Deck 5: Pharmacological

Question 1

For which of the following life-threatening adverse effects is it MOST important to ensure that you have obtained informed consent? The patient has been prescribed lovastatin (Mevacor/Altocor).

A)Asthenia
B)Pruritis
C)Rhabdomyolysis
D)Lupus-like syndrome

Answer 1

Rhabdomyolysis

Question 2

A 72 year old woman has been prescribed Boniva. What is the best way for this prescription to be taken?

A)Right before bedtime.
B)With minimum water and in the evening at least two hours after a meal
C)Anytime during the day with no food requirements
D)In the morning at least 30 minutes before any meal and with a full glass of water.

Answer 2

In the morning at least 30 minutes before any meal and with a full glass of water.

Question 3

A patient arrives and asks you about his Depacon prescription. Which of the following is important to determine and why?

A)Whether the patient takes Clonazepam and has a history of absence seizure, because these may increase with Depacon.
B)Whether the patient drinks alcohol, because alcohol increases the CNS depressive effect blood concentration of valproate.
C)Both A and B are correct.
D)Neither A nor B are correct.

Answer 3

Both A and B are correct.

Question 4

Which of the following is the correct epinephrine dosage with an infusion rate of 30 mL/hr and an epinephrine concentration of 1 mg in 250 mL of a solution of 5% dextrose in water?

A)2 mcg/min
B)4 mcg/min
C)10 mcg/min
D)135 mcg/min

Question 5

Which of the following drugs is a beta-adrenergic blocker?

A)Busiperone
B)Budenoside
C)Bisoprolol
D)Phenoxybenzamine

Question 6

Which of the following is the correct nitroglycerin dosage with an infusion rate of 9 mL/hr and a nitroglycerine concentration of 50 mg in250 mL of a solution of 5% dextrose in water (D5W)?

A)30 mcg/min
B)60 mcg/min
C)25 mcg/min
D)100 mcg/min

Question 7

Which of the following creams reduces contraceptive effectiveness?

A)Clindamycin
B)Vagifem
C)Miconazole
D)Metronidazole

Question 8

Which of the following should be used on a short-term basis due to the risk of physical and psychological dependence?

A)Sustiva
B)Edrophonium
C)Ambien
D)None of the above; these are all very safe medications.

Question 9

Your patient has a prescription for Glucophage/metformin (850 mg three times a day (TID)). His doctor added Glyburide to increase glycemic control. What is the maximum dose of metformin in combination with another hypoglycemic?

A)1000 mg TID
B)2000 mg every day
C)Nothing; they cannot be combined.
D)Whatever dose is needed to reduce blood sugar to below 126 mg/dL.

Question 10

Which of the following vitamins is water-soluble?

A)Vitamin E
B)Vitamin D
C)Vitamin K
D)Vitamin B12

Question 11

For which of the following pediatric conditions has the FDA (Food and Drug Administration) approved the use of decongestants?

A)Allergic rhinitis and the common cold, for children over the age of 2.
B)Sinusitis and allergic rhinitis, for children over the age of 5.
C)Sinusitis, rhinitis and the common cold, for children over the age of 12.
D)Sinusitis for any child.

Question 12

A patient on phenelzine (Nardil; 15 mg tablets) asks you if there is any food he should avoid. You can tell him:

A)There is no problem; you can eat anything you want.
B)You should stay away from peanut butter.
C)You should stay away from high fat foods because it decreases absorption of the drug.
D)Any foods with tyramine should be avoided.

Question 13

A patient is diagnosed with iron-deficiency anemia and is give iron supplements. They ask if they should take it with food. Your response is:

A)Iron is best absorbed when taken with milk.
B)Iron should be taken with food to increase absorption and minimize gastric upset.
C)Iron is best taken with water only and at least one hour before eating.
D)None of the above is correct.

Question 14

Which of the following drugs would be likely to be used in an elderly patient with hypertension? The patient doesn't remember the name of the pill, and only remembers that it is a pretty little pink, oval pill, and she is certain it is not one of those "water pills." Which of the following is most likely her medication?

A)0)5 mg alprazolam/Xanax
B)80 mg/12.5 mg Diovan HCT
C)500 mg Amoxil
D)200 mg Augmentin

Question 15

A patient of yours is on tegaserod. Which of the following co-morbidities would indicate a need for caution?

A)Alzheimer's Disease
B)Gallstone
C)Concurrent viral infections
D)Pre-existing cataracts

Question 16

A patient comes to you in her 3rd trimester and says that she forgot to tell you about one of her medications; it is trandolapril. She is now concerned about the safety of her unborn child. What can you tell her?

A)If the doctor prescribed it, it is safe.
B)Trandolapril is contraindicated during pregnancy. We will find a substitute for you while you are pregnant.
C)There is no contraindication to taking Trandolapril while pregnant.
D)Trandolapril is contraindicated for women who are breastfeeding, but not for women who are pregnant.

Question 17

Which of the following is a combination of amlodipine and benzepril?

A)Premphase
B)Vusion
C)Truvada
D)Lotrel

Question 18

Which of the following has a "black box warning" associated with it?
I. Parenteral tobramycin
II. Gadolimium-based contrast agents
III. Topical tacrolimus
IV. Salmeterol

A)I and II only
B)II and III only
C)All have black box warnings associated with them
D)None of the listed agents have black box warnings associated with them.

Question 19

A clinic specializing in congestive heart failure has asked you to monitor outcomes on a number of elderly patients. They use both nesiritide and tezosentin and would like your input on these drugs. You can tell them:

A)Tezosentin is an endothelin-receptor dual agonist but has been shown to be ineffective in improving dyspnea or reducing the risk of cardiovascular events.
B)Nesiritide is a recombinant human B-type natriuretic peptide and should not be used in patients with low cardiac filling pressures.
C)Both A and B are correct.
D)A is correct, but B is incorrect. The filling pressure may safely be less than 90mm Hg as long as the patient is continuously monitored.

Question 20

A patient has a prescription for lansoprazole. What is the likely diagnosis?
I. GERD
II. Duodenal ulcer
III. Crohn's disease
IV. UC

A)I and III are likely diagnoses
B)I and II are likely diagnoses
C)III and IV are likely diagnoses
D)Lansoprazole is not used in any of these conditions.

Question 21

A patient is taking Nimotop (nimodopine) 60 mg PO q 4hrs. Nimotop is available as a 30 mg capsule. The label reads: Take two capsules 2 times a day with meals. What is the error on the label?

A)The capsules should be taken every 4 hours.
B)The capsule should never be taken by mouth.
C)The capsules should not be taken except 1 hour before meals or 2 hours after meals
D)None of the above

Question 22

As a medication assistant, you are given an order that reads: Hydromorphone, 80 mg, PO q 4hrs. What is wrong with this order?

A)It represents an overdose.
B)It is correct as written for severe pain.
C)Hydromorphone is only given by injection.
D)Hydromorphone is only given as a rectal suppository.

Question 23

You are asked to monitor a multiple myeloma patient on IV melphalan. Which of the following lab parameters need to be determined to appropriately monitor the patient?

A)Serum glucose levels.
B)Creatinine clearance.
C)Serum potassium levels
D)Platelet counts

Question 24

Which of the following warnings are appropriate for tetracycline?
I. Do not take antacid with tetracycline
II. Do not take with milk to avoid stomach upset.
III. Avoid sunlight.
IV. If prolonged therapy is anticipated, regular blood testing will be required.

A)I and II only
B)II and III only
C)III only
D)All are true.

Question 25

A patient is taking 40 mg PO of simvastatin with her evening meal. She comes to you to ask about what she read on the Internet about adverse effects, saying that for the last 2-3 weeks, her legs felt like they were cramping. Which of the following tests would you recommend?

A)Liver function tests
B)A CBC (complete blood count) and a full Comp Metabolic (chemistries) test
C)Total simvastatin urine concentrations
D)Creatine phosphokinase (CPK), the MM isoenzyme.

Question 26

Of the following terms is another term for Vitamin K?
I. Mephyton
II. Phytonadione
III. Pyridoxine

A)I only
B)I and II only
C)All three are terms for Vitamin K.
D)None of the three listed are terms for Vitamin K.

Question 27

A patient using minocycline approaches you asking what possible side effects there might be. What could you tell him?
I. Hemolytic anemia
II. Pericarditis
III. Dental problems

A)I only
B)II only
C)II and III only.
D)All are possible side effects.

Question 28

What is the most common and most serious adverse effect of sulindac (Clinoril)?
I. GI bleeding
II. Hyperkalemia
III. Hyponatremia

A)I only
B)II and III only
C)I and II only
D)III only

Question 29

Which of the following would be best considered for the treatment of acute migraines?

A)Loxapine
B)Etanercept
C)Sumatriptan
D)Eptifibatide

Question 30

For which of the following conditions would QVAR be indicated?
I. COPD
II. Community acquired pneumonia
III. Asthma

A)I only
B)II only
C)III only
D)I and II only

Question 31

A patient is on simvastatin. What is the biochemical pathway that is inhibited by this drug?

A)The pentose phosphate pathway
B)The mevalonate pathway
C)The eiconosoid pathway
D)The electron transport chain

Question 32

Saquinavir is used to treat _______ and is contraindicated with/in ___________.

A)Infection with Gram (+) bacteria, blood dyscrasias
B)Mycoplasma, immunosuppresion
C)Advanced HIV infections, concurrent use of anti-arrhythmics
D)Viral URIs, emphasema

Question 33

Eletriptan (Relpax) is used to treat _______, and it is contraindicated with/in ___________. Its major adverse reaction is _______________.

A)Gout, blood dyscrasias, arrhythmias
B)Rheumatoid arthritis, osteoporosis, spontaneous fractures.
C)Diabetes, hypoglycemia, respiratory arrest
D)Migraine (with or without aura), uncontrolled hypertension, ischemia

Question 34

Which of the following statements is false concerning Phase I, II or III clinical trials?

A)A phase I trial is often quite large (N>500) and seeks to determine the safe dose range for a new drug.
B)A phase II trial is often larger than a phase I trial and seeks to determine if a new drug is effective enough to test in a phase III trial and to delineate adverse effects.
C)A Phase III trial compares a new treatment with an established treatment and is usually much larger than either a phase I or a phase II trial.
D)All three of the statements are correct.

Question 35

A patient is prescribed Roferon-A. Of the following, what is the most likely diagnosis?

A)A MRSA infection
B)Multiple sclerosis
C)Chronic hepatitis C
D)Infertility.

Question 36

Of the following medications, which is NOT used to treat Hashimoto's Thyroiditis?

A)Levothyroxing
B)Propylthiouracil
C)Cytomel
D)Thyrolar

Question 37

Of the following organisms, which would be susceptible to azithromycin?
I. Chlamydia pneumoniae
II. Staphyloccoccus pneumoniae
III. Mycoplasma hominis

A)I and II only
B)I, II and III
C)I and III only
D)I only

Question 38

A patient that is newly diagnosed with multiple sclerosis (MS) is concerned about the interferon-beta injections she was told to give herself. What would you want to make her aware about concerning adverse reactions?
I. The most common adverse reactions involve the injection site and include pain, redness and soreness.
II. Keep the syringe in the refrigerator, rotate the areas where you inject and use NSAIDS for any flu-like symptoms.
III. The most serious adverse reactions concern suicidal ideation, cardiac arrhythmias, blood abnormalities and intestinal obstruction.

A)Both I and II are correct
B)Both II and III are correct
C)Only I and III are correct
D)All are correct

Question 39

Which of the following disorders is a contraindication for the use of sulindac?

A)Asthma
B)A history of breast cancer
C)Cardiac arrhythmias
D)G6PD (Glucose-6-Phosphate Dehydrogenase) deficiency

Question 40

Concerning ulcerative colitis (UC) and Crohn's disease (CD), which of the following statements is TRUE?
I. Ulcerative colitis (UC) is a risk factor for colon cancer.
II. Crohn's disease (CD) can appear anywhere from the mouth to the rectum.
III. UC has a continuous pattern of GI inflammation.
IV. CD has a segmented pattern of GI inflammation.

A)I and II only
B)II and IV only
C)III and IV only
D)All are true

Question 41

Which of the following statements accurately reflects the difference between accuracy and precision in measurements?
I. Precision is a measure of how close an experimental value is to the dependent variable.
II. Accuracy is a measure of how close an experimental value is to the expected value.
III. Precision is a measure of how close a series of experimental values are to each other.
IV. Accuracy is a measure of how close an experimental value is to the independent variable.

A)I and II are true.
B)II and III are true.
C)I and IV are true.

Question 42

A patient has a Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency. Of the following drugs, which should be avoided in this patient?

A)Macrolides
B)Omeprazole
C)Vitamin B12
D)Quinolones

Question 43

Which of the following is a common anti-emetic used as an adjunct in chemotherapy AND is a 5HT3 receptor antagonist?

A)Aprepitant
B)Ondansetron
C)Metoclopramide
D)All of the above.

Question 44

Which of the following is TRUE of HIPAA (Health Insurance Portability and Accountability Act)?
I. One purpose was to improve the Medicare and Medicaid programs
II. It is enforced by the Office of Civil Rights
III. HIPAA regulations apply to electronic healthcare transactions
IV. HIPAA addresses privacy issues as one of its primary goals.

A)Only answer IV is true
B)Only answers II and IV are true
C)Only answers I, II and IV are true
D)All the answers are true

Question 45

Which of the following can induce a photoreaction in a sensitive individual?
I. Chlorthiazide
II. Oxaprozin
III. Tretinoin
IV. Hydroxyurea

A)I and II only
B)I and IV only
C)I, II and III only
D)III only

Question 46

Rivastigmine is a(n) ____________ used to treat __________ and rarely has the adverse effect of inducing ____________.

A)ACE inhibitor, hypotension, tachycardia
B)Voltage-gated Na+ channel blocker, hypertension, aplastic anemia
C)Cholinesterase inhibitor, Alzheimer's disease, anxiety and tremor
D)Serotonin antagonist, post-operative nausea and vomiting, hyperemesis

Question 47

Which of the following drugs is used to treat rheumatoid arthritis?

A)Tolcapone
B)Etanercept
C)Topiramate
D)Risdronate.

Question 48

Which of the following is not likely to be used in the treatment of iron deficiency anemia?

A)Ferrous sulfate, PO
B)Dextran 40, IV
C)Sodium ferric gluconate, IV
D)Iron sucrose, PO

Question 49

Which of the following is FALSE concerning the use of NSAIDs for pain management?

A)NSAIDs are analgesic and anti-inflammatory.
B)NSAIDs inhibit prostaglandin synthesis via the lipo-oxygenase pathway.
C)NSAIDs can cause GI upset and GI bleeds.
D)Indomethacin should not be taken in excess of 200 mg per day.

Question 50

What does the "B" in the chemotherapeutic combination, ABVD represent?

A)Bleomycin
B)Baclofen
C)Bivalirudin
D)Buspirone

Question 51

Imuran is used as an immunosuppressant to prevent kidney transplant rejection. Which of the following should be monitored in a patient on Imuran?
I. Amylase and lipase levels
II. Liver Function Tests (LFTs)
III. CBC with differential
IV. Creatine phosphokinase levels

A)I only
B)II only
C)I, II and III only
D)IV only

Question 52

Which of the following drugs is used to treat tuberculosis?

A)Pyrazinamide
B)Celecoxib
C)Propoxyphene
D)None of the above

Question 53

For the following chemotherapeutic agents, determine the INCORRECT combination of agent/mechanism of action.
I. Olanzapine/ Dopamine and Serotonin-2 receptor antagonist
II. Paclitaxel/anti-mitotic
III. Pindolol/ beta-adrenergic antagonist
IV. Donepezil/alkylating agent

A)I and II only
B)II and IV only
C)III and IV only
D)IV only

Question 54

Which of the following are anti-arrhythmics?

A)Ondansetron
B)Filgrastim
C)Zolpidem
D)None of the above

Question 55

Which of the following statements is true concerning Cholecalciferol?

A)It is contraindicated in hypercalcemia.
B)One needs to monitor a patient on cholecalciferol for possible thromboembolic events.
C)Statement B is true, but statement A is false.
D)Both statements A and B are true.

Question 56

Of the following medications, which is the only neuromuscular blocker?

A)Botulinum toxin A
B)Oxcabazepine
C)Chlordiazepoxide
D)Finasteride

Question 57

A 23-year-old female patient has been diagnosed with bipolar disorder. Which of the following would be the best therapeutic approach?

A)An antipsychotic such as aripiprazole
B)An anxiolytic such as azothioprine.
C)A calcium regulator such as zoledronic acid
D)A mood stabilizer such as lithium or lamotrigine.

Question 58

Which of the following is NOT an atypical antipsychotic?

A)Quetiapine.
B)Olanzapine
C)Clozapin
D)Amitriptyline

Question 59

Which of the following are TRUE sign/symptoms/complications of anemia of chronic kidney disease?
I. Red blood cells are macrocytic and the MCV (mean corpuscular volume) is normal.
II. The hematocrit is low, usually less than 30.
III. The red blood cells are normocytic and normochromic.
IV. Fatigue, irritability, sore tongue, shortness of breath and weakness are all common symptoms.

A)I and II only
B)II and III only
C)I, II, and III only
D)II, III and IV only

Question 60

Which of the following is a brand name for irbesartan?

A)Nimotop
B)Plendil
C)Avapro
D)Plaquenil

Question 61

You are preparing an insulin infusion. Which of the following should NOT be combined with insulin in an IV?

A)Heparin
B)Hydrocortisone.
C)Nitroglycerin
D)Potassium chloride

Question 62

Which of the following would be considered a contraindication for the use of docusate?

A)Pregnancy
B)Hip dysplasia
C)IDDM
D)Intestinal obstruction

Question 63

Which of the following drugs is an opioid agonist?

A)Dapsone
B)Rifapentine
C)Pyrazinamide
D)Meperidine

Question 64

Which of the following is the generic name of Altace?

A)Zonisamide
B)Lovastatin
C)Lisinopril
D)Ramipil

Question 65

Which of the following is potential side effect of lovastatin?

A)Pruritis, rash
B)Hepatic necrosis/hepatotoxicity
C)Myalgia, cramping
D)All of the above

Question 66

Which of the following are possible adverse effects of methotrexate?
I. Leukoencephalopathy
II. Tubular necrosis
III. Hepatotoxicity
IV. GI bleed

A)I and II only
B)II and III only
C)I and III only
D)All of the above are possible adverse effects.

Question 67

Which of the following medications is a Pregnancy Category X?

A)Rivastigmine
B)Dronobinol
C)Infliximab
D)Methotrexate

Question 68

Which of the following tablets and capsules should NOT be crushed?
I. Boniva
II. Inderide
III. OxyContin
IV. Propylthiouracil

A)I only
B)II only
C)I, II and III only
D)IV only

Question 69

Which of the following statement(s) about A1c is/are untrue?

A)Measurement of A1c correlates approximately with the lifespan of a red blood cell, about 6-8 months.
B)Normal A1c should be at 4-6%.
C)A1c gives an approximation of glucose control in a patient corresponding to the previous 3-4 months.
D)A1c will also be raised in chronic renal failure.

Question 70

Which of the following is a loop diuretic?

A)Verapamil
B)Adenosine
C)Propafenone
D)Bumetanide

Question 71

Which of the following are ACE inhibitors?
I. Benzapril
II. Ramipril
III. Losartan

A)All of the above
B)None of the above
C)I only
D)I and II only

Question 72

Which of the following is an appropriate agent and dosing schedule for a newly diagnosed patient with gout?

A)Acarbose, 100mg, PO, tid
B)Alitretinoin, 0.1% topical gel, qid
C)Hydroxycobalamin, 500mcg, PO, qd
D)Allopurinol, 200 mg PO, qd

Question 73

What do the "B" and the "M" in the chemotherapeutic combination BEAM represent?

A)BCNU (carmustine) and melphalan
B)Bendamustine and melphalan
C)BCNU (carmustine) and meloxicam
D)Bleomycin and Matulane (procarbazine)

Question 74

Which of the following trade names is NOT correctly matched with its generic name?

A)Nitazoxanide-Alinia
B)Nisoldipine-Sular
C)Felopidine -Plendil
D)Rifaximin-Zifaxanilimide

Question 75

What is the therapeutic class of itracozanole (Sporanox)?

A)Itracozanole is an anti-fungal agent.
B)Itracozanole is an antibacterial agent.
C)Itracozanole is an antiviral agent.
D)Itracozanole is a GABA agonist.

Question 76

Which of the following is potential side effect of pindolol?
I. Erectile dysfunction
II. Hypoglycemia
III. Bronchospasm
IV. Heart failure

A)I and II only
B)I and III only
C)IV only
D)All of the above

Question 77

Of the following medications, which is also known as phytonadione?

A)Vitamin A
B)Vitamin E
C)Vitamin D
D)Vitamin K

Question 78

Which of the following is a calcium channel blocker?

A)Aripiprazole
B)Modafinil
C)Moricizine
D)Nifedipine

Question 79

Repaglinide is a(n) ____________ used to treat __________ and rarely has the adverse effect of inducing ____________.

A)Non-selective beta-blocker, hypotension, tachycardia.
B)Hypoglycemic, diabetes, hypoglycemia.
C)Anti-psychotic, schizophrenia, psychotic breaks.
D)Platelet inhibitor, post-MI, bleeding.

Question 80

Which of the following are signs/symptoms/complications of an adverse reaction to sulfisoxazole?

A)Diarrhea
B)Shortness of breath, dyspnea
C)Hypertension
D)Both A and B are possible symptoms.