Pharmacology Quiz on Medications and Dosages
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Questions and Answers

Which of the following statements regarding reconstituted medications is correct?

  • Most reconstituted medications expire within 10 to 14 days after reconstitution. (correct)
  • All reconstituted medications must be refrigerated to maintain stability.
  • All reconstituted medications are stable for at least 30 days.
  • Reconstituted medications are stable at room temperature for up to six weeks.
  • A 3-year-old child is diagnosed with acute otitis media. What is the recommended oral dosage of amoxicillin for this condition, based on the content?

  • 60 mg/kg/day, administered in 3 divided doses
  • 45 mg/kg/day, administered once daily
  • 120 mg/kg/day, adminstered in 4 divided doses
  • 90 mg/kg/day, administered in 2 divided doses (correct)
  • Which of the following antibiotics is NOT effective against Pseudomonas aeruginosa?

  • Azithromycin (correct)
  • Ceftazidime
  • Amikacin
  • Ciprofloxacin
  • Which of the following beta-lactam antibiotics is available in both intravenous (IV) and oral (PO) formulations?

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

    Which of the following antibiotics is a fifth-generation cephalosporin with activity against MRSA?

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

    Which of the following is a known adverse effect associated with the long-term use of omeprazole?

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

    Omeprazole inhibits which specific cytochrome P450 enzyme?

    <p>CYP2C19 (A)</p> Signup and view all the answers

    Which of the following is NOT a typical anticholinergic effect?

    <p>Increased salivation (C)</p> Signup and view all the answers

    Which of the following medication is classified as a first-generation antihistamine?

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

    Which of the following is a known inducer of CYP450 enzymes?

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

    What is the primary purpose of a Phase I clinical trial?

    <p>To assess safety in healthy volunteers (B)</p> Signup and view all the answers

    What does the term 'bioavailability' refer to in pharmacology?

    <p>The percentage of a drug that reaches systemic circulation from its site of administration. (D)</p> Signup and view all the answers

    According to the list of ISMP guidelines, which of the following is NOT a recommended practice?

    <p>Use 'q.d' for daily dosing. (A)</p> Signup and view all the answers

    Which of the following antibiotics is correctly paired with the bacterial species it is indicated to treat?

    <p>Doxycycline - CA-MRSA (D)</p> Signup and view all the answers

    Which of the following drug classes inhibits cell wall synthesis?

    <p>Beta-Lactams (D)</p> Signup and view all the answers

    A bacterium has developed resistance to sulfonamides by acquiring the ability to scavenge folic acid from its environment. This is an example of which resistance mechanism?

    <p>Bypassing metabolic inhibitions (A)</p> Signup and view all the answers

    What is the maximum daily dose of acetaminophen for an adult?

    <p>4000 mg (A)</p> Signup and view all the answers

    A patient in their third trimester of pregnancy is experiencing pain. Which of the following analgesics is contraindicated due to the risk of premature closure of the ductus arteriosus?

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

    A patient has a prescription with the sig code 'OD'. What does this abbreviation signify?

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

    A lactating patient requires a nasal decongestant. Which of the following is most likely to reduce milk production?

    <p>Pseudoephedrine (C)</p> Signup and view all the answers

    Which antibiotic inhibits protein synthesis?

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

    A patient is prescribed ibuprofen. What is the maximum daily dose approved for children?

    <p>1200 mg (A)</p> Signup and view all the answers

    What is the primary mechanism of action of antacids in treating gastrointestinal issues?

    <p>Acting as a buffering agent to neutralize stomach acid (A)</p> Signup and view all the answers

    A bacterium becomes resistant to beta-lactam antibiotics due to the production of beta-lactamase. This is an example of which resistance mechanism?

    <p>Antibiotic inactivation/modification (C)</p> Signup and view all the answers

    A patient needs a topical treatment for acne. Which concentration of salicylic acid is most appropriate?

    <p>0.5-2% (B)</p> Signup and view all the answers

    Which of the following H2 receptor antagonists is known for inhibiting CYP450 enzymes, potentially affecting the metabolism of other drugs?

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

    A patient seeks an over-the-counter option for cold symptoms during the first trimester of pregnancy. Which of the following is considered the first line option?

    <p>Intranasal cromolyn (C)</p> Signup and view all the answers

    What is the approximate percentage of an infant's dose of a Advil that can transfer through breast milk during lactation?

    <p>0.6-0.9% (B)</p> Signup and view all the answers

    Which class of drugs, when used during pregnancy, has a potential risk of causing cleft lip/palate?

    <p>Intranasal corticosteroids (D)</p> Signup and view all the answers

    Flashcards

    Antacids

    A class of drugs that neutralize stomach acid and provide rapid relief from heartburn and indigestion. They work by buffering the acidic contents of the stomach.

    H2 Receptor Antagonists

    A class of drugs that block the production of stomach acid by competitively inhibiting the H2 receptors in the stomach lining. They are used to treat conditions like peptic ulcers, GERD, and heartburn.

    Proton Pump Inhibitors - PPIs

    A class of drugs that irreversibly block the proton pump, which is the enzyme responsible for pumping hydrogen ions (H+) into the stomach lumen, effectively reducing acid secretion. They can take longer to take effect than H2 blockers, but their effects last longer.

    Salicylic Acid

    A type of acid found in skin care products that, in lower concentrations, treats acne by exfoliating and removing dead skin cells. In higher concentrations, it can remove warts by burning away the affected skin.

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    NSAIDS (Non-steroidal Anti-inflammatories) in Pregnancy

    A class of medications that can cause premature closure of the ductus arteriosus, prolonged labor, increased postpartum bleeding, and delayed parturition. They are generally contraindicated during the third trimester of pregnancy.

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    Aspirin in Pregnancy

    A pain reliever often used during pregnancy, but is generally avoided during the entire pregnancy due to its possible association with various complications.

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    Antihistamines in Lactation

    A class of drugs that can affect milk production in lactating mothers, and are generally considered contraindicated during lactation.

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    Pseudoephedrine in Lactation

    A common cold symptom reliever, but is generally compatible with lactation, although it may cause reduced milk production.

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    Albumin

    A measure of protein levels in the blood, indicating the amount of protein available for bodily functions.

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    Bioavailability

    The percentage of a drug that reaches the bloodstream after administration, affecting its effectiveness.

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    Anticholinergic Drugs

    Drugs that block the action of acetylcholine, a neurotransmitter, leading to effects like dry mouth, blurred vision, and constipation.

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    Phase 1 Drug Trial

    The phase of drug development where the drug is tested on a small group of healthy volunteers to assess its safety.

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    Phase 2 Drug Trial

    The phase of drug development where the drug is tested on a larger group of patients to assess its efficacy and determine the optimal dose.

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    Phase 3 Drug Trial

    The phase of drug development where the drug is tested on a large population of patients to confirm its efficacy and safety for broader use.

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    Cytochrome P450 (CYP) Enzymes

    A group of enzymes responsible for metabolizing drugs in the body, affecting how drugs are processed and eliminated.

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    CYP Inducers

    Substances that increase the activity of CYP enzymes, leading to faster drug metabolism and potentially lower drug levels.

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    Refrigerating Reconstituted Medications

    Reconstituted medications made from powders should be refrigerated when indicated on the drug label. Refrigeration will help to prevent the medication from going bad and ensure its potency.

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    Treating Otitis Media

    Amoxicillin is a frequently prescribed antibiotic for treating acute otitis media in children. It is effective at combating the common bacteria that cause ear infections.

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    Cefdinir and Stool Color

    Cefdinir, a third-generation cephalosporin antibiotic, is known to cause a temporary red discoloration of the stool. This is a common side effect and does not mean there is an issue with the medication.

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    Aminoglycosides

    Aminoglycosides are a class of antibiotics often given intravenously (IV) to treat serious infections. Some examples of this class include gentamicin, tobramycin, and amikacin.

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    Treating Pseudomonas aeruginosa

    Aztreonam is a monobactam antibiotic commonly used to treat infections caused by Pseudomonas aeruginosa, a type of bacteria often associated with hospital-acquired infections.

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    Beta-lactams

    A class of antibiotics that work by inhibiting bacterial cell wall synthesis. Examples include penicillin, cephalosporin, carbapenem, and monobactam.

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    Vancomycin

    An antibiotic that inhibits bacterial cell wall synthesis. It is used to treat serious infections caused by bacteria resistant to other antibiotics.

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    Macrolides, Clindamycin, Linezolid, Tetracyclines, Aminoglycosides

    A group of antibiotics that interrupt bacterial protein synthesis, preventing essential proteins from being made.

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    Quinolones

    A type of antibiotic that inhibits bacterial DNA synthesis by blocking the action of DNA gyrase, an enzyme essential for unwinding DNA.

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    Sulfonamides and Trimethoprim

    An antibiotic that inhibits bacterial folate synthesis, a vital process for nucleic acid production.

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    Antibiotic Inactivation/Modification

    A mechanism of bacterial resistance to antibiotics where bacteria produce enzymes that break down the antibiotic before it can reach its target.

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    Alteration of Target/Binding Site

    A mechanism of bacterial resistance to antibiotics where bacteria alter the target site where the antibiotic binds, preventing the antibiotic from working.

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    Bypassing Metabolic Inhibitions

    A mechanism of bacterial resistance to antibiotics where bacteria develop ways to bypass the effect of the antibiotic, allowing them to survive.

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    Study Notes

    OTC Drug Information

    • OTC drugs include information on indications, classifications, mechanisms of action (MOAs), adverse effects, and interactions with other medications.

    Salicylic Acid for Acne/Warts

    • Salicylic acid (0.5-2%) treats acne, having low UV protection
    • Higher concentrations (17-40%) are used to remove warts.

    Medications for Pregnant Patients (NSAIDS)

    • Nonsteroidal anti-inflammatory drugs (NSAIDs) are contraindicated in the third trimester due to potential complications like premature closure of the ductus arteriosus, prolonged labor, increased postpartum bleeding, and delayed parturition.
    • Aspirin should be avoided throughout pregnancy.
    • Azole topical therapies are preferred for 7 days during pregnancy.
    • Intranasal cromolyn is a first-line option for colds, allergies, and coughs during pregnancy.
    • Oxymetazoline is a preferred nasal decongestant during pregnancy (phenylephrine is for the first trimester, while pseudoephedrine can cause abdominal wall defects).
    • Diphenhydramine and Chlorpheniramine are preferred antihistamines (second-generation antihistamines can also be used).
    • Intranasal corticosteroids may cause cleft lip/palate and low birth weight.

    Medications for Lactating Patients

    • Infant doses should be 0.6-0.9%.
    • Acetaminophen doses should be 3.98%.
    • Aspirin should be avoided during lactation.
    • Pseudoephedrine may reduce milk production.
    • Antihistamines are contraindicated during lactation.
    • Dextromethorphan, guaifenesin, benzocaine, camphor (topical), and menthol carry a low risk and are suitable for use during breastfeeding.

    Gastrointestinal (GI) Treatment Medications (Antacids)

    • Antacids have an onset of 5 minutes.
    • Their mechanism of action involves buffering agents.
    • Adverse effects are not a major concern, unless related to renal issues.
    • Drug interactions involve chelation with divalent cations.
    • Histamine type 2 receptor antagonists (e.g., cimetidine, famotidine) have an onset of 30-45 minutes.
    • Their mechanism of action is blocking hydrochloric acid (HCl) production.
    • Adverse effects include antiadrenergic properties.

    Drug Interactions and CYP Enzymes

    • Cimetidine inhibits CYP450 enzymes (1A2 and 2C19).
    • Proton pump inhibitors (PPIs), like omeprazole, esomeprazole, and lansoprazole, have an onset of 60 minutes to days, blocking gastric secretion.
    • PPIs are associated with increased risks of Clostridium difficile (C. diff), bacterial peritonitis, and osteoporosis with long-term use.
    • Omeprazole inhibits CYP2C19.
    • Various vitamins (C, B3, B9, B12) are mentioned but not extensively discussed.
    • Understanding drug interactions and adverse effects, especially concerning anticholinergic drugs (dry mouth, blurred vision, urinary retention, constipation), is crucial. The first and second generation antihistamines are differentiated (e.g. diphenhydramine,loratadine).

    Drug Trials Phases

    • Phase 1 focuses on safety, involving 20-80 healthy volunteers (6-12 months).
    • Phase 2 evaluates safety and efficacy (dose response), involving 100-300 subjects (1-2 years).
    • Phase 3 determines safety and efficacy at specific doses, with involvement of a wide range of participants (hundreds to thousands).

    Bioavailability and Albumin

    • Bioavailability measures the percentage of a drug reaching systemic circulation.
    • Albumin is a measure of protein.
    • Important considerations for drug administration, and dosages need further elaboration.

    Pediatric Pearls/Medication Expiry

    • Reconstituted medications typically expire within 10-14 days and may require refrigeration.
    • Specific drug combinations such as Clindamycin require flavoring and may cause stool discoloration.
    • Treatment for acute uncomplicated otitis media (AOM): amoxicillin 90mg/kg/day orally, divided doses for 10 days, is noted for its effectiveness.

    Antibiotics and Bacteria

    • Various antibiotics and bacterial infections are listed across multiple pages, with information on routes of administration (e.g., intravenous (IV), oral (PO)).
    • The study material highlights the importance of knowing the types of bacteria and appropriate antibiotics based on laboratory data for proper treatment protocols.

    Antibiotic MOA and Adverse Reactions

    • Information on the mechanisms of action (MOAs) of different antibiotics for various bacterial infections is given. The antibiotic treatment options are categorized by the type of bacterial infection being treated (e.g., CA-MRSA)
    • Adverse reactions related to antibiotics require further exploration (reference to written notes).

    Max Doses and Resistance Mechanisms

    • Maximum dosages for acetaminophen, ibuprofen, and naproxen are specified.
    • Specific resistance mechanisms in bacteria are outlined, including antibiotic inactivation, alteration of target sites, bypassing metabolic inhibition, and preventing accumulation of the antibiotic.

    Significant Codes and Abbreviations

    • Codes like "EAR" and "EYE" are mentioned, but without context, their meaning remains unclear.

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    Description

    Test your knowledge on reconstituted medications, antibiotics, and their appropriate dosages. This quiz covers various aspects of pharmacology, including drug classifications, adverse effects, and clinical trial phases. Perfect for students and professionals in the healthcare field!

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