Pharm Case Files #3 Flashcards
A 60-year-old male patient is brought to the emergency department with severe chest pain radiating to his arms and neck. He is a smoker and has history of uncontrolled mild hypertension and high blood cholesterol. His ECG confirms the diagnosis of myocardial infraction. He was immediately treated with a drug known to convert specifically fibrin-bound plasminogen to plasmin. Which of the following drugs has NOT been prescribed?
Alteplase Urokinase Tenecteplase Streptokinase Reteplase
Streptokinase— Lack of specificity leads to risk of bleeding
A 55-year-old female patient presents to your office complaining of pain in her right leg. She just returned from a trip to Russia. Her flight was more than 10 hours long. Duplex ultrasonography shows the presence of deep vein thrombosis in the affected leg. You decide to prescribe enoxaparin. Which of the statements describes the rational use of enoxaparin in this outpatient?
Enoxaparin can be effectively monitored by measuring the patient’s INR
Enoxaparin can be effectively monitored by measuring the patient’s aPTT
Enoxaparin has a shorter duration of action compared to heparin which reduces the likelihood of adverse effects
Enoxaparin therapy does not require monitoring–LMWH
Enoxaparin has an effective antidote called protamine sulfate
Enoxaparin therapy does not require monitoring–LMWH
Mr. Jim visits your clinic for follow-up. He has been on verapamil for six weeks for the treatment of hypertension. He complains of unusual constipation. Constipation is one of the leading adverse effects of verapamil. You prescribe an osmotic laxative to help relieve his constipation. Which of the following laxatives has been prescribed?
Senna Lactulose Docusate Psyllium Mineral oil
Lactulose– osmotic laxative
Mr. John is a 21 years old medical student with history of aspirin sensitivity. He has been eagerly preparing for Step 1 USMLE. On his way to the examination center he experiences a sudden onset of stomach cramp that is likely to be a precursor to an attack of diarrhea. He stops at the closest pharmacy to purchase an OTC antidiarrheal medication. All of the following therapeutics would be appropriate in this patient, EXCEPT:
Loperamide Aluminum Hydroxide Methylcellulose Bismuth Subsalicylate None of the above
Loperamide
A 42-year-old stock broker suffering from peptic ulcer was first treated with omeprazole. He visits his physician complaining of the recurrence of ulcer pain. He then tested positive for Helicobacter pylori with C13 labeled urea test. His physician prescribed triple therapy.
Which of the following antibiotic is commonly used for the eradication of Helicobacter pylori?
Neomycin Streptomycin Amoxicillin Cefaclor Cefazolin
Amoxicillin
Which of the following two drug pairs is first-line along with antibiotics in triple therapy for the treatment of peptic ulcer associated with Helicobacter pylori infection?
Omeprazole-Misoprostol Misoprostol – Cimetidine Cimetidine – Omeprazole Omeprazole – Sucralfate Misoprostol - Sucralfate
Cimetidine – Omeprazole
A 56-year-old female patient has been scheduled to receive 4 cycles of highly emetogenic cancer treatment for the treatment of ovarian cancer. The cycles will be administered every four weeks. Following the first cycle, her laboratory test shows: Red Blood Cells 4.0 trillion cells/L (N: 3.90 – 5.03 trillion cells/L), Platelets 102 billion cells/L (N: 150 – 450 billion cells/L). Which of the following drugs could be added to this patient’s therapeutic regimen to manage the side effect of chemotherapy?
Romiplostim Eltrombopag--- patient friendly but this patient I throwing up so cant be given. Sargramostin Filgrastim Epoetin alfa
Romiplostim
A 48-year-old with history of chronic kidney disease presents to your clinic for follow-up. He complains of fatigue, poor concentration, irritability and headache. You ordered a CBC. The results show: RBC 3.94 trillion cells/L (N: 4.32 – 5.72 trillion cells/L), Hb 10.7 g/dL (N: 13.5 – 17.5 g/dL), hematocrit 35.2 (N: 38.8 -50%), WBC 3.9 billion cells/L (N: 3.5 – 10.5 billion cells/L). Which of the following hematopoietic agents would you recommend in this patient?
Cyanocobalamin Erythropoietin Folic acid Iron-dextran Pyridoxine
Erythropoietin
An electrocardiogram (ECG) is used to record the electrical activity of the heart. It detects electrical impulses generated by the depolarization and repolarization of cardiac tissue and translates them into a measurable waveform. Which of the following statements best describes the effect of a drug that slows impulse conduction through the AV node?
Prolonged PR Prolonged QRS Prolonged ST Increased T wave amplitude Increased P wave amplitude
Prolonged PR
A 62 years old with 2 years history of recurrent Atrial Fibrillation is being treated with sotalol. Sotalol is a beta blocker used as antiarrhythmic. All of the following statements describe sotalol, EXCEPT:
Diminishes slope of phase 4 Decreases automaticity Increases AV conduction Exhibits Class III antiarrhythmic properties Inhibits the efflux of K ions
Increases AV conduction
A 28 year old male patient had renal transplant. He was prescribed an immunosuppressant for the prevention of rejection. Few weeks later, he presents to your office complaining of gingival swelling. Intraoral examination revealed severe generalized gingival hyperplasia shown on the figure belowWhich of the following immunosuppressants has been most likely prescribed?
Azathioprine Tacrolimus Prednisone Cyclosporine Daclizumab
Cyclosporine
Which of the following is the mechanism of the prescribed immunosuppressant?
Inhibits the action of IL-2 Inhibits calcineurin Inhibits purine synthesis Inhibits folic acid pathway Inhibit mTOR
Inhibits calcineurin
The cardiac action potential is the change in electrical potential associated with the passage of an impulse along the membrane of cardiac muscle cell. Complete inactivation of Na/Ca channel is achieved is archived at:
Phase 0 Phase 1 phase 2 Phase 3 Phase 4
Phase 3
Thrombosis is the formation of blood clot inside blood vessels, obstructing the flow of blood through the circulatory system. When a blood vessel is injured, the body activates platelets and fibrin to form a blood clot to prevent excessive blood loss. All of the following substances induce the activation of platelets, EXCEPT:
PGI2 Thromboxane A2 Serotonin Calcium ADP
PGI2
A new antiplatelet is being evaluated in phase 1 clinical trial to determine its pharmacokinetics profile. The new drug was found to inhibit irreversibly P2Y ADP receptor in preclinical experiments. Which of the following drugs has the same mechanism of action?
Eptifibatide Tirofiban Clopidogrel Dipyridamole Aspirin
Clopidogrel
