My HAAD Exam Review: Pharmacology Questions and Answers

A 28-year-old woman has been taking fluoxetine for depression and now has worsening depressive episodes. The resident doctor on the floor has been asked by consultant to stop fluoxetine and initiate phenelzine. How long should the washout period be before starting phenelzine? D. 5 weeks...

A 28-year-old woman has been taking fluoxetine for depression and now has worsening depressive episodes. The resident doctor on the floor has been asked by consultant to stop fluoxetine and initiate phenelzine. How long should the washout period be before starting phenelzine? D. 5 weeks A. 2 weeks B. 3 weeks C. 4 weeks What is the pharmacological category for insulin lispro? B. Rapid-acting insulin A. Long-acting insulin C. Short-acting insulin D. Intermediate-acting A 16 year-old girl with asthma recently had aroutine laboratory follow up (see lab results) Which medication is most likely to have contributed to her results? B. Inhaled short-acting B2 agonist A. Inhaled corticosteroid C. Leukotriene receptor antagonist D. Inhaled short-acting anti-muscarinic Ans: Inhalation of beta-agonists induces hypokalemia.  Which of the following NSAIDs has the gastrointestinal side effect? A. Naproxen B. Meloxicam C. Ibuprofen D. Diclofenac How many grams of 5% diclofenac cream should be mixed with 100 g of 1% cream to make a 2.5% diclofenac cream? B. 60 g C. 90 g A. 30 g D. 120 g Following is the prescription for a six-year-old boy: Rx How many micrograms of levothyroxine should be used to dispense this Levothyroxine 12 prescription? micrograms 28.8 mcg 12 mcg 24 mcg 34.8 mcg Syrup tolu 5 ml Not sure 100 % about the Ans: 30 tabs X 12 mcg =360 mcg ÷ 12.5 mcg (the recommended starting Syrup wild cherry dose for child) = 28.8 mcg qs ad 5 ml d. t. p #30 (NOAC) Non-Vitamin K antagonist Oral Anticoagulants: Dabigatran, Apixaban & Rivaroxaban The doctor wants to change anticoagulant for discharge patient from IV to NOAC which of the following patients have the best criteria to take? Patient taking multiple medicines including atorvastatin rosuvastatin clopidogrel aspirin (can't remember the choices very well but I chose one with fluoxetine & not sure) X - Clopidogrel, aspirin and cholecalciferol Dual-antiplatelets = Relative contraindication = Increased risk of bleeding No interaction No interaction - Clopidogrel, rosuvastatin and fluoxetine X- Atorvastatin, fluoxetine, and phenytoin serious interaction - https://www.cec.health.nsw.gov.au/__data/assets/pdf_file/0007/326419/noac_guidelines.pdf use alternative Table 7 Which NSAID permanently inactivates thromboxin-A2 synthesis in platelets? A. Aspirin B. Naproxen C. Celecoxib D. Ibuprofen  A 55-year-old man is prescribed simvastatin for hyperlipidemia. He is already taking verapamil for hypertension. What should be the maximum dose of simvastatin to be prescribed? A. 10mg B. 20mg C. 40mg D. 80mg Verapamil (inhibitor)+ Simvastatin Verapamil will increase the level or effect of simvastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternative Drug. Do not exceed simvastatin 10 mg daily when given concurrently. Potential for increased risk of myopathy/rhabdomyolysis. Which of the following medications can be used to lower the elevated serum potassium concentration? Treatment for HYPERkalemia. Kayexalate Sevelamer Dextrose Sodium bicarbonate What is the appropriate mode of taking chewable aspirin tablet? X A. Should be chewed D. Should crushed and dissolved in 30 ml of water. B. Should be swallowed C. Can be chewed or swallowed. How many milliliters of 0.9% normal saline can be prepared from 40 gram of NaC1? 4444 1000 2222 6666 A content uniformity test for tablets is endorsed by the United Stated Pharmacopeia to ensure which quality? Potency Bioavailability Stability Solubility What is the bioavailability (F) of a diclofenac intramuscular injection? Approximately 100% 75% 25% 50% Which one of the following medications can cause weight loss? B, D gain. C. no weight effect A. Orlistat B. Olanzapine C. Atorvastatin D. Glibenclamide A 54-year-old man with reduced ejection fraction heart failure presented to the pharmacy with mild pain in his knees and requesting an OTC pain killer. Which of the following is the best OTC medication? Paracetamol is the first line treatment for mild pain and safest in HFrEF Paracetamol Ibuprofen Celecoxib Naproxen Which of the following is a benefit of the formulary system? Increased safety Decreased cost Less patient confusionPhysician satisfaction It serves as a cost-saving measure. A 61-year-old woman with deep vein thrombosis is on heparin 1200 units/ hour. The nurse asks for heparin dosing recommendation after receiving the hematology test this morning Test Result Normal Values APTT 240 30-40 sec INR 1.1 0.8-1.2 Prothrombin time 12 10-13 sec What is the best recommendation based on hospital heparin protocol? Hold the infusion for 60 minutes, then resume with 900 units/ hour. Hold the infusion for 60 minutes, then resume with 1000 units/hour. Decrease the infusion rate to 1100 unit/ hour. Keep the same dose. Which of the following parenteral anticoagulants require routine monitoring of coagulation lab parameters? UFH intravenously aPPT, INR, PT, ACT IJFH subcutaneously Enoxaparin subcutaneously Fondaparinux subcutaneously  Which of the following P2Y12 receptor inhibitors exhibit the most variable anti-platelet effects? D. Clopidogrel A. Prasugrel least variable B. Ticagrelor C. Ticlopidine Stroke or previous TIA is a contraindication to the use of which anti-platelet agent? Prasugrel Ticagrelor Clopidogrel Aspirin Prasugrel is contraindicated in patients with prior stroke or transient ischemic attack (TIA) due to evidence of net harm in this group. Bleeding rates were especially high in elderly patients (≥75 years) and those with reduced body weight (