Clinical Pharmacy Overview Quiz
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Questions and Answers

What is the primary goal of pharmaceutical care?

  • To maximize the cost of medication therapy
  • To create new medications
  • To eliminate the need for healthcare providers
  • To enhance or preserve a patient’s quality of life (correct)

    • Clinical pharmacy exclusively focuses on medication therapy optimization.

    False (B)

    What philosophy does clinical pharmacy embrace?

    Pharmaceutical care

    Match the following elements of clinical pharmacy with their corresponding descriptions:

    <p>Optimizes medication therapy = Improves the effectiveness of drug treatments Promotes health = Encourages healthy lifestyle choices Disease prevention = Reduces the risk of developing health issues Patient-related outcomes = Improvements in the patient's health status</p> Signup and view all the answers

    Clinical pharmacists work in a variety of ______ settings.

    <p>healthcare</p> Signup and view all the answers

    Which of the following is NOT a target for clinical pharmacy?

    <p>Pharmaceutical companies (A)</p> Signup and view all the answers

    Clinical pharmacists are only found in hospital settings.

    <p>False (B)</p> Signup and view all the answers

    List one of the core frameworks used in clinical pharmacy.

    <p>CORE, PRIME, or SOAP/FARM</p> Signup and view all the answers

    What is a key indicator of therapeutic drug monitoring (TDM)?

    <p>Performing a quantitative procedure for drugs with a narrow therapeutic index (B)</p> Signup and view all the answers

    The trough concentration reflects the highest level of drug in the blood.

    <p>False (B)</p> Signup and view all the answers

    What is the first step in the medication reconciliation process?

    <p>Develop a list of current medications</p> Signup and view all the answers

    Therapeutic drug monitoring is performed for drugs with a ________ therapeutic index.

    <p>narrow</p> Signup and view all the answers

    Match the following concentrations with their definitions:

    <p>Trough Concentration = Lowest level of drug in the blood Peak Concentration = Highest level of drug in the blood after administration</p> Signup and view all the answers

    What happens to the trough level if the clearance rate of a drug increases?

    <p>The trough level decreases (D)</p> Signup and view all the answers

    All medications require therapeutic drug monitoring.

    <p>False (B)</p> Signup and view all the answers

    What is the consequence of overdosing and underdosing for certain medications?

    <p>Serious consequences</p> Signup and view all the answers

    What is the primary goal of medication reconciliation?

    <p>To avoid medication errors (C)</p> Signup and view all the answers

    Medication reconciliation should only be done when a patient is admitted to the hospital.

    <p>False (B)</p> Signup and view all the answers

    List two types of errors that medication reconciliation aims to prevent.

    <p>Omissions and drug interactions</p> Signup and view all the answers

    The process of comparing a patient’s medication orders to all medications they have been taking is known as __________.

    <p>medication reconciliation</p> Signup and view all the answers

    Match the types of medication errors with their definitions:

    <p>Omissions = Failure to include a medication Duplications = Taking the same medication twice Dosing errors = Incorrect dose administered Drug interactions = When two or more drugs negatively affect each other</p> Signup and view all the answers

    Which drug class requires therapeutic drug monitoring (TDM) to assess cardiac contractility?

    <p>Cardioactive Drugs (D)</p> Signup and view all the answers

    Drug interactions can affect therapeutic drug monitoring.

    <p>True (A)</p> Signup and view all the answers

    What is the recommended therapeutic range for digoxin levels?

    <p>0.8-2 ng/mL</p> Signup and view all the answers

    _______ patients are known to be resistant to digoxin.

    <p>Hyperthyroid</p> Signup and view all the answers

    Which factor critically affects the interpretation of drug levels for bronchodilators?

    <p>Time of blood collection (D)</p> Signup and view all the answers

    Match the following drug classes with their characteristics:

    <p>Antibiotics = Serum electrolytes affect therapeutic action Anti-epileptic Drugs = Large dose inhibits Na-K-ATPase Immunosuppressive Drugs = Variable absorption in the GIT Anti-Inflammatory/Analgesics = Free drug sequestered into muscle cells</p> Signup and view all the answers

    Renal filtration only affects the elimination of the free form of drugs.

    <p>True (A)</p> Signup and view all the answers

    What is a common physiological change that can unpredictably affect drug concentrations?

    <p>Change in the patient's physiologic state</p> Signup and view all the answers

    What is the bioavailability fraction (BA) of IV route administration?

    <p>1 (B)</p> Signup and view all the answers

    PO-administered drugs should achieve a bioavailability fraction of 0.5.

    <p>False (B)</p> Signup and view all the answers

    What is the therapeutic level of a drug in ng/mL?

    <p>0.5-2 ng/mL</p> Signup and view all the answers

    The elimination of Digoxin primarily occurs through __________.

    <p>Hepatic Metabolism</p> Signup and view all the answers

    Match the following cardioactive drugs with their primary classifications:

    <p>Lidocaine = Class I - Rapid sodium channel blockers Propanolol = Class II - Beta receptor blockers Amiodarone = Class III - Potassium channel blockers Verapamil = Class IV - Calcium channel blockers</p> Signup and view all the answers

    Which of the following is a symptom of drug toxicity?

    <p>Nausea/Vomiting (N/V) (D)</p> Signup and view all the answers

    What concentration of free drug is considered toxic?

    <blockquote> <p>2 ng/mL</p> </blockquote> Signup and view all the answers

    Lidocaine can be administered orally without any concerns about hepatic metabolism.

    <p>False (B)</p> Signup and view all the answers

    What is the therapeutic level range for Monoethylglycinexylidide (MEGX)?

    <p>1.5-4.0 ug/mL (A)</p> Signup and view all the answers

    Quinidine is primarily eliminated through renal filtration.

    <p>False (B)</p> Signup and view all the answers

    What is the peak serum level time for Quinidine sulfate after oral administration?

    <p>2 hours</p> Signup and view all the answers

    Propranolol is used to treat __________, hypertension, and coronary artery disease.

    <p>angina</p> Signup and view all the answers

    Match the following medications with their primary toxicity effects:

    <p>Propranolol = Bradycardia Quinidine = Cinchonism Procainamide = CHF and Heart Block Amiodarone = Seizure</p> Signup and view all the answers

    What is the toxic level for Procainamide?

    <blockquote> <p>8.0 ug/mL (D)</p> </blockquote> Signup and view all the answers

    Disopyramide has an anticholinergic effect when its level exceeds 4.5 ug/mL.

    <p>True (A)</p> Signup and view all the answers

    What percentage of Quinidine is protein bound?

    <p>85%</p> Signup and view all the answers

    The therapeutic level for Amiodarone is __________.

    <p>50-100 ng/mL</p> Signup and view all the answers

    Which medication is NOT used to treat cardiac arrhythmias?

    <p>Verapamil (B)</p> Signup and view all the answers

    Study Notes

    Clinical Pharmacy and Pharmacotherapeutics

    • Clinical pharmacy is the science and practice of rational medication use
    • Clinical pharmacy optimizes medication therapy, promotes health and wellness, and prevents disease
    • Clinical pharmacists provide care in all healthcare settings
    • Pharmaceutical care is the responsible provision of medication therapy to enhance a patient's quality of life
    • CORE, PRIME, and SOAP/FARM are documentation methods for pharmaceutical care
    • CORE documents patient condition, medication therapy evaluation, and outcomes
    • PRIME documents pharmacotherapy needs and issues
    • FARM/SOAP documents findings, assessment, resolution, and monitoring
    • Medication reconciliation is the process of comparing a patient's current medications with prescribed medications
    • Therapeutic Drug Monitoring (TDM) is a quantitative procedure for drugs with a narrow therapeutic index
    • It allows for safe medication use when dealing with drugs that have toxic effects at small differences between therapeutic and toxic doses
    • TDM involves measuring drug concentrations in the blood
    • Trough concentrations are measured immediately before the next dose
    • Peak concentrations are measured one hour after an oral dose, or after the infusion for IV drugs
    • Drugs like Digoxin, Lidocaine, Quinidine, Procainamide, Disopyramide, Propranolol, Amiodarone, and Verapamil are common drugs that require TDM
    • Some common drug classes that require TDM include cardioactive drugs, antibiotics, anti-epileptic drugs, psychoactive drugs, bronchodilators, immunosuppressants, antineoplastic drugs, anti-inflammatory/analgesics, and neuroleptics
    • Routes of administration include intravenous (IV), intramuscular (IM), and oral (PO)
    • Causes of drug toxicity include elevated free drug concentration, abnormal response, and presence of active drug metabolites

    Medication Reconciliation

    • Medication reconciliation compares a patient's current medications to prescribed medications
    • Its goal is to prevent medication errors by identifying omissions, duplications, and dosage errors
    • It is performed at every transition of care

    Therapeutic Drug Monitoring (TDM)

    • TDM measures drug concentrations in the blood to optimize therapy
    • It is used for drugs with narrow therapeutic indexes
    • Trough concentrations are measured before the next dose to ensure adequate drug levels
    • Peak concentrations are measured after drug administration to evaluate drug absorption
    • Indications for TDM include serious consequences of overdosing or underdosing the drug, small differences between therapeutic and toxic doses, poor correlation between the circulating dose and the therapeutic/toxic effects, and change in the patient's physiological state that might unpredictably affect the circulating drug concentrations

    Common Drug Classes Requiring TDM

    • Cardioactive drugs
    • Antibiotics
    • Anti-epileptic drugs
    • Psychoactive drugs
    • Bronchodilators
    • Immunosuppressants
    • Antineoplastic drugs
    • Anti-inflammatory/Analgesics
    • Neuroleptics

    Anti-Inflammatory/Analgesics

    • Salicylates (aspirin), Acetaminophen, and Ibuprofen are commonly used analgesic/anti-inflammatory drugs
    • Salicylates, like aspirin, can cause chronic toxicity with side effects such as anemia, renal damage, and GI disturbance if abused
    • Acetaminophen, when taken in high doses, can cause hepatotoxicity
    • Ibuprofen, compared to the other two, carries minimal risks for toxicity.

    Carbohydrates

    • Carbohydrates are hydrates of aldehyde or ketone (e.g., glucose)
    • Sugars are classified as reducing or non-reducing based on their chemical structure
    • The brain depends on blood glucose for energy

    Pancreas

    • The pancreas has both exocrine and endocrine functions
    • Islets of Langerhans are clusters of cells within the pancreas
    • Beta cells secrete insulin
    • Alpha cells secrete glucagon
    • Delta cells secrete somatostatin
    • F cells secrete pancreatic polypeptide

    Diabetes Mellitus (DM)

    • DM is characterized by hyperglycemia due to defects in insulin secretion or insulin receptors
    • Types include Type 1 (insulin-dependent), Type 2 (non-insulin-dependent), Gestational, and other types
    • Classification is based on the underlying cause of hyperglycemia
    • Symptoms include polyuria, polydipsia, polyphagia, weight loss, and possible loss of consciousness.
    • DM is often screened by fasting blood sugar (FBS), oral glucose tolerance test (OGTT), glycosylated hemoglobin (HbA1c), and other biomarkers.

    Atypical Antipsychotics

    • Atypical antipsychotics commonly include Risperdal, Olanzapine, Quetiapine, and Aripiprazole

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    Description

    Test your knowledge on the principles and practices of clinical pharmacy. This quiz covers key concepts such as pharmaceutical care goals, therapeutic drug monitoring, and clinical pharmacist roles. Challenge yourself with questions that explore the various settings and frameworks of clinical pharmacy.

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