PCOA Review and Practice
How many moles of sodium hydroxide are required to fully hydrolyze 0.25 moles of triglyceride?
0.75 moles
Required by federal law in skilled nursing facilities:
1. Continuous 24 hour RN supervision 2. Monthly drug regimen reviews conducted by a consult pharmacist
Database studies differ from randomized controlled clinical trials in that:
1. The time needed to conduct the studies is likely to be shorter 2. The studies are likely to be less expensive
True regarding patients in a hospital patient-focused care unit:
1. They have shorter average hospital stays 2. They have fewer follow up emergency room visits 3. They are readmitted to these units less often
Epimers:
2 isomers differ in configuration at only one stereogenic center
In healthy humans how many chromosomes does a haploid cell contain?
23
How many calories should a patient receive per day
25 kcal/kg/day
Calories needed per day for burn victimes
35-40 kcal/kg/day
pH at the surface of normal skin:
4.5-5.5
In healthy humans how many chromosomes does a diploid cell contain?
46
Which of the following compounds would exhibit pure opiate-antagonist properties? (see picture)
A
Phenothiazine chemical structure
A 'thiazine' is a 6-membered, unsaturated ring (-ine) with a sulfur (thi-) and a nitrogen (az-). The 'pheno' tells you that there is a benzene ring(s) attached. These agents are a common class of psychoactive drugs that possess antipsychotic, antihistaminic, antiemetic, and anesthetic activities. They are lipophilic and can cross the blood-brain barrier. They are used for a variety of indications including treatment of schizophrenia, nausea/vomiting, and sedation. They have varying activity against muscarinic, adrenergic, dopamine, histamine, and serotonin receptors, dependent on the functional group substitutions. Ex: Chlorpromazine
The standard of substituted judgement as it relates to situations when a patient is unable to express treatment preferences:
A family member decides on the patients treatment based on how he believes the patient would decide
Cost-Utility
A form of economic study design in which interventions which produce different consequences, in terms of both quantity and quality of life, are expressed as 'utilities'
A patient brings in a prescription and the pharmacist notes that the claims processor sets a reimbursement level of $9.00 for the brand-name product. Because the pharmacy normally charges cash-paying customers $8.90 for this prescription, the pharmacist submits $8.60 to the insurer and fills the prescription. This is an example of using the: A. "usual and customary" clause B. discounted AWP C. generic substitution rule D. Maximum allowable cost
A. "Usual and customary" clause
Which substituent (R) would provide for a nitrogen mustard that should only be administered intravenously?
A. (not sure)
Which of the following is a variable cost of filling medication orders in a hospital pharmacy? A. Depreciation B. Unit-dose supplies C. Laminar flow hood D. Pharmacy license fees
A. Depreciation
Which of the following questions is NOT part of the three prime questions methods of patient counseling? A. Do you know how to take this medication? B. What did your doctor tell you this medication is for? C. What did your doctor tell you to expect from this medication? D. Just to make sure I advised you correctly, please tell me how you will use this medication
A. Do you know how to take this medication? (close ended question)
Which of the following citations is an example of primary literature? Picture attached
A. N Engl J Med
Which route of enteral nutrition is the most appropriate for a vomiting patient who is expected to recover quickly? A. Nasojejunal Tube B. Nasogastric Tube C. Percutaneous gastric tube D. Percutaneous jejunal tube
A. Nasojejunal Tube
Which of the following is the most appropriate for treating constipation in a patient receiving an opioid analgesic? A. Senna B. Psyllum C. Polycarbophil D. Magnesium citrate
A. Senna (mush and push) Bulk formulations - these agents may increase the risk of bowel obstruction in patients with impaired GI motility.
If the mean of a normally distributed sample of exam scores is 70 and the standard deviation is 5, what can be concluded about the total population of exam scores? (unsure of the answer) A. The mode is between 67.5 and 72.5 B. The median is 70 and the range is 10 C. Approximately 68% of the scores fall between 65 and 75 D. A 95% confidence interval will encompass all scores in the distribution
A. The mode is between 67.5 and 72.5
How should a pharmacist's questions differ for patients when counseling on new prescriptions and refills? A. ask what the doctor told them to expect on new; ask what problems occurred on refills B. Ask what the patient expects on new; ask what positive outcomes occurred on refills C. Ask what the doctor asked them about their expectations on new; ask the patient's expectations on refills D. Ask what the patient wants to have happen on new; ask what actually happened on refills
A. ask what the doctor told them to expect on new; ask what problems occurred on refills
Metabolic acidosis secondary to diabetic ketoacidosis is partially caused by the accumulation of:
Acetoacetate, b-hydroxybutrate
Plasma cells are component of:
Acquired specific immunity
Trying to solve a patients personal or emotional problems is an example of:
Advising
Ezetimibe side effects:
Allergic reaction skin rash Dark yellow or brown urine Yellowing of the skin and eyes
metabotropic receptors use which of the following mechanisms to alter cell function? A. Binding of the receptor-ligand complex to a nuclear response element B. Activation of G-proteins resulting in depolarization C. Opening of ligand-gated ion channels leading to depolarization D. Impulse transmission via gap junctions
B. Activation of G-proteins resulting in depolarization Ionotropic receptors form an ion channel pore. In contrast, metabotropic receptors are indirectly linked with ion channels on the plasma membrane of the cell through signal transduction mechanisms, often G proteins. Hence, G protein-coupled receptors are inherently metabotropic.
If a somatic motor neuron is stimulated, which of the following occurs? A. the sensation of pain B. Skeletal muscle excitation C. Constriction of blood vessels D. A Change in the diameter of the pupil
B. Skeletal muscle excitation
Which of the following was an impetus for the change from apprenticeship to university-based education of pharmacists in the United States? A. Abraham Flexner's report which declared that pharmacy was not a profession B. The American Association of Colleges of Pharmacy's recommendation of the general adoption of a 4 year Bachelor of science in Pharmacy degree C. The Passage of the Durham-Humphrey amendment to the Food, Drug, and Cosmetic Act D. The creation of the Board of Pharmaceutical Specialties (BPS)
B. The American Association of Colleges of Pharmacy's recommendation of the general adoption of a 4 year Bachelor of science in Pharmacy degree (not sure)
Deliquescence occurs when: A. Two hygroscopic durgs mix B. a hygroscopic drug is exposed to water vapor C. a hydrophobic drug is exposed to a water vapor D. the vapors of two drugs do not follow Henry's law
B. a hygroscopic drug is exposed to water vapor
Incorporating more salads and green vegetables in the diet of a patient receiving warfarin is most likely to: A. Increase INR B. Decrease INR C. bind dietary vitamin K D. Increase vitamin K elimination
B. decrease INR
Central fill pharmacies must:
Be staffed with a licensee pharmacist
Which of the following is the structure of a broad-spectrum, bactericidal, aminoglycoside antibiotic? (see picture)
C
Cyclodextrins can enhance the water solubility of drugs via the mechanism of: A. cavitation B. Sublimation C. complexation D. PEGylation
C. Complexation
which measurement from the electrocardiogram best represents conduction time through the AV node? A. RR interval B. QT interval C. PR interval D. ST interval
C. PR interval
Which formulation excipient is the most likely to slow drug release from a tablet? A. Lactose B. Sodium starch glycolate C. Silicon dioxide D. Magnesium stearate
C. Silicon dioxide
An accurate definition of clearance is the: A. volume of drug removed from the blood per unit time B. volume of blood from which the drug is completely removed per unit time C. amount of drug removed from the blood by glomerular filtration per unit time D. amount of drug removed from the blood by metabolic processes per unit time.
C. amount of drug removed from the blood by glomerular filtration per unit time.
Which of the following combinations represents a pharmacodynamic drug-drug interaction? A. rifampin/phenytoin (PK decrease phenytoin) B. amiodarone/warfarin (increase risk of bleeding) C. diazepam/oxycodone (respiratory depression) D. Ciprofloxacin/theophylline (PK increase theophylline)
C. diazepam/oxycodone (additive effect)
The most likely complication of poorly-controlled type 1 diabetes mellitus is: A. increased serum transaminases B. impaired hearing C. impaired sensation in the lower extremities D. increased serum amylase
C. impaired sensation in the lower extremities
Regarding point mutations, the exchange of a purine for a pyrimidine is: A. translocation B. frameshift substitution C. transversion D. an inversion
C. transversion
Which of the following liquids has the greatest surface tension? A. Water with salt B. Ethanol with salt C. Water with surfactant D. Ethanol with surfactant
C. water with surfactant (water is higher than ethanol and surfactant increases surface tension when combined with water)
What questionnaire would be appropriate to detect possible alcoholism when taking a patient history?
CAGE; 2 or more yes answers indicates a drinking problem
Example's of publication type's that may be subject to author bias:
Case Reports Case Series Editorials
subjects vulnerable to coercion and or undue influence
Children, Prisoners, Pregnant Women, mentally disabled persons, and economically and educationally disadvantaged persons
Asthma pathophysiology is characterized by:
Chronic inflammation
A patient with chronic obstructive pulmonary disease treated with prednisone and theophylline is started on a 14 day course of ciprofloxacin. Which of the following is the most likely to happen?
Ciprofloxacin will cause an increase in theophylline concentrations.
Conformers:
Cis, trans
Clearance formula
Cl = Vd x Ke or Cl = Rate of elimination/Cp or CL = (F*dose)/AUC
The CIWA-Ar is:
Clinical institute withdrawal assessment for alcohol
According to the institute for Safe Medication Practices, which one of the following dose designations is the most appropriately expressed to minimize mediation errors? A. Clonidine 0.2 mg B. Warfarin 1.0 mg (tailing 0) C. Levothyroxine 25 ug (mcg) D. Nystatin 1,000,000 Units (Use commas for dosing units at or above 1,000, or use words such as 100 "thousand" or 1 "million" to improve readability)
Clonidine 0.2 mg
The mini-mental state examination (MMSE) is used to test for:
Cognitive impairments
A prolonged QRS complex means:
Conduction is impaired within the ventricles
A delirium monitoring instrument for ICU patients is the:
Confusion assessment method (CAM-ICU)
A 12 year old child who is consistently higher than 80% on her peak flow meter should:
Continue using her current dose of albuterol Continue using her spacer with her albuterol
Third party payers utilize patient cost sharing primarily to:
Control utilization
Three drug treatments have equivalent outcomes, what is the most appropriate economic analysis to use to select the least costly alternative?
Cost-minimization analysis
Steady state concentration formula
Css = DR/Cl
Concentration formula (with time passed)
Ct = Co*e^-kt
Inflammation resulting from conversion of arachidonic acid to prostagladins is accomplished through the actions of:
Cyclooxgenase
Which of the following statements is true regarding fixed drug eruptions? A. Lesions are frequently associated with skin necrosis B. Severity of eruptions is related to the dose of offending drug C. These are the most common type of dermatologic reaction to drugs D. Lesions recur at the same location after repeated exposure of the offending drug
D. Lesions recur at the same location after repeated exposure of the offending drug The term fixed drug eruption describes the development of one or more annular or oval erythematous patches as a result of systemic exposure to a drug; these reactions normally resolve with hyperpigmentation and may recur at the same site with reexposure to the drug. Repeated exposure to the offending drug may cause new lesions to develop in addition to "lighting up" the older hyperpigmented lesions
What is the primary determinant of a journal's impact factor? A. years of publication B. circulation of the journal C. number of articles published annually D. number of citations in other journal articles
D. Number of citations in other journal articles
Which document helped to formulate the current requirements for patient informed consent? A. Pure Food and Drug Act of 1906 B. Food, Drug, and Cosmetic Act of 1938 C. Kefauver-Harris Amendment D. Nuremberg Code
D. Nuremberg Code
Which of the following bacterial species requires combination therapy in neutropenic patients with bloodstream infection? A. Serratia marcescens B. Enterobacter cloacae C. Staphylcoccus aureus D. Pseudomonas aeruginosa
D. Pseudomonas aeruginosa
Which of the following is a major ECG abnormality associated with diagnosis of myocardial infarction? A. Prolonged ST segment B. TQ segment elevation C. Prolonged QRS complex D. ST segment elevation
D. ST segment elevation
The ability of white blood cells to leave the circulation and enter peripheral tissues requires a first step of adhesion which is mediated by: A. interleukins and interferons B. cluster of differentiation factors (CDs) and CD ligands C. major histocompatibility complexes and "self" antigen D. Selectins and integrins
D. Selectins and integrins
A healthy, 55 year old patient asks what she can do to prevent osteoporosis. The pharmacist can appropriately recommend all of the following EXCEPT: A. begin taking OsCal + D 500 mg TID B. hydrotherapy 30 minutes a day, TID C. begin walking 30 minutes a day, TID D. Begin drinking an 8 ounce glass of milk TID
D. begin drinking an 8 ounce glass of milk TID (Previous research has shown that the calcium in milk can help strengthen bones and prevent osteoporosis. ... But this new study found that drinking large amounts of milk did not protect men or women from bone fractures, and was linked to an overall higher risk of death during the study period) - not effective for patients age
Gentamicin is clinically utilized as a mixture or three compounds because: A. stereoselective synthesis and purification is unable to be accomplished B. Chemical interconversion occurs during prolonged storage conditions C. reconstitution of lyophilized product leads to a decomposition prior to administration D. commercial extraction of fermentation broths provides a mixture of bioactive molecules
D. commercial extraction of fermentation broths provides a mixture of bioactive molecules
Which of the following statements regarding the adverse effects of antiplatelet doses of aspirin is true? A. The risk of gastric ulcer is high B. Hypersensitivity reactions are not a concern C. The most common adverse effect is intracranial hemorrhage D. The incidence and severity of reported adverse effects are low
D. the incidence and severity of reported adverse effects are low
Simvastatin side effects:
Diabetes Sexual dysfunctions
Which of the following activities represents an inappropriate practice for pharmacists in the prevention of medication errors? A. regularly visiting patient care areas B. Reviewing the original medication order C. Counseling patients and caregivers D. Dispensing medications in multi-dose vials to inpatient units
Dispensing medications in multi-dose vials to inpatient units
Rational drug use is promoted when:
Drug utilization procedures have been implemented
For a straight line plot of log k vs 1/temperature for a drug, the slope of the line is related to the drugs:
Energy of activation
What method is most appropriate when incorporating a small amount of potent substance with a large amount of excipient:
Geometric dissolution
Which of the following graphs is consistent with a nonlinear elimination process? (Cp = plasma concentration)
Graph B
Saquinavir (Invirase and Fortovase) is used in the treatment of:
HIV/AIDS
Conditions that could cause a lower than normal initial dose of Warfarin:
Heart failure or Heart conditions Deep Vein Thrombosis Pulmonary embolism
Acyclovir is primarily used for the treatment of:
Herpes simplex virus infections, chickenpox, and shingles
Nitric oxide or Nitrous oxide is also known as "laughing gas" and cause:
Hypotension, sweating, dizziness
what to do if medications exceeds available resources
Improve efficiency, reduce demand, increase financial resources, accept a decline in quality of care
Beta lactam chemical structure
In organic chemistry, a 'lactam' is a cyclic amide. The Greek letter nomenclature tells you how big the ring is (i.e., the carbon atom that connects back to the nitrogen making the ring). The beta (β) lactam antibiotics are composed of the pencillins, cephalosporins, carbapenems, and monobactams. These drugs mimic the D-Ala-D-Ala amino acid residues in the peptidoglycan layer of the bacterial cell wall. They are recognized by, and by virtue of their reactive beta lactam ring, covalently bind to and inhibit the transpeptidase enzymes responsible for cell wall biosynthesis.
Factors that contribute to the development of ascites:
Increased aldosterone secretion Increased portal venous pressure Increased sodium reabsorption Decreased albumin synthesis
Hypercalcemia associated with cancer is most often the result of:
Increased bone reabsorption secondary to hyperparathyroidism
Zanamivir (Relenza) is indicated for:
Influenza A
Cimetidine can increase the risk of bleeding in a patient receiving Warfarin therapy by what MOA?
Inhibition of warfarin metabolism
Examples of "high alert" medications according to the Institute for Safe Medication Practices
Insulin, EPINEPHrine, Epoprostenol, methotrexate, promethazine, vasopressin, opium, oxytocin, potassium chloride or phosphate,
Telling a patient "You should or should not feel....." is an example of
Judging
Elimination rate constant formula
Ke = Cl/Vd
_____ is an intestinal enzyme that can activate a prodrug containing a cholesterol ester
Lipase
Inflammation resulting from conversion of arachidonic acid to Leukotrienes
Lipoxygenase
Tautomers:
Look similar, one may have a double bond and the other a single bond
For what population is the PSA test indicated for?
Men over 50
Cost-effectiveness is a:
Method for assessing the gains in health relative to the costs of different health interventions
Cost-Benefit is a
Method in which all costs and consequences of a program are expressed in the same units, usually money
Enantiomers:
Mirror images
Levigation is the process of:
Moistening a powdered chemical before mixing it into a cream or ointment to lessen the graininess of the drug
Cholestyramine side effects
N/V/D Bloating and gas Rash
Examples of Secondary literature:
New England Journal of Medicine EMBASE Medline
Flushing, itching, and GI intolerance are in patients taking:
Niacin
The overarching element of any planning process is the:
Organizations vision
Which of the following plants does NOT contain solanaceous alkaloids? A. pacific yew B. nightshade C. Henbane D. Jimsonweed
Pacific yew
______ cause's nitration-mediated tissue damage during inflammation
Peroxynitrite
Telling a patient "Don't worry Im sure this medication will make you feel better" is an example of?
Placating
Example of a publication type that is LEAST likely to be subject to author bias:
Practice guidelines
Out-of-pocket payments are an example of which type of healthcare financing mechanism? A. Neutral B. Progressive C. Proportional D. Regressive
Progressive - payments are an increasing proportion of ability to pay. Regressive - payments are a decreasing proportion of ability to pay. Proportional - payments remain a constant proportion of ability to pay. D. Regressive
Trituration:
Reduction to powder by friction or grinding
A patient presents to the pharmacy complaining of constipation for several days. What recommendation will likely improve the patients symptoms?
Regular exercise Increase fiber intake Increase fluid intake
For Acyclovir to have efficacy, herpes simplex 1 virus must be:
Replicating
Calcium Deficiency
Ricketts
Prior to entering a pharmacy clean room a pharmacist must be wearing:
Shoe coverings
Half life formula
T1/2 = (0.693*V)/Cl or T1/2 = 0.693/ke
Phase 1 Trials
Tests for the safety of a drug or device in healthy volunteers
Central nervous system structure that is critical for reflexive motor control:
The Spine
Ascites definition:
The accumulation of fluid in the peritoneal cavity, causing abdominal swelling
Residual volume:
The amount of air remaining in the lung at the end of a maximal exhalation
Sulfonylureas chemical structure
The characteristic sulfone combined with a urea (sulfonylurea) is shown There are several 'generations' of these antidiabetic (hypoglycemic) agents used to treat type 2 diabetes. They act by antagonizing K+ channels on the pancreatic beta cells which ultimately results in an increased release of insulin. Like the thiazide diuretics, these agents were initially discovered by studying the sulfonamide antibacterial agents. Ex: Glyburide, Glimepiride, Glipizide
Tetracycline chemical structure
The complicated chemical structure of tetracycline (shown) with a rigid scaffold of 4-fused rings and multiple stereocenters is indicative of a natural product. The 4-ring scaffold is a reduced 'naphthacene' (aka tetracene) ring system. These broad-spectrum antibacterial agents possess an easily recognizable, 4-ring scaffold. Their antibacterial activity derives from inhibition of the bacterial ribosome, and a resulting blockade of protein production. They possess many adverse effects, but some recent approvals with expanded activity against resistant pathogens have renewed interest in this class.
Coumarins chemical structure
The coumarin ring system is shown in red in the structure of warfarin shown. Note the chiral center indicated by the asterisk. Marketed warfarin is racemic, but the R- and S-isomers possess significant differences in potency and metabolism. Coumarin-derivatives possess well-known anticoagulant activity by their inhibition of vitamin K biosynthesis (required by clotting factors). Newer, direct-acting agents such as factor Xa and thrombin inhibitors are beginning to replace coumarin use as they are safer agents, but the prototype agent, warfarin, is still highly prescribed and merits inclusion here.
ST segment elevation is a major ECG abnormality associated with:
The diagnosis of myocardial infarction
Inspiratory reserve volume is:
The maximal amount of air that can be inhaled
Vital capacity:
The maximum amount of air a person can expel from the lungs after a maximum inhalation
Alveolar deposition of particles from metered dose inhalers is most affected by:
The particle size of the drug molecules
Phenethylamines chemical structure
The phenethylamine scaffold is shown in red. Addition of a hydroxyl group at the 1 (beta)-carbon gives a phenylethanolamine, while addition of meta- and para-hydroxyl groups on the benzene ring give a catecholamine. In chemistry nomenclature 'phenyl' typically means possessing a benzene ring. These agents and the related catecholamines and phenylethanolamines are typically associated with stimulant activity by acting as agonists of the adrenergic receptors (alpha and beta) or dopamine receptors. Lipophilic analogs are also known to possess CNS activity (e.g. amphetamines).
Quinolones & Fluoroquinolones Chemical Structure
The quinolone core structure is shown. Ring-numbering begins at the nitrogen atom and skips ring juncture (not substitutable) atoms. The fluorine (of fluoroquinolones) is attached to the 6-position. The S.A.R. of these agents is well established. The quinolone and the related fluoroquinolone antibiotics possess a bicyclic, 4-quinolone core structure. A quinolone is quinoline with a ketone at the 2- or 4-position (the -one suffix commonly means possessing a ketone). These agents are used to treat a wide variety of Gram-positive and Gram-negative infections and act by inhibiting the bacterial topoisomerase enzymes that are responsible for maintaining DNA topology during replication and transcription.
What is the therapeutic index for a drug?
The ratio of the median toxic dose (TD50) to the median effective dose (ED50)
Steroids chemical structure
The steroid scaffold is one of the most easily recognized chemical scaffolds, possessing four rings connected in a specific pattern (three 6-membered rings, and one 5-membered ring). Differing substitution patterns of functional groups and degrees of ring unsaturation (double bonds) yield the different activities seen related to steroid receptor affinity. Agents that fall in this class include glucocorticosteroids, mineralocorticosteroids, androgens, estrogens, and progestins. Depending on the sub-class, the steroid agents possess a wide range of biological activities by acting as agonists (activators) of the intracellular steroid receptors. Steroid receptors are 'nuclear receptors' that act as transcription factors that bind to DNA and regulate gene expression.
Benzodiazepine chemical structure
The structure is easily recognizable if you understand the chemistry naming conventions: benzo (containing a benzene ring), -diaz- (two nitrogens), -epine (7-membered unsaturated ring). These agents are agonists of the GABA receptors, and because they are lipophilic, can cross the blood-brain barrier easily (i.e. they are psychoactive). They are commonly used for CNS indications such as sedative-hypnotics, anxiety, and for treatment of seizure disorders.
Aminoglycoside doses should be adjusted for obese patients because:
There is significant difference in the total amount of water per kg in obese patients
Thiazides chemical structure
These agents are derivatives of benzothiadiazine (red portion) and are weak acids. The scaffold possesses two sulfonamide groups, one at the 7-position, and a cyclic sulfonamide (aka a sultam). Thiazides (and thiazide-like agents) are a common class of diuretics used to treat hypertension and edematous conditions (heart failure, liver failure, kidney failure). They promote diuresis by blocking an ion transporter in the kidney, preventing reabsorption of sodium and chloride (and hence water).
Opioids chemical structure
These agents are natural products (or derived from natural products), hence the more complicated structure. The structure of morphine (shown as most commonly drawn) has five joined rings, including one bridging ring system (dark lines). The stereochemistry is very important for activity. Opioid drugs act as agonist of the opioid receptors and are typically used as central analgesics for pain management. They are lipophilic and can cross the blood-brain barrier. These agents, exemplified by the prototype morphine, possess multicyclic scaffolds of 5-rings (morphine), 4-rings (morphinan class), 3-rings (benzazocine class), or 2-rings (oripavine). The 5-ring class (morphine, codeine, hydromorphone, hydrocodone, etc.) is the most common and most recognizable.
Infections commonly seen in immunosuppressed patients
Thrush caused by Candida albicans
The volume of air moved in and out of the lungs with each normal breath is the:
Tidal volume
The cerebrum controls all:
Voluntary motor activity
Contraindications for Q10
Warfarin
Which drug is indicated for influenza Type A: A. Ribavirin B. Acyclovir C. Saquinavir D. Zanamivir
Zanamivir
A deficiency of which of the following may be associated with impaired decubitus ulcer healing A. Zinc B. Selenium C. Potassium D. Magnesium
Zinc
engineering model
a dehumanizing approach and usually ineffective
Parasympatholytic
a substance or activity that reduces the activity of the parasympathetic nervous system. (The parasympathetic nervous system is often colloquially described as the "Feed and Breed" or "Rest and Digest" portion of the autonomic nervous system.
citric acid
acidifying agent
value theory
addresses what kinds of consequences are good in given situation
Virtue theory
addresses what kinds of of character traits are morally praiseworthy
2 way crossover study
all subjects receive the same treatment
Ferrous sulfate deficiency
anemia
Strategic planning
based on thorough and objective assessment of organization's current situation
P>0.05
both study groups are the same
P<0.05
clinically important differance between study groups
drug bank
contains drug data with correlating comprehensive drug target
RTECS
database that contains toxicity information from open scientific literature
basic outcome list
death, disease, disability, discomfort, dissatisfaction, and dollars
fluoride deficiency
dental decay
Expected cash payments
detailed in cash disbursements budget
Expected cash collections
detailed in cash receipts budget
observational study
does not require a control group
Sympatholytic
drug is a medication that opposes the downstream effects of postganglionic nerve firing in effector organs innervated by the sympathetic nervous system (SNS. Drugs for ADHD
Office of Civil Rights
enforces HIPAA
penetrate BBB more easily
erythromycin, sulfadiazpaine
Cash budget details
expected cash receipts and and disbursements
Cash budget details
expected cash receipts and disbursements
Phase 2 trials
experimental vs control
Program planning
focuses on clearly defined medium term objectives within the organization's long term goal
Action theory
focuses on the action itself
phase 2 metabolism
glucoronidation, acetylation, sulfation
Iodine Deficiency
goiter or hypothyrpoidism
IRB
has the power to approve, require modification or disapprove research
IRB (Institutional review board)
has the power to approve, require modification or disapprove research
Analytical Model
identifies a caregiver as a scientist dealing only in facts and does not consider the human aspect of the patient
adulterated
if a medications strength differs from on the label
deficiency in zinc
impaired wound healing
tampering
making unauthorized changes to a medication
1 year
minimum age of vaccination for varicella
Phase 1 metabolism
oxidation
List of expenses
part of selling, general, and administrative, budget
Sympathomimetic
producing physiological effects characteristic of the sympathetic nervous system by promoting the stimulation of sympathetic nerves. Example is nasal decongestants
Mccarthy proposed tools
product, price, place, promotion
4 p's of marketing
product, pricing, promotion, and place
priestly model
provides caregiver with a godlike paternalist attitude that makes decisions for and not with the patient
TTS
provides information about known and explored therapeutic protein and nucleic acid targets such as targeted disease pathway information, and corresponding drugs directed at each target
collegial model
provides more cooperative model of pursuing healthcare between provider and patient involving trust and common goals
Waxman Hatch Amendment
provides patent extensions to innovator drugs and allows generics to go to market faster
class 1 recall
recall issued due to a serious adverse health effect and even death
class 2 recall
recall when a drug may cause temporary or adverse drug effects
class 3 recall
recalls not likely to cause adverse health effects
Kefauver Harris Amendment
requires drugs to be proven safe and effective
Nutrition labeling and education act
requires fda to regulate dietary supplements more as food than drugs
Prescription drug user fee act
requires manufacturers to pay fees for applications and supplements when FDA must review clinical studies
Durham Humphrey Amendment
requres labels to contain Caution: Federal law prohibits dispensing without a prescription
Asthma symptoms are most likely to be exacerbated by: A. flaxseed B. acidophilus C. royal jelly D. grape seed
royal jelly
Work Planning
short term planning, covers specific tasks, such as producing a national formulary manual for the first time
In molecular biology, the acronym SNP stands for?
single nucleotide polymorphism
pharmaceutical industry
single richest source of high quality data
purified water
solvent
project management
step by step procedure in project management
retrospective pre-post design
study that can be completed in a short amount of time
Parasympathomimetic
substance that stimulates the parasympathetic nervous system (PSNS). These chemicals are also called cholinergic drugs because acetylcholine (ACh) is the neurotransmitter used by the PSNS.
phase 3 trials
target population
Normative theory
third level of moral discourse in which norms of behavior and character are discussed
sodium chloride
tonicity agent used to render a solution similar to osmotic characteristics
DEA Form 224
used for a new application for a new pharmacy, hospital, clinic, practitioner or teaching institution
sodium hydroxide
used to adjust ph
cost effectiveness analysis
used to compare alternatives with therapeutic effects measured in physical units, where ratio of cost and effectiveness is also computed
Cost Utility analysis
used to estimate the cost of a disease in a defined population
Cost analysis
used to measure and compare costs of various options without the measurement of outcomes
Cost benefit analysis
used to measure benefit in monetary units and computes net gain
DEA Form 222
used to order schedule control 1 or 2 drugs
DEA form 106
used to report loss or theft of controlled substances
DEA form 41
used to return or destroy drugs per DEA approval
DEA form 104
used to surrender controlled substances voluntarily, usually to close a pharmacy
Glucosamine and Chondrotin contraindications
warfarin
