Pharm exam 1 - quiz answers

What initial daily dose of folic acid is typically effective in treating anemia secondary to folic acid deficiency?

1000 mcg

An analgesic is ordered for intramuscular injection. If the concentration of analgesic available is 8 mg/ml, how many milliliters should be administered for a dosage of 20 mg?

2.5

In a phase 1 clinical trial, "Caputomycin," a new drug, was administered intravenously to 25 volunteers, and blood samples were taken for several hours. Several inactive metabolites were found as well as declining concentrations of Caputomycin. A graph was prepared as shown below, with the Caputomycin plasma levels plotted on a logarithmic ordinate and time on a linear abscissa. It was concluded that the drug has first-order kinetics. From this graph, what is the best estimate of the elimination half-life of Caputomycin? (see other side.....sorry)

3H

. A pharmacokinetic study of a new antihypertensive drug is being conducted in healthy human volunteers. The half-life of the drug after administration by continuous intravenous infusion is 12 hours. Which of the following best approximates the time for the drug to reach steady state?

60hrs

JG is a 7-year-old female. You are asked to evaluate her renal function in preparation for starting intravenous antibiotics. Which method for assessment is most appropriate? A. Schwartz (original) equation B. "Bedside" Schwartz equation C. Cockcroft-Gault equation D. Modification of Diet in Renal Disease (MDRD) equation

B: "bedside" Schwartz equation

Which patient with iron deficiency anemia would need the parenteral form of iron replacement? A. 22-year-old woman with heavy menstrual periods B. 58-year-old man with end stage renal disease on hemodialysis C. 32-year-old woman in the first trimester of pregnancy D. 40-year-old man with a diabetic foot infection

B: 58-yr old man with end stage renal dz on hemodialysis

Which regimen provides the recommended daily dose of elemental iron for the treatment of iron related deficiency anemia? A. Iron fumarate 50 mg, 1 tablet by mouth twice daily B. Iron sulfate 325 mg, 1 tablet by mouth three times a day C. Iron polysaccharide 125 mg/5 mL, 5 mL by mouth daily D. Iron gluconate 240 mg, 1 tablet by mouth once daily

B: Iron sulfate 325mg, 1 tablet by mouth 3 times a day

When evaluating drug therapy for meningitis, which of the following factors is expected to have the LEAST influence on the penetration and concentration of an antibacterial agent in the cerebrospinal fluid? A. Protein binding of the drug B. Minimum inhibitory concentration of the drug C. Molecular weight of the drug D. Lipid solubility of the drug

B: MIC of the drug

Can warfarin be used safely during pregnancy in patients with venous thromboembolism? A. Yes, no risks to mother or fetus B. No, warfarin should not be used during pregnancy because of significant risks C. Yes, but adjusted-dose heparin must be given until the INR is >2.0 in patients with venous thromboembolism D. Yes, but only if the mother is not planning to breastfeed

B: No, warfarin should not be used during pregnancy b/c of significant risks

Which of the following antibiotics is effective against bacteria that cause an atypical pneumonia? A. Cefotaxime B. Azithromycin C. Vancomycin D. Amoxicillin E. Amoxicillin/clavulanate

B: azithromycin

Warfarin is therapeutically useful because it: A. Can be given intravenously B. Can be used to prevent the formation of venous thrombi C. Does not synergize with aspirin to increase the anticoagulant response D. Inhibits the same site of action as dabigatran E. Has a quick onset of action within 2 hours

B: can be used to prevent the formation of venous thrombi

Which of the following antibiotics has clinically useful activity against anaerobic bacteria? A. Ceftazidime B. Cefoxitin C. Cefazolin D. Cefotaxime E. Cefuroxime

B: cefoxitin

The main pharmacokinetic feature of aminoglycosides is that they are: A. Extensively metabolism in the liver B. Excreted mostly unchanged in the urine C. Lipid soluble D. Devoid of serious adverse effects E. Well absorbed orally

B: excreted mostly unchanged in the urine

A 47-year-old woman exhibits severe neutropenia after a course of chemotherapy for breast cancer, select the best treatment from the lettered choices. A. Dabigatran B. Filgrastim C. Cyanocobalamin D. Epoetin E. Hydroxyurea

B: filgastrim

Which of the following is NOT an adverse effect of heparins? A. Bruising at the injection site, hematomas B. Increased urination C. Petechiae D. Hematuria E. Thrombocytopenia

B: increased urination

Pegylation of a recombinant protein is employed for which purpose? A. Increasing oral bioavailability B. Increasing duration of action C. Increasing binding to receptors D. Reducing adverse effects

B: increasing duration of action

Warfarin has a boxed cautionary warning describing risk factors for: A. Headache B. Major or fatal hemorrhage C. Hypoglycemia D. Alopecia E. Fatigue

B: major or fatal hemorrhage

The continued suppression of bacterial growth after an antibiotic has been eliminated from the body. A. Synergistic effect B. Postantibiotic effect C. Bacteriostatic D. Time-dependent killing E. Concentration-dependent killing

B: postantibiotic effect

If this patient undergoes a percutaneous coronary angiography procedure and placement of a stent in a coronary blood vessel, he will need to be on dual antiplatelet therapy, eg, aspirin and clopidogrel for at least a year. Which of the following most accurately describes the mechanism of action of clopidogrel? A. Clopidogrel facilitates the action of antithrombin III B. The active metabolite of clopidogrel binds to and inhibits the platelet ADP receptors C. Clopidogrel irreversibly inhibits cyclooxygenase D. Clopidogrel directly binds to the platelet ADP receptors E. The active metabolite of clopidogrel binds to and inhibits the platelet glycoprotein IIb/IIIa receptors

B: the active metabolite of clopidogrel binds to and inhibits the platelet ADP receptors

. Virulence refers to: A. Bacteria that cause disease as well as colonizing flora B. The pathogenicity or disease severity produced by an organism C. Antimicrobial therapy targeting bacterial colonization may lead to the emergence of resistant bacteria D. The presence of bacteria that are causing disease E. Infections acquired in a medical facility

B: the pathogenicity or dz severity produced by an organism

Methylphenidate helps patients with attention deficit hyperactivity disorder (ADHD) maintain attention and perform better at school or work, with an ED50 of 10 mg. However, methylphenidate can also cause significant nausea at higher doses (TD50 = 30 mg). Which is correct regarding methylphenidate? A. Methylphenidate is more potent at causing nausea than treating ADHD B. The therapeutic index of methylphenidate is 3 C. Methylphenidate is more efficacious at causing nausea than treating ADHD D. The therapeutic index of methylphenidate is 0.3

B: the therapeutic index of methylphenidate is 3

A cephalosporin could be given to a patient that states they have experienced which of the following reaction(s) to Amoxicillin? A. Anaphylaxis B. Rash C. Gastrointestinal disturbance D. Laryngospasm E. All of the above

C: GI disturbance

Which is considered "fibrin selective" because it rapidly activates plasminogen that is bound to fibrin? A. Fondaparinux B. Argatroban C. Alteplase D. Apixaban E. Bivalirudin

C: alteplase

1. Which of the following drugs is active against methicillin-resistant Staphylococcus aureus (MRSA)? A. Cefazolin B. Cefepime C. Ceftaroline D. Ceftriaxone E. Cefoxitin

C: ceftaroline

_____________ refers to decreasing antimicrobial regimen spectrum of activity to provide coverage against antimicrobial-sensitive pathogens recovered from culture. A. Collateral damage B. Nonadherence C. De-escalation D. Pharmacodynamics E. None of the above

C: de-escalation

this drug is used orally for treatment of heavy menstrual bleeding A. Fondaparinux B. Eptifibatide C. Tranexamic acid D. Enoxaparin E. Dabigatran F. Prasugrel G. Rivaroxaban

C: tranexamic acid

An orally administered drug that directly inhibits thrombin A. Fondaparinux B. Eptifibatide C. Tranexamic acid D. Enoxaparin E. Dabigatran F. Prasugrel G. Rivaroxaban

E: Dabigatran

Which microbe is part of the normal microbiome of the skin? A. Pseudomonas aeruginosa B. Bacteroides fragilis C. Enterococcus sp D. Escherichia coli E. Staphylococcus epidermidis

E: S epi

A 68-year-old man with diabetic nephropathy and end-stage renal disease exhibits peripheral reticulocytopenia and anemia, select the best treatment from the choices. A. Cyanocobalamin B. Folic acid C. Ferrous fumarate D. Filgrastim E. Epoetin

E: epoetin

Which statement is FALSE regarding off-label use of medications? A. It includes use of a medication outside the licensed age range B. It includes dosing outside of those recommended by the manufacturer's package insert C. It is used in situations where there is no appropriate pediatric-approved alternative. D. It is based on limited data about the use in infants and children E. It is not permitted by law in the pediatric population due to lack of data

E: it is not permitted by law in the pediatric population due to lack of data

Drug metabolism in humans usually results in a product that is:

less lipid soluble than the original drug

Based on a dose-response curve, the ceiling effect refers to the:

maximal response to a given drug

The time from drug administration to the first observable drug effect is known as the:

onset of action

A 60 year-old patient with severe cancer pain is given 15 mg tablet of morphine orally. The plasma concentration is found to be only 30% of that found after intravenous administration of the same dose. Which of the following terms describes the process by which the amount of active drug in the body is reduced after administration but before entering the systemic circulation?

first-pass effect

Select the appropriate penicillin prophylaxis regimen for a 4-year-old child with Sickle Cell Disease (SCD). A. 250 mg twice daily until 5 years of age, then discontinue B. 250 mg twice daily and continue through adolescence C. 125 mg twice daily until 5 years of age, then discontinue D. 125 mg twice daily and continue through adolescence E. Penicillin is not indicated for prophylaxis in SCD

A: 250mg twice daily until 5yrs of age and then discontinue

Which of the following situations describes empiric antibiotic therapy? A. Beginning nitrofurantoin for a patient with signs and symptoms of a urinary tract infection with a positive urinalysis B. Beginning nitrofurantoin for a patient with signs and symptoms of a urinary tract infection with E. coli growing in the urine that are resistant to nitrofurantoin C. Beginning nitrofurantoin for a patient with a history of repeated urinary tract infections to prevent another infection D. Beginning nitrofurantoin for a patient with signs and symptoms of a urinary tract infection with E. coli growing in the urine that are susceptible to nitrofurantoin

A: Beginning nitrofurantoin for a patient with signs and symptoms of a urinary tract infection with a positive urinalysis

Which of the following antibiotics can be safely used in small children? (Select all that apply) A. Azithromycin B. Amoxicillin C. Doxycycline D. Tetracycline E. Ciprofloxacin

A: azithromycin and B: amoxicillin

Which iron supplement contains the highest percentage of elemental iron? A. Carbonyl iron B. Ferrous bisglycinate chelate C. Ferrous gluconate D. Iron citrate E. Ferrous sulfate

A: carbonyl iron

. _____________ refers to development of resistance occurring in a patient's non-targeted flora that can cause secondary infections. A. Collateral damage B. De-escalation C. Pharmacodynamics D. Source control E. None of the above

A: collateral damage

If 1 mg of lorazepam produces the same anxiolytic response as 10 mg of diazepam, which is correct? A: Lorazepam is more potent than is diazepam B: Lorazepam is a full agonist, and diazepam is a partial agonist C: Lorazepam is more efficacious than is diazepam D: Lorazepam is a better drug to take for anxiety than is diazepam

A: lorazepam is more potent than is diazepam

Which of the following drugs is highly active against Pseudomonas aeruginosa? A. Piperacillin B. Ampicillin C. Tigecycline D. Vancomycin E. Clarithromycin

A: piperacillin

Which is most appropriate for reversing the anticoagulant effects of heparin? A. Protamine sulfate B. Aminocaproic acid C. Tranexamic acid D. Andexanet alfa E. Vitamin K1

A: protamine sulfate

Which of the following statements regarding the FDA labeling requirements for Erythropoiesis-Stimulating Agent (ESA) therapy is true? A. The hemoglobin for initiation of therapy should be < 10 g/dL B. Limit ESA therapy to patients receiving chemotherapy or radiation therapy C. ESAs should be limited to patients with chronic kidney disease D. All of the above are true

A: the hemoglobin for initiation of therapy should be < 10g/dL

. Of the many pharmacokinetic changes that occur with aging, which is the most important change for pharmacotherapy in older adults? A: Reduced renal function B: Delayed gastric emptying C: Increased conjugation D: Phase II hepatic metabolism

A; reduced renal function

Under what circumstances would you recommend giving a patient IV vitamin K? INR goal range 2-3 in patient with atrial fibrillation. A. No bleeding, INR 3.5, patient is a low bleeding risk B. Nose bleed, INR 2.5, patient high bleeding risk C. No bleeding INR 7.5, low bleeding risk D. Bleeding, INR 10, high bleeding risk E. All of the above

D: INR 10, high bleeding risk

A 22 year old woman who experienced pain & swelling in her right leg presented at ED. An ultrasound study showed thrombosis in popliteal vein. The patient, who was in her 2nd trimester of pregnancy, was treated for 6 days with unfractionated heparin. The pain resolved during course of therapy, and the patient was discharged on day seven. Which of the following drugs would be most appropriate out-patient follow-up therapy for this patient who lives 75 miles from the nearest hospital? A. Rivaroxaban (Xarelto) B. Unfractionated heparin C. Warfarin (Coumadin) D. Low-molecular-weight heparin (LMWH) E. Aspirin

D: LMWH

A 56-year-old man on a ventilator in the ICU is diagnosed with possible pneumonia. A Gram stain of an endotracheal aspirate shows many WBCs, few epithelial cells, and many Gram-positive cocci in clusters. Which of the following organisms is most likely to be the one seen on the Gram stain? A. Moraxella catarrhalis B. Listeria monocytogenes C. Escherichia coli D. Staphylococcus aureus E. Streptococcus pneumoniae

D: S aureus

TG, a 1-week-old, 2.5-kg girl born at 30-weeks' gestation, is to be started on intravenous gentamicin for suspected neonatal sepsis. Which of the following is true regarding PG's apparent volume of distribution (Vd) in milliliters per kilogram for gentamicin compared with adults and children with normal renal function? A: Vd will be greater than those used in adults but less than in children B: Vd will be less than those used in adults and children C: Vd will be less than those used in adults but similar to children D: Vd will be greater than those used in adults and children

D: Vd will be greater than those used in adults and children

Which of the following antibiotic regimens would be the most appropriate for a patient with a severe infection caused by Pseudomonas aeruginosa? A. Ampicillin + Tobramycin B. Metronidazole + Amikacin C. Piperacillin + Rifampin D. Ceftazidime + Tobramycin E. Ceftriaxone + Gentamicin

D: ceftazidime + tobramycin

Which of the following antibiotics would be expected to have the least activity against anaerobic bacteria? A. Amoxicillin/clavulanate B. Clindamycin C. Imipenem/Cilastatin D. Ceftriaxone E. Metronidazole

D: ceftriaxone

. Prior to clinical trials in patients with heart failure, an animal study was carried out to compare two new positive inotropic drugs (A and B) to a current standard agent (C). The results of cardiac output measurements are shown in the graph below. Which of the following statements is correct? (see next slide) A. Drug A is most effective B. Drug B is least potent C. Drug C is most potent D. Drug B is more potent than drug C and more effective than drug A E. Drug A is more potent than drug B and more effective than drug C

D: drug B is more potent than drug C and more effective than drug A

. Which drug would be beneficial to reduce the frequency of painful crises in a patient with sickle cell disease? A. Deferiprone B. Sargramostim C. Filgrastim D. Hydroxyurea E. Epoetin alfa

D: hydroxyurea

Doxycycline is useful in treating infections caused by all of the following bacteria EXCEPT: A. Brucella abortus B. Chlamydia trachomatis C. Rickettsia rickettsii D. Pseudomonas aeruginosa E. Leptospira interrogans

D: psuedomonas aeruginosa

Which of the following drugs carries the highest risk of nephrotoxicity? A. Ceftriaxone B. Erythromycin C. Ciprofloxacin D. Tobramycin E. Trimethoprim/sulfamethoxazole

D: tobcramycin

Which of the following antibiotics is NOT a β-lactam? A. Meropenem B. Cefoxitin C. Ampicillin D. Vancomycin E. Ceftriaxone

D: vancomycin

This drug produces irreversible blockade of platelet adenosine diphosphate P2Y12 receptors A. Fondaparinux B. Eptifibatide C. Tranexamic acid D. Enoxaparin E. Dabigatran F. Prasugrel G. Rivaroxaban

F prasugrel

This orally administered inhibitor of active factor X is used to prevent and treat DVTs A. Fondaparinux B. Eptifibatide C. Tranexamic acid D. Enoxaparin E. Dabigatran F. Prasugrel G. Rivaroxaban

G: Rivaroxaban

When epinephrine is administered to stimulate heart rate, the medication is acting as a(n):

agonist

A drug that has the potential for abuse and is regulated by the Drug Enforcement Agency is classified as a:

controlled substance

When the dosage of a particular drug must be increased in order to attain the effect that the drug gave previously, this is known as:

drug tolerance

This drug is a reversible fibrinogen antagonist at GP-IIb/IIIa receptors A. Fondaparinux B. Eptifibatide C. Tranexamic acid D. Enoxaparin E. Dabigatran F. Prasugrel G. Rivaroxaban

eptifibatide

. The measurement of serum creatinine can be used to evaluate:

renal function

When the combined effect of two drugs is greater than the sum of their individual effects, this is known as:

synergism

The pharmacokinetic process or property that distinguishes the elimination of ethanol and high doses of phenytoin and aspirin from the elimination of most other drugs is called:

zero-order elimination