIT
III.Renal and hepatic function do not affect the patient’s response to a medication
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I and II only

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How could you counsel a patient who is prescribed a ketoconazole and an antacid, knowing that the ketoconazole requires an acidic environment to achieve dissolution after oral administration?
A. Advice the patient that both drugs could be taken together.
B. Advice the patient to go back to the doctor and have the ketoconazole replaced with another drug.
C. Advice the patient to take the antacid two hours after taking the ketoconazole.
D. Advice the patient to go to the doctor and have both drugs changed.
E. Advice the patient to stop taking both medications.

Advice the patient to take the antacid two hours after taking the ketoconazole

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A patient is prescribed ciprofloxacin to treat a respiratory tract infection. What would you advice the patient?
I. Do not take with milk and or dairy products
II. Take aluminum or magnesium containing antacids when stomach upset occurs
III. The patient may continue taking iron supplements even while on the medication
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I only

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The mechanism of drug interaction between tetracycline and milk, tetracycline and aluminum or magnesium-containing antacids
A. Alteration of gastric emptying rate
B. Complexation
C. Alteration of pH
D. Alteration of GI absorption
E. Alteration of distribution

Complexation

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The mechanism of drug interaction between oral contraceptives and antibiotics
A. Alteration of GI flora
B. Alteration of pH
C. Complexation and adsorption
D. Alteration of distribution
E. Alteration of metabolism in the GIT

Alteration of GI flora

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The mechanism of drug interaction between phenytoin and valproic acid
A. Displacement form protein binding site
B. Drug-food interaction
C. Alteration of GI flora
D. Stimulation of metabolism
E. Alteration of active transport

Displacement form protein binding site

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Phenobarbital causes enzyme induction hence, increases the rate of metabolism of warfarin when taken together. As the pharmacist, what would be your recommendation to the prescriber?
I. Increase the dose of warfarin while on phenobarbital then lower it down once phenobarbital is discontinued
II. Consider an alternative to phenobarbital such as benzodiazepines which are not likely to interact withwarfarin
III.There is no need to make any recommendation to the prescriber
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I and II only

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The following are examples of a drug with a narrow therapeutic index, EXCEPT
A. Theophylline
B. Warfarin
C. Digoxin
D. Penicillin
E. Lithium

Penicillin

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An example of a type A adverse drug reaction
A. Carcinogenesis
B. Anaphylaxis from penicillins
C. Tachycardia from salbutamol
D. Teratogenesis
E. None of these

Tachycardia from salbutamol

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As a pharmacist, what would you advice your patient when dispensing ophthalmic solutions:
I. Never allow the tip of the dropper to touch any surface
II. Never rinse the dropper
III. Never use eyedrops that have changed color
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I, II and III

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During medication review, the patient reveals that he is an avid fan of grapefruit and takes his medications,including verapamil, with grapefruit juice. Which of the following is TRUE regarding verapamil and grapefruitjuice?
I. Avoid taking medications with grapefruit juice
II. The combination may inhibit the metabolism of the drug (verapamil) resulting to increased pharmacologiceffects and increased risk of adrs
III.The combination may increase the metabolism of the drug (verapamil) resulting to decreasedpharmacologic activity
A. Only I
B. Only III
C. I and II
D. II and III
E. I, II and III

I and II

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A patient complains of extreme muscle weakness and myopathy. Which of his medications may have causedthis?
A. Metformin 500 mg BID
B. Atorvastatin 80 mg hs
C. Losartan 50 mg qam
D. Multivitamins
E. Paracetamol 500 mg Q 4 to 6 h prn

Atorvastatin 80 mg hs

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A patient with hypertension complains of swelling in her feet and mentions that this started when she was givenher new antihypertensive drug. Which of the following medications may have caused this?
A. Metoprolol
B. Hydrochlorothiazide
C. Valsartan
D. Furosemide
E. Amlodipine besylate

Amlodipine besylate

Amlodipine dilates your blood vessels, which improves blood flow. But this can put pressure on smaller blood vessels (called capillaries), causing fluid to leak out into surrounding tissues.

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A patient with infection was given levofloxacin 500 mg once daily for 10 days. The patient noticed no improvementof symptoms on the seventh day of therapy. A review of the patient’s medication profile reveals that he is takingwhich of the following drugs that may have interacted with the antibiotic?
A. Ferrous sulphate
B. Vitamin C
C. Guaifenesin
D. Ibuprofen
E. Paracetamol

Ferrous sulphate

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A patient comes to the pharmacy asking for a recommendation for a cough medicine because of persistent cough. A review of the patient’s medication profile revealed that one of his medications is causing this symptom. What drug is this?
A. Enalapril
B. Losartan
C. Metoprolol
D. Hydrochlorothiazide
E. Furosemide

Enalapril

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Which of the following drugs may cause postural hypertension and reflex tachycardia once the drug is initiated and when increasing doses?
A. Prazosin
B. Amlodipine
C. Labetalol
D. Propranolol
E. Furosemide

Prazosin

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A patient’s blood pressure has been well controlled for years using a thiazide diuretic. But lately there has been an increase in his diastolic blood pressure warranting an additional blood pressure medication. However, he noticed that lately he has been experiencing erectile dysfunction. Which of the following medication classes may have caused this?
A. Thiazide diuretics
B. Beta blockers
C. ACE inhibitors
D. ARBS
E. Loop diuretics

Beta blockers

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A common side effect of minoxidil
A. Persistent dry cough
B. Peripheral edema
C. Reflex tachycardia
D. Drowsiness
E. Hypertrichosis

Hypertrichosis

Hypertrichosis is defined as excessive hair growth anywhere on the body in either males or females.

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A patient’s routine lab results showed an increase in her serum potassium levels. Her physician informed her that her hypertensive medication which one initiated three months ago may have caused this increase. Which of the following is her medication?
A. Furosemide
B. Hydrochlorothiazide
C. Losartan
D. Nifedipine
E. Chlorthalidone

Losartan

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A patient who is hypertensive and has history of gout was placed by his physician on a diuretic. He develops an attack of gout a few weeks after starting therapy. Which of the following diuretics was he taking?
A. Spironolactone
B. Hydrochlorothiazide
C. Triamterene
D. Urea
E. Chlorthalidone

Hydrochlorothiazide

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This antihypertensive drug is associated with drug-induced lupus that resolves upon cessation of the drug.
A. Digoxin
B. Hydralazine
C. Minoxidil
D. Labetalol
E. Valsartan

Hydralazine

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A patient on an antiarrhythmic medication complains of dry mouth, blurred vision, and urinary hesitancy. Which of the following medications is the patient taking?
A. Disopyramide
B. Flecainide
C. Lidocaine
D. Amiodarone
E. Sotalo

Disopyramide

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This antiarrythmic may induced the symptoms of cinchonism.
A. Quinidine
B. Flecainide
C. Procainamide
D. Mexiletene
E. Sotalo

Quinidine

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A common adverse effect of mexiletine
A. Bleeding
B. Anorexia
C. Dyspepsia
D. Somnolence
E. Shortness of breath

Dyspepsia

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An antiarrythmic that should be avoided by patient’s with asthma
A. Propafenone
B. Flecainide
C. Quinidine
D. Sotalol
E. Mexiletine

Propafenone

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The following are adverse effects of amiodarone EXCEPT
A. Pulmonary fibrosis
B. Neuropathy
C. Blue-gray skin discoloration
D. Hypo- or hyperthyroidism
E. Bleeding

Bleeding

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A patient comes inti the pharmacy and hands you, the pharmacist, a prescription for sildenafil. You recall that you just counselled this same patient two weeks ago regarding the use of sublingual nitroglycerin. What would be the result of the interaction between the two medications?
I. Potentiate the effects of sildenafil
II. Dangerous hypertension
III. Dangerous hypotension
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

III only

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The interaction between aspirin and ketorolac would result to which of the following:
A. Increased bleeding
B. Dry mouth
C. Blurred vision
D. All of these
E. None of these

Increased bleeding

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A patient who is on probenecid for his gout reports that he has been experiencing attacks of his gout when he was on daily aspirin therapy. This is due to which of the following:
I. Increased metabolism of aspirin
II. Increased vasodilation
III. Decreased uricosuric effect of probenecid
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

III only

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A patient is on clopidogrel for her arrythmia and she came to you to bring in a prescription for omeprazole from her doctor. What can you say about this combination?
I. The two drugs could be given together
II. The combination is not recommended
III. Patients on clopidogrel should avoid omeprazole
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

II and III

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A treatment for excessive bleeding due to heparin therapy
I. Vitamin K
II. Discontinue heparin
III.Protamine sulfate
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

II and III

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A consequence of long tern heparin therapy
A. Osteoporosis
B. Persistent cough
C. Obesity
D. Weight gain
E. Hair loss

Osteoporosis

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A patient brought in a new prescription for fluconazole. A review of her medication profile revealed that she is on warfarin therapy. Which of the following statements is TRUE regarding the combination of these two drugs?
I. The two drugs are safe to be taken together
II. Fluconazole inhibits the metabolism of warfarin
III.The combination of these two medications could lead to serious bleeding
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

II and iII

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A patient complains of weakness and muscle achiness that will not resolve. He said that his symptoms are interfering with his daily activities for he feels too weak even to get out of bed. You reviewed his medication profile and found out that one of his medications may be the cause of his condition. Which of the following medications may have caused these symptoms?
A. Losartan 50 mg daily
B. Lipitor 80 mg daily
C. Ibuprofen 200 mg q 4 to 6 h prn pain
D. Multivitamins 1 cap daily
E. Metformin 500 mg daily

Lipitor 80 mg daily

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The following are adverse effects of niacin, EXCEPT
A. Intense cutaneous flush
B. Pruritus
C. Hepatotoxicity
D. Anorexia
E. Abdominal pain

Anorexia

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Which of the following statements is TRUE regarding simvastatin and gemfibrozil?
I. The use of gemfibrozil is contraindicated with simvastatin
II. The combination increases the risk for myopathy and rhabdomyolysis
III. There is no interaction between the two medications
A. I only
B. III only
C. I and II
D. II and III
E. I, II and III

I and II

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Which of the following statements is TRUE regarding bile acid sequestrants?
I. Most common side effects include constipation, nausea, and flatulence
II. They may impair the absorption of Vitamin A,D,E,K
III. They may impair the absorption of many drugs, such as warfarin, digoxin, etc.
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I, II and III

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A counselling point when dispensing colesevelam to a patient on a warfarin therapy.
A. Stop taking warfarin for his interacts with colesevelam
B. Take warfarin 1 to 2 hours before or 4 to 6 hours after the bile acid-binding resin
C. Switch colesevelam to cholestyramine
D. Take both drugs at the same time with food
E. Take both drugs at the same time on an empty stomach

Take warfarin 1 to 2 hours before or 4 to 6 hours after the bile acid-binding resin

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Which of the following patient groups would be more likely to experience the adverse effect of HMG coa reductase inhibitors (myopathy and rhabdomyolysis)?
A. Patients with on blood thinners
B. Patients with heperuriemia
C. Patients with hypertension
D. Patients with renal insufficiency
E. Patients with hypertriglyceridemia

Patients with renal insufficiency

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The most serious and common adverse reaction to insulin.
A. Hypotension
B. Hypoglycemia
C. Hypertension
D. Hyperglycemia
E. Hypercholesterolemia

Hypoglycemia

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How can lipodystrophy, an adverse effect of insulin use, be minimized?
A. Switch to an oral medication
B. Rotate injection sites
C. Inject insulin into the muscle
D. Inject once daily only
E. Use insulin pens

Rotate injection sites

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Major adverse effects of sulfonylureas
I. Weight gain
II. Hypoglycemia
III. Hyperinsulinemia
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I, II and III

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A rare, but serious side effect of metformin
A. Candidiasis
B. Lactic acidosis
C. Pancreatitis
D. Urinary tract infection
E. Heart failure

Lactic acidosis

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Adverse effect associated with estrogen therapy
A. Breast tenderness
B. Nausea
C. Thromboembolism
D. Breast cancer
E. All of these

All of these

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Which of the following antidiabetic drugs is associated with a risk of pancreatitis?
A. Metformin
B. Liraglutide
C. Glimepiride
D. Insulin
E. Nateglinide

Liraglutide

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A patient on warfarin therapy brought in a prescription for naproxen. Upon consult, you were informed that he did not tell his prescriber that he is taking warfarin. You recall that warfarin is 97% protein bound and naproxen is 99% protein bound. What would happen if this patient takes naproxen?
A. The patient will benefit from this combination
B. The pain and inflammation will be treated
C. There is no interaction between the two drugs
D. The patient may experience bleeding
E. The patient would have blood clots

The patient may experience bleeding

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This should be checked by the pharmacist when dispensing suppositories
A. Excessive softening
B. Oil stains on packaging
C. Presence of precipitate
D. A and B
E. B and C

A and B

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The following are common side effects encountered when using ophthalmic preparations EXCEPT
A. Persistent burning sensation
B. Tearing
C. Decreased vision
D. Foreign body sensation
E. Margin crusting

Persistent burning sensation

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A patient brought in a prescription for finasteride. Your pharmacy technician assigned at the filling station is in her 1st trimester of pregnancy. What precautions should be observed?
I. Let her fill the prescription
II. Tell her not to fill the prescription and have somebody else fill it.
III. Remind her not to touch the medication
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

II and III

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Drug interaction includes the following
A. Drug-drug interaction
B. Drug-lab test interaction
C. Drug-food interaction
D. Drug-herb interaction
E. All of these

All of these

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The type of interaction that occurs when the pharmacokinetic disposition of the drug is altered by genetic polymorphism in affecting processes
A. Pharmacokinetic
B. Pharmacogenetic
C. Biopharmaceutical
D. Pharmacodynamic
E. Pharmaceutical

Pharmacogenetic

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A contraindication for the use of ergotamine and dihydroergotamine
I. Angina
II. Peripheral vascular disease
III. Diabetes
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I and II only

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An antimicrobial agent that have the potential to cause interstitial nephritis
A. Methicillin
B. Ceftriaxone
C. Naproxen
D. Cephalexin
E. Sertraline

Methicillin

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Red man syndrome is an adverse event associated with which medication
A. Erythromycin
B. Vancomycin
C. Ciprofloxacin
D. Moxifloxacin
E. Daptomycin

Vancomycin

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An adverse effect associated with the use of daptomycin
A. Red man syndrome
B. Rhabdomyolysis
C. Bleeding
D. Flushing
E. Ototoxicity

Rhabdomyolysis

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Phototoxicity is associated with the use of which antibiotic
A. Tetracycline
B. Gentamicin
C. Erythromycin
D. Amoxicillin
E. Neomycin

Tetracycline

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A patient maintained on warfarin was given a prescription for clarithromycin for an upper respiratory tract infection. Which of the following statements is TRUE?
I. The prescriber needs to be informed that the patient is on warfarin therapy
II. Clarithromycin inhibits the metabolism of warfarin which could lead to bleeding
III. There is no need to contact the prescribers, it is safe to take both medications together
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I and II only

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A contraindication for the use of tetracycline is children below 8 years old because tetracyclines
A. Crosses the blood brain barrier
B. Do not cross into the cerebrospinal fluid
C. Deposits into the bones and teeth
D. Do not cross into the cerebrospinal fluid
E. Can cause blood disorders

Deposits into the bones and teeth

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A drug that colors body fluids
A. Tetracycline
B. Lexofloxacin
C. Bacitracin
D. Rifampin
E. Neomycin

Rifampin

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Rifampin and oral contraceptives
I. Reduced effect of oral contraceptives
II. Increased metabolism of oral contraceptives
III.Need for back-up contraception while on rifampicin
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I, II and III

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A drug that causes optic neuritis with blurred vision, and also red-green color blindness
A. Pyrazinamide
B. Streptomycin
C. Dapsone
D. Ethambutol
E. Capreomycin

Ethambutol

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The interaction between simvastatin and itraconazole would result to:
I. Treatment failure of itraconazole
II. Increased exposure to simvastatin
III. Increased risk of rhabdomyolysis
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

II and III

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The co-administration of triazolam and any protease inhibitor (ritonavir, saquinavir, indinavir, etc.) is contraindicated because
A. This could result to excessive sedation
B. This could lead to treatment failure of the protease inhibitor
C. There is no interaction between the two drugs
D. Both drugs are expensive
E. None of these

This could result to excessive sedation

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Paclitaxel is associated with serious hypersensitivity reactions. Premedications necessary for a patient who would be administered paclitaxel include:
I. Dexamethasone
II. Ranitidine
III. Diphenhydramine
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I, II and IiI

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The toxicity associated with this agent is interstitial nephritis
A. Bleomycin
B. Cyclophosphamide
C. Cytarabine
D. Cisplatin
E. Doxorubicin

Cyclophosphamide

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The drug, chemical or food elemet causing the imteraction.
A. Object drug
B. Precipitant drug
C. Target drug
D. Precipitated drug
E. None of these

Precipitant drug

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Mechanism of interaction between an antacid and an enteric-coated tablet
A. Alteration of gastric pH
B. Increased GI motility
C. Alteration of intestinal flora
D. Complexation
E. Decreased GI motility

Alteration of gastric pH

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Mechanism of interaction between digoxin and antibiotics resulting an increase in digoxin levels
A. Alteration of gastric pH
B. Increased in GI motility
C. Alteration of intestinal flora
D. Complexation
E. Decreased GI motility

Alteration of intestinal flora

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Which of the following herbal preparations increase bleeding in patients on warfarin therapy?
A. Garlic
B. Ginger
C. Feverfew
D. A and B
E. A, B, and C

A, B and C

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Interaction between St. John’s wort and calcium channel blockers result to:
A. Failure of therapy of calcium channel blockers
B. Failure of therapy of St. John’s wort
C. There is no interaction between St. John’s wort and calcium channel blockers
D. Elevated levels of St. John’s wort
E. Elevated levels of calcium channel blockers

Failure of therapy of calcium channel blockers

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A patient asks you for a recommendation for an over the counter product for hot flashes due to menopause. Black cohosh is a common herbal supplement indicated for hot flashes. However further interview revealed that she has maintenance medications for hypertension. What would happen if she takes black cohosh together with her antihypertensive?
A. Hypertension
B. No interaction
C. Treatment failure of black cohosh
D. Hypotension
E. None of these

Hypotension

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Factors that increase the chances of a drug interaction to occur
I. Multiple prescribers
II. Multiple drug therapy
III. Geriatric therapy
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I, II and III

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The interaction between probenecid and penicillin
I. Is beneficial
II. Inhibits renal tubular secretion of penicillin
III. Decreases the plasma half-life of penicillin
A. I only
B. III only
C. I and II
D. II and III
E. I, II and III

I and II

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A type of chemical incompatibility
A. Complexation
B. Reduction
C. Photolysis
D. Oxidation
E. All of these

All of these

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Factors affecting IV compatibility
A. pH
B. Order of mixing
C. Length of time in solution
D. Temperature
E. All of these

All of these

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Therapeutic hazards for IV preparations
A. Drug instability
B. Labelling errors
C. Preservative and solubilizing agent toxicity
D. Incompatibility
E. All of these

All of these

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The interaction between ginkgo biloba and warfarin could result to
I. Increased risk of bleeding
II. Decreased risk of bleeding
III.Antagonism
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I only

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The mechanism for the interaction between ethanol and phenobarbital
A. Increased metabolism of phenobarbital
B. Decreased metabolism of phenobarbital
C. Decreased absorption of phenobarbital
D. Decreased metabolism of ethanol
E. None of these

Increased metabolism of phenobarbital

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False-positive urine ketone tests may result in patients taking valproic acid. This is significant for this type of patients when using urine tests
A. Hypertensive patients
B. Diabetic patients
C. Seizure patients
D. Asthma patients
E. All of these

Diabetic patients

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The following are adverse effects of anticholinergic drugs, EXCEPT
A. Dry mouth
B. Increased urination
C. Constipation
D. Urinary retention
E. Decreased sweating

Increased urination

Medications with anticholinergic properties, such as tricyclic antidepressants, cause urinary retention by decreasing bladder detrusor muscle contraction.

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These agents potentiate the side effects of anticholinergics
I. Antihistamines
II. Antidepressants
III.Phenothiazines
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I, II and III

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Taking which of the following drugs could result to a false-positive Coombs test
A. Levodopa
B. Amantadine
C. Bromocriptine
D. Selegiline
E. Phenothiazine

Levodopa

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The combination of levodopa and phenelzine is avoided because it could result to
A. Hypertensive crisis
B. Urinary incontinence
C. Nausea and vomiting
D. Hypotension
E. Profuse sweating

Hypertensive crisis

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Pyridoxine should be taken with caution in Parkinson’s patients on levodopa because
A. Pyridoxine increases the peripheral metabolism of levodopa
B. The effect of levodopa will be decreased
C. The effect of levodopa will be increases
D. A and B
E. B and C

A and B

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A patient was prescribed amantadine. A review of his medication profile revealed that he has hydrochlorothiazide-triamterene tablets for the management of his hypertension. What could be the result if these are given together?
A. There would be an increase in the plasma concentration of amantadine
B. There will be a decrease in the urinary excretion of amantadine
C. There will be no interaction between the two medications
D. A and B
E. B and C

A and B

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An extrapyramidal side effect that describes sudden muscle spasms that primarily occur in the eye, neck, face, and throat muscles.
A. Acute dystonia
B. Tardive dyskinesia
C. Akathisia
D. Pseudoparkinsonism
E. None of these

Acute dystonia

Dystonia is a movement disorder that causes the muscles to contract involuntarily. This can cause repetitive or twisting movements.

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An extrapyramidal side effect that is defined as the inability to sit still and as being functionally motor restless.
A. Acute dystonia
B. Tardive dyskinesia
C. Akathisia
D. Pseudoparkinsonism
E. None of these

Akathisia

People with akathisia feel a strong compulsion or need to move — mainly, their lower extremities from their hips to their ankles. If you have akathisia, you may: Cross and uncross your legs repetitively.

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Which of the following is considered most sedating antipsychotics?
A. Chlorpromazine
B. Clozapine
C. Olanzapine
D. Thioridazine
E. All of these

All of these

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An uncommon but potentially fatal adverse effect of antipsychotics, characterized by fever, severe rigidity, altered mental status, unstable blood pressure, tachycardia, incontinence, elevated creatinine kinase, and increased WBC count.
A. Stevens-Johnsons syndrome
B. Tardive dyskinesia
C. Serotonin syndrome
D. Neuroleptic malignant syndrome
E. None of these

Neuroleptic malignant syndrome

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Cholestyramine can bind with digoxin. Which of the following is TRUE regarding this drug interaction?
I. Cholestyramine is the object drug
II. Digoxin is the precipitant
III.Digoxin is the object drug
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

III only

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Which of the following is paired correctly?
A. Tetracycline -object drug
Antacid – precipitant drug
B. Ciprofloxacin – precipitant
Milk – object drug
C. Cimetidine – object drug
Atorvastatin – precipitant drug
D. Tetracycline – precipitant
Antacid – object drug
E.Penicillin – precipitant
Probenecid – object drug

Tetracycline - object drugAntacid - precipitant drug

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A patient asks you about using Coenzyme Q10 since he has read about its benefits in a magazine. Further interview of the patient revealed that he is maintained on 2 mg daily dose of warfarin. What would be the recommendation for this patient?
A. There is no reason for concern, the patient could take Coenzyme Q10
B. Coenzyme Q10 may antagonize the activity of warfarin, use of which warrants a consult with the doctor
C. Warfarin antagonizes the effect of Coenzyme Q10, do not take warfarin
D. Tell the patient to tell the doctor to remove his warfarin so he could take Coenzyme Q10
E. It is not safe to take both medications together, so stop taking warfarin before taking Coenzyme Q10

Coenzyme Q10 may antagonize the activity of warfarin, use of which warrants a consult with the doctor

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A patient comes in complaining that the diazepam that was dispensed to him was not working. Upon reviewing the patient profile and further interview, it was revealed that the patient still has not stopped smoking despite the doctor’s and your recommendations to do so. What could be the cause for the patient’s complaint?
A. Smoking does not affect the activity of diazepam. There might be another reason.
B. Smoking decreases the activity of diazepam by inducing its metabolism
C. Smoking decreases the activity of diazepam by inhibiting its metabolism
D. Smoking increases the activity of diazepam, by inducing its metabolism
E. Alcohol decreases the activity of diazepam by inhibiting its metabolism

Smoking decreases the activity of diazepam by inducing its metabolism

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A safety technique observed in community pharmacies to minimize medication errors.
I. Organized and simplified work procedures
II. Working on one prescription at a time, instead of handling several prescriptions at once.
III.Using a magnifying lens when necessary
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I, II and III

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Purpose of auxillary labels, EXCEPT
A. Ensure proper use of medications
B. Reinforce information given during counselling
C. To minimize verbal patient counselling
D. Ensure proper storage of the medication
E. Warm against taking with food or other drugs

To minimize verbal patient counselling

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An alcoholic taking paracetamol 500 mg every 6 hours prn back pain, is exposed to:
A. Increased risk of renal toxicity
B. Increased risk of hepatotoxicity
C. Increased risk of photosensitivity
D. Decreased effect of paracetamol
E. All of these

Increased risk of hepatotoxicity

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A patient refills a prescription for oral contraceptives. You recall seeing this patient in the parking lot smoking cigarettes with a couple of friends a few minutes before she came into the pharmacy. This patient is at an increased risk for developing
A. Cardiovascular disease
B. Hepatic disease
C. Lung disease
D. Renal disease
E. There is no reason for concern regarding this patient

Cardiovascular disease

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A monitoring parameter for a patient on warfarin therapy
A. ANC
B. CBC
C. ECG
D. INR
E. Platelet count

INR

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A patient comes to you complaining of sleepiness, feeling lethargic, and seems like not in the mood to do anything. Which of the following medications that the patient is currently on could cause the patient’s complaints?
A. Gabapentin
B. Lorazepam
C. Hydrocodone/Acetaminophen
D. All of these
E. None of these

All of these

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An antiseizure drug associated with gingival hyperplasia
A. Carbamazepine
B. Phenytoin
C. Divalproex
D. Lamotrigine
E. Topiramate

Phenytoin

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Inhibitors of platelet aggregation, EXCEPT
A. Heparin
B. Dipyridamole
C. Absiximab
D. Clopidogrel
E. Ticlopidine

Heparin

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TRUE about thrombolytic agents
A. Hemorrhage is a major adverse effect
B. Contraindicated in pregnancy
C. Cannot be given to patients with a history of cerebrovascular accident
D. Head trauma and intracranial bleeding are also contraindications
E. All of these

All of these

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Which of the following effects is associated to physostigmine?
A. Miosis
B. Bradycardia
C. Hypotension
D. Contraction of visceral smooth muscles
E. All of these

All of these

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The following cholinergic agonists are matched correctly with the effects, EXCEPT
A. Bethanecol – treat urinary retention
B. Neostigmine - treat myasthenia gravis
C. Pilocarpine – reduces intraocular pressure
D. Carbachol – produce miosis during ocular surgery
E. Acetylcholine -produce mydriasis in eye surgery

Acetylcholine - produce mydriasis in eye surgery

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Which of the following effects is associated with atropine?
A. Atropine
B. Antispasmodic
C. Xerostomia
D. Cycloplegia
E. All of these

All of these

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Scopolamine as an anti- motion sickness drug is available in what dosage form?
A. Oral tablet
B. Chewable tablet
C. Transdermal patch
D. Effervescent tablet
E. Suppository

Transdermal patch

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Antimuscarinic agents approved as bronchodilators
A. Ipratropium
B. Tiotropium
C. Cyclopentolate
D. A and B
E. B and C

A and B

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Which of the following antimuscarinic agents is correctly matched with its therapeutic use?
A. Oxybutinin- treatment of overactive bladder
B. Benztropine -treatment of alzheimer’s
C. Nicotine – smoking cessation
D. Scopolamine – treatment of COPD
E. Atropine – to produce miosis

Oxybutinin - treatment of overactive bladder

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An antidiarrheal agent contains diphenoxylate and atropine. What is the effect of atropine in the preparation?
A. Increases GI motility
B. Decreases GI motility
C. Increases urination
D. Increases salivation
E. Increases acid secretion

Decreases GI motility

A patient who is going on a cruise comes to the pharmacy to pick up her prescription for scopolamine patches. She informed you that she knows the patch is applied behind the ear, but wonders why only three patches were dispensed when she would be on the cruise for 7days. What should you tell her?
A. There was an error in filling her prescription.
B. The doctor only prescribed three patches and that is what she’s getting
C. The patched is designed for the drug to be delivered over a period of three days and the patch should be replaced every three days.
D. The wrong quantity was dispensed
E. You will call the doctor to check for the correctness of the prescription

The patch is designed for the drug to be delivered over a period of three days and the patch should be replaced every three days

Which of the following adverse effects is observed with adrenergic agonists?
A. Arrythmia
B. Insomnia
C. Nausea
D. Hyperactivity
E. All of these

All of these

An adrenergic agonist used in the management of anaphylactic shock
A. Phenylephrine
B. Oxymetazoline
C. Epinephrine
D. Pseudoephedrine
E. Clonidine

Epinephrine

An adrenergic agonist commonly used in over the counter nasal sprays for nasal congestion
A. Oxymetazoline
B. Clonidine
C. Albuterol
D. Isoproterenol
E. Dobutamine

Oxymetazoline

Counselling points regarding the use of OTC nasal decongestant sprays
I. Topical nasal decongestants should not be shared with others
II. Use should be limited for 3 to 5 days only
III.This could be used as long as the patient is still congested
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I and II only

An important counselling point when dispensing first generation antihistamines
I. This may cause drowsiness
II. Do not drink, drive or operate machinery while on this medication
III.Avoid activities that would require you full attention while on this medication
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I, II and III

The following are adverse effects commonly observed in patients treated with propranolol, EXCEPT
A. Bronchodilation
B. Sexual impairment
C. Arrythmia (with abrupt withdrawal)
D. Fatigue
E. Bronchoconstriction

Bronchodilation

These substances may liquefy or form eutectic mixtures when in close, prolonged contact with one another
A. Aspirin
B. Phenol
C. Camphor
D. Menthol
E. All of these

All of these

All of the following are drugs with narrow therapeutic indices, EXCEPT
A. Amoxicillin
B. Levothyroxine
C. Warfarin
D. Heparin
E. Quinidine

Amoxicillin

Adverse effects of cimetidine associated with its action as a nonsteroidal antiandrogen
I. Gynecomastia
II. Galactorrhea
III. Hirsutism
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I and II only

Isotretinoin, a vitamin A derivative, is used in the treatment of severe acne. How would you counsel a patient on this medication?
I. This is a potent teratogen and should be avoided in pregnancy
II. If the patient plans to get pregnant she should talk with her doctor and plan to stop the use of the medication
III.Isotretinoin is perfectly safe for even if she becomes pregnant
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I and II only

A patient on theophylline is also taking cimetidine prescribed by another doctor. What would be the result of the interaction between these two medications.
A. Increased clearance of theophylline
B. Decreased clearance of theophylline
C. Decreased clearance of cimetidine
D. Increased clearance of cimetidine
E. No change in clearance profiles of both drugs

Decreased clearance of theophylline

Sudden cessation of beta blockers could result in
A. Cardiac arrythmia
B. Hypotension
C. Angina
D. Bronchodilation
E. None of these

Cardiac arrythmia

Common side effect of colchicine
A. Nausea
B. Alopecia
C. Aplastic anemia
D. Diarrhea
E. All of these

All of these

A patient who was recently started on allopurinol therapy comes to the pharmacy complaining that his medication is not working, for he has had more gouty attacks than before. What should you tell this patient?
I. Acute gouty attacks do occur more frequently during the first few months of therapy
II. Ensure patient is prescribed colchicine, NSAIDS or corticosteroids to minimize symptoms
III.Agree with the patient that there was indeed an error in filling the prescription
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I and II only

A patient who was given diphenhydramine capsules for the management of an allergic reaction continues to drink alcohol. What could be the result of taking both together?
A. Increased alertness
B. Increased craving for alcohol
C. Increased sedation
D. Decreased effect of diphenhydramine
E. There would be no effect to the patient

Increased sedation

The concurrent administration of antihistamines with MAO inhibitors could result to
A. Increased anticholinergic effect
B. Decreased anticholinergic effect
C. Hypertensive crisis
D. Arrythmia
E. None of these

Increased anticholinergic effect

A patient with Alzheimer’s disease is on donepezil. Concurrent administration with diphenhydramine could result to which of the following
A. Increased effect of diphenhydramine
B. Decreased effect of diphenhydramine
C. Increased effect of donepezil
D. Decreased effect of donepezil
E. None of these

Decreased effect of donepezil

A patient on phenelzine had smoked fish and red wine for dinner, what could happen to this patient?
I. This patient would not be able to metabolize tyramine from the diet.
II. This patient would experience a hypertensive crisis
III. This patient should be on a restricted diet free of tyramine-containing foods.
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I, II and III

The co-administration of MAO inhibitors with SSRIs is contraindicated because
A. The combination will decrease the effect of MAO inhibitors
B. The combination will decrease the effect of SSRIs
C. The patient will be more depressed
D. The combination could cause serotonin syndrome
E. None of these

The combination could cause serotonin syndrome

Which of the following statements is/are TRUE regarding the use of MAO inhibitors and SSRIs?
I. These could be given together safely
II. A wash out period of at least 2 weeks is necessary before the other type is administered
III.Fluoxetine should be discontinued at least 6 weeks before a MAOI is initiated
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

II and III

The drug interaction between levodopa and phenelzine could result to which of the following
A. Serotonin syndrome
B. Hypertensive crisis
C. Hyperthyroidism
D. Hyperthermia
E. None of these

Hypertensive crisis

A patient takes levodopa together with his Vitamin B complex vitamins. The B complex preparation contains vitamins B1, B6 and B12. What should you tell the patient about this?
A. Levodopa should not be co-administered with vitamin B6
B. The B complex vitamins enhance the effects of levodopa
C. There is a risk of developing hypervitaminosis
D. Take vitamin C and minerals with his B complex
E. There is no interaction between the two drugs

Levodopa should not be co-administered with vitamin B6

Celecoxib, a COX-2 inhibitor, has a black box warning because it is linked with which of the following
A. Increased risk of peptic ulcer
B. Increased risk of cardiovascular events
C. Contraindicated in patients with sulfa allergy
D. Is associated with alopecia
E. None of these

Increased risk of cardiovascular events

Aspirin should not be used in patients being treated with methotrexate because
A. The combination increases the toxicity of methotrexate
B. The combination decreases the toxicity of methotrexate
C. The combination increases the effect of aspirin
D. The combination decreases the effect of aspirin
E. None of these

The combination increases the toxicity of methotrexate

Common adverse effect associated with narcotic pain relievers
A. Constipation
B. Nausea
C. Vomiting
D. Sedation
E. All of these

All of these

The most serious adverse effect accompanying narcotic overdose
A. Respiratory depression
B. Renal toxicity
C. Hemorrhage
D. Hepatotoxicity
E. Neuralgia

Respiratory depression

Narcotic analgesics, when used together with benzodiazepines could result to
A. Sedation
B. Cardiovascular event
C. Bleeding
D. GI upset
E. None of these

Sedation

Adverse effects commonly seen in patients on opioid therapy.
A. Constipation
B. Nausea
C. Hypotension
D. Sedation
E. All of these

All of these

Which of the following is a clinical use of opioids?
A. Analgesia
B. Relief cough
C. Anesthesia
D. Treatment of diarrhea
E. All of these

All of these

Major adverse effect associated with the use of triptans
A. Cardiovascular effects
B. Renal toxicity
C. CNS depression
D. Hepatotoxicity
E. None of these

Cardiovascular effects

An incompatibility where there is migration of the packaging material into the drug product
A. Permeation
B. Leaching
C. Lamination
D. Sorption
E. None of these

Leaching

An example of loop diuretic
A. Triematerene
B. Hydrochlorothiazide
C. Furosemide
D. Chlorthalidone
E. Spironolactone

Furosemide

Thiazide diuretic use increases the risk for
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
E. None of these

Hypokalemia

All are broad spectrum antibiotics, EXCEPT
A. Ceftriaxone
B. Ciprofloxacin
C. Imipenem
D. Isoniazid
E. Tetracycline

Isoniazid

A patient comes to you asking for a recommendation for an over the counter cough preparation. You were informed that it is a dry form of cough that is bothersome especially in the evening. You went ahead and reviewed the patient’s medication profile and found out that one of her medications is causing the dry cough. Which medication is this?
A. Metformin
B. Captopril
C. Multivitamins
D. Paracetamol
E. Furosemide

Captopril

ACE inhibitors should be used with caution in which of the following patients
A. Patients who are on potassium sparing diuretics
B. Patients with renal disease
C. Pregnant hypertensive women
D. A and B
E. B and C

A and B

A commonly encountered side effect of calcium channel blockers
A. Peripheral edema
B. Dry mouth
C. Pruritus
D. Hypertension
E. All of these

Peripheral edema

Which of the following agents is used in the management of gestational hypertension
A. Propranolol
B. Benazepril
C. Labetalol
D. Losartan
E. Terazosin

Labetalol

This group of diuretics may cause ototoxicity
I. Loop diuretics
II. Thiazide diuretics
III.Potassium sparing diuretics
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I only

This drug is contraindicated in a patient with a history of severe allergic reaction to a sulfa drug
A. Spironolactone
B. Hydrochlorothiazide
C. Amiloride
D. Mannitol
E. Furosemide

Hydrochlorothiazide

A condition that predisposes a patient to digoxin toxicity
A. Hypokalemia
B. Hyperkalemia
C. Anorexia
D. Hypotension
E. All of these

Hypokalemia

The type of interaction when two drugs taken concurrently producing additive effects
A. Pharmacokinetic
B. Pharmacogenetic
C. Pharmacodynamic
D. Pharmaceutical
E. All of these

Pharmacodynamic

Drugs that are highly protein bound to a carrier protein can be displaced if the second drug introduced has a higher binding affinity to the carrier protein. This is what type of drug interaction?
A. Pharmacokinetic
B. Pharmacogenetic
C. Pharmacodynamics
D. Pharmaceutical
E. None of these

Pharmacokinetic

Promethazine taken together with OTC antihistamines could result to
A. Excessive dryness of the mouth
B. Blurred vision
C. Urinary retention
D. All of these
E. None of these

All of these

Atypical antipsychotics taken together with amiodarone may result to
A. Prolongation of QT interval
B. Increased anticholinergic effect
C. Decreased antipsychotic effect
D. A and B
E. B and C

Prolongation of QT interval

Rifampin when co-administered with carbamazepine would result to
A. Increased rifampin effects
B. Decreased rifampin effects
C. Increased carbamazepine effects
D. Decreased carbamazepine effects
E. None of these

Decreased carbamazepine effects

Cimetidine when co-administered with metoprolol would result to
A. Hypotension
B. Sedation
C. Anorexia
D. Hypertension
E. None of these

Hypotension

Protease inhibitors taken together with St. John’s wort could result in
A. Lower levels of protease inhibitors
B. Induced metabolism of protease inhibitors
C. Inhibit metabolism of protease inhibitors
D. A and B
E. B and C

A and B

Evening primrose oil when taken by patients on antiplatelet therapy would lead to
A. Increased antiplatelet effect
B. Bleeding
C. Failure of antiplatelet therapy
D. A and B
E. B and C

A and B

When dispensing amoxicillin 500 mg capsules, it is important to tell the patient to take this on an empty stomach because
A. Food delays the absorption of amoxicillin
B. Food would minimize stomach upset
C. Food would alter the taste of amoxicillin
D. Food enhances the absorption of amoxicillin
E. All of these

Food delays the absorption of amoxicillin

Which of the following statements is TRUE regarding chemical-drug interaction
I. Smoking induces the metabolism of theophylline
II. Chronic alcoholism increases the rate of metabolism of warfarin
III. Acute alcohol intoxication can inhibit hepatic enzymes in nonalcoholics
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I, II and III

Disulfiram and alcohol (ethanol) when taken together results in
I. Severe alcohol intolerance
II. Disulfiram inhibits aldehyde dehydrogenase
III. The metabolism of ethanol is limited in the presence of disulfiram
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I, II and III

Which of the following when given in large doses produce symptoms of cinchonism
A. Colchicine
B. Procainamide
C. Sotalol
D. Quinidine
E. Amiodarone

Quinidine

The following are adverse effects of amiodarone, EXCEPT
A. Pulmonary fibrosis
B. Hepatotoxicity
C. Blue-gray skin discoloration
D. Neuropathy
E. Cinchonism

Cinchonism

Concomitant administration of quinidine and nitroglycerin could result to
A. Hypertension
B. Hemorrhage
C. Myalgia
D. Severe orthostatic hypotension
E. Arthralgia

Severe orthostatic hypotension

Which of the following drugs antagonize quinidine activity and may reduce the therapeutic activity of quinidine
A. Phenytoin
B. Antacid
C. Sodium bicarbonate
D. All of these
E. None of these

Phenytoin

Amiodarone may increase the pharmacologic effects of which of the following
A. Beta blockers
B. Calcium channel blockers
C. Warfarin
D. All of these
E. None of these

Beta blockers

NSAIDS ______ the effect of loop and thiazide diuretics
I. Decrease
II. Increase
III. No effect
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I only

Thiazide diuretics should be used with caution in which of the following patient groups
A. Those with sulfa allergy
B. Those with gout
C. Those with diabetes
D. All of these
E. None of these

None of these

A patient on warfarin therapy is started on erythromycin, the patient’s INR would be
I. Increased
II. Decreased
III. No effect
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I only

Bradycardia, hypotension, increased airway resistance, and congestive heart failure are adverse events associated with which class of drugs
A. Nitrites and nitrates
B. Cardiac glycosides
C. Angiotensin converting enzyme inhibitors
D. Calcium channel blockers
E. Beta adrenergic antagonists

Beta adrenergic antagonists

Possible hyperkalemia, acute renal failure, angioedema, persistent dry cough and birth defects when taken during early pregnancy are adverse events associated with which drug class
A. Nitrites and nitrates
B. Cardiac glycosides
C. Angiotensin converting enzyme inhibitors
D. Calcium channel blockers
E. Beta adrenergic agonists

Angiotensin converting enzyme inhibitors

Anorexia, nausea and vomiting, halos, photophobia, visual disturbances (yellow-green vision), confusion, AV block, ventricular tachycardia are adverse events associated with which drug class
A. Nitrites and nitrates
B. Cardiac glycosides
C. Angiotensin converting enzyme inhibitors
D. Calcium channel blockers
E. Beta adrenergic blockers

Cardiac glycosides

Patients on furosemide and digoxin should be monitored for which of the following
A. Liver enzymes
B. Creatinine clearance
C. Pulmonary function
D. INR
E. Electrolyte levels

Eletrolyte levels

Abrupt cessation of which of the following drugs could lead to rebound hypertension
A. Clonidine
B. Gaunfacine
C. Guanabenz
D. Methyldopa
E. All of these

All of these

Long term adverse effects of proton pump inhibitors
A. Hypomagnesemia
B. Bone fractures
C. Vitamin B12 deficiency
D. All of these
E. None of these

All of these

The most common side effect of sulfonylureas
A. Hyperglycemia
B. Hypoglycemia
C. Hyperthermia
D. Hypertension
E. Hypotension

Hypoglycemia

Trimethoprim is known to increase repaglinide (a short-acting insulin secretagogue) levels by 60%. Which of the following statements is true?
I. The dosage of repaglinide needs to be adjusted while the patient is on trimethoprim
II. Increased repaglinide levels may result to prolonged hypoglycemic reactions
III.Increased repaglinide levels may result to inefficient hypoglycemic control
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I and II only

A contraindication for the use of tetracyclines
I. Neonate
II. Breast feeding women
III.Women on their 2nd trimester of pregnancy
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I, II and III

The process of calling the prescriber to discuss concerns identified during a drug utilization review
A. Pharmaceutical intervention
B. Therapeutic intervention
C. Comprehensive medication review
D. Therapeutic substitution
E. Medication therapy

Therapeutic intervention

The information that should be provided when conducting a therapeutic intervention
A. A brief description of the problem
B. A reference source that documents the problem
C. A description of the clinical significance of the problem
D. A suggestion of a solution to the problem
E. All of these

All of these

An example of a drug therapy problem
A. A prescribed drug with no indication
B. There is a more effective drug for the condition indicated
C. Incorrect dosing frequency resulting to insufficient dose to the patient
D. The patient is only taking half tablet instead of whole tablet because of cost
E. All of these

All of these

A patient brought in new prescription for his medications for peptic ulcer. While counselling this patient, you mentioned that if he smokes he needs to try to quit smoking. Why?
I. Cigarette smoking impairs ulcer healing
II. Cigarette smoking increases ulcer recurrence
III.Cigarette smoking increases ulcer risk
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I, II and III

A patient’s drug regimen for the management of his peptic ulcer includes the following:
Proton pump inhibitor bid
Clarithromycin 500mg bid
Amoxicillin 1 g BID
All medications to be taken for 14 days
The patient wanted to know why there is an antibiotic included in the medications that were prescribed to him. The antibiotics would
A. Decreased acid secretion
B. Eradicate H. pylori which is the bacteria present in PUD
C. Eradicate all intestinal flora that may cause PUD
D. Increase the effect of other drugs
E. None of these

Eradicate H. pylori which is the bacteria present in the PUD

Which of the following statements is TRUE regarding drug distribution?
I. Drugs distribute rapidly to tissues with limited blood flow
II. Drugs distribute rapidly to tissues with high blood flow
III.The liver is an example of a highly perfused organ where drugs could distribute rapidly
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

II and III

Aside from tissue perfusion (blood flow in tissues), what are other factors affecting drug distribution
I. Protein binding
II. Drug permeability
III. Presence or absence of disease
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I, II and III

Which of the following is match correctly?
A. Cyanocobalamin – B12
B. Pyridoxine – B1
C. Thiamine – B5
D. Nicotinic acid – B3
E. Biotin – B6

Cyanocobalamin - B12

The following are adverse effects of nicotine lozenges, EXCEPT
A. Skin irritation on application site
B. Nausea
C. Insomnia
D. Dyspepsia
E. Coughing

Skin irritation on application site

Which of the following is used as an over the counter sleep aid?
A. Melatonin
B. Valerian root
C. Doxylamine
D. Diphenhydramine
E. All of these

All of these

An over the counter cough preparation that is recommended for non-productive cough
A. Dextromethorphan
B. Codeine
C. Guaifenesin
D. A and B
E. B and C

A and B

The combination of bisacodyl and antacids could result to
A. Decreased effect of bisacodyl
B. Increased effect of bisacodyl
C. Decreased effect of antacid
D. Increased effect of antacid
E. There is no interaction

Decreased effect of bisacodyl

What would you advice a patient on bisacodyl and antacids?
A. Take both drugs with a full glass of water
B. Take both drugs with foods
C. Take bisacodyl at least an hour before the antacid
D. There is no need to space the two drugs
E. Do not take antacids

Take bisacodyl at least an hour before the antacid

As part of colon prep for a colonoscopy procedure, the patient purchases a bottle of magnesium citrate. What should you tell the patient regarding the use of magnesium?
I. The whole bottle should be consumed
II. Refrigeration of the product helps improve palatability
III.Keep the product at room temperature only
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I and II only

Food – alendronate interaction results in
A. Decreased absorption of alendronate
B. Increased absorption of alendronate
C. Decreased elimination of alendronate
D. Increased metabolism of alendronate
E. None of these

Decreased absorption of alendronate

A prostaglandin analog used in the treatment of open angle glaucoma that increases eyelash prominence, length and darkness.
A. Latanoprost
B. Bimatoprost
C. Travoprost
D. Tafluprost
E. Epoprostenol

Bimatoprost

Sildenafil is contraindicated in patients maintained on nitrates because of
A. Severe hypotension
B. Sexual dysfunction
C. Priapism
D. Severe hypertension
E. Therapeutic failure of nitroglycerin

Severe hypotension

Which of the following drugs is matched correctly with its therapeutic use?
A. Oxybutynin – overactive bladder
B. Tamsulosin – BPH
C. Tadalafil – erectile dysfunction
D. Androgel – testosterone replacement therapy
E. All of these

All of these

A precaution when using D5W in parenteral preparations
I. Instability when used with acid-sensitive drugs
II. Must be used cautiously in diabetic patients
III.Instability when used with acidic drugs
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I and II only

The most serious problem that may occur during infusion of antineoplastics
I. too long infusion time
II. Inflammation of a vein
III.Extravasations
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

II and III

These are large volume admixtures that are used when enteral nutrition cannot be tolerated.
A. NGT feeding
B. Total parenteral nutrition
C. Direct GI feeding
D. Parenteral admixtures
E. None of these

Total parenteral nutrition

Visible color change or darkening of color is a type of
I. Physical incompatibility
II. Chemical incompatibility
III. Therapeutic incompatibility
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I and II only

The manifestation of the incompatibility when phosphate and calcium are combined in solution
A. Evolution of gas
B. Dark discoloration of solution
C. Precipitate formation
D. Visible color change
E. Formation of separate layers

Precipitate formation

When penicillin G is given after tetracycline when treating a patient with infection, a reduction in the bactericidal activity of the former is observed
I. Physical incompatibility
II. Chemical incompatibility
III. Therapeutic incompatibility
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I and II only

The following drug classes may cause tinnitus, EXCEPT
A. Salicylates
B. Aminoglycosides
C. Loop diuretics
D. Penicillins
E. Chemotherapeutic agents

Penicillins

A patient was given cefdinir but continued to take iron supplements. What could be the result of this drug interaction?
A. Failure of antibiotic therapy
B. Patients develop iron- deficiency anemia
C. Cefdinir toxicity
D. Decreased effect of iron
E. None of these

Failure of antibiotic therapy

The interaction between theophylline and erythromycin could result in
A. Inhibition of metabolism of theophylline
B. Toxic accumulation of theophylline
C. Induction of metabolism of theophylline
D. A and B
E. B and C

A and B

Patients treated for 1 week or longer with erythromycin estolate may develop
A. Cholestatic hepatitis
B. Hypertension
C. Ototoxicity
D. Renal failure
E. None of these

Cholestatic hepatitis

Clarithromycin co-administered with cisapride could result in
A. Serious cardiac arrythmias
B. Difficulty breathing
C. Enzyme depletion
D. Bradycardia
E. None of these

Serious cardiac arrythmias

Clarithromycin and oral anticoagulants when given together
A. Potentiate anticoagulant effect
B. Prothrombin time needs to be monitored
C. Diminish anticoagulant effect
D. A and B
E. B and C

A and B

Tetracycline when given together with phenytoin would result to
A. Decreased antibiotic effect
B. Increased antibiotic effect
C. Increased phenytoin effect
D. Decreases phenytoin effect
E. None of these

Decreased antibiotic effect

An antibiotic drug class that may cause QT prolongation
A. Fluoroquinolones
B. Tetracyclines
C. Penicillins
D. Macrolides
E. None of these

Fluoroquinolones

Concurrent use of fluoroquinolones with antiarrythmics could result in
A. QT prolongation
B. Increased CNS stimulation
C. Decreased fluoroquinolone absorption
D. Failure of antibiotic therapy
E. None of these

QT prolongation

Norfloxacin when taken together with antacids results in
A. Increased antibiotic effect
B. Decreased antibiotic effect
C. There is no interaction between the two
D. Increased CNS effect
E. None of these

Decreased antibiotic effect

The antibiotic associated with gray-baby syndrome in neonates
A. Ciprofloxacin
B. Sulfamethoxazole
C. Clindamycin
D. Chloramphenicol
E. Trimethoprim

Chloramphenicol

Fluconazole is prescribed to a patient taking sulfonylureas, this could lead to
A. Decreased antibiotic effect
B. Increased antibiotic effect
C. Decreased hypoglycemic effect
D. Increased hypoglycemic effect
E. None of these

Increased hypoglycemic effect

Co-administration of ketoconazole with terfenadine will cause
I. Increased terfenadine levels
II. Life-threatening dysrrythmias and death
III.Increased ketoconazole levesl
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I and II only

Chloroquine and hydrochloroquine are known to concentrate in the liver. These should be used with caution in this patient group
A. Those with hepatic disease
B. Those with pulmonary disease
C. Those with cardiac disease
D. Those with renal disease
E. Those with diabetes

Those with hepatic disease

Quinine is contraindicated in patients with
I. G6PD deficiency
II. Tinnitus
III. Optic neuritis
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I, II and III

Quinine should be used with caution in patients with
A. Hepatic disease
B. Atrial fibrillation
C. Diabetes
D. Bone disease
E. Respiratory tract infection

Atrial fibrillation

A patient prescribed with metronidazole still continues to drink alcohol, what could this patient experience?
A. Alcohol intolerance
B. Anorexia
C. Diarrhea
D. Euphoria
E. Sedation

Alcohol intolerance

An adverse effect associated with the use of daptomycin
A. QT prolongation
B. Hypertension
C. Hot flashes
D. Rhabdomyolysis
E. Wheezing

Rhabdomyolysis

A concern in elderly patients on aminoglycoside antibiotics
A. Nephrotoxicity
B. Ototoxicity
C. Diabetes
D. A and B
E. B and C

A and B

An adverse effect of aminoglycoside antibiotics associated with a rapid increase in concentrations or concurrent administration with neuromuscular blockers
A. Bone resorption
B. Neuromuscular paralysis
C. Aplastic anemia
D. CNS depression
E. None of these

Neuromuscular paralysis

The safest antibiotic to give a pregnant patient with MRSA
A. Tetracycline
B. Clindamycin
C. Methicillin
D. Doxycycline
E. Tigecycline

Clindamycin

An auxillary label when dispensing nystatin to treat oral candidiasis
A. Shake well
B. Dispense 30ml
C. Drink with a full glass of water
D. Do not drive
E. No refills

Shake well

A contraindication for sulfa drugs because of the danger of kernicterus
A. Adult patients with renal disease
B. Adult patients with hepatic disease
C. Neonates and infants less than 2 months of age
D. Patients with diabetes
E. Children above 6 years of age

Neonates and infants less than 2 months of age

Which of the following drugs is correctly matched with its adverse effect?
A. Nitrofurantoin- pulmonary fibrosis
B. Tetracycline- phototoxicity
C. Fluoroquinolone- tendonitis
D. Sulfa drugs – SJS
E. All of these

All of these

The most serious side effect of isoniazid
A. Hepatitis
B. Hypoglycemia
C. Hypotension
D. Optic neuritis
E. None of these

Hepatitis

Which of the following anti – TB drugs causes peripheral neuropathy?
A. Rifampicin
B. Isoniazid
C. Pyrazinamide
D. Ethambutol
E. Streptomycin

Isoniazid

A patient came back to the pharmacy to refill his prescription for anti – tubercular drugs. He informs you that he is doing well, except that he seems to be having difficulty reading books and has actually set an appointment with an ophthalmologist and plans to get glasses. Which of his medications may be causing his decline in vision?
A. Isoniazid
B. Pyrazinamide
C. Rifabutin
D. Ethambutol
E. Rifampicin

Ethambutol

What should be determined prior to intiation of anti- TB therapy because the drugs may cause hepatitis
A. Renal function test
B. Baseline hepatic enzyme measurement
C. ECG
D. CBC
E. Lung function test

Baseline hepatic enzyme measurement

IV administration of amphotericin B may cause thrombophlebitis, this could be prevented by adding ____ to the infusion
A. Heparin
B. Aspirin
C. Diphenhydramine
D. Warfarin
E. Paracetamol

Heparin

A contraindication for azole antifungals
A. Pregnancy
B. Hypertension
C. Asthma
D. Pneumonia
E. Diabetes

Pregnancy

Itraconazole has a negative inotropic effect and should be avoided by which patients
A. Diabetic patients
B. Asthmatic patients
C. Those with heart failure
D. Those with hypertension
E. None of these

Those with heart failure

Common adverse effects of zidovudine (AZT)
A. Anemia
B. Neutropenia
C. Headaches
D. All of these
E. None of these

All of these

A major adverse effect of didanosine (ddl)
A. Pancreatitis
B. Renal failure
C. Headache
D. Hepatitis
E. Diarrhea

Pancreatitis

These agents work by dissolving or breaking down the outermost layer of skin, causing peeling of the stratum corneum
A. Cytostatic agents
B. Keratolytic agents
C. Tocolytic agents
D. Astringents
E. Antimetabolites

Keratolytic agents

An example of a keratolytic agent
A. Coal tar
B. Salicylic acid
C. Hydrocortisone OTC
D. Selenium sulphide
E. Burow’s solution

Salicylic acid

These are mild protein precipitants that result in contraction of tissue, which in turn decreases the local edema and inflammation
A. Cytostatic agents
B. Keratolytic agents
C. Tocolytic agents
D. Astringents
E. Antimetabolites

Astringents

An example of an astringent
A. Coal tar
B. Salicylic acid
C. Hydrocortisone OTC
D. Selenium sulphide
E. Burow’s solution

Burow’s solution

The major plasma protein involved in drug protein binding
A. Alpha 1 – glycoprotein
B. Transcortin
C. Lipoprotein
D. Albumin
E. None of these

Albumin

The process by which drugs are eliminated through the kidneys into the urineI. Glomerular filtrationII. Tubular reabsorptionIII.Active tubular secretion
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I, II and III

The effect of the administration of sodium bicarbonate to weakly acidic drugs such as salicylates
A. No effect
B. Decreased excretion
C. Increased excretion
D. All of these
E. None of these

Increased excretion

Most biologic products are sensitive to which of the following
A. Extreme heat
B. Light
C. Freezing
D. Shaking
E. All of these

All of these

Adalimumab (Humira), a monoclonal antibody used for treating autoimmune disorders, has a black box warning of
A. Increased risk of lactic acidosis
B. Increased infections
C. Increased cardiovascular events
D. All of these
E. None of these

Increased infections

The type of incompatibility between oxidizing agents and reducing agents
A. Physical incompatibility
B. Chemical incompatibility
C. Therapeutic incompatibility
D. A and B
E. B and C

Chemical incompatibility

In TPN preparations, a potential problem that may occur is between
A. Potassium chloride and sodium chloride
B. Potassium phosphate and calcium gluconate
C. Potassium phosphate and magnesium chloride
D. Zinc chloride and sodium chloride
E. None of these

Potassium phosphate and calcium gluconate

Strategy to manage drug metabolism
A. Use of different dosage forms
B. Modification of key functional groups
C. Concurrent use of enzyme inhibitors
D. All of these
E. None of these

All of these

A patient who is a slow acetylator of isoniazid will experience ________
A. Hypertension
B. Peripheral neuropathy
C. Hypotension
D. Hypertrophy
E. Arthritis

Peripheral neuropathy

These are morphine-related toxicities
A. Diarrhea
B. Constipation
C. Respiratory depression
D. A and B
E. B and C

B and C

A therapeutic advantage of using prodrugs
A. Increases water solubility
B. Increased oral absorption
C. Increased duration of action
D. Decreased GI irritation
E. All of these

All of these

The process by which a drug reversibly leaves the bloodstream and enters the extracellular fluid and the tissues is known as
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
E. Elimination

Distribution

When drawing cisplatin from vials, a stainless- steel needle should be used instead of aluminum because aluminum displaces the platinum in cisplatin. What type of incompatibility is described?
A. Chemical incompatibility
B. Therapeutic incompatibility
C. Physical incompatibility
D. All of these
E. Nome of these

Chemical incompatibility

An auxillary label that ensures proper preparation, storage and disposal of medicines
A. Keep refrigerated. Do not freeze.
B. Shake well
C. Protect from light
D. Keep out of reach of children
E. All of these

All of these

An auxillary label that is also a warning label about potential adverse drug reactions, EXCEPT
A. Avoid sun exposure
B. May cause drowsiness. Do not drink, drive or operate machinery
C. External use only
D. May cause discoloration of urine or feces
E. All of these

External use only

An auxillary label that ensures appropriate dosing considerations
A. Take with food
B. Take with a full glass of water
C. Finish all this medication
D. Take on an empty stomach
E. All of these

All of these

A patient comes to the pharmacy telling you that her salbutamol inhaler is not working properly. You recall that this is a new medication for the patient and this patient denied to be counselled regarding the use of this new medication. What is the best thing to do?
I. Ask the patient to demonstrate how the inhaler is used
II. Tell the patient that the device may be defective
III.Remind the patient that she refused counselling regarding this medication
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I only

Patients on which of the following medications should be strongly reminded that they should always have these with them for emergency use
A. Nitroglycerin sublingual tablets
B. Salbutamol inhaler
C. Injectable epinephrine
D. All of these
E. None of these

All of these

Information that is included during patient counselling
A. Route of administration
B. Missed dose instruction
C. Directions for use
D. Frequency of taking the drug
E. All of these

All of these

These powders contain water of hydration that may be released when the powders are triturated or when stored in an environment of low relative humidity resulting to powders that are damp or pasty.
A. Hygroscopic powders
B. Deliquescent powders
C. Efflorescent powders
D. Amorphous powders
E. None of these

Efflorescent powders

An agent that softens the skin or soothes irritation in skin or mucus membranes
A. Humectant
B. Occlusive
C. Protective
D. Emollient
E. None of these

Emollient

Primary adverse effects associated with the use of lithium
A. Tremors
B. Edema
C. Loss of sensitivity to antidiuretic hormone
D. Decreased thyroid function
E. All of these

All of these

You have a patient on tramadol, who was also prescribed lactulose to be taken prn. Lactulose is for the management of which side effect of tramadol?
A. Sedation
B. Vomiting
C. Constipation
D. Nausea
E. Diarrhea

Constipation

An SNRI that is also used for the management of bone and muscle pain
A. Venlafaxine (Effexor)
B. Mirtazapine (Remeron)
C. Paroxetine (Paxil)
D. Duloxetine (Cymbalta)
E. Fluoxetine (Prozac)

Duloxetine (Cymbalta)

When counselling patients with depression who are on antidepressant medications, they should be informed of which of the following
I. Adherence to the treatment plan is essential to achieve a successful outcome
II. The adverse effects of the drugs may occur immediately, while the resolution of symptoms may take 2 to 4 weeks or longer
III.The resolution of symptoms is immediate while the adverse effects may take a while to occur
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I and II only

The following medications should be used with caution in patients on MAO inhibitors because of a risk of hypertensive crisis
A. Topical and systemic decongestants
B. Epinephrine
C. Other MAOIs
D. All of these
E. None of these

All of these

The interaction between fluoxetine and other MAOIs could result in
A. Hypertensive crisis
B. Serotonin syndrome
C. Hypotension
D. A and B
E. B and C

A and B

Which of the following may be experienced when bupropion is given to a patient who are on medications that lower the seizure threshold?
A. Increased incidence of seizures
B. Decreases incidence of seizures
C. No effect on seizure activity
D. All of these
E. None of these

Increased incidence of seizures

A serious ADR that is common to all antidepressants
A. Hypotension
B. Suicidality
C. QT interval prolongation
D. Serotonin syndrome
E. All of these

Suicidality

When carbamazepine is administered together with valproate, valproate displaces carbamazepine from protein binding sites. What type of drug interaction was described?
A. Pharmacokinetic interaction
B. Pharmacodynamics interaction
C. Pharmaceutical interaction
D. All of these
E. None of these

Pharmacokinetic interaction

The combination of clozapine and carbamazepine is not recommended because of the possibility of bone marrow suppression with both agents. What is the type of interaction described?
A. Pharmacokinetic interaction
B. Pharmacodynamics interaction
C. Pharmaceutical interaction
D. All of these
E. None of these

Pharmacodynamics interaction

Valproate is often prescribed together with lamotrigine, resulting in an augmentation of mood stabilizing and antidepressant properties as well as a reduction in the clearance of lamotrigine. What type of interaction is involved in the drug combination?
A. Pharmacokinetic interaction
B. Pharmacodynamics interaction
C. Pharmaceutical interaction
D. A and B
E. B and C

A and B

A patient on alprazolam continues to take alcohol which results in additive CNS depressant effects. The type of interaction is
A. Pharmacokinetic interaction
B. Pharmacodynamics interaction
C. Pharmaceutical interaction
D. A and B
E. B and C

Pharmacodynamics interaction

Concurrent use of a benzodiazepine with St. John’s wort results in a reduction of benzodiazepine levels. The combination could result in
A. Toxicity of benzodiazepine
B. Increased CNS depression
C. Decreased benzodiazepine effect
D. A and B
E. B and C

Decreased benzodiazepine effect

You were called to counsel a patient regarding sildenafil. However, this is a female patient, what could she be using this drug for?
A. Erectile dysfunction
B. Pulmonary hypertension
C. Hormone replacement therapy
D. Hypotension
E. Androgen therapy

Pulmonary hypertension

The following drugs are known to sorb to glass or plastics
I. Insulin
II. Nitroglycerin
III.Diazepam
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I, II and III

This chemotherapeutic drug in a co-solvent system requires the use of non- PVC containers and administration set because of the problem of leaching
A. Paclitaxel
B. Cyclosporine
C. Propofol
D. Vitamin A
E. All of these

Paclitaxel

The most concerning adverse effect of amiodarone used in the management of arrythmia
A. Hypertension
B. Pulmonary fibrosis
C. Bronchospasm
D. Hypoglycemia
E. Renal toxicity

Pulmonary fibrosis

A patient counselling point for asthmatic patients maintained on inhaled corticosteroids
I. Rinse mouth after using the inhaler
II. Using a spacer may help minimize fungal infections
III.Inhaled corticosteroids are not for acute asthma attacks
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I, II and III

Drug absorption in the gastrointestinal tract is affected by the following, EXCEPT
A. Changes in gastric pH
B. Increased or decreaed GI motility
C. Enzyme induction or inhibition
D. Complexation or chelation
E. Alteration of GI flora

Enzyme induction or inhibition

The effect of laxatives and cathartics on drug absorption
A. Increased absorption
B. Decreased absorption
C. No effect on drug absorption
D. All of these
E. None of these

Decreased absorption

The interaction between epinephrine and lidocaine, a local anesthetic is
I. A desired drug interaction
II. Allows local anesthesia with minimal bleeding and without systemic absorption while repairing a skin wound
III.Epinephrine and lidocaine should not be administered together
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I, II and III

A patient on salbutamol (Ventolin) and salmeterol and fluticasone (Advair) should be informed of the following
I. Salbutamol inhaler should be used during acute asthma attacks
II. Salmeterol and fluticasone is the maintenance inhaler to be used daily to minimize asthma attacks
III.If there is a need to administer both at the same time, administer salbutamol first
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I, II and III

Carbamazepine is both a substrate and an inducer of the CYP3A4 isoenzyme. Which of the following statements is TRUE?
I. Carbamazepine induces its own metabolism
II. It may take 3 to 4 weeks to achieve stable blood levels of carbamazepine
III.Carbamazepine induces the metabolism of other drugs metabolized via the same pathway
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

I, II and III

A patient who is taking methadone to manage pain from a sports injury continues to drink grapefruit juice. What could happen to this patient?
I. No effect on the patient
II. Failure of therapy of the pain medication
III.May experience toxicity due to methadone
A. I only
B. III only
C. I and II only
D. II and III
E. I, II and III

III only

A common side effect of nitrates
A. Hypertension
B. Headaches
C. Dry cough
D. Bronchospasm
E. Vasoconstriction

Headaches

A manifestation of aa chemical incompatibility, EXCEPT
A. Evolution of gas
B. Gel formation
C. Immiscibility
D. Photolysis
E. None of these

Immiscibility

Oral antidiabetic drugs that are structurally different with sulfonylureas however exert the blood glucose lowering action by the same mechanism
A. Metformin
B. Insulin
C. Meglitinides
D. Tolazamide
E. None of these

Meglitinides

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Module 3: Dispensing Flashcards

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