Senior Comps v.1

Patients treated with prasugrel were 23% less likely to experience a nonfatal MI than patients treated with clopidogrel.

13,608 moderate-to-high risk patients with an acute coronary syndrome managed with percutaneous coronary intervention were randomly assigned to receive prasugrel (60 mg loading dose and 10 mg daily maintenance dose) or clopidogrel (300 mg loading dose and 75 mg daily maintenance dose) for 6 to 15 months. The primary efficacy endpoint was death from cardiovascular causes, nonfatal myocardial infarction or nonfatal stroke. The key safety endpoint was major bleeding. Based on the results of the study, which statement accurately describes the relative risk reduction in nonfatal MI? A. Patients treated with prasugrel were 77% less likely to experience a nonfatal MI than patients treated with clopidogrel. B. Patients treated with clopidogrel were 77% as likely to experience a nonfatal MI as patients treated with prasugrel. C. Patients treated with prasugrel were 23% as likely to experience a nonfatal MI as patients treated with clopidogrel. D. Patients treated with prasugrel were 23% less likely to experience a nonfatal MI than patients treated with clopidogrel. E. Patients treated with clopidogrel were 77% less likely to experience a nonfatal MI as patients treated with prasugrel.

2.2 *ARR = RC - RT RC = 822/6795 RT = 676/6831 ARR = 822/6795 - 676/6831 -> 2.2

13,608 moderate-to-high risk patients with an acute coronary syndrome managed with percutaneous coronary intervention were randomly assigned to receive prasugrel (60 mg loading dose and 10 mg daily maintenance dose) or clopidogrel (300 mg loading dose and 75 mg daily maintenance dose) for 6 to 15 months. The primary efficacy endpoint was death from cardiovascular causes, nonfatal myocardial infarction or nonfatal stroke. The key safety endpoint was major bleeding. Calculate the absolute risk reduction for the primary efficacy endpoint. (Express the answer as a percentage; no units or commas; round the final answer to the nearest TENTH.)

46

13,608 moderate-to-high risk patients with an acute coronary syndrome managed with percutaneous coronary intervention were randomly assigned to receive prasugrel (60 mg loading dose and 10 mg daily maintenance dose) or clopidogrel (300 mg loading dose and 75 mg daily maintenance dose) for 6 to 15 months. The primary efficacy endpoint was death from cardiovascular causes, nonfatal myocardial infarction or nonfatal stroke. The key safety endpoint was major bleeding. How many patients need to be treated with prasugrel to prevent the primary endpoint from occurring in one patient? (Answer must be numeric; no units or commas.)

1.3

13,608 moderate-to-high risk patients with an acute coronary syndrome managed with percutaneous coronary intervention were randomly assigned to receive prasugrel (60 mg loading dose and 10 mg daily maintenance dose) or clopidogrel (300 mg loading dose and 75 mg daily maintenance dose) for 6 to 15 months. The primary efficacy endpoint was death from cardiovascular causes, nonfatal myocardial infarction or nonfatal stroke. The key safety endpoint was major bleeding. If the safety analysis in this trial showed that major bleeding occurred in 146 patients treated with prasugrel and 111 patients treated with clopidogrel, what is the calculated hazard ratio for major bleeding with prasugrel? (Express the answer as a decimal; no units or commas; round the final answer to the nearest TENTH.)

- Primary efficacy endpoint - Nonfatal myocardial infarction

13,608 moderate-to-high risk patients with an acute coronary syndrome managed with percutaneous coronary intervention were randomly assigned to receive prasugrel (60 mg loading dose and 10 mg daily maintenance dose) or clopidogrel (300 mg loading dose and 75 mg daily maintenance dose) for 6 to 15 months. The primary efficacy endpoint was death from cardiovascular causes, nonfatal myocardial infarction or nonfatal stroke. The key safety endpoint was major bleeding. Which of the following outcomes demonstrated a statistically significant difference in this trial? (Select ALL that apply.) A. Primary efficacy endpoint B. Death from any cause C. Nonfatal myocardial infarction D. Nonfatal stroke E. Death from cardiovascular causes

The study was designed to detect a difference in the incidence of a composite outcome

13,608 moderate-to-high risk patients with an acute coronary syndrome managed with percutaneous coronary intervention were randomly assigned to receive prasugrel (60 mg loading dose and 10 mg daily maintenance dose) or clopidogrel (300 mg loading dose and 75 mg daily maintenance dose) for 6 to 15 months. The primary efficacy endpoint was death from cardiovascular causes, nonfatal myocardial infarction or nonfatal stroke. The key safety endpoint was major bleeding. Which of the following statements about the study design is true? A. A patient enrolled in the study was more likely to receive prasugrel than clopidogrel B. The study was a crossover, randomized, placebo-controlled design C. The study was designed to detect a difference in the incidence of a composite outcome D. The primary endpoint was death from cardiovascular causes E. Patients were randomly assigned to receive prasugrel for 15 months or clopidogrel for 6 months

Chi-square test

13,608 moderate-to-high risk patients with an acute coronary syndrome managed with percutaneous coronary intervention were randomly assigned to receive prasugrel (60 mg loading dose and 10 mg daily maintenance dose) or clopidogrel (300 mg loading dose and 75 mg daily maintenance dose) for 6 to 15 months. The primary efficacy endpoint was death from cardiovascular causes, nonfatal myocardial infarction or nonfatal stroke. The key safety endpoint was major bleeding. Which type of statistical test is appropriate to analyze the primary efficacy endpoint in this study? A. Paired student t-test B. ANOVA C. Kruskal-Wallis test D. Chi-square test E. Wilcoxon Signed-Rank test

21.4 *180lbs -> 81.8 kg

A 180 pound man receives Flolan 56 mL/day. His cassette is made with three Flolan 1.5 mg vials diluted to a total volume of 100 mL. What is his dose in ng/kg/min? (Answer must be numeric; no units or commas; include a leading zero if the answer is less than 1; round the final answer to the nearest TENTH.)

- A consent form warning about birth defects must be signed before starting treatment. - The patient must have two negative pregnancy tests before starting treatment. - Two forms of birth control must be used during treatment

A 24-year-old female is starting isotretinoin treatment. Which of the following is true? (Select ALL that apply.) A. A consent form warning about birth defects must be signed before starting treatment. B. A 3-month supply can be dispensed at one time. C. The patient must have two negative pregnancy tests before starting treatment. D. Two forms of birth control must be used during treatment. E. The patient must wait 6 months after stopping treatment before getting pregnant

Risperdal (risperidone)

A 65-year-old male patient approaches the pharmacist to ask about a "sensitive issue." He is concerned that he has been unable to sustain an erection during intercourse with his wife. This is a new problem. Which of the following medications, if included on the patient's medication profile, might alert the pharmacist to possible drug-induced sexual dysfunction? A. Nexium B. Risperdal C. Amiodarone D. Valium E. Prednisone

36 mL/min, 1 gram IV Q24H

A 78-year-old female patient (5'4", 120 lbs) is being started on cefepime. Her labs and the dosing recommendations for cefepime are below. What is the patient's estimated CrCl and recommended cefepime dose? A. 68 mL/min, 1 gram IV Q12H B. 36 mL/min, 1 gram IV Q24H C. 55 mL/min, 1 gram IV Q24H D. 24 mL/min, 500 mg IV Q24H E. 18 mL/min, 500 mg IV Q24H *(((140-age) x weight in kg)/(72 x SCr)) x 0.85 if female

ISO 7

A hospital has the following layout for its sterile compounding area. One buffer room is used for preparing sterile non-hazardous drugs. A second cleanroom is used for preparing sterile hazardous drugs. These two rooms share an anteroom. What is the minimum ISO air requirement for the anteroom? A. ISO 5 B. ISO 6 C. ISO 7 D. ISO 8 E. ISO 9

Mucinex D

A patient approaches the pharmacist for advice on over-the-counter cough and cold products. Her physician recommended that she purchase a decongestant for her symptoms. Which product contains a decongestant? A. Flonase Allergy Relief B. Mucinex D C. Claritin Reditabs D. G Tussin AC E. Robitussin DM

The applesauce must be eaten immediately; do not chew the beads.

A patient has been instructed by her provider to open her Kadian capsule and sprinkle the beads on applesauce. The pharmacist should include this essential information in the counseling: A. The applesauce must be eaten immediately; do not chew the beads. B. The applesauce can be stored for up to 30 minutes. C. The applesauce can be stored for up to 60 minutes. D. The beads can be crushed, if the patient continues to have difficulty swallowing. E. The beads cannot be crushed, but can be chewed slowly.

25.6

A patient has received D5NS + 40 mEq KCl running at 80 mL/hr for 8 hours. If the hospital stocks 1 liter bags of D5NS + 40 mEq of KCl, how many mmols of KCl has the patient received? (MW K = 39; MW Cl = 35.5). (Answer must be numeric; no units or commas; include a leading zero when the answer is less than 1; round the final answer to the nearest TENTH.)

6 *18 x 90 = 1620 units/hour 25,000/250 x x/100 -> 10,000 units left 1620/1hour x 10,000units/x -> 6.17 -> 6 hours

A patient in the ICU (6'1", 198 pounds) is receiving a heparin drip. The current order is for heparin 25,000 units in 250 mL D5W to infuse at 18 units/kg/hour. There are currently 100 milliliters remaining in the bag. Assuming no rate changes, how many hours does the pharmacist have before the bag will be empty and the nurse will need to hang a new bag? (Answer must be numeric; no units or commas; round the final answer to the nearest WHOLE number.)

Alpha-1 agonist - increased blood pressure

A patient in the ICU is receiving a phenylephrine infusion. What is the mechanism of action of phenylephrine and the clinical effect? A. Dopamine-1 agonist - increased renal perfusion B.Phosphodiesterase-3 inhibitor - decreased blood pressure C.Beta-2 agonist - increased cardiac contractility D.Alpha-1 agonist - increased blood pressure E.Beta-1 agonist - increased heart rate

13.4

A patient in the surgical ICU is receiving 1,675 mL of D20W, 725 mL of FreAmine 8.5%, 224 mL of 20% Intralipid and 50 mL of electrolytes/minerals. What percentage of the total daily calories is represented by the protein component? (Answer must be numeric; no units or commas; include a leading zero if the answer is less than 1; round the final answer to the nearest TENTH.)

62.5 *15 drops/mL x 1000mL/4 hr x 1 hr/60 min = 62.5

A patient will receive 2 grams of magnesium sulfate in 1 liter of 0.9% NaCl over 4 hours. The hospital has IV tubing sets that deliver 15 drops/mL. How many drops/min will the patient receive? (Answer must be numeric; no units or commas; include a leading zero if the answer is less than 1; round the final answer to the nearest TENTH.)

84 *21 lbs -> 9.54 kg 1.4g/kg/day x 9.54 kg = 13.36 g/day 13.36 g/day x 1 dL/16g x 100 mL/1 dL = 83.5 -> 84

A pediatric patient is starting enteral nutrition with Nutren 2.0 premixed formula. The patient weighs 21 pounds and requires 1.4 g/kg/day of protein. If Nutren 2.0 provides 16 g/dL of protein, how many milliliters of Nutren 2.0 are required per day to meet the patient's protein requirement? (Answer must be numeric; no units or commas; round the final answer to the nearest WHOLE number.)

Twice weekly

A pharmacist is counseling a patient with a new Oxytrol patch prescription. How often should the patch be changed? A. Once daily B. Once weekly C. Once monthly D. Twice daily E. Twice weekly

7.2 *Q1 x C1 = Q2 x C2 12g x 2% = Q2 x 1.25% Q2 = 19.2 19.2/12 = 7.2

A pharmacist is preparing a 1.25% hydrocortisone ointment from commercially available 2% ointment and petrolatum (as a diluent). How many grams of petrolatum should be added to 12 grams of the 2% ointment to prepare the 1.25% strength? (Answer must be numeric; no units or commas; include a leading zero if the answer is less than 1; round the final answer to the nearest TENTH.)

Gelatin * Gelatin is made with pork

A vegetarian patient brings a prescription to the compounding pharmacy. Which ingredient, if included on the master formula, would need to be modified? a. Sorbitol b. Lactose c. Gelatin d. Sodium lauryl sulfate e. Ascorbic acid

2 *15 lbs -> 6.82 kg 10mg/kg x 6.82 kg = 68mg 160 mg/5 mL = 68mg/x -> x = 2

A worried parent walks into a community pharmacy and asks to speak with the pharmacist. Her 6-month-old infant (15 lbs) has a fever and she was advised by her pediatrician to purchase Tylenol Infants' suspension to reduce the fever. Tylenol Infants' comes in a 160 mg/5 mL suspension. The pediatrician recommended 10 mg/kg/dose. How many milliliters should be given for each dose? (Answer must be numeric; no units or commas; round the final answer to the nearest WHOLE number.)

Dolasetron

A. Neulasta B. Docetaxel C. Dolasetron D. Lorazepam E. Xeloda

Immediately before the 5th dose on Thursday at 0700

An investigational medication has the following pharmacokinetic parameters: Vd = 26 L F = 0.75 Ke = 0.0753 hr-1 Recommended dose = 250 mg IV Q12H Recommended monitoring = trough level (immediately before dose) at steady state A test subject started receiving the investigational medication dosed at 250 mg IV Q12H on Tuesday at 0700 (dose #1). Assuming all doses are given on schedule and steady state is achieved after 5 halflives, when can the earliest trough level be obtained? A. Immediately before the 3rd dose on Wednesday at 0700 B. Immediately before the 4th dose on Wednesday at 1900 C. Immediately before the 5th dose on Thursday at 0700 D. Immediately before the 6th dose on Thursday at 1900 E. Immediately before the 7th dose on Friday at 0700

28 days (4 weeks)

BH calls the pharmacy for clarification about how to store her rapid-acting insulin vials. How long are her "in use" vials stable when stored at room temperature? a. 42 days b. 10 days c. 3 days d. Until the expiration date on the vial e. 28 days

Drug allergy *Bactrim + sulfa allergy

Based on MI's medication regiment, what drug therapy problem requires immediate attention? a. Duplication of therapy b. Drug allergy c. Untreated medical condition d. Adverse drug reaction e. Drug interaction

429 *ANC (Absolute Neutrophile Count) = WBC x (%segs + %bands) x 10 2.2 x (13.5% + 6) x 10 = 429

Calculate PT's absolute neutrophile count. (Answer must be numeric; no units or commas; round the final answer to the nearest WHOLE number)

Continue the current treatment for 1 more week then switch to a 14 mg patch daily

During the clinic visit, the pharmacist assesses MK's attempt to quit smoking. MK reports that he has stopped smoking and he has been using his current treatment for approximately 5 weeks. Which of the following should the pharmacist recommend? a. Continue the current treatment for 1 more week then switch to a 14 mg patch daily b. Continue the current treatment for 12 weeks then stop c. Switch to a 14 mg patch today and continue for 6 more weeks d. Continue current treatment for 7 more weeks then switch to a 7 mg patch daily e. Discontinue the current treatment as the quit attempt was successful

Zithromax

ER has a true allergy to penicillin. She required intubation after receiving it as a child. She could have a similar reaction to all of the following medications EXCEPT: A. Augmentin B.Zithromax C.Zosyn D.Invanz E.Keflex

Hepatitis C *Epclusa is used to treat this

GJ is a 48-year-old female who presents to the Urgent Care Clinic complaining of a milk-like discharge from her nipples and several missed periods. She thinks she might be pregnant. Assuming GJ's medications are all being used for valid, FDA-approved indications, what medical problem is missing from her past medical history? A. Diabetes B. Osteoporosis C.HIV D. Inflammatory Bowel Disease E. Hepatitis C

Invega (paliperidone)

GJ is a 48-year-old female who presents to the Urgent Care Clinic complaining of a milk-like discharge from her nipples and several missed periods. She thinks she might be pregnant. What is the most likely cause of the ECG findings? - prolonged QT interval a. Pitavastatin b. Norvasc c. Lamotrigine d. Catapres e. Invega

- UoToDate - Diagnostic and Statistical Manual of Mental Disorders

GJ is a 48-year-old female who presents to the Urgent Care Clinic complaining of a milk-like discharge from her nipples and several missed periods. She thinks she might be pregnant. What reference could the pharmacist consult to learn more about the criteria used to diagnose GJ's psychiatric condition? (Select ALL that apply) a. UpToDate b. Harriet Lane Handbook c. Diagnostic and Statistical Manual of Mental Disorders d. Merck Index e. CDC Pink Book

Invega (paliperidone)

GJ is a 48-year-old female who presents to the Urgent Care Clinic complaining of a milk-like discharge from her nipples and several missed periods. She thinks she might be pregnant. Which medication is most likely responsible for the symptoms that brought GJ to the clinic today? a. Clopidogrel b. Bumetanide c. Invega d. Catapres-TTS-1 e. Hydroxyzine

Valsartan (Diovan)

GJ is a 48-year-old female who presents to the Urgent Care Clinic complaining of a milk-like discharge from her nipples and several missed periods. She thinks she might be pregnant. Which medication should be added to GJ's regimen? a. Valsartan b. Digoxin c. Diltiazem d. Furosemide e. Bisoprolol

5 *NNT = 1/ARR ARR = RC - RT RT = 31/140 RC = 75/159 NNT = 4.2 -> 5

Hepatic encephalopathy is a chronic debilitating complication of hepatic cirrhosis. The efficacy of rifaximin, a minimally absorbed antibiotic, is well documented in the treatment of acute hepatic encephalopathy. Efficacy for prevention of the disease has not been established. What is the number needed to treat to prevent one episode of overt hepatic encephalopathy? (Answer must be numeric; no units or commas.)

40 *RRR = 1 - RR RR = RT/RC RT = 19/140 -> .1357 RC = 36/159 -> .2264 RR = .1357/.2264 -> 60% RRR = 1 - 60% -> 40

Hepatic encephalopathy is a chronic debilitating complication of hepatic cirrhosis. The efficacy of rifaximin, a minimally absorbed antibiotic, is well documented in the treatment of acute hepatic encephalopathy. Efficacy for prevention of the disease has not been established. What is the relative risk reduction for hospitalization involving hepatic encephalopathy? (Express the answer as a percentage; no units or commas; round the final answer to the nearest WHOLE number.)

Patients receiving rifaximin 550 mg twice daily experienced fewer hospitalizations involving hepatic encephalopathy than patients receiving placebo.

Hepatic encephalopathy is a chronic debilitating complication of hepatic cirrhosis. The efficacy of rifaximin, a minimally absorbed antibiotic, is well documented in the treatment of acute hepatic encephalopathy. Efficacy for prevention of the disease has not been established. Which of the following statements is correct regarding the endpoint of hospitalization involving hepatic encephalopathy? A. Rifaximin 550 mg twice daily resulted in a statistically significant reduction in hospitalizations involving hepatic encephalopathy versus placebo. B.Hospitalization involving hepatic encephalopathy was the primary endpoint of the trial. C.Patients receiving rifaximin 550 mg twice daily experienced more hospitalizations involving hepatic encephalopathy than patients receiving placebo. D.Patients receiving rifaximin 550 mg twice daily experienced fewer hospitalizations involving hepatic encephalopathy than patients receiving placebo. E.Thirty six patients in the rifaximin group experienced hospitalization involving hepatic encephalopathy in this trial

2400 *4g/100g = x/60 -> 2.4 g -> 2400 mg

How many milligrams of hydroquinone are needed to make 60 grams of a 4% hydroquinone cream? (Answer must be numeric; no units or commas; round the final answer to the nearest WHOLE number)

38 mL

How much is in the graduated cylinder? a. 39.5 mL b. 38 mL c. 39 mL d. 38.5 mL e. 40 mL

At least weekly

How often should the plastic actuator for Atrovent HFA be cleaned? A. At least weekly B. Every day C. After every use D. If the inhaler hasn't been used for > 3 days E. Every two weeks

The distal convoluted tubule *HCTZ is the diuretic

In which part of the nephron does the patient's diuretic exert its mechanism of action? a. The distal convoluted tubule b. The ascending limb of the loop of Henle c. The collecting duct d. The glomerulus e. The proximal tubule

Take two loperamide tablets after the first loose stool, then take one tablet after each subsequent loose stool. Do not exceed 4 tablets daily

JA is a 37-year-old female who is self-treating diarrhea due to mild ulcerative colitis with OTC Imodium A-D. JA asks her pharmacist how she should take the tablets that she has purchased. Which of the following is correct? A. Take one loperamide tablet daily until diarrhea resolves. B. Take one loperamide tablet after the first loose stool, then take one tablet after each subsequent loose stool. Do not exceed 16 tablets daily. C. Take one loperamide tablet after the first loose stool, then take two tablets after each subsequent loose stool. Do not exceed 8 tablets daily. D. Take two loperamide tablets after the first loose stool, then take one tablet after each subsequent loose stool. Do not exceed 16 tablets daily. E. Take two loperamide tablets after the first loose stool, then take one tablet after each subsequent loose stool. Do not exceed 4 tablets daily

Hold warfarin, monitor INR and resume warfarin at a lower dose when the INR is in therapeutic range

KP is a 58-year-old female who is usually well-controlled on a warfarin regimen of 5 mg daily. She has been sick for the past week but feels better today. She ate little during her illness. She presents to the anticoagulation clinic to have her INR checked. Her INR is elevated today at 5.8. There is no noticeable bleeding, and she is at low risk of bleeding. Choose the preferred course of action: A. Hold warfarin, monitor INR and resume warfarin 5 mg daily when the INR is in therapeutic range. B.Hold warfarin, monitor INR and resume warfarin at a lower dose when the INR is in therapeutic range. C.Hold warfarin and administer phytonadione 2 mg by SC injection. D.Hold warfarin and administer vitamin K 5 mg orally. E.Hold warfarin and administer phytonadione 2 mg by IM injection.

Administer phytonadione 2.5 mg orally

KP is a 58-year-old female who is usually well-controlled on a warfarin regimen of 6 mg daily. She has been sick for the past week but feels better today. She ate little during her illness. She presents to the anticoagulation clinic to have her INR checked. Her INR is elevated today at 11.4. There is no noticeable bleeding, and she is at low risk of bleeding. In addition to holding warfarin, choose the preferred course of action: a. Decrease warfarin dose and recheck INR in 3 days b. Administer protamine 5 mg by slow IV injection c. Administer phytonadione 5 mg by SC injection d. Administer vitamin K a10 mg IV + Kcentra e. Administer phytonadione 2.5 mg orally

2.2

LK is a female patient being treated for pneumonia with sepsis in the ICU. How many mEq/kg IBW/day of sodium chloride did LK receive from her maintenance fluid on February 7th (MW NaCl = 58.5)? (Answer must be numeric; no units or commas; include a leading zero if the answer is less than 1; round the final answer to the nearest TENTH.)

5.9 *22mL/hr x 1 hr/60 min x 4 mg/250 mL x 1000 mcg/1 mg

LK is a female patient being treated for pneumonia with sepsis in the ICU. How many mcg/min of norepinephrine was LK receiving on February 6th? (Answer must be numeric; no units or commas; include a leading zero if the answer is less than 1; round the final answer to the nearest ONE DECIMAL PLACE.)

3476

LK is a female patient being treated for pneumonia with sepsis in the ICU. How many millimeters of fluid did LK receive from all intravenous sources on February 6th? (Answer must be numeric; no units or commas; include a leading zero if the answer is less than 1; round the final answer to the nearest TENTH.)

Trissel's (via Clinical Pharmacology) *This resource is for IV compatibility

LK is a female patient being treated for pneumonia with sepsis in the ICU. LK's nurse calls for the pharmacy to ask if Zosyn can be infused via a Y-site into the line being used for the norepinephrine infusion. What reference could the pharmacist consult for the answer? a. CDC Pink Book b. Harriet Lane Handbook c. Trissel's (via Clinical Pharmacology) d. Hansten and Horn's e. Remington: The Science and Practice of Pharmacy

Respiratory acidosis

LK is a female patient being treated for pneumonia with sepsis in the ICU. What acid-base disorder was this patient experiencing on February 6th? a. No acid-base abnormality b. Metabolic acidosis c. Metabolic alkalosis d. Respiratory acidosis e. Respiratory alkalosis

The tobramycin trough level is too high

LK is a female patient being treated for pneumonia with sepsis in the ICU. Which of the following assessments can the pharmacist make on February 6th? a. The tobramycin peak was drawn at the wrong time. b. The tobramycin trough level is too high. c. The tobramycin levels need to be plotted on the Hartford nomogram. d. The vancomycin level is too low for the condition being treated. e. A vancomycin peak is needed to assess treatment.

Benicar (Olmesartan)

LY develops a condition of severe, chronic diarrhea. Which medication is the most likely causative agent? a. Coreg CR b. Keflex c. Celexa d. Digoxin e. Benicar

Apixaban (an anticoagulant)

MI should be counseled to monitor for signs and symptoms of bleeding with which medication? a. Triumeq b. Diovan c. Apixaban d. Furosemide e. Nexium

Bactrim DS 1 tablet PO daily

MK is a 31-year-old male who presents to the HIV clinic today for a routine appointment. He is doing well and has no complaints at this time. Which medication should be prescribed for MK? A. Zithromax 1,200 mg PO weekly B. Bactrim DS 1 tablet PO daily C. Cipro 500 mg PO Q12H D. Fluconazole 400 mg PO daily E. Valganciclovir 900 mg PO daily

This is the correct dose of Eliquis for this patient.

MR is a 65-year-old female (5'7", 150 pounds, SCr is 1.1 mg/dL) who arrives at the clinic pharmacy with a prescription for Eliquis 5 mg BID. She explains to the pharmacist that she was just diagnosed with a heart problem called "atrial fibrillation." Which of the following is true? A. This is the correct dose of Eliquis for this patient B. The antidote for Eliquis is phytonadione C. Eliquis is not approved for treating atrial fibrillation D. Missed doses of Eliquis should be doubled up if needed E. The generic name of Eliquis is rivaroxaban

Diarrhea and mucositis

PT should be counseled about which common side effects from this chemotherapy regimen? a. Pulmonary toxicity and peripheral neuropathy b. Renal toxicity and rash c. Peripheral neuropathy and fluid retention d. Hemorrhagic cystitis and diarrhea e. Diarrhea and mucositis

Pravastatin 80 mg daily

PT's healthcare provider would like to switch the Zocor (Simvastatin) to an equivalent dose of an alternate statin in order to avoid a drug interaction with his hypertension medications. Which of the following can be recommended? a. Fluvastatin 80 mg daily b. Pitavastatin 2 mg daily c. Rosuvastatin 20 mg daily d. Atorvastatin 40 mg daily e. Pravastatin 80 mg daily

Hold the inhaler upright and press both side buttons until a click in heard.

Proper technique for use of SZ's COPD medication includes all of the following EXCEPT: a. Hold breath for as long as possible, up to 10 seconds. b. Turn the clear base in the direction of the arrows until a click is heard. c. Open the cap, then turn the head away from the inhaler and breathe out fully. d. Hold the inhaler upright and press both side buttons until a click in heard. e. Press the dose release button while taking a slow, deep breathe in through the mouth.

Gabapentin

RE has started to use Ortho Tri-Cyclen. All of the following medications would be expected to decrease the efficacy of Ortho Tri-Cyclen EXCEPT: a. Gabapentin b. Dilantin c. Topamax d. St. John Wort e. Rifampin

Depression

SJ is a 41-year-old African American female who is at a 1-month follow-up visit with her PCP after repeat lab testing. Diagnostic Tests: 2/4: HAM-D score = 18 The diagnostic test reported on SJ's profile is used to evaluate which of the following conditions? A. Depression B. Seizure disorder C. Peripheral neuropathy D. Readiness to quit smoking E. Cardiovascular risk

Prediabetes *5.7 - 6.4%

SJ is a 41-year-old African American female who is at a 1-month follow-up visit with her PCP after repeat lab testing. What new medical problem should be added to the patient's profile? a. Prediabetes b. Diabetes c. Dehydration d. Obesity e. Hypercalcemia

- Celebrex (Celecoxib) - Zyban (Bupropion)

SJ is a 41-year-old African American female who is at a 1-month follow-up visit with her PCP after repeat lab testing. Which medication/s on SJ's profile is/are contraindicated? (Select ALL that apply) a. Celebrex b. Nicotine gum c. Cholecalciferol d. Phenytoin e. Zyban

The reported phenytoin level is within the goal range for safety and efficacy *goal range is 1 - 2

SJ is a 41-year-old African American female who is at a 1-month follow-up visit with her PCP after repeat lab testing. Which of the following is true regarding SJ's antiepileptic treatment? a. A corrected phenytoin level should be calculated b. A total phenytoin level is a more accurate assessment of drug therapeutic affect c. The reported phenytoin level is a measurement of both bound and unbound drug d. The reported phenytoin level is within the goal range for safety and efficacy e. The reported phenytoin level indicates that the drug is exhibiting linear kinetics

Tramadol *an opioid that can cause Serotonin Syndrome when taken with antidepressant

TW has been taking phenelzine (Nardil) for many years to treat depression. Which drug will interact with TW's antidepressants? a. Omeprazole b. Avelox c. Xarelto d. Theophylline e. Tramadol

Lasix 40 mg IV daily *40 mg of oral Lasix = 20 mg of IV Lasix so if SZ is getting 80 mg of Lasix daily then that's equivalent to 40 mg of IV Lasix

The admitting physician requests that SZ's Lasix be converted to an equivalent IV dose. What dose should the pharmacist recommend? a. Lasix 20 mg IV daily b. Lasix 40 mg IV Q12H c. Lasix 40 mg IV daily d. Lasix 30 mg IV Q12h e. Lasix 80 mg IV Q24H

14

The hospital uses premixed heparin bags (25,000 units/250 mL). What rate (mL/hr) should the continuous infusion of heparin be started at? (Answer must be numeric; no units or commas; round the final answer to the nearest WHOLE number)

Entacapone must be administered with carbidopa/levodopa

The pharmacist is conducting admission medication reconciliation. What medication issue should be addressed immediately? a. Entacapone is contraindicated with nitroglycerin products. b. Entacapone should only be taken as needed. c. Entacapone must be administered with carbidopa/levodopa. d. Entacapone is not approved for any of the patient's medical conditions. e. Entacapone is contraindicated with digoxin.

Two 150 mg tablets and eight 500 mg tablets

The pharmacy stocks 150 mg and 500 mg Xeloda tablets. How many of each tablet will TS need to take each day? a. Four 150 mg tablets and two 500 mg tablets b. Two 150 mg tablets and four 500 mg tablets c. Two 150 mg tablets and eight 500 mg tablets d. One 150 mg tablet and two 500 mg tablets e. One150 mg tablet and one 500mg tablet

Hemoglobin less than 10 g/dL

What criteria must be met to start Procrit in this patient? a. Hemoglobin less than 13.5 g/dL b. Hemoglobin less than 10 g/dL c. ANC < 1,000 d. Platelet count < 100,000 cells/mm3 e. ANC < 500 cells/mm3

Decreases uric acid production. *zyloprim (allopurinol) is used for gout

What is the mechanism of action of Zyloprim? a. Depletes CD20 B cells. b. Increases production of allantoin. c. Inhibits tumor necrosis factor alpha. d. Increases renal excretion of uric acid. e. Decreases uric acid production.

Suspending vehicle

What is the purpose of Ora-Plus? a. Hydrophobic solvent b. Lubricant c. Gelling agent d. Emollient e. Suspending vehicle

Low pH, low serum bicarbonate

What lab values are characteristic of a metabolic acidosis? A. Low pH, low serum bicarbonate B.Low pH, high serum bicarbonate C.High pH, low serum bicarbonate D.High pH, high serum bicarbonate E.Low pH, low alkaline phosphatas

Atrovent HFA (Ipratropium Bromide)

Which inhaler should be cleaned at least once per week by rinsing the mouthpiece under warm running water? a. Pulmicort Flexhaler b. Spirivia HandiHaler c. Symbicort d. Atrovent HFA e. Arcapta Neohaler

Digox *Digoxin can cause blurred vision

Which medication is most likely causing the non-respiratory symptoms that SZ has been experiencing lately? a. Procardia XL b. Altace c. Digox d. Coreg CR e. Aldactone

Liraglutide

Which medication is preferred, in combination with metformin, for lowering of BY's A1C? a. Rosiglitazone b. Insulin glargine c. Liraglutide d. Saxagliptin e. Glimepiride

Strattera and Kapvay (Atomoxetine and Clonidine)

Which medications used for ADHD are NOT controlled substances? a. Vyvanse and Intuniv b. Daytrana and Strattera c. Concerta and Ritalin d. Kapvay and Adderall e. Strattera and Kapvay

CYP450 2E1

Which metabolic pathway is responsible for the production of the toxic metabolite NAPQI? A. Glucuronidation B. Sulfation C. CYP450 2E1 D. CYP450 2D6 E. Conjugation

Zyban (bupropion) *Used for smoke cessation but also causes insomnia

Which of BY's medications is most likely contributing to her insomnia? a. Zyban b. Vimovo c. Ramipril d. Zolpidem e. Clopidogrel

- Digox (can cause HF) - Coreg CR (A Beta-blocker)

Which of SZ's medications can decrease her heart rate? (Select ALL that apply) a. Digox b. Combivent Respimat c. Aldactone d. Coreg CR e. Altace

- Grapefruit - Ritonavir - Diflucan (Fluconazole)

Which of the following are CYP3A4 inhibitors? (Select ALL that apply) a. Grapefruit b. Ritonavir c. Dilantin d. Diflucan e. Phenobarbital

- Transderm-Scop - Meclizine (Antivert) - Dimenhydrinate (Dramamine)

Which of the following are treatment options for motion sickness in adults? (Select ALL that apply) a. Mesalamine b. Transderm-Scop c. Meclizine d. Dimenhydrinate e. Entereg

Serotonin agonist (Sumatriptan -> 5HT3)

Which of the following best describes the mechanism of action of the medication BH uses for the treatment of migraine? a. Dopamine agonist b. Serotonin agonist c. Alpha-1 agonist d. Serotonin antagonist e. Alpha-1 antagonist

A water-containing oral solution that is stored in the refrigerator

Which of the following compounded preparations would have the shortest beyond use date? A. An intravenous solution (low CSP risk level) that is stored in the freezer B. A nonaqueous ointment that is stored at room temperature C. A water-containing oral solution that is stored in the refrigerator D. A water-containing topical lotion that is stored at room temperature E. A water-containing mucosal liquid that is stored at room temperature

- Ampicillin - Dilantin (Phenytoin) - Invanz (Ertapenem)

Which of the following drugs are compatible with saline only? (Select ALL that apply) a. Ampicillin b. Cefepime c. Dilantin d. Bactrim e. Invanz

- Methotrexate - Sulfamethoxazole/Trimethoprim

Which of the following drugs can cause folic acid deficiency? (Select ALL that apply) a. Methotrexate b. Daptomycin c. Metformin d. Sulfamethoxazole/Trimethoprim e. Citalopram

- Gloves must be changed every 30 minutes while compounding. - Two pairs of ASTM-rated gloves are required. - The outer pair of gloves must be sterile.

Which of the following is a requirement for gloves while preparing this compound? (Select ALL that apply) a. Two pairs of gloves are required, both placed under the cuff of the gown. b. Gloves must be changed every 30 minutes while compounding. c. Two pairs of ASTM-rated gloves are required. d. Two pairs of gloves are required, both placed over the cuff of the gown. e. The outer pair of gloves must be sterile.

Glatiramer acetate (Copaxone)

Which of the following is an approved treatment for multiple sclerosis? a. Etanercept b. Hydroxychloroquine c. Glatiramer acetate d. Ethosuximide e. Interferon alfa

Levofloxacin (Levaquin)

Which of the following is the best recommendation for empiric treatment of pneumonia in this patient? a. Amoxicillin/clavulanate + azithromycin b. Doxycycline c. Levofloxacin d. Ciprofloxacin e. Moxifloxacin + azithromycin

Enoxaparin 130 mg SC Q12H *Lovenox dosing 1mg/kg Q12H so 287 lbs -> 130 kg -> 130mg Q12H

Which of the following is the correct enoxaparin dose for BY? A. Enoxaparin 30 mg SC Q12H B. Enoxaparin 130 mg SC daily C. Enoxaparin 130 mg SC Q12H D. Enoxaparin 90 mg SC daily E. Enoxaparin 90 mg SC Q12H

- Spiriva HandiHaler - Arcapta Neohaler

Which of the following medications comes as a capsule meant for inhalation? (Select ALL that apply) A. Spiriva HandiHaler B. Combivent Respimat C. Advair Diskus D. Xolair E. Arcapta Neohaler

Ondansetron (Zofran)

Which of the following medications is the patient taking for nausea and vomiting? a. Irinotecan b. Aprepitant c. Prochlorperazine d. Palonosetron e. Ondansetron

- Mycamine (Micafungin) - Doxycycline

Which of the following medications require a "protect from light" cover while infusing? (Select ALL that apply) a. Bactrim b. Mycamine c. Ceftriaxone d. Doxycycline e. Daptomycin

- Bactrim DS (covers MRSA + Anaerobes) - Doxycycline (Covers MRSA)

Which of the following oral antibiotics are appropriate for the pharmacist to recommend on June 8th? (Select ALL that apply.) A. Zithromax B. Bactrim DS C. Dicloxacillin D. Doxycycline E. Levofloxacin

Prempro

Which of the following oral treatments can be recommended to manage vasomotor symptoms in a woman with a uterus? A. Vivelle-Dot B. Estrace C. Premarin D. Prempro E. Depo-Provera

Clinical Pharmacology

Which reference can be consulted to find room temperature stability information for MI's diabetes medication? a. Clinical Pharmacology b. USP 800 c. Handbook of Nonprescription Drugs d. NIOSH List e. Sanford guide

CHA2DS2-VASc *Used for anticoagulation/AFIB Child-Pugh is for liver disease/transplantation ASCVD is used for stroke/CV issues

Which scoring system should be used to verify MI's need for anticoagulation? A. ASCVD risk B. CHA2DS2-VASc C. Apgar D. Naranjo scale E. Child-Pugh CHA2DS2-VASc

Triumeq is safe to use in this patient *If HLA-B*5701 is negative, then the patient can take Triumeq If HLA-B*5701 is positive, then the patient cannot take Triumeq

Which statement is a correct drug therapy assessment based on the pharmacogenomic test result reported? a. Triumeq is not safe to use in this patient b. Apixaban is not safe to use in this patient c. Bactrim is safe to use in this patient d. Triumeq is safe to use in this patient e. Lantus is safe touse in this patient

Flovent HFA

a. Symbicort b. Xolair c. Spiriva Respimat d. Flovent HFA d. Singulair