1.
Advantages of administering medications by I.V. infusion include
Correct Answer
D. All of the Above
Explanation
Administering medications by I.V. infusion has several advantages. Firstly, it allows for the replacement of essential fluids in the body. Secondly, it enables the drug to be administered over an extended period, ensuring a constant concentration in the body. Lastly, when the drug contacts the walls of the veins, it is less concentrated and therefore less irritating. Therefore, all of the above advantages are true for administering medications by I.V. infusion.
2.
Intravenous (I.V.) drug therapy in large-volume fluids is only a common practice in inpatient but not outpatient settings
Correct Answer
B. False
Explanation
Intravenous (I.V.) drug therapy in large-volume fluids is not only a common practice in inpatient settings but also in outpatient settings. This means that it is not true that it is only a common practice in inpatient settings and not in outpatient settings.
3.
In general, it is OK to mix solutions of parenterals even though there is the potential for incompatibility
Correct Answer
B. False
Explanation
"In general, it is not recommended to mix solutions of parenteral because of the potential for incompatibility"
4.
Stability – a product or combination of drugs that retain ____% of its original potency during the life span of the product
Correct Answer
C. 90
Explanation
Stability refers to the ability of a product or combination of drugs to maintain its original potency over its lifespan. In this case, the correct answer is 90%, which means that the product or drug combination will retain 90% of its original potency throughout its entire lifespan. This indicates a high level of stability, as a significant portion of the drug's effectiveness is maintained over time.
5.
This term is usually applied to chemical reactions that are continuing without interruption, irreversible, and result in distinctly different chemical entities (degradation products) that can be both therapeutically inactive and possibly exhibit toxicity
Correct Answer
B. Instable
Explanation
The term "instable" is the correct answer because it describes chemical reactions that are continuing without interruption, irreversible, and result in distinctly different chemical entities (degradation products). These degradation products can be both therapeutically inactive and possibly exhibit toxicity. The term "instable" suggests that these reactions are not stable and can lead to undesirable outcomes.
6.
This term generally refers to physiochemical phenomena such as concentration-dependent precipitation and acid-base reactions with the products of reaction manifested as a change in physical state or protonation-deprotonation equilibria
Correct Answer
A. Incompatible
Explanation
The term "incompatible" is used to describe physiochemical phenomena that result in a change in physical state or protonation-deprotonation equilibria. This can include concentration-dependent precipitation and acid-base reactions. Incompatibility refers to substances or conditions that cannot coexist without causing a reaction or change in state, indicating that they are not compatible with each other.
7.
These occur when two drugs combine in a solution to produce a change in the appearance of that solution
Correct Answer
B. pHysical incompatiblities
Explanation
Physical incompatibilities refer to the changes in the appearance of a solution when two drugs combine. This can include alterations in color, clarity, or the formation of precipitates or particles. Unlike chemical incompatibilities, where a chemical reaction occurs between the drugs, physical incompatibilities do not involve a chemical change. Instead, they involve changes in the physical properties of the solution. Therefore, the correct answer is physical incompatibilities.
8.
Which of the following is not a visual change that might indicate a physical incompatibility is taking place?
Correct Answer
C. Change in odor
Explanation
A change in odor is not a visual change, but rather a change in the sense of smell. It indicates a chemical change or reaction taking place, rather than a physical incompatibility. Visual changes such as changes in color, development of a haze, evolution of a gas, or formation of a precipitate can indicate physical incompatibility.
9.
For drugs that are weak acids or bases, solubility is a direct function of
Correct Answer
B. Solution pH
Explanation
solution pH along with DRUG pKa
10.
Drugs that are poorly water soluble are often formulated using water miscible cosolvent such as
Correct Answer
D. All of the above
Explanation
Drugs that are poorly water soluble can be difficult to formulate. One approach to improve their solubility is to use a water miscible cosolvent. Ethanol, propylene glycol, and polyethylene glycol are all examples of water miscible cosolvents that can be used to enhance the solubility of poorly water soluble drugs. Therefore, the correct answer is "all of the above."
11.
When mixing solutions that contain calcium and phophate, which should be added first?
Correct Answer
B. pHospHate
Explanation
Dr. Moore said to remember "ph-ph-phosphate... f-f-first!"
12.
The concentration of amino acids plays no role in the determination of calcium and phosphate precipitation.
Correct Answer
B. False
Explanation
Concentration of amino acids and AA composition both play an important role.
13.
What is the term for when an intact drug is lost from solution by adsorption to the surface or absorption into the matrix of the container material, administration set or filter
Correct Answer
C. Sorption
Explanation
Leaching is the opposite effect to adsorption and is when phthalate plasticizers leach out into the solution
14.
Chemical incompatabilites may not be visibly observable
Correct Answer
A. True
Explanation
Chemical incompatibilities can occur between different substances, resulting in potentially dangerous reactions. However, these reactions may not always be visibly observable, meaning that there may not be any visible signs or indications of the incompatibility. This is why it is important to be aware of potential chemical incompatibilities and to follow proper safety protocols when handling different substances, even if there are no visible signs of incompatibility.
15.
Oxidation is
Correct Answer
C. Electron loss that causes a positive increase in valence
Explanation
Remember OIL RIG... Oxidation Is Loss... Reduction Is Gain
16.
Which of the following should not be used to try and control the process of oxidation?
Correct Answer
A. Oxygen should always be included in the dosage form
Explanation
Oxygen may be excluded from the dosage form
17.
A visual check for precipitation, turbidity or color change before administering the mixture guarantees compatibility
Correct Answer
B. False
Explanation
The statement suggests that visually checking for precipitation, turbidity, or color change before administering the mixture guarantees compatibility. However, this is not true because visual checks may not always be accurate indicators of compatibility. Some incompatible mixtures may not exhibit visible changes. Therefore, relying solely on visual checks is not a reliable method to ensure compatibility.
18.
Drug incompatibility will result when an interaction occurs between
Correct Answer
C. Ionized bases and ionized acids
Explanation
This results in the formation of the molecular acid and base which are water insoluble
19.
Which of the following is not true about molecular acids?
Correct Answer
A. Molecular acids are strong
Explanation
Molecular acids are relatively weak (pKa 3-8). Therefore, must force HB (the acid) to relinquish H+ by reacting with a strong base (e.g. NaOH, KOH, Al(OH)3, Ca(OH)2).
20.
WHich of the following is not a basic salt?
Correct Answer
C. Calcium hydroxide
Explanation
Couple name of unionized acid with name of metal ion from the original metal hydroxide used to make the salt
21.
WHich of the following is not an acidic salt?
Correct Answer
D. Atropine methylbromide
Explanation
to name an acid salt, Couple name of original unionized (molecular, :B) base with a modified name of the acid used to make the salt (HX) (e.g. Cl ---> chloride; H2SO4 ---> sulfate).
22.
__________reactions in aqueous solution are a major source of drug incompatibility
Correct Answer
B. Proton transfer
Explanation
Morphine sulfate + Cefazolin Sodium ----->
(ionized acid) (H2O soluble) (ionized base) (H2O soluble)
Morphine + Cefazolin + Na2SO4
(mol. base) (H2O insol.) (mol. acid) (H2O insol.) (H2O sol.)
The ionized acid (+1) donates a proton to the anionic (-1) base, generating the unionized conjugate base of the original acid and unionized conjugate acid of the original base, resulting in precipitation.
23.
You should wait an ample amount of time before administering an admixture to see if any precipitation forms before giving it to the patient.
Correct Answer
B. False
Explanation
Use solutions promptly after preparation in order to assure administration of the most stable product, since the degradation of many drugs is time dependent.
24.
Biological substances including blood products and insulin are prone to denaturation when exposed to variations in pH and osmolality
Correct Answer
A. True
Explanation
There are some compatibility studies for blood and insulin but not for newly marketed biologicals such as infliximab, interferons and recombinant coagulation factors, so mixing is not recommended.
25.
Injecting drugs through a running I.V. can be done while observing for any signs of incompatibility
Correct Answer
A. True
Explanation
Mix two bags of the drugs to be administered. Send one bag immediately to the floor and keep the second bag in the pharmacy. Call the nurse and explain that no drug compatibility information exists on combining these drugs in the same bag. The nurse should hang the bag immediately and observe for any signs of incompatibility. The bag in the pharmacy should also be observed carefully for any signs of incompatibility. Stop I.V. at the first sign of incompatibility.
26.
Some incompatibilities may be predictable from simple chemical knowledge
Correct Answer
A. True
Explanation
Simple chemical knowledge allows us to understand certain properties and behaviors of chemicals. Based on this knowledge, we can make predictions about potential incompatibilities between different chemicals. For example, we may know that mixing an acid with a base will result in a neutralization reaction. Therefore, it is possible to predict some incompatibilities by applying basic chemical principles.
27.
Which of the following is not an example of chemical incompatibility?
Correct Answer
B. Precipitation
Explanation
Precipitation shows a physical incompatibility
28.
___________ is a common mode of chemical decomposition causing the majority of drug instabilities
Correct Answer
C. Hyrdolysis
Explanation
Hydrolysis is a common mode of chemical decomposition that occurs when a compound reacts with water, resulting in the breakdown of chemical bonds. This process is a major cause of drug instabilities, as many drugs are susceptible to hydrolysis in the presence of moisture or under certain pH conditions. Hydrolysis can lead to the formation of degradation products, which may result in reduced potency or altered pharmacokinetics of the drug. Therefore, it is important to consider the potential for hydrolysis when formulating and storing pharmaceutical products.
29.
Neutral quaternary ammonium salts can either accept or donate proton
Correct Answer
B. False
Explanation
Neutral quaternary ammonium salts can neither accept nor donate proton, and are compatible in solution with either ionized acids or ionized bases.
30.
Published data on incompatibility studies is complete
Correct Answer
B. False
Explanation
The statement "Published data on incompatibility studies is complete" is false. This means that the available published data on incompatibility studies is not complete. The answer suggests that there is either missing or insufficient information in the published data regarding incompatibility studies.