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Module 3: RATIONALIZATION

Module 3: RATIONALIZATION. Practice of Pharmacy (Clinical Pharmacy, Hospital Pharmacy, Dispensing, Incompatibilities, ADR, Pharmaceutical Calculations).

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Module 3: RATIONALIZATION

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  1. Module 3: RATIONALIZATION Practice of Pharmacy (Clinical Pharmacy, Hospital Pharmacy, Dispensing, Incompatibilities, ADR, Pharmaceutical Calculations)

  2. 1. It refers to the responsible provision of drug therapy to achieve definite outcomes that are intended to improve a patient’s quality of life: • Drug therapy assessment • Therapeutic drug monitoring • Pharmaceutical care • Professional-patient relationship • Formal documentation Components of Pharmaceutical care: • Equal responsibility (to patient and prescriber) • Professional-patient relationship • Formal documentation ( clinical interventions and therapeutic outcomes )

  3. 2. A way of summarizing the health benefits and resources used by competing health care programs so that policy makers can choose among them: • Cost-of-Illness Evaluation • Cost-Minimization Analysis • Cost-Utility Analysis • Cost-Effectiveness Analysis • Cost-Benefit Analysis

  4. 3. Any noxious, unintended, and undesired effect of a drug that occurs at doses used in humans for prophylaxis, diagnosis or therapy: • Allergy • Adverse drug reaction • Adverse drug event • Hypersensitivity • idiosyncracy -adverse drug event is used to describe an injury resulting from administration of drug

  5. 4. Patient R.S. had bone marrow transplant 5 years ago. This information belong in which section of the patient’s medical chart: • ROS – Review of Systems • FH – Family History • HPI – History of Present Illness • PMH – Past Medical History • PMP – Patient Medication Profile

  6. 5. Which of the following insulins exert the longest duration of action • Humalog – Insulin Lispro • Lantus – Insulin Glargine • HumulinR – regular Insulin • Novo rapid – Insulin Aspart • Insulin NPH

  7. 6. Which of the following is not an objective parameter: • Bilirubin • Creatinine • Urine output • Vertigo • CBG – Capillary Blood Glucose

  8. 7. When blood urea nitrogen (BUN) is above the normal values, it indicates the following conditions except: • Dehydration • GI bleeding • Liver disease • Renal disease -BUN is the measure of the amount of nitrogen in the blood in the form of urea, and a measurement of renal function. Urea is a by- product from metabolism of proteins by the liver, and therefore removed from the blood by the kidneys.

  9. 8. The clinical pharmacist functions focus on the: • Product • Hospital • Diagnosis • Patient • Income

  10. 9. Which of the following provides the greatest number of calories per gram: • Dextrose • Proteins • Fats • Ethanol Fat: 1 gram = 9 calories Protein: 1 gram = 4 calories Carbohydrates: 1 gram = 4 caloriesAlcohol: 1 gram = 7 calories

  11. 10. Exforge® is an anti hypertensive agent which is a combination of: • Amlodipine & valsartan • Telmisartan & HCTZ • Valsartan & HCTZ • Enalapril & amlodipine

  12. 11. Which of the following dosages of dopamine is selected for its positive inotropic effects in treating the patient with Heart Failure: • 40 mg/kg/min • 40 ug/kg/min • 10-20 ug/kg/min • 5-10 ug/kg/min • 2 ug/kg/min

  13. 12. Measures the electrical activity of the brain, and helps to identify functional cerebral changes underlying structural abnormalities: • CBG – Capillary Blood Glucose • EEG – Electroencephalogram • MRI – Magnetic Resonance Imaging • PET – Positron Emitting Tomography • CSF – Cerebro Spinal Fluid - EEG serves as diagnostic tool in classifying seizures.

  14. 13. Agent/s that inhibit smooth muscle contractions in asthmatic patients is/are: • Beta adrenergic agonists • Methylxanthines • Glucocorticoids • Anticholinergics • I and IV • I, II and IV • II, III and IV • AOTA • I,II and III Drugs that inhibit smooth muscle contraction are often called “quick relief medications” ex. Beta adrenergic agonists, methylxanthines, anticholinergics Glucocorticoids are considered “long term control medications”

  15. 14. It is a rapid-acting insulin preparation: • Humalog – Insulin Lispro • Lantus – Insulin Glargine • Levemir – Insulin Detemir • HumulinN – Insulin NPH • Insulin NPH

  16. 15. It is the hypermetabolic syndrome that occurs from excessive production of thyroid hormone with classic symptoms of weight loss despite increases appetite, nervousness, palpitations, heat tolerance and insomnia: • Thyrotoxicosis or “Hyperthyroidism” • Hypothyroidism • Graves disease – autoimmune disorder causing hyperthyroidism. • Cushing syndrome • Hashimoto’s disease

  17. 16. Which of the following types of questions should be avoided while interviewing the patient: • Leading questions • Multiple questions • Excessive yes/no questions • AOTA • NOTA

  18. 17. The following are clinical functions of pharmacists except: • Prepare medications • Taking inventories • Participate in patient education program • Assess drug interactions and ADRs

  19. 18. In hospital abbreviations, Pt. means: • Prothrombin Time • ProTime • Patient • Pint

  20. 19. Txmeans: • Treatment • Therapeutic • Therapeutics • Therapy

  21. 20. Patient N.H. has a BMI of 27kg/m2, patient N.H. is considered to be: • Underweight • Normal weight • Overweight • Obese -BMI = weight in kg / (Height in meters)2 Interpretation: Underweight < 18.5 Normal weight = 18.5 - 24.9 Overweight = 25.0 - 29.9 Obese > 30.0

  22. 21. The successor of the first hospital pharmacist that revolutionize the practice of pharmacy and medicine in the hospital setting: • Jonathan Roberts • John Morgan • Jason Bourne • Jonathan Morgan

  23. 22. First hospital pharmacy practice was observed in which hospital? • Pennsylvania • Plymouth • San Antonio • Washington

  24. 23. The first hospital pharmacist: • Jonathan Roberts • John Morgan • Jason Bourne • Jonathan Morgan

  25. 24. A form of therapy offered as a substitute for drug therapy that follows the biochemical effects derived from essential oils: • Acupuncture • Aromatherapy • Massage • Chiropratic medicine

  26. 25. Patients who can walk and not bedridden: • Institutionalized • Inpatient • Ambulatory • Outpatient

  27. 26. A facility where patients who are not confined are treated by a set of physician practicing together: • Hospital • In-house facility • ER • Clinic

  28. 27. Which is not a fundamental function of a hospital? • Research • Wellness • Education • NOTA

  29. 28. ASHP stand for: • American Society of Hospital Pharmacist • American Society for Hospital Practitioners • Asian Society of Hospital Pharmacist • American Society of Health-system Pharmacists - New meaning of ASHP

  30. 29. Hospitals function in assisting their communities the incidence of illness and improve quality of life, is under what fundamental function? • Research • Education • Patient Care • Wellness

  31. 30. The Hospital Pharmacist holds what position in the P&T Committee? • Chair • Secretary • Treasurer • NOTA

  32. 31. The degradation reaction of ASA involves: • hydrolysis • racemization • oxidation • photolysis • Reduction - in presence of moisture or water, ASA will hydrolyze into acetic acid and salicylic acid.

  33. 32. The most serious drug-induced blood disorder: • aplasticanemia • leukemia • agranulocytosis • Thrombocytopenia • This is also referred to as pancytopenia resulting from damaged pluripotent stem cells. • It is characterized by acellular or hypocellular bone marrow

  34. 33. Which is NOT true for camphor? I. forms a eutectic mixture with menthol II. can be powdered by rubbing with a small amount of alcohol or ether III. dissolves readily in water • I only • III only • I and II only • II and III only • I, II, and III -Camphor is soluble in alcohol and organic solvents but is only slightly soluble in water (1g in 800 ml)

  35. 34. Which one of the following diluents is LEAST suitable for reconstituting single-dose vials? • Bacteriostatic Sterile Water for Injection (BSWFI) • D5W injection • N/S injection • 0.5 N/S injection • Sterile Water for Injection (SWFI) BSWFI should not be used for reconstituting single-dose units because the preservative present would serve no useful purpose, and large amounts of the preservative could increase the incidence or severity of toxicity. The use of BSWFI may be appropriate if a powder in a multidose vial is being reconstituted.

  36. 35. Methysalicylate is also known as: • camphorated oil • peppermint oil • salicylamide • oil of wintergreen • sweet oil -Methyl salicylate can be used in small quantities as flavoring or perfuming agent. -It is also included in many topical products such as rubbing alcohol, gels and liniments

  37. 36. Alcohol is suitable as a solvent for menthol and salicylic acid when preparing which of the following dosage forms? I. lotions II. ointments III. Suppositories • I only • III only • I and II only • II and III only • I, II, and III

  38. 37. The ideal weight for a vaginal suppository will be approximately: • 1 g • 2 g • 5 g • 10 g • 15 g - rectal suppositories: 2 grams

  39. 38. The most practical method for sterilizing the ophthalmic solution is: • autoclaving for 15 minutes • autoclaving for 30 minutes • membrane filtration through 0.2-micron filter • membrane filtration through 5-micron filter • use of ethylene oxide gas - Membrane filtration involves the passing of solutions through a 0.2 micron filter using one of the commercially available sterile filter units such as Millipore's Millex or Swinnex units.

  40. 39. Boric acid is present in the formula as a (an) : I. antioxidant II. antimicrobial preservative III. buffering agent • I only • III only • I and II only • II and III only • I, II, and III

  41. 40. Ondansetron is available under the trade name of : • Kytril - Granisetron • Marinol - Dronabinol • Reglan - Metoclopramide • Zofran • Zoloft – Sertraline (Antidepressant) -all except Zoloft are used for nausea and vomiting during chemotherapy

  42. 41-42. 41. How many mg of codeine base is in each dose of the cough product? (mol. wt.: codeine = 299; codeine phosphate = 406) • 6 mg • 8 mg • 11 mg • 16 mg • 24 mg

  43. 42. How many mg of codeine phosphate are being consumed daily by a patient taking the prescription as directed? • 6.25 mg • 8.25 mg • 19 mg • 25 mg • 33 mg

  44. (E) Because the volume of a standard teaspoon is considered to be 5 mL, the patient in this prescription is receiving four daily doses for a total of 20 mL.

  45. 43. A hospital pharmacy technician has written the following formula for inclusion into the master manufacturing formula book.

  46. (cont..) When reviewing this formula, the pharmacist should comment upon which of the following expressions? I. 0.5 II. gr III. qs • I only • III only • I and II only • II and III only • I, II, and III

  47. 44. Alcohol has many pharmaceutical uses and is available in several concentrations. What is the concentration (% v/v) of diluted alcohol? • 49% • 70% • 92% • 95% • 100%

  48. 45. How many grams of glacial acetic acid (99.9% w/w) must be added to 1 gal purified water to prepare an irrigation solution containing 0.25% wt./vol. acetic acid? • 1.2 g • 9.5 g • 12 g • 20 g • 95 g One gallon contains 3,785 mL; thus 3,785 mL × 0.25% = 9.46 or 9.5 g. Because the volume contributed by the acetic acid is insignificant when compared to 3,785 mL, it does not enter into the calculation of the final volume.

  49. 46. A nurse adds a 4-mL Tubex unit containing 2.4 M units penicillin suspension to a 20-mL vial containing 10 mL of normal saline. What is the new concentration of penicillin expressed as units/mL? • 170 • 240 • 170,000 • 240,000 • 600,000 2.4 megaunits is 2.4 million units or a total of 2,400,000 units. The final dilution will have a volume of 14 mL.

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