***Practice Final*** Flashcards
A common medication error involves drug names that look or sound alike. One such pair is Adderall and Inderal. What are these two drugs? A. Methylphenidate and Isuprel B. Amitriptyline and Metoprolol C. Bupropion and Buspirone D. Fentanyl and Enalapril E. Dextroamphetamine and Propranolol
Dextroamphetamine and Propranolol
A nursing student reads that 10 mg of Morphine is considered to provide the same pain relief as 200 mg of Codeine, another analgesic. The student knows from this information that Morphine is more \_\_?\_\_ than Codeine. A. Expensive B. Popular C. Potent D. Rare E. Long lasting
Potent
Accolate and Accutane have been confused many times on hand-written and phone orders, because the names are so similar. Accolate is used to treat asthma. Accutane is for acne. This is a scary error because of the serious nature of the hazards associated with Accutane. Which of the following best expresses these significant risks?
A. Hemolytic anemia and other blood dyscrasias
B. Cancer
C. Potent teratogenicity, severe depression, psychosis, benign intracranial hypertension, serious skin reactions including Steven Johnson’s Syndrome, pancreatitis, elevations in serum triglycerides, hearing impairment, liver disease, inflammatory bowel disease, etc.
D. Cardiovascular disease and stroke
E. Suicidal ideation and liver failure
Potent teratogenicity, severe depression, psychosis, benign intracranial hypertension, serious skin reactions including Steven Johnson’s Syndrome, pancreatitis, elevations in serum triglycerides, hearing impairment, liver disease, inflammatory bowel disease, etc.
Aldactone and Apresoline are both used in patients with hypertension, so are often confused. One is a diuretic and the other a vasodilator. Aldactone is __?__ and Apresoline is __?__.
A. Spironolactone and Hydralazine
B. Verapamil and Sildenafil
C. Amlodipine and Diltiazem
D. Furosemide and Nitroprusside
E. Hydrochlorothiazide and Nitroglycerin
Spironolactone and Hydralazine
Amantadine and Ranitidine have similar looking and sounding names. In which patient would you question the order for Ranitidine?
A. A 20 year old male with psychosis experiencing drug-induced tremors
B. A 35 year old female with duodenal ulcers
C. A 60 year old male treated for hypertension experiencing heart burn symptoms
D. A 65 year old female with benign gastric ulcers
E. A 25 year old with allergic rhinitis complicated by GERD
A 20 year old male with psychosis experiencing drug-induced tremors
Ativan is ofen confused with the trade name for Zolpidem which is: A. Aricept B. Antivert C. Artane D. Actos E. Ambien
Ambien
Benazepril and Benadryl are mistaken for each other. In which patient would this error be possible?
A. A 15 year old female with acne
B. A 75 year old female with osteoporosis
C. A 3 month old with allergic rhinitis
D. A 60 year old male treated for hypertension
E. A 20 year old male treated for diabetes mellitus type 2
A 60 year old male treated for hypertension
Celebrex is confused with Celexa. Celexa is an antidepressant while Celebrex is a(n): A. Antidepressant B. Anticoagulant C. NSAID used to treat arthritis D. Antihypertensive E. Typical antipsychotic
NSAID used to treat arthritis
Chlorpheniramine has been accidentally substituted for Cholestyramine due to their look-alike names. Which statement best summarizes what will happen to a patient expecting to take Cholestyramine who takes chlorpheniramine instead?
A. They will become very sleepy due to lowered blood glucose.
B. Blood cholesterol levels may increase putting the patient at risk for a cardiovascular event.
C. Since both drugs are antihistamines, they may only notice less sedation.
D. They will develop a Superinfection as Chlorpheniramine is antibiotic.
E. Cholestyramine is an antiarrhythmic, so they may be at risk for torsade de pointes.
Blood cholesterol levels may increase putting the patient at risk for a cardiovascular event.
Dabigatran, a direct thrombin inhibitor, is most similar to: A. Aspirin B. Eptifibatide C. Aminocaproic acid D. Bivalirudin E. Clopidogrel
Bivalirudin
Dantrium and Danazol have similar names. Danazol is a synthetic steroid used mainly to treat endometriosis and fibrocystic breast disease. Dantrium is: A. Dantrolene, an antispasmodic B. Digoxin, an antiarrhythmic C. Donepezil, an Alzheimer’s medication D. Lithium, a mood stabilizer E. Diazepam, a benzodiazepine
Dantrolene, an antispasmodic
Deltasone and Trazodone are mistaken for each other. In patient taking Deltasone chronically, this substitution could result in a fatal withdrawal syndrome that mimics:
A. Hyperthyroidism
B. Hypothyroidism
C. Diabetes insipidus
D. Adrenal hyperactivity (Cushing’s syndrome)
E. Adrenal insufficiency
Adrenal insufficiency
Demerol and Desyrel have been mistaken for each other with serious consequence. Additionally, both are available as 100 mg white tablets. Unfortunately, if a patient has been taking Desyrel and then takes Demerol, they are at a much higher risk of: A. Steven Johnson’s syndrome B. Hemolytic anemia C. Serotonin syndrome D. Hypotension E. Thrombocytopenia
Serotonin syndrome
Diazepam has been inappropriately substituted for Midazolam. Which statement best sums up why this is a problem?
A. Only midazolam can be used in the elderl
B. They are in different drug classes
C. Only midazolam is a respiratory depressant
D. Only diazepam is available as a parenteral
E. They have vastly different half lives
They have vastly different half lives
Diazepam is mistaken for many drugs including Diltiazem. Diazepam is most often used as an anxiolytic or a sedative-hypnotic. Someone taking Diltiazem probably has which condition? A. Gastroesophageal Reflux Disease B. Psychosis C. Depression D. Ulcers E. Hypertension
Hypertension
Doxepin and Donepezil have sufficiently similar looking names that poorly handwritten orders have been mistakenly filled with the inappropriate drug. In which of the following patients would this be a very difficult error to catch?
A. A 45 year old male treated for hypertension
B. A 3 month old with allergic rhinitis
C. A 20 year old male treated for diabetes mellitus type 2
D. A 15 year old female with acne
E. A 75 year old female with depression
A 75 year old female with depression
Eldepryl and Enalapril can be mistaken for each other, especially on hand written orders. In which situation could substituting Eldepryl for Enalapril be a fatal error?
A. Patient who no longer takes antidepressants.
B. Patient on a low salt diet, rich in fruits and vegetables.
C. Patient with a local diet rich in Spam, and other processed meats.
D. Patient adhering to the DASH diet.
E. Patient avoiding OTC decongestants as part of a heart-healthy routine to reduce hypertension.
Patient with a local diet rich in Spam, and other processed meats.
Erythromycin and Azithromycin are both Macrolide antibiotics, however they are substantially different in several respects. None-the-less, the generic names are similar enough to cause confusion. If someone has been prescribed Azithromycin and is given Erythromycin, what is the most obvious problem?
A. Azithromycin is only dosed SID for 1-5 days, while Erythromycin requires a course lasting 7-14 days given BID or QID, so there will probably be treatment failure.
B. Erythromycin is a prokinetic and may cause diarrhea.
C. They have vastly different spectra of antibacterial action.
D. A & B, not C
E. A & C, not B
Azithromycin is only dosed SID for 1-5 days, while Erythromycin requires a course lasting 7-14 days given BID or QID, so there will probably be treatment failure.
Flomax and Fosamax clearly have look-alike, sound-alike names. If each of these patients is taking several medications, WHICH is MOST likely to have been prescribed FOSAMAX and NOT Flomax?
A. A 50 year old male with urinary retention
B. A 45 year old male treated for erectile dysfunction
C. A 60 year old male treated for hypertension
D. A 75 year old female with osteoporosis
E. A 65 year old male with benign prostatic hypertrophy
A 75 year old female with osteoporosis
Gabapentin has been confused with Guaifenesin. Guaifenesin is \_\_?\_\_ while Gabapentin is \_\_?\_\_. A. Expectorant/Anti-seizure B. Analgesic/Antitussive C. Surfactant/Analgesic D. Mucolytic/Anesthetic E. Decongestant/Antiarrhythmic
Expectorant/Anti-seizure
Lamivudine and Lamotrigine are often confused because of the similarity in both the sound and look of their names, but these drugs have very different indications. Lamivudine is an antiviral drug used to treat HIV-AIDs and Lamotrigine is a(n) \_\_?\_\_ A. Oral antihyperglycemic for DMT2 B. Antihypertensive C. Anti-seizure medication D. Antiarrhythmic E. Antiemetic
Anti-seizure medication
Lexapro and Celexa are both antidepressants in the same class that are commonly confused. Their generic names, Escitalopram and Citalopram are very similar. But the dosage of Escitalopram is about half that of Citalopram. Why is this?
A. Citalopram is the isolated, active isomer so it is more potent
B. Citalopram is old and worn out
C. Escitalopram is the isolated, active isomer so it is more potent
D. Escitalopram has a chemically improved structure
E. Resistance and tolerance have not developed to Escitalopram yet
Escitalopram is the isolated, active isomer so it is more potent
Lomotil (Diphenoxylate + atropine) has been accidentally given instead of Lamictal (Lamotrigine). Which of the following is a serious consequence of this substitution that could affect the patient expecting to take Lamictal? A. Increased seizure frequency B. Diarrhea C. Tremors D. Hypertension E. Vivid dreams
Increased seizure frequency
Loperamide and Diphenoxylate are both opioid-derived antidiarrheal agents. Both potentially have CNS activity. Diphenoxylate is compounded with atropine to prevent abuse, but Loperamide is not. Why?
A. Diphenoxylate doesn’t have CNS activity when mixed with atropine.
B. Loperamide is not absorbed from the GIT.
C. Loperamide is a P-glycoprotein substrate and is pumped rapidly out of the brain.
D. Diphenoxylate is not absorbed from the GIT.
E. Loperamide is metabolized too quickly to have any effects.
Loperamide is a P-glycoprotein substrate and is pumped rapidly out of the brain
Lopid and Lipitor are sound-alike look-alike names. Lopid is actually \_\_?\_\_ and Lipitor is \_\_?\_\_ A. Niacin and Ezetimibe B. Gemfibrozil and Atorvastatin C. Atorvastatin and Clopidogrel D. Cholestyramine and Atorvastatin E. Enoxaparin and Heparin
Gemfibrozil and Atorvastatin
Meclobemide is an antidepressant that has been mistaken for Metoclopramide. Metoclopramide is Reglan, a drug with which set of indications?
A. As an antiviral for influenza A and to treat movement disorders associated with Parkinson’s Disease and drug-induced EPS
B. It is prokinetic, it stimulates lactation and is antiemetic
C. As an anti-inflammatory analgesic for arthritis and muscle pain
D. It lowers blood cholesterol and reduces the risk of stroke
E. To treat protozoal and helminthic infections
It is prokinetic, it stimulates lactation and is antiemetic
Methylphenidate is a controlled substance. It is a(n): A. CNS stimulant B. Opioid C. Benzodiazepine D. Sedative hypnotic E. Barbiturate
CNS stimulant
Norepinephrine has been confused with Nitroprusside in the emergency department. Both are used in cardiac emergencies, but for vastly different reasons. Which statement best sums up the difference between these two drugs?
A. One is an oral drug, the other is only parenteral
B. One can be used chronically
C. They have opposite effects on coagulation
D. They have opposite effects on blood pressure
E. One has a very long half life
They have opposite effects on blood pressure
Paroxetine and Fluoxetine are both SSRI antidepressants, but there have been serious medication errors involving the mix up of these sound alike names. Which of the following best sums up why the error would be a problem?
A. Only one is still indicated as an antidepressant
B. One must be taken with food
C. Only one is oral
D. Only one is effective
E. One is always dosed daily, the other may be once per week
One is always dosed daily, the other may be once per week
Penicillin G Potassium is a formulation of Penicillin G that may be injected IM, as a continuous IV drip, as a local infusion such as intrapleural or as an intrathecal injection. It may be a significant medication error to accidentally substitute Penicillin G Procaine in an IV drip as Penicillin G Procaine is associated with:
A. Severe, potentially permanent neurovascular damage that may require amputation.
B. Torsade de pointes
C. Cataracts
D. Hemolytic anemia
E. Steven Johnson’s syndrome
Severe, potentially permanent neurovascular damage that may require amputation
Procanbid (procainamide, a Class Ia antiarrhythmic) and Probenecid have been switched on orders due to their look-alike, sound-alike names. What is Probenecid indicated to treat? A. Cancer B. Gout C. Arthritis D. Viral infections E. Hypertension
Gout
Pyrantel (PinX) would be expected to be prescribed to a child with: A. Ring worm B. Pin worms C. Diabetes mellitus type two D. Diabetes insididus E. Diabetes mellitus type one
Pin worms
Ranitidine is a histamine receptor blocker, or antihistamine, but not in the sense that diphenhydramine is an antihistamine. What is different about them?
A. Diphenhydramine can be used for all allergic reactions, Ranitidine is for allergic rhinitis
B. Diphenhydramine blocks histamine receptors in the stomach, Ranitidine blocks them in the brain
C. Diphenhydramine blocks all histamine receptors, Ranitidine only blocks H2 receptors
D. Diphenhydramine is not an antiemetic, Ranitidine is a good antiemetic
E. Diphenhydramine is an H1 blocker, Ranitidine is an H2 blocker
Diphenhydramine is an H1 blocker, Ranitidine is an H2 blocker
Rasburicase and allopurinol are used to reduce uric acid levels in gout, and more specifically the high uric acid levels that are a result of: A. Cancer B. Antibiotic use C. Hypertension D. Superinfection E. Tumor Lysis Syndrome
Tumor Lysis Syndrome
Risperidone is used to control explosive behaviors in kids with autism spectrum disorder and/or Attention Deficient Hyperactivity Disorder. Which of the following would be a significant risk of using Risperidone for this use that may lead to permanent disability?
A. Bronchospasm
B. Blood dyscrasias including thrombocytopenia
C. Tardive dyskinesia
D. Steven Johnson’s Syndrome
E. Kidney failure
Tardive dyskinesia
Scopolamine is most similar to: A. Diphenhydramine B. Succinylcholine C. Aspirin D. Chlorpheniramine E. Atropine
Atropine
Sumatriptan and Somatropin are often confused for each other. Somatropin is used in cases of growth failure acting to replace human growth hormone, but Sumatriptan is used to treat: A. Hypertension B. Cancer C. Viral infections D. Migraine E. Bipolar disorder
Migraine
The combination of Sulfamethoxazole and Trimethoprim is used to treat:
A. Viral infecitons including influenza A
B. Hemolytic anemia
C. Bacterial infections like in UTIs
D. Diabetes mellitus type 2
E. Fungal infections such as ring worm
Bacterial infections like in UTIs
The generic form of Bupropion has been dispensed to patients prescribed Buspirone for anxiety. If the patient is in a smoking cessation program, taking which of these drugs which also contains bupropion, will put them at high risk for seizures? A. Zyban B. Neolid C. Zarontin D. Zofran E. Chantix
Zyban
The trade name for Acetylcysteine (Mucomyst) is frequently mixed up with Mucinex. Mucinex is actually: A. Cromolyn B. Guaifenesin C. Theophylline D. Montelukast E. Isoproterenol
Guaifenesin
The Trade name for Montelukast is often confused with the Trade name for this antidepressant: A. Doxepin B. Atomoxetine C. Olanzapine D. Amitriptyline E. Duloxetine
Doxepin
There have been a number of medication errors related to the fact that Diovan looks and sounds like Zyban. This is very unfortunate because one is used to help people stop smoking, while the other is __?__.
A. Venlafaxine, an antidepressant
B. Varenicline, a nicotinic receptor agonist also used in smoking cessation programs
C. Verapamil, a CCB used to treat hypertension
D. Divalproex, an anti-seizure medication useful in several conditions
E. Valsartan, an ARB used to treat hypertension
Valsartan, an ARB used to treat hypertension
What do Amantadine, Lithium and Digoxin all have in common?
A. A narrow therapeutic margin
B. Indications
C. All are parenteral only
D. Side effects include suicidal ideation
E. All are only available as generics
A narrow therapeutic margin
Which of the following drug orders would you question for a gentleman who has had a heart attack where the indication is anticoagulation? A. Integriin B. Plavix C. Aspirin D. Paxil E. Coumadin
Paxil
Which of the following is a Prodrug that must be activated by metabolism? A. Clopidogrel B. Warfarin C. Heparin D. Eptifibatide E. Aspirin
Clopidogrel
You are helping a patient who you know is being treated for depression. They are concerned by a change in the name of their antidepressant medication. They hand you a prescription for Prilosec. Which of the following antidepressants is the most likely involved in this medication error due to a sound alike name? A. Doxepin B. Citalopram C. Sertraline D. Fluoxetine E. Mirtazapine
Fluoxetine
Your patient has mild Alzheimer’s and is taking Aricept, but you notice that another nurse is about to inject Aranesp. What is Aranesp? A. Amitriptyline B. Acetaminophen C. Memantine D. Darbepoetin alfa E. Diphenhydramine
Darbepoetin alfa
Zetia has been mistaken for Zyrtec on prescriptions. Zyrtec is an antihistamine called cetirizine that is somewhat similar to diphenhydramine. Zetia, on the other hand is used to:
A. Lower blood pressure by causing vasodilation
B. Reduce inflammation associated with rheumatoid arthritis
C. Reduce gastric acid secretion
D. Control allergies and asthma
E. Lower cholesterol by inhibiting cholesterol absorption
Lower cholesterol by inhibiting cholesterol absorption
Doxazosin and Dexamethasone are look-alike sound-alike names. Which patient would most likely be taking the Doxazosin?
A. A 20 year old male treated for diabetes mellitus type 2
B. A 60 year old male treated for hypertension
C. A 3 month old with allergic rhinitis
D. A 15 year old female with acne
E. A 75 year old female with osteoporosis
A 60 year old male treated for hypertension
Ropinirole is a dopamine agonist used to treat restless leg syndrome. There have numerous, serious medication errors because of the similarity with Risperidone which, as you know, is a(n): A. Anti-seizure medication B. Antidepressant C. Atypical antipsychotic D. Typical antipsychotic E. Antihypertensive drug
Atypical antipsychotic
Which product avoids 1st
pass hepatic metabolism and allows nicotine to be slowly released over a number of hours.
A .Polacrilex Gum
B. Commit Lozenge
C. Nicotine Transdermal (Patch) System
D. All of the products avoid 1st pass hepatic
metabolism
E. None of the products avoid 1st pass hepatic
metabolism
Nicotine Transdermal (Patch) System
Which of the following is one of the six rights of medication? A. Client B. Drug C. Dose D. A & B E. A, B & C
A, B & C
Which of these is the stem for β blockers? A .–olol B. –alol C .–afil D. –pril E .None of the
-olol
Which of the following can increase the risk of having severe angina, or an MI, ( a rebound effect ) if suddenly stopped? A. ACE inhibitors B. Beta blockers C. Corticosteroids D. Opiates E. Proton pump inhibitors
Beta blockers
Which of these is a problem related to genetics?
A. Cystic fibrosis
B.. Glucose 6 Phosophate Dehydrogenase Deficiency
C. Warfarin response
D. All of these
E. None of the
All of these
Which of these is the muscarinic ligand? A. Acetyl choline B. Norepinephrine C. Epinephrine D. Dopamine E. Serotonin
Acetyl choline
Zileuton differs from Zafirlukast in that Zileuton is a \_\_?\_\_. A. Beta blocker B. 5 Phosphodiesterase inhibitor C. 5 lipoxygenase inhibitor D. 3 Phosphodiesterase inhibitor E. Leukotriene receptor block
5 lipoxygenase inhibitor
Which of the following was originally isolated from Autumn crocus and has been used for centuries to treat gout? A. Allopurinol B. Colchicine C. Probenecid D. Rasburicase E. None of the above
None of the above
