1.
A drug interaction that occurs when a drug w/no inherent activity reverses the effects of another drug would be considered to be which of the following interaction types?
Correct Answer
C. Antagonism
Explanation
this is one of the quiz questions from class
2.
You prescribe moxifloxacin to your patient for the treatment of bacterial conjunctivitis. However your patient comes back a week later and states that although the bacterial conjunctivitis cleared up it also caused some of her eyelashes to fall out. What is another term for an unusual or unexpected response to a drug?
Correct Answer
B. Idiosyncracy
Explanation
An idiosyncrasy is a term used to describe an unusual or unexpected response to a drug. In this case, the patient experienced the unexpected side effect of eyelash loss after taking moxifloxacin for bacterial conjunctivitis. This idiosyncratic reaction is not a common or typical response to the drug, but rather a unique reaction specific to this individual.
3.
An optometrist places one drop of 0.5% proparacaine in a patient's OD eye prior to instilling a mydriatic/cycloplegic agent. In this case, the use of proparacaine would be considered to be wich of the following?
Correct Answer
B. Prophylactic
Explanation
Example question from class - she said most of her questions would be in this fashion.
4.
Which of the following drugs primary use is not for treatment?
Correct Answer
B. Proparacaine
Explanation
Metoprolol is for hypertension, and lopressor is the brand name
Moxifloxacin is for Tx of bacterial conjunctivitis
Vancomycin and gentamicin is required t treat bacterial endocarditis
5.
A patient comes in for an annual exam. While taking the case history they tell you they have been placed on a new heart medication by their cardiologist. The patients reveals to you that they have had episodes of delirium and hallucinations in the past few weeks. What does it sound like the patient is experiencing?
Correct Answer
B. Adverse drug effect (ADE)
Explanation
Based on the given information, it sounds like the patient is experiencing an adverse drug effect (ADE). The patient's episodes of delirium and hallucinations could be side effects or negative reactions to the new heart medication prescribed by their cardiologist.
6.
A 63 yr, asian male comes in for an eye exam. While taking his case history you discover they are taking Clonidin for the treatment of hypertension. Clonidin is an oral medication that works by decreasing your heart rate and relaxing the blood vessels so that blood can flow more easily through the body. You patient states he feels fine and mentions that he is almost out of medication and does not plan to refill his prescription since the doctor wants to increase the dosage. Why would you warn your patient against that course of action?
Correct Answer
D. Physiologic dependence
Explanation
Physiologic dependence - occurs when the body physically/ physiologically develops reliance on a drug. Abrupt drug discontinuance can lead to adverse effects including but not limited to withdrawal, rebound etc.
This is a danger in drugs such as Prednisone and opiate narcotics as well
7.
Another celebrity has made it to the tabloids for a drug problem. The publicist has announced that Justin Bieber is boldly getting help for opiate withdrawals. Which of the following is not a symptoms he would be experiencing from OPIATE withdrawls?
Correct Answer
C. Seizures
Explanation
Opiate withdrawals can cause symptoms such as piloerection (goosebumps), diarrhea, insomnia, and irritability. However, seizures are not typically associated with opiate withdrawals.
8.
During a pharm party people will bring pharmaceutical drugs and randomly take them not knowing what they are for. An 18yr old girl has just ingested two pills, because she's dumb she didn't realize that each of the drugs she took has CNS depressant effects. She is now feeling extremely sedated because the result of the two drugs is twice the CNS depressant effects experienced by the patient. This is an example of what kind of drug interaction?
Correct Answer
C. Additive Effects
Explanation
Additive effects - The response elicited by combined drugs is EQUAL to the combined responses of the individual drugs. 1 +1 = 2
Sedatives combined with opiates are a good example
9.
You patient was previously admitted to the Emergency Department (ED) for bacterial endocarditis. The attending physician was very aggressive with treatment and prescribed a course of medication with both Vancomysin and Gentamicin. The result is that the combination of these medications is more effective in killing the bacteria causing the infection than the effect that would be achieved by using either of the antibiotics.
Correct Answer
D. Synergism
Explanation
The response elicited by combined drugs is GREATER than the combined responses of the individual drugs. 1+1 = 3
Synergism refers to the intended clinical effect(s), not potential adverse effects.
10.
A patient was in a traumatic car accident. Upon arrival to a primitive hosipital the patient was given morphine for the pain ( they didn't have the really good stuff). After a few days the patient was given Naloxone to reverse the effect of morphine so they could get him out of the ED to make room for another poor sap. By itself naloxone typically does nothing, it's action is revealed after it is coupled with an opiate. The CNS, cardiovascular and respiratory depressant effect of morphine is reversed. This is an example of what kind of drug interaction?
Correct Answer
B. Antagonism
Explanation
Antagonism: Drug inhibits the effect of another drug. Usually the antagonist has no inherent activity. "1 + 1 = 0"
Synergism refers to the intended clinical effect(s), not potential adverse effects.
11.
Clavulanate is a drug with no clinical effect. However coupled with amoxicillin it has been found to be particularly useful against bacteria that are resistant to treatment with amoxicillin alone. Clavulanate provides protection to amoxicillin by keeping the beta-lactact ring within the amoxicillin structure in tact. This is an example of what kind of drug interaction?
Correct Answer
C. Potentiation
Explanation
Don't confuse potentiation with synergism.
Potentiation: A drug which has no principal effect enhances the effect of a second drug. "0 + 1 = 2"
Remember: Amoxicillin with clavulanate is trademarked as AUGMENTin
12.
Altered absorption is always due to chelation
Correct Answer
B. False
Explanation
Altered absorption - drugs may inhibit absorption of other drugs across physiologic membranes. Not all altered absorption is due to chelation
An anti-ulcer medication that coats the stomach may decrease the GI absorption of other drugs = example of physiologic barrier to altered absorption.
13.
Most drugs are absorbed in the doudenum and the _____. Few medications are absorbed in the _____ lining.
Correct Answer
jegunum, stomach
Explanation
Most drugs are absorbed in the duodenum and the jejunum, which are parts of the small intestine. These sections of the small intestine have a large surface area and are lined with specialized cells that facilitate the absorption of medications into the bloodstream. However, a few medications can also be absorbed in the stomach lining, although this is less common compared to absorption in the duodenum and jejunum. The stomach lining has a different structure and function compared to the small intestine, but it can still allow for some limited absorption of certain drugs.
14.
Cisplatin is a type of platinum-based chemotherapy drug that has been commonly used in the chemical treatment of various cancers, including sarcomas, lymphomas, germ cell tumors and certain carcinomas. Your patients's nephrologist has suggested adding mannitol to cisplatinum therapy minimizes the renal tubular damage that can occur with administration of cisplatinum along. The diuretic effect of mannitol prevents prolonged cisplatinum contact time which lessens the potential for cellular damage. This is an example of what kind of drug interaction?
Correct Answer
A. Altered excretion
Explanation
Altered excretion - drugs may act on the kidneys to reduce or enhance excretion of specific drugs. Important because if you have damaged kidneys other routes must be explored.
15.
Regarding altered metabolism: interactions can occur when ____ enzymes are inhibted or induced.
Correct Answer
p450
Explanation
The correct answer is p450. P450 enzymes are a group of enzymes responsible for metabolizing various drugs and toxins in the body. When these enzymes are inhibited or induced, it can lead to altered metabolism and potentially affect the effectiveness or toxicity of certain medications.
16.
Drugs that bind to serum proteins may compete with other drugs for the protein binding sites. Displacement of drug " A" from serum proteins by drug "B" may increase the concentration of unbound drug " A" in the serum
Correct Answer
A. True
Explanation
Albumin is a major serum carrier, many drugs target albumin to help get it to the site of action. If a pt has a low albumin level and they have to take drugs that need albumin as a carrier the patient is often given serum from blood fractions.
17.
Select the false statement
Correct Answer
E. Aspirin is an example of a chemical name that is irrespective of the manufacturer
Explanation
The statement "Aspirin is an example of a chemical name that is irrespective of the manufacturer" is false. The chemical name of a drug is specific to its chemical structure and is not affected by the manufacturer. However, the trade name or brand name of a drug, such as Bayer Aspirin, can vary depending on the manufacturer.
18.
The formulation of drugs is NOT dependent on the following factor:
Correct Answer
D. Half life of the drug
Explanation
pg. 9 of the manual
19.
Intravenous medications might be needed in situations occurring in hospitals, whereas oral and opthalmic or other forms of medication are often more appropriate for outpatient use.
Correct Answer
A. True
Explanation
This is an example of intended use of the drug effecting the formulation of the drug.
20.
Select the route of drug administration you might prefer to use during an emergency or very urgent situation according to Dr. J.
Correct Answer
D. Intravenous
Explanation
Pg. 9 - under clinical situation
21.
Drugs such as insulin are denaturated by acid and are not effective when administered orally because they may be destroyed in the low pH environment of the stomach. What kind of consideration would this be in drug formulation?
Correct Answer
D. Drug stability in various physiologic environments
Explanation
This question is asking about the consideration that needs to be taken into account in drug formulation when drugs like insulin are denatured by acid and are not effective when administered orally due to the low pH environment of the stomach. The correct answer, "Drug stability in various physiologic environments," explains that the formulation of the drug needs to ensure its stability in different physiological environments, such as the stomach's low pH, in order for it to be effective when administered orally.
22.
Blood from the mesenteric circulation ( GI) passes through the liver before entering other organs. Medications absorbed through the GI tract which pass through the liver can undergo some degree of metabolism on the first pass through the liver. At times, the effect can be so significant, that the oral dose must be much higher than the parenteral dose in order to assure effective serum concentraction levels after the initial pass through the liver. What is this phenomenon typically called?
Correct Answer
first pass effect
Explanation
The phenomenon described in the question is typically called the "first pass effect." This refers to the metabolism or alteration of a drug that occurs in the liver after it is absorbed from the gastrointestinal tract. The drug is metabolized before it reaches systemic circulation, which can result in a significant reduction in its bioavailability. As a result, a higher oral dose of the medication may be required compared to a parenteral (non-oral) dose to achieve the desired therapeutic concentration in the bloodstream.
23.
The dosage for metoprolol/lopressor when prescribed orally is typically 25-50mg. This particular drug's dosage is affected by the first pass effect. If prescribed intravenously what dosage would you expect for metoprolol?
Correct Answer
D. 2.5mg
Explanation
You know that because of the first pass effect you will be able to administer a lower dosage through an IV. Only one answer choice is lower than the dosage for the oral dosage of metoprolol
24.
If a doctor is wants to prescribe medication that will allow the patient maximum ease to dose themselves what route of drug administration would be recommended?
Correct Answer
D. Oral
Explanation
pg. 10 - Oral one of the easiest routes for patients to dose themselves. Medications for oral administration should ideally be acid stable to withstand the low pH environment of the stomach. They should be absorbed quickly and passed through the intestinal lining in order to enter the bloodstream.
25.
Current National Patient Safety Guidelines discourage use of"SL" as an abbreviation for sublingual.
Correct Answer
A. True
Explanation
It can be mistaken for "SC" - subcutaneous
26.
If a patient has been prescribed tylenol or aspirin but the chart says the patient is NPO, how would you administer the medication?
Correct Answer
D. PR
Explanation
NPO - means nothing by mouth
Rectal/PR is the route to use when all other other routes are unavailable, in this case it's the only one available
27.
Which of the following elements is required for a California -licensed prescriber to include on a new prescription?
Correct Answer
D. Date that the prescription is issued
Explanation
One of her questions from class, I just changed the options a bit.
28.
A diabetic patient with impaired gastroparesis will have trouble with which of the routes of drug administration?
Correct Answer
C. Oral
Explanation
A diabetic patient with impaired gastroparesis will have trouble with the oral route of drug administration because gastroparesis is a condition that affects the stomach's ability to empty its contents properly. This can result in delayed or inconsistent absorption of orally administered drugs, making it difficult for the patient to receive the intended therapeutic effects of the medication.
29.
Which of the following statements is false concerning the dermatologic route of drug administration.
Correct Answer
D. It can be administered beneath the cutaneous layer of the skin
Explanation
The last option refers to subcutaneous which is a form of Parenteral route of drug administration
30.
Which of the following is not true regarding the parenteral route of drug administration?
Correct Answer
C. Drug solubility and formulation does not limit the ability of drugs to be administered intravenously
Explanation
The statement that drug solubility and formulation does not limit the ability of drugs to be administered intravenously is not true. Drug solubility and formulation are important factors to consider when administering drugs intravenously. Some drugs may not be soluble in water or may have a formulation that is not suitable for intravenous administration. Therefore, drug solubility and formulation can indeed limit the ability of drugs to be administered intravenously.
31.
Convert the following prescription into shorthand: Metoprolol 25 milligram tablet, take two tablets orally twice daily
Correct Answer
C. Metoprolol 25mg TAB, two TABs PO B.I.D
Explanation
Option 1: expects pt to know they need to take 2 25mg tablets
Option 2: lacks concentration and route
Option 3: correct
Option 4: gives amount for entire day, but it doesn't specify division of doses
32.
Select the best answer : Convert the following prescription: Artifical tears instill two drops in both eyes as needed for dryness/itching
Correct Answer
B. Artificial tears 2 gtts OU PRN dryness/itching
Explanation
Option 1: not as concise as Option 2
Option 3: which eye?
Option 4:no amount given
33.
Convert the following shorthand to lay person terms select the best option: Docusate sodium 100mg. one tab P.O. B.I.D PRN constipation
Correct Answer
B. Docusate sodium 100 milligrams, one tablet orally twice daily as needed for constipation
Explanation
The correct answer is "Docusate sodium 100 milligrams, one tablet orally twice daily as needed for constipation." This option accurately translates the shorthand instructions to lay person terms, specifying the medication (Docusate sodium), the dosage (100 milligrams), the route of administration (orally), the frequency (twice daily), and the indication (as needed for constipation).
34.
Convert the following shorthand to lay person terms, select the best option: Clindamycin 600mg, one tab. P.O. q8hr x 7days
Correct Answer
B. Clindamycin 600 milligrams, one tablet orally every eight hours for a treatment course of seven days
Explanation
The correct answer is "Clindamycin 600 milligrams, one tablet orally every eight hours for a treatment course of seven days". This option accurately converts the shorthand prescription into lay person terms by specifying the dose (600 milligrams), route of administration (orally), frequency (every eight hours), and duration (seven days) of the medication.
35.
Convert the following shorthand to lay person terms, select the best option: Regular insulin 5 units, SC qAC, HS
Correct Answer
A. Regular Insulin 5 units, subcutaneous before every meal and before bedtime
Explanation
SC and SQ can both be used to mean subcutaneous - SQ is more common in the medical setting
Option 3: NEVER abbreviate units as "U" because it can look like a "0" and they will give 50 units of insulin instead of 5
DC = discontinue
HS = at bedtime
AC = BEFORE meals
PC = AFTER meals
36.
Convert the follow to shorthand: Levothyroxine 75 micrograms, take one tablet orally every morning one hour before breakfast
Correct Answer
B. Levothyroxine 75mcg, one tab P.O. qAM one hr prior to breakfast
Explanation
The correct answer is "Levothyroxine 75mcg, one tab P.O. qAM one hr prior to breakfast". This answer accurately converts the original prescription to shorthand by using the appropriate abbreviation for micrograms (mcg) and indicating the route of administration (P.O. for orally). It also specifies the frequency (qAM for every morning) and timing (one hr prior to breakfast) for taking the medication. The other options either use the incorrect abbreviation for micrograms (mg) or do not provide the necessary instructions for timing and frequency.
37.
Which of the following drug information monograph sections below should an OD review in order to find information on how the drug acutally works to produce its clinical effects.
Correct Answer
B. Mechanism of action
Explanation
Example of question from class
38.
Which of the following FDA preg. Risk factor categories is identified by the following description/ there is a positive evidence of human fetal risk, but the benefits from use during pregnancey may be acceptable despite the risk.
Correct Answer
C. Cat. D
Explanation
Question from class
39.
How many half lives would be needed before 95% or more of an administered drug dose is eliminated ? at 7am the first dose is 100mg.
Correct Answer
B. 5
Explanation
The correct answer is 5. Each half-life of a drug eliminates 50% of the remaining dose. Therefore, after 1 half-life, 50mg of the drug would remain. After 2 half-lives, 25mg would remain. After 3 half-lives, 12.5mg would remain. After 4 half-lives, 6.25mg would remain. And after 5 half-lives, only 3.125mg would remain. Since 95% or more of the drug dose needs to be eliminated, it would take at least 5 half-lives to achieve this.
40.
Select the false statement
Correct Answer
B. If a drug that is dependent on drug serum concentraction has trouble reaching the site of action this will result in a shorter half life.
Explanation
Option 2 - false statement, in class she said if you have trouble getting to the site of action because you have a low serum concentration then you would have a longer half life
41.
_____ doses are given to reach therapeutic serum drug concentrations more quickly than administering routine intermittent doses. The first dose of the drug is calculated to be higher than the doses that will follow.
Correct Answer
Loading
Explanation
Loading doses are given to reach therapeutic serum drug concentrations more quickly than administering routine intermittent doses. The first dose of the drug is calculated to be higher than the doses that will follow. This initial higher dose helps to rapidly achieve the desired drug levels in the body, allowing for a quicker onset of therapeutic effects. Once the loading dose has been administered, subsequent doses can be given at regular intervals to maintain the desired drug concentration in the body.
42.
Which of the following is not a drug based factor that can affect the absorption through tissues and membranes?
Correct Answer
F. None of the above
Explanation
The question asks for a factor that does not affect absorption through tissues and membranes. The options given are formulation, water solubility, molecular weight, ionization, and lipid solubility. All of these factors can affect absorption to some extent. Formulation refers to the composition and preparation of the drug, which can affect its absorption properties. Water solubility and lipid solubility determine how easily the drug can dissolve in water or lipids, respectively, which can affect its ability to cross membranes. Molecular weight and ionization can also impact the drug's ability to pass through tissues and membranes. Therefore, none of the above options are correct as they are all drug-based factors that can affect absorption.
43.
What drug transport mechanism would most likely be the quickest route for small, nonionic, lipophilic drug molecules?
Correct Answer
D. Passive diffusion
Explanation
Passive diffusion does not require energy or a transport carrier . This transport mechanism would be slow for larger, ionic , hydrophilic molecules.
44.
Which of the following drug transport mechanisms requires a transport carrier?
Correct Answer(s)
B. Active transport
D. Carrier assisted diffusion
Explanation
Active transport and carrier assisted diffusion both require a transport carrier. In active transport, energy is used to move molecules against their concentration gradient, and a carrier protein is needed to facilitate this process. In carrier assisted diffusion, molecules move down their concentration gradient with the help of a carrier protein. Both mechanisms involve the use of specific carrier proteins to transport molecules across the cell membrane.
45.
What drug transport mechanism best fits the following description?: It does not require energy or a transport carrier to function. Drugs with a MW less than 200 are able to diffuse along concentration gradient via this route.
Correct Answer
C. Hydrophilic channels
Explanation
Hydrophilic channels best fit the description provided. These channels allow the passive diffusion of drugs with a molecular weight less than 200, without requiring energy or a transport carrier. Passive diffusion refers to the movement of molecules along a concentration gradient, without the need for any external energy source or carrier molecule. Hydrophilic channels provide a pathway for these drugs to move through the cell membrane, taking advantage of their small size and hydrophilic nature.
46.
Concerning drug transport mechanisms - molecules that are structurally similar can compete for carriers. Noncovalent binding binds drugs to carriers which then facilitate diffusion or carrier assisted diffusion.
Correct Answer
A. True
Explanation
Molecules that are structurally similar can compete for carriers in drug transport mechanisms. Noncovalent binding allows drugs to bind to carriers, which then facilitate diffusion or carrier assisted diffusion. This means that drugs with similar structures can potentially interfere with each other's transport by competing for the same carriers. Therefore, the statement is true.
47.
Select the true statement
Correct Answer
C. Ionization makes a drug molecule less lipid soluble
Explanation
Membranes are often lipophilic, so highly lipid soluble drugs cross these membranes easily.
Lipid soluble drugs that are composed of smaller molecular structure and which are not ionized have a better ability to pass through plasma membranes.
48.
When drugs bind to albumin or other serum proteins, the amount of free, unbound drug is ______ ( increased or decreased ).
Correct Answer
decreased
Explanation
Protein bound drugs can reach higher concentrations between the blood and the tissues, whereas unbound, or free drug will reach an equilibrium between the blood and tissues.
Decreases serum free drug usually means that there is less available drug to concentrate in a target organ.
49.
Some drugs can deposit in specific tissues and accumulate there. This may result in ____ ( slower or faster ) drug release or eventual changes in the tissues. Examples of drugs with drug deposition issues include amiodarone/Pacerone and doxycycline/Vibramycin.
Correct Answer
slower
Explanation
Some drugs have the ability to deposit in certain tissues and build up over time. When this happens, the release of the drug into the bloodstream may be slower than usual. This drug deposition can also lead to changes in the tissues where the drug accumulates. Two examples of drugs known to have this issue are amiodarone/Pacerone and doxycycline/Vibramycin.
50.
Select the false statement
Correct Answer
C. During phase II reactions drugs are oxidized or reduced to a more polar form
Explanation
Phase II reactions are when a polar molecular group is conjugated to the drug, which substantially increases its polarity
Phase I reactions: drugs are oxidized or reduced to a more polar form