Pharma 2.0

Question 1

Answer 1

Question 2

Answer 2

Question 3

Answer 3

Question 4

Answer 4

Question 5

Answer 5

Question 6

Answer 6

Question 7

mention a regimen for treatment of meningitis

Answer 7

Question 8

Naltrexone / Buproprion MOA and one SE

Answer 8

They work synergistically in hypothalamus and mesolimbic dopamine circuit to promote satiety, decrease food intake, and increase energy expenditure

Sleep disorder

Question 9

In general, what supplements are usually needed after bariatric surgery?

Answer 9

• Zinc: Zinc deficiency induces hair loss, impaired sense of taste, and sexual dysfunction
• Selenium is absorbed primarily in the duodenum; therefore, patients after malabsorptive procedures are at risk of selenium deficiency
• The separation of calcium and iron supplements is recommended.
• If iron concentrations continue to remain low with oral supplementation, intravenous iron is recommended

Question 10

How can bariatric surgery affect drug distribution

Answer 10

• Decrease in fat decreases the Vd of fat-soluble drugs
• Many patients experience hypoalbuminemia after bariatric surgery, with decreased plasma protein binding of drugs and this increases the free plasma fraction and causes decrease in the volume of distribution
  (Vd).

Question 11

Describe withdrawal to benzodiazepines.

Answer 11

It occurs more common with the short acting preparations and in case of sudden withdrawal of the drug, this will lead to withdrawal symptoms such as: Anxiety, Restlessness, Confusion, Insomnia, Orthostatic hypotension, hyperactive reflexes and generalized seizures.

Question 12

Classify the following hypnotics as either suitable to improve sleep latency or sleep duration: Eszopiclone lorazepam ramelteon Suvorexant triazolam zaleplon

Answer 12

→Eszopiclone→ Treat Sleep Maintenance insomnia

→Lorazepam→ Treat Sleep Maintenance insomnia

→Ramelteon→ Treat Sleep onset insomnia

→Suvorexant→ Treat Sleep Maintenance insomnia

→Triazolam→ Treat Sleep onset insomnia

→Zaleplon→ Treat Sleep onset insomnia + For patient with awakening in the middle of the night

Question 13

Mention three cautions with writing hypnotic prescriptions.

Answer 13

• A dose that does not impair mental activity or motor functions during waking hours.
• Prescriptions should be written for short periods
• Assess the efficacy of therapy from the patient’s subjective responses.
• Combinations of antianxiety agents should be avoided
• Patients should be cautioned about the consumption of alcohol and the concurrent use of over-the-counter medications containing antihistaminic or anticholinergic drugs

Question 14

List antimicrobials for eradication of Group A beta Hemolytic Streptococci (GAS) for penicillin allergic and non-allergic patients.

Answer 14

Antibacterials:
Penicillins (drug of choice): Benzathine penicillin G Or Penicillin V

For patients allergic to penicillin:
Azithromycin Or
Clarithromycin Or
Clindamycin

Question 15

Enumerate the lines of management of acute adrenal
insufficiency?

Answer 15

1- Steroid replacement - hydrocortisone Mineralocorticoid replacement:
fludrocortisone

2- Intravenous fluids for Shock or moderate to severe dehydration

3- To Treat hypoglycemia: Bolus: IV dextrose

4- To Treat Hyperkalemia: monitor by ECG: If Potassium is >7.0 mmol/ Treat with either calcium gluconate or insulin infusion

Question 16

How can bariatric surgery affect drug distribution

Answer 16

• Decrease in fat decreases the Vd of fat-soluble drugs

Many patients experience hypoalbuminemia after bariatric surgery, with decreased plasma protein binding of drugs and this increases the free plasma fraction and causes decrease in the volume of distribution
(Vd).

Question 17

How do benzodiazepines produce CNS depression?

Answer 17

They bind to GABAA receptors at a site different from where GABA binds —> increase the affinity of GABA for the GABA-binding site —►increase the frequency of the opening of the ion channel controlled by the GABAA receptor Opening of the central ion channel, allows chloride entry—► hyperpolarization of the neuron and decreases neurotransmission by inhibiting the formation of action potentials.

Question 18

Mention three cautions with writing hypnotic prescriptions

Answer 18

• A dose that does not impair mental activity or motor functions during waking hours.
• Prescriptions should be written for short periods
• Combinations of antianxiety agents should be avoided

Question 19

1. Mention two alternative antibacterial therapies that can be used for the treatment of community-acquired pneumonia in absence of comorbidities and absence of risk factors for MRSA. (No doses required)

Answer 19

Amoxicillin every 8 hours
or
Doxycycline every 12 hours

Question 20

Mention two alternative antibacterial therapies that can be used for the treatment of community-acquired pneumonia for a patient with diabetes mellitus but in absence of risk factors for MRSA. (No doses required)

Answer 20

Amoxicillin-clavulanate and clarithromycin

Doxycycline

Question 21

Mention two alternative antibacterial therapies that can be used for the treatment of hospital-acquired pneumonia in the absence of risk for MRSA and for mortality. (No doses required)

Answer 21

Penicillin based antipseudomonal

or

Cephalosporin based antipseudomonal

Question 22

Mention two alternative antibacterial therapies that can be used for the treatment of hospital-acquired pneumonia in the presence of risk for MRSA in the absence of mortality risk. (No doses required)

Answer 22

Question 23

Mention two alternative antibacterial therapies that can be used for the treatment of hospital-acquired pneumonia in the presence of risk for MRSA and for high mortality risk. (No doses required)

Answer 23