Pharmacy Capsules and Tablets Overview
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Questions and Answers

What condition suggests that a capsule has become too moist?

  • Brittleness
  • Stickiness (correct)
  • Fogging
  • Cracking

When converting dosage from milligrams to grains, how many milligrams are in one grain?

  • 60 mg
  • 75 mg
  • 65 mg (correct)
  • 70 mg

Which type of tablet is specifically designed to be split?

  • Effervescent tablet
  • Chewable tablet
  • Unscored tablet
  • Scored tablet (correct)

What is the formula to calculate percentage error?

<p>((Measured - Target) / Target) * 100 (A)</p> Signup and view all the answers

How would you estimate a sum of 2378 when rounded to the nearest thousand?

<p>2400 (B)</p> Signup and view all the answers

In reducing and enlarging formulas, what method is typically used?

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

What weight does 70 kg convert to in pounds?

<p>154 lbs (C)</p> Signup and view all the answers

What is indicated by fogging in a container of capsules?

<p>Capsules are too moist (B)</p> Signup and view all the answers

If a 250 mg dose tablet weighs 400 mg, how much of that weight is due to excipients?

<p>150 mg (A)</p> Signup and view all the answers

What is the primary function of the Teach-Back Method in patient counseling?

<p>To ensure patient understanding of instructions. (A)</p> Signup and view all the answers

In the context of blood pressure assessment, which phase of Korotkoff sounds is identified as the diastolic blood pressure?

<p>Phase 5 (C)</p> Signup and view all the answers

When calculating Creatinine Clearance using the Cockcroft-Gault equation, what adjustment is made for female patients?

<p>Multiply by 0.85. (C)</p> Signup and view all the answers

What does the 'A' in the SOAP documentation format stand for?

<p>Assessment of the diagnosis. (A)</p> Signup and view all the answers

Which of the following statements regarding body temperature classifications is correct?

<p>Hypothermia is defined as a temperature below 95°F. (A)</p> Signup and view all the answers

What is the general respiratory rate classification for bradypnea?

<p>Less than 12 breaths per minute. (C)</p> Signup and view all the answers

What is the primary purpose of using open-ended questions in patient counseling?

<p>To encourage comprehensive and detailed responses. (D)</p> Signup and view all the answers

Which classification best describes a Body Mass Index (BMI) that is less than 18.5?

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

What is the standard normal range for body temperature measured in Fahrenheit?

<p>97–99°F (D)</p> Signup and view all the answers

What term is used to describe the concentration of sodium in the blood?

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

Which of the following is primarily affected by gender-affirming treatments with respect to laboratory value reference ranges?

<p>Reference ranges for nonbinary individuals (D)</p> Signup and view all the answers

Which laboratory parameter does the term 'kalemia' refer to?

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

An individual with a serum potassium level of 5.6 mEq/L is diagnosed with which condition?

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

Which of the following statements about reference ranges is accurate?

<p>A disease may be present even with lab values in the reference range. (C)</p> Signup and view all the answers

What is the significance of observing deviations from normal values for diagnosing conditions?

<p>They are stronger diagnostic factors than reference ranges. (B)</p> Signup and view all the answers

What is the reference range for serum sodium in mEq/L?

<p>135 to 145 (C)</p> Signup and view all the answers

What is a primary requirement when evaluating laboratory test results?

<p>Assess the individual's clinical signs and symptoms. (D)</p> Signup and view all the answers

Which condition is indicated by serum sodium levels of 130 mEq/L?

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

Which of the following is a common symptom associated with hyperkalemia?

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

What term is used to denote low serum chloride levels?

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

In what condition might a patient experience muscle weakness and arrhythmias due to increased potassium levels?

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

What laboratory value indicates metabolic acidosis when low?

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

Which type of acid-base disturbance is indicated by high serum bicarbonate levels?

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

What condition commonly results from severe dehydration and may present with elevated serum chloride?

<p>Hyperchloremic metabolic acidosis (A)</p> Signup and view all the answers

Which measurement helps evaluate kidney function alongside serum creatinine levels?

<p>Blood urea nitrogen (BUN) (B)</p> Signup and view all the answers

What is the reference range for serum chloride levels?

<p>95 to 105 mEq/L (D)</p> Signup and view all the answers

What would be a likely cause of decreased BUN levels?

<p>No known pathological consequences (C)</p> Signup and view all the answers

Which condition is characterized by a decreased serum sodium concentration?

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

What is a possible cause of hyperkalemia?

<p>Increased potassium intake (B)</p> Signup and view all the answers

Which of the following is NOT a common symptom of hypokalemia?

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

What electrolyte abnormality is indicated by an increased serum sodium concentration?

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

Which of the following factors may cause hypokalemia?

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

What is the primary purpose of clinical laboratory monitoring in patient care?

<p>To screen and diagnose diseases, and monitor treatment (A)</p> Signup and view all the answers

Which of the following accurately describes the difference between serum and urine concentrations?

<p>Serum is extracted from blood using centrifuge, while urine is measured with minimal processing. (C)</p> Signup and view all the answers

What criteria are used to establish reference ranges for serum and urine chemistries?

<p>Values from healthy adults that create a bell-shaped curve (A)</p> Signup and view all the answers

When measuring serum concentrations, what type of fluid is primarily analyzed?

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

Which term refers to a decreased serum potassium concentration?

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

What condition is suggested by serum potassium levels at 5.6 mEq/L?

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

Which term is used to describe normal serum sodium concentration levels?

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

Which condition is indicated by a serum calcium level that is excessively high?

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

Which of the following indicates low serum potassium levels?

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

What condition is described by a serum chloride level that is elevated?

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

A condition characterized by low serum sodium levels is known as what?

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

What condition is indicated by an elevated serum level of magnesium?

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

Which term refers to a low concentration of serum calcium?

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

What is the condition characterized by excessive potassium levels in the serum?

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

Which term describes low serum sodium levels?

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

What is the condition characterized by elevated sodium levels in the serum typically called?

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

An individual with serum sodium levels slightly deviating from the normal range but showing no symptoms should be diagnosed with:

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

Which term describes a condition where serum bicarbonate levels are elevated?

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

What is the term for low serum chloride levels?

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

What is the condition characterized by a serum sodium level greater than 145 mEq/L?

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

What condition is typically indicated by decreased bicarbonate in the serum?

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

In evaluating potassium levels, what does the suffix '-emia' typically indicate?

<p>A condition affecting blood concentration (A)</p> Signup and view all the answers

If an individual presents with serum potassium at 3.0 mEq/L, what condition does this suggest?

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

Elevated serum potassium levels contribute to which cardiac condition?

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

What is the suggested diagnosis if an individual's serum sodium levels are 140 mEq/L?

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

What term describes an abnormally low serum concentration of potassium?

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

Which term specifically refers to an individual with normal serum potassium levels?

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

What is known as high serum chloride levels?

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

Which condition may be caused by excessive hydration via normal saline administration?

<p>Hyperchloremic metabolic acidosis (B)</p> Signup and view all the answers

What is the term for elevated blood urea nitrogen levels indicating possible kidney injury?

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

What is the condition characterized by high serum levels of bicarbonate that can lead to metabolic alkalosis?

<p>Excessive bicarbonate intake (A)</p> Signup and view all the answers

When assessing laboratory values, what is the term for decreased serum potassium levels?

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

Which term is used to describe elevated serum chloride levels?

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

What is indicated by low serum bicarbonate levels in laboratory results?

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

What term describes low serum chloride levels?

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

What term is used to refer to a condition characterized by sodium levels below the reference range?

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

What condition is typically marked by elevated serum triglycerides and can impact cardiovascular health?

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

Which condition may result from severe dehydration and is indicated by elevated serum chloride levels?

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

What term signifies a condition with an increased rate of metabolism alongside metabolic acidosis?

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

Match the following terms with their corresponding serum chemistry abbreviations.

<p>Sodium = Na Potassium = K Chloride = Cl Calcium = Ca Phosphorus = P Magnesium = Mg Blood Urea Nitrogen = BUN Creatinine = Cr Glucose = Glu Bicarbonate = HCO3</p> Signup and view all the answers

What is the term for a low serum sodium concentration?

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

What is the term for a high serum potassium concentration?

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

What is the term for a low serum magnesium concentration?

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

What is the term for a low serum chloride concentration?

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

What is the term for a low serum phosphate concentration?

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

What is the term for a low serum glucose concentration?

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

What is a term for a low serum albumin concentration?

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

What is the term for a low white blood cell count?

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

What is the term for a low platelet count?

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

What is the term for a high neutrophil percentage in a differential white blood cell count?

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

What is the term for a high number of bands in a differential white blood cell count?

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

What is the term for a low neutrophil count?

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

What is the term for a high lymphocyte percentage?

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

What is the term for a low monocyte percentage?

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

What is the term for a high eosinophil percentage?

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

What is the term for a low basophil percentage?

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

What are the three forms of Calcium found in the extracellular domain?

<p>Free (ionized) form | Bound to plasma proteins like Albumin | Bound to other extracellular compounds such as bicarbonate, phosphate and citrate</p> Signup and view all the answers

What are the two main types of white blood cells?

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

The normal reference range for Serum Sodium is between 115-125 mEq/L.

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

What does a 'left shift' in a CBC with differential refer to?

<p>Increased percentage of segmental neutrophils (segs) and Bands in the differential count</p> Signup and view all the answers

What is the ideal body weight calculation for a male who is 70 inches tall?

<p>50kg + 2.3(70 – 60)</p> Signup and view all the answers

Match the following conditions with their corresponding symptoms:

<p>Hyponatremia = Confusion, weakness, seizures, cerebral edema and death Hypernatremia = Thirst, restlessness, muscle spasms, seizures and death Hypokalemia = Arrhythmias, muscle cramps and weakness Hyperkalemia = Muscle weakness, arrhythmias, bradycardia, hypotension and cardiac arrest</p> Signup and view all the answers

What is the correct reference range for serum calcium?

<p>8.5 to 10.5 mg/dL (B)</p> Signup and view all the answers

What is the major cation of extracellular fluid (ECF)?

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

Which of the following is NOT a common cause of decreased serum potassium concentration (Hypokalemia)?

<p>Increased renal function (D)</p> Signup and view all the answers

Which of the following conditions is NOT associated with high serum calcium concentration (Hypercalcemia)?

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

Which of the following is the most accurate method for estimating GFR, but is typically not used for guiding drug therapy adjustment?

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

Which of the following is NOT a potential cause of increased serum creatinine levels?

<p>Increased muscle mass (A)</p> Signup and view all the answers

The reference range for serum creatinine in healthy adults is 0.5 to 1.3 mg/dL.

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

Which of the following statements about hypoglycemia is TRUE?

<p>Symptoms of hypoglycemia can include sweating, dizziness, and seizures. (B)</p> Signup and view all the answers

Which of the following blood cells are considered phagocytes?

<p>Both A and C (D)</p> Signup and view all the answers

An elevated WBC count can be caused by an infection, inflammation, or a malignancy.

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

Which of the following white blood cells is responsible for cell-mediated immunity?

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

Which of the following statements about a “left shift” in a differential WBC count is TRUE?

<p>It typically indicates a bacterial infection. (C)</p> Signup and view all the answers

What is a common laboratory test that measures the concentration of particles in the urine?

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

Which of the following is a measure of renal function?

<p>All of the above (D)</p> Signup and view all the answers

Which of the following statements about the Cockcroft-Gault equation for creatinine clearance is TRUE?

<p>It is only accurate for individuals with stable kidney function. (C)</p> Signup and view all the answers

The reference range for serum sodium in a healthy adult is 3.5 to 5.0 mEq/L.

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

When a patient's actual body weight is greater than or equal to 30% over their calculated IBW (ideal body weight), it is recommended to use AdjBW (adjusted body weight) in the Cockcroft-Gault equation.

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

The Schwartz equation is used to estimate creatinine clearance in older adults, while the Cockcroft-Gault equation is used for younger adults.

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

Which of the following laboratory tests is used to measure the difference between cations and anions in the serum?

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

The corrected calcium equation is mainly used when albumin levels are:

<p>Less than 4.0 g/dL (D)</p> Signup and view all the answers

What is indicated by an elevated Anion Gap greater than 12 mEq/L?

<p>Metabolic acidosis due to unmeasured anions (B)</p> Signup and view all the answers

Which of the following statements about the normal Anion Gap is true?

<p>It may suggest hyperchloremic metabolic acidosis. (C)</p> Signup and view all the answers

How is the Anion Gap calculated using the provided component values of Na⁺, Cl⁻, and HCO₃⁻?

<p>Na⁺ - (Cl⁻ + HCO₃⁻) (D)</p> Signup and view all the answers

In which scenario would a low Anion Gap be expected?

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

What role does bicarbonate (HCO₃⁻) play in the context of the Anion Gap?

<p>It serves as the primary buffer in the body. (C)</p> Signup and view all the answers

Flashcards

Creatinine Clearance (CrCl)

A measure of how well your kidneys are filtering waste from your blood.

Cockcroft-Gault Equation

A formula used to estimate creatinine clearance, especially for patients with kidney problems.

Open-Ended Questions

Questions that encourage patients to provide detailed, specific responses.

Closed-Ended Questions

Questions requiring a simple yes/no or short answer.

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Teach-Back Method

A technique where patients repeat instructions to confirm understanding.

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SOAP Format

A method for documenting patient information: Subjective, Objective, Assessment, Plan.

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Korotkoff Sounds

Sounds heard during blood pressure measurement, indicating systolic and diastolic pressure.

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BMI (Body Mass Index)

A measure of body fat based on height and weight.

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Fahrenheit to Celsius Conversion

To convert degrees Fahrenheit to Celsius, subtract 32 from the Fahrenheit temperature and then multiply by 5/9.

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Celsius to Fahrenheit Conversion

To convert degrees Celsius to Fahrenheit, multiply the Celsius temperature by 9/5 and then add 32.

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Capsule Sizes

Human-use capsules are numbered 000 (largest) to 5 (smallest). Smaller numbers indicate larger capsules.

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Advantages of Capsules

Capsules can mask unpleasant tastes and smells, combine multiple drugs in one dosage, and are easy to transport and store.

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Disadvantages of Capsules

Capsules can be difficult to swallow, cannot contain liquids if gelatin-based, and can be affected by moisture.

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Cracking or Brittleness in Capsules

Indicates the capsule has become dry and brittle, likely due to excessive moisture loss.

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Stickiness or Bloating in Capsules

Indicates the capsule has absorbed excessive moisture, causing the contents to become sticky and potentially swell.

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Scored Tablets

Tablets with a line or groove designed for breaking them in half.

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Unscored Tablets

Tablets without a line or groove. Splitting these tablets doesn't guarantee a consistent dose.

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Effervescent Tablets

Tablets containing sodium bicarbonate and acids (like citric acid). They dissolve in water with fizzing.

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Weight of Tablets

Tablets weigh more than the actual dose due to excipients, which are inactive ingredients like binders and fillers.

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Dimensional Analysis

Using conversions to change units. Useful for calculating drug doses and ratios.

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Kalemia

The concentration of potassium in the blood.

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Natremia

The concentration of sodium in the blood.

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Calcemia

The concentration of calcium in the blood.

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Pre-Analysis Errors

Laboratory errors that occur before the actual test analysis. This might include incorrect test ordering, incomplete specimen collection, or administrative mistakes.

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Analysis Errors

Laboratory errors occurring during the test analysis itself. These might include incorrect test procedures, faulty reagents, or misinterpretation of results.

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Post-Analysis Errors

Laboratory errors occurring after the test analysis. This might include delays in receiving results, lack of patient notification, or improper follow-up procedures.

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Patient Factors

Factors related to the patient that can influence lab results, such as food ingestion, interfering with the test's accuracy.

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Importance of Accurate Lab Values

Precise lab values are critical for correct diagnosis and treatment. Errors can delay proper therapy, lead to unnecessary treatments, or provide insufficient care.

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Sodium (Na+) in the Body

The major cation (positively charged ion) in the fluid surrounding cells (extracellular fluid). It plays a crucial role in regulating the total amount of water in the body.

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Hyponatremia

A condition where the sodium concentration in the blood is lower than normal. This can be caused by either a decrease in total body sodium or an increase in total body water, leading to dilution of sodium.

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Hypernatremia

A condition where the sodium concentration in the blood is higher than normal. This happens when the body loses more water than sodium, leading to a concentration of sodium.

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Potassium (K+) in the Body

The major cation (positively charged ion) found inside cells (intracellular fluid). It is essential for nerve and muscle function, including heart rhythm.

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Hypokalemia

A condition where the potassium concentration in the blood is lower than normal. This can happen due to excessive potassium loss (like diarrhea) or when potassium shifts into cells.

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Hypochloremia

Low chloride levels in the blood. Often caused by excessive chloride excretion but not usually a major medical concern.

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Hyperchloremia

High chloride levels in the blood, often associated with metabolic acidosis (renal disease, severe dehydration), or caused by normal saline (NaCl) administration.

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Metabolic Acidosis

A condition where the body produces too much acid or does not eliminate enough acid, leading to low bicarbonate levels.

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Metabolic Alkalosis

A condition where the body loses too much acid or gains too much bicarbonate, resulting in high bicarbonate levels.

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Blood Urea Nitrogen (BUN)

A measurement of urea nitrogen in the blood, which is a waste product of protein metabolism.

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Increased BUN

High BUN levels are associated with kidney problems, either intrinsic kidney injury or pre-renal injury, when combined with serum creatinine.

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Decreased BUN

Low BUN levels usually don't have significant medical implications.

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Serum Creatinine

A measure of creatinine in the blood, which is a waste product produced by muscle breakdown. It helps assess kidney function.

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Serum Concentration

The concentration of a substance in a patient's extracellular fluid (ECF), usually found in blood serum after centrifuge separation.

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Urine Concentration

The concentration of a substance in a patient's urine, usually measured 'as-is' without extensive extraction procedures.

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Reference Range

The range of laboratory values considered normal for a particular test in healthy individuals, typically covering the middle 95% of the population.

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Outlier

A patient whose test result falls outside the reference range but is still considered healthy.

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Pediatric Reference Ranges

Reference ranges for laboratory test results in children, often differing from adult ranges.

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Clinical Lab Monitoring

Using laboratory tests to monitor a patient's health status, detect diseases, diagnose, evaluate medication adherence, and detect adverse effects.

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What makes serum different from whole blood?

Serum is separated from whole blood via centrifuge, it's the clear liquid portion without the cells and clotting factors.

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Why are first or second voids preferred for urine samples?

They often provide a more concentrated sample, reflecting overall body function more accurately.

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How are reference ranges determined?

By analyzing results from a large group of healthy individuals, establishing a bell-shaped curve with the middle 95% representing the normal range.

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Why might a patient have a lab result outside the reference range?

They may be healthy but fall outside the 95% range, or they may have a medical condition impacting their lab values.

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Individual Normal Value

A patient's own normal range for a measurement, determined by previous test results, which may be different from general reference ranges.

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Deviation from Normal

A lab value outside the patient's own typical range (not just outside the general reference range). It's a more significant indicator than comparing to a standard.

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Hypo- or Hyper-

Prefixes used to indicate low (hypo-) or high (hyper-) levels of a compound in the body.

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Bakerman's ABCs

A common textbook used in pharmacy education to reference normal lab values. It's a helpful source for pharmacy students to compare lab results.

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mEq/L

Milliequivalents per liter. A unit of measurement commonly used for electrolytes (e.g., sodium, potassium) in blood and urine.

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Serum Sodium (Na)

The level of sodium in the blood, a key electrolyte for maintaining fluid balance and nerve function.

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Serum Potassium (K)

The level of potassium in the blood, a key electrolyte for muscle function and heart rhythm.

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Accurate Lab Values

Precise lab values are critical for correct diagnosis and treatment. Errors can delay proper therapy, lead to unnecessary treatments, or provide insufficient care.

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Sodium (Na+)

The major positively charged ion (cation) found outside cells, crucial for fluid balance in the body.

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Potassium (K+)

The major positively charged ion (cation) found inside cells, essential for nerve and muscle function, especially heart rhythm.

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What are some signs and symptoms of hyperkalemia?

Muscle weakness, arrhythmias (irregular heartbeat), bradycardia (slow heart rate), hypotension (low blood pressure), and cardiac arrest.

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Serum vs. Urine

Serum is the clear liquid portion of blood, separated from cells and clotting factors by centrifuge. Urine is collected directly from the patient, usually without extraction procedures.

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Pediatric Ranges

Reference ranges for lab tests in children can differ from adult ranges.

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Why First/Second Void?

First or second voids of the day are preferred for urine samples because they are generally more concentrated, providing a more accurate reflection of overall body function.

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Blood Chemistry

The concentrations of specific molecules or compounds in the blood, particularly in the serum.

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Trailing Zeros

Zeros after the decimal point in a number; should be avoided because they can be misinterpreted or lead to rounding errors.

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Leading Zeros

Zeros before the decimal point in a number; should ALWAYS be included to ensure proper place value and prevent errors.

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Units in Measurement

Units used to clarify the meaning of a measurement, such as mg (milligrams), mL (milliliters), or hr (hours). They prevent dosing errors and ensure accurate communication.

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Round Down Drops

Always round down to the nearest whole number when calculating medication drops, even if the number is very close to the next whole number.

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Rounding Flow Rate

For flow rates, utilize general rounding rules based on the significance of the decimal place.

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Fractional Tablets

Only use fractional tablets (splitting tablets) if the tablet is scored for breaking in half.

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Gowning Steps

The sequence of steps for putting on sterile compounding attire to maintain a sterile environment, typically starting with hand hygiene, gown, gloves, and mask.

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Cleaning Sterile Hood

Clean a sterile hood from back to front, and top to bottom, to prevent contaminating the workspace.

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Flow Rate Formula

The formula for calculating flow rate is Flow Rate (mL/hr) = Volume (mL) / Time (hrs).

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Concentration Formula

The formula for calculating concentration is Concentration (mg/mL) = Amount (mg) / Volume (mL).

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BID Dosing

BID stands for 'Bis in Die' (Latin for 'twice a day'). This indicates that a medication should be taken twice a day.

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QID Dosing

QID stands for 'Quater in Die' (Latin for 'four times a day'). This indicates that a medication should be taken four times a day.

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PO Administration

PO stands for 'per os' (Latin for 'by mouth'). This indicates that a medication is taken by mouth.

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PRN Administration

PRN stands for 'pro re nata' (Latin for 'as needed'). This indicates that a medication is given as needed.

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Schedule II Medications

Schedule II medications have a high potential for abuse and dependence, require a new prescription for refills and cannot be refilled without a new prescription from a healthcare provider.

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Schedule IV Medications

Schedule IV medications have a lower potential for abuse than Schedule II drugs, but misuse may still be dangerous. They allow up to 5 refills within 6 months.

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Sharps Container

A puncture-resistant container designated for the safe disposal of sharp objects like needles, syringes, and lancets.

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Accurate Measurements

Precise measurements are crucial in pharmacy practice to ensure patient safety, prevent overdoses, and guarantee the correct dosage of medications.

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Overdosing Consequences

Taking more medication than prescribed can result in toxicity, adverse drug reactions, or harmful side effects.

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Underdosing Consequences

Taking less medication than prescribed can lead to therapeutic failure, meaning the medication won't work properly, and may prolong illness.

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Compounding

The process of preparing customized medications for individual patients based on their specific needs and prescriptions. It involves mixing, measuring, and preparing drugs using specialized techniques.

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Manufacturing

The large-scale production of medications for general sale, usually involving automated processes and quality control measures to ensure consistent quality and safety.

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Regulations in Compounding

Compounding practices are regulated by specific guidelines and standards, including state boards of pharmacy and the United States Pharmacopeia (USP), to ensure patient safety and quality.

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Regulations in Manufacturing

Manufacturing processes are strictly regulated by the FDA, which ensures safety, labeling, and distribution of all medications to protect public health.

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Manufactured Drugs

Medications produced in large quantities, usually without a specific prescription, and intended for widespread distribution.

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Regulatory Oversight

The supervision of compounding and manufacturing practices by relevant authorities to ensure safety, quality, and effectiveness of medications.

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Compounding Regulations

Guidelines for sterile and non-sterile compounding are determined by USP for non-sterile compounding and USP for sterile compounding, along with state boards of pharmacy.

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Good Manufacturing Practices (GMP)

A set of standards, procedures, and guidelines that manufacturing facilities must adhere to for ensuring the safety, quality, and efficacy of medications.

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Four-Step Compounding Process

A process that involves four key steps: Measure, Mix, Mold, and Package, to prepare medications.

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Measure in Compounding

The first step in compounding, where active ingredients and excipients are accurately weighed and measured using tools like graduated cylinders, balances, and syringes.

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Mix in Compounding

The second step in compounding, where measured ingredients are combined thoroughly using techniques like trituration (grinding) and levigation (mixing with a liquid to make a paste).

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Mold in Compounding

The third step in compounding, where mixtures are poured or pressed into molds to create solid dosage forms like suppositories or lozenges.

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Package in Compounding

The final step in compounding, where the prepared medication is placed in an appropriate container and labeled with instructions, beyond-use dates, and patient information.

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Beyond-Use Dates (BUD)

The date after which a compounded product should not be used, to ensure safety, efficacy, and sterility.

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Risk Level of Compounding

A classification system for sterile preparations based on their risk of contamination. Low-risk, medium-risk, and high-risk preparations have different beyond-use dates, based on the compounding environment and complexity of the process.

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Storage Conditions

The ideal storage temperature for compounded products, which can vary based on the medication and stability. Room temperature, refrigerated, or frozen storage can affect BUDs.

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Drug Stability

How long a medication remains effective, potent, and safe to use. Stability is affected by factors such as light, temperature, pH, and the presence of other substances.

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Quality Assurance (QA) Program

A systematic program designed to ensure that compounded products meet high standards of quality, safety, and efficacy.

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Standard Operating Procedures (SOPs)

Written instructions that outline every step of the compounding process for consistency and to reduce errors.

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Personnel Training

Providing training for all pharmacy staff involved in compounding to minimize the potential risks of contamination, incorrect compounding, and errors.

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Environmental Monitoring

Regular checks and monitoring of the compounding environment for the presence of particulate matter, microbial contamination, and airflow quality to maintain a sterile environment.

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Equipment Calibration and Maintenance

Regular calibration and maintenance of all equipment used in compounding to ensure accurate measurements and prevent potential issues.

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Final Product Testing

Testing of compounded products for sterility, potency, and other quality parameters before dispensing to ensure they meet required standards.

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Documentation and Record Keeping

Maintaining thorough records of every compounded product, including the preparation process, to ensure traceability and accountability.

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Avoirdupois System

A weight system commonly used in the U.S. for measuring solid ingredients and non-liquids, where 1 pound equals 16 ounces.

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Concentration

The amount of a substance (solute) dissolved in a given volume of solution (e.g., mg/mL).

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Flow Rate

The volume of fluid (e.g., medication) delivered per unit of time, typically measured in milliliters per hour (mL/hr).

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Graduated Cylinder

A cylindrical container marked with graduations for accurately measuring liquid volumes.

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Minimum Weighable Quantity (MWQ)

The smallest amount of a substance that can be accurately weighed on a balance, given a specific error tolerance.

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Sensitivity

The smallest weight that can cause a perceptible movement in a balance, representing its ability to detect small changes in weight.

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SIG Codes

Standard abbreviations used in prescriptions to indicate directions for use (e.g., BID, PO, PRN).

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Sterile Compounding

The preparation of medications in a sterile environment, using aseptic techniques to prevent contamination.

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To Contain (TC)

A designation for volumetric glassware that indicates it holds a specific volume of liquid.

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To Deliver (TD)

A designation for volumetric glassware that indicates it delivers a specific volume when emptied.

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USP-NF

The United States Pharmacopeia-National Formulary, a compendium of drug standards for pharmaceuticals and dietary supplements used in the United States.

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Importance of Units

Units clarify measurements, preventing dosing errors by specifying what the measurement represents (e.g., mg, mL, hr).

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Rounding Drops

Always round down to the nearest whole number when calculating medication drops, even if the number is close to the next whole number.

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Schedule II Substances

Schedule II substances have a high potential for abuse and dependence, requiring a new prescription for refills and cannot be refilled without a new prescription from a healthcare provider.

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Schedule IV Substances

Schedule IV substances have a lower potential for abuse than Schedule II but misuse can still be dangerous, allowing up to 5 refills within 6 months.

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Sodium Reference Range

The normal range for sodium levels in the blood is 135-145 mEq/L.

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Potassium Reference Range

The normal range for potassium levels in the blood is 3.5-5.0 mEq/L.

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Chloride Reference Range

The normal range for chloride levels in the blood is 95-105 mEq/L.

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CO2/HCO3 Reference Range

The normal range for carbon dioxide (CO2) or bicarbonate (HCO3) levels in the blood is 24-30 mEq/L.

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Serum Creatinine Reference Range

The normal range for creatinine levels in the blood is 0.5-1.3 mg/dL.

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Glucose Reference Range (Fed)

The normal range for glucose levels in the blood after eating is 65-120 mg/dL.

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Glucose Reference Range (Fasted)

The normal range for glucose levels in the blood when fasting is 70-99 mg/dL.

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Calcium Reference Range

The normal range for calcium levels in the blood is 8.5-10.5 mg/dL.

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Phosphorous Reference Range

The normal range for phosphorous levels in the blood is 2.6-4.5 mg/dL.

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Magnesium Reference Range

The normal range for magnesium levels in the blood is 1.7-2.4 mg/dL.

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Albumin Reference Range

The normal range for albumin levels in the blood is 3.1-4.3 g/dL.

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RBC Reference Range (Male)

The normal range for red blood cell count in men is 4.3-5.9x10^6 cells/mm^3.

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RBC Reference Range (Females)

The normal range for red blood cell count in women is 3.5-5.5x10^6 cells/mm^3.

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Hematocrit Reference Range (Males)

The normal range for hematocrit in men is 42-52%.

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Hematocrit Reference Range (Females)

The normal range for hematocrit in women is 37-47%.

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Hemoglobin Reference Range (Males)

The normal range for hemoglobin in men is 14-18 g/dL.

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Hemoglobin Reference Range (Females)

The normal range for hemoglobin in women is 12-16 g/dL.

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Platelet Count Reference Range

The normal range for platelets in the blood is 150,000-400,000/mm3.

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WBC Reference Range

The normal range for white blood cell count is 4.5-11 x10^3 cells/mm^3.

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Neutrophils Reference Range

The normal range for neutrophils is 50-70% of WBCs.

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Bands Reference Range

The normal range for bands (immature neutrophils) is 0-5% of WBCs.

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Lymphocytes Reference Range

The normal range for lymphocytes is 20-40% of WBCs.

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Monocytes Reference Range

The normal range for monocytes is 1-6% of WBCs.

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Eosinophils Reference Range

The normal range for eosinophils is 1-5% of WBCs.

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Basophils Reference Range

The normal range for basophils is 0-1% of WBCs.

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Anion Gap (AG)

A calculation used to assess metabolic acidosis by evaluating the difference between unmeasured anions and cations in the blood.

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What is the purpose of calculating the Anion Gap?

The Anion Gap is used to identify and evaluate metabolic acidosis and assess acid-base imbalances in the body.

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What are the components of the Anion Gap calculation?

The Anion Gap is calculated using sodium (Na⁺), chloride (Cl⁻), and bicarbonate (HCO₃⁻) levels in the blood.

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Normal Anion Gap

A normal Anion Gap, typically between 8 and 12 mEq/L, indicates that the blood is balanced in terms of acids and bases.

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Elevated Anion Gap

An elevated Anion Gap (> 12 mEq/L) suggests the presence of metabolic acidosis caused by an increase in unmeasured anions like lactic acid or ketones.

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Study Notes

Exam Format

  • Exam includes 40-50 questions.
  • Question types are fill-in-the-blank and multiple-choice.
  • Exam covers cumulative material and new content.

Capsules

Capsule Sizes

  • Capsule sizes range from 000 (largest) to 5 (smallest).
  • Smaller numbers indicate larger capsules.
  • Largest capsule holds the most powder.

Advantages and Disadvantages

  • Advantages: Masks taste/smell, combines multiple drugs, easy transport/storage.
  • Disadvantages: May be hard to swallow, can't contain liquids (gelatin-based), moisture can cause issues.

Instability Signs

  • Dried out: Cracking/brittleness.
  • Too moist: Stickiness/bloating.
  • Instability: Fogging in containers.

Rule of Sixes (Capsule Filling)

  • Assumes powder density of 0.6 g/mL.
  • Capsule size calculation formula is provided.
  • 1 grain = 65 mg.

Tablets

Properties of Tablets

  • Scored tablets: Designed to be split.
  • Unscored tablets: Not intended for splitting (dose uniformity not guaranteed post-splitting).
  • Effervescent tablets: Contain sodium bicarbonate and acids (e.g., citric acid).

Instability Signs

  • Tablets Instability: Brittleness/cracking, swelling/sticking together.

Tablet Weight

  • Tablet weight > drug dose due to excipients (binders, fillers).

Calculations

Doses and Dimensional Analysis

  • Utilize conversions like 1 grain = 65 mg, 1 kg = 2.2 lb.
  • Example calculation provided.

Reducing & Enlarging Formulas

  • Use the proportion method for formula scaling.
  • Example calculation provided.

Estimation Problems

  • Round to the nearest thousand for estimations.
  • Example estimation problem included.

Percentage Error

  • Formula for percentage error is provided.
  • Example percentage error calculation is detailed.

BMI Calculations

  • BMI formula is provided.
  • Example calculation is demonstrated.

Creatinine Clearance (CrCl)

  • Cockcroft-Gault equation for CrCl is presented (separate male and female formulas).
  • Example calculation using the equation is shown.
  • Calculation for adjusted body weight (AdjBW) is included.

Patient Counseling

Open-ended vs Closed-ended Questions

  • Open-ended: Encourages detailed responses (e.g., "How do you feel?").
  • Closed-ended: Simple responses (e.g., "Did you take your medication?").

Teach-Back Method

  • Confirmation of patient understanding through repetition of instructions.

Documentation

  • Use SOAP format (Subjective, Objective, Assessment, Plan).

Blood Pressure Assessment

Korotkoff Sounds

  • Phase 1: Systolic BP.
  • Phase 5: Diastolic BP.

Classification

  • Blood pressure classifications are given.

Respiratory Rate (RR) Classification

  • Bradypnea: RR < 12

Temperature Classification

  • Normal: 97–99°F (36.1–37.2°C)
  • Fever: >100.4°F (>38°C)

Unit Conversions

  • Fahrenheit to Celsius and Celsius to Fahrenheit.
  • Weight conversions (kg to lbs).
  • Height conversions (conversions are not detailed).

Serum Osmolality

  • Equation: 2 x [Na+] + [Glucose]/18 + [BUN]/2.8
  • Reference range: 285-295 mOsm/kg H₂O
  • Used to assess tonicity (hypertonic/hypotonic solutions).

Corrected Calcium

  • Equation: [(4.0-albumin) * 0.8] + serum calcium
  • Used when albumin is < 4.0 g/dL

Corrected Sodium

  • Equation: Serum Sodium + [0.016 * (Glucose – 100)]
  • Used for hyperglycemia to rule out pseudohyponatremia
  • Accounts for displaced water/sodium due to high glucose levels

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Description

This quiz covers the essential aspects of pharmacy capsules and tablets, including their sizes, advantages, disadvantages, and stability signs. Test your knowledge on the properties of different tablet types and the Rule of Sixes for capsule filling. Perfect for pharmacy students and professionals alike.

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