Pharm Exam 4

Question 1

When is the best time to take a triptan medication?

Answer 1

When a headache starts!

Question 2

When taking aspirin to prevent an MI, what should a patient report to a provider in fear of possible toxicity?

Answer 2

Tinnitus

think ototoxicity

Question 3

How many grams of acetaminophen is the max to be taken per day by a healthy adult?

Answer 3

4g / day (for purposes of the exam)

Question 4

COX2 inhibitors are best known for decreasing inflammation

Answer 4

True.
COX2 enzyme causes inflammation.
COX2 inhibitor does opposite

Question 5

When is the best time of day for a patient to take levothyroxine?

Answer 5

1 hour before meals

Question 6

How long does it take to achieve a therapeutic effect of levothyroxine (Synthroid)?

Answer 6

Several weeks

Question 7

What are the signs of overdose of thyroid replacement hormone?

Answer 7

Tachycardia, chest pain, anxiety, nervousness

Question 8

Why should hypothyroidism be treated during pregnancy?

Answer 8

A child could have neuropsychological defects

Question 9

What are the clinical symptoms (physical assessment) of hypothyroidism?

Answer 9

Brittle hair, pale skin, low temperature

Question 10

How do levothyroxine (Synthroid) and warfarin (Coumadin) interact?

Answer 10

Synthroid requires a decrease in warfarin

Question 11

What is a side effect of low-dose radioactive iodine when used to treat Graves’ disease?

Answer 11

Nausea, dry mouth, dry eyes, swollen salivary glands

Question 12

When is the best time to take sumitriptan (Imitrex - serotonin-selective agonist) for the management of symptoms?

Answer 12

Take as soon as headache starts

Question 13

What are the signs of acute salicylates (aspirin) poisoning?

Answer 13

Headache, tinnitus, GI distress

Question 14

Why is acetaminophen (Tylenol) not effective for the treatment of rheumatoid arthritis?

Answer 14

Not meant for inflammation

Question 15

Think of examples of physical conditions that would be appropriate for a nonsteroidal anti-inflammatory agent.

Answer 15

RA, osteoarthritis, tendonitis, muscle aches, backaches, dental pain, gout, bursitis, menstrual cramps, fever, aches, ankle sprain

Question 16

When should high-dose aspirin be discontinued prior to surgery?

Answer 16

7 to 14 days

Question 17

Which medication may cause Reye’s syndrome?

Answer 17

Aspirin

Question 18

Understand early sign of salicylate toxicity (aspirin overdose).

Answer 18

Headache, tinnitus, GI distress

Question 19

Acetaminophen (Tylenol) should not exceed what max daily dose

Answer 19

4 g

Question 20

What do COX-2 inhibitors do?

Answer 20

Decrease inflammation, pain, fever

Question 21

What is the reversal agent for morphine?

Answer 21

Narcan (naloxone)

Question 22

What are constipation treatment options for someone on chronic morphine treatment?

Answer 22

Laxative or stool softener

Question 23

What are life threatening symptoms of an opioid overdose?

Answer 23

Respiratory depression

Question 24

What are serious side effects of long-term opioid use?

Answer 24

Potential medical risks include serious fractures, breathing problems during sleep, hyperalgesia, immunosuppression, chronic constipation, bowel obstruction, myocardial infarction, and tooth decay secondary to xerostomia.

Question 25

What are considerations when converting a morphine dose from the intravenous to the oral route?

Answer 25

Increased dose due to digestion

Question 26

What are the risks of giving a mixed opioid agonist-antagonist with a opioid agonists?

Answer 26

Withdrawal

Question 27

What needs to be assessed prior to administering morphine?

Answer 27

RR and BP

Question 28

What is the reversal agent for Tylenol toxicity?

Answer 28

Acetylcysteine (NAC)

Question 29

What are symptoms of normeperidine toxicity?

Answer 29

Tremor meperidine= tramadol (narcotic analgesic)

Question 30

What is the reversal agent for aspirin?

Answer 30

None

Question 31

What is the ideal way for someone to wean off anti-seizure medications?

Answer 31

Eradicating all seizure activity then weaning off medication once patient is seizure-free for 3 months

Question 32

When is the best time to take trazodone (Desyrel)?

Answer 32

Bed time

Question 33

Which drugs are appropriate to treat inflammation?

Answer 33

COX 2 inhibitors

Question 34

What are the contraindications for acetaminophen (Tylenol)?

Answer 34

Cirrhosis d/t alcohol use

Question 35

A common drug ending for a Serotonin-receptor agonist?

Answer 35

Triptans

Question 36

What labs must be monitored for Valproic Acid (Depakote)?

Answer 36

Liver and platelets

Question 37

What is a common, non-serious side effect of imipramine (Toframil)?

Answer 37

Sedation imipramine is a tricyclic antidepressant (TCA)

Question 38

How long will it take to achieve a therapeutic response from imipramine (Tofranil)?

Answer 38

1-3 weeks

Question 39

What is a common, non-serious side effect of tricyclic antidepressant that would most likely diminish over time?

Answer 39

Drowsiness

Question 40

Between bupropion (Wellbutrin) and serotonin selective reuptake inhibitors (SSRIs) which would have less adverse sexual side effects?

Answer 40

Wellbutrin

Question 41

What is the interaction between an SSRI, fluoxetine (Prozac) and St. John's Wort?

Answer 41

Serotonin syndrome

Question 42

After symptoms are controlled, how long does one continue antidepressant medications?

Answer 42

One year

Question 43

What is the interaction of monoamine oxidase inhibitors (MAOIs) and foods containing tyramine?

Answer 43

Hypertensive crisis

Question 44

What are the anticholinergic effects associated with antidepressant agents?

Answer 44

Constipation, dry mouth, urinary retention

Question 45

What symptoms should a patient seek emergency care for when taking a monoamine oxidase inhibitor (antidepressant)?

Answer 45

Chest pain, dizziness, headache

Question 46

What is general patient education regarding lithium and fluids and salt intake?

Answer 46

Drink 2-3L of fluid

Question 47

What drug counteracts benzodiazepine, chlordiazepoxide (Librium)?

Answer 47

Flumazenil/Romazicon

Question 48

What are common contraindications for benzodiazepines?

Answer 48

COPD, bronchitis, sleep apnea, myasthenia gravis

Question 49

When is the best time to take trazodone (Desyrel)?

Answer 49

Bedtime

Question 50

What are common side effects of the benzodiazepine, diazepam (Valium)?

Answer 50

Drowsiness, dizziness, fatigue, constipation

Question 51

What is the effect of buspirone (BuSpar) on the central nervous system?

Answer 51

No effect

Question 52

Drug endings to indicate a benzodiazepine

Answer 52

-pam clonazepam (klonopin)

Question 53

What side effects are classified as anticholinergic effects?

Answer 53

Constipation, dry mouth, urinary retention

Question 54

What antidepressant medication is contraindicated for those with a history of seizures?

Answer 54

Bupropion/wellbutrin

Question 55

What are signs of Steven Johnson Syndrome?

Answer 55

Rash, fever, coughing, redness, itching, sore throat, swelling, mouth blisters

Question 56

What are the effects of an Amitriptyline overdose?

Answer 56

Cardiac arrest, dangerously low blood pressure, seizures

Question 57

At what dose of amitriptyline could a patient experience adverse side effects?

Answer 57

Initiating with high doses (low initial doses minimize adverse reactions and help promote adherence), 150 mg/day is max dose

Question 58

What are dietary considerations for those taking MAOI medication?

Answer 58

Foods high in tyramine: aged cheese, chicken, beef, avocado, beer, figs, fava beans

Question 59

What is the black box warning for SSRIs?

Answer 59

Suicidality in ages 15-24